Contact: Name Email x-IT-OPT. AGENCY Division/Program Contract Name/Contract Number Contract ID: ADPICS BPO No.: (Enter original BPW approval information, i.e. date and item Contract Approved: number) DoIT Item x-IT (mm/dd/yyyy) Contractor Name, City and State Contractor: (Enter short narrative describing contract) Contract Description: (Enter which option is being exercised such as, to Option Description: “Request exercise the second of three one-year renewal options.”) (Enter inclusive dates to include number/length of renewal options, Original Contract Term: i.e. 7/1/2007 6/30/2009 (W/1 one-year renewal option). – (Enter inclusive dates of the renewal, i.e. 9/1/2007 8/31/2008. Option Term: – Renewal option start and end dates must agree with the original Contract as modified (if applicable) and the ADPICS renewal BPO.) (Enter base period amount of the original contract) Original Contract Amount: (Enter dollar amount of the renewal option followed by the time Option Amount: duration, such as Year)”) “(1 (Enter or a discrete amount if there was any prior Prior Modifications/Options: “None” modification(s) and/or option(s) and Attachment” or Attachment X” (if there is more “see “see than 1 Attachment). When there was any prior modification(s) or option(s), create an attachment with prior modification/option renewal history. For each prior mod or option include: the amount, a brief description, and the period covered, including BPW item numbers and approval dates, if applicable.) (Enter the dollar total, which is the sum of the amounts of Revised Total Contract Amount: the original contract, plus all prior modifications/options, plus this option.) Competitive Sealed Proposals, Competitive Sealed Original Procurement Method: Bidding, Sole Source, etc. Enter MBE participation % MBE Participation: Enter MBE compliance % MBE Compliance:
Contact: Name Email x-IT-OPT. AGENCY Division/Program Contract ID: Contract Name/Contract Number ADPICS BPO No.: Contract Approved: (Enter original BPW approval information, i.e. date and item number) DoIT Item x-IT (mm/dd/yyyy) Contractor: Contractor Name, City and State Contract Description: (Enter short narrative describing contract) Option Description: (Enter which option is being exercised such as, “Request to exercise the second of three one-year renewal options.”) Original Contract Term: (Enter inclusive dates to include number/length of renewal options, i.e. 7/1/2007 – 6/30/2009 (W/1 one-year renewal option). Option Term: (Enter inclusive dates of the renewal, i.e. 9/1/2007 – 8/31/2008. Renewal option start and end dates must agree with the original Contract as modified (if applicable) and the ADPICS renewal BPO.) Original Contract Amount: (Enter base period amount of the original contract) Option Amount: (Enter dollar amount of the renewal option followed by the time duration, such as “(1 Year)”) Prior Modifications/Options: (Enter “None” or a discrete amount if there was any prior modification(s) and/or option(s) and “see Attachment” or “see Attachment X” (if there is more than 1 Attachment). When there was any prior modification(s) or option(s), create an attachment with prior modification/option renewal history. For each prior mod or option include: the amount, a brief description, and the period covered, including BPW item numbers and approval dates, if applicable.) Revised Total Contract Amount: (Enter the dollar total, which is the sum of the amounts of the original contract, plus all prior modifications/options, plus this option.) Original Procurement Method: Competitive Sealed Proposals, Competitive Sealed Bidding, Sole Source, etc. MBE Participation: Enter MBE participation % MBE Compliance: Enter MBE compliance %
Template-Renewal.docx