Attachment 0013 Sample Order 1.pdf

SAMPLE PERFORMANCE WORK STATEMENT

LSFS-1 AIRCRAFT MAINTENANCE

1.0 SCOPE

This Performance Work Statement (PWS) describes the efforts required to store and maintain H-60 aircraft. The contractor shall perform scheduled and unscheduled maintenance, required inspections, apply Modification Work Orders (MWO) and provide flyable storage for ten (10) aircraft. The contractor shall provide a full-time maintenance team capable of performing all periodic, scheduled and unscheduled maintenance. The aircraft maintenance shall be located at a facility within the Logistic Support Facility Management Activity (LSFMA) Multiple Award (MA) Indefinite Delivery/Indefinite Quantity (IDIQ) area. Contractor shall be responsible for the security and accountability of all Government equipment, and tools made available to them.

2.0 APPLICABLE DOCUMENTS

The applicable Mission Design Series (MDS) Technical Manuals (TM), Technical Bulletins (TB), DA Pamphlets (DA PAM), Depot Maintenance Work Requests (DMWR), Maintenance Engineering Calls (MEC), and Maintenance Engineering Orders (MEO) shall be used to accomplish this PWS.

3.0 Major Tasks:

In the Contract Year (CY) complete the following on UH 60 aircraft:

Five (5) Periodic Maintenance Inspections (PMI) 1’S and Five (5) PMI 2’S.

Scheduled and unscheduled maintenance to support a 500 flight hour program.

Ten (10) aircraft transfers. Ten (10) ea Maintenance Engineering Changes (MEC’s) requiring a total of 50 manhours per MEC.

Ten (10) each 20 level Modification Work Orders (MWO’s) requiring a total 50 man-hours per MWO.

Store and maintain ten (10) H-60 aircraft.

All support missions required to accomplish the missions in paragraph 5 (For example but not limited to, costs to accomplish support for ALSE, Quality Control, Technical Supply, HAZMAT, and Safety support).

All aircraft maintenance shall be located at a facility within the area designated in the base contract of the Logistic Support Facility Management Activity (LSFMA) Multiple

Award (MA) Indefinite Delivery/Indefinite Quantity (IDIQ) area.

Detailed tasks:

3.1 Receive and Secure Aircraft and Equipment

3.1.1 The contractor shall receive aircraft and associated equipment, store aircraft and equipment, inventory, and perform proper security and mooring. The contractor shall be responsible for the security and accountability of all Government equipment made available to them.

3.1.2 The contractor shall conduct aircraft DA Form 2408-9 inventory upon receipt of the aircraft. Upon completion of this inventory, the contractor shall store and maintain aircraft in accordance with (IAW) paragraph 3.2 unless otherwise directed by the Government.

3.1.3 Review aircraft’s DA Forms 2408-5, 2408-5-1, and 2408-15 to ensure status of MWOs, Safety of Flight (SOF) messages, Aviation Safety Action Messages (ASAM), Aviation Maintenance Action Messages (AMAM), and Technical Bulletins (TB) are entered into the aircraft records.

3.2 Aircraft Maintenance and Support

3.2.1 The contractor shall perform all scheduled maintenance activities required in the applicable TMs to include 2408-18 inspections and run-ups while the aircraft is in flyable storage. The contractor shall perform scheduled and unscheduled maintenance and inspections as required. The contractor shall be responsible for safe storage and security of aircraft rotor blades and any other component not installed on the aircraft.

For proposal purposes, assume one (1) full time maintenance team throughout the Period of Performance (PoP) capable of all periodic, scheduled and unscheduled maintenance. The Government will assign priority of maintenance based on aircraft requirements. When performing scheduled or periodic maintenance all work shall be completed by the maintenance team within the allotted working days given in current service guidance; however, if Government priorities require a redirection of work for more than 1 business day the contractor may request a per day schedule relief from the schedule requirement. The contractor shall submit this request to the Contracting Officer Representative (COR).

3.2.2 All applicable notices to include but not limited to ASAMs, AMAMs, and MWOs shall be identified by the contractor and shall be performed at the guidance of the COR.

Contractor shall provide all consumables, HAZMAT, supplies and parts under $2500.00 individual price. If not readily available, the Government will provide the major components as Government Furnished Material (GFM).

3.2.3 It is the Governments intent to perform all Maintenance Operation Checks (MOC) and Maintenance Test Flights (MTF). The contractor shall DD1149 the aircraft back to the Government to perform the MOCs and MTFs. The contractor shall perform MOC/MTFs in instances where the Government is unable. The contractor shall propose no more than 200 hours of contractor performed MOC and MFT throughout the PoP.

3.2.4 Aircraft may be used by the contractor crewmembers to maintain aircraft currency/proficiency as required by DCMA INST 8210.1. Contractor shall provide fuel and maintenance coverage for these flights.

3.2.5 The contractor shall ensure aircraft availability within 72 hours of notification from the Government.

3.2.6 The contractor shall temporarily move aircraft indoors to prevent potential damage from inclement weather, in accordance with the contractor’s inclement weather procedures.

3.3 Modification Work Orders shall be completed as outlined in each MWO document received.

3.4 Aircraft Records and Database

3.4.1 The contractor shall maintain and update all aircraft forms and records in a like-flight ready condition utilizing the currently assigned system of record for that aircraft.

The contractor shall make aircraft and aircraft records available for inspection and inventory in support of aircraft transfer to other agencies or as required by the Government within 72 hours of notification from the Government.

3.5 Aircraft Transfer Actions

3.5.1 The contractor shall transfer aircraft IAW AR 700-138.

4.0 KICKOFF MEETING

4.1 The contractor shall conduct a kickoff meeting at the contractor’s facility within 5 days after award of contract. The contractor shall coordinate a detailed agenda with the Government Project Lead, and deliver agenda 2 business days prior to kickoff meeting, and deliver meeting minutes IAW DI-ADMN-81505, CDRL A001 (Attachment 1). A copy of all briefings shall include any corrections made during the meeting and provided to the COR in accordance with applicable CDRL. The contractor shall identify its Project Lead for this effort at the kickoff meeting. All contractor personnel responsible for the requirements within the scope of the PWS shall be present to discuss their approach to successful completion of this PWS.

5.0 INTEGRATED PRODUCT TEAMS (IPT)

5.1 For proposal purposes the contractor shall provide a cost estimate for man hours required to support the conduct of IPTs on a monthly basis at the contractor’s facility or as otherwise pre-arranged 1 week in advance, to discuss technical, schedule, performance, and cost matters throughout the project’s lifecycle. IPT meetings shall include regular attendance by all members of the IPT core team (COR, Contractor, and

LSFMA) with additional ad hoc participation by functional area representatives as required by the IPT. The contractor shall prepare a record of all meetings with charts, as required, and minutes IAW DI-ADMN-81505, CDRL A001.

6.0 OVER AND ABOVE (O&A) / OVERTIME LABOR N/A for proposal purposes.

6.1 Over and Above – O&A will be in accordance with appropriate clause referenced in the LSFMA MAIDIQ base contract but shall not be used for proposal purposes.

6.2 Overtime – Will not be used for proposal purposes.

7.0 CONTRACT MANAGEMENT

7.1 For proposal purposes, the contractor shall provide a Weekly Status Report per aircraft IAW DI MGMT 81928, CDRL A002.

7.2 For proposal purposes, the contractor shall provide a Performance and Cost Report IAW DI-FNCL-80912A, CDRL LSFS001 as referenced in the LSFMA MA IDIQ base contract, and a Performance and Cost Closeout Report IAW DI-FNCL-80912A, CDRL LSFS003.

8.0 INSPECTION AND ACCEPTANCE

8.1 Inspection and acceptance Origin will be made utilizing a DD250 in Wide Area Workflow (WAWF) S0109A. Inspection and acceptance Destination will be made utilizing a DD250 in WAWF using the appropriate Department of Defense Activity Address Code (DoDAAC) (TBD)

9.0 SECURITY FOR CONTRACTORS REQUIRING COMMON ACCESS CARD

(CAC)

9.1 For proposal purposes, contractor must identify and outline the individual security requirements to support all implied and stated security requirements and provide a total program cost for 1 year of such efforts. The contractor employee will be issued a CAC only if duties involve one of the following: (1) Both physical access to a Department of Defense (DoD) facility and access, via logon, to DoD networks on-site or remotely; (2) Remote access, via logon, to a DoD network using DoD-approved remote access procedures; or (3) Physical access to multiple DoD facilities or multiple non-DoD federally controlled facilities on behalf of the DoD on a recurring basis for a period of 6 months or more.

