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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 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

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

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: TDP - 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 CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL 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 III. 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 III are the administrative and other expenses related to reproducing and

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 (BACK), FEB 2001

data_item: A010 title: Program Management Reviews PMRs sub: PMR Deliverables, Agenda, Minutes auth: DI-MGMT-81893 ref: PWS PARA 12.6 req_ofc: AFLCMC/HBZBD dd250: NO appcode: N/A dist: B freq: BLK 16 asof: BLK 16 firstsub: BLK 16 subsub: BLK 16 addressee1: AFLCMC/HBZKA draft1:

reg1: 1 repro1:

addressee2: 6039 Wardleigh Rd draft2:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: BLK 9: Distribute to PCCIE Mailbox

BLK 11,12,13: The contractor shall participate in semi-annual Program Management Reviews (PMRs) with the Government. PMRs shall be held at Hill AFB, Utah at a mutually agreed time.

The contractor shall develop agendas for the reviews and include pertinent topics received from the government.

Contractor shall record minutes of reviews and meetings and send an electronic copy to the PCCIE mail box NLT 5 days from review or meeting; aflcmc.hbzbd.pccie@us.af.mil Contractor shall provide an electronic copy of PMR slides 5 days prior to PCCIE Office via PCCIE email: aflcmc.hbzbd.pccie@us.af.mil

Delete section 2

Block 14:

Submit to PCCIE Procurement Contracting Officer (PCO) via official government email.

Submit to the PCCIE Program Office via email @ aflcmc.hbzbd.pccie@us.af.mil group: NSP total_price: 0.00 prep_name:

prep_sign:

prep_date: 20230112 app_by:

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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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A011 title: Emergency Telephone Identification sub: Emergency Call in Center’s telephone number auth: DI-MGMT-81893 ref: PWS PARA 14.4 req_ofc: AFLCMC/HBZBD dd250: NO appcode: N/A dist: B freq: As Required asof: BLK 16 firstsub: BLK 16 subsub: BLK 16 addressee1: AFLCMC/HBZKA draft1:

reg1: 1 repro1:

addressee2: 6039 Wardleigh Rd draft2:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: Block 9: Approved for distribution to authorized government agencies only.

BLK 11,12,13: During the first instance of preventative maintenance the contractor shall place a sticker in a visible location on the UPS with the 24/7/365 emergency telephone number until all UPS's on contract have a notification sticker

Block 4: 10.1 and 10.2 Change "Service Technical Assistance Activity Report" to "Emergency Call in Telephone number"

10.2.5 Does not apply

10.2.6 Does not apply

10.2.7 Does not apply

group: NSP total_price: 0.00 prep_name:

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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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A012 title: Service Reports and Delivery sub: Preventative and Emergency MX Report auth: DI-MGMT-81893 ref: PWS PARA 11.3.3 req_ofc: AFLCMC/HBZBD dd250: NO appcode: N/A dist: B freq: Block 16 asof: N/A firstsub: As Required subsub: As Required addressee1: AFLCMC/HBZKA draft1:

reg1: 1 repro1:

addressee2: 6039 Wardleigh Rd draft2:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks:

Block 9: Approved for distribution to authorized government agencies only

BLK 10: Preventative and Emergency Maintenance is considered complete when Government signed service report documenting work performed have been uploaded to the contractors Internet data base and email to the PCCIE Office NLT 20 business days upon completion of work.

BLK 14:

Submit to PCCIE Procurement Contracting Officer (PCO) via official government email.

Submit to the PCCIE Program Office via email @ aflcmc.hbzbd.pccie@us.af.mil group: NSP total_price: 0.00 prep_name:

prep_sign:

prep_date: 20230112 app_by:

app_sign:

app_date: 20230112

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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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A013 title: Plan of Action/Escalation Plan sub: Escalation Plan auth: DI-MGMT-81893 ref: PWS PARA 14.6 req_ofc: AFLCMC/HBZBD dd250: NO appcode: N/A dist: B freq: As Required asof: BLK 16 firstsub: BLK 16 subsub: BLK 16 addressee1: AFLCMC/HBZKA draft1:

reg1: 1 repro1:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: Block 4: section 2 letter E Contractor shall add the action/escalation plan in detail

Block 9: Approved for distribution to authorized government agencies only

BLK 11,12,13: If deemed necessary, per the direction of the PCCIE PM, contractor shall identify escalation plan, action plan for a PM service and/or EM repair action and/or CLIN 0006 activity if deemed necessary and as directed by the PCCIE PM and/or PCO. This action plan shall be delivered to the PCCIE Office and PCO NLT 48 hrs from incident.

