Attachment 4- CDRLs Portfolio.pdf

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PREVIOUS EDITION MAY BE USED.

DD FORM 1423, FEB 2024

Page of

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoDM 5010.12 for detailed instructions.)

DD FORM 1423, FEB 2024

Page of

CONTRACT DATA REQUIREMENTS LIST

C. CATEGORY:

14. DISTRIBUTION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft

Final

Reg

Repro

16. REMARKS

14. DISTRIBUTION

15.TOTAL

Image of arrow pointing towards totals

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 (e.g., Mission Design Series (MDS) designator).

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

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

Item G. Name of preparer of CDRL.

Item H. Date CDRL was prepared and signature of preparer of CDRL.

Item I. Name of CDRL approval authority.

Item J. Date CDRL was approved and signature of CDRL approval authority.

Item 1. See DFARS Subpart 204.71 for proper numbering. To add or delete additional data items, point and click the plus or minus sign to the right of Block J.

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. Identify only one Data Acquisition Document No. If a single work task generates more than one deliverable data product, prepare a separate data item for each deliverable data product.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work/Performance Work Statement 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 and computer software, specify the contractor's requirement to mark the appropriate distribution statement on the technical data or computer software (ref. DoDI 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.

Identify for which data item additional remarks are provided. When tailoring the Data Acquisition Document invoked in Item 4, identify which portions of that Document are being tailored.

Identify any referenced attachments to the form. Attachments can be added using the button at the bottom of page 1.

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 rights to use the data shall be governed by the pertinent provisions of the contract.

9.0.0.2.20120627.2.874785

DD Form 1423, "Contract Data Requirements List"

CurrentPage:

PageCount:

Select Classification from drop-down list.: 1

CUI Indicator Information:

Click on this button to attach a file(s).:

A. CONTRACT LINE ITEM NUMBER: 1

exhibit: 1

C. CATEGORY: Select for "TDP.": 0

C. CATEGORY: Select for "TM.": 0

C. CATEGORY: Select for "OTHER.": 1

C. CATEGORY: Enter specification for "Other.": CONTRACT REQUIREMENTS

System: inTransition

ContractNum: HT001125R0047

Contractor: TBD

1. DATA ITEM NUMBER: 14

titleDataItem: nTransition Data Analytics subtitle: N/A

4. AUTHORITY (Data Acquisition Document Number): DI-MGMT-80508 contractRef: PWS 5.2.2 reqOffice: DHA MA

7. DD 250 REQUIREMENT: N/A

8. APPROVAL CODE : N/A

9. DISTRIBUTION STATEMENT REQUIRED: See BLK 16.

freq: See BLK 16.

asOfDate: See BLK 16.

dateFirstSub: See BLK 16.

dateSubseqSub: See BLK 16.

16. REMARKS: BLK 9: Distribution Statement F. Further distribution only as directed by DHA or higher DoD authority.

BLK 10-13: As described below.

BLK 14: Electronic submission via email.

The contractor shall provide inTransition-specific data analytics, reported on a frequency required per the Government. All metrics, though, will be included at minimum and rolled up in the quarterly and annual metrics reports. The report will include analytic summaries (e.g., counts, minimum, maximum, mean, standard deviation) appropriate to the metric reported. Specific program objectives and data reporting requirements will be provided by the Government and subsequently discussed with the contractor to ensure feasibility at contract award.

The following variables must be included in the regularly collected data analytics, with additional TBD as required.

Age Sex Status (AD or Veteran) Branch of Service Location (CONUS/OCONUS) Time since separation (if applicable) MH/TBI conditions (if available) Attempts at contact (disposition) Time to complete outreach for each monthly list (if applicable) Source of referrals Resources provided Number of intakes completed Time from intake to first coaching session Time from coaching session to connection to follow-on care Number of new and active coaching cases Number of coaching sessions per case Length of time case in coaching Cases reporting scheduled appointment with provider Cases confirmed attended appointment with provider Location of new provider

Click to add continuation field for Remarks:

14. DISTRIBUTION - a. ADDRESSEE, new line:

15.TOTAL - Total draft copies is automatically calculated.:

15.TOTAL - Total final regular copies is automatically calculated.:

15.TOTAL - Total final reproducible copies is automatically calculated.:

priceGrp:

estTotalPrice:

remarks:

preparedBy: Mr. Duane Thomas

J. SIGNATURE: H. SIGNED ON 20250314

J. SIGNATURE: J. SIGNED ON 20250324

J. SIGNATURE:

approvedBy: Karen Dennis

Click to add additional data items.:

Click to delete additional data items.:

viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

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Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other

Page of

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoDM 5010.12 for detailed instructions.)