9.2 At the discretion of the sponsoring activity, an initial CAC/PKI may be issued based on a favorable review of the FBI fingerprint check and a successfully scheduled NACI at the Office of Personnel Management.

10. ADMINISTRATIVE REPORTS

10.1 For proposal purposed, The contractor shall provide a man hour estimate required to provide a Task Execution Plan (TEP) IAW DI-MGMT-80004A, CDRL A003.

11.0 PERIOD of PERFORMANCE (PoP)

The contractor shall provide option pricing to complete all above reference requirements for the below periods for complete Contract Years (CY) from award, with no fractionalization for Fiscal years. Contractor shall comply with PoP reporting per DI-

MISC-80167A, LSFS005.

11. 1 The Pop is:

A one year base effort from 1 May 2023 to 1 May 2024

Option Year 1 from 2 May 2024 to 30 Apr 2025

Option Year 2 from 1 May 2025 to 30 Apr 2026

Option Year 3 from 1 May 2026 to 30 Apr 2027

ATTACHMENTS

Attachment 1 - CDRLs

Keepers, Kirk E CIV AMCOM IMMC What is the correct way to show the period of performance for the TO?

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION

Page of

CONTRACT DATA REQUIREMENTS LIST (CDRL)

REV 0

CONTRACT DATA REQUIREMENTS LIST

(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 Contract/PR No. listed in Block E.

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

TDP TM OTHER ADMN

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

UHPO ACFT MAINTENANCE W58RGZ-22-R-0090/XXXX

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

GROUP

A001 Reports, Record of Meeting Minutes Meeting Minutes

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-ADMN-81505 PWS Para 4.1 SFAE-AV-UH INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION IN

LT 1TIME SEE BLOCK 16 b. COPIES

SECT. B

8. APP CODE SEE BLOCK 16 11. AS OF DATE 13. DATE OF

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

A N/A N/A Reg

Repr o

16. REMARKS:

BLOCK 8: The Government will have 15 days to review and approve/disapprove with comments. If disapproved the contractor shall correct and resubmit within 10 days after notification of comments.

BLOCK 9: Distribution Statement D for unlimited rights.

BLOCKS 12: Submittal shall be NLT 10 days after completion of the meeting.

BLOCK 14: The Contractor shall electronically deliver the data to the Government via CDRLExpress (https://topvue.peoavn.army.mil/topvue-uh). CDRL Express maximum size for individual files is 100MB. Zip files that exceed 100MB may be broken down into multiple files 100MB or less and uploaded to CDRL Express with notification of delivery. Individual files that exceed 100MB shall be delivered via AMRDEC SAFE (https://safe.amrdec.army.mil ) with a notification letter uploaded to CDRL Express. Files that cannot be transmitted electronically shall be mailed to the following address and the notification letter uploaded to CDRLExpress:

Program Executive Office, Aviation Utility Helicopters Project Office 5308 Patton Road Redstone Arsenal Al 35898-5000

SEE BLOCK 16

0 1 0

15. TOTAL 0 1 0

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

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 Contract/PR No. listed in Block E.

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

TDP TM OTHER NDTI

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

UHPO ACFT MAINTENANCE W58RGZ-22-R-0090 /XXXX

1. DATA ITEM

NO.

2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A002 Contractor’s Progress, Status and Management Report Weekly Status Report

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATE

D TOTAL

PRICE

DI-MGMT-81928 PWS Para 7.1 SFAE-AV-UH INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION IN

LT SEE BLOCK 16 SEE BLOCK 16 b. COPIES SECT. B

8. APP CODE B/D 11. AS OF DATE 13. DATE OF

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draf t

Final

NA N/A SEE BLOCK 16

Rep ro

16. REMARKS:

Block 9: : Block 9: Distribution Statement B for anything other than unlimited rights. Distribution Statement D for unlimited rights.

