Commonwealth of Pennsylvania
Award Form
Please enter the ID for the Award Form.
This form is to be completed by the Agency issuing the Contract/PO for procurements that exceed the dollar thresholds established in Part 1, Chapter 7 of the Procurement Handbook for this identified procurement.
  1. Agency provides, if  full delegation is granted.
  2. BOP/OIT provides, if they led the solicitation and the agency executed the resulting contract/PO.
  3. BOP/OIT provides, if they led the solicitation and executed the resulting contract.
Please Choose one of the Following
Contract Award Information
Date:   7/1/2015
Agency Contact Person:*
Contact Tel#:*
Format : ###-###-####
Contact Email:*
Project Manager:*
Project Title:*
Solicitation Number:*
Description of Project* * For IT-Services and IT Materials, please choose IT

Method of Procurement:*

Costars (DGS Use Only):

No Of Contracts:*

Please click the Go button after Entering the Number of Contracts

Contract Number
Start Date
End Date (w/o renewals)
New End Date
Supplier Name
Supplier Number
Supplier FIN# If only SSN,Leave Blank
Contract Term:* Original Term: year(s)
Number of Renewals: ea year(s) Enter decimal for months
Contract Value:* Per Original Contract Term without Renewals
Please identify below the direct labor performed under the contract that will be performed outside the United States and not within the geographical boundaries of a party to the World Trade Organization Government Procurement Agreement and identify the country where the direct labor will be performed.
Domestic Workforce Utilization:(Mandatory for Services, RFPs and Services Multiple Awards) Percent Committed on Shore 
Country (if not in USA or WTO)
SDB Commitment: %:

$ (if % above is based on other than Contract Value)
Select SDB Type
A copy of the Domestic Workforce Certification, and a copy of the small diverse business commitments made in the contract must accompany this form, and if applicable, a copy of the Small Business Procurement Initiative self-certification.
Upload Documents*

Documents naming conventions should not contain special characters (i.e. -, (), &, etc).
Submit this completed form and attachments within (10) ten days after contract/PO executed.

By clicking the Submit button, the form will be submitted to DGS/OIT depending upon the category selected.