A02 CDRL.pdf

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 7 Pages

C O N T R A C T D A T A R E Q U I R E M E N T S L I S T (1 Data Item)

Form Approved OMB No. 0704-0188

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

24-3-10 Electric Forklifts

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

Installation and Preparation Documentation

3. SUBTITLE

Equipment Characteristics

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD250 REQ

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a copy of this information in either electronic or paper format, no later than 30-calendar-days after award of the contract. The contractor shall provide this information in electronic format using Microsoft Excel format.

The specific data required is:

This information is available in the attached spreadsheet 22-9-11 Equipment Characteristics Request.

PROVIDE COPIES, AS REQUESTED TO THE FOLLOWING:

Rock Island Arsenal

ATTN: TARA-LGC

Jeff Merry Bldg 220-B-D28 Rock Island, IL 61299-6400

15. TOTAL

G. PREPARED BY

Tad Larson

H. DATE

06-Nov-2023

I. APPROVED BY

J. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 2 of 7 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing

2. TITLE OF DATA ITEM

Installation and Preparation Documentation

3. SUBTITLE

Equipment Identification

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a copy of this information either in electronic or paper format, a minimum of 60-calendar-days prior to delivery of equipment.

This document shall consist of the make & model of the equipment with a complete list of standard features, optional features being installed in order to meet the specification, and a list of optional features available for field installation but not included. Each section shall be clearly identified.

Also included will be any technical data or brochures applicable to the equipment being provided.

ATTN: TARA-LGC

Jeff MERRY

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 3 of 7 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing

2. TITLE OF DATA ITEM

Maintenance Manual

3. SUBTITLE

Safety Lockout Procedure

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide (3) copies of this manual/information with delivery of the equipment. Of these, (2) will be paper, and (1) shall be electronic. Acceptable electronic formats include acrobat files (.pdf), drawing exchange files (.dxf), and initial graphic exchange specification (.igs).

This shall be a written procedure describing safe machine shutdown and the sequence by which lockout devices, and if necessary, line blocks and other restraints are affixed and removed prior to maintenance and service.

This may include drawings or photographs for clarity.

ATTN: TARA-LGC

Jeff Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 4 of 7 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing

2. TITLE OF DATA ITEM

Maintenance Manual

3. SUBTITLE

Preventive Maintenance Procedure

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide (3) copies of this manual/information with delivery of the equipment. Of these, (2) will be paper, and (1) shall be electronic. Acceptable electronic formats include acrobat files (.pdf), drawing exchange files (.dxf), and initial graphic exchange specification (.igs).

This section of the documentation shall include: Daily Operator Checklist, Visual Inspections, and a Lubrication Schedule. Procedures and schedules for inspections, adjustments, cleaning, and component replacements.

ATTN: TARA-LGC

Jeff Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 5 of 7 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing

2. TITLE OF DATA ITEM

Operator Manual

3. SUBTITLE

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide (3) copies of this manual/information with delivery of the equipment. Of these, (2) will be paper, and (1) shall be electronic. Acceptable electronic formats include acrobat files (.pdf), drawing exchange files (.dxf), and initial graphic exchange specification (.igs).

This section of the documentation shall include: Procedures for safe operation of the equipment in all modes. It shall include information necessary for performing all the operations and utilizing all the functions listed in the purchase description.

ATTN: TARA-LGC

Jeff Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 6 of 7 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing

2. TITLE OF DATA ITEM

Environmental Compliance Data

3. SUBTITLE

Material Safety Data Sheets (MSDS)

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide (1) copies of this information in paper format no later than 30-calendar-days prior to delivery of the equipment.

MSDS Sheets for all liquids (e.g. oils or coolants) and any hazardous materials shall be provided.

ATTN: TARA-LGC

Jeff Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 7 of 7 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing

2. TITLE OF DATA ITEM

Environmental Compliance Data

3. SUBTITLE

Chemical List

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide (1) copies of this information in paper format no later than 30-calendar-days prior to delivery of the equipment.

A list of all chemicals necessary to operate the equipment shall be provided by the vendor. This is necessary in order to meet environmental compliance requirements. The list shall include the type, grade, and quantity of each liquid or gas regardless of who is to provide the actual material. (E.g. if hydraulic oil is necessary to operate the system, it shall be listed as 200-gal-u.s. of DTE-XX.)

ATTN: TARA-LGC

Jeff Merry

Tad Larson

H. DATE