Date:

_________________

Closure Type:

DIRECT FINAL ____
INTERIM ____
INTERIM TO FINAL ____

Country Code-Implementing Agency-Case:

_________________

Net Case Value:

_________________

Case Closed at Zero Value per FMS Purchaser's Request:

YES_____ NO______

Final Delivered Articles/Services value (including CAS and LSC):

_________________

1. ___ The net case value shown on line 4 agrees with Implementing Agency records and Obligational Authority released to this agency via DD Form 2060 or automated equivalent.

   AND

2. ____ The contracts awarded in connection with the case are logistically complete with no associated unliquidated obligations

   OR

   ___ The contracts awarded in connection with the case are logistically complete; but, unliquidated obligations exists. Responsible officials have advised that no additional costs beyond the recorded unliquidated obligations in line 8 below can be identified.

   AND

3. ____ All requisitions, reimbursable work orders, MIPRs and invitational travel orders that were processed pursuant to this case are accounted for and the costs thereof are included in line 6. Reimbursements from the DFAS/JAX/IN have been credited to the financing appropriation or Miscellaneous Receipt Account 3041, as applicable.

   AND

4. ____ All estimated deliveries were converted to actual deliveries.

   AND

5. Check one below that applies:

   ____ Constructive delivery transactions have been reported for all major end items.

   OR

   ____ Constructive delivery reporting does not apply to this case.

   AND

6. ____ All outstanding discrepancy reports against the case were processed.

   AND

7. ____ All Performance Reporting and Cash Disbursements were reconciled with Implementing Agency accounting records and are equal in value.

   AND

8. ____ All accessorial charges have been validated.

Above-the-line disbursements excluding CAS and LSC:

_________________

Unliquidated obligation balance (to include ULO CAS):

_________________

ULO CAS:

_________________

Unliquidated Obligation supporting documentation attached for Interim Closures:

YES _____ N/A _____

Closure certificate point of contact:
(Name, email, phone number)

_________________

Note: Sum of all entries in this column must equal ULO amount specified in item 7 of the certificate

Note: Identify ULO category as provided in A7.C3.13.1.

Also include future physical completion date, when available.

007

N00024-02-C-0001

PBD044-2715-0001

$100,247.03

$95,868.92

$4,378.11

Open contract; estimated physical completion date is Jun 2007

Dec 2017