AFARS – PART 5153   Forms

(Revised  8 December 2020)

Subpart 5153.2 –  Prescription of Forms

5153.201 Federal  acquisition system.

5153.201-90 Sample  contracting officer’s representative designation letter.

In  accordance with 5101.602-2-91, the Army will use the Virtual  Contracting Enterprise Contracting Officer’s Representative (COR)  module to nominate, appoint, track, and revoke COR appointments.  When the Virtual Contracting Enterprise COR module is unavailable,  contracting officers shall use the sample COR designation letter  format in 5153.303-1 to designate a COR. Designate CORs using  official letterhead and follow standard procedures for  correspondence. Address the designation to the individual by name,  including rank or grade, and full mailing address.

5153.201-91 Sample  ordering officer appointment letter.

Use  the sample ordering officer appointment letter format in 5153.303-2  to appoint an ordering officer in accordance with 5101.602-2-92. Use  official letterhead and follow standard procedures for  correspondence. Address the appointment to the individual by name,  including rank or grade, and full mailing address.

5153.206 Competition  requirements.

5153.206-90 Format  for justification review document.

Use  the justification review document format at 5153.303-4 to document  the requesting activity’s internal review of a proposed  justification when using other than full and open competition.  Contracting officers will tailor the justification review document  format to accommodate the justification’s approval threshold. For  example, justifications approved by a contracting officer may not  require command advocate for competition, senior contracting official  or head of the contracting activity review. The completed format  becomes the cover page(s) of the justification. Do not use  letterhead for this document.

5153.206-91 Format  for justification and approval for other than full and open  competition.

Use  the justification and approval format at 5153.303-5 to support  justifications for other than full and open competition in accordance  with the Competition in Contracting Act as implemented in the FAR.  Contracting officers shall tailor the justification and approval  format to accommodate other type justifications in accordance with  the FAR approval thresholds and required content. Do not use  letterhead for this document. The approval page is separate from the  certifications.

5153.213 Simplified  acquisition procedures.

5153.213-70  Completion of DD Form 1155, order for supplies or services.

(a) Instructions for DD Form 1155 entries. (See DFARS PGI  253.213-70.)

Block  19, Schedule of Supplies or Services, for task orders under job order  contracts, see 5117.9004-3(g)(1).

5153.233 Protests,  disputes, and appeals.

5153.233-90 Format  for bid protest action report.

Use  the format for a bid protest action report at 5153.303-6 to provide  notification of a Government Accountability Office protest  resolution. Contracting officers will email the report to the  addressees provided at 5133.190-1 within 15 calendar days of its  resolution.

5153.233-91 Format  for quarterly bid protest analysis report.

Use  the sample format for the quarterly bid protest analysis report at  5153.303-7 to submit quarterly bid protest reports in accordance with  5133.190-2. The quarterly bid protest analysis report for Government  Accountability Office protests is emailed with copies of the bid  protest action reports to the addressee in 5101.290(b)(5), not later  than 30 calendar days following the end of the quarter.

5153.242 Contract  administration and audit services.

5153.242-90  Contractor Performance Assessment Reporting System initial  registration consolidated format.

Use  the sample Contractor Performance Assessment Reporting System (CPARS)  initial registration consolidated format at 5153.303-9 to  submit contract registration information to the CPARS contracting  activity focal point upon award of a contract eligible for a past  performance assessment report. Retain the completed document in the  official contract file.

5153.242-91 CPARS  access request format.

Use  the sample CPARS access request format at 5153.303-10 to submit  contract access information to the CPARS contracting activity focal  point upon award of a contract eligible for a past performance  assessment report. Retain the completed document in the official  contract file.

5153.245 Government  property.

5153.245-90 Sample  withdrawal of approval of property control system letter.

Use  the sample withdrawal of approval of property control system letter  at 5153.303-8 in accordance with FAR subpart 45.5 and DFARS subpart  245.5 to notify a contractor that approval of his property control  system is withdrawn. Use official letterhead and follow standard  procedures for correspondence.

