DD1423- W911QX25Q0017 (DRAFT).pdf
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- Solicitation number
- W911QX25Q0017
About this file
This document is a Contract Data Requirements List (DD Form 1423-1) for a federal contract opportunity. The contract is for preventative maintenance of a deionized water system located at the Army Research Laboratory in Aberdeen Proving Ground, Maryland. It includes requirements for three types of test/inspection reports to be submitted: field generated reports, reverse osmosis disinfection reports, and heterotrophic bacteria test reports. The reports must be delivered electronically within two weeks of each site visit. The contract has a one-year base period and four one-year option periods. The procurement is set aside for small businesses under NAICS code 811310, with a $12.5 million size standard. Award will be made to the most advantageous offer based on price, technical capability, and past performance evaluation criteria.
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Template last updated 09/29/2017
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
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 (0704-1088). 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
Water System Preventative Maintenance
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A001
2. TITLE OF DATA ITEM
TEST / INSPECTION REPORTS
3. SUBTITLE
FIELD GENERATED REPORT
4. AUTHORITY (Data Acquisition Document No.)
DI-NDTI-80809B
5. CONTRACT REFERENCE
C.3.8.1.
6. REQUIRING OFFICE
TBD
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
A
10. FREQUENCY
TWICE
12. DATE OF FIRST
SUBMISSION
SEE BLK 16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION SEE BLK 16
Draft Final
Reg Repro
16. REMARKS
BLK 4: FIELD GENERATED REPORT SHALL BE DELIVERED ELECTRONICALLY IN A
MEDIA SELECTED BY THE GOVERNMENT AT TIME OF DELIVERY. MEDIA TYPES
WHICH CAN BE ACCEPTED INCLUDE: FILE TRANSFER PROTOCOL (FTP), CD-ROM AND
DVD-ROM.
BLK 12: No later than (NLT) two (2) weeks after each visit.
BLK 14: FIELD GENERATED REPORT SHALL BE DELIVERED TO:
TBD
TBD 1 1
15. TOTAL 1 1
G. PREPARED BY
H. DATE
10-16-2024
I. APPROVED BY
Phillip J. Amador
J. DATE
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 6 Pages
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 (0704-1088). 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.
D. SYSTEM/ITEM
Water System Preventative Maintenance
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM
TEST / INSPECTION REPORTS
3. SUBTITLE
REVERSE OSMOSIS DISINFECTION REPORT
4. AUTHORITY (Data Acquisition Document No.)
DI-NDTI-80809B
5. CONTRACT REFERENCE
C.3.8.1
6. REQUIRING OFFICE
TBD
7. DD 250 REQ
LT
TWICE
12. DATE OF FIRST
SUBMISSION
8. APP CODE
N/A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION SEE BLK 16
Draft Final
Reg Repro
16. REMARKS
BLK 4: THE REVERSE OSMOSIS DISINFECTION REPORT SHALL BE DELIVERED
ELECTRONICALLY IN A MEDIA SELECTED BY THE GOVERNMENT AT TIME OF
DELIVERY. MEDIA TYPES WHICH CAN BE ACCEPTED INCLUDE: FILE TRANSFER
PROTOCOL (FTP), CD-ROM AND DVD-ROM.
BLK 12: No later than (NLT) two (2) weeks after each visit.
BLK 14: REVERSE OSMOSIS DISINFECTION REPORT SHALL BE DELIVERED TO:
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 2 of 6 Pages
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 (0704-1088). 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.
D. SYSTEM/ITEM
Water System Preventative Maintenance
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A0003
2. TITLE OF DATA ITEM
TEST / INSPECTION REPORT
3. SUBTITLE
HETEROTROPHIC BACTERIA TEST REPORT
4. AUTHORITY (Data Acquisition Document No.)
DI-NDTI-80809B
5. CONTRACT REFERENCE
C.3.8.1
6. REQUIRING OFFICE
TBD
7. DD 250 REQ
LT
ONCE
12. DATE OF FIRST
SUBMISSION
8. APP CODE
N/A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION SEE BLK 16
Draft Final
Reg Repro
16. REMARKS
BLK 4: HETEROTROPHIC BACTERIA TEST REPORT
SHALL BE DELIVERED ELECTRONICALLY IN A MEDIA SELECTED BY THE
GOVERNMENT AT TIME OF DELIVERY. MEDIA TYPES WHICH CAN BE ACCEPTED
INCLUDE: FILE TRANSFER PROTOCOL (FTP), CD-ROM AND DVD-ROM.
BLK 12: No later than (NLT) two (2) weeks after the visit.
BLK 14: HETEROTROPHIC BACTERIA TEST REPORT
SHALL BE DELIVERED TO:
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 3 of 6 Pages
X
Contract Specialist
X
Contracting Officer (KO)
EXHIBIT A – ATTACHMENT 1
ARMY RESEARCH LABORATORY
Report Title Goes Here Any Subtitles Go Here
By Some Author and Another Author
Month XXXX
Prepared by
Whatever Technology Corporation 0000 Research Drive
Anywhere, ST 20006-1000
Under contract
W911QX-XX-C-XXXX
DISTRIBUTION STATEMENT GOES HERE
EXHIBIT A – ATTACHMENT 2
The findings in this report are not to be construed as an official Department of the Army position unless so designated by other authorized documents.
Citation of manufacturer's or trade names does not constitute an official endorsement or approval of the use thereof.
DESTRUCTION NOTICE: For classified documents, follow the procedures in DoD 5220.22-M, National Industrial Security Program Operating Manual, Chapter 5, Section 7. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
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