A005 - ECIS CPSR FINAL.pdf

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1

CONTRACT DATA REQUIREMENTS LIST (CDRL)

(1 Data Item)

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP _____ TM ___ OTHER SUSTAINMENT DATA

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

ECIS N61340-21-R0048

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A005 TECHNICAL REPORT: STUDY/SERVICES CIS CONTRACT PERFORMANCE SUMMARY REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MISC-80508B SEE BLK 16 NAWCTSD

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED MTHLY SEE BLK 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft Final

SEE BLK 16 Reg Repro

16. REMARKS: NAWCTSD PJM 1 1

1. BLK4: ONLY DID PARAGRAPH 3.9(C)(2) APPLIES.

2. SEE ANNEX A005 FOR SAMPLE REPORT CONTENTS.

3. BLK 5: SEE PWS PARAGRAPH 3.2.1

4. BLK 12: FIRST SUBMISSION SHALL BE DUE NLT THE FIFTH (5TH) WORKING DAY OF THE

FIRST (1ST) MONTH FOLLOWING CONTRACT SUPPORT DATE (CSD).

5. BLK 13: SUBSEQUENT SUBMISSIONS SHALL BE SUBMITTED TO THE COR FOR

SIGNATURE THE FIFTH (5TH) WORKING DAY AFTER THE END OF EACH MONTHLY

REPORTING PERIOD. DISTRIBUTION OF COPIES VIA EMAIL ARE DUE WITHIN THREE

(3) DAYS AFTER RECEIPT OF COR SIGNATURE.

6. THE GOVERNMENT WILL HAVE FIFTEEN (15) WORKING DAYS FOR REVIEW AND

ACCEPTANCE/REJECTION OF EACH SUBMISSION. NO RESPONSE WILL INDICATE

ACCEPTANCE.

7. BLK 14: REPORTS FOR COR ADDRESSEES SHALL BE DISTRIBUTED ONLY TO THE

RESPECTIVE COR’S SITE. SUBMISSIONS SHALL BE SENT VIA EMAIL. ALL APPLICABLE

EMAIL ADDRESES FOR DISTROBUTION (BLOCK 14) SHALL BE ON EACH CDRL. DATA

ITEM NUMBER, LOCATION, AND PERIOD (E.G.; N6134020F00XX-A002-ORLANDO-

14JAN2020). ALL REPORTS SHALL BE ATTACHMENT FILES TO THE EMAIL. ALL

REPORTS SHALL BE IN MICROSOFT® WORD 2016 (OR LATER VERSION) COMPATIBLE

FORMAT. FILES AND DATA CELLS SHALL NOT BE LOCKED OR PASSWORD

PROTECTED. FILES SHALL NOT INCLUDE HIDDEN DATA AND SHALL BE PREPARED AT

UNDER ONE MEGABYE SIZE WHERE PRACTICAL. EMAIL ADDRESSES ARE PROVIDED

IN THE CONTRACT SCHEDULE AND/OR THE CDRL ADDRESSEE LIST (ATTACHMENT 3

OF THE CONTRACT).

8. BLK 9: THE FOLLOWING STATEMENT SHALL BE INCLUDED ON THE DELIVERABLE:

DISTRIBUTION D: DISTRIBUTION AUTHORIZED TO DOD AND DOD CONTRACTORS

ONLY, ADMINISTRATIVE OR OPERATIONAL USE, 14 JANUARY 2020. OTHER

REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE COMMANDING

OFFICER, NAVAL AIR WARFARE CENTER TRAINING SYSTEMS DIVISION, IN-

SERVICE SUPPORT DIVISION, 12211 SCIENCE DRIVE, ORLANDO, FL 32826-3224.

NAWCTSD PCO 1 1

NAWCTSD Sustainment 1 1

COR San Diego 1

COR Norfolk 1

COR Newport 1

COR Pearl Harbor 1

COR Newport

COR ZTF, San Diego

COR SLC, New London 1

15. TOTAL ▬▬▬▬► 3 10

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

R. SMITH, NAWCTSD Sustainment

02/10/2021 C. CAUDILL NAWCTSD PJM

04/22/2021

ANNEX TO CDRL A005

CIS CONTRACTOR PERFORMANCE SUMMARY REPORT (CPSR)

ECIS CDRL REQUIREMENT

1.0 Report Contents.

1.1 Header Information. Data elements to be provided as header information are as follows, in the order shown.

a. Contract. Enter appropriate contract number.

b. Contractor. Enter name of contractor's firm.

c. Reporting Period. Enter month and year for which report is being prepared.