5153.245-91  Consumption reports for ammunition.

When  the contract, including a delivery or task order, will involve the  furnishing of munitions as Government Furnished Material (GFM),  contracting officers shall include a contract line item and Section J  attachment for the Contract Data Requirements List (CDRL), DD Form  1423-2 (Rev. Aug 96) to collect periodic consumption data for the GFM  from the contractor as authorized by Federal Acquisition Regulation  clause 52.245-1, Government Property. The CDRL shall identify the  format, frequency, and addressee(s), to include the Defense Contract  Management Agency when applicable, for submission of the periodic  consumption reports as identified by the requiring activity.

Subpart 5153.3 –  Illustration of Forms

5153.303 Agency  forms.

This  subpart sets forth standard Army formats for specified actions.  Contracting officers may tailor these formats where appropriate, and  when they are not otherwise limited, to fit the specific acquisition  or contracting action.

5153.303-1 Sample  contracting officer’s representative (COR) designation.

Subject:  Designation of Contracting Officer’s Representative (COR) for  Contract (Enter number.).

1.  Pursuant to DFARS 201.602-2, you are designated as the contracting  officer’s representative (COR) in administration of the following  contract:

Contract  Number:

For:  (Enter item/system/services.)

Contractor:

Contract  Period:

2.  You are authorized by this designation to take action with respect  to the following:

a.  Verify that the contractor performs the technical requirements of  the contract in accordance with the contract terms, conditions and  specifications. Specific emphasis should be placed on the quality  provisions, for both adherences to the contract provisions and to the  contractor’s own quality control program.

b.  Perform, or cause to be performed, inspections necessary in  connection with paragraph 2.a. and verify that the contractor has  corrected all deficiencies. Perform acceptance for the Government of  services performed under this contract.

c.  Maintain liaison and direct communications with the contractor.  Written communications with the contractor and other documents  pertaining to the contract shall be signed as “Contracting  Officer’s Representative” and a copy shall be furnished to the  contracting officer.

d.  Monitor the contractor’s performance, notify the contractor of  deficiencies observed during surveillance and direct appropriate  action to effect correction. Record and report to the contracting  officer incidents of faulty or nonconforming work, delays or  problems. In addition, you are required to submit a monthly report  concerning performance of services rendered under this contract.

e.  Coordinate site entry for contractor personnel, and insure that any  Government-furnished property is available when required.

3.  You are not empowered to award, agree to or sign any contract  (including delivery orders) or contract modification or in any way to  obligate the payment of money by the Government. You may not take  any action which may affect contract or delivery order schedules,  funds or scope. All contractual agreements, commitments, or  modifications which involve price, quantity, quality, delivery  schedules, or other terms and conditions of the contract must be made  by the contacting officer. You may be personally liable for  unauthorized acts. You may not re-delegate your COR authority.

4.  This designation as a COR will remain in effect through the life of  the contract, unless sooner revoked in writing by the contracting  officer or unless you are separated from Government service. If you  are to be reassigned or to be separated from Government service, you  must notify the contracting officer sufficiently in advance of  reassignment or separation to permit timely selection and designation  of a successor COR. If your designation is revoked for any reason  before completion of this contract, turn your records over to the  successor COR or obtain disposition instructions from the contracting  officer.

5.  You are required to maintain adequate records to sufficiently  describe the performance of your duties as a COR during the life of  this contract and to dispose of such records as directed by the  contracting officer. As a minimum, the COR file must contain the  following:

a.  A copy of your letter of appointment from the contracting officer, a  copy of any changes to that letter, and a copy of any termination  letter.

b.  A copy of the contract or the appropriate part of the contract and  all contract modifications.

c.  A copy of the applicable quality assurance (QA) surveillance plan.

d.  All correspondence initiated by authorized representatives  concerning performance of the contract.

e.  The names and position titles of individuals who serve on the  contract administration team. The contracting officer must approve  all those who serve on this team.

f.  A record of inspections performed and the results.

g.  Memoranda for record or minutes of any pre-performance conferences.

h.  Memoranda for record of minutes of any meetings and discussions with  the contractor or others pertaining to the contract or contract  performance.

i.  Applicable laboratory test reports.

j.  Records relating to the contractor’s quality control system and  plan and the results of the quality control effort.

k.  A copy of the surveillance schedule.

l.  Documentation pertaining to your acceptance of performance of  services, including reports and other data.

