INDIVIDUAL CONTRACTING ACTION REPORT

Report Control Symbol DD-AT&L(M)1014

A1  Type of Report ______(0) Original; (1) Canceling; or (2) Correcting

A2  Report Number

A3  Contracting Office

A3A  Reporting Agency FIPS 95 Code

A3B  Contracting Office Code

A4  Name of Contracting Office

B1  Contract Identification Information

B1A  Contract Number

B1B  Origin of Contract (A) DoD; (B) NASA; or (C) Other Non-DoD Agency

B1C  Bundled Contract____ (Y) Yes; or (N) No

B1D  Bundled Contract Exception . (A) Mission Critical; (B) OMB Circular A-76; or (C) Other

B1E  Performance-Based Service Contract (Y) Yes; or (N) No

B2  Modification, Order, or Other ID Number

B3  Action Date (yyyymmdd)

B4  Completion Date (yyyymmdd)

B5  Contractor Identification Information

B5A  Contractor Identification Number (DUNS)

B5B  Government Agency  _ (Y) Yes; or (N) No

B5C  Reserved

B5D  Contractor Name and Division Name
Contractor _
Division

B5E  Contractor Address
Street or PO Box  __
City or Town
State or Country                  Zip Code _

B5F  Taxpayer Identification Number          _

B5G  Parent Taxpayer Identification Number                    ___

B5H  Parent Name

B6  Principal Place of Performance

B6A  City or Place Code

B6B  State or Country Code  _

B6C  City or Place and State or Country Name

B7  Type Obligation  (1) Obligation; (2) Deobligation; or (3) No Dollars Obligated or Deobligated

B8  Obligated or Deobligated Dollars (Enter Whole Dollars Only)

B9  Foreign Military Sale ______  (Y) Yes; or (N) No

B10  Multiyear Contract  (Y) Yes; or (N) No

B11  Total Estimated Contract Value (Enter Whole Dollars Only)  

B12  Principal Product or Service

B12A  Federal Supply Class or Service Code

B12B  DoD Claimant Program Code

B12C  Program, System, or Equipment Code

B12D  NAICS Code

B12E  Name or Description

B12F  EPA-Designated Product(s)_______(A) EPA-Designated Produce(s) with Minimum Recovered Material Content; (B) FAR 23.405(c)(1) Justification; (C) FAR 23.405(c)(2) Justification; (D) FAR 23.405(c)(3) Justification; or (E) No EPA-Designated Produce(s) Acquired

B12G Recovered Material Clauses____(A) FAR 52.223-4; or (B) FAR 52.223-4 and FAR 52.223-9

B13  Kind of Action

B13A  Contract or Order ___(1) Letter Contract; (3) Definitive Contract; (4) Order under an Agreement; (5) Order under Indefinite-Delivery Contract; (6) Order under Federal Schedule; (7) BPA Order under Federal Schedule; (8) Order from Procurement List; or (9) Award under FAR Part 13

B13B  Type of Indefinite-Delivery Contract ___(A) Requirements Contract (FAR 52.216-21); (B)  Indefinite-Quantity Contract (FAR 52.216-22); or (C) Definite-Quantity Contract (FAR 52.216-20)

B13C  Multiple or Single Award Indefinite-Delivery Contract ___(M) Multiple Award; or (S) Single Award

B13D  Modification ___(A) Additional Work (new agreement); (B) Additional Work (other); (C)  Funding Action; (D) Change Order, (E) Termination for Default; (F) Termination for Convenience; (G) Cancellation; (H) Exercise of an Option; or (J) Definitization

B13E  Multiple Award Contract Fair Opportunity ___(A) Fair Opportunity Process; (B) Urgency; (C)  One/Unique Source; (D) Follow-On Contract; or (E) Minimum Guarantee

B13F  Indefinite-Delivery Contract Use ___(A) Government-Wide; (B) DoD-Wide; (C) DoD Department or Agency Only; or (D) Contracting Office Only

B13G  Indefinite-Delivery Contract Ordering Period Ending Date (yyyymmdd) _________________

B14  CICA Applicability ___(A) Pre-CICA; (B) CICA Applicable; (C) Simplified Acquisition Procedures Other than FAR Subpart 13.5; or (D) Simplified Acquisition Procedures Pursuant to FAR Subpart 13.5

B15  Information Technology Products or Services ___(A) Commercially Available Off-the-Shelf Item; (B) Other Commercial Item of Supply; (C) Nondevelopmental Item Other man Commercial Item; (D) Other Noncommercial Item of Supply; (E) Commercial Service; or (F) Noncommercial Service.

B16  Clinger-Cohen Act Planning Compliance    _ (Y) Yes; or (N) No