Contract Status Certification

Contract:

____________________

SPIIN(s):

____________________

Contractor:

____________________

 

 

ACO:

____________________

PCO:

____________________

 

A.

This Program Office has completed the required steps outlined on the back of this form (next page) and has determined the above contract has been closed out (obligations and expenditures have been reconciled) based on the following:

 

___________

Copy of DD Form 1594/PK9 (Yes/No) or

 

___________

Copy of final mod/ DD Form 250 (Yes/No) or

 

___________

ACO/PCO Memorandum for the Record on letterhead or e-mail indicating no records available (Yes/No)
AND:

 

 

___________

MOCAS - Closed History or Contingency Liability Report (CLR)

 

 

___________

Paying Office ledgers/spreadsheets/disbursement vouchers/final DD Form 250

 

 

___________

Contractor Billing Record/billing invoices (public vouchers/DD Form 250)

 

 

___________

Treasury Records

B.

Copies of all documentation are attached.

C.

Request excess commitments/obligations be decommitted / deobligated.

D.

If additional charges are subsequently identified, those charges are posted to the affected line of accounting and the appropriate obligation reinstated.

 

Submitted:

____________________________________
Program Office

 

____________________________________
Date

 

 

 

 

Approved:

____________________________________
Comptroller

 

____________________________________
Date