DoN Wireless Contract Template
(Initial Version, subject to continuous updating)
DATED 2 January 2015
· Requesting Activity Name:
· Activity Point of Contact:
· Activity Phone Number:
· Command Shipping Address
· Identify who will be given access to online reporting and invoice receipt notice (WAWF)
o Name
o Email
o Phone Number
· Is there a previous order number for this service? Yes No
If Yes, Provide the contractor name:
If Yes, Provide the order number:
If Yes, Provide the current account number:
Provide Order performance period:
· Contracting officer representative and/or commands wireless manager
o Name
o Email
o Phone Number
§ Please Fill out the WAWF info below:
Service Acceptor DODAAC:
Local Processing Office (Certifier):
Paying Office DODAAC:
Acceptor/COR Email Address:
Financial Point of Contact:
**Note: If more than one WAWF POC, provide above info for each WAWF POC
Defining the Requirement
o Every 500 minute Plan shall be assigned only one user.
o Every 4000 minute or Unlimited Plan shall be assigned one user unless additional users are assigned to share the total number of minutes under the 4000 minute plan. Unlimited Plans are not capable of having more than one user assigned.
§ In circumstances where a single plan will utilize more than one user the command shall only mark the number of plans required to be spread among the total users (To be addressed in the ELIN template below).
§ Example: A command has 4 users that will utilize two 4000 Bucket (SHARED) Voice Minutes under ELIN B01. In this circumstance the command will fill in a quantity of 2 under the quantity.
***NON -NMCI certified Smart Phones cannot be used by those on the NMCI Network***
· Commands are required to check each of the four Contractors list of ELINS posted on the website unless valid exemption [in accordance with FAR 16.5] applies.
· Please check the following boxes for each contractor prices requested
o AT&T Checked Yes No
§ Date Requested
o Sprint Checked Yes No
§ Date Requested
o T-Mobile Checked Yes No
§ Date Requested
o Verizon Checked Yes No
§ Date Requested
· If answered ‘No’ to any of the contacted above do you have a valid exemption Yes No
o If NO, you must check the ELIN(S) on the website and add accordingly.
o If yes, attach a valid sole source statement or Justification and Approval to this document before submitted.
***NMCI transition Costs are not a valid exemption from contacting Contractors for pricing***
Contractor / AT&T Price / Sprint Price / T-Mobile Price / Verizon PriceTotal Price offered by Each Contractor
· Commands shall identify the User (Title/Section) and the ELIN(S) that individual will be utilizing in the table below. In addition, identify current phone numbers and/or device number.
· Many of the ELIN(S) have devices included that are not separately priced. Commands shall specify in the table below if it intends to keep current devices (if the previous contractor is selected for award). If the current contractors is not selected or there is no previous order in place for the requested service the ordering officer shall contact your command with available items on selected ELINS.
· Also if current devices are retained the device name and number shall be included to ensure compatibility with current contracts.
Command User*Current Phone Number** / Title/ Section *** / Replace? Y or N / Ported? Y or N**** / User Signed Accountability Form? Y or N / ELIN Number Utilized*****
***Table Notes**
* If more services or devices are needed than there are spaces above, add a sheet to this template with the additional users in the same format as the table.
** Only add the number if a user is utilizing a current phone number.
*** The Title/Section is the individual user’s name that will be assigned or is assigned the phone number or device.
**** Fill in if current user phone number will be retained.
***** Applies to the ELIN number selected in the previous table under which the selected user will have service.
· Is your command on the NMCI Network Yes No
o If Yes, Are these services currently being provided under another task order Yes No
§ If No, proceed on with the remainder of the form.
§ If yes, contact your business office and ask what the cost will be for switching from one provider to another. Fill in the contractor switching costs (if applicable) in the table below.
NMCI Transition CostsContractor / AT&T / Sprint / T-Mobile / Verizon
NMCI Cost
Total Cost of Obtaining service
***Table Notes**
* Total cost of obtaining services: The NMCI cost plus the offered cost of the Contractors from the section above.
** NMCI costs are a onetime cost and shall not reflect on any option period requested.
· The contractor that offers the lowest total price to the Government at this point is at the quoted dollar amount of .
o The total quoted dollar amount should not include the NMCI Cost.
o The NMCI costs labeled in this table are for evaluation purposes only and should not be included on any funding document or order.
· Does command require service or devices that were not specified on the ELINS? Yes No
o If No, Proceed with remainder of the form.
o If Yes, Check the category that items or service falls in below.
§ International [Voice, Data (BlackBerry & Smart Phone), Data Card, Mobile to Mobile, PTT, Texting & Tethering, etc.] Yes No
· If Yes, fill out the International wireless worksheet and attach to this document.
§ Non-specified cellular equipment/Material Yes No
· If Yes, Please provide Justifications for each:
· If Yes, provide the salient characteristics of each item that can be recognized by all Contractors unless an exemption exists.
· List of salient Characteristics
§ Non-specified cellular services Yes No
· If Yes, provide the salient characteristics of service that can be recognized by all Contractors unless an exemption exists.
· If Yes, Please provide Justifications for each:
· List of salient Characteristics
· Fill in the pricing table below with quantities, unit of issue and prices offered from each contractor
OTHER CELLULAR SERVICES & DEVICESNon priced ELIN Number / Description / Need Quantity / AT&T Price / Sprint Price / T-Mobile Price / Verizon Price
G01 / International [Voice, Data (BlackBerry & Smart Phone), Data Card, Mobile to Mobile, PTT, Texting & Tethering, etc.] / * / * / * / *
G02 / Non-specified cellular equipment/Material
G03 / Non-specified cellular services
G04 / Taxes, FCC charges, etc, expressed as a percentage
Total Price offered by Each Contractor
* Should be the total amount that each vendor offered in response to the defined requirement on the international wireless template.
· Does your command require evaluation on any specific factors other than price? Yes No
If yes, define each on the lines below and assign an evaluation rank in order of importance (1 being most important). If two or more items have equivalent rank they shall be checked with the same value of importance. An example is below.
**Price is always an evaluation factor****
§ Price, Lowest Price Technically Acceptable (LPTA)
Price Factor Number Rank 1 2 3 4
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· Indicate the total amount for ELINS and other items (Priced from market research) from the each of the vendors in the table below.
Total Charge per Contractor including NMCI CostsContractor / AT&T / Sprint / T-Mobile / Verizon
Total cost
· Select the lowest total cost vendor from the above table and subtract out the option pricing and any NMCI costs and fill it in the line below
o The lowest price contractor that fills the need is
o Total Amount
o This is your estimated amount and the amount that should be reflected as the nit price on the purchase request.
o Total to be Provided
o Requisition Number
Prepared By:
Typed Name / Signature / Date***** COMMANDS SHALL RETAIN THIS DOCUMENT ELECTRONICALLY SO IT CAN BE SENT TO THE BUYING ACTIVITY. *****
Attachments
1. International Wireless Worksheet
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