APPENDIX I

CONTRACTING OFFICER REPRESENTATIVE QUALIFICATION STATEMENT

Use a format similar to this with the following information:

Last/Middle/ First Name:

Title, Series, Grade:

Agency/Office/Organizational Identification Number (four-digit code):

Office Address:

American Citizen: [ ] Yes [ ] No

Telephone Number: Fax Number: E-Mail Address:

COR Experience:

Information on each position should include :(Begin with your current position

and work back until you have demonstrated the required relevant work

experience).

Name of Employer

Dates Employed

Title of Position

Description of Work

Percent of Time Spent on COR Duties

Type of Acquisition Project (e.g., Policy, IT, Construction, A/E, General, SAP)

Education:

High School: Yes_____ No_____

College: Yes_____ No_____ Graduated Yes_____ No_____

Graduate School Yes_____ No_____ Graduated Yes_____ No_____

Major Field of Study: _____________________________________________

Procurement Related Training: (Attach a copy of your ACMIS printout or equivalent)

Name of Course

Dates Attended

Training Mode (e.g., tests, classroom, waiver, etc.)

Name of School/Vendor

Number of Training Hours Per Course