PROCUREMENT FORMS instances where a connection charge, other than the fee described above, is involved, the "Connection Charge” clause (7.5003-3) and Appendix C (16.501-52(c)) shall be included in the contract. (b) Appendix B, Service Specifications. Appendix B, the service specifications applicable to the contract, shall consist of: (i) NASA Form 550A-1 (Electric Service Specifications), NASA Form 550A-5 (Sewage Service Specifications), whichever is applicable, appropriately completed; or (ii) a specially drafted attachment to the contract bearing the legend “Appendix B, attached to and made a part of Contract No. .....," and the title of the appropriate service specifications. Each page shall indicate its numerical order in the total number of pages comprising Appendix B, as, for example, "page 1 of 3." Such appendix shall set forth as a minimum: (i) the premises to be served; (ii) an estimate of the service requirements; (iii) the point of delivery to the Government; (iv) a description of the service; (v) a statement of how the service is to be measured for purposes of billing; (vi) the quality of service to be rendered; and (vii) a statement of the capacity and flow of the service. (c) Appendix C, Connection Charge Schedule. Appendix C, the schedule required whenever the contract includes the connection charge clause prescribed by 7.5003-3 or the termination charge clause prescribed by 7.5003-4, shall bear the legend “Appendix C, attached to and made a part of Contract No......," and be entitled "Connection Charge Schedule." Each page shall indicate its numerical order in the total number of pages comprising Appendix C, as, for example, “page 1 of 3." The appendix shall set forth as a minimum: (i) a detailed description of the new facilities to be furnished by the contractor; and (ii) the agreed salvage value of such facilities. 16.501-53 Contents of a Negotiated Utility Service Contract. (a) Contract Using NASA Form 550. Any contract for which 16.501-50(a) prescribes the use of NASA Form 550 shall consist of: (i) NASA Form 550, together with any alterations and/or additions thereto (A) required by 7.5001 and 7.5002, (B) authorized by 7.5003, or (C) approved by the Assistant Administrator for Procurement, pursuant to 4.5006(d); (ii) an Appendix A, Rate Schedule (see 16.501-52(a)); (iii) an Appendix B, Service Specifications (see 16.501-52(b)); and (iv) an Appendix C, Connection Charge Schedule (see 16.501-52(c) and 7.5003–3). (b) Contract Using NASA Form 550S. Any contract for which 16.501-51(a) allows the use of NASA Form 550S shall consist of: (i) NASA Form 550S without any alteration, addition, or deviation whatsoever; and (ii) an Appendix A, which will be the established rate schedule of the contractor applicable to the contract and the rules and regulations pertaining thereto. 16.501-54 Terms, Conditions, and Provisions. Detailed instructions for use of the clauses contained in NASA Form 550A are set forth in Part 7, Subpart 50, of this Regulation. 16.501-54 CFR TITLE 41 CHAPTER 18 Subpart 6-Forms for Coordinated Procurement 16.600 Scope of Subpart. This Subpart prescribes forms to be used for the procurement of supplies or services by NASA from or through the Military Departments. 16.601 NASA-Defense Purchase Request (NASA Form 523). NASA-Defense Purchase Request (NASA Form 523) shall be used by NASA procurement offices for requesting procurement of supplies or services from all activities of the Military Departments, in accordance with 5.1002. 16.602 Acceptance of NASA-Defense Purchase Request. Acceptance by the procuring department of NASA's request for supplies or services (NASA Form 523) shall be made on a DD Form 448-2, Acceptance of MIPR Form (see 5.1002–3). 16.603 Payments (Standard Form 1080). Standard Form 1080, Voucher for Transfer Between Appropriations and/or Funds, shall be used in connection with payments to the Military Departments for supplies and services furnished to or procured for NASA (see 5.1005). NASA PROCUREMENT REGULATION 16.603 Subpart 7-Contract Termination Forms 16.700 Scope of Subpart. This Subpart prescribes forms for use in connection with terminated contracts (see Part 8 of this Regulation). 16.701 Notices of Termination. There are no specific forms prescribed for use in issuing termination notices. However, 8.801 sets forth texts of telegraphic and letter notices of termination which may be used. 16.702 Settlement Proposal Forms. Although the forms prescribed below are designed for use by prime contractors, they are equally suitable for use by subcontractors. 16.702-1 Settlement Proposal-Inventory Basis (DD Form 540). DD Form 540 is prescribed for use by contractors in presenting claims resulting from the termination of fixed-price contracts when such claims are computed on the inventory basis. 16.702-2 Settlement Proposal-Total Cost Basis (DD Form 541). DD Form 541 is prescribed for use by contractors in presenting claims resulting from the termination of either fixed-price or cost-reimbursement type contracts when such claims are computed on the total cost basis. 16.702-3 Settlement Proposal for Cost-Reimbursement Type Contracts (DD Form 547). DD Form 547 is prescribed for use by contractors in submitting claims resulting from the termination of cost-reimbursement type contracts. 