6.  At the time of contract completion, you will forward all records to  the contracting officer for retention in the contract files.

7.  All personnel engaged in contracting and related activities shall  conduct business dealings with industry in a manner above reproach in  every aspect and shall protect the U.S. Government’s interest, as  well as maintain its reputation for fair and equal dealings with all  contractors. DoD 5500.7-R sets forth standards of conduct for all  personnel directly and indirectly involved in contracting.

8.  A COR who may have direct or indirect financial interests which  would place the COR in a position where there is a conflict between  the COR’s private interests and the public interests of the United  States shall advise the supervisor and the contracting officer of the  conflict so that appropriate actions may be taken. CORs shall avoid  the appearance of a conflict of interests to maintain public  confidence in the U.S. Government’s conduct of business with the  private sector.

9.  You are required to summarize the contractor’s contractual  performance at least annually using the Contractor Performance  Assessment Reporting System (CPARS) at http://www.cpars.gov. The  narrative you write must support the rating given based on the rating  definitions in the CPARS Guide on the website.

10.  You are required to acknowledge receipt of this designation on the  duplicate copy and return it to the contracting officer. Your  signature also serves as certification that you have read and  understand the contents of DoD 5500.7-R. The original copy of this  designation should be retained for your file.

Signature  Block Of

Contracting  Officer

Receipt  of this designation is acknowledged.

Name:  ___________________(Print or type) Signature: ____________________ 

Title: ____________________ Date: ________________________ 

Rank/Grade: ___________________ Telephone: ___________________

5153.303-2 Sample  ordering officer appointment.

Subject:  Appointment of Ordering Officer

1. Appointment.  Under AFARS 5101.602-2-92, you are appointed an Ordering Officer for  the purposes set forth in paragraph 2. Your appointment becomes  effective (enter date) and will remain effective, unless sooner  revoked, until expiration of the contract(s) enumerated in paragraph  2 or until you are reassigned or your employment is terminated. You  are responsible to and under the technical supervision of the chief  of the (enter name of installation or activity) contracting office  for your actions as an Ordering Officer.

2. Authority,  Limitations and Requirements. Your  appointment is subject to the use of the following method(s) of  purchase, limitations and requirements:

a.  Subject to your ensuring that local purchase authority exists for  the transaction, you may make purchases using imprest funds for  payments and using Standard Form 1165, Receipt for Cash -  Subvouchers, provided all of the following conditions are satisfied:

(1)  The aggregate amount of a purchase transaction is not in excess of  $500 under emergency conditions. You may not split purchases to  avoid this monetary limitation.

(2)  The supplies or nonpersonal services are available for delivery  within 60 calendar days, whether at the supplier’s place of  business or at destination.

(3)  The purchase does not require detailed, technical specifications or  technical inspection.

b.  Subject to your ensuring that funds are available and that local  purchase authority exists for the transaction, you may make purchases  using Standard Form 44, Purchase Order -- Invoice -- Voucher,  provided all of the following conditions are satisfied:

(1)  The aggregate amount of the purchase transaction is not in excess of  $3,000. You may not split purchases to avoid this monetary  limitation.

(2)  Supplies or nonpersonal services are immediately available.

