Figure A7.C4.F2. Contract Status Certification

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)

    ___________ 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
Approved: ____________________________________