ATTACHMENT J-1 Carrier_Disposal CDRLs.pdf

EXHIBIT A Page 1 of 8

CONTRACT DATA REQUIREMENTS LIST

(2 Data Items)

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, (0704-0188) 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. 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:

CLIN 0001 - 0004 A TDP TM OTHER

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

SHIP DISPOSAL N00024-20-R-4204

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

A001 TOW PLAN TOW PLAN

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

SEE BLOCK 16 Section C-Paragraph C-2.1 SEA 21I TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ONE TIME SEE BLOCK 16 b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

Final

N/A SEE BLOCK 16 AS REQUIRED Draft Reg Repro

16.

REMARKS

Blocks 11 and 12: The towing plan and completed Appendix H shall be submitted to the government no later than 30 days prior to commencement of ship towing. The

Contractor shall notify the Contracting Officer no later than thirty (30) days of the projected completion of towing preparations, so that an inspection can be conducted by the NAVSEA towing technical authority prior to the tow departure date.

Block 4: Contractor format is acceptable.

SEA 21I

ACO

COR

OSR

15. TOTAL 0 4 0

A002 SCHEDULE SCHEDULES

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

TOTAL PRICE

SEE BLOCK 16 Section C-Paragraph C-2.2.1 SEA 21I

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT AS REQUIRED AS REQUIRED b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

N/A SEE BLOCK 16 AS REQUIRED

Draft Reg Repro

Block 11: Requirement for a schedule begins at award and is initially satisfied by schedule submitted with proposal, which shall be continuously refined and resubmitted as required.

ACO

G. PREPARED BY:

Nick Tastad

H. DATE

16 Jul 20

I. APPROVED BY

William Boozer

J. DATE

16 Jul 20

EXHIBIT A Page 2 of 8

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, (0704-0188) 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. 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:

CLIN 0002, 0004 A TDP TM OTHER

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

SHIP DISPOSAL N00024-20-R-4204

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

A003 CERTIFICATION OF DEMILITARIZATION AND

DISMANTLEMENT

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

SEE BLOCK 16 Section C-Paragraph C-2.2.3, C-2.2.4 SEA 21I TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ONE TIME AS REQUIRED b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

Block 11: A certification shall be prepared and signed for the ship. Certification shall be incorporated as part of the Final Project Status Report (Data Item A007).

ACO

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

A004 CERTIFICATION OF PROPER DISPOSAL OF

HAZARDOUS MATERIAL AND WASTE

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

TOTAL PRICE

SEE BLOCK 16 Section C- Paragraph C-2.2.6 SEA 21I

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT AS REQUIRED AS REQUIRED b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

Block 11: The Contractor shall provide the Government with legible copies of all hazardous and non-hazardous materials/wastes manifests, bills of lading, and all other waste shipping documents shall be incorporated as part of the Final Project Status

Report (Data Item A007). As part of the Final Project Report, the Contractor shall certify, in writing, that the Contractor has accomplished all hazardous material removal and regulated hazardous waste removal and disposal in compliance with all Federal, State, and local laws & regulations.

ACO

15. TOTAL 0 4

Nick Tastad

H. DATE

16 Jul 20

I. APPROVED BY

William Boozer

EXHIBIT A Page 3 of 8

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, (0704-0188) 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. 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:

CLIN 0001 - 0004 A TDP TM OTHER

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

SHIP DISPOSAL N00024-20-R-4204

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

REGULATORY AGENCY CORRESPONDENCE

A005

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

TOTAL PRICE

SEE BLOCK 16 Section C- Paragraphs C-2.2.7, C-2.2.7.1, C-2.2.8, and C-2.2.8.1

SEA 21I

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT AS REQUIRED AS REQUIRED b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

Block 11: Requirement is effective at date of contract award.

ACO

A006 ACCIDENT, INCIDENT, AND INJURY REPORT

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

SEE BLOCK 16 Sec C-Paragraph C-2.2.7.3, C-2.2.8.3 SEA 21I TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT AS REQUIRED AS REQUIRED b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

N/A SEE BLOCK 16 SEE BLOCK 16 Draft Reg Repro

Block 11: Required within one (1) day of a condition triggering this report. The

Contractor shall record and immediately, within one (1) day, report to the Contracting

Officer, all available facts relating to injury to either Contractor or Government personnel or each instance of damage to Government property.

Block 13: Summation of accident, incident, and injury reports shall be incorporated with the Final Project Status Report (Data Item A007).

G. PREPARED BY

Nick Tastad

H. DATE

16 Jul 20

I. APPROVED BY

William Boozer

EXHIBIT A Page 4 of 8

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, (0704-0188) 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. 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:

CLIN 0002, 0004 N/A TDP TM OTHER

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

SHIP DISPOSAL N00024-20-R-4204

A007 PROGRESS / STATUS REPORT

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

SEE BLOCK 16 Sec C Para C-2.2.5-6, 2.2.8-9, 3.3 SEA 21I

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

NO** WEEKLY SEE BLOCK 16 b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

Block 11 and 12; First submission within two weeks of contract award.