(3)  One delivery and one payment shall be made.

c.  Subject to your ensuring that funds are available and that local  purchase authority exists for the transaction, you may place delivery  orders (DD Form 1155) without monetary limitation, except that  specified in individual contracts, against --

(1)  Brand Name contracts published in Defense Personnel Support Center  Supply Bulletins in the SB 10-500 or SB 10-600 series;

(2)  Defense Personnel Support Center requirements contracts for  subsistence items;

(3)  Defense Fuel Supply Center and Defense General Supply Center  requirements contracts; and

(4)  The following indefinite delivery contracts, copies of which are  attached: (List contracts by number and name of contractor.)

d.  Subject to your ensuring that funds are available and that local  purchase authority exists for the transaction, you may place Service  Orders for Household Goods, DD Form 1164, against Commercial  Warehousing and Related Services for Household Goods contracts for  military and civilian personnel, subject to the criteria and  procedures prescribed in DoD 4500.34-R, Chapter 2, and provided that  no Service Order shall be in excess of $10,000.

e.  You are responsible for --

(1)  Distributing and administering delivery orders that you place;

(2)  Establishing controls necessary to ensure that all contract terms  and conditions are met and that supplies or nonpersonal services  ordered conform to contract requirements before acceptance is made or  payment authorized, and

(3)  Reporting deficiencies in contractor performance promptly to the  contracting officer who awarded the contract against which the  delivery order was placed. You may not make any changes in the terms  or conditions of any contracts against which you place delivery  orders.

f.  The authority granted in this appointment may not be redelegated to  any other person.

3. Standards  of Conduct and Contracting Action Reporting Requirements.

a.  You shall comply with the standards of conduct prescribed in DoD  5500.7-R.

b.  You shall furnish the undersigned and the contracting officer to  whom you are responsible such information as may be required for  contracting action reporting purposes in the manner and the time  specified.

4. Termination  of Appointment.

a.  Your appointment may be revoked at any time by the undersigned  authority or successor and shall be terminated in writing, except  that no written termination of your appointment shall be made upon  expiration or termination of contracts enumerated in paragraph 2.

b.  Should you be reassigned from your present position or separated  from Government service while this appointment is in effect, you  shall promptly notify the appointing authority in writing. Your  appointment will be terminated in writing if you are reassigned; it  shall automatically be terminated on the date you are separated from  Government service, if it is not revoked sooner.

5. Acknowledgement  of Receipt.  You are required to acknowledge receipt of this appointment on the  duplicate copy and return it to the contracting officer. Your  signature also serves as certification that you have read and  understand the contents of DoD 5500.7-R. The original copy of this  designation should be retained for your file.

  Signature  Block Of

Appointing  Authority

Receipt  of this appointment is acknowledged.

Name:  ___________________(Print or type) Signature: ____________________ 

Title: ___________________ Date: ________________________ 

Rank/Grade: ___________________ Telephone: ___________________

5153.303-3 Reserved.

5153.303-4 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: ______________________

Command  Advocate for Competition

Typed  Name: DSN: ______________________

Signature:  ______________________ Date: ______________________

Senior  Contracting Official

Typed  Name: DSN: ______________________

Signature:  ______________________ Date: ______________________

(1)  Add Program Executive Officer signature block when item is Program  Executive Officer managed. 

Head  of the Contracting Activity

Typed  Name: DSN: ______________________

Signature:  ______________________ Date: ______________________

5153.303-5 Format for  a justification and approval for other than full and open  competition.

This  format is mandatory for all justifications and approvals (J&As)  in support of other than full and open competition. Contracting  officer will tailor the J&A’s format to accommodate other type  justifications in accordance with the FAR approval thresholds and  required content.

Control  No:

Justification  and Approval for Other Than Full and

Open  Competition

1. Contracting  Activity:  Specify the contracting activity responsible for this action.

2. Description  of Action:  State whether the approval is for a new contract or a modification.  Include the type of contract, type of funds to be used (Military  Construction; Research, Development, Test and Evaluation; Other  Procurement, Army; or Operation and Maintenance, Army) and, when  applicable, the estimated share and ceiling arrangements, and fee or  profit.

3. Description  of Supplies/Services:  Name and describe the required supplies/services. Include the  estimated total value, including options, if any.