16.702-4 Settlement Proposal-Short Form (DD Form 831). DD Form 831 is authorized for use by contractors in submitting claims resulting from the termination of fixed-price contracts when the total claim is less than $10,000. 16.702-5 Inventory Schedules (DD Forms 542, 543, 544, 545, and 832). The DD Form 832 (Termination Inventory Schedule E-Short Form) is prescribed for use by contractors to support settlement proposals submitted on DD Form 831. For other inventory schedule forms to support settlement proposals submitted on DD Forms 540, 541, and 547, see 16.818. 16.702-6 Schedule of Accounting Information (DD Form 546). DD Form 546 is prescribed for use by contractors in connection with settlement proposals (see 8.307-1(e)). 16.703 Application for Partial Payment (DD Form 548). DD Form 548 is prescribed for use by contractors when applying for partial payments (see 8.213-1). 16.704 [Reserved] 16.705 Forms of Settlement Agreements. Use of Standard Form 30 (Amendment of Solicitation/ Modification of Contract) is prescribed in 8.210-1 for termination settlement agreements. Appropriate texts are set forth in 8.805. 16.706 Instructions for Use of Termination Forms (DD Form 1114, NASA Edition). DD Form 1114, NASA Edition consists of instructions for the use of contract termination settlement and inventory schedule forms. 16.750 Instructions in Preparing Inventory Schedules of Contractor Inventory (DD ASPR Form 1115, NASA Edition). DD ASPR Form 1115, NASA Edition consists of instructions for preparation of inventory schedules DD Forms 542, 543, 544, 545, and 832. 16.751 Contract Termination Status Report (DD Form 1598). DD Form 1598 is prescribed for use in reporting status of all fixed-price contracts terminated for the convenience of the Government and all terminated cost-reimbursement type contracts. Reference to the "ASBCA" on the form should be changed to read "NASABCA". 16.752 Termination Authority (NASA Form 1412). NASA Form 1412 is prescribed for use by cognizant NASA installations when initiating action to terminate a contract for either convenience of the Government or for default of the contractor. The termination authority shall normally be originated by the project manager or other NASA official responsible for the decision to terminate and shall be submitted to the NASA installation procurement office for use in recording subsequent decisions regarding the type of termination and assignment of the responsibility for final settlement. 16.753 Termination Docket Checklist (NASA Form 1413). NASA Form 1413 is prescribed for use as a checklist to ensure adequacy of records pursuant to 8.206-3. NASA PROCUREMENT REGULATION 16.753 Subpart 8-Miscellaneous Forms 16.800 Scope of Subpart. This Subpart prescribes miscellaneous forms, other than contract forms, for use in connection with the procurement of supplies and services. 16.801 [Reserved] 16.802 Statement of Contingent Fees (Standard Form 119). Standard Form 119 is prescribed for use in accordance with 1.509 and 1.550. 16.803 Compliance With Labor Laws, Regulations, and Clauses. 16.803-1 Construction Contracts (DB 11, Standard Form 1093, CB 16–19). (a) Department of Labor Form DB 11, Request for Determination, shall be used in accordance with the provisions of 12.404-2. (b) Standard Form 1093, Schedule of Withholdings Under the Davis-Bacon Act, shall be used in accordance with the provisions of 12.404-9. (c) Census Bureau Form 16-19, Construction Contract Award Notification, shall be used for reporting construction contract awards in accordance with the provisions of 12.404-13. 16.803-2 Supply Contracts (PC-13, PC-16, Standard Form 99). (a) Department of Labor Form PC-13, combination Letter-Poster, shall be furnished to the contractor in accordance with 12.604. (b) Department of Labor Form PC-16 shall be furnished to the contractor in accordance with 12.604. (c) Standard Form 99, Notice of Award of Contract, shall be used in accordance with the provisions of 12.604. 16.803-3 [Reserved] 16.803-4 Employer Information Report EEO-1 (Standard Form 100). Standard Form 100 shall be used in accordance with the provisions of 12.812. 16.804 U.S. Tax Exemption Certificate (Standard Form 1094). (a) The U.S. Tax Exemption Certificate, Standard Form 1094, shall be used as prescribed in 11.502-1. (b) Treasury Department Form 1444 (Tax Free Spirits for Use of United States) and Treasury Department Form 1486 (Specially Denatured Spirits for Use of United States) shall be used in accordance with the provisions of 11.250. 16.805 Bond Forms. The bond forms listed below are available for use in accordance with the provisions of Part 10 of this Regulation. (i) Bid Bond (Standard Form 24). (ii) Annual Bid Bond (Standard Form 34). (iii) Performance Bond (Standard Form 25). (iv) Payment Bond (Standard Form 25-A). (v) Continuation Sheet (Standard Form 25-B) (For Standard Forms 24, 25, 25-A). (vi) Affidavit of Individual Surety (Standard Form 28). (vii) Annual Performance Bond (Standard Form 35). (viii) DD Form 1673, Payment Bond for other than Construction Contracts (NASA Edition). 16.806 through 16.809 [Reserved] 16.810 Bidders Mailing List Application (Standard Form 129) and Bidders Mailing List Application Supplement (DD Form 558-1). 