Attachment 4 - NSW USSOCOM KTR Vaccine Report_Template_3 NOV 21.xlsx
XLSX spreadsheet 26 KB Posted
- Attached to
- Role Player Support Services
- Solicitation number
- H92240-22-Q-2000
- Issued by
-
United States Special Operations Command
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Other files
| File | Type | Posted |
|---|---|---|
| Attachment 5 - WD 202103071.txt | TXT text file | |
| RFQ H92240-22-Q-2000- Combined Synopsis Solicitation_Amendment0003.docx | DOCX document | |
| Attachment 2 - Pricing Spreadsheet_Rev2.xlsx | XLSX spreadsheet | |
| Attachment 7 - DD Form 254.pdf | ||
| Questions_Answers_10Dec2021.pdf | ||
| Questions_Answers 2Dec2021.pdf | ||
| Attachment 2 - Pricing Spreadsheet_Rev1.xlsx | XLSX spreadsheet | |
| (CUI) Attachment 1 - PWS - Role Player Support Services_Rev1.pdf | ||
| Attachment 3 - Quality Assurance Surveillance Plan_Rev1.docx | DOCX document | |
| RFQ H92240-22-Q-2000- Combined Synopsis Solicitation_Amendment0001.docx | DOCX document | |
| RFQ H92240-22-Q-2000- Combined Synopsis Solicitation.docx | DOCX document | |
| Attachment 6 - Sample FY22 Role Player TOR.docx | DOCX document | |
| Attachment 3 - Quality Assurance Surveillance Plan.docx | DOCX document | |
| Attachment 2 - Pricing Spreadsheet.xlsx | XLSX spreadsheet | |
| (CUI) Attachment 1 - PWS - Role Player Support Services.pdf |
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Text version
Tab 1 - Instructions
| CORONAVIRUS DISEASE 2019 (COVID-19) STATUS REPORT | |
| Ref: | (a) Executive Order 14043, “Requiring Coronavirus Disease 2019 Vaccination for Federal Employees,” signed 9 September 2021 |
(b) Safer Federal Workforce Task Force, “COVID-19 Workplace Safety: Guidance for Federal Contractors and Subcontractors,” issued 24 September 2021
(c) 252.223-7999 Ensuring Adequate COVID-19 Safety Protocols for Federal Contractors (Deviation 2021-O0009)
| GENERAL INSTRUCTIONS: Do NOT include employee names or other Personally Identifiable Information (PII). The term "Covered Employee" per the above cited referrences. | |
| Populate Tab 2 for All Covered Contractor Employees as defined by Safer Federal Workforce Task Force. https://www.saferfederalworkforce.gov/contractors/ | |
| Populate Tab 3 for All Covered Contractor Employees performing work on-site in USSOCOM designated spaces. USSOCOM spaces are defined as the USSOCOM enterprise facilities including headquarters, and all subordinate component commands (NAVSOC, USASOC, MARSOC, AFSOC, etc.) Itemize by task order or individual contract (sample entries are provided in red for illustrative purposes). | |
| DL = Direct Labor | |
| IDL = Indirect Labor | |
| Direct Labor (DL) is taken in the traditional context where the employee is directly contributing to performing the task as defined in the PWS. Indirect would be any employee not directly performing such as company leadership, managers of employees, etc. So if the FTEs you list below are performing the tasks directly, then they are DL. | |
| OCOM |
Tab 2 - All Covered Employees
| Contractor: |
| CAGE Code: |
| Prepared By/Date Prepared: |
| Total Population | Fully Vaccinated | Not Fully Vaccinated | ||||||||||||||||||||
| Exemptions (Medical or Religious only) | ||||||||||||||||||||||
| (pending or approved regardless of duration (temp or perm)) | Refusals | |||||||||||||||||||||
| (no intention of seeking exemption) | Vaccination Incomplete | |||||||||||||||||||||
| (2 of 2 Pfizer/Moderna or 1 dose J&J) | (includes partially vaccinated and non-vaccinated; all others) | |||||||||||||||||||||
| IDL | DL | ALL | IDL | DL | ALL | IDL | DL | ALL | ||||||||||||||
| IDL | DL | ALL | IDL | DL | ALL | MED | Relig. | MED | Relig. | MED | Relig. | CIV | CTR | ALL | CIV | CTR | ALL | |||||
| - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | |||||
| - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | |||||
| 1. Populate your data by personnel category; "ALL" columns are auto sum. | ||||||||||||||||||||||
| 2. Personnel should only be counted in one column. | ||||||||||||||||||||||
| 3. Exemptions include all exemptions pending or approved for medical or religious requests. | ||||||||||||||||||||||
| 4. Data is used from shaded cells above to populate data total personnel and is used in calculations shown on the briefing product. (Chart to right is actual CG briefing product) | ||||||||||||||||||||||
| 5. Refusals are those who do not intend to submit a exemption request or submit to vaccination. |
Tab 3-Covered Employees On-site
| Contractor: | |||||||||||||||||||||||||||
| CAGE Code: | |||||||||||||||||||||||||||
| Prepared By/Date Prepared: | |||||||||||||||||||||||||||
| Sample entries are provided in red for illustrative purposes | |||||||||||||||||||||||||||
| PIID | TO | Location | Total Population | Fully Vaccinated | Not Fully Vaccinated | ||||||||||||||||||||||
| Exemptions (Medical or Religious only) | |||||||||||||||||||||||||||
| (pending or approved regardless of duration (temp or perm)) | Refusals | ||||||||||||||||||||||||||
| (no intention of seeking exemption) | Vaccination Incomplete | ||||||||||||||||||||||||||
| (2 of 2 Pfizer/Moderna or 1 dose J&J) | (includes partially vaccinated and non-vaccinated; all others) | ||||||||||||||||||||||||||
| IDL | DL | ALL | IDL | DL | ALL | IDL | DL | ALL | |||||||||||||||||||
| IDL | DL | ALL | IDL | DL | ALL | MED | Relig. | MED | Relig. | MED | Relig. | CIV | CTR | ALL | CIV | CTR | ALL | ||||||||||
| H9224021D000X | H9224021F000X | NAB Coronado | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | |||||||
| H9224021F000Y | Stennis, MS | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | ||||||||
| H9224021D000Y | H9224021F000Z | Little Creek, VA | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | |||||||
| H9224021C000Y | Tampa, FL | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | |||||||
| - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | - 0 | ||||
| NOTES PART 1: | 1. Populate your data by personnel category; "ALL" columns are auto sum. | ||||||||||||||||||||||||||
| 2. Personnel should only be counted in one column. | |||||||||||||||||||||||||||
| 3. Exemptions include all exemptions pending or approved for medical or religious requests. | |||||||||||||||||||||||||||
| 4. Data is used from shaded cells above to populate data total personnel and is used in calculations shown on the briefing product. (Chart to right is actual CG briefing product) | |||||||||||||||||||||||||||
| 5. Refusals are those who do not intend to submit a exemption request or submit to vaccination. |
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