Exhibit A - CDRLs.pdf

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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 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

Untitled

1_DATA_ITEM_NO: A009

2_TITLE_OF_DATA_ITEM: Aircraft Progress Report

3_SUBTITLE: Flight Operations Daily Checklist

4_AUTHORITY_Data_Acquisit: DI-MISC-81462

5_CONTRACT_REFERENCE: PWS 2.2.4.10.2; 2.5.2.1.9

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: CS draft2:

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16_REMARKS: Flight Operations Daily Checklist.

- Shall be submitted by 0800 SAST daily.

- Report shall be submitted electronically.

- The report shall be prepared in contractor format, and document that procedures and/or checklist was followed for oversight and management of day-to-day flight operations functions.

- Report shall be submitted to the KO, CS, COR, ACOR and GFR.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 1

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 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

1_DATA_ITEM_NO: A011

2_TITLE_OF_DATA_ITEM: Technical Manual Quality Assurance (TMQA) Program Plan

3_SUBTITLE: Quality Control Program Report

4_AUTHORITY_Data_Acquisit: DI-TMSS-81817

5_CONTRACT_REFERENCE: PWS 2.5.2.1.11, Block 16

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: CS draft2:

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16_REMARKS: Quality Control Program Report.

- Shall be submitted by the 10th working day of the following month.

- Report shall be submitted electronically.

- The report shall provide the inspection schedule 90 days out and the findings from the previous month's inspections (announced and unannounced).

- Report shall include the Status of all open corrective action plans (CAP) shall be reported until the CAP is closed (discrepancy is under control).

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: TMSS

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 1

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 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

1_DATA_ITEM_NO: A012

2_TITLE_OF_DATA_ITEM: Personnel Report

3_SUBTITLE: List of Key Positions/Personnel

4_AUTHORITY_Data_Acquisit: DI-MISC-81419

5_CONTRACT_REFERENCE: PWS 2.3.1.1.5; 2.3.2.5.5; 2.5.2.1.12

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: CS draft2:

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addressee3: COR draft3:

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16_REMARKS: List of Key Positions/Personnel.

- The initial list with hierarchy for each key position shall be submitted to the Government within five (5) days of award. Once staffed, those key positions become key personnel.

- Shall be submitted as required, but within 24 hours of any change in on-site managers.

- Report shall be submitted electronically.

- The list of on-site managers shall include their addresses (to include e-mail), and telephone numbers within their assigned area of operations.

- The contractor shall provide immediate replacement of on-site managers found not qualified by the Government or who do not meet the security clearance requirements.

- Report shall be prepared in contractor format and submitted to the KO, CS, COR, ACOR and GFR as soon as available and whenever changes occur.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 1

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 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

Untitled

1_DATA_ITEM_NO: A013

2_TITLE_OF_DATA_ITEM: Accident/Incident Report

3_SUBTITLE: Serious Incident Reporting

4_AUTHORITY_Data_Acquisit: DI-SAFT-81563

5_CONTRACT_REFERENCE: PWS 2.5.2.1.13; Block 16

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See Block 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: OPM SAS draft2:

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16_REMARKS: Serious Incident Reporting (PWS 2.2.4.6.3, PWS 2.2.4.7.4, PWS 2.2.4.7.3 and PWS 2.2.4.7.10) The Contractor shall promptly, thoroughly and impartially investigate and report simultaneously to the Contracting Officer, the OPM Special Assistant – Security, COR, ACOR, and GFR any circumstances which indicate that a serious incident, as defined herein, has occurred. The Special Assistant (Security) will notify the OPM-SANG chain of command. Doubtful cases shall be resolved in favor of satisfying the investigation and reporting requirements specified herein.

b. Initial notification shall be made within 2 hours of the incident. (An initial report shall be generated for each individual involved in the incident) Follow-up reporting shall be made every 12 hours after the initial report until it is determined that the incident is resolved. (A Follow-up report shall be generated for each individual involved in the incident) Initial notification shall include, at a minimum, the following information:

(1) Type of incidents/accidents, including but not limited to the following: Property Damage, Vehicular accidents, Theft, Personal Injury, Vandalism, Bombing, Kidnapping, Direct assault, employee arrest and or incarceration, etc. The Contractor shall require similar reporting requirement in all subcontracts.

