70Z08525RLREP0002 Attachment 8 Change Request Proposal Form.xlsx

XLSX spreadsheet 45 KB Posted

Attached to
BERTHOLF_DS_FY25 Federal contract opportunity
Solicitation number
70Z08525RLREP0002
Issued by
Department of Homeland Security US Coast Guard

About this file

This is a Change Request Proposal Form template used by the U.S. Coast Guard Naval Engineering for contract modifications on the USCGC BERTHOLF. The form includes sections for detailed labor estimates across multiple trades (welders, ship fitters, electricians, etc.), subcontractor costs, materials costs, and schedule impact assessments.

The template requires contractors to submit detailed price proposals within 3 calendar days of issuance by the Contracting Officer. It includes provisions for documenting schedule extensions beyond current delivery dates and requires notification to Operational Commanders regarding potential delays. The form is part of solicitation 70Z08525RLREP0002 for dockside repairs and alterations to USCGC BERTHOLF to be performed at its homeport in Alameda, CA during February-April 2025.

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Govt Est

Department of Transportation // U.S. Coast Guard // Naval Engineering // Form 002 (Rev 12/00)
Independent Contractor EstimatePage
Contract AvailabilityCR1of1
Auto fillUSCGC BERTHOLFItem:Estimate Prepared By:Date Prepared
Auto fillTBDAFC:
CFR Nr.
WelderLabor ScaleShip FitterSheet MetalSandblasterRiggerPipefitterPainterLaggerLayoutMachinistShipwrightEquip OperElectricianSteel WorkNDTCompetent
PersonQuality AssuranceFirewatch
Totals From Page 2:0000000000000000000
Trade Totals(inlcudes page 2):0000000000000000000
SUMMARY OF LABOR
Total Regular Labor Hours Cost$ - 0
Total Overtime Labor Hours Cost$ - 0
Total Cost of Labor$ - 0
SUMMARY OF SUB-CONTRACTOR
Sub-ContractorCost
$ - 0
$ - 0
$ - 0
Totals From Page 2:
Total:$ - 0
SUMMARY OF MATERIALS
ItemU/IQTYCostTotal Cost
$ - 0
$ - 0
$ - 0
Totals From Page 2:
Total:0$ -0$ - 0
SUMMARY OF ESTIMATEThe above work will require an extension ofdays beyond the current delivery
Labor$ - 0date of
Material$ - 0
Sub Contractor$ - 0
mark-up/loading rate for materials and subcontractors$ - 0
Total Estimate$ - 0

MLCPAC(vr) Approval: Spec Review Required?

Department of Transportation // U.S. Coast Guard // Naval Engineering // Form 002 (Rev 12/00)
Independent Government Estimate (Cont.)Page
Contract AvailabilityWork Request Nr:2of2
USCGC BERTHOLFItem:Estimate Prepared ByEstimate Prepared By:Date PreparedDate Prepared
TBDCFR Nr:

0 Welder Labor Scale Ship Fitter Sheet Metal Sandblaster Rigger Pipefitter Painter Lagger Layout Machinist Shipwright Equip Oper Electrician Steel Work NDT Competent Person

Trade Totals:0000000000000000000
SUMMARY OF LABOR
Total Regular Labor Hours0
Total Overtime Labor Hours
Total of All Labor Hours0
Total Cost of Labor$ - 0
SUMMARY OF SUB-CONTRACTOR
Sub-ContractorCost
Total$ - 0
SUMMARY OF MATERIALS
ItemU/IQTYCostTotal Cost
Total$ - 0
SUMMARY OF ESTIMATE
Labor$ - 0
Material$ - 0
Sub Contractor$ - 0
Profit$ - 0
Total Estimate$ - 0

Part I. This is a request for proposal only. You are requested to provide a detailed price proposal within 3 calendar days from the date of issuance by the Contracting Officer or earlier. No obligation is created for the United States Government to award any work until an agreement on price and performance period is reached and a bilateral contract modification is executed between the Government and the Contractor.

The work described below is withing the scope fo the subject contract. All terms and conditions of the subject contract are applicable to this work request.

Provide all labor and materials to accomplish the following additional work. This work request is in response to the Contractor's CFR listed above:

The above work will require an extension of ______ days beyond the current delivery date of __________.

