Type of Procurement Action:

Sealed Bidding

Full and Open Competition

Negotiated Under 10 U.S.C. 2304(b)( )

Negotiated Under 10 U.S.C. 2304(c)( )

_____ Negotiated Under 40 U.S.C. 541 Brooks Act

Negotiated Pursuant to Changes Clause

_____ Claim Settlement

Definitization of Letter Contract

Final Price (Incentive, Redeterminable, or EPA)

Type of Clearance:

Pre-Negotiation

Post Negotiation

Letter Contract

Solicitation/Contract Number:

Activity:

Contractor(s):

Name:

City/State:

Program:

Description of Supplies/Services:

Pricing Structure: Proposal Pre-Negotiation Post-Negotiation

Cost (Excluding COM)

Cost of Money

Total Cost

Fee/Profit ( %)

Base Fee ( %)

Award Fee ( %)

Total

Ceiling Price

Sharing Arrangement:

Clearance Total:

Performance Period:

Start Finish

Or Deliveries:

First Final

Prepared By:

Name:

Title:

Phone:

Date:

Contracting Officer:

Signature: ____________________________

Printed Name:

Phone:

Date

Legal Counsel (If applicable):

Signature: ____________________________

Printed Name:

Phone:

Date:

Reviewer (If applicable):

Signature: ____________________________

Printed Name/Title:

Phone:

Date:

Approval (If other than Contracting Officer):

Signature: ____________________________

Printed Name/Title:

Phone:

Date:

Unconditional Approval _____

Not Approved _____

Conditional Approval _____

Conditions (If applicable):