(2) Date, Time and Location of incident. (Injured evacuated to where).

(3) Personnel Involved. (Name, Position, Duty Related, Injuries suffered, Casualties).

(4) Notifications. (Contractor chain of command, Host Nation authorities, US Embassy), as applicable.

(5) Actions of Host Nation Authorities, if applicable.

(6) Summary of current security status, if applicable Follow-up reporting shall include all pertinent information discovered within the 12 hour update period. Follow-up information shall be submitted in the same format as the initial report.

c. Serious incidents are defined as, but not limited to, the following:

(1) Any incident which involves the investigation, arrest or incarceration of Contractor personnel by local or national Saudi Arabian law enforcement or security agencies.

(2) Any confrontation or altercation between Contractor personnel and or member(s) of the SANG, Kingdom of Saudi Arabia officials or Saudi Arabian Nationals.

(3) Any act by Contractor's personnel which may constitute a violation of Saudi Arabian or U.S. laws, other than minor traffic offenses.

(4) Any court action or judgment(s), EEO case, legal action, or claim which may affect the Modernization Program or relations between OPM and SANG or may affect program costs.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 2

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 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

Untitled

1_DATA_ITEM_NO: A013

2_TITLE_OF_DATA_ITEM: Accident/Incident Report

3_SUBTITLE: Serious Incident Reporting

4_AUTHORITY_Data_Acquisit: DI-SAFT-81563

5_CONTRACT_REFERENCE: PWS 2.6.2.1.14; Block 16

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See Block 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: OPM SAS draft2:

reg2: 1 repro2:

addressee3: COR draft3:

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addressee36:

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draft37:

reg37:

repro37:

addressee38:

draft38:

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total_draft: 0 total_repro: 0

16_REMARKS: Serious Incident Reporting (PWS 2.2.4.6.3, PWS 2.2.4.7.4 and PWS 2.2.4.7.10 ) ---------continued--------

(5) Any other act of any nature involving Contractor personnel which might adversely affect the Modernization Program or relations between OPM-SANG and the SANG.

d. The Contractor shall, immediately (no later than 2 hours) after he becomes aware of circumstances which indicate that a serious incident has occurred, make a verbal report as stated in paragraphs a and b above. Within forty-eight hours of the verbal report, the Contractor shall submit a written report to the Contracting Officer. Upon completion of all investigative effort, the Contractor shall submit a final written report to the Government. Verbal and written reports shall contain all reasonably available relevant information to include copies of documents and photographs of evidence.

e. The Contractor shall take all reasonable actions to assure that investigations are prompt, thorough, and impartial. To the extent feasible, written statements should be obtained from all persons having knowledge of the circumstances which indicate that a serious incident has occurred.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 2 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 2

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 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

Untitled

1_DATA_ITEM_NO: A001

2_TITLE_OF_DATA_ITEM: Status of Government Furnished Equipment (GFE) Report

3_SUBTITLE: Operational Readiness Report

4_AUTHORITY_Data_Acquisit: DI-MGMT-80269

5_CONTRACT_REFERENCE: PWS 2.5.2.1.1; 2.3.1.1.7

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: CS draft2:

reg2: 1 repro2:

addressee3: COR draft3:

reg3: 1 repro3:

addressee4: ACOR draft4:

reg4: 1 repro4:

addressee5: GFR draft5:

reg5: 1 repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

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total_draft: 0 total_repro: 0

16_REMARKS: Operational Readiness Report

- The Contractor shall provide status for air traffic control equipment and firefighting by airfield in contractor format. The Contractor shall have available, an equipment readiness report in a format comparable to DA Form 2406 Materiel Condition Status Report for the USG and the MNG AVN review.

