PDF DD Form 1144, Support Agreement, November 2001.

1. AGREEMENT NUMBER (Provided by Supplier)

5. SUPPLYING ACTIVITY a. NAME AND ADDRESS

SUPPORT AGREEMENT

2. SUPERSEDED AGREEMENT NO. 3. EFFECTIVE DATE (YYYYMMDD) (If this replaces another agreement)

4. EXPIRATION DATE (May be "Indefinite")

6. RECEIVING ACTIVITY a. NAME AND ADDRESS

b. MAJOR COMMAND

b. MAJOR COMMAND

7. SUPPORT PROVIDED BY SUPPLIER a. SUPPORT (Specify what, when, where, and how much)

______________(Contracting/Supplying Activity Name) will provide procurement support to __________________ (Requesting/Receiving Activity Name), who is deployed without organic or Component procurement capability.

b. BASIS FOR REIMBURSEMENT

______________(Contracting/Supplying Activity Name) will provide contract services to include solicitation development, contract award, contract administration and contract closeout.

__________________(Requesting/Receiving Activity Name) will provide any market research for the supplies or services needed. __________________(Requesting/Receiving Activity Name) will provide a trained and qualified Contracting Officer Representative (COR) if needed.

_________(Requesting/Receiving Activity Name)will provide funding utilizing a DD Form 448 (MIPR) or ___________.

c. ESTIMATED REIMBURSEMENT

ADDITIONAL SUPPORT REQUIREMENTS ATTACHED: 8. SUPPLYING COMPONENT a. COMPTROLLER SIGNATURE

SIGN HERE

c. APPROVING AUTHORITY (1) TYPED NAME

YES b. DATE SIGNED

NO 9. RECEIVING COMPONENT a. COMPTROLLER SIGNATURE

SIGN HERE

c. APPROVING AUTHORITY (1) TYPED NAME

(2) ORGANIZATION

(3) TELEPHONE NUMBER (2) ORGANIZATION

b. DATE SIGNED (3) TELEPHONE NUMBER

(4) SIGNATURE

SIGN HERE

(5) DATE SIGNED

(4) SIGNATURE

SIGN HERE

10. TERMINATION (Complete only when agreement is terminated prior to scheduled expiration date.)

a. APPROVING AUTHORITY SIGNATURE

b. DATE SIGNED c. APPROVING AUTHORITY SIGNATURE

SIGN HERE

SIGN HERE

DD FORM 1144, NOV 2001

PREVIOUS EDITION MAY BE USED.

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(5) DATE SIGNED

d. DATE SIGNED Page 1 of 3 Pages

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11. GENERAL PROVISIONS (Complete blank spaces and add additional general provisions as appropriate: e.g., exceptions to printed provisions, additional parties to this agreement, billing and reimbursement instructions.)

a. The receiving components will provide the supplying component projections of requested support. (Significant changes in the receiving component's support requirements should be submitted to the supplying component in a manner that will permit timely modification of resource requirements.)

b. It is the responsibility of the supplying component to bring any required or requested change in support to the attention of prior to changing or cancelling support.

c. The component providing reimbursable support in this agreement will submit statements of costs to: .

d. All rates expressing the unit cost of services provided in this agreement are based on current rates which may be subject to change for uncontrollable reasons, such as legislation, DoD directives, and commercial utility rate increases. The receiver will be notified immediately of such rate changes that must be passed through to the support receivers.

e. This agreement may be cancelled at any time by mutual consent of the parties concerned. This agreement may also be cancelled by either party upon giving at least 180 days written notice to the other party.

f. In case of mobilization or other emergency, this agreement will remain in force only within supplier's capabilities.

____There are no unique requirements beyond the basic support requested on the DD Form 448 (MIPR).

Effective Date (box 3) - The effective date must be completed. The effective date must match the date signed by comptroller or it must be dated after comptroller signature.

Expiration Date (box 4) - Since it may be difficult to determine the exact date of award, leave "Indefinite" in the expiration date.

Under Receiving Component: The Comptroller for your agency must sign and date in boxes 9a-b.The Approving Authority is the Requesting Activity and their contact information and signature must be completed in boxes 9c(1-5).

ADDITIONAL GENERAL PROVISIONS ATTACHED:

YES

NO

12. SPECIFIC PROVISIONS (As appropriate: e.g., location and size of occupied facilities, unique supplier and receiver responsibilities, conditions, requirements, quality standards, and criteria for measurement/reimbursement of unique requirements.)

____The following unique requirements are required in order to support our mission:

ADDITIONAL SPECIFIC PROVISIONS ATTACHED:

DD FORM 1144, NOV 2001

YES

NO

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13. ADDITIONAL PROVISIONS (Use this space to continue general and/or specific provisions, as needed.)

In compliance with Federal Acquisition Regulation 17.502-1, I, ______________________(Requestor Name) make the following determination: __________________(Enter Name and Requesting Activity Name) has obtained concurrence from ________________(Enter responsible supporting contracting office) and determined that the best procurement approach to satisfy __________________(Requesting/Receiving Activity Name) mission requirements is by receiving support from ______________(Contracting/Supplying Activity Name). I further determine the support to be received is the most cost effective means to support the mission, and the procurement will result in the use of funds in accordance with appropriation limitations and compliance with requesting agency's laws and policies (see FAR 17.502-1(a)). The Requesting Activity makes the following determination and findings pursuant to the Economy Act (31 U.S.C. 1535) as implemented in FAR 17.502-2 (each element to be filled in by the Requesting Activity with the approval of the contracting officer of the requesting agency, or another official designated by the head of the Requesting Activity): a) State why the proposed acquisition represents the best procurement approach:

b) State why the services/supplies cannot be obtained as conveniently or economically by the Requesting Activity by contracting directly with a private source:

c) Include a statement that at least one of the following circumstances applies to the proposed acquisition by checking the appropriate box and providing a brief statement as to why at least one of the elements below applies to the proposed acquisition: i) The acquisition will appropriately be made under an existing contract of the servicing agency, entered into before placement of the order, to meet the requirements of the servicing agency for the same or similar supplies or services:

ii) the servicing agency is specifically authorized by law or regulation to purchase such supplies or services on behalf of the other agencies;

iii) the servicing agency has the capability or the expertise to enter into a contract for such supplies that is not available within the requesting agency.

DD FORM 1144, NOV 2001

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