CLAIM,
PASS-THROUGH TO GOVERNMENT
(SUB-CONTRACTOR)
Date
Mr. Prime Contractor
(Address)
Re: Claim for Equitable Adjustment
(Subject)
Contract number
Dear Sir:
Regarding my Request for Change Order dated
, I consider this matter to be in dispute. I am claiming an increase in my
sub-contract amount of $ , and a time extension of calendar days.
(Note: If you have any additional data to
submit, include this sentence: Attached please find two copies of additional
supporting data.)
I believe that the claim is self-explanatory
regarding the damaging events and extra costs and time of performance which we
have incurred under this contract. However, should you require additional
information regarding this claim, please contact me at telephone number (000)
000-0000.
I request that you sponsor this claim to the
Government, properly certified by you, and that you request a final written
decision of the Contracting Officer within sixty (60) days, as provided for by
the "Disputes" clause of the prime contract. I also ask that you send
me a copy of your cover letter forwarding the claim to the Government.
Although I believe the Government to be
responsible for this change, my contract is wit you, and I must reserve my
rights to pursue this matter against you, should efforts to obtain fair
compensation from the Government fail, or should you refuse to sponsor my claim
to the Government.
I hereby certify that the claim is made in
good faith; that the supporting data are accurate and complete to the best of
my knowledge and belief; that the amount requested accurately reflects the
contract adjustment for which the Contractor believes the Government is liable;
and that I am duly authorized to certify the claim on behalf of the Contractor.
(Note: Last paragraph not required for a
claim of less than $50,000.00)