Attachment 2 CDRL A005 - Employee Changes.pdf

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The Federal Aviation Administration (FAA) has a requirement for Second Level Engineering Services
Solicitation number
6973GH-26-R-00011
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This document is a Contract Data Requirements List (CDRL) for Second Level Engineering Services. The CDRL outlines a specific data item (A005) for monthly "Employee Changes" reporting, which requires the contractor to submit a report on the 5th of each month after full performance begins. The report must list employees who have been added, deleted, or had name changes, presented in alphabetical order. The document indicates the contract/PR number and contractor are to be determined (TBD), with the requiring office listed as AJW-1/AMC-700. The form was prepared by Richard Pak on 30 Dec 2016 and approved by Chris Trubizi on 10 Jan 2025, with distribution to AJW-11 COR and AMC-700/Security.

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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:

SEE BLOCK 16 TDP ____ TM _____ OTHER _________________________

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

SECOND LEVEL ENGINEERING SERVICES TBD TBD

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

A005 EMPLOYEE CHANGES

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

TOTAL PRICE

SOW 8.5 AJW-1/AMC-700

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

N/A REQUIRED MONTHLY SEE BLOCK 16

a. ADDRESSEE

b. COPIES

8. APP CODE

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

Draft Final

SEE BLK 16 5TH OF EACH MONTH Reg Repro

16. REMARKS AJW-1/ COR 1

BLOCK A - 0006, 1006, 2006, 3006, 4006

BLOCK 11 - DATE OF ASSUMING FULL PERFORMANCE

BLOCK 12 - AFTER ASSUMING FULL PERFORMANCE, REPORT IS DUE ON THE 5TH OF EACH

MONTH AFTER CHANGES OCCUR.

THE REPORT SHALL INCLUDE THE DATE OF THE REPORT, THE REPORTING MONTH, AND THE

NAMES OF EMPLOYEES THAT HAVE BEEN ADDED/DELETED, OR HAD THEIR NAMES CHANGED.

THE LIST SHALL BE IN ALPHABETICAL ORDER.

CONTRACTOR FORMAT IS ACCEPTABLE.

AMC-700/SECURITY 1

15. TOTAL ▬▬▬▬► 2

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

RICHARD PAK, AJW-11

30 Dec 2016

CHRIS TRUBIZI, AJW-14

10 Jan 2025

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

File details come from the government source that posted it. Updated .