A1_CDRL_A001_Contractor_Service_Report_Technician_Qualification_Template.docx

This is a Contractor Service Report and Technician Qualification Confirmation template (CDRL A001) for on-site repair services of a government-owned Haas HS-4R Milling Machine (Serial Number 2052422) located at MDMC Production Plant Barstow (Building 638, Yermo Annex). The template is designed to document and verify technician qualifications and service work performed under contract with Phillips Corporation, Federal Division/Phillips Federal Service, with Luke Wirick identified as the Government Technical Point of Contact.

The form requires contractors to provide technician information and qualification documentation, including verification that the technician is a Haas Certified Technician, OEM Employee, OEM-Authorized Service Provider, or Federal Haas Factory Outlet Technician. The service report section captures specific parts and components installed during the repair, including the SMTC M-Code Relay Triac Kit (93-32-3087C), I/O PCB AC CCA (93-6442), and Maincon PCB Retrofit for ColdFire Processor (93-6405). Contractors must also document on-site service dates and hours, work performed, machine configuration actions, safety and ESD precautions used, and any remaining deficiencies or recommendations. The authorized contractor representative must certify the accuracy of the information and submit the completed form upon completion of service or upon government request in accordance with the contract requirements.