5153.303-4 Format for a justification review document for other than full and open competition.

Control No:

Justification Review Document for Other Than Full and Open Competition

Program/Equipment:

Authority:

Amount:

Prepared by:

Typed Name: DSN: _____________________

Title: Date: _____________________

E-mail:___________________________

Contracting Officer:

Typed Name: DSN: ______________________

Date Reviewed: ___________________

E-Mail: __________________________

Technical Representative:

Typed Name: DSN: _____________________

Title: Date Reviewed: _____________

Requirements Representative:

Typed Name: DSN: ______________________

Title: Date Reviewed: _____________

Reviews: I have reviewed this justification and find it adequate to support other than full and open competition.

Program Manager (1)

Typed Name: DSN: ______________________

Signature: ______________________Date: ______________________

Legal Counsel

Typed Name: DSN: ______________________

Signature: ______________________Date: ______________________

Command Advocate for Competition

Typed Name:DSN: ______________________

Signature: ______________________Date: ______________________

Senior Contracting Official

Typed Name: DSN: ______________________

Signature: ______________________Date: ______________________

(1) Add Program Executive Officer signature block when item is Program Executive Officer managed.

Head of the Contracting Activity

Typed Name:	DSN: ______________________
Signature: ______________________	Date: ______________________