DD FORM 1423, FEB 2024

Page of

CONTRACT DATA REQUIREMENTS LIST

C. CATEGORY:

14. DISTRIBUTION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft

Final

Reg

Repro

16. REMARKS

14. DISTRIBUTION

15.TOTAL

Image of arrow pointing towards totals

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 (e.g., Mission Design Series (MDS) designator).

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

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

Item G. Name of preparer of CDRL.

Item H. Date CDRL was prepared and signature of preparer of CDRL.

Item I. Name of CDRL approval authority.

Item J. Date CDRL was approved and signature of CDRL approval authority.

Item 1. See DFARS Subpart 204.71 for proper numbering. To add or delete additional data items, point and click the plus or minus sign to the right of Block J.

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. Identify only one Data Acquisition Document No. If a single work task generates more than one deliverable data product, prepare a separate data item for each deliverable data product.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work/Performance Work Statement 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 and computer software, specify the contractor's requirement to mark the appropriate distribution statement on the technical data or computer software (ref. DoDI 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.

Identify for which data item additional remarks are provided. When tailoring the Data Acquisition Document invoked in Item 4, identify which portions of that Document are being tailored.

Identify any referenced attachments to the form. Attachments can be added using the button at the bottom of page 1.

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 rights to use the data shall be governed by the pertinent provisions of the contract.

9.0.0.2.20120627.2.874785

DD Form 1423, "Contract Data Requirements List"

CurrentPage:

PageCount:

Select Classification from drop-down list.: 1

CUI Indicator Information:

Click on this button to attach a file(s).:

A. CONTRACT LINE ITEM NUMBER: 1

exhibit: 1

C. CATEGORY: Select for "TDP.": 0

C. CATEGORY: Select for "TM.": 0

C. CATEGORY: Select for "OTHER.": 1

C. CATEGORY: Enter specification for "Other.": CONTRACT REQUIREMENTS

System: inTransition

ContractNum: HT001125R0047

Contractor: TBD

1. DATA ITEM NUMBER: 15

titleDataItem: System Security Plan subtitle: N/A

4. AUTHORITY (Data Acquisition Document Number): DI-MGMT-81864 contractRef: PWS 6.3, 6.5.1.1 reqOffice: DHA MA

7. DD 250 REQUIREMENT: N/A

8. APPROVAL CODE : N/A

9. DISTRIBUTION STATEMENT REQUIRED: N/A

freq: See BLK 16.

asOfDate: See BLK 16.

dateFirstSub: See BLK 16.

dateSubseqSub: See BLK 16.

16. REMARKS: BLK 10: One time.

BLK 12. Within 15DAC.

BLK 13. n/a.

BLK 14: Electronic submission via email.

The system security plan outlines specific procedures and safeguards that will protect all private and sensitive information as related to execution of the inTransition program, particularly in the telework environment. This plan will be due and submitted electronically to the Government no later than 15 days post contract award.

Click to add continuation field for Remarks:

14. DISTRIBUTION - a. ADDRESSEE, new line:

15.TOTAL - Total draft copies is automatically calculated.:

15.TOTAL - Total final regular copies is automatically calculated.:

15.TOTAL - Total final reproducible copies is automatically calculated.:

priceGrp:

estTotalPrice:

remarks:

preparedBy: Mr. Duane Thomas

J. SIGNATURE: H. SIGNED ON 20250314

J. SIGNATURE: J. SIGNED ON 20250324

J. SIGNATURE:

approvedBy: Karen Dennis

Click to add additional data items.:

Click to delete additional data items.:

viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.

Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other

Page of

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoDM 5010.12 for detailed instructions.)