1.2 Report Body.

1.2.1 This report documents and summarizes status and performance for ECIS contract for

Contractor Instructional Services (CIS). The main body of the report shall be completed in accordance with (IAW) the attached sample format. Block 16 of each Contract Data Requirements List (CDRL) shall tailor each reports requirements by applying the annex paragraphs delineated in annex paragraph 2.0 (a through g). Entry of actual data is to be made in the appropriate column for the period covered by the report. Refer to Performance Work Statement (PWS), for definition of terms.

1.3 Format. The report shall include up to six parts as specified in the contract and the CDRL.

The summary shall be presented in Excel format to facilitate reporting of data on multi-station devices/equipment items or where multiple devices/equipment items are collocated (refer to applicable samples). Any of the following formats may apply as per block 14 and 16 of the CDRL:

1.3.1 Hard Copy. Where applicable, individual areas shall be prepared as delineated in the contract on 8 ½ inch by 11 inch sized paper.

1.3.2 Magnetic Media. Where applicable, individual area files shall be placed on Compact

Disc - Recordable/Re-Writable (CD-R/CD-RW; 1x-4x drive capable media) optical disc.

Magnetic files shall be compatible to Microsoft® Office formats as specified in Block 16 of the CDRL.

1.3.3 Electronic Mail (E-mail). Reports shall be attached files to E-mail that are compatible to

Microsoft® Office formats as specified in Block 16 of the CDRL.

2.0 Summary Report Content. The CIS Contractor Performance Summary Report may consist of all or a portion of the following (as specified in the CDRL):

a. CIS Contractor Performance Summary Report Definition of Terms

b. Part I - CIS Contractor Performance Summary Report (Over-all System Site

Summary) (Figure 1)

c. Part II - CIS Contractor Usuage and Prediction Summary Report (Figure 2)

d. Part III - CIS Contractor Performance Summary Report (Instruction Units Summary)

(Figure 3)

e. Part IV - CIS Contractor Instuction Units Breakout Report (Figure 4)

f. Part VI - CIS Contractor Instruction Units Summary Breakout Report (Overall Contract Totals) (Figure 5)

2.1 Figure block definitions/format.

2.1.1 Part I: Figure 1 (Overall Site Summary).

Header:

a. Date of Report. Enter date report is prepared (e.g., ddmmmyy).

b. From. Enter Contractor Site Manager’s name and full address.

c. Contract Name. Enter full contract number (e.g. N61340-21-D-0099).

d. Contractor Name/Cage Code. Enter full name of prime contractor and Command and Government Entity (CAGE) code.

e. CLINs/SLINs. Enter the applicable contract line item numbers (CLIN)/sub-line item numbers (SLIN) that apply to the CIS Technical Data and Information (DD Form 1423-1 CDRL) and CIS service.

f. CDRL Number. Enter the data item number (e.g., A005).

g. CDRL Title. Enter the title and sub-title of data item of the CDRL for this report

(e.g., Technical Report-Study/Services/ CIS Contractor Performance Summary Report).

h. Training Type(s) (SWSC Training, PMS 339 or SLC). Enter type of training

i. Command/Location. Enter name of supported command (s) and location where training is accomplished. (e.g. San Diego, CA Newport, RI)

j. Classification of Report. Enter the security classification of this report (e.g., UNCLAS).

k. Reporting Period. Enter the date of the first and last day of the reporting period

(e.g., ddmmmyy to ddmmmyy).

l. Summary of Reporting Period. Provide narrative of completed tasks, on-going projects, issues, status of training. If the reporting period is the mobilization period, include status of key requirements (hiring status, training, inventory, résumés, etc).

m. Signature of Contractor Site Manager. Print name, insert electronic signature and date of signature.

n. Signature of COR. Print name, insert electronic signature and date of signature.

o. COR Remarks. Check the applicable block (COR remarks attached or no COR remarks attached).

p. Contract Personnel. On a separate report sheet (page), provide list of contractor personnel on site providing: name, Department of Labor (DoL) position title, areas/dates trained and certified to instruct, employment status (full/part-time), and DoL anniversary date.

