CDRL B001 Condition Found Report_USNS JOHN LENTHALL.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.

A. CONTRACT LINE ITEM NO.

CLIN 0001

B. EXHIBIT

B

C. CATEGORY:

XXXX

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

D. SYSTEM/ITEM

Material Handling Equipment

E. CONTRACT/PR NO.

I

F. CONTRACTOR

1. DATA ITEM NO.

B001

2. TITLE OF DATA ITEM

Condition Found Report Form

3. SUBTITLE 17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE SOW 3.b N32205 (MSC N441)

18. ESTIMATED

TOTAL PRICE

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

7.DD250 REQ

DD

9. DIST STATEMENT

REQUIRED

See Block 16

10. FREQUENCY

ASGEN

12. DATE OF FIRST SUBMISSION

ASGEN; 1DATC

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Reg

Final

Repro

16. REMARKS

A Condition Found Report (CFR) shall be submitted 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.

All forms shall be submitted in accordance with Block 14a to the MHE Type Desk at

MSC_MHEOHE@US.NAVY.MIL

No Distribution Statement Required

MSC_MHEOHE@US.NAVY.M IL XX

G.PREPARED BY H. DATE

Digitally signed by

HADLEY.RICHARD.T.III.1454717569 HADLEY.RICHARD.T.III.1454717569

Date: 2023.09.05 12:29:21 -04'00'

15. TOTAL

I.APPROVED BY (N441 Acting) Digitally signed by Dennis Lewis Date: 2023.09.05 12:47:05 -04'00' mailto:MSC_MHEOHE@US.NAVY.MIL mailto:MSC_MHEOHE@US.NAVY.M

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TOP - Technical Data Package; TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CORL.

Item H. Date CORL was prepared.

Item I. Signature of CORL approval authority.

Item J. Date CORL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15. Examples are: Tailoring of documents cited in Item 4;

Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group Ill. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group Ill are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data. These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423-1, AUG 96

Condition Found Report

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: