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OCONTRACT 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 X |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| 0002 |
| Lockout/Tagout (LOTO) |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| DD |
| REQUIRED |
| ASRE Q |
| SEE BLOCK 16, ASREQ |
| a. ADDRESSEE |
| b. COPIES |
| 8. APP CODE |
| B |
| 11. AS OF DATE |
| 13. DATE IF SUBSEQUENT SUBM. |
A
| SEE BLOCK 16 |
| SEE BLOCK 16 |
| 16. REMARKS |
| RRAD, Contracting |
Per block 5. Contractor shall furnish a graphical, machine specific LOTO procedure that clearly and specifically describes the steps necessary to establish a zero-energy state for the equipment in accordance with the requirements of OSHA Regulation CFR 1910.147. This procedure shall be printed on a durable laminated material suitable for posting on the equipment. All LOTO locations on the equipment shall be clearly identified with a durable label keyed to the LOTO procedure. Contractor shall furnish the procedure in an electronic format so the information can be easily transferred into a maintenance management. Reference PD 4.3
Per block 8. Contractor shall furnish LOTO as listed in the PD 4.3 one time prior to work completion.
Per block 9. For administrative and operational use only. (See DoDI 5230.24)
Per block 10. LOTO will be required one time prior to work completion.
Per block 11. LOTO will be required one time prior to work completion.
Per block 12. LOTO will be required one time prior to work completion.
Distribution addresses:
POC – Ryan Bailey, Production Engineering Division Luke Leitschuck, RRAD, Contracting
Repro = electronic delivery
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Ryan Bailey |
| 15 Feb 2024 |
| Andy Graves, Chief Facilitization Team |
| 15 Feb 2024 |