Attachment 5 - CDRL A001 - Contract Employee Listing.pdf

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:

TDP ____ TM _____ OTHER _________________________

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

TELECOMMUNICATIONS SERVICES TBD TBD

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

A001 CONTRACT PERSONNEL EMPLOYEE ROSTER

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

TOTAL PRICE

SOW PARA B 2.1 AMK-222A

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 SEE BLOCK 16 Reg Repro

16. REMARKS AAQ-732/CO 1 D

BLOCK 11 - DATE OF ASSUMING FULL PERFORMANCE

BLOCK 12 - AFTER ASSUMING FULL PERFORMANCE, REPORT IS DUE ON THE 15TH DAY

FOLLOWING THE MONTHLY REPORTING PERIOD

BLOCK 13 - SUBSEQUENT REPORTS ARE DUE ON THE 15TH DAY OF EACH MONTH FOLLOWING

EACH MONTHLY REPORTING PERIOD

CONTRACTOR FORMAT TO INCLUDE THE FOLLOWING INFORMATION:

LAST NAME

FIRST NAME

CURRENT TASK ORDER NO.

FAA BADGE EXPIRATION DATE

FAA ORG ROUTING SYMBOL

REPORT TO BE ALPHABETIZED BY LAST NAME

AMK-011/MMAC PM

*1

AMC-700/SECURITY 1

15. TOTAL ▬▬▬▬► *

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

MICHAEL HAMMER AMK-222A

25 Mar 2016

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