CDRL MUTC Contract Report Item 12 Fork Truck Maintenance Inspection Form.pdf
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- Attached to
- MSC Underway Replenishment Training Center (MUTC) Service Federal contract opportunity
- Solicitation number
- N3220522R4039
About this file
This Contract Data Requirements List (CDRL) outlines reporting requirements for a non-personnel services contract to provide instructor support and equipment maintenance at the Military Sealift Command's Underway Replenishment Training Center. The contractor must submit monthly Fork Truck Maintenance Inspection Forms capturing inspections performed at the training site. The forms are due on the first of each month utilizing the provided MS Office template. In addition, the contractor must report on curriculum reviews for training courses within the MUTC portfolio upon completion of each course review. This CDRL applies to the F-4 Milestones/Deliverables and paragraph 5.2.8.2 of the referenced solicitation for MSC Underway Replenishment Training Center services.
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Text version
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
| 1_DATA_ITEM_NO: MUTC012 |
| 2_TITLE_OF_DATA_ITEM: Forklift Repors |
| 3_SUBTITLE: |
| 4_AUTHORITY_Data_Acquisit: |
| 5_CONTRACT_REFERENCE: See block 16 |
| 6_REQUIRING_OFFICE: N13/N12 |
| 7_DID_250_REQ: NO |
| 8_APP_CODE: N/A |
| DIST_STATEMENT: |
| 10_FREQUENCY: See Block 16 |
| 11_AS_OF_DATE: |
| 12_DATE_OF_FIRST_SUBMISSI: See Block 16 |
| 13_DATE_OF_SUBSEQUENT_SUB: See Block 16 |
| addressee1: COR |
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| 16_REMARKS: (Block 5.) Applies to F-4 Milestones/Deliverables and PARA 5.2.8.2. |
1. Submit curriculum review reports upon completion of each training course review.
Workload: Monthly, 12 times per year, Fork Truck Maintenance Inspection Form
Frequency: Monthly
MS Office Product
See Attachment MHE 004 for an example of the Report Format
| 17_PRICE_GROUP: | |
| ESTIMATED_TOTAL_PRICE: | |
| G_PREPARED_BY: William Kordyjak | |
| H_DATE: 10 Dec 2021 | |
| 1_APPROVED_BY: | |
| J_DATE: 17 Mar 2022 | |
| Page: 1 | |
| reg38t: 3 | |
| A_CONTRACT_LINE_ITEM_NO: F-4 Milestones/deliverables | |
| B_EXHIBIT: | |
| TDP: | |
| TM: | |
| OTHER: Management | |
| DSYSTEMITEM: MSC N13/N12 | |
| E_CONTRACTPR_NO: | |
| FCONTRACTOR: | |
| of_pages: 1 | |
| Reset: | |
| 2022-03-17T12:31:09-0400 | |
| KORDYJAK.WILLIAM.EDWARD.1015150862 |
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