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GSA Assisted Acquisition AHC Form

This form is to be used by GSA Regional Telecommunications Managers when assisting in the acquisition of a Networx service for an agency. The form will generate an AHC in the proper format and submit it to the GSA DAR Administrator for registration with the appropriate Networx contractor. Detailed instructions for form use can be found in the Networx Transition Library.

Directions and Information:

1. Fill out all fields.
2. This information serves as official notification to Hillary LaMay, GSA Networx DAR Administrator of the AHCs you wish to submit for registration.
3. Send completed form to hillary.lamay@gsa.gov by clicking the Generate AHC and then the Submit button at the bottom of this form.

Your Contact Information

Full Name:
Street Address:
Street Address2:
City:
State:	Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Federated States of Micronesia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Wicked Dark Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming
Zip:
Email:

AHC Information

AHC:	(read-only)
GSA Assisted Acquisition Identifier:	(read-only)
Region:	Region 1 Region 2 Region 3 Region 4 Region 5 Region 6 Region 7 Region 8 Region 9 Region 10 Region 11 - NCR
Vendor/Contract Name:	AT&T Universal AT&T Enterprise Level 3 Enterprise Qwest Universal Qwest Enterprise Sprint Enterprise Verizon Universal Verizon Enterprise
Agency's AB Code (Open):
Service:	You must select a Vendor/Contract Name in order to proceed
Open:

GOVERNMENT LINKS

• Networx Transition Information Portal (TIP)