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Federal Highway Administration
1200 New Jersey Avenue, SE
Washington, DC 20590
202-366-4000


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FHWA Order 4400.4

Order
Subject
Contracting Officer Warrant Program
Classification Code Date Office of Primary Interest
4400.4 August 18, 2008 HAAM–1

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Order 4400.4 - Attachment A

FHWA CONTRACTING OFFICER WARRANT APPLICATION FORM

1. Applicant Information:

a. Name of Appointee (Last, First, Middle):
b. Office Code:
c. Position Title:
d. Civilian Series and Grade:
e. Number of years experience in Government Contracting:
f. Acquisition Career Field (e.g., contracting, program management):

2. Type of Request

a. Check box Initial Request. Check box to identify the authority requested:

Check box Warrant Level I (SAP)
(Up to $100,000 under FAR Part 8) (desired dollar limit) $
(Up to $25,000 under FAR Part 13) (desired dollar limit) $

Check box Warrant Level I
(Up to $100,000) (desired dollar limit) $
(Up to $25,000 under FAR Part 13) (desired dollar limit) $

Check box Warrant Level II (SAP)
(Up to $500,000 under FAR Part 8) (desired dollar limit) $
(Up to $100,000 under FAR Part 13) (desired dollar limit) $

Check box Warrant Level II
(Up to $500,000) (desired dollar limit) $

Check box Warrant Level II (a)
(Up to $50,000,000 under FAR Part 36) (desired dollar limit) $

Check box Warrant Level III
(Unlimited) (desired dollar limit) $

Check box Providing additional authority to approve and execute Grants, Cooperative Agreements and Other Transactions within designated warrant level above.

Check box Other Authority/Limitations:
b. Check box Change in Warrant Level and/or Dollar Limit:
  From Level   $ To Level   $    

c. Contracting Officer Primary Warrant Type:

Check box Procuring Contracting Officer (PCO)

Check box Administrative Contracting Officer (ACO).

Check box Warrant Authority covers PCO and ACO functions

d. Check box Termination of Warrant, effective date (dd-mmm-yyyy):
Reason for termination:

3. Provide a brief explanation why a warrant is required for the applicant:

4. Applicant's qualifications to be a Contracting Officer:

a. Meet educational and experience qualification requirements for current grade (check all that apply):

Check box Successfully completed all mandatory contracting courses or equivalents for current grade,

Check box Has the required experience for a contracting position,

Check box Have received a Baccalaureate degree from an accredited educational institution,

and/or

Check box Completed at least 24 semester credit hours, or equivalent study from an accredited educational institution in any of the following disciplines: accounting, business finance, law, contracts, purchasing, economics, industrial management, marketing, quantitative methods, and organization and management; and

Check box Held a civilian position in the GS-1102 occupational series on January 1, 2000.

b. Meet Federal Acquisition Certification in Contracting (FAC-C) requirements

Check box Certified at an appropriate level to support warrant obligations
Highest Achieved Certification Level (i.e., Level II)

c. Waiver

Check box The Senior Procurement Executive approved the Contracting Officer Warrant Waiver Request dated on .

5. Prior Warrant(s) Held

Check box None

Check box Yes. Check appropriate boxes and include obligation limit.

  Obligation Limit: Date: Agency
Check box Procuring Contracting Officer $    
Check box Administrative Contracting Officer $    
Check box Terminating Contracting Officer $    
Check box Grants Officer $    
Check box Warrant other than those above $    

SIGNATURES

Supervisor Endorsement: I recommend the above named individual be appointed as a Contracting Officer to enter into, administer and/or terminate contracts, and to make related determinations and findings. I certify the above named individual posses the qualifications as cited in FAR 1.603-2 and TAM 1201.603-2 as supported by attached documentation.

Supervisor Signature/Office
Date
Office Head
Date
Chief of Contracing Office
Date
Date Warrant Issued   Warrent Number  
Warrant Amount  
Date Warrant Termination Approved  
Federal Highway Administration | 1200 New Jersey Avenue, SE | Washington, DC 20590 | 202-366-4000