ATT0053 CDRL TS24 Site Survey Report.pdf

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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:

TDP ________ TM _______ OTHER

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page of Pages

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

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

TDP ________ TM _______ OTHER

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

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423-1 (BACK), FEB 2001

All travel will be conducted in accordance with Joint Travel Regulations (JTR).

If multiple personnel on the same task order support a travel task, only ONE site survey report will be required.

The site survey report will clearly and accurately depict the condition of the facility surveyed. When the survey is performed in support of an upcoming implementation, detailed discussion of what issues or problems that have been identified as requiring consideration in order to successfully complete the implementation shall be clearly addressed. Photos shall be included as required to document potential problems. All point of contact information for survey participants and key site personnel (e.g., the site manager, Officer in Charge (OIC), circuit actions officer, security manager, etc.) is provided and accurate. SMO codes and shipping addresses (MIL AIR and Fed Ex) are provided.

All site survey reports shall be developed in Microsoft Word and submitted in soft copy. The document shall not be locked or protected in any fashion that would prevent text to be copied or edited by the government after delivery.

1. Format

(a) Report shall be written for printing on 8 1/2" X 11" standard letter size paper (Portrait orientation) although necessary attachements, figures, and sketches may be submitted in a size/orientation that best displays the information being presented.

(b) Font shall be Arialn, size 12.

(c) Report shall be grammatically correct.

(d Report shall be one page minimum and of sufficient length to document the findings of the survey. Five pages will be the the typical maximum.

2. Content

(a) Cover Sheet. A cover sheet with the USAISEC and CECOM logos shall comprise the first page of the site survey report. The following information will be included on the cover sheet:

- The title of the site survey report to include location and project in capital letters

- Directorate for whom the site survey report was prepared in capital letters

- Disclaimer statement

- Signature block for the preparer, to include full name and title

- Signature block for the Government reviewer, to include full name and title (this will typically be the TM).

(b) Page 1. The text of the site survey report shall begin on page 1, which follows the title page. The format of page 2 will differ slightly from all subsequent pages as follows:

- The title of the site survey report, as shown on the title page, shall be centered at the top of page 1 using Title Case lettering.

- The page number will not be shown on this page.

(c) Header. All pages following page 1 shall contain a header which includes the site and project name for which the site survey is being conducted. The header shall right justified with a .5" top margin and shall be displayed on all remaining pages of the trip report. The dates of the site survey shall be shown below the site and project name.

(d) Section 1. Subject. This section shall contain a brief statement indicating the subject of the site survey report.

(e) Section 2. Location and Dates of travel. This section shall identify the location(s) of travel and the range of dates during which the site survey was performed.

(f) Section 3. Purpose. This section shall contain a brief summary of the purpose of the site survey.

(g) Section 4. Traveler(s). This section shall contain the names of the USAISEC personnel (Government and contract) conducting the site survey.

(g) Section 5. Points of Contact. This section shall contain a table identifying personnel from other organizations who participated in the site survey or who were contacted for information in support of the site survey. The information provided shall include: Name, Organization, Email, DSN and Commercial phone numbers. (NOTE: The Points of Contact may be entered using 10 pt. font if necessary in order to include all information while minimizing wrap-around text).If the list is long (e.g., more than half a page), the points of contact list may be included as an attachment at the end of the site survey report. If this occurs, it shall be clearly noted in Section 5 as “See attached list for all personnel supporting this overall effort.”

(h) Section 6. Discussion. This section shall provide information gathered during the site survey which will be directly relevant to the successful completion of the planned project. Other facility information which may be of general value should be included, as applicable. This section may be broken into subsections as required to group and present information in the clearest manner possible. If appropriate, a subsection summarizing agreements shall be included in this section.

(i) Section 7. Potential Impacts. This section shall address issues which may impact the successful completion of the planned effort.

(j) Section 8. Recommendations. This section shall identify recommendations for actions to be taken to ensure successful execution of the planned effort.

(k) Section 9. Conclusions. This section shall contain a general summary of the outcome of the site survey.

4. Method of delivery: One (1) soft copy of the report shall be submitted to the Technical Monitor (TM), and Contracting Officer’s Representative (COR) via e-mail. The report shall be fully identified and referenced in the subject line of the email message. The document shall not be locked or protected in any fashion that would prevent text to be copied or edited by the Government after delivery.