5153.9004 - Format for a Justification Review Document for Other Than Full and Open Competition.

Control No:

Justification Review Document for Other Than Full and Open Competition

Program/Equipment:
Authority: Amount:
Prepared by:
Typed Name: DSN: ____________________
Title: Date: ____________________
E-mail:__________________________
Contracting Officer:
Typed Name: DSN: ____________________
Date Reviewed: __________________
E-Mail:_________________________
Technical Representative:
Typed Name: DSN:______________________
Title: Date Reviewed: _____________

Requirements Representative:
Typed Name: DSN: ______________________
Title: Date Reviewed: _____________

Reviews: I have reviewed this justification and find it adequate to support other than full and open competition.

Program Manager (1)
Typed Name: DSN: ______________________
Signature: ____________________ Date: ____________________

Legal Counsel
Typed Name: DSN: ______________________
Signature: ____________________ Date: ____________________

Principal Assistant Responsible for Contracting
Typed Name: DSN: ______________________
Signature: __ Date: ____________________

(1) Add PEO signature block when item is PEO managed.

Special Competition Advocate

Typed Name: DSN:_____________________

Signature: Date:_____________________

Head of the Contracting Activity

Typed Name: DSN:_____________________

Signature: Date:_____________________