GSA1781
Motor Vehicle Requisition
GSA Form 1781, Motor Vehicle Requisition, is a three-page General Services Administration (GSA) form, printed as GSA 1781 (REV. 9/2009) with GENERAL SERVICES ADMINISTRATION in its footer. GSA hosts it in its forms library. GSA's page lists a current revision date of 09/2009 and no authority or regulation.
The instructions say the form should be used by federal agencies for ordering standard type vehicles under Federal Standard numbers 122 (sedans and station wagons), 307 (light trucks 4 x 2 and 4 x 4), 794 (medium trucks 4 x 2 and 4 x 4) and 807 (heavy trucks 6 x 4 and 6 x 6), and nonstandard types under applicable Federal Standards. It says the form may be used as the requisitioner's own purchase order or requisition, and that it is only for ordering delivery to ONE consignee, any quantity of ONE item number.
Page 1 has the FEDSTRIP/MILSTRIP data line and blocks 2 to 11 for the order, funding, addresses, estimated cost and signatures. Page 2 has the instructions and page 3 a FEDSTRIP data chart and space for continued remarks. You can fill it out free in your browser on this page and download the result without an account.
Card columns 1 to 61: document and routing identifiers, media and status, stock code and NIIN, quantity, the requisition number (requisitioner, date, serial number), supplementary address, signal, fund, distribution, project and priority.
Agency order number, color(s) desired, the Federal Standard marked with an X and its alpha character, the standard item number and option codes, boxes for additional requirements or a nonstandard vehicle, and a contact for specification matters.
5A has a contractor order number, a justification, a printed statement on fair opportunity to compete under FAR 16.505(a) and (b), and boxes for Replacement, Addition or Direct Purchase. 5B has funding codes and a signed statement that funding has been approved.
The requisitioner's name and address, a vehicle delivery address if different than item 8 with a contact and telephone number, and the consignee mailing address with ZIP Code.
The estimated unit cost and total cost of the order.
The contractor requisition certification and the requisitioning officer, each with name and title, telephone and fax numbers, signature and date.
Item 1 says to enter the data under FPMR 101-26 and the chart on page 3. The chart says the document identifier is preprinted AOD, the routing identifier is preprinted GWO, and requisitioners shall not complete the stock number field for vehicle requisitions.
Item 3 says to indicate the color(s) desired, and if the manufacturer's standard color is acceptable, to insert Mfg. Std.
Mark an X by the applicable Federal Standard and show its alpha character. Then enter the complete standard item number and standard option code from that Federal Standard.
Item 4c says to mark X in the box, and that the requisitioner shall furnish a complete description and the vehicle standards or options required on a separate sheet attached to the form.
Complete the funding codes in 5B and sign the funding certification, then complete the signature blocks in 10 and 11.
The instructions say to submit the original and one copy of the completed form to the GSA Automotive Division address printed on page 2.
You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.
The instructions say to submit the original and one copy to U.S. General Services Administration, Federal Acquisition Service, Automotive Division (FFA), Washington, DC 20406.
The form says only one identical type (item number), for delivery to one consignee, may be listed on one form, in any quantity.
Item 1 points to FPMR 101-26 for the FEDSTRIP/MILSTRIP data, and block 5A prints a statement on fair opportunity to compete under FAR 16.505(a) and (b).
The PDF prints no OMB number, time estimate or Privacy Act statement.
GSA's page lists form number GSA1781, a current revision date of 09/2009 and no authority or regulation.
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The instructions say federal agencies use it to order vehicles. The form names these people and offices.
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The footer reads GENERAL SERVICES ADMINISTRATION and GSA 1781 (REV. 9/2009). GSA hosts it in its forms library.
The instructions say federal agencies use it to order standard and nonstandard vehicles, and that it may be used as the requisitioner's own purchase order or requisition.
No. The form says to use it only for ordering delivery to one consignee, any quantity of one item number.
The instructions say to submit the original and one copy to U.S. General Services Administration, Federal Acquisition Service, Automotive Division (FFA), Washington, DC 20406.
Mark X in the nonstandard vehicle box. Item 4c says the requisitioner shall furnish a complete description and the standards or options required on a separate sheet attached to the form.
The FEDSTRIP chart on page 3 says requisitioners shall not complete the stock number field, columns 8 to 22, for vehicle requisitions.
Item 3 says that if the manufacturer's standard color is acceptable, insert Mfg. Std.