CDRL A0001.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved

(1 Data Item) 0MB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the lime 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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 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 ii does not display a currently valid 0MB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the ContracVPR No. listed in Block E.

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

1 SOW N32205 (MSC N441)

18. ESTIMATED

TOTAL PRICE

7. DD250 REQ

DD

9. DIST STATEMENT

REQUIRED

SEE BLOCK 16

10.FREQUENCY

ASGEN

12.DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8.APP CODE

N/A

11.AS OF DATE

N/A

13.DATE OF SUBSEQUENT

SUBMISSION

N/A

Final Draft

Reg Repro

16. REMARKS

A Condition Report (CR) shall be submitted within 10 days of receiving asset unless otherwise noted for all inspections, calibrations, adjustments, and measurements conducted by the service provider for each asset.

The vendor may utilize their own CFR Form provided the form contains the following information:

• Date of Condition Found

• Contract Number

• CFR Sequence #

• Ship Name

• Asset # or Serial Number

• CFR Title

• Condition Found describing the inspection, calibration, adjustment, or measurement including all results

(pictures are recommended but not required unless otherwise noted)

• Recommended repairs

• A statement regarding whether the work is believed to be outside the current scope

• A statement whether the work, if approved by a Contracting Officer would require additional PoP time

• A listing of any parts required as well as if they need to be furnished by the Govt

The first CFR shall include the following pictures and shall be submitted in conjunction with CDRL A001:

For MHE (Forklifts, AWPs, Pallet Jacks)

• 4 pictures of the overall condition of the asset (1 for each side- Front, Right, Back, Left) showing current condition of the preservation and marking

• 1 picture of the asset OEM data tag showing the OEM serial number and any attachment codes

For Battery Chargers

• 1 picture of the asset showing overall condition of the preservation and marking

• 1 picture of the asset OEM data tag showing the OEM serial number and additional pertinent data

Subsequent forms shall be submitted via email within 1 day of completion of any inspection, calibration, adjustment, or measurement.

Forms shall be submitted in an Adobe or Microsoft compatible format with the following file naming convention:

CDRL#-Seq #_MSC Barcode_Date in YYYYMMDD format example: CDRLB001-1_23-02785_20230821

A sample CFR is attached and may be used to meet this requirement. An MS Excel version is available upon request.

MSC_MHEOHE@US.NAVY.M IL

15. TOTAL

G.PREPARED BY H.DATE I.APPROVED BY

HADLEY.RICHARD.T.III.14 Digitally signed by Digitally signed by

54717569

HADLEY.RICHARD.T.III.1454717569 LEWIS.DENNIS.JAMES.1053575079

Date: 2024.02.12 14:15:17 -05'00' Date: 2024.02.14 09:32:53 -05'00'

J.DATE

DD FORM 1423-1, AUG 96 (EG) PREVIOUS EDITION MAY BE USED. Page of Pages Designed using Perform Pro, WHS/DIOR, Aug 96

A. CONTRACT LINE ITEM NO.

CLIN 0001

B. EXHIBIT

A

C. CATEGORY:

XXXX

TDP TM ---------------- OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO.

Material Handling Equipment 1301136689

F. CONTRACTOR

3. SUBTITLE 1. DATA ITEM NO.

A0001

2. TITLE OF DATA ITEM

Condition Report Form mailto:MSC_MHEOHE@US.NAVY.M

Condition Report Form

Contract Number:

CFR Sequence #

Ship Name:

MSC Barcode Number or Serial Number:

Date:

CFR Title:

Condition Found:

Recommended Repair

Describe any machinery discrpancies and/or all inspections, calibrations, adjustments, or measurements taken. Provide pictures as necessary

Describe any required repair actions necessary to restore the machinery to full working order

Is the work within the current approved Scope Of Work?

Yes No

If approved by a Contracting Officer, will the work require additional time added to the PoP?

Yes No

Will parts be required? Yes No

Description Part Number Qty Govt

Furnished?

***Additional Pages may be added as necessary

Continuation Page #

Contract Number:

CFR Sequence #

Ship Name:

MSC Barcode Number or Serial Number: