Delegation Of Contract Authority (Dca) Request Form printable pdf download

Delegation Of Contract Authority (Dca) Request Form

FIRST - DELEGATION OF CONTRACT AUTHORITY (DCA) REQUEST FORM

Part I – Requestor Information:

Customer POC: _____________________________________________________________

Phone: ________________ Fax: ______________ Email: ___________________________

Alternate POC: ______________________________________________________________

Phone: ________________ Fax: ______________ Email: ___________________________

Organization and Mailing Address:

________________________________________________________

Delegated Contracting Official (DCA/KO) : ______________________________________

Phone: ________________ Fax: _________________ Email: ________________________

Organization and Mailing Address:

________________________________________________________

DCA/KO Warrant Authority Amount: _______________________________

(Please attach photocopy of Warrant)

Part II – Type of Delegation Requested:

Single TO

Multiple TO’s

Requested DCA Total Amount (including any contracting option) : ____________

DCA Base Period - From: _______________ To : _____________________

(NTE 1 year)

Special Conditions/Waivers Sought: ____________________________________________

____________________________________________________________________________

Delegation Of Contract Authority (Dca) Request Form