Technical Exhibit I - DA-Form-1687 Template.pdf
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- Solicitation number
- W91ZLK-25-R-0002
About this file
This is DA Form 1687, a Department of the Army Notice of Delegation of Authority form template for receipt of supplies. The form is used to formally delegate or withdraw authority for designated representatives to request or receive supplies on behalf of an organization.
The form includes fields for authorized representatives' names, locations, and signature blocks, along with checkboxes to indicate whether authority is being delegated or withdrawn. Key sections include the organization receiving supplies, DODAAC/account number, unit identification code, and expiration date. The bottom portion contains an assumption of responsibility statement requiring grade, telephone number, and signature of the authorizing official. This is a blank template dated May 2009 that would be used as part of the facilities infrastructure and logistics support services contract at Aberdeen Proving Ground.
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Text version
NOTICE OF DELEGATION OF AUTHORITY - RECEIPT FOR SUPPLIES
GRADE
AUTHORIZED REPRESENTATIVE(S)
AUTHORIZATION BY RESPONSIBLE SUPPLY OFFICER OR ACCOUNTABLE OFFICER
SIGNATURE AND INITIALS
I ASSUME FULL RESPONSIBILITY
SIGNATURE
DA FORM 1687, MAY 2009 APD LC v1.00ES
DELEGATES TO THE UNDERSIGNED HEREBY WITHDRAWS FROM THE PERSON(S) LISTED ABOVE,
THE AUTHORITY TO:
LAST NAME-FIRST NAME-MIDDLE INITIAL
REQ REC
AUTHORITY
ORGANIZATION RECEIVING SUPPLIES
DATE
LOCATION
REMARKS
UNIT IDENTIFICATION CODE
LAST NAME-FIRST NAME-MIDDLE INITIAL
DODAAC/ACCOUNT NUMBER
EXPIRATION DATE
PREVIOUS EDITIONS ARE OBSOLETE
For use of this form, see DA PAM 710-2-1. The proponent agency is DCS, G-4.
TELEPHONE
NUMBER
NOTICE OF DELEGATION OF AUTHORITY - RECEIPT FOR SUPPLIES
GRADE
AUTHORIZED REPRESENTATIVE(S)
AUTHORIZATION BY RESPONSIBLE SUPPLY OFFICER OR ACCOUNTABLE OFFICER
SIGNATURE AND INITIALS
I ASSUME FULL RESPONSIBILITY
SIGNATURE
DA FORM 1687, MAY 2009
APD LC v1.00ES
DELEGATES TO
THE UNDERSIGNED HEREBY
WITHDRAWS FROM
THE PERSON(S) LISTED ABOVE,
THE AUTHORITY TO:
LAST NAME-FIRST NAME-MIDDLE INITIAL
REQ
REC
AUTHORITY
ORGANIZATION RECEIVING SUPPLIES
DATE
LOCATION
REMARKS
UNIT IDENTIFICATION CODE
LAST NAME-FIRST NAME-MIDDLE INITIAL
DODAAC/ACCOUNT NUMBER
EXPIRATION DATE
PREVIOUS EDITIONS ARE OBSOLETE
For use of this form, see DA PAM 710-2-1. The proponent agency is DCS, G-4.
TELEPHONE NUMBER
1.00
APD
NOTICE OF DELEGATION OF AUTHORITY - RECEIPT FOR SUPPLIES
DA Form 1687, MAY 2009
| DATE: |
| ORGANIZ: |
| LOCATION: |
| NAME_A: |
| REQ_A: |
| REC_A: |
| SIGNAT_A: |
| NAME_B: -- NOT USED-- |
| REQ_B: |
| REC_B: |
| SIGNAT_B: |
| NAME_C: |
| REQ_C: |
| REC_C: |
| SIGNAT_C: |
| NAME_D: |
| REQ_D: |
| REC_D: |
| SIGNAT_D: |
| AUTHRTY_TO: |
| REMARKS: |
| IDENT_NO: |
| DODAAC_NO: W91P1B |
| RESPON_NAM: |
| RESPON_GRD: |
| RESPON_TEL: |
| EXP_DATE: |
| DELEGATE: |
| WITHDRAW: |
| signature_BUTTON1: |
| signature_BUTTON2: |
| signature_BUTTON3: |
| signature_BUTTON4: |
| signature_BUTTON5: |
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