4. Authority  Cited:  Identify the statutory authority permitting other than full and open  competition followed by the specific FAR citation and its title. For  example: 10 United States Code 2304(c)(1) as implemented in Federal  Acquisition Regulation 6.302-1(a)(2)(iii)(B), Only one responsible  source and no other supplies or services will satisfy agency  requirements.

5. Reason  for Authority Cited:  Describe how this action requires the use of the authority cited.  If applicable, identify the proposed or potential contractor(s) and  include a discussion of the proposed contractor’s unique  qualifications for fulfilling the contract requirements.

(a)  The rationale used for justifying the cited authority should be  consistent throughout the document as appropriate.

(b)  Justifications citing FAR 6.302-1(a)(2)(ii) or (iii) as the  authority for less than full and open competition on a follow-on  contract must reflect (1) substantial duplication of cost that is not  expected to be recovered through competition and/or (2) unacceptable  delays in filling agency requirements. If the authority cited is  substantial duplication of costs, then paragraph 5 should compare the  duplicate costs the government would incur to create competition and  the estimated savings expected to be recovered through subsequent  competition. In addition, the justification must include an  explanation for how the requesting office derived their estimates and  why they believe they are a substantial duplication. Justifications  citing unacceptable delays must identify firm schedule limitations  that do not result from a lack of planning. For example, firm  schedule limitations could include an approved Army campaign plan or  significant loss of life or property.

(c)  Justifications citing FAR 6.302-2 must explain how failure to limit  sources would seriously injure the Government, and include a  discussion of the required delivery schedule and lead-time involved.  If the delay associated with the requirement for first article  testing is the principal reason for not awarding the contract on a  full and open basis, clearly describe the reasons why first article  testing is required and why other quality assurance techniques are  inadequate. Contracting officers may submit J&As citing this  authority for approval after the contract has been awarded (see FAR  6.302-2(c)(1)).

(d)  Justifications citing FAR 6.302-2 or 6 must request offers from as  many potential sources as practicable under the circumstances.

(e)  If applicable, explain why technical data packages, specifications,  engineering descriptions, statements of work or purchase descriptions  suitable for full and open competition were not developed or are not  available.

6. Efforts  to Obtain Competition:  Describe the efforts to solicit offers from as many potential  sources as is practicable.

a. Effective  competition.  Describe the extent of effective competition anticipated for this  acquisition. Also, state that the notices required by FAR 5.201  shall be or have been published, and that any bids or proposals  received shall be considered. If a notice is not posted, state which  exception in FAR 5.202 applies.

b. Subcontracting  competition.  In single source situations, address efforts by the Government to  assure that the prime contractor obtains as much competition as  possible in its subcontracting.

7. Actions  to Increase Competition:  There may be instances when it is not possible to compete the  current acquisition. In these cases, include a statement of the  actions taken, or to be taken, to increase competition (e.g., procure  needed technical data for full and open competition or breakout  subsystems or components for full and open competition) before any  subsequent acquisition of the supplies or services. If future  competition will be based on the procurement of technical data,  provide the approximate date the technical data package will be  available.

8. Market  Research:  Describe the extent and the results of the market research (FAR Part  10) conducted to identify all qualified sources. Research must have  been meaningful (demonstrated attempt to discover all relevant  material) and conducted within the previous 12 months.

9. Interested  Sources:  Include a listing of the sources that have written to express  interest in the acquisition. If applicable, clearly state “To  date, no other sources have written to express an interest.” If 10  U.S.C. 2304(c)(1)/FAR 6.302-1 is the authority cited, explain why  other sources were rejected.

10. Other  Facts:  Discuss any other facts supporting the use of other than full and  open competition, such as the following:

a. Procurement  history. Reasonable  efforts to retrieve the following items from computer records,  contract files, competition advocate office files or other sources  are expected:

(1)  Contract numbers and dates of the last several contracts for these  same requirements.

(2)  The competitive status of these actions.

(3)  Authority previously cited if less than full and open competition  was used.

(4)  If a justification was prepared to support the procurement made  before this one, a summary of the contents of paragraph 7 of the  justification for that procurement and an explanation of the results.