(1) Name of employee

(2) Position (Site Manager (SM), Assistant/Alternate Site Manager (ASM), Lead

Instructor (LI)

(3) Type of Contract Instructor (CI): Type of Contract Instructor (CI), but limited to: High Risk, Diesel Engine Inspector, Hull Technician, Machinery Repairman, Repair Party Leader, Diesel Engine, Electrician Mate, NDT, Perspective Engineering Officer (Newport), Sonar Tech Submarines, Fire Control Tech., Electronics Tech., Gas Turbine, DDG 1000 Damage Control, DDG 1000 Electrical and Top Snipe

(4) DoL Wage Grade Category Number

(5) Full time (FT) or Part time employee status (PT)

(6) Employment Anniversary Date (DDMMMYY) for pay.

(7) Initially On-board Date – date reported on working site for employment

(8) Training Start Date (ddmmmyy)

(9) Certification Date (ddmmmyyy)- date individual is certified as CI (in writing from government) and/or date anticipated to be certified per training track – ddmmmyy *Est)

(10) Level of Security Clearance/Access (e.g, Secret). Must meet requirements of

PWS

(11) System (i.e. DC trainier.)

(12) Remarks: Note if new employee or any dates of termination and dates badges are turned in. (Position title, areas/dates trained and certified to instruct, employment status (full/part-time), and DOL anniversary date)

2.1.2 Part II: Figure 2 - CIS Contractor Usuage and Prediction Summary Report (Instruction

Units).

a. ECIS usuage and prediction. Enter as of Date

b. Contract Year X. Enter Period of Performance Reporting Period c CLIN No. Enter Applicable CLIN

d. Description. Enter CLIN Description

e. Contacted Hours (HPY). Enter Contracted Hours per Year for each CLIN

f. Usage Month. Enter Usuage Month Dates

g. Sked. Enter Hours scheduled

h. Used. Enter Hours Used per reporting month

i. Contracted Hours Used as of. Enter total Contracted Hours Used as of reporting month

j. Contracted Hours Remaining this PoP. Enter total number of Contracted Hours remaining as of period of performance (PoP)

k. % Usuage to date. Enter percent usuage as of reporting month

l. Contracted Hours Sked through this PoP. Enter Contracted Hours scheduled through PoP

m. % Planned Usage including Sked Hours. Enter percent of planned usuage hours to include scheduled hours

2.1.3 Part III: Figure 3 - CIS Contractor Performance Summary Report. Complete for each

CLIN

a. CLIN No. Applicable CLIN for the system/site/type of CI

b. Instruction Units Contracted. Enter the total number of instruction units contracted per the PWS for the reporting period. (Instruction Units Contracted = INS + IS)

c. Training Type. Enter trainng type (e.g., PMS 339 Training and/or SWSC Training)

d. Month. Enter Usuage Month Dates

e. Instruction Units Completed (IC). Enter the total number of scheduled instructional units completed during the reporting period

f. Non-chargeable Lost Instruction Units (LI). Enter the total number of instruction units lost for the reporting period that are not chargeable to the contractor as defined in the PWS (e.g., device down, student fails to show up).

g. Lost Instruction Units (LI). Enter the total number of scheduled instruction units lost for the reporting as defined in the PWS (e.g., CI instructor fails to complete or show up for a scheduled instruction unit).

h. Instruction Units Scheduled (IS). Enter the total number of contracted instruction units scheduled during the reporting period. (IS = IC+LI+CLI)

i. Instruction Units Not Scheduled (INS). Enter the number of Instruction Units Contracted minus the Instruction Units Scheduled.

j. Instruction Factor (IF). Percent value derived from the performance algorithm specified in the PWS.