Block 14:

group: NSP total_price: 0.00 prep_name:

prep_sign:

prep_date: 20230112 app_by:

app_sign:

app_date: 20230112

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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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A014 title: Contractor Exit Criteria sub: Site/Contract Data auth: DI_MGMT-80227 IT ref: PWS PARA 14.7 req_ofc: AFLCMC/HBZBD dd250: NO appcode: N/A dist: B freq: As Required asof: BLK 16 firstsub: BLK 16 subsub: BLK 16 addressee1: AFLCMC/HBZKA draft1:

reg1: 1 repro1:

addressee2: 6039 Wardleigh Rd draft2:

reg2:

repro2:

addressee3: Hill AFB, UT. 84056 draft3:

reg3:

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addressee4: ATTN: PCCIE PCO draft4:

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draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 2 total_repro: 0 remarks: Block 9: Approved for release to authorized government agencies only.

BLK 11,12,13: The contractor shall provide the PCCIE program office all required data elements for the POP, for the entire duration of the contract IAW the PWS in the form of a normalized data file in flat-file format (MS Excel), which shall be 98% accurate and ready for import into a government database.

a. 10.3 will be revised to read "Content-The information contained on the web shall include: Task Order Number, site name, serial number, work order number, description of preventative/emergency maintenance to be performed, due date, completion date, and comments relating to the completion of the preventative/emergency maintenance. The data base shall also include a report that tracks funds obligated, expended and remaining by CLIN. Also included in this requirement will be a monthly conference call to discuss the status of all actions."

b. Will be revised to read," Provide PCCIE program office all required data elements for the POP, meaning cumulative, of the contract IAW PWS in the form of a normalized data file ready for import into a government data base in flat-file format which is to be 98% accurate.

Block 14:

group: NSP total_price: 0.00 prep_name:

prep_sign:

prep_date: 20230112 app_by:

app_sign:

app_date: 20230112

Page:

app: Adobe Professional 7.0 line_item: 0008 exhibit: A & B xtdp: Off xtm: Off othercat: Contractor Furnished Items system:

ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A015 title: Inventory Spare Part Kits sub: Site Spare Parts Kit auth: DI-MGMT-81893 ref: PWS PARA 15.6.3 req_ofc: AFLCMC/HBZBD dd250: NO appcode: N/A dist: B freq: As Required asof: BLK 16 firstsub: BLK 16 subsub: BLK 16 addressee1: AFLCMC/HBZBD draft1:

reg1: 1 repro1:

addressee2: 6039 Wardleigh Rd draft2:

reg2:

repro2:

addressee3: Hill AFB, UT. 84056 draft3:

reg3:

repro3:

addressee4: ATTN: PCCIE PM draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6: Site POC draft6:

reg6: 1 repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9: AFLCMC/HBZBD draft9:

reg9: 1 repro9:

addressee10: 6039 Wardleigh Rd draft10:

reg10:

repro10:

addressee11: Hill AFB, UT 84056 draft11:

reg11:

repro11:

addressee12: ATTN: PCCIE Office draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 3 total_repro: 0 remarks: Block 4: Contractor shall add a detailed inventoried list of all the spare parts on site when applicable to section "d."

Block 9: Approved for government agencies

BLK 11,12,13: Inventory shall be performed in conjunction with the first instance of Preventative Maintenance per contract task order and be reported to the site POC and PCCIE Program Office/Manager attached to Field Service Report.

Block 14:

Submit to PCCIE Program Manager via official government email.

Submit to site POC via official government email.

group: NSP total_price: 0.00 prep_name:

prep_sign:

prep_date: 20230112 app_by:

app_sign:

app_date: 20230112

Page:

app: Adobe Professional 7.0 line_item: 0008 exhibit: A & B xtdp: Off xtm: Off othercat: Contractor Furnished Items system:

ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A016 title: UPS Service Reporting sub: Submitting Field Activity Report auth: DI-MGMT-81893 ref: PWS PARA 15.8 req_ofc: AFLCMC/HBZBD dd250: NO appcode: N/A dist: B freq: As Required asof: Award firstsub: BLK 16 subsub: BLK 16 addressee1: Site POC draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16: MAJCOM PM draft16:

reg16: 1 repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18: AFLCMC/HBZBD draft18:

reg18: 1 repro18:

addressee19: 6039 Wardleigh Rd draft19:

reg19:

repro19:

addressee20: Hill AFB, UT. 84056 draft20:

reg20:

repro20:

addressee21: ATTN: PCCIE Office draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 3 total_repro: 0 remarks: BLK 11,12,13: : Service reports documenting work performed have been provided to the site POC, if applicable, MAJCOM Program Manager, PCCIE Program Account manager and/or PCCIE workflow email. This shall be accomplished NLT twenty (20) business days upon completion of work. If there is an issue with the UPS, it shall be immediately brought to the attention of the site POC, PCCIE program manager and MAJCOM program manager so that a corrective action can be implemented.

Block 14:

Submit to site POC via official government email.

Submit to MAJCOM Program Manager (PM) via official government email.

group: NSP total_price: 0.00 prep_name:

prep_sign:

prep_date: 20230112 app_by:

app_sign:

app_date: 20230112

Page:

app: Adobe Professional 7.0 line_item: 0008 exhibit: A & B xtdp: Off xtm: Off othercat: Contractor Furnished Items system:

ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A017 title: Emergency Telephone Assistance sub: Telephone Support auth: DI-MGMT-81893 ref: PWS PARA 15.9.1 req_ofc: AFLCMC/HBZBD dd250: NO appcode: N/A dist: B freq: As Required asof: Upon Award firstsub: Upon Award subsub: BLK 16 addressee1: AFLCMC/HBZKA draft1:

reg1: 1 repro1:

addressee2: 6039 Wardleigh Rd draft2:

reg2:

repro2:

addressee3: Hill AFB, UT. 84056 draft3:

reg3:

repro3:

addressee4: ATTN: PCCIE PCO draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8: AFLCMC/HBZBD draft8:

reg8: 1 repro8:

addressee9: 6039 Wardleigh Rd draft9:

reg9:

repro9:

addressee10: Hill AFB, UT. 84056 draft10:

reg10:

repro10:

addressee11: ATTN: PCCIE Office draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 2 total_repro: 0 remarks: Block 4: Contractor incorporate toll free number and report according to DID. Contractor shall add toll free technical support as line E to DID

Block 9: Approved for distribution to authorized government agencies only

BLK 13: Contractor shall provide a dedicated 24X7X365 toll-free telephone number for technical assistance, advice and failure notification. This number is to be maintained and supported through out the entirety of the contract.

Block 14:

Submit to the PCCIE Program Office via email @ aflcmc.hbzbd.pccie@us.af.mi group: NSP total_price: 0.00 prep_name:

prep_sign:

prep_date: 20230112 app_by:

app_sign:

app_date: 20230112

Page:

app: Adobe Professional 7.0 line_item: 0008 exhibit: A & B xtdp: Off xtm: Off othercat: Emergency MX Support system:

ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A018 title: Emergency Notification Content sub: Emergency Report Content auth: DI-MGMT-81893 ref: PWS PARA 15.10.1 req_ofc: AFLCMC/HBZBD dd250: NO appcode: N/A dist: B freq: As Required asof: BLK 16 firstsub: BLK 16 subsub: As Needed addressee1: AFLCMC/HBZKA draft1:

reg1: 1 repro1:

addressee2: 6039 Wardleigh Rd draft2:

reg2:

repro2:

addressee3: Hill AFB, UT. 84056 draft3:

reg3:

repro3:

addressee4: ATTN: PCCIE PCO draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9: AFLCMC/HBZBD draft9:

reg9: 1 repro9:

addressee10: 6039 Wardleigh Rd draft10:

reg10:

repro10:

addressee11: Hill AFB, UT. 84056 draft11:

reg11:

repro11:

addressee12: ATTN: PCCIE Office draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 2 total_repro: 0 remarks: Block 9: Approved for distribution to authorized government agencies only

BLK 11 & 12: Upon emergency notification from site Contractor shall shall follow the PWS as instructed.

Block 14:

group: NSP total_price: 0.00 prep_name:

prep_sign:

prep_date: 20230112 app_by:

app_sign:

app_date: 20230112

Page:

app: Adobe Professional 7.0 line_item: 0008 exhibit: A & B xtdp: Off xtm: Off othercat: Emergency MX Support system:

ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

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 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

TD