CONTRACT NO:

MOD, DELIVERY ORDER OR OTHER NUMBER:

DATE & TIME OF AWARD:

(5:00 P. M., WASH, DC Time)

ANNOUNCEMENT AMOUNT: $

ESTIMATED FACE VALUE:

CONTRACT WITH OPTIONS

BASE YEAR AWARD: $

TOTAL IF ALL OPTIONS EXERCISED: $

CUM TOTAL OF THIS CONTRACT: $

INCREMENTALLY FUNDED: YES □ NO □

THIS INCREMENT = $

TOTAL ALL INCREMENTS (ESTIMATE) =$

MULTI-YEAR: YES □ NO □

TYPE OF CONTRACT:

TYPE OF FUNDS (complete appropriation, FY, type of funds & amount):

CONTRACTOR:

ADDRESS:

ITEM (QTY) OR SERVICE PROCURED (One or two lines in complete sentences):

SOL OR RFP ISSUE DATE:

BIDS SOLICITED:

EST COMPLETED DATE:

BIDS RECEIVED:

FOREIGN MILITARY SALES: YES NO

IF YES, NAME OF COUNTRY

LARGE BUSINESS SMALL BUSINESS

PERFORMANCE LOCATION (S), CITY, STATE AND ZIP CODE WITH PERCENTAGES AND DOLLAR AMOUNT:

CONGRESSIONAL DISTRICT OR ZIP CODE:

REPORTING CONTRACT OFFICE:

REPORTED BY: PHONE NUMBER:

PRIMARY POC

SECONDARY POC

PHONE NUMBER:

FOR OFFICIAL USE ONLY