DD FORM 1423, FEB 2024

Page of

CONTRACT DATA REQUIREMENTS LIST

C. CATEGORY:

14. DISTRIBUTION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft

Final

Reg

Repro

16. REMARKS

14. DISTRIBUTION

15.TOTAL

Image of arrow pointing towards totals

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 (e.g., Mission Design Series (MDS) designator).

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

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

Item G. Name of preparer of CDRL.

Item H. Date CDRL was prepared and signature of preparer of CDRL.

Item I. Name of CDRL approval authority.

Item J. Date CDRL was approved and signature of CDRL approval authority.

Item 1. See DFARS Subpart 204.71 for proper numbering. To add or delete additional data items, point and click the plus or minus sign to the right of Block J.

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. Identify only one Data Acquisition Document No. If a single work task generates more than one deliverable data product, prepare a separate data item for each deliverable data product.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work/Performance Work Statement 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 and computer software, specify the contractor's requirement to mark the appropriate distribution statement on the technical data or computer software (ref. DoDI 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.

Identify for which data item additional remarks are provided. When tailoring the Data Acquisition Document invoked in Item 4, identify which portions of that Document are being tailored.

Identify any referenced attachments to the form. Attachments can be added using the button at the bottom of page 1.

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 rights to use the data shall be governed by the pertinent provisions of the contract.

9.0.0.2.20120627.2.874785

DD Form 1423, "Contract Data Requirements List"

CurrentPage:

PageCount:

Select Classification from drop-down list.: 1

CUI Indicator Information:

Click on this button to attach a file(s).:

A. CONTRACT LINE ITEM NUMBER: 1

exhibit: 1

C. CATEGORY: Select for "TDP.": 0

C. CATEGORY: Select for "TM.": 0

C. CATEGORY: Select for "OTHER.": 1

C. CATEGORY: Enter specification for "Other.": CONTRACT REQUIREMENTS

System: inTransition

ContractNum: HT001125R0047

Contractor: TBD

1. DATA ITEM NUMBER: 16

titleDataItem: Contact Center Operations Plan subtitle: N/A

4. AUTHORITY (Data Acquisition Document Number): DI-MGMT-81864 contractRef: PWS 5.2.7 reqOffice: DHA MA

7. DD 250 REQUIREMENT: N/A

8. APPROVAL CODE : N/A

9. DISTRIBUTION STATEMENT REQUIRED: N/A

freq: See BLK 16.

asOfDate: See BLK 16.

dateFirstSub: See BLK 16.

dateSubseqSub: See BLK 16.

16. REMARKS: BLK 10: One time.

BLK 12. Within 30DAC.

BLK 13. n/a.

BLK 14: Electronic submission via email.

Contractor will provide a Contact Center Operations Plan that details program operations to include flow of information within the system and transfers, follow-up as indicated. This document will be provided to the Government electronically within 30 days after contract award.

Click to add continuation field for Remarks:

14. DISTRIBUTION - a. ADDRESSEE, new line:

15.TOTAL - Total draft copies is automatically calculated.:

15.TOTAL - Total final regular copies is automatically calculated.:

15.TOTAL - Total final reproducible copies is automatically calculated.:

priceGrp:

estTotalPrice:

remarks:

preparedBy: Mr. Duane Thomas

J. SIGNATURE: H. SIGNED ON 20250324

J. SIGNATURE: J. SIGNED ON 20250324

J. SIGNATURE:

approvedBy: Karen Dennis

Click to add additional data items.:

Click to delete additional data items.:

viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.

Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other

Page of

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoDM 5010.12 for detailed instructions.)

DD FORM 1423, FEB 2024

Page of

CONTRACT DATA REQUIREMENTS LIST

C. CATEGORY:

14. DISTRIBUTION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft

Final

Reg

Repro

16. REMARKS

14. DISTRIBUTION

15.TOTAL

Image of arrow pointing towards totals

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 (e.g., Mission Design Series (MDS) designator).

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

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

Item G. Name of preparer of CDRL.

Item H. Date CDRL was prepared and signature of preparer of CDRL.

Item I. Name of CDRL approval authority.

