Fillable Dd Form 2647 - Reimbursable Project Worksheet (Page 2 of 2) in pdf

INSTRUCTIONS FOR COMPLETING THE WORKSHEET

NOTE: The Reimbursable Project Worksheet is to be used exclusively for projects/services in buildings operated by WHS. GSA Form 2957

must be used to request reimbursable services in buildings operated by GSA.

22. ESTIMATE - CALCULATION. Provide a detailed breakdown of the cost

SECTION I - ORDERING DOD COMPONENT REQUEST

estimate for this project.

(To be completed by the ordering DoD component)

ACTIVITY. Use the five character alpha numeric Program/Activity

CONTROL NUMBER (Optional).

Insert requesting organization's internal

code that best describes the services to be accomplished.

For

work order control number.

example:

PX110 = Custodial

DATE (YYMMDD). Insert the date of this request.

PX130 = HVAC

PX151 = Repairs (over $10,000)

REQUESTING DOD COMPONENT. Enter the name of the DoD Component

PX160 = Protective Services

requesting the work; i.e., Air Force, Army, ...OSD.

PRODUCTIVE HOURS (RATE $

). For each activity indicate the

POINT OF CONTACT (POC) AND TELEPHONE NUMBER. Enter the name of

total number of productive hours that will be expended by in-house

the Agency official to be contacted regarding this project.

personnel and the hourly productive rate that will be applied.

POC TELEPHONE NUMBER.

Enter the telephone number (including area

Indicate the estimated cost of in-house labor for each

LABOR.

code) for the POC.

activity: Productive Hours x Productive Hourly Rate.

BUILDING NAME.

Enter the complete address of the work location,

MATERIALS.

For each activity indicate the estimated cost for

including the room number(s) where the work will be performed and the

supplies and materials to be expended.

building number.

CONTRACT/OTHER.

For each activity show the cost of those

FUNDING SOURCE.

Place an "X" in the appropriate box to indicate the

portions of the project that will be performed by contract.

Also

funding source.

include all other costs that cannot be categorized as in-house labor,

supplies or materials.

WORK ORDER TYPE. Place an "X" in the appropriate box to indicate the

action being taken on this RPW - initiate a new project; cancel an existing

Indicate the total cost for each activity by adding the

TOTAL.

project; modify in scope and/or funding for an existing project. Note: if this

amounts shown in blocks 22c, 22d, and 22e.

is a "change" to an existing project insert the change number; e.g., 1, 2, 3,

etc., in the space provided.

(1)

SUBTOTAL. Indicate subtotal for each column (columns 22b, 22c,

22d, and 22e, and 22f.).

WORK START DATE (YYMMDD). Enter the date that work should begin.

(2)

ADMIN (

%). Indicate amount that will be charged to the work for

10.

WORK COMPLETION DATE (YYMMDD).

Enter the date on which work

administrative expenses. For example, if the administrative charge is

should be completed.

10%, insert 10% of the subtotal (Item 22f.)

11.

DESCRIPTION OF WORK.

Enter a detailed description of the requested

(3)

TOTAL ESTIMATE.

Show grand total (including Admin cost) for

work. If additional space is required, a continuation sheet may be used.

each column (22b, 22c, 22d, and 22e, and 22f).

Copies of plans and/or drawings should also be attached.

(4)

ACTUAL.

Complete this block only when project is certified as

12.

ATTACHMENTS.

Insert an "X" in the appropriate block(s) indicating if

financially complete (see block 25b).

Based upon a financial

supporting documentation (continuation sheets, drawings, etc.) has been

reconciliation of this project with official accounting records, insert

forwarded with the RPW.

total actual obligations incurred for this project that will be reflected

in the accounting system and billed to the customer.

SECTION II - WHS ESTIMATES (To be completed by WHS servicing

23.

PERFORMANCE AUTHORIZATION. Insert the name, title, and signature

organization)

of the Building Manager or other appropriate program official and

concurring officials (as needed), authorizing the accomplishment of the

13.

INTERNAL CONTROL NUMBER (optional).

Insert servicing organization's

project. Performance authorization may only be given after acceptance

internal control number.

(see Section III below) of the estimate and certification of funds

availability by the requesting DoD Component.

14.

RPW NUMBER. Insert nine character alpha numeric IAD Account Number

(e.g., RRWO19999/DWO19999) that will be assigned to this project.

24.

CONCURRING OFFICIAL. Self-explanatory.

15.

Insert the four-digit; e.g. 7400, 9800 Organization Responsibility

ORC.

25.

WORK COMPLETION CERTIFICATION.

Indicate the date (YYMMDD)

Code for the organization that will be responsible for the financial tracking

that the project was physically and financially completed. Include initials

and control of this project.

of the RE&F certifying official.

PHYSICALLY COMPLETE. Initialing and dating this block certifies

Insert an "X" in the appropriate block(s) to

16.

CLEARANCE REQUIRED.

that all work is physically completed and/or the requested service

indicate each organization that must review the cost estimate and/or scope

has been delivered.

of work before the estimate is provided to the requesting DoD Component:

SOHO = Safety & Occupational Health Office

FINANCIALLY COMPLETE. Initialing and dating this block certifies

SPAD = Space Policy & Acquisition Division

WHS Accounting System accurately reflects all valid obligations

DPS

= Defense Protective Service

(including labor distribution and all administrative charges) for this

Other = (Please Specify)

project. No further obligation of funds shall be made against this

project after it has been certified as financially complete.

SIGNATURE OF PLANNER/ESTIMATOR.

Signature of Planner/Estimator

who performed the project cost estimate.

SECTION III - REQUESTING DOD COMPONENT ACCEPTANCE

(To be completed by the DoD Component requesting the work)

18.

DATE OF ESTIMATE. Indicate date that the cost estimate was developed

by Planner/Estimator.

26.

Insert the name, title and signature of the

AUTHORIZING OFFICIAL.

19.

SERVICING OFFICE.

Activity that will be primarily responsible for

official authorized to accept or reject the cost estimate.

performing the requested service(s).

27.

ESTIMATE.

Insert an "X" in the space provided to indicate the

acceptance or rejection of the estimate. If the estimate is accepted, a

20.

POINT OF CONTACT (POC)/TELEPHONE NUMBER (Include Area Code).

DD Form 448 (Military Interdepartmental Purchase Request (MIPR)) must

Insert name and telephone number of the individual to be contacted by the

be prepared for the estimated amount of the work, and attached to this

requesting DoD component regarding the status of this work.

form and forwarded to WHS/RE&F/RMO. In the space provided, indicate

the amount of the DD Form 448.

21.

ESTIMATED DELIVERY DATE (YYMMDD). Indicate the estimated delivery

28.

AGENCY FUND CITATION. In the space provided insert agency fund

date for this project.

Use Remarks section as necessary to explain

citation referenced in the MIPR.

contingencies that may offset the ability of the serving office to meet the

estimated delivery date.

29.

REMARKS (Optional).

DD Form 2647, JAN 93 (Back)

Dd Form 2647 - Reimbursable Project Worksheet Page 2

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