16.810-1 General. Standard Form 129 shall be used in connection with the establishment and maintenance of bidders lists as prescribed in 2.205. Supplemental information, where required, may be obtained by using DD Form 558-1 (Bidders Mailing List Application Supplement). 16.810-2 Conditions for Use. (a) The application shall be submitted and signed by the supplier (the manufacturer or regular dealer), as distinguished from an agent of the supplier. However, suppliers are not precluded from designating, in the Standard Form 129, their agents to receive Invitations for Bids and Requests for Proposals. (b) Pending the publication of a new edition of the form, the representation prescribed by 1.332-1(e) shall be added as a fourth entry after the entry entitled "Commerce Business Daily" on Page 2. NASA PROCUREMENT REGULATION 16.810-2 13-139 0-83--42 PROCUREMENT FORMS 16.810-3 Item Listings for Information of Bidders. In order to enable suppliers to indicate readily the items on which they will generally desire to submit bids or proposals, there shall be attached to Standard Form 129 forwarded to suppliers for completion, a list of items, or item groups, or an index to such listing of the items, procured by the purchasing activity maintaining the list, which are considered applicable to the supplier's type of business. 16.811 Security Requirements (DD Forms 441 and 254). 16.811-1 Security Agreement. DD Form 441, Security Agreement, is authorized for use in connection with the requirements of 7.104-12, 7.204-12, and 7.451-24. 16.811-2 Contract Security Classification Specification. DD Form 254, Security Required by the "Security Requirements" clause (see 7.104-12, 7.204-12, and 7.451-24), which is included in all contracts classified "Confidential" or higher and in other contracts the performance of which may require access to classified information or material. Instructions for preparation are included in the form. 16.812 Release and Assignment Forms (NASA Forms 778, 779, 780, and 781). The forms identified below are approved for use in complying with the release and assignment provisions of paragraph (f) of the allowable cost clause of a cost-reimbursement type contract (see 7.203-4, 7.402-3, and 7.451-3). (i) Contractor's Release (NASA Form 778); (ii) Assignee's Release (NASA Form 779); (iii) Contractor's Assignment of Refunds, Rebates, Credits, and Other Amounts (NASA Form 780); and (iv) Assignee's Assignment of Refunds, Rebates, Credits, and Other Amounts (NASA Form 781). Forms differing from the above approved forms may be used if the contracting officer determines that such forms meet the applicable requirements of the clause. 16.813 Small Purchase Pricing Memorandum. Small Purchase Pricing Memorandum (DD Form 1784) shall be used to document purchase order files as to reasonableness of price when a separate form is used for that purpose (see 3.604–2). Local reproduction of DD Form 1784 is authorized. 16.814 Experience Data Forms (Standard Forms 254 and 255). (a) The Architect-Engineer and Related Services Questionnaire (Standard Form 251) is designed to provide for uniform presentation, by architect-engineer firms, of information regarding their general professional qualifications. This form shall be used whenever an installation desires to obtain such information for use in contracting for services of an architect-engineer nature relating to construction, alteration, or repair of buildings, bridges, roads, or other kinds of real property. Services related to construction include planning, engineering studies, investigations, development of design, preparation of plans and specifications, and inspection and supervision of work performed during the construction period. Firms are encouraged to submit annually an updated statement of qualifications and performance data on Standard Form 254. (b) Architect-Engineer and Related Services Questionnaire for Specific Project (Standard Form 255) is designed to supplement Standard Form 254; it will be used to secure additional, specific detailed information on the prospective firms qualifications for a particular project. This supplemental form shall be used to secure such supplemental data whenever the fee for the project is estimated at $25,000 or more. The form may also be used for those projects for which the fee is estimated at less than $25,000 when it is determined to be in the best interest of the Government. (c) Use of the forms prescribed in subparagraphs (a) and (b) above is not required in the procurement of architect-engineer services related to construction, alterations, repair, processing and assembling of vessels, aircraft, or other kinds of personal property. 16.815 Contract Modification Forms (Standard Forms 30 and 36). 16.815-1 Modifications Pursuant to Provisions of Contract. Modifications affecting the price or time for performance of a construction contract may be made pursuant to the "Changes" "Changed Conditions" and "Termination for Default-Damages for Delay-Time Extensions" clauses of the contract and shall be accomplished on Standard Form 30. Although such modifications may be issued unilaterally by the contracting officer, usually an agreement with the contractor is obtained prior to the issuance of the formal contract modification. The reason for CFR TITLE 41 CHAPTER 18 16.810-3 |