CDRL A004 p2 Serious Incident Reporting Schools 240213.pdf

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Attached to
MNG CONUS SCHOOLS SUPPORT Federal contract opportunity
Solicitation number
W519TC-24-R-2005
Issued by
Department of the Army Materiel Command Contracting Command Rock Island Arsenal

About this file

This document package outlines requirements for management and support services for the U.S. Army's schools located within the continental United States. The services include weekly and monthly reporting on performance metrics, after action reports, and immediate verbal and written reporting of any serious incidents. The Army Materiel Command Contracting Command at Rock Island Arsenal will award an indefinite delivery/indefinite quantity contract for the base period of one year with four one-year options. Contract Data Requirements Lists specify the format and timing for submission of performance reports and incident reports to the Contracting Officer and Contracting Officer's Representative. Offerors must submit capability statements by February 12, 2024 in response to the sources sought notice to be considered for the follow-on award.

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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

Untitled

1_DATA_ITEM_NO: A004
2_TITLE_OF_DATA_ITEM: Accident/Incident Report
3_SUBTITLE: Serious Incident Reporting
4_AUTHORITY_Data_Acquisit: DI-SAFT-81563
5_CONTRACT_REFERENCE: PWS 3.4
6_REQUIRING_OFFICE: OPM-SANG G-3
7_DID_250_REQ: N/A
8_APP_CODE: N/A
DIST_STATEMENT: B
10_FREQUENCY: See Block 16
11_AS_OF_DATE: See Block 16
12_DATE_OF_FIRST_SUBMISSI: See Block 16
13_DATE_OF_SUBSEQUENT_SUB: See Block 16
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16_REMARKS: Serious Incident Reporting

---------continued--------

(5) Any other act of any nature involving Contractor personnel which might adversely affect the Modernization Program or relations between OPM-SANG and the SANG.

d. The Contractor shall, immediately (no later than 2 hours) after he becomes aware of circumstances which indicate that a serious incident has occurred, make a verbal report as stated in paragraphs a and b above. Within forty-eight hours of the verbal report, the Contractor shall submit a written report to the Contracting Officer. Upon completion of all investigative effort, the Contractor shall submit a final written report to the Government. Verbal and written reports shall contain all reasonably available relevant information to include copies of documents and photographs of evidence.

e. The Contractor shall take all reasonable actions to assure that investigations are prompt, thorough, and impartial. To the extent feasible, written statements should be obtained from all persons having knowledge of the circumstances which indicate that a serious incident has occurred.

17_PRICE_GROUP:
ESTIMATED_TOTAL_PRICE:
G_PREPARED_BY:
H_DATE:
1_APPROVED_BY:
J_DATE:
Page: 2
reg38t: 2
A_CONTRACT_LINE_ITEM_NO: XXXX
B_EXHIBIT: A
TDP:
TM:
OTHER: MGMT
DSYSTEMITEM: OPM CONUS Schools
E_CONTRACTPR_NO: ####
FCONTRACTOR: TBD
of_pages: 2
Reset:

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