FOR COAST GUARD USE ONLY

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

The above work will require an extension of days beyond the current delivery date of ____.

FOR COAST GUARD USE ONLY

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phonecon between and of

The above work will require an extension of ______ days beyond the current delivery date of __________.

FOR COAST GUARD USE ONLY

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

The above work will require an extension of days beyond the current delivery date of ____.

FOR COAST GUARD USE ONLY

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

The above work will require an extension of ______ days beyond the current delivery date of __________.

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

See page 1 for info on need for contract extension.

Part I. This is a request for proposal only. You are requested to provide a detailed price proposal within 3 calendar days from the date of issuance by the Contracting Officer or earlier. No obligation is created for the United States Government to award any work until an agreement on price and performance period is reached and a bilateral contract modification is executed between the Government and the Contractor.

The work described below is withing the scope fo the subject contract. All terms and conditions of the subject contract are applicable to this work request.

Provide all labor and materials to accomplish the following additional work. This work request is in response to the Contractor's CFR listed above:

The above work will require an extension of ______ days beyond the current delivery date of __________.

FOR COAST GUARD USE ONLY

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

The above work will require an extension of days beyond the current delivery date of ____.

FOR COAST GUARD USE ONLY

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

The above work will require an extension of ______ days beyond the current delivery date of __________.

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

The above work will require an extension of days beyond the current delivery date of ____.

FOR COAST GUARD USE ONLY

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

The above work will require an extension of ______ days beyond the current delivery date of __________.

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

The above work will require an extension of days beyond the current delivery date of ____.

FOR COAST GUARD USE ONLY

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Part I. This is a request for proposal only. You are requested to provide a detailed price proposal within 3 calendar days from the date of issuance by the Contracting Officer or earlier. No obligation is created for the United States Government to award any work until an agreement on price and performance period is reached and a bilateral contract modification is executed between the Government and the Contractor.

The work described below is withing the scope fo the subject contract. All terms and conditions of the subject contract are applicable to this work request.

Provide all labor and materials to accomplish the following additional work. This work request is in response to the Contractor's CFR listed above:

The above work will require an extension of ______ days beyond the current delivery date of __________.

FOR COAST GUARD USE ONLY

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

The above work will require an extension of days beyond the current delivery date of ____.

FOR COAST GUARD USE ONLY

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

The above work will require an extension of ______ days beyond the current delivery date of __________.

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

The above work will require an extension of days beyond the current delivery date of ____.

FOR COAST GUARD USE ONLY

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

The above work will require an extension of ______ days beyond the current delivery date of __________.

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

The above work will require an extension of days beyond the current delivery date of ____.

FOR COAST GUARD USE ONLY

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Part I. This is a request for proposal only. You are requested to provide a detailed price proposal within 3 calendar days from the date of issuance by the Contracting Officer or earlier. No obligation is created for the United States Government to award any work until an agreement on price and performance period is reached and a bilateral contract modification is executed between the Government and the Contractor.

The work described below is withing the scope fo the subject contract. All terms and conditions of the subject contract are applicable to this work request.

Provide all labor and materials to accomplish the following additional work. This work request is in response to the Contractor's CFR listed above:

The above work will require an extension of ______ days beyond the current delivery date of __________.

FOR COAST GUARD USE ONLY

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________ Remarks:

The above work will require an extension of days beyond the current delivery date of ____.

FOR COAST GUARD USE ONLY

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Provide all labor and materials to accomplish the following:

The above work will reuire an extension of ______ days beyond the current delivery date of __________.

FOR COAST GUARD USE ONLY

Operational Commander (___________________) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phoncon between _____________________ and _________________________ Of _________________________________________________________________

Remarks:

Operational Commander ( ___ ) notified of potential delay and concures or acknowledges that potential schedule impact may result from this change.

Ref: Phonecon between and _______ of

You are requested to provide a detailed price proposal for the work described below to the Contracting Officer within 3 calendar days (or earlier if requested) from the date of issuance. No obligation is created for the United States Government to award any work until an agreement on price and performance period is reached. Following agreement on price and performance period a bilateral contract modification is executed between the Government and the Contractor.

The work described below is within the scope of the subject contract. All terms and conditions of the subject contract are applicable to this work request.

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