(5)  If any prior contract for this requirement was accomplished using  full and open competition, include a detailed explanation of the  changed circumstances causing this action to now limit the sources.

(6)  An explanation of any unusual patterns that may be revealed by the  history, e.g., several consecutive, urgent buys.

(7)  If a justification was prepared to support the procurement made  before this one, briefly describe the circumstances justifying the  procurement and whether there have been any significant changes.

b. Other  facts.  Provide any other facts necessary to justify limiting competition  that were not previously stated.

(Certifications  will normally be provided on a separate page at the end of the J&A  to allow minor, administrative changes to be made during the review  process.)

11. Technical  Certification:  Include the following statement:

I  certify that the supporting data under my cognizance, which are  included in the justification are accurate and complete to the best  of my knowledge and belief.

Typed  Name: Date: __________________________

Title:  Signature: ______________________

12. Requirements  Certification:  Include the following statement:

I  certify that the supporting data under my cognizance, which are  included in the justification are accurate and complete to the best  of my knowledge and belief.

Typed  Name: Date: __________________________

Title:  Signature: ______________________

Only  the most senior persons within the organization responsible for  acquiring the supplies or services described in the justification  (e.g. program manager, depot commander, or senior program engineer)  and with specific knowledge of the individual requirement (commodity,  technology, and/or function) shall sign the technical and  requirements certifications.

13. Fair  and Reasonable Cost Determination: Include  the following determination:

I  hereby determine that the anticipated cost to the Government for this  contract action will be fair and reasonable.

Provide  the basis for this determination (e.g., describe techniques to be  used to determine fair and reasonable price, such as cost analysis,  price analysis, audit, should cost, independent Government estimate,  etc.). As part of the basis, indicate whether certified cost or  pricing data will be required or if one of the exceptions in FAR  15.403 applies.

Typed  Name: Date: __________________________

Title:  Signature: ______________________

14. Contracting  Officer Certification: This  certification shall be made by the contracting officer who will sign  the contract resulting from this justification and approval. Include  the following statement:

I  certify that this justification is accurate and complete to the best  of my knowledge and belief.

Typed  Name: Date: __________________________

Title:  Signature: ______________________

Note:  It is recommended for the contracting officer to annotate at the  bottom of each J&A page the following marking, as appropriate,  prior to posting on the internet: “Controlled Unclassified  Information”.

Approval

(The approval statement is drafted on a separate page from the certifications and tailored to the instant contract action)

Based  on the foregoing justification, I hereby approve the procurement of  (state equipment/services being procured) on an other than full and  open competition basis pursuant to the authority of 10 U.S.C. 2304(c)  (insert authority and general title), subject to availability of  funds, and provided that the services and property herein described  have otherwise been authorized for acquisition.

Date:  ___________________ Signature: ___________________

5153.303-6 Format for  a bid protest action report.

Bid  Protest Action Report

(RCS  DD-DR&E(AR)1669)

Protester:  ________________________________________________________________

Protest  number: ___________________________________________________________

Protest  Forum (GAO/AGENCY): ____________________________________________

Has  there been a Freedom of Information Act request or Congressional,  Office of the Secretary of Defense; Headquarters, Department of Army;  media, or other high level interest in any aspect of the protested  acquisition or action (including the period prior to any protest)?

Circle  One: Pre-award/Post Award Negotiated/Sealed Bid

Best  Value: Yes No

Description  of item or service:

Solicitation  Number:

Contract  Number:

Awardee:

Award  Date: ______________________. Award Amount:

Estimated  Amount (if pre-award):   (Do not round off/abbreviate dollar  amounts)

Stop  Work? Yes No.   If Yes, date issued:

Attorney  assigned to the protest (include phone):

Contracting  Officer (include phone):

Lessons  Learned and  legal/acquisition costs are to be submitted by letter covering a copy  of decision. Include information concerning whether or not a GAO  dismissal or withdrawal of a GAO protest was the result of a  corrective action taken by the contracting office.