- The report shall cover from the 15th of one month through the 15th of the following month report, and delivered on the 1st of the next month. The report shall be prepared in contractor format.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 1

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 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

1_DATA_ITEM_NO: A002

2_TITLE_OF_DATA_ITEM: Contractor's Standard Operating Procedures

3_SUBTITLE: SOP, POI, and Checklists Page 1 of 2

4_AUTHORITY_Data_Acquisit: DI-MGMT-81580

5_CONTRACT_REFERENCE: PWS 2.5.2.1.2, Block 16

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: CS draft2:

reg2: 1 repro2:

addressee3: COR draft3:

reg3: 1 repro3:

addressee4: ACOR draft4:

reg4: 1 repro4:

addressee5: GFR draft5:

reg5: 1 repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

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total_draft: 0 total_repro: 0

16_REMARKS: - Contractor shall update, implement, maintain and review (no less than annually) multiple SOP/POI and Checklists IAW current AR 95-20.

- Documents shall be submitted electronically.

- Documents shall be prepared in contractor format.

- Initial documents shall be submitted NLT 90 days from the Transfer of Responsibility to deliver any SOP/POI and Checklists required for functional area and PWS paragraphs below and provide to USG for review and approval.

- Report shall be submitted to the KO, CS, COR, ACOR and GFR.

- PWS 2.2.2.6 Property Management SOP; PWS 2.2.4.1.2 Airfield Operations Manual (AOM); PWS .2.4.1.2 Airfield/Heliport flight operations operating procedures (A/HOP); PWS 2.2.3.5 Facilities Management Operating Procedure; PWS 2.2.4.2 ATC systems and NAVAIDS Maintenance Procedures ; PWS 2.2.4.3.3 Crash, Fire, and Rescue Standard Operating Procedure; PWS 2.2.4.3.4 Airfield/Heliport Qualification training plan (Emergency Responder Job Book); PWS 2.2.4.3.6 MNG Airfield/Heliport Flight Line Fire Prevention Safety Inspection Checklist; PWS 2.2.4.5.4 Aviation Procedures Guide (APG); PWS 2.2.4.5.4 Airfield Operations Manual; PWS 2.2.4.5.4 Airfield Safety Program Standard Operating Procedures; PWS 2.2.4.6.1 Environmental Compliance Standard Operating Procedure; PWS 2.2.4.8.1 Air Traffic Control Standard Operating Procedure; PWS 2.5.2.1.9 MNG Airfield/ Ground and Flight Operations Section And Procedures (FOP/GOP); PWS 2.2.4.10.2 Flight Operations Daily Checklist; PWS 2.2.4.11.3 Refueling/Defueling Procedures; PWS 2.2.4.12.1 Aviation Ground Support Equipment Maintenance Procedures; PWS 3.2 Transition Out Procedures;

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 2

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 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

1_DATA_ITEM_NO: A003

2_TITLE_OF_DATA_ITEM: Status Report

3_SUBTITLE: Monthly Reports

4_AUTHORITY_Data_Acquisit: DI-MGMT-80368A

5_CONTRACT_REFERENCE: PWS 2.5.2.1.3; Block 16

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: COR draft2:

reg2: 1 repro2:

addressee3: GFR draft3:

reg3: 1 repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

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repro6:

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total_draft: 0 total_repro: 0

16_REMARKS: Monthly Reports.

- Shall be submitted not later than close of business by the 15th day following the first of the month.

- Reports shall be submitted electronically.

- The reports shall be prepared in contractor format.

-Reports should be at an operational level for use as a planning and management tool.

- Reports shall be prepared in contractor format and submitted to the KO, COR and GFR.

