GRC 644 will be used to request Pre-award Clearance on ... - NASA

INSTRUCTIONS
GENERAL -- <strong>GRC</strong> <strong>644</strong> <strong>will</strong> <strong>be</strong> <strong>used</strong> <strong>to</strong> <strong>request</strong> <strong>Pre</strong>-<strong>award</strong> <strong>Clearance</strong> on contracts and
subcontracts of $10M or more (excluding construction). Submit the original and two (2) copies.
Use a separate set of forms for the contrac<strong>to</strong>r and each subcontrac<strong>to</strong>r requiring clearance.
Blocks 1 through 18, where applicable, shall <strong>be</strong> completed by the Contracting Officer, and
Blocks 19, 20 and 21 <strong>will</strong> <strong>be</strong> completed by EEO.
<strong>Pre</strong>-<strong>award</strong> <strong>Clearance</strong>s shall <strong>be</strong> <strong>request</strong>ed at least thirty (30) calendar days prior <strong>to</strong> the
proposed date of <strong>award</strong>.

REQUEST FOR PRE-AWARD EEO APPROVAL
DATE
TO: Office of Equal Opportunity (EEO) FROM: Last Name First Name MI Mail S<strong>to</strong>p
1. Please obtain the necessary pre-<strong>award</strong> EEO <strong>Clearance</strong> for:
SUBJECT: EEO <strong>Pre</strong>-<strong>award</strong> clearance per FAR Subpart 22.805
PRIME CONTRACTOR SUBCONTRACTOR CONTRACT
2. CORPORATE NAME 3. CITY (Corporate)
CONTRACT
MODIFICATION
4. DIVISION NAME 5. STREET ADDRESS
6. CITY 7. PHONE NO. 8. PLACE OF PERFORMANCE
9. NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEMS (NAICS) CODE 10. PURCHASE REQUEST NO.
11. ANTICIPATED DATE OF AWARD 12. AMOUNT OF AWARD
13. IF MODIFICATION, FURNISH NO. 14. CONTRACT NO. 15. CURRENT DOLLAR VALUE
16. BRIEF DESCRIPTION OF AWARD
17. The contrac<strong>to</strong>r has has not previously held any government contracts or subcontracts.
18. SIGNED
19. Contrac<strong>to</strong>r is currently in compliance with the EEO laws, therefore the contract may <strong>be</strong> <strong>award</strong>ed.
EEO
CONFIRMATION
Contrac<strong>to</strong>r is currently in violation with the EEO laws, therefore the contract may not <strong>be</strong> <strong>award</strong>ed.
Contrac<strong>to</strong>r has failed <strong>to</strong> develop an acceptable affirmative action program, however, if the C.O.
determines that the proposed contract is for less than $50,000 or the company has fewer than 50
employees and, in either case, has not previously <strong>be</strong>en required <strong>to</strong> develop an affirmative action program,
the <strong>award</strong> may <strong>be</strong> made.
Other
20. CONTRACT COMPLIANCE OFFICER
21. DATE
<strong>GRC</strong> <strong>644</strong> (SEP 09)
See work page for instructions