GSA1458

Motor Vehicle Maintenance, Repair and Service Purchase Order

Agency
GSA
Revision
Rev. 7/2023
Fillable fields
76
Pages
2
Official source
GSA form page
Checked
October 20, 2026
Fill GSA1458 online
Page 1 of form GSA1458

GSA Form 1458: Motor Vehicle Maintenance, Repair, and Service Purchase Order

GSA Form 1458, Motor Vehicle Maintenance, Repair, and Service Purchase Order, is a General Services Administration form, GSA 1458 (REV. 7/2023), Prescribed by APD 2800.12B, hosted in GSA's forms library. The footer says PREVIOUS EDITION IS NOT USABLE.

The front takes the vehicle's description, odometer reading, class, tag number, region, fleet management center and vehicle identification number, the repair facility and vendor details including business classification, Unique Entity Identifier (UEI), vendor number and whether the vendor is registered in the System for Award Management (SAM), a cost code, and the repairs authorized with their estimated costs. It has room for three supplements, agency contact details, Authorized By and Certified By signatures, and the total authorized amount, total modified amount and final cost. The back lists the Terms and Conditions: 23 clauses under the heading Federal Acquisition Regulation or Clause, each with an effective date. The form prints no instructions, OMB number or privacy statement.

You can fill it out free in your browser on this page and download the result without an account.

What's on GSA Form 1458

Vehicle and transaction details

Date, vehicle description, odometer reading, ACT number, contract number when applicable, whether an FMS 2553 transaction was prepared, class, tag number, region, FMC, sub FMC, VIN, date and payment type.

Repair facility and vendor

Name and address of repair facility, Billed To, vendor contact, telephone, vendor e-mail, vendor number, SAM registration and invoice number.

Business classification and cost code

Boxes for small, other than small, small disadvantaged, women-owned, HUBZone, emerging small, veteran and service disabled veteran, the UEI, and cost code 145, 180, 160, 190 or 811.

Authorized repairs

Under ONLY REPAIRS DESCRIBED BELOW ARE AUTHORIZED: date, description of repairs and estimated costs, then total estimated costs, plus remarks and comments.

Supplements and totals

Supplements 1 to 3 with date, signature and amount, the total cost, and the total authorized amount, total modified amount and final cost.

Back: terms and conditions

23 clauses with effective dates, from 52.204-7 System for Award Management (October 2018) to 552.232-78 Commercial Supplier Agreements - Unenforceable Clauses (July 2000).

How to complete GSA Form 1458

  1. 1

    Describe the vehicle

    Enter the date, vehicle description, odometer reading, class, tag number, region, FMC, sub FMC and vehicle identification number.

  2. 2

    Add the transaction numbers

    Enter the ACT number and the contract number when applicable, and check Yes or No for whether an FMS 2553 transaction was prepared.

  3. 3

    Enter the vendor

    Fill in the repair facility, Billed To, vendor contact and e-mail, business classification, UEI, vendor number, SAM registration and invoice number.

  4. 4

    List the authorized repairs

    Check one cost code, then enter the date, description and estimated cost of each repair and the total estimated costs.

  5. 5

    Record any supplements

    For each supplement, enter the date, the Supplemented By signature and the amount, then the total cost.

  6. 6

    Authorize and certify

    Add the agency contact, then the Authorized By and Certified By signatures, printed names and dates, and the total authorized amount, total modified amount and final cost.

Why fill Form GSA1458 on indox

You get the real form, filled in a browser tab, with nothing standing between you and the finished PDF.

  • Fill the form right in your browser, no software to install
  • Free to fill and free to download, with no account
  • The official blank straight from the GSA, not a copy someone retyped
  • Works on a phone, tablet or computer

What the form says

Authorized work

The form says ONLY REPAIRS DESCRIBED BELOW ARE AUTHORIZED, above the repair lines.

Terms and conditions

The back lists 23 clauses under the heading Federal Acquisition Regulation or Clause, including 52.232-25 Prompt Payment (January 2017) and 552.232-77 Payment by Government Commercial Purchase Card (March 2000).

Edition and authority

The footer reads GSA 1458 (REV. 7/2023), Prescribed by APD 2800.12B, and PREVIOUS EDITION IS NOT USABLE. GSA's page lists APD 2800.12B as its authority or regulation.

Where it goes

The form prints no address. It has a Billed To block and an agency contact block, and no instructions, OMB number or privacy statement.

Related forms

Who fills out GSA Form 1458?

  • The repair vendor

    The repair facility's name and address, vendor contact, telephone and e-mail, business classification, UEI, vendor number, SAM registration and invoice number.

  • The agency contact

    Agency contact name, e-mail and phone number.

  • Whoever authorizes the order

    Authorized By takes a signature, a printed name and the date. The form says only repairs described below are authorized.

  • Whoever certifies it

    Certified By takes a signature, a printed name and the date, beside the total authorized amount, total modified amount and final cost.

  • Whoever supplements it

    Up to three supplements each take a date, a Supplemented By signature and an amount.

The form does not say who prepares each block. Its blocks name these parties.

Official sources and the blank

Do it all with indox

View all 123 tools

Questions about Form GSA1458

Who issues GSA Form 1458?

The footer reads GENERAL SERVICES ADMINISTRATION, GSA 1458 (REV. 7/2023) and Prescribed by APD 2800.12B. GSA hosts it in its forms library.

Can an older edition of GSA Form 1458 be used?

The footer says PREVIOUS EDITION IS NOT USABLE. The current edition is REV. 7/2023.

What vendor details does the form ask for?

The repair facility's name and address, vendor contact, telephone and e-mail, business classification, Unique Entity Identifier (UEI), vendor number, whether the vendor is registered in SAM, and the invoice number.

What are the cost codes on GSA Form 1458?

The form has boxes for cost codes 145, 180, 160, 190 and 811, marked Check one. It does not explain the codes.

How are changes to the order recorded?

Up to three supplements, each with a date, a Supplemented By signature and an amount, followed by the total cost, total authorized amount, total modified amount and final cost.

What is on the back of GSA Form 1458?

Terms and Conditions: 23 clauses under the heading Federal Acquisition Regulation or Clause, each with an effective date, from 52.204-7 System for Award Management to 552.232-78 Commercial Supplier Agreements - Unenforceable Clauses.