DRAFT CDRL B0001 Template - OTA Invoice Review Report.docx
DOCX document 44 KB Posted
- Solicitation number
- TSA25-04-03883
About this file
This document contains an invoice review report template for an Other Transaction Agreement between the Transportation Security Administration and an airport authority. The report provides details on reimbursable costs for a checked baggage screening equipment project, including budgets for construction and personnel costs. Invoices and progress updates are included from the prime contractor and subcontractors. A financial summary outlines eligible expenses, payments to date against the agreement ceiling, and a remaining balance.
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Text version
Volume I Proposal Title Goes Here
Transmittal Number: ## U.S. Department of Homeland Security Transportation Security Administration
Attention: OTA COR
| Subject: | XXX Airport |
| XXXX Aviation Authority | |
| Reimbursement Request #, Invoice # | |
| OTA HSTS04-##-X-XX#### |
References: (1) Contract Number:
(2) Task Order:
Dear Mr. / Mrs.
The Invoice Review Team has reviewed the subject invoice and makes the following recommendation:
| Amount Requested |
| $00.00 |
| Adjustment |
| $00.00 |
| TSA Eligible @ 100% |
| $00.00 |
| TSA Share @ 90% |
| $00.00 |
| TSA Share @ 100% |
| $00.00 |
| Total TSA Share |
| $00.00 |
| OTA Retainage @ 10% |
| ($00.00) |
| Net Recommended Amount |
| $00.00 |
| Paid to Date (including this invoice) |
| $00.00 |
| Remaining Available |
| $00.00 |
This invoice recommendation package contains all supporting documents and pertinent comments. Should you or your staff have any questions or require additional information, please contact the undersigned…
Sincerely, cc: Contracting Officer
Airport Code OTA HSTS04-##-H-CT#### Invoice # Month/Day/Year
Project: Short description of project
Budget: Summary of costs, costs share, contingency, NTE Amount
OTA funding is outlined as follows:
| Funding Breakout |
| TSA Share NTE |
| 1. CBIS Project Costs |
| $ |
| 2. Contingency |
| $ |
| 3. Airport Personnel Project Management |
| $ |
| TOTAL: |
| $ |
A percentage of all submitted costs identified by TSA as allowable, allocable and reasonable shall be retained by TSA until certain milestones of the Project are completed, and will be reimbursed to the CCAA upon successful completion of the following Milestones:
| OTA Retainage |
| Milestone |
| 10% |
| 3. Until CBIS project is successfully completed as evidenced by TSA Acceptance Letter. |
Note 1
Note 2:
Schedule: The term of this Agreement shall be from the date of execution of the Agreement XXXX until XXXX. (POP of the OTA)
Proof of payment: Description of proof of payment
VENDOR INVOICES: $00.00
XYZ Engineering: $00.00 XYZ Engineering provides Project Management and Construction Administration services for the new CBIS construction project at ABC Airport.
Two (2) invoices were submitted from XYZ Engineering totaling $00.00, of which 100% was allowable and allocable. Work was performed during the months of March and April YYYY The reviewer requested and received the subcontractor invoices to document the XYZ Engineering invoices. Reconciliation to subcontractor invoices was enabled when informed that the Personnel Management portion of the invoice is progress based and includes a 5% mark-up.
The amount eligible for TSA reimbursement is $00.00
ABC Construction Corp.: $XXX.XX ABC Construction Corporation serves as the Prime Construction Contractor for the new CBIS construction project at XXX Airport.
Two (2) invoices were submitted from ABC Construction totaling $XXX.XXX.ABC pay application 6-Revised contained a change order in the amount of $XX.XX prior to Sponsor retainage. After the Sponsor retainage of 10% is applied, the TSA eligible is reduced by $XX.XX. Work was performed during the months of March and April 2018.
The amount eligible for TSA reimbursement is $XXX.XX
ACME Personnel: $XXX.XX ACME Personnel provide Project Management services. The OTA specifies a Not to Exceed TSA share of $XX.XX for XXX airport personnel costs.
Two (2) invoices were submitted from XXX Airport Authority for personnel project management services totaling $XXX.XXX of which 100% was allowable and allocable. Work was performed during the months of March and April 2018. The TSA share of these costs is 100%.
The amount eligible for TSA reimbursement is $XXXX.XX.
PROGRESS REPORT:
Status as of May 10, 2018:
· Airport reports 10% of the work scheduled completed.
· XX% of total costs budgeted for the project have been spent to date.
· Airport reports project within budget.
Work Performed this Pay Period:
· Continued installation for the electrical power and data raceways for the Temporary Screening Facility (TSF).
· Completed installation of the HVAC system for the TSF.
· Installation started for the BHS to support the TSF.
· Final activities to complete the BHS right of way continued.
Upcoming Activities:
· Continue current activities toward the completion of the Temporary BHS installation.
CURRENT WORK ESTIMATE (CWE):
| PROJECT COSTS |
| TOTAL |
| CUMULATIVE |
| TSA |
| TSA SHARE |
| TSA % |
| BUDGETED |
| TO DATE * |
| BUDGETED |
| TO DATE * |
| Costs Incurred |
BHS COSTS
OTHER CONSTRUCTION COSTS
CONTRACTOR MARK UPS
CCTV IT
HARD COSTS
SOFT COSTS
TOTAL COSTS
* To Date totals in the CWE reflect the actual cost of work performed prior to Airport/Sponsor retainage.
SITE LEAD COMMENTS:
FINANCIAL SUMMARY:
Invoice 03R Reimbursement Request 4
| Eligible Paid |
| TSA Share |
| TSA Retainage |
| Net Payment |
| 100% |
| 90% |
| 10% |
CBIS Project Costs
Contingency
Airport Personnel Project Management*
Total Request:
Adjustments:
Net Recommended Payment:
Paid to Date (including this invoice):
OTA Obligated Remaining Balance:
| TRACKING OF OTA FUNDS |
| OTA NTE |
| TSA Share |
(to Date) Balance
CBIS Project Costs
Contingency
Airport Personnel Project Management*
TOTALS (including this invoice):
* Airport Personnel Project Management reimbursed at a TSA Share of 100% until NTE
| 2 | Section Name Goes Here |
| Use or disclosure of data contained on this sheet is subject to the restriction on the title page of this proposal. | Source Selection Information - See FAR 2.101 and 3.104 |
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