Dd Form 2647 - Reimbursable Project Worksheet

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REIMBURSABLE PROJECT WORKSHEET
SECTION I - ORDERING DOD COMPONENT REQUEST
1. AGENCY CONTROL NUMBER
2. DATE (YYMMDD)
3. REQUESTING DOD COMPONENT
4. POINT OF CONTACT (POC)
5. POC TELEPHONE NUMBER
6. BUILDING NAME (Include Room and Building Number)
(Include Area Code)
9. WORK START DATE (YYMMDD)
7. FUNDING SOURCE
8. WORK ORDER TYPE
a. O&M
a. INITIAL
b. RE&FD
b. CANCELLATION
10. WORK COMPLETION DATE (YYMMDD)
c. MILCON
c. CHANGE NUMBER
d. PROCUREMENT
e. OTHER (Specify)
11. DESCRIPTION OF WORK
12. ATTACHMENTS (Please check appropriate block(s))
DRAWING(S)
CONTINUATION SHEET(S)
SECTION II - WHS ESTIMATE
13. INTERNAL CONTROL
14. RPW NUMBER
15. ORC
16. CLEARANCE
INITIALS
DATE
(YYMMDD)
NUMBER
REQUIRED
a. SOHO
17. SIGNATURE OF PLANNER/ESTIMATOR
18. DATE OF ESTIMATE
b. DPS
(YYMMDD)
c. SPAD
d. OTHER (Specify)
19. SERVICING OFFICE
20. POINT OF CONTACT (POC)/TELEPHONE NUMBER
(Include Area Code)
21. WHS ESTIMATED DELIVERY DATE
(YYMMDD)
22. COST ESTIMATE
PROD. HRS.
CONTRACT/
23. PERFORMANCE AUTHORIZA-
ACTIVITY
(RATE $
)
LABOR
MATERIALS
OTHER
TOTAL
TION (Name, title and signature)
a.
b.
c.
d.
e.
f.
AND DATE (YYMMDD)
0.00
0.00
0.00
0.00
0.00
0.00
24. CONCURRING OFFICIAL (Name,
0.00
0.00
title and signature) AND DATE
0.00
0.00
(YYMMDD)
0.00
0.00
0.00
0.00
0.00
0.00
25. WORK COMPLETION
0.00
0.00
CERTIFICATION (Date and initial)
0.00
0.00
(1) SUBTOTAL
0
0.00
0.00
0.00
a. PHYSICALLY
0.00
COMPLETE
(2) ADMIN. (
%)
0.00
0.00
(3) TOTAL ESTIMATE
b. FINANCIALLY
0
0.00
0.00
0.00
0.00
COMPLETE
(4) ACTUAL
SECTION III - REQUESTING DOD COMPONENT ACCEPTANCE
26. AUTHORIZING OFFICIAL (Name, title and signature)/DATE
27. ESTIMATE
a. ACCEPTED
b. REJECTED
c. MIPR ATTACHED $
28. AGENCY FUND CITATION
29. REMARKS
DD Form 2647, JAN 93
Adobe Professional 7.0

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