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(is practicable, show separately amount of disposal credits applicable to acceptable finibed product reported on Format 803-3) NOTE,- Individual items of small amounts may be grouped into a single entry in Schedules A, I, C, D, E, and G.

WWERT THE WACI MOVIDO POR ANY WNIOUMATION IS INSUTIKIUNT, ANTACH SUALAN HORTINO SCHEDUUS

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CONTRACTING MESS AND PARTIAL PAYMENTS

USE OF AMOUNT

AGENCY ONLY

8 1-8.802-3 Format 802-3, Settlement Proposal (Short

contracts.

SETTLEMENT PROPOSAL

(SHORT FORM) FOR USE BY A PEINE CONTRACTOR OR SUBCONTRACTOR IN SETTLEMENT OF A FIXED-PRICE TERMINATED CONTRACT WHEN THIS PROPOSAL APPLIES TO (Check one)

COMPANY
A PRIME CONTRACT
with THE GOVERNMENT

SUBCONTRACT OR PURCHASE ORDER
SUACONTRACT OR PURCHASE ORDER NO(S).

STREET ADDRESS
CONTRACTOR WHO SENT NOTICE OF TERMINATION
NAME

NAME OF GOVERNMENT AGENC

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IMEN

Jinbar CIANT, ATTACH SEPARATE SUPPORTING SCHEDULES T1CATE representative of the contractor, certifies that he has examined dge and belief: ed settlement (exclusive of charges set forth in Item 14) and sup om the books of account and records of the contractor in =; they include only chose charges allocable to the terminated wledge that they will, or may, be used directly or indirectly us ited States or an agency thereof; and the charges as stated are

actor has examined, or caused to be examined, co an extent be

immediate subcontractors (exclusive of claims filed against such Etlements on account of immediate subcontractors' own charges erminated portion of this contract and said settlements were af immediate subcontractors than those which the contractor would olved; (c) the contractor bas received from all his immediate

claims, which centificates are substantially in the form of this ing him to doube (i) the reasonableness of the settlements with them are allocable to this contract. Upon receipt by the con

subcontractors, the contractor will pay or credit them promptly - previously done so. The term "subcontractor" u used above

(SATOMITROPOSED SETTLEMENT NO

(Iecinde only itera Settorale the terminated pertion of contract) CHARGE FOR ACCEPTABLE FINISHED PRODUCT NOT CORREO BY INVOICING (From Formal 803-9) 7 CHARGE FOR WORK IN PROCESS, RAW MATERIAL, ETC. ON HAND (From Format 893-9) 3 OTHER CHARGES INCLUDING PROFIT AND SETTLEMENT EXPENSES 4 CHARGES FOR SETTLEMENT(S) WITH SUBCONTRACTORS 5 GROSS PROPOSED SETTLEMENT (Itens I thru 4)

DISPOSAL AND OTHER CREDITS (From Formal 803-9. Col. 8) 1 NET PROPOSED SETTLEMENT (Itrat 5 less 6)

ADVANCE, PROGRESS AND PARTIAL PAYMENTS
NET PAYMENT REQUESTED (Item 7 less 8)
List your intentory on Format 803-9 and attach a copy berete. Retain for the applicable pe

papers and records relating to this proposal for future examination by your customer or by :be GIVE A BIBT EXPLANATION OF HOW YOU ARRIVED AT THE AMOUNTS SHOWN IN ITEMS 3, 4, 6 AND 7

Nature of outborized facial)

NAME OF YOUR CO THE UNDERSIGNED CERTIFIES THAT THE ABOVE PROPOSED SETTLEMENT INCLUDES ONLY CHARGES ALLOCABLE TO THE TERMINATED PORTION OF THE CONTRACT OR PURCHASE ORDER, THAT THE TOTAL CHARGES (iten S) AND THE DISPOSAL CREDITS (item 6) ARE

DY (Signature of FAR AND REASONABLE, AND THAT THIS PROPOSAL HAS BEEN PREPARED WITH KNOW. LEDGE THAT IT WILL, OR MAY, BE USED DIRECTLY OR INDIRECTLY AS A BASIS FOR SETTLE. MENT OF A CLAIM OR CLAIMS AGAINST THE UNITED STATES OR AN AGENCY THEREOF.

TITLE

81-8.802-3 Format 802–3, Settlement Proposal (Short Form)—fixed-price typo

contracts.

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455

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CERTIFICATE

SPECIMEN

The undersigned, individually and sh authorized representative of the contracto sealement proposal and that, to the best of his knowledge and belief:

(1) AS TO CONTRACTOR'S OWN CHARGES- The proposed sealement (exclusive supporting schedules and explanations have been prepared from the books of account cordance with the terms of the contract; they include only those charges allocable to the prepared with kaowledge chat they will, or may be used directly or indirectly as th claims against the United States of an agency thereof; and the charges as stated are fa

(2) AS TO SUBCONTRACTORS CHARGES-(a) The contractor has examined, tent be considered necessary in the circumstances, the claims of his immediate subcontra sucb immediate subcontractors by ibeir subcontractors); (b) the settlements on account of im are fair and reasonable, said charges are allocable to the terminated portion of this cont tiated in good faith and ate not more favorable to his immediate subcontractors than tho if reimbursement by the Government were not involved; (c) the contractor has recei tractors appropriate certificates with respect to their claims, which certificates are substa ind (d) the contractor has no information leading him to doubt (i) the reasonablen mote subcontractors, or (ii) that charges for them are allocable to this contract. Upon covering settlements with his immediate subcontractors, the contractor will pay or cre so received, co the extent that he has not previously done so. The term subcontracto

NAME OF CONTRACTOR

DY (Signature d authorized official)

TITLE

NAME OF SUPERVISORY ACCOUNTING OFFICIAL

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