Fill and Sign the Kottak Life Insurance Form

DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION Part 853—Forms SUBCHAPTER H—CLAUSES AND FORMS PART 853—FORMS Sec. 853.000 Scope of part. Subpart 853.1 – General 853.107 Obtaining forms. Subpart 853.2 – Prescription of Forms 853.201 853.201-1 853.213 853.215 853.215-70 853.236 853.236-70 853.271 853.271-1 853.271-2 Federal acquisition system. Contracting authority and responsibilities (SF 1402). Simplified acquisition procedures (SF’s 18, 30, 44, 1165, 1449, and OF’s 336, 347, and 348). Contracting by negotiation. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. Construction and architect-engineer contracts. VA Form 10-6298, Architect-Engineer Fee Proposal. Loan Guaranty, Education and Vocational Rehabilitation and Employment Programs. Loan Guaranty Program (VA Forms 26-6724 and 26-1839). Education Programs. Subpart 853.3 – Illustration of Forms 853.300 Scope of subpart. AUTHORITY: 38 U.S.C. 501; 40 U.S.C. 121(c); and 48 CFR 1.301-1.304. January 2008 Edition 853-1 DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION Part 853—Forms This page intentionally left blank. January 2008 Edition 853-2 DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION Part 853—Forms 853.000 Scope of part. This part prescribes VA forms for use in the acquisition of goods and services. It only identifies forms that are used between VA and its contractors or the general public. It does not identify forms for uses internal to VA or between VA and another Federal agency. SUBPART 853.1 – GENERAL 853.107 Obtaining forms. The VA forms may be obtained from any VA contracting office or by requesting such forms from the Deputy Assistant Secretary for Acquisition and Materiel Management, Department of Veterans Affairs, 810 Vermont Avenue, NW., Washington, DC 20420. SUBPART 853.2 – PRESCRIPTION OF FORMS 853.201 Federal acquisition system. 853.201-1 Contracting authority and responsibilities (SF 1402). tandard Form (SF) 1402, Certificate of Appointment, is used in accordance with FAR 1.603-3, Appointment, to appoint VA contracting officers under VA’s Contracting Officer Certification Program (see 801.690-6). 853.213 Simplified acquisition procedures (SF’s 18, 30, 44, 1165, 1449, and OF’s 336, 347, and 348). The following forms are prescribed as stated in this section for use in simplified acquisition procedures, orders under existing contracts or agreements, orders from required sources of supplies and services, and orders for other supplies or services: (a) VA Forms 90-2138, Order for Supplies or Services, or 90-2138-ADP, Purchase Order for Supplies or Service, shall be used as indicated in 813.307. They may be used in lieu of OF 347, Order of Supplies and Services, or Standard Form 1449, Solicitation/Contract/Order for Commercial Items. (b) The following forms are for use for obtaining indicated medical and dental services within the limitations prescribed in 813.307: (1) VA Form 10-7078, Authorization and Invoice for Medical and Hospital Services. January 2008 Edition 853-3 DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION Part 853—Forms (2) VA Form 10-7079, Request for Outpatient Medical Services. (3) VA Form 10-2570d, Dental Record Authorization and Invoice for Outpatient Service. (c) VA Form 10-2511, Authority and Invoice for Travel by Ambulance or Other Hired Vehicle, will be used as prescribed in 813.307. (d) VA Form 10-2421, Prosthetics Authorization and Items and Services, will be used for indicated procurements not to exceed $300 as prescribed in 813.307. 853.215 Contracting by negotiation. 853.215-70 VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA. VA Form 10-1170, Application for Furnishing Nursing Home Care to Beneficiaries of VA, will be used for establishing contract nursing home care for VA beneficiaries. 853.236 Construction and architect-engineer contracts. 853.236-70 VA Form 10-6298, Architect-Engineer Fee Proposal. VA Form 10-6298, Architect-Engineer Fee Proposal, shall be used as prescribed in 836.606-71. 853.271 Loan Guaranty, Education and Vocational Rehabilitation and Counseling Programs. 853.271-1 Loan Guaranty Program (VA Forms 26-6724 and 26-1839). (a) VA Form 26-6724, Invitation, Bid, and/or Acceptance or Authorization, will be used in obtaining services specified in Subpart 871.1. (b) VA Form 26-1839, Compliance Inspection Report, will be used for inspection of repairs for properties under the Loan Guaranty Program as specified in 846.472. 853.271-2 Education Programs. To obtain education or rehabilitation services, contracting officers may use an individual written contract or VA Form 28-1905, Authorization and Certification of Entrance or Reentrance into Rehabilitation and Certification of Status. January 2008 Edition 853-4 DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION Part 853—Forms SUBPART 853.3 – ILLUSTRATION OF FORMS 853.300 Scope of subpart. VA Forms will not be illustrated in this VAAR. Persons wishing to obtain copies of VA forms prescribed in the VAAR may do so in accordance with 853.107. VA forms may also be available on the Web at http://www.va.gov/vaforms/. January 2008 Edition 853-5 DEPARTMENT OF VETERANS AFFAIRS ACQUISITION REGULATION Part 853—Forms This page intentionally left blank. January 2008 Edition 853-6