5153.303-7 Format for  a quarterly bid protest analysis report.

Quarterly  Bid Protest Analysis Report

(Separate  Report for Government Accountability Office (GAO) Protests)

For  the period covering:

1.  Protests filed this quarter:

a.  Total number:

b.  Numbers filed by Army Command/Major Subordinate Command, Heads of  Contracting Activities (HCAs):

2.  Number of protests sustained/granted in this quarter:

3.  Number of protests resolved using GAO Flexible Alternative  Procedures in accordance with 4 CFR 21.10 this quarter:

4.  Costs:

a.  Costs and fees awarded by GAO to protester:

b.  Dollar value of award:

(1)  Preaward protests:

(2)  Postaward protests:

5.  Lessons Learned, Issues and Trends, Divergence from Precedent.  Provide a copy of all decisions for sustained protests along with the  lessons learned.

5153.303-8 Withdrawal  of approval of property control system.

(Official  Letter Head)

Office  Symbol

Contractor’s  Name and Address

Government  contract (insert contract number) requires (insert contractor’s  name) to establish and maintain, in accordance with FAR Subpart 45.5  and DFARS Subpart 245.5, a system to control, protect, preserve, and  maintain Government property in your possession. The applicable  provisions of the referenced contract provide that failure of the  contractor to maintain and administer an acceptable program or system  shall be presumed to be a failure resulting from willful misconduct  or lack of good faith on the part of the contractor’s managerial  personnel.

The  Property Administrator, by letter dated (insert date) gave  notification that (insert contractor’s name) system for the  maintenance, protection, preservation, and control of Government  property was reviewed and found not to meet the requirements of FAR  Subpart 45.5 and DFARS Subpart 245.5 in the following respects:

(list  all deficiencies)

By  letter of (insert date) you were advised that approval of the  property control system would be withdrawn unless the noted  deficiencies were corrected by (insert date). As of this date, these  corrections have not been accomplished. This undue delay in  complying with your contractual requirements concerning Government  property and your continued delay in rectifying noted deficiencies  indicate a lack of concern by (insert contractor’s name) managerial  personnel. Therefore, the approval of your Property Control System  is withdrawn as of (insert date). As a result of this action,  (insert contractor’s name) shall be liable for any loss or damage  to the Government property occurring after receipt of this notice in  accordance with the provisions of the contract.

A  copy of this letter is being furnished to the Chief of the  Contracting Office. Your failure to maintain an acceptable property  control system could adversely affect future recommendations for the  award of contracts. Restoration of approval of your property system  is dependent upon the correction of the above listed deficiencies to  the satisfaction of the contracting officer.

Sincerely,

(Signature)

Contracting  Officer

(Note:  Send by registered or certified mail.)

5153.303-9 Contractor  Performance Assessment Report System initial registration  consolidated format.

(Submit  a copy to the Contractor Performance Assessment Report System (CPARS)  focal point upon award, along with the CPARS access request format at  5153.303-10. Other formats may be used if all applicable information  below is included.)

CONTRACT  NUMBER: ________________________

ORDER  NUMBER ________________ (Include  General Services Administration (GSA) number and basic procurement  instrument identification “F” order number.)

CONTRACT  TITLE/EFFORT DESCRIPTION:  ______________________________________________________________________________

CAGE CODE:________ DUNS:________________ PSC:________ NAICS: ____________

CONTRACTOR  NAME, ADDRESS (as  listed in System for Award Management, www.sam.gov):  _____________________________________________________________________________ 

BUSINESS  SECTOR (Circle one): Systems  or Non-systems

LOCATION  OF CONTRACTOR PERFORMANCE (if  other than contractor address above):

_____________________________________________________________________________

CONTRACT  AWARD DATE ____________ EFFECTIVE DATE: ___________________

COMPLETION  DATE (Include  last possible date, if all options exercised): ______________ 

DOLLAR  VALUES:

