AFGE Local Number
Point of Contact Phone Number
Title
PART A
Contract Number Date of Award
Description
PART B
Cost Comparison Direct Conversion
Competitive Acquisition
Small Business Set-Aside or
Unrestricted Competitive Acquisition (Competition open to large and small businesses)
Restricted Acquisition
Sole Source 8(a) program
Competitive 8(a) program
Other
PART C
Initial Award Information: Request from Contracting Officer
1. Award Document: Part I, Section A
Bid Schedule: Part I, Section B
Contract Administration Data: Part I, Section G
Applicable DOL Wage Determination: Part III, Section J
Reps and Certs: Part IV, Section K
2. Contract Cost:
Initial Award Amount:
Basic Year Period $ Performance Period:
First Option Year* $ Performance Period:
2nd Option Year** $ Performance Period:
3rd Option Year *** $ Performance Period:
4th Option Year**** $Performance Period:
Total Amount for Basic and Options
First Option Year
Modification Exercising Option:
Applicable Wage Determination Amount Funded
Modification(s) for Basic Year that resulted in increase/decrease in contract amounts.
Request for Equitable Adjustment:
Modification incorporating Changes to PWS/SOW:
Settlement of Claims:
Value unsettled claims:
Total amount of Increase or Decrease:*
AFGE analysis for cost increase/decrease:
2nd Option Year
Modification(s) that resulted in increase/decrease in first option period.
3rd Option Year
Modification(s) that resulted in increase/decrease in second option period.
4th Option Year
Modification(s) that resulted in increase/decrease in 3rd option year.
* Total difference between the initial awarded amount for each option and actual value of options.