15. DD1391 FSRM TEMPLATE 2020-02-05.docx

1. COMPONENT

[MAJCOM]

FY 20[XX] PROJECT DATA

2. DATE

DD MMM YY

3. INSTALLATION AND LOCATION

BASE/SITE, STATE or COUNTRY

4. PROJECT TITLE:

[descriptive verb] [facility name/descriptor] [facility number] [phase]

5. PROGRAM ELEMENT

Sust ***78 R&M ***76 If project includes multiple PECs, list the predominant PEC

6. CATEGORY CODE

XXXXXX

If MULTI, list in Block 11

7. PROJECT NUMBER

[4-digit GEOLOC][2-digit FY indicator][4-digit generated number][applicable suffix]

8. PROJECT COST ($000)

$XXX.X

9. COST ESTIMATE

PRIMARY FACILITIES

$[1+2]

REPAIR

Total Primary Facility Repair Cost

$[1]

CONSTRUCTION

Total Primary Facility Construction Cost

$[2]

SUPPORTING FACILITIES

$[3+4]

REPAIR

Total Supporting Facilities Repair Cost

$[3]

CONSTRUCTION

Total Supporting Facilities Construction Cost

$[4]

Sub Total REPAIR

$[1+3]

DB Design Cost (4%) [if applicable]

SIOH (5.6%)

TOTAL REPAIR

$[5]

Sub Total CONSTRUCTION

$[2+4]

DB Design Cost (%) [if applicable]

SIOH (5.6%)

TOTAL CONSTRUCTION

$[6]

TOTAL PROJECT COST [match block 8]

$[5+6]

Requirements not funded by the project

Unfunded costs

Design-Bid-Build Design Costs

Communications Equipment

Companion Project FXSB204567CB

This project will be executed as a [Design Build/Design Bid Build] project.

This estimate is based on a XX% complete design as of DD MMM YYYY.

Note: A currency exchange rate of XX% was applied to convert costs from [Euros] to USD.

Note: This project is planned for execution in FY 20XX. Costs as shown represent an escalation factor of X.X% per year from FY20XX costs.

ITEM

[project title] FXSB204567PA

$[7]

[project title] FXSB204567PB

$[8]

[project title] FXSB204567PC

$[9]

[project title] FXSB204567PD

$[10]

FXSB204567 TOTAL PROJECT COST

$[Block 8 +7+8+9+10]

See DD1391c for Block 9 and Block 10 information for each phase/child project.

This project will be executed as a [Design-Build/ Design-Bid-Build] project.

This estimate is based on a XX% complete design as of DD MMM YYYY.

Note: A currency exchange rate of XX% was applied to convert costs from [Euros] to USD.

Note: This project is planned for execution in FY 20xx. Costs as shown represent an escalation factor of X.X% per year from FY20XX costs.

10. DESCRIPTION OF PROPOSED WORK:

(SUCCINT AND DESCRIPTIVE) (See Section 10 of FSRM Business Rules) Describe the scope of work, using a separate paragraph for each work classification used. Do not describe sequencing as phasing.

Include major functions, architectural features, site work, items needed to be complete and usable, demolition required, capitalized work, abatement, and other descriptions necessary to explain the project. Avoid the use of verbs or other language that would indicate an inaccurate work classification, such as “repair/construct” when you are describing maintenance. Do not describe sequencing of the work during execution as ‘phasing’. Do not describe the purpose or mission requirement of the facility. Do not duplicate Block 11 information.

MAINTENANCE

[TEXT}

REPAIR

[TEXT]

CONSTRUCTION

[TEXT]

Describe any temporary facility requirements, such as swing space which must be provided, re-routing traffic or utilities, etc. Include related construction, leases, and other activities that will be required to be carried out as part of the project.

Note the most current design status (what percentage of the design is complete and the “as of” date, as in, “Project design is 25% complete as of 15 May 2021). The design date and percentage must be equal to or greater than the percentage and date listed at the bottom of Block 9. The design date and percentage listed in Block 10 must be accurate as of the signing of the DD1391. The design date and percentage listed in Block 9 must be accurate as of the estimate providing costs in Block 9.

Block 10 of the parent project shall reference the project name and number of all associated child projects, e.g., “The following projects are attached to this requirement: [list child project names and numbers]”.

Phased and Multiple-Facility Projects. Programmers will use a single DD1391c to show detailed Block 10 information for all child projects within the overall project. Block 10 of the parent project will include a detailed description of the overall project in accordance with the guidance above. Block 10 of each child project will ONLY describe the work for THAT child project. In the DD1391c, programmers should show Blocks 9 and 10 together for each child project.

Block 10 of the each child project shall reference the associated parent project name and number, e.g., “This project is attached to the following requirement: [state parent project name and number]”.

Sustainable principles, to include life cycle cost-effective practices, will be integrated into the design, development, and construction of the project in accordance with UFC 1-200-02.

11. REQUIREMENT

(See Section 11 of the FSRM Business Rules)

FACILITY PURPOSE. [This is a few sentences about the respective mission and how the facility supports/enables it—the mission requirement—why does the facility exist. Briefly explain the installation mission and the purpose of the facility to the installation mission, MAJCOM mission, COCOM mission, and/or Strategic Plans (e.g. Strategic Master Plan, A4 Flight Plan, etc.). What key activities take place in the facility (including, but not limited to, units/air frames supported, numbers of passes & Gross Weight on Take-Off (GWT), numbers of occupants or bed spaces, utilities demand in peak/daily usage, required pressures, retention volumes, etc.)? ]

MISSION-RELATED CONSTRUCTION STANDARDS: [State any mission-drive compliance requirements, e.g., ICD 705.]

TENANT OR SUPPORTED SERVICE REQUIREMENT: [State whether or not the requirement is driven by a tenant or supported service. e.g. “This is an ARNORTH supported service requirement.”

“This is an AFRL tenant requirement.”

“This is not a tenant or supported service requirement.”]

CURRENT SITUATION & IMPACT

[See Section 11.2. of the FSRM Business Rules] [Describe shortfalls and impacts to meeting the requirement—why does the state of the facility fall short of the requirement and what is the impact to the mission. Includes pertinent information about the facility and actions taken to mitigate the current situation. Details are important.]

PROJECT

[See details in Section 11.3. of the FSRM Business Rules] [Do not re-state work description from Block 10. How will project enable the facility to meet the requirement and resolve the current situation? How does it align with asset management principles? If phased, note that it is phased and briefly explain why.]

ADDITIONAL

[See details in Section 11.4. of the FSRM Business Rules] [Provide information in the order listed below] PROJECT COST: [$X, matches Block 8] SOURCE OF FUNDS: [type of funds—O&M, RDT&E, WCF, etc.] CONSTRUCTION AREA COST FACTOR: [ACF per DoD published guidance] [If project includes construction, include following statement] The FYXX DoD Area Cost Factor is [value] at [location], resulting in a statutory authority of [$cost limit] for Unspecified Minor Construction.

PRICING DATA SOURCE: [e.g., RS Means Cost Database 2015] EXECUTION AGENT: Intended execution agent is [USACE/NAVFAC/ETC] ESTIMATED MILCON REPLACEMENT COST: [$Z, do not provide calculations on the DD1391]

REPAIR-TO-REPLACEMENT RATIO: [$X/$Z =Y%]

PLANT REPLACEMENT VALUE (PRV): [$A]

REPAIR-TO-PRV RATIO: [$X/$A =B%, used only for the AT compliance metric.]

REPAIR-TO-REPLACEMENT RATIO:

[for non-networked facilities] The total funded cost of $X is Y% of the $Z estimated cost of a MILCON project to replace the facility.

[for networked facilities] The total funded cost of $X is Y% of the $Z estimated cost of a MILCON project to replace the [name of network from AFI 32-1032, Paragraph 3.5.4.] networked facility.

[for networked facilities, as applicable] In accordance with AF/A4C guidance, this repair project replaces less than 75% of the [ networked facility name of from AFI 32-1032, Paragraph 3.5.4.] networked facility. [If the project replaces >75% of the networked facility, then the work must be classified as construction.]

COMPLIANCE STATEMENTS

SEISMIC RULE: [include one statement about both 30% and 50% rules] Compliance with the 30% repair-to-replacement ratio rule for Seismic Design Category D, E, or F buildings is required. The scope of this project complies.

Compliance with the 30% repair-to-replacement ratio rule for Seismic Design Category D, E, or F buildings is not required.

Compliance with the 50% repair-to-replacement ratio rule for Seismic Design Category C buildings is required. The scope of this project complies.