AWARDED  VALUE (Grand  total, including unexercised options):  _______________ CURRENT VALUE  (Current funded amount as of registration date. Use target price or  total estimated amount for incentive contracts.): ____________________________

CONTRACT  TYPE (Circle one. For hybrid, put a “P” next to the predominate  type and identify other type with an “O” next to it.):

FFP  __ FPI ___ FPR ___ CPFF ___ CPIF ___ CPAF  ___   HYBRID ___ OTHER: _________________

COMPETITIVE  (Basis of award): YES  or NO

PROGRAM/PRODUCT/PROJECT  MANAGER ___________________

E-MAIL:  _____________________________ TELE: _________________

CONTRACT  SPECIALIST ___________________

E-MAIL:  ____________________________ TELE: _________________

CONTRACTING  OFFICER ___________________

E-MAIL:____________________  TELE: _________________

GOVERMENT  CONTRACTING OFFICER’S REPRESENTATIVE/QUALITY ASSURANCE EVALUATOR  ___________________

E-MAIL:_____________________________  TELE: _________________

CONTRACTOR  PROGRAM MANAGER:______________________________  TELE:_________________E-MAIL: ___________________________________

PERIOD  OF PERFORMANCE (POP) FOR 1^ST  ASSESSMENT:

FROM:____________  TO:___________ CPAR COMPLETED:_________

OPTION  1 POP FROM:___________ TO:___________ CPAR COMPLETED:_________

OPTION  2 POP FROM:___________ TO:___________ CPAR COMPLETED:_________

OPTION  3 POP FROM:___________ TO:___________ CPAR COMPLETED:_________

OPTION  4 POP FROM:___________ TO:___________ CPAR COMPLETED:_________

(View  completed reports in the Past Performance Information Retrieval  System-Report Card, available via the Internet at https://www.ppirs.gov.)

5153.303-10  Contractor Performance Assessment Report System access request  format.

(Submit  a copy to the Contractor Performance Assessment Report System (CPARS)  focal point upon award, along with the CPARS initial registration  consolidated format at 5153.303-9. Other formats may be used if all  applicable information below is included.)

Note: For  report completion and security measures, user(s) are responsible for  notifying the focal point for removal of person(s) no longer  associated with the contract(s) below. A change in Assessing  Official Representative or Assessing Official requires that person to  start an Interim Assessment for continuity.

A.  Enter Contract  Numbers/Order Numbers:

Note:  For General Services Administration (GSA) orders, you must include a  GSA schedule number.

1.             6.

2.             7.

3.             8.

4.             9.

5.             10.

B.  Enter Name of Assessing Official:

The  Assessing Official may input ratings and narrative, sign the  assessment report, and release it to the contractor, and modify the  report following contractor comments or close the report if it is not  contentious. The Assessing Official is the person with overall  responsibility for the program/project or job/task/delivery order.  The Assessing Official must be a U.S. Army employee.

Name  Email  Address

1.

C.  of Assessing  Official Representative(s) (Optional):

The  Assessing Official Representative (AOR) may assist the Assessing  Official by inputting ratings and narrative. The AOR may not  sign the report. Examples of AORs include technical experts (i.e.,  engineering, logistics), Defense Contract Management Agency program  integrators, quality and other team members. An AOR must be a  government employee.

Name  Email  Address

1.

2.

3.

4.

D.  Enter Name of Contractor Representative:

This  individual, the Contractor’s Program Manager equivalent, will  comment on the Government Assessing Official’s assessment. The  contractor representative can input comments for the contracts listed  above and view the completed report(s).

Name  Email  Address

1.

2.

3.

4.

E.  Enter Name of Reviewing Official:

A  Reviewing Official, generally a level above the Assessing Official,  provides the check-and-balance whenever the Government Assessing  Official and the Contractor Representative disagree on the  assessment. The Reviewing Official can input comments for the  contracts listed above. The Reviewing Official must be a U.S. Army  employee in the Assessing Official's chain of command.

Name  Email  Address

1.

Individual  Submitting This Request for Access:

Name:

Title:

Phone:

Date: