Attachment 5.5d - AF3000-3064-3065.pdf

For Evaluation and Action

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Form Approved OMB No 9000-0062 Expires May 31, 2005

MATERIAL APPROVAL SUBMITTAL

(See Instructions on Reverse)

Public reporting burden for this collection of information is estimated to average 20 minutes 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 the 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 OMB No 9000-0062, Washington DC 20503. Please DO NOT RETURN your form to either of these addresses. Send your completed form to: SAF/AQCP, 1060 Air Force Pentagon, Washington DC 20330-1060.

TO: (Contracting Officer) FROM: (Contractor) DATE

CONTRACT NUMBER SUBMISSION NUMBER SUBMITTAL

NEW RESUBMITTAL

PREVIOUS SUBMISSION NUMBER PROJECT NUMBER

TO BE COMPLETED BY CONTRACTOR FOR GOVERNMENT USE ONLY

ITEM SPECIFICATION SECTION/ DESCRIPTION OF MATERIAL AP-

PROVED

DISAP-

PROVED

SEE

REVERSE INITIAL

BY COMPLETING THIS FORM, THE UNDERSIGNED CONTRACTOR CERTIFIES THAT

THE MATERIAL COMPLIES WITH ALL SPECIFICATIONS OF SUBJECT CONTRACT.

DATE

TYPE OR PRINT NAME AND TITLE SIGNATURE

FOR GOVERNMENT USE ONLY

TO: (Base Civil Engineering Officer)

DATE TYPE OR PRINT NAME AND GRADE SIGNATURE

TO: (AF Contracting Office)

RECOMMEND APPROVAL DISAPPROVAL AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE

DATE TYPE OR PRINT NAME AND GRADE SIGNATURE

TO: (Contractor)

DISAPROVED AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE SIDE. REQUESTAPPROVED

RESUBMITTAL ON DISAPPROVED ITEMS WITHIN DAYS OF DATE SHOWN BELOW.

DATE TYPE OR PRINT NAME AND GRADE

SIGNATURE

AF IMT 3000, 20030901, V1 PREVIOUS EDITION IS OBSOLETE.

NO. PARA NO./DRAWING NO. (Include Type, Model Number, Catalog Number, Mfg., etc.)

COMMENTS

(Number to correspond with applicable Item Number on reverse)

INSTRUCTIONS TO CONTRACTORS

1. The term "material" is defined as articles, supplies, raw materials, equipment, parts, components, and end items that are to be incorporated into the work required by the contract.

2. This form is to be used by contractors for submitting Shop Drawings, Equipment Data, Manufacturer's Literature and Certificates and samples of Materials to the Government for approval in accordance with the provisions of this contract. Unless otherwise specified, it is to be prepared in 4 copies, signed, and provided to the contracting officer with appropriate attachments.

3. Item(s) to be approved will be clearly tabbed or identified. Data pertaining to item(s) to be approved will be clearly identified or tabbed, particularly where documents are voluminous, in order to properly evaluate the materials or articles to be incorporated in the work. Each attachment will be numbered to correspond with the item number shown on the face of this form.

4. Requests submitted shall be numbered consecutively, by contract, in the space entitled "Submission No.". This number, in addition to the Contract No., will be used to identify each Material Approval Submittal. Resubmissions will be indicated in the appropriate block and the insertion of previous submission number and data in addition to a new submission number. A single submission should be used for all work of a section of the specifications, but in NO instance should the submission include work for more than one (1) contract. Submittals requiring priority handling will be submitted by separate submittal using the form and so marked across the face of the form.

5. This Material Approval Submittal is not valid unless it is signed by the contracting officer. This approval is required as called for by the contracting officer under the terms of this contract.

AF IMT 3000, 20030901, V1

CONTRACT PROGRESS SCHEDULE Form Approved OMB NO. 0704-0188(See Contractor's Instructions on Reverse)

Public reporting burden for this collection of information is estimated to average 15 minutes 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/questionnaire to either of these addresses. Send your completed form/questionnaire to : SAF/AQCP, 1060 Air Force Pentagon, Washington DC 20330-1060

DATE SIGNED

DATE SIGNED CONTRACTING OFFICER'S SIGNATURE

CONTRACTOR'S NAME (Last, First, Middle Initial)

1. CONTRACT NO. 8. PROJECT TITLE

3. COMPLETION DATE

4. PURCHASE REQUEST NO.

LINE

NO

A

WORK ELEMENTS %

C

WEEKS

D E F G H I J K L M N O P Q

10. APPROVAL RECOMMENDED BY:

DATE SIGNED

2. STARTING DATE

INSTALLATIONS ENGINEER'S SIGNATURE

5. PROJECT NO.

6. ACTUAL STARTING DATE

7. ACTUAL COMPLETION DATE

9. SUBMITTED BY:

ADDRESS (Street, City, State, Zip Code)

CONTRACTOR'S SIGNATURE 11. APPROVED BY:

AF IMT 3064, 20030901, V1 PREVIOUS EDITIONS ARE OBSOLETE

INSTRUCTIONS TO CONTRACTORS

1. Prepare three copies of AF Form 3064, in accordance with these instructions, and submit to the contracting officer at the time stated in the contract or as established by the contracting officer.

