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Staff Manual Guide 2620.1, Attachment A

(HEW-393 Preprinting Requisition Number)

The following certificate shall be attached to, or made a part of, all HEW-393 requisitions for Executive Wood Furniture. It shall be certified and approved by Headquarters or the Field, as appropriate.

Certificate

This is to certify that the furniture described herein is being purchased to satisfy new requirements (explain), or as replacement for item(s)in use (explain). Furniture is being purchased for Name, Grade, Position Title, who meets the eligibility requirements established in FDA Staff Manual Guide 2620.1. Suitable property to meet this requirement is not available from unassigned inventories, excess, or reassignment from persons under my jurisdiction who are assigned, but not otherwise entitled to, this type of furniture.

(HEADQUARTERS)

 

CERTIFIED: ___________________________
Director, Bureau of Drugs
APPROVED: _____________________________
Chief, Procurement, Property
and Facilities Management Br.
       
DATE: ___________________________ DATE: _____________________________

 

(FIELD)

 

CERTIFIED: ___________________________
Region V (Detroit)
APPROVED: _____________________________
RFDD, Region V (Chicago)
       
DATE: ___________________________ DATE: _____________________________