A008 COST DATA REPORT

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

SEE BLOCK 16 Section C-Paragraph C-2.2.9, 3.3.2 SEA 21I TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT SEE BLOCK 16 SEE BLOCK 16 b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

BLOCK 10, 11, 12, 13: Reports shall be submitted no later than 15 days after the contract has reached 25%, 50%, 75% and 100% physical progress. A Final Project

Report shall be submitted no later than 30 days after final completion of all work, including sale or disposal of all scrap and reusable equipment/material. The final cost data report shall be incorporated with the Final Project Report.

Nick Tastad

H. DATE

16 Jul 20

I. APPROVED BY

William Boozer

EXHIBIT A Page 5 of 8

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, (0704-0188) 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. 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:

CLIN 0001-0004 N/A TDP TM OTHER

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

SHIP DISPOSAL N00024-20-R-4204

A009 NOTIFICATION OF ITEMS FOUND ON BOARD

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

SEE BLOCK 16 Section C-Paragraph C-3.4 SEA 21I TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

NO** AS REQUIRED AS REQUIRED b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

Block 11: The contractor shall immediately notify the Contracting Officer of items found onboard the ship.

ACO

15. TOTAL 4 0

A010 SELF-ASSESSMENT REPORT FOR ENVIRONMENTAL

SAFETY AND HEALTH AND

HEALTH & SAFETY (AND CLIN 0004 SECURITY)

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

TOTAL PRICE

SEE BLOCK 16 Section C-Paragraph C-3.6.2 SEA 21I

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT SEE BLOCK 16 SEE BLOCK 16 b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

N/A SEE BLOCK 16 AS REQUIRED

Blocks 10, 11, and 12: submit no later than 15 calendar days prior to the commencement of the Government’s ES&H and/or security assessment.

Nick Tastad

H. DATE

16 Jul 20

I. APPROVED BY

William Boozer

EXHIBIT A Page 6 of 8

(1 Data Item)

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, (0704-0188) 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. 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:

CLIN 0002, 0004 N/A TDP TM OTHER

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

SHIP DISPOSAL N00024-20-R-4204

A011 SOUVENIR PLATES

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

SEE BLOCK 16 Section C- Paragraph C-3.7 SEA 21I

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ONE TIME SEE BLOCK 16 b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

N/A SEE BLOCK 16 N/A Draft Reg Repro

Block 11, 12: The contractor shall prepare and deliver ten (10) souvenir plates with dimensions of three inches by five inches; free of sharp edges and applied paint, with the name and hull number of the ship and the ship’s frame number the plate came from engraved in quarter inch letters. The souvenir plates shall be submitted no later than 30 days after final completeion of all work, including sale or disposal of all scrap and reusable equipment/material.

15. TOTAL 0 10 0

Nick Tastad

H. DATE

16 Jul 20

I. APPROVED BY

William Boozer

EXHIBIT A Page 7 of 8

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, (0704-0188) 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. 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:

CLIN 0003-0004 N/A TDP TM OTHER

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

SHIP DISPOSAL N00024-20-R-4204

A012 SECURITY CHANGES AND VIOLATIONS REPORT

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

SEE BLOCK 16 Section C-Paragraph C-3.1.1 SEA 21I

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT AS REQUIRED AS REQUIRED b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

Block 11: The Contractor shall record and report all available facts within one (1) day of any changes to the Contractor’s facility that effect the physical security programs or violation of security procedures pertaining to facility and/or personnel.

Block 13: A summation of violations shall be incorporated as part of the Final Project

Status Report (Data Item A007).

ACO

A013 PERSONNEL SECURITY CLEARANCE

CERTIFICATIONS

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

SEE BLOCK 16 Section C-Paragraph C-3.1.1 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT AS REQUIRED SEE BLOCK 16 b. COPIES

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

N/A SEE BLOCK 16 SEE BLOCK 16

Block 11, 12: Upon Contract award, the Contractor shall provide the Contracting

Officer with the current 100% listing of all persons having authorized access to the facility and the vessel, along with validation of active status of individual

CONFIDENTIAL security clearances.

Block 13: Changes to this listing shall be provided to the Contracting Officer within two (2) weeks.

15. TOTAL 4 0

Nick Tastad

H. DATE

16 Jul 20

I. APPROVED BY

William Boozer

EXHIBIT A Page 8 of 8

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and

Reports, (0704-0188) 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. 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:

CLIN 0003-0004 N/A TDP TM OTHER

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

SHIP DISPOSAL N00024-20-R-4204

A014 SECURITY MANAGEMENT/OPSEC PLAN

4. AUTHORITY (Data Acquisition Document No.)

SEE BOCK 16

5. CONTRACT REFERENCE

Section C-Paragraph C-3.1.3 and

Section J

6. REQUIRING OFFICE

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

AS REQUIRED

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

16.REMARKS

BLK 12: at time of award.

BLK 13: After the initial submission of the Security Management Plan, and within 30 days of contract award, the Government will review and comment on the plan in accordance with the security requirements of the contract. Subsequent submission of the plan is required within 30 days of receipt of Government comments.

G. PREPARED BY: H. DATE

I. APPROVED BY

William Boozer