CDRL E001 Work Order Form_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

E

C. CATEGORY:

XXXX

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

D. SYSTEM/ITEM

Material Handling Equipment

E. CONTRACT/PR NO.

I

F. CONTRACTOR

1. DATA ITEM NO.

E001

2. TITLE OF DATA ITEM

MHE Work Order Detail Form

3. SUBTITLE 17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED SOW 3.e N32205 (MSC N441) TOTAL PRICE

7. DD250 REQ

DD

9. DIST STATEMENT

REQUIRED

See Block 16

10.FREQUENCY

ASGEN

12.DATE OF FIRST SUBMISSION

ASGEN

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8.APP CODE

N/A

11.AS OF DATE

13.DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

Repro Reg

16. REMARKS

A MHE Work Order Form shall be submitted for each asset (forklift, pallet jack, AWP) that details/ documents all parts utilized for a particular asset to support compliance with 29CFR1910.178(q).

Work Order Form shall include the following information at a minimum:

• Contract Number

• Ship Name

• MSC Barcode

• Date

• Part Number

• Manufacturer

• Description

• Quantity

• Unit price in Dollars (US)

• Installation Manhours

Forms shall be submitted in an Adobe or Microsoft compatible format with the following file naming convention:

CDRL#_MSC Barcode_Date in YYYYMMDD format example: CDRLE001_23-02785_20230821

A sample Work Order Form is attached and may be used to meet this requirement. An MS Excel version is available upon request.

Submit all forms 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

HADLEY.RICHARD.T.III.1454717569 Dig D itally signed by HADLEY.RICHARD.T.III.1454 e: 2023.09.05 12:27:47 -04'00'

15. TOTAL

I.APPROVED BY (N441

17569 Acting)

Digitally signed by Dennis Lewis Date: 2023.09.05 12:47:33 -04'00'

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 mailto:MSC_MHEOHE@US.NAVY.MIL mailto:MSC_MHEOHE@US.NAVY.MIL mailto:MSC_MHEOHE@US.NAVY.M

Work Order Form

Contract Number:

Ship Name:

MSC Barcode Number or Serial Number:

Part Number Description Manufacturer Qty Unit Price Installation ManHrs