2.1.4 Part IV: Figure 4- CIS Contractor Instuction Units Breakout Report. Complete for each CLIN

a. CLIN No. Applicable CLIN for the system/site/type of CI

b. Instruction Units Contracted. Enter the total number of instruction units contracted per the PWS for the reporting period. (Instruction Units Contracted = INS + IS)

c. Trainer/Device Instruction and/or Operations. The number of Primary Instructor

Units the CI provides for scheduled trainer/simulator trainee instruction AND trainer/simulator operator services (including brief and debrief).

d. Classroom Instruction. The number of Primary Instructor Units the CI provides scheduled classroom instruction services.

e. Syllabi/Curriculum Updates/Maintenance/Scenario Devleopment. The number of Primary Instructor Units the CI provides scheduled Subject Matter Expert (SME):

update/maintenance services. Specify/explain duties/accomplishments in contractor remarks section.

f. Canceled/No-Shows. The number of Insturction Units the CI provides for Canceled/No-Shows.

g. Other. The number of Primary Instructor Units that the contractor CI provides scheduled other duties (not included in the other columns) that are defined in the PWS. Specify/explain duties/accomplishments in contractor remarks section.

h. Total. The total number of hours used for that reporting month

i. Contractor Remarks. General remarks as applicable about reporting period and explain what was accomplished when SME and Other hours are used.

j. Signature of Contractor Site Manager and date. Print name, insert electronic signature and date of signature.

k. COR Remarks. Enter remarks as may be applicable.

l. Signature of COR and date. Print name, insert electronic signature and date of signature.

2.1.5 Part VI: Figure 5- CIS Contractor Instruction Units Summary Breakout Report (Overall

Contract Totals)

a. Contract Option Year. Enter Contract Option Year

b. Period Ending. Enter the period ending date

c. Instruction Units Contracted. Enter the total number of instruction units contracted per the PWS for the reporting period. (Instruction Units Contracted = INS + IS)

d. Trainer/Device Instruction and/or Operations. The number of Primary Instructor

Units the CI provides for scheduled trainer/simulator trainee instruction AND trainer/simulator operator services (including brief and debrief).

e. Classroom Instruction. The number of Primary Instructor Units the CI provides scheduled classroom instruction services.

f. Syllabi/Curriculum Updates/Maintenance/Scenario Devleopment. The number of Primary Instructor Units the CI provides scheduled Subject Matter Expert (SME):

update/maintenance services. Specify/explain duties/accomplishments in contractor remarks section.

g. Canceled/No-Shows. The number of Insturction Units the CI provides for Canceled/No-Shows.

h. Other. The number of Primary Instructor Units that the contractor CI provides scheduled other duties (not included in the other columns) that are defined in the PWS. Specify/explain duties/accomplishments in contractor remarks section.

i. Total. The total number of hours used for that reporting month

j. Contractor Remarks. General remarks as applicable about reporting period and explain what was accomplished when SME and Other hours are used.

Contract Instructional Services (CIS) Contractor Performance Summary Report

Date of Report From: (Site Manager name and address) To: (COR name and address)

Contract #.

System / Platform Contractor Name/Cage Code Supported Command/ Location CLINs/SLINs Classification of Report CDRL Number Reporting Period CDRL Title/Sub-title

Summary of Reporting Period

Mobilization status

Issues/On-going Project(s)

Completed tasks; status of training

Significant accomplishments

Other

Site Manager Name (print0 Site Manager Signature Date

COR Remarks

COR Name (Print) COR Signature Date

CONTRACTOR PERSONNEL REPORT

Last name, First MI. Position Type

CI

DoL Category

Status

FT/PT

Employment Pay

Anniversary Date

Initial On-board

Date

Training Start date

Certification Date / Trng Track Est*

Security Clearance System(s)

Remarks (Note: end date of any employment; badges turned in)

1. Smith, John (SAMPLE) SM MML1 29100 FT 1-Oct-04 1-Nov-05 1-Nov-05 1-Jan-06 N/A DC

Trainer Incumbent from previous contract

2. Adams, David (SAMPLE) LI MLM 29100 PT 1-Nov 04 1 –Dec 05 1-Dec-05

60F 01Jan 05 / 60 H *Est 01Feb

N/A DC

Trainer New Employee

3.

4.

5.

6.

Acronyms: Site Manager (SM) / Assistant SM (ASM) High Risk HR / Diesel Engine Inspector DEI / Hull Technician HT / Machinery Repairman MR / Repair Party Leader RPM / Diesel Engine DE/ Electrician Mate EM / Non Destructive Testing NDT / Perspective Engineering Officer PEO (Newport) / Sonar Tech Submarines STS / Fire Control Tech. FCT / Electronics Tech., ET / Gas Turbine DDG 1000 GTDDG / Damage Control, DDG 1000 DCDDG / Electrical EMDDG and Top Snipe TSDDG / Full time (FT) / Part Time (PT)

Figure 1 –CI Contractor Performance Summary Report (Over-all System Site Summary/Personnel Report) Restricted Information – For Official Use Only (FOUO)

Figure 2 - CIS Contractor Usuage and Prediction Summary Report (Instruction Units).

Sked Used Sked Used Sked Used Sked Used Sked Used Sked Used Sked Used Sked Used Sked Used Sked Used Sked Used Sked Used 2001 Everett MML-1 2002 Everett MML-2 2003 Pearl Harbor MML- 1 2004 Pearl Harbor MML- 2 2005 San Diego MML-1 2006 San Diego MML-2 2007 San Diego MLM 2008 Yokosuka & Sasebo Japan MML-1 2009 Yokosuka & Sasebo Japan MML-2 2016 San Diego LCS 2020 San Diego DDG 1000

PAC TOTAL 0 0.0 0 0.0 0.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

2010 Mayport & Pascagoula MML-1 2011 Mayport & Pascagoula MML-2 2012 Norfolk, Bath, Rota, Bahrain MML-1 2013 Norfolk, Bath, Rota,Bahrain MML-2 2014 Norfolk, Bath, Rota, Bahrain MLM 2015 Mayport LCS 2017 Newport LCS 2018 Great Lakes QM A 2019 Newport ADOC 2021 Newport MML-1 2022 Newport MLM

LANT TOTAL 0 0.0 0 0.0 0.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0.0 0 0

2030 Additional Instruction Everett 2031 Additional Instruction Pearl Harbor 2032 Additional Instruction San Diego 2033 Additional Instruction Yokosuka & Sasebo Japan 2034 Additional Instruction Mayport & Pascagoula 2035 Additional Instruction Norfolk, Bath, Rota, Bahrain 2036 Additional Instruction Newport 2037 Additional Instruction Great Lakes

CONTRACT TOTAL 0 0.0 0 0.0 0.0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Contract Year X (POP Reporting Period)

Description CLIN

Usage Month 9

Usage Month 11

Usage Month 12 Contracted hours Used as of

% Usage to date

Usage Month 7

Usage Month 8

NSS CIS usage and prediction (as of insert date)

Contracted Hours

(HPY)

Usage Month 1

Usage Month 2

Usage Month 3

Usage Month 4

Usage Month 5

Usage Month 6 Contracted hours remaining this PoP

Contracted hours Sked through this PoP

% Planned usage including Sked hours

(Insert Month 1 Dates)

Usage Month 10

Instruction Units Contracted

(HPY)

Training Type

SWSC Training PMS 339 Training

SLC Training

SWSC Training PMS 339 Training

SLC Training

SWSC Training PMS 339 Training

SLC Training

SWSC Training PMS 339 Training

SLC Training

SWSC Training PMS 339 Training

SLC Training

Instructor Factor (IF)

Month 11 Month 12Month 2 Month 3 Month 4 Month 5 Month 6 Month 7 Month 8 Month 9 Month 10 Month 1 (Insert

Month 1 Dates)

Instruction Units Completed (IC)

Non-Chargeable Lost Instruction Units (NLI)

Lost Instruction Units (LI)

Instructor Units Scheduled (IS)

Instructor Units Not Scheduled (INS)

Figure 3 - CIS Contractor Performance Summary Report

Figure 4- CIS Contractor Instuction Units Breakout Report.

Contractor Remarks:

Signature of Contractor Site Manager and Date:

COR Remarks:

COR Signature and Date:

Total

Month 4 Month 5 Month 6 Month 7

CLIN XXXX -Insert Location

Trainer/Device Instruction Classroom Instruction

Syllabi/Curriculum Updates/ Maintenance/Scenario Development

Other

Month 8 Month 9 Month 10 Month 11 Month 12

Month 1 (Insert

Month 1 Dates)

Month 2 Month 3

Canceled/No-Shows

Instruction Units Contracted Hours-per-year (HPY)

Figure 5- CIS Contractor Instruction Units Summary Breakout Report (Overall Contract Totals)

Period ending

Contractor Remarks:

Instruction Units Contracted Hours-per-year (HPY)

Option Total

Enter Contract Option Year

Canceled/No-Show

Feb March April May June July Aug Sep Oct Nov Dec Jan

Other Total

Training Device Instruction

Classroom Instruction

Syllabi/Curriculum Updates/ Maintenance/Scenario Development