CDRL A0004 WORK ORDER.pdf

PDF 276 KB Posted

Attached to
USNS PATUXENT HYSTER Forklift Recertification Federal contract opportunity
Solicitation number
N3220522Q2241
Issued by
Department of the Navy Military Sealift Command

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CDRL A0003 SAFETY CERTIFICATION.pdf PDF
CDRL A0002 Fork Inspection Form.pdf PDF
Other than Full and Open BRAND NAME .doc DOC document
Combined Synopsis Solicitation.docx DOCX document
CDRL A0001 FINAL CONDITION REPORT.pdf PDF

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As Required

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 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 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 i:: rson shall be subject to any penalty for failing to com�with a collection of information if it does not display a currenUy valid 0MB control number. Please DO NOT RETURN your rm to the above address. Send completed form to the ovemment Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A.CONTRACT LINE ITEM NO. B.EXHIBIT C. CATEGORY:

CDRLA0004

D.SYSTEMnTEM Material Handling Equipment

TOP TM --- OTHER

E.CONTRACT/PR NO. F.CONTRACTOR

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

0004 MHE Work Order

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 8.REQUIRING OFFICE sow 1 Para 6.6

N32205

7.DD 250 REQ

NIA

9. DIST STATEMENT

REQUIRED

10.FREQUENCY

As Required

12.DATE OF FIRST SUBMISSION

As Required

14. DISTRIBUTION

b.COPIES B.APPCODE 11.AS OF DATE 13.DATE OF SUBSEQUENT a.ADDRESSEE Final

Production

18.ESTIMATED

TOTAL PRICE

NIA SUBMISSION Draft As Required

18.REMARKS MHE HELP DESK

Service provider shall submit an itemized list of all maintenance that was performed MSC MHEOHE®US.NA VY.MIL including parts with associated cost on each forklift/pallet jack asset to Military Sealift Command, Norfolk, VA. (CORL0004).

Reg Repro

G.PREPARED BY H.DATE I. APPROVED BY

15.TOTAL

J.DATE

Robert Hall SCHMITT.DAMIAN.R. Digitally signed by SCHMITT.DAMIAN.R.1032996643

1032996643 Date: 2022.09.01 15:59:11 -04'00'

DD FORM 1423-1, AUG 96 (EG) PREVIOUS EDITION MAY BE USED. Page_1_of 1 Pages Designed using Perform Pro, WHSloiOR, Aug 96

7/13/2022

A.CONTRACT LINE ITEM NO. B.EXHIBIT C. CATEGORY:
D.SYSTEMnTEM
E.CONTRACT/PR NO. F.CONTRACTOR
0004 MHE Work Order
Production
As Required
including parts with associated cost on each forklift/pallet jack asset to Military Sealift Command, Norfolk, VA. (CORL0004).
G.PREPARED BY H.DATE I. APPROVED BY
Robert Hall

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