Item J. Date CDRL was approved and signature of CDRL approval authority.

Item 1. See DFARS Subpart 204.71 for proper numbering. To add or delete additional data items, point and click the plus or minus sign to the right of Block J.

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. Identify only one Data Acquisition Document No. If a single work task generates more than one deliverable data product, prepare a separate data item for each deliverable data product.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work/Performance Work Statement 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 and computer software, specify the contractor's requirement to mark the appropriate distribution statement on the technical data or computer software (ref. DoDI 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.

Identify for which data item additional remarks are provided. When tailoring the Data Acquisition Document invoked in Item 4, identify which portions of that Document are being tailored.

Identify any referenced attachments to the form. Attachments can be added using the button at the bottom of page 1.

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 rights to use the data shall be governed by the pertinent provisions of the contract.

9.0.0.2.20120627.2.874785

DD Form 1423, "Contract Data Requirements List" add continuation

CurrentPage:

PageCount:

Select Classification from drop-down list.: 1

CUI Indicator Information:

Click on this button to attach a file(s).:

A. CONTRACT LINE ITEM NUMBER: 1

exhibit: 1

C. CATEGORY: Select for "TDP.": 0

C. CATEGORY: Select for "TM.": 0

C. CATEGORY: Select for "OTHER.": 1

C. CATEGORY: Enter specification for "Other.": CONTRACT REQUIREMENTS

System: inTransition

ContractNum: HT001125R0047

Contractor: TBD

1. DATA ITEM NUMBER: 2

titleDataItem: Monthly Progress Report (MPR) subtitle: N/A

4. AUTHORITY (Data Acquisition Document Number): DI-MGMT-80508 contractRef: PWS 1.18, 3.4.1, 5.2.2, 5.2.7.1 reqOffice: DHA MA

7. DD 250 REQUIREMENT: N/A

8. APPROVAL CODE : N/A

9. DISTRIBUTION STATEMENT REQUIRED: See BLK 16.

freq: MTHLY asOfDate: See BLK 16.

dateFirstSub: See BLK 16.

dateSubseqSub: See BLK 16.

16. REMARKS: BLK 9: Distribution Statement F. Further distribution only as directed by DHA or higher DoD authority.

BLK 11: EOM.

BLK 12. No later than 45DAC BLK 13: Submitted no later than the 15th of the following month.

BLK 14: Electronic submission via email.

The Contractor shall ensure that a MPR is submitted outlining the GFE inventory, billings, progress, status, and any problems/issues encountered in the performance of this contract. The Contractor shall require all subcontractors to provide input to the MPR where there are critical or significant tasks related to the prime contract. Critical or significant tasks shall be defined by mutual agreement between the Government and Contractor. MPR format will be directed by the Government. The MPR will include, but is not limited to:

All ODCs A log of all contact center activities (e.g., calls, emails, text messages, website chats, and coaching sessions) Updated inventory report Metrics of effectiveness Outreach documentation

The MPR is due 45 days after this contract is awarded and is due no later than the 15th day of each month thereafter. Delivery is electronic via email.

Click to add continuation field for Remarks:

14. DISTRIBUTION - a. ADDRESSEE, new line:

15.TOTAL - Total draft copies is automatically calculated.:

15.TOTAL - Total final regular copies is automatically calculated.:

15.TOTAL - Total final reproducible copies is automatically calculated.:

priceGrp:

estTotalPrice:

remarks:

preparedBy: Mr. Duane Thomas

J. SIGNATURE: H. SIGNED ON 20250324

J. SIGNATURE: J. SIGNED ON 20250324

J. SIGNATURE:

approvedBy: Karen Dennis

Click to add additional data items.:

Click to delete additional data items.:

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Page of

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoDM 5010.12 for detailed instructions.)

DD FORM 1423, FEB 2024

Page of

CONTRACT DATA REQUIREMENTS LIST

C. CATEGORY:

14. DISTRIBUTION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft

Final

Reg

Repro

16. REMARKS

14. DISTRIBUTION

15.TOTAL

Image of arrow pointing towards totals

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 (e.g., Mission Design Series (MDS) designator).

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

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

Item G. Name of preparer of CDRL.

Item H. Date CDRL was prepared and signature of preparer of CDRL.

Item I. Name of CDRL approval authority.

Item J. Date CDRL was approved and signature of CDRL approval authority.

Item 1. See DFARS Subpart 204.71 for proper numbering. To add or delete additional data items, point and click the plus or minus sign to the right of Block J.

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. Identify only one Data Acquisition Document No. If a single work task generates more than one deliverable data product, prepare a separate data item for each deliverable data product.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work/Performance Work Statement 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 and computer software, specify the contractor's requirement to mark the appropriate distribution statement on the technical data or computer software (ref. DoDI 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.

Identify for which data item additional remarks are provided. When tailoring the Data Acquisition Document invoked in Item 4, identify which portions of that Document are being tailored.

Identify any referenced attachments to the form. Attachments can be added using the button at the bottom of page 1.

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 rights to use the data shall be governed by the pertinent provisions of the contract.

9.0.0.2.20120627.2.874785

DD Form 1423, "Contract Data Requirements List" add continuation

CurrentPage:

PageCount:

Select Classification from drop-down list.: 1

CUI Indicator Information:

Click on this button to attach a file(s).:

A. CONTRACT LINE ITEM NUMBER: 1

exhibit: 1

C. CATEGORY: Select for "TDP.": 0

C. CATEGORY: Select for "TM.": 0

C. CATEGORY: Select for "OTHER.": 1

C. CATEGORY: Enter specification for "Other.": CONTRACT REQUIREMENTS

System: inTransition

ContractNum: HT001125R0047

Contractor: TBD

1. DATA ITEM NUMBER: 3

titleDataItem: Data Dictionary subtitle: N/A

4. AUTHORITY (Data Acquisition Document Number): DI-MGMT-80508 contractRef: PWS 1.6.1.2 reqOffice: DHA MA

7. DD 250 REQUIREMENT: N/A

8. APPROVAL CODE : N/A

9. DISTRIBUTION STATEMENT REQUIRED: N/A

freq: See BLK 16.

asOfDate: See BLK 16.

dateFirstSub: See BLK 16.

dateSubseqSub: See BLK 16.

16. REMARKS: BLK 12. No later than 45DAC BLK 13: Updated annually.

BLK 14: Electronic submission via email.

Contractor shall develop a data dictionary that defines all data and variables collected. The data dictionary is due 45 days after this contract is awarded and annually thereafter. Delivery is electronic via email.

Click to add continuation field for Remarks:

14. DISTRIBUTION - a. ADDRESSEE, new line:

15.TOTAL - Total draft copies is automatically calculated.:

15.TOTAL - Total final regular copies is automatically calculated.:

15.TOTAL - Total final reproducible copies is automatically calculated.:

priceGrp:

estTotalPrice:

remarks: Call Center Requirements

The Contractor shall:

1. Maintain a United States-based inTransition Call Center consisting of licensed mental health care providers who provide telephonic and/or video-teleconferencing coaching and supportive services to Service members and Veterans during their transition from one mental health and/or moderate to severe TBI care providers to another, either within a health care system or between health care systems, or to initiate mental health care for the first time. Non-licensed personnel may conduct outbound calls and conduct intakes for Service members and Veterans seeking coaching services. The Call Center will also support the PHRC, where a live person responds to inquiries with information and psychological health resources; the PHRC provides services to anyone but does not engage in coaching. PHRC personnel may be staffed by non-licensed personnel as well. All aspects of the inTransition Call Center will provide a live, 24/7 response, with coaching services available Monday through Friday unless otherwise mutually agreed upon by the Service member/Veteran and the call center coach.

2. Maintain and organize all DHA-provided lists of automatically enrolled Service members and eliminate multiple contacts for Service members already enrolled in the program.

3. Contact all Service members on the monthly DHA-provided lists no more than 30 calendar days following receipt of the list. Make three outreach attempts within seven days of initial outbound call to Service member to confirm enrollment. Note that while the number of outreach attempts made to each name on the DHA provided monthly list is three, monthly requirements for number of outreach attempts may be reduced based on monthly consultation of Government assessment and need.

4. Answer all inbound calls within no more than 28 seconds.

5. Not place a caller on hold for more than two minutes total duration after initial pickup. On a routine basis, telephonic 'Hold' time must not exceed 2 minutes; periodically, research into a particular subject by inTransition personnel may require 2-3 minutes; in this event, the caller will be given an option to 'Hold' beyond the 2-3 minutes during resource research, or receive a call back or email within a 1/2 hour of the originating call requesting resource information.

6. Support inbound provider referrals and self-referrals from Service members and Veterans to include Active Duty, Reserve Component, National Guard, Coast Guard, and Veterans of these organizations, regardless of time in service or characterization of discharge.

7. Refer all non-Service members or Veterans who call inbound to inTransition to the PHRC.

8. Maintain a PHRC where a live person is standing by to provide information on transition support and psychological health resources targeted to the caller’s needs and geographic location. Note that the PHRC is available to anyone but does not provide coaching services. The PHRC must have a different phone number than the one used for coaching services and have a “live chat” function where someone can interface through text with a live PHRC staff member. The PHRC will leverage the same inTransition directory of resources to support all callers.

9. Ensure that coaching services are available to assist Service members and Veterans both CONUS and OCONUS with transition related needs, Monday through Friday, unless otherwise mutually agreed upon with Service member/Veteran and call center personnel.

10. Ensure capability of Call Center personnel to email with Service members or Veterans and other healthcare agencies/providers such as VA Liaisons and VA Transition and Care Managers. Note, contractor should ensure that call center personnel have additional capabilities for engagement, to include text messaging and video teleconferencing, though these platforms will not be used unless direction is provided by the Government.

11. Ensure that all coaches are licensed mental health professionals (i.e., social work, psychology, marriage and family therapy, behavioral health counseling). Other Call Center personnel may have lesser professional qualifications and are suitable to support the outbound calls to Service members, conduct intakes, and support those who contact the PHRC. All Call Center personnel must have demonstrated experience in triage, care management, motivational interviewing, and crisis counseling; for example, a nurse may have this experience as well as someone who has worked at a crisis call center or other mental health-related environment. All coaches should preferably have at least three years’ experience providing care in a health care setting.

12. Maintain all written data records in secure database which is easily accessible by authorized personnel identified by the Government.

13. Record and store for no less than one year all inbound and outbound outreach attempts and electronic communications. These attempts, to include all calls/communications, should be stored using a secure platform and should be available for Government review within 24 hours of request.

14. Enact a Call Center-based quality control and supervision plan to ensure that intakes and coaching are meeting clinical and programmatic standards. Supervision plan must be approved by the Government and COR NLT 15 days after contract award.

15. Implement a method of tracking the number and type of services that are provided to each caller, as well as the duration of each call. Provide this data in the MPR IAW CDRL 2.

preparedBy: Mr. Duane Thomas

J. SIGNATURE: H. SIGNED ON 20250324

J. SIGNATURE: J. SIGNED ON 20250324

J. SIGNATURE:

approvedBy: Karen Dennis

Click to add additional data items.:

Click to delete additional data items.:

viewer may not be able to display this type of document.

You can upgrade to the latest version of Adobe Reader for Windows®, Mac, or Linux® by visiting http://www.adobe.com/go/reader_download.

For more assistance with Adobe Reader visit http://www.adobe.com/go/acrreader.

Windows is either a registered trademark or a trademark of Microsoft Corporation in the United States and/or other countries. Mac is a trademark of Apple Inc., registered in the United States and other countries. Linux is the registered trademark of Linus Torvalds in the U.S. and other

Page of

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoDM 5010.12 for detailed instructions.)

DD FORM 1423, FEB 2024

Page of

CONTRACT DATA REQUIREMENTS LIST

C. CATEGORY:

14. DISTRIBUTION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft

Final

Reg

Repro

16. REMARKS

14. DISTRIBUTION

15.TOTAL

Image of arrow pointing towards totals

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 (e.g., Mission Design Series (MDS) designator).

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

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

Item G. Name of preparer of CDRL.

Item H. Date CDRL was prepared and signature of preparer of CDRL.

It…