Blocks 10, 12 and 13: Delivery shall be 30 days after contract award. The contractor shall deliver weekly status updates.

Block 14: The Contractor shall deliver via TOP VUE. Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

Program Executive Office, Aviation Utility Helicopters Project Manager’s Office 5308 Patton Road

SEE BLOCK 16 0 1 0

15. TOTAL

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

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 Contract/PR No. listed in Block E.

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

TDP TM OTHER MISC

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

UHPO ACFT MAINTENANCE W58RGZ-22-R-0090 /XXXX

1. DATA ITEM

NO.

2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A003 Management Plan Task Execution Plan (TEP), Administrative Support

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

PWS Para 10.1

6. REQUIRING OFFICE 18.

ESTIMATE

D TOTAL

PRICE

DI-MGMT-80004A SFAE-AV-UH INSERT

7. DD 250

REQ

9.DIST

STATEMENT

REQUIRED

10.

FREQUENCY

12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION IN

LT SEE BLOCK 16 SEE BLOCK 16 b. COPIES SECT. B

8. APP

CODE

B/D 11. AS OF DATE 13. DATE OF

SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

A N/A SEE BLOCK 16

Repr o

16. REMARKS:

Block 8: The Government will have 15 days after receipt of data to review, approve/disapprove with consolidated comments. If disapproved contractor shall correct and resubmit within 15 days after receipt of Government comments.

Block 9: : Block 9: Distribution Statement B for anything other than unlimited rights. Distribution Statement D for unlimited rights.

Blocks 10, 12 and 13: Delivery shall be 30 days after contract award.

Updates to the plan shall be submitted if there is a change in schedule and/or an increase in the estimated labor hours and dollars required to complete this

SUBESM.

Block 14: The Contractor shall deliver via TOP VUE. Data that cannot be delivered electronically shall be delivered on CD ROM to the following address:

Program Executive Office, Aviation Utility Helicopters Project Manager’s Office 5308 Patton Road

SEE BLOCK 16 0 1 0

15. TOTAL

G. PREPARED BY

H. DATE I. APPROVED BY

J. DATE

Form Approved OMB No. 0704-

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:

0004 A TDP TM _ OTHER FNCL

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

W58RGZ-22-R-0090

F. CONTRACTOR

LSFS-1 Program

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

Functional Hour Cost Report

17. PRICE GROUP

LSFS001 PERFORMANCE AND COST REPORT

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

AMAM-MFM-S

18. ESTIMATED

TOTAL PRICE

NSP DI-FNCL-80912

PWS para 3.0

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION LT REQUIRED Monthly SEE BLOCK 16

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final N/A SEE BLOCK 16 SEE BLK 16 30 DARR Reg Repro

16. REMARKS See Blk #16 0 1 0

The contractor shall submit a Performance and Cost report (PCR) in contractor format to the Government for each Cost Plus Fixed Fee (CPFF) Task Order (TO)/Delivery Order (DO). Reports shall be submitted monthly and continue throughout the TO/DO performance. The PCR shall be provided at a Summary level and a CLIN Level. The PCR Page Title shall contain at a minimum the TO/DO/CLIN Number, Requirement/Project Title, Requirement CLIN Title, Period of Performance (POP) Begin and End date and the Date of the Cost Reporting period. Format shall contain -Hours: Total Award hours by labor category, previous year actual hours by labor category, current year actual hours by labor category, current month actual hours by labor category, inception to date ·actual hours by labor category. Estimate to complete hours by Fiscal year by labor category and Estimate at Completion hours by labor category.

Cost: Award cost, previous year actual cost, current year actual cost, current month actual cost, inception to date actual cost, Estimate to complete cost by fiscal year, and estimate at completion cost. Cost shall be reported by Direct Labor, Direct Labor Overtime, Temp Labor, Subcontract Cost, Material, Travel, Other Direct Cost, Indirect Cost, Fee, Total Cost, and percentage of funding spent/estimated on inception to date and Estimate to Complete.

