CDRL A003.pdf

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications 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

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

The contractor shall complete and submit a preventive and comprehensive diagnostic report for all of the equipment listed in Appendix A of the PWS. The contractor shall immediately notify the COR verbally and provide in writing within 10 calendar days of the event, all deficiencies identified during the performance of a PM event. The contractor shall submit a work performed summary consisting of PM performed and description of operational issues identified, replacement parts and services recommended.

The submission of this report is acceptable in the contractor's format.

Reports shall contain a minimum of the following:

• Identification of Personnel Performing Work

• Date

• DoD Asset Number

• Dates and Time of Maintenance Action

• General Condition (Machine hours, location, serial number)

• Status of the Machine by Major Component

• Description of PM performed

• Description of operational issues identified

• Corrective Action Statement (Status of System, description of malfunction, location of system)

• Changes in Operating Procedures (if any)

• List of References Used

• List of Recommended Replacement Parts (by nomenclature) and Services

• Cost Breakdown of Recommended Replacement Parts (by nomenclature) and Services

• Estimated Repair Time (Estimated time for Parts to be Received, Repair to be Performed, Cost of Parts and Service)

• Fire and Safety Violations (Location of Violations, Actions Taken (if any) to Correct Violations, Cost Breakdown by Parts and Services to Repair Violations)

• Number of Mechanical Man-Hours

• Number of Electrical/Electronic Man-Hours

• Total Man-Hours

Block 9: Distribution Statement D. Distribution authorized to the Department of Defense and U.S. DoD contractors only. Other requests for this document shall be referred to the Program Officer listed in the contract.