2. Blocks 1, 2, and 3. Enter the contract number, starting date, and completion date as shown on the contract.

3. Block 8. Enter the title of the project as shown on the contract.

4. Block 9. Enter name and address of your firm. The three copies submitted to the contracting officer must be dated and signed by the contractor or an authorized representative of the firm.

5. Lines 1 through 12. Major elements of work (whether unit price or lump sum contract) such as excavation, concrete work, carpentry, engineering, installation of communication electronic facilities, etc., will be shown in Column B in logical sequence and in sufficient detail to identify the element. If the contract calls for more than 11 work elements, additional copies of the AF Form 3064 may be used as a continuation for the work elements.

6. The percentage of each listed work element to the complete job will be shown opposite each element in Column C. As an example, if 3 work elements are shown: excavation, concrete work, and backfill, and it is estimated that excavation is 50% of the total job, concrete 30%, and backfill 20%, these percentages will be shown opposite each element. The total must equal 100%.

7. Columns D through Q will be used to show planned periodic progress, as required by the contracting officer, during the period of the contract. Only the top half of the space under these columns will be used by contractors. Using the example cited above and assuming that the contract period for performance is 8 weeks, and it is planned to accomplish 10% of the excavation work the 1st week and 20% each week until excavation is complete, 10 would be shown in the upper half of Line 1 under Column D, 20 under Column E, and 20 under Column F for a total of 50%. If it is planned to accomplish the concrete work during the 4th, 5th, and 6th weeks in equal amounts, 10 would be entered under Columns G, H, and I on Line 2. Assuming the backfill will be accomplished during the 7th and 8th weeks, 10 would be entered under Columns J and K on Line 3. If the contract extends beyond 14 weeks, additional copies of AF Form 3064 may be used as a continuation of performance record.

8. Total amount of work planned at intervals as shown in Columns D through Q will be totaled and entered in the top half of the space under the appropriate column of Line 12. Again, using the example cited above, the totals under Columns D through K would read 10, 20, 20, 10, 10, 10, 10, 10 for a total of 100%. These totals will be used to plot an overlay graph using Lines 4 through 11, beginning with Column D and extending to the right the number of columns (weeks) authorized by the contract for performance time.

9. In the event the contract is modified by the contracting officer under terms of the contract, changing the progress of work as originally scheduled, adding or deleting work or changing the original completion date, a revised progress schedule will be prepared and submitted to the contracting officer for approval. In preparing the revised schedule, the amount of work completed will be considered, together with the changed new completion date set forth in the contract modification. Considering these factors, the work under the contract will be rescheduled over the new total performance time in the same manner that the original schedule was prepared. The new completion date will be entered in Block 3. "First Revised Schedule," "Second Revised Schedule," etc., will be entered to the left of the form title. Time of submission of the revised schedule will be determined by the contracting officer.

10. At such intervals as may be established by the contracting officer, the contractor will submit to the contracting officer AF Form 3065, "Contract Progress Report," indicating the percentage of work accomplished for each work element during the established reporting period. Accurate reports are of the utmost importance to the contractor and to the Government, since the percentage of completion, or progress, thus reported is used in administration of the contract and may be used in connection with approval of partial payments under the contract. Care should be taken to plan the work in such manner that it can be accomplished as stated in this schedule. If, for any reason, it becomes known that any part of the progress under this contract will be delayed, this fact should be reported to the contracting officer immediately.

AF IMT 3064, 20030901, V1 PREVIOUS EDITIONS ARE OBSOLETE

OMB NO. 0704-0188CONTRACT PROGRESS REPORT

Public reporting burden for this collection of information is estimated to average 15 minutes 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 the Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (OMB No. 9000-0058), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. 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 ADDRESS. RETURN COMPLETED FORM TO : SAF/AQCO, 1060 Air Force Pentagon, Washington DC 20330-1060.

CONTRACTOR ADDRESS

REPORT NO. PERIOD COVERED

FROM:

PROJECT NO. CONTRACT NO. COMPLETION DATE

TO:

LINE

NO.

% OF

TOTAL JOB

% COMPLETED

THIS PERIOD

% COMPLETED

CUMULATIVE

WORK ELEMENT

TOTAL

REMARKS

At the Contracting Officer's discretion and according to the payments clause of the contract, the information provided on this form may be used for computing progress payments.

PROGRESS OR COMPLETION CERTIFICATE

I hereby certify that the contractor has satisfactorily completed the indicated percentage of the contract per contract specifications.

SUBMITTED BY OR FOR

CONTRACTOR BASE CIVIL ENGINEER

TYPE OR PRINT NAME AND TITLE SIGNATURE DATE

REVIEWED BY OR FOR CONTRACTING OFFICER

TYPE OR PRINT NAME AND TITLE SIGNATURE DATE

AF IMT 3065, 19960401, V1 PREVIOUS EDITION IS OBSOLETE.