Contractor Documentation for Request for Equitable Adjustments (Modifications) Based on COVID-19
Impacts
This questionnaire is supplemental documentation for requests for equitable adjustment (REA) or
modifications related to performer impacts due to COVID-19. Submit this questionnaire with any formal
REA to help ensure DARPA receives all applicable documentation to quickly make a decision on any
adjustment(s). Failure to submit this questionnaire, and answer all questions thoroughly, will likely
require follow up from the contracting/agreements officer and delay DARPA’s ability to make a timely
decision on your request.
Performers are strongly encouraged to submit this questionnaire and any associated REA as soon as
practicable. DAPRA has limited financial resources and may have to make difficult program decisions,
having a more complete picture on the impact for our entire performance base will help DARPA make
timely informed decisions.
Please fill out a separate questionnaire for each contract or agreement requesting relief and for each
authority you are requesting relief under (e.g., Section 3610 of cares act, existing contract clause, OMB
guidance).
Questionnaire and Supplemental Documentation
1. What is the contract or agreement number?
2. Explain how COVID-19 restrictions or precautions directly impacted your ability to complete
work on this specific DARPA contract or DARPA agreement. Provide a detailed explanation of
the circumstances that caused the need for the equitable adjustment, and the reasonableness
of the delay or changed circumstances.
3. What steps have you taken to minimize COVID-19 impacts on this contract or agreement (e.g.,
telework, existing leave, and training)?
4. Under what authority are you requesting this REA (e.g., 3610 CARES Act, existing contract
clause, OMB direction)? If requesting an REA under different authorities for one contract or
agreement, submit a questionnaire for each.
5. Will your company receive, has your company received, or is your company eligible to receive
any reimbursement for COVID-19 related costs by other means, to include any assistance from
the federal, state, or local government (e.g., SBA’s Paycheck Protection Program)? If so, explain
and calculate how you have deducted this other assistance from your REA. Provide self-
certification by a corporate official that this information is current and accurate and that all
other reimbursements from federal, state or local government have been reported to DARPA.
6. Has your contract or agreement been determined as mission critical or has your company been
determined to be within the Defense Industrial Base Essential Critical Infrastructure? If so,
explain why one, or both, of these designations has not eliminated or reduced COVID-19
impacts on the contract or agreement.