Block 9: Use "B" for project of Limited Rights Data and "D" for remainder documents.

Export Control Act Warning: when directed by a Government Task Order -shall be IAW DoD 5230.24, paragraph E3. L.l.8 for the appropriate notice.

Block 12: Delivery shall be at 60 calendar days after delivery order award. Block 14: Electronic (email) delivery shall be made to LSFMA: usarmy.redstone.amcom.mbx.lsfma-cdrls@mail.mil

Email addresses for TO/DO will be provided with the issuance of the formal Request for Offerors Proposals

(RFOP)

Data that cannot be delivered Electronically shall be delivered on CD-ROM to the following address.

Logistic Support Facility Management Activity (LSFMA)

AMAM-MFM-S

Bldg 3777, Maintenance Row Redstone Arsenal, AL 35898

AMAM-MFM-S 1 1 1

15. TOTAL ▬▬▬▬► 1 2 1

William T. Ferguson j

H. DATE

I. APPROVED BY

Alan Ruzicka mailto:usarmy.redstone.amcom.mbx.lsfma-cdrls@mail.mil

Form Approved OMB No. 0704-

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:

0004 A TDP TM OTHER FNCL

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

W58RGZ-22-R-0090

F. CONTRACTOR

LSFS-1 Program

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

LSFS003 PERFORMANCE COST REPORT PRELIMINARY CLOSE OUT REPORT

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

AMAM-MFM-S

18. ESTIMATED

TOTAL PRICE

NSP DI-FNCL-80912

PWS para 3.3

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

LT REQUIRED 1 SEE BLOCK 16

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final A B SEE BLK 16 N/A Reg Repro

16. REMARKS

The contractor shall submit a Preliminary Close Out Cost Report to the Government no later than (NLT) 90 days after completion of the TO/DO. Information shall be in accordance with the Contractor standard format. The Government will review and approve or disapprove with comments within 15 days of submission. If disapproved the contractor shall revise in accordance with (IAW) comments and resubmit within 15 days after receipt of disapproval.

Block 11 and 12: Delivery shall be at 90 days after completion of TO/DO.

Block 14: Electronic (email) delivery shall be made to

LSFMA : usarmy.redstone.amcom.mbx.lsfma-cdrls@mail.mil

Email address for TO/DO will be provided with formal RFP. Data that cannot be delivered Electronically shall be delivered on CD-ROM to the following address.

Logistic Support Facility Management Activity (LSFMA) AMSAM-MLS Bldg 3777, Maintenance Rd.

Redstone Arsenal, AL 35898

See Blk #16 0 1 0

William T. Ferguson

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:

0004 A TDP TM _ OTHER FNCL

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

W58RGZ-22-R-0090

F. CONTRACTOR

LSFS-1 Program

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

Period of Performance Report

17. PRICE GROUP

LSFS005 Contract Data Status and Schedule Report

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

AMSAM-MLS

18. ESTIMATED

TOTAL PRICE

NSP DI-MISC-80167A

PWS para 3.5

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION LT REQUIRED Monthly See BLK 16

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final N/A SEE BLOCK 16 SEE BLK 16 Monthly Reg Repro

16. REMARKS See Blk #16 0 1 0

The contractor shall submit a Period of Performance (POP) report in contractor excel format to the Government by Task Order (TO)/Delivery Order (DO) and by Contract Line Item Number (CLIN) detailing a thirty (30), sixty (60) and ninety (90) day end notice prior to POP expiration date. Reports shall be submitted monthly and continue throughout the TO/DO performance.

Format shall contain - TO/DO number, Project/Requirement Title, CLIN Title, Days prior to expiring, contract type, and POP end date.

Block 11 and 12: Delivery shall be 90 days prior to completion of a TO/DO

CLIN.

Block 14: Electronic (email) delivery shall be made to

LSFMA : usarmy.redstone.amcom.mbx.lsfma-cdrls@mail.mil

Data that cannot be delivered Electronically shall be delivered on CD-ROM to the following address.

Logistic Support Facility Management Activity (LSFMA) AMSAM-MLS Bldg 3777, Maintenance Rd.

Redstone Arsenal, AL 35898

William T. Ferguson