Compliance with the UFC 3-310-04 seismic 50% repair-to-replacement ratio rule for Seismic Design Category C buildings is not required.

[If ratio exceeds a threshold, Block 10 must note appropriate measures to comply.]

ANTITERRORISM (AT) RULE:

Compliance with the AT 50% repair-to-PRV ratio [is/is not] required. The scope of this project complies. [Only include the second sentence if compliance IS required.] [If ratio exceeds threshold, Block 10 must note appropriate measures to comply.]

FIRE PROTECTION RULE:

Compliance with the 50% Fire Protection Rule [is/is not] required. The scope of this project complies. [Only include the second sentence if the Repair-to-Replacement ratio is greater than 50%.] [If ratio exceeds threshold, Block 10 must note appropriate measures to comply.]

ECONOMIC ANALYSIS (EA) RULE:

[For Repair] This project’s programmed amount [does/does not] exceed both $2M and 75% of the estimated cost of a military construction project to replace the facility, therefore an economic analysis of alternatives [was/was not] completed. [completed EA or EA waiver must be attached to the approval request package]

[For Construction] This project’s programmed amount exceeds the UMC cost limit, therefore an economic analysis of alternatives was performed.

FLOODPLAIN MANAGEMENT RULE: [include the applicable statement] [project not in a 100-year floodplain] This project does not fall within or partly within a 100-year flood plain.

[repair projects] The existing facility [falls/partly falls] within the 100-year flood plain. The existing Finished Floor Elevation (FFE) is [XXX.XX] and the 100-year floodplain Water Surface Elevation (WSE) is [XXX.XX]. A [Finding Of No Practical Alternative (FONPA) / Finding Of No Significant Impact (FONSI)] has been issued for the proposed action. As noted in Block 10, risk mitigation measures have been incorporated.

[construction projects] This project [falls/partly falls] within the 100-year flood plain. The risk will be mitigated by constructing the facility and any flood-susceptible utilities above the 100-year flood level. This is a [non-missional critical / mission critical] facility. The facility and any flood-susceptible utilities will be constructed a minimum of [two / three] feet above the 100-year flood elevation.

[project not in a FEMA-studied location] FEMA has not completed a study to determine flood hazard for [location]. The FEMA-published Flood Insurance Rate Map (FIRM) shows the location in Zone D - 'Areas of Undetermined Flood Hazard'. The proposed action to repair [facility] at existing grades will not alter the flood elevations, nor the resulting hazard risk to the surrounding area.

STANDARD DESIGN: [include the applicable statement] [standard design available and used] This design shall conform to criteria established in the Air Force Corporate Facilities Standards (AFCFS), the Installation Facilities Standards (IFS) [if available], and shall employ the standard facility design [insert the specific standard design reference].

[standard design not available] This design shall conform to criteria established in the Air Force Corporate Facilities Standards (AFCFS), the Installation Facilities Standards (IFS) [if available], but will not employ a standard facility design because there is no AF standard facility design for this project and there is no applicable standard design from [applicable Agent].

[standard design available and not used] This design shall conform to criteria established in the Air Force Corporate Facilities Standards (AFCFS), the Installation Facilities Standards (IFS) [if available], but will not employ a standard facility design because [explain the reason for not using a design standard even though one exists].

RENTED OR LEASED FACILITY:

[if not rented or leased] The facility in this project is not a rented or leased facility.

[if rented or leased, add and complete the following] Location: [street address, city, state (or country)] Occupant: [official name of agency using facility] Lease Number: [official lease number under which facility is being used] Annual Rental: [annual rent paid for use of the property]

CERTIFICATION: I have reviewed this document and certify it is complete and accurate, and is compliant with appropriate statute(s) and instructions. I have validated the project’s primary and supporting costs and work classification. It has been fully coordinated with the user and other appropriate agencies and approved by the Installation Facility Board.

[if pursuing or using funding under the Energy Program include the following statement] I have reviewed this document and certify it is complete and accurate. It meets the intent of the Energy Program and the project is the best lifecycle cost solution. I have validated the project’s primary and supporting costs, Building Lifecycle Cost (BLCC) and work classification. It has been fully coordinated with the user and other appropriate agencies, and approved by the Installation Facility Board.

[BCE name] Base Civil Engineer, XYZ AFB

(123) 456-7890

DD FORM 1391, DEC 99 Previous editions are obsolete Page No 1