- PWS 2.2.1.7.1 OJT Status Report; PWS 2.2.1.7.7 Attendance Report; PWS 2.2.2.21 Inventory reports; PWS 2.2.4.2.3 Facilities Management Report; PWS 2.2.4.3.6 MNG Airfield/Heliport Inspection Report; PWS 2.2.4.6.1 Safety Program Statistics Report; PWS 2.3.1.1.2.3 Program Management Review; PWS 2.3.2.5 Staffing Report;

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 3

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 1

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 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

1_DATA_ITEM_NO: A004

2_TITLE_OF_DATA_ITEM: Personnel Report

3_SUBTITLE: Monthly Staffing Report and CTIP Certification

4_AUTHORITY_Data_Acquisit: DI-MISC-81419

5_CONTRACT_REFERENCE: PWS 2.3.2.5; 2.5.2.1.4; Block 16

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT:

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: COR draft2:

reg2: 1 repro2:

addressee3: GFR draft3:

reg3: 1 repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

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total_draft: 0 total_repro: 0

16_REMARKS: Monthly Staffing Report.

- Shall be submitted not later than close of business by the 15th day following the first of the month.

- Reports shall be submitted electronically.

- The reports shall be prepared in contractor format.

- Percentage of staffing on the force structure approved upon award of this contract in accordance with USG directed incremental mobilization schedule shall be reported monthly.

- The Contractor shall submit annual certification to the Contracting Officer of implementation of a compliance plan to prevent any prohibited CTIP activities IAW FAR Clause 52.222-50.

- PWS 2.2.1.3.1 Training Management Offices (TMO); PWS 2.2.1.10.13 IMS-instructors; PWS 2.2.4.1.1 Airfield Management Operations (Base Operations) and Flight Operations facility; PWS 2.3.1.1.5 Key Positions; PWS 2.3.1.1.6 Site Management;

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 3

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 1

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 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

1_DATA_ITEM_NO: A005

2_TITLE_OF_DATA_ITEM: GOVERNMENT FURNISHED EQUIPMENT (GFE) INVENTORY REPORT

3_SUBTITLE: Inventory Reports

4_AUTHORITY_Data_Acquisit: DI-MGMT-82173

5_CONTRACT_REFERENCE: PWS 2.2.2.6; 2.3.1.1.4; 2.5.2.1.5

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: COR draft2:

reg2: 1 repro2:

addressee3: GFR draft3:

reg3: 1 repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

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addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

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draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS: Inventory Reports.

- Shall provide inventory reports of accountable items by location to USG of 10% of accountable items monthly.

- Shall provide inventory reports of accountable items by location to USG of 100% of accountable items annually.

- Reports shall be submitted electronically.

- The reports shall be prepared in contractor format.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 3

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 1

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 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

1_DATA_ITEM_NO: A006

2_TITLE_OF_DATA_ITEM: Disaster Preparedness Exercise Evaluation Report

3_SUBTITLE: Quarterly Exercises of the Airfield Pre-Accident Plan

4_AUTHORITY_Data_Acquisit: DI-MISC-80394

5_CONTRACT_REFERENCE: PWS 2.2.4.3.5; 2.5.2.1.6

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: CS draft2:

reg2: 1 repro2:

addressee3: COR draft3:

reg3: 1 repro3:

addressee4: ACOR draft4:

reg4: 1 repro4:

addressee5: GFR draft5:

reg5: 1 repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

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total_draft: 0 total_repro: 0

16_REMARKS: Quarterly Exercises of the Airfield Pre-Accident Plan.

- The Contractor shall collaborate with the MNG Safety Officer, USG Safety Officer, Brigade Aviation Safety Officer, Standardization and Evaluation Pilots, Airfield Safety Manager, GFR and Airfield Manager to implement, and conduct quarterly exercises of the Airfield Pre-Accident Plan.

- After Action Report with findings and determinations of the exercise results shall be prepared in contractor format submitted to the KO, CS, COR, ACOR and GFR.

- If required, an updated Airfield Pre-Accident Plan shall be submitted within 30 days prior to the following Quarterly Exercise of the Airfield Pre-Accident Plan.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 1

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 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

1_DATA_ITEM_NO: A007

2_TITLE_OF_DATA_ITEM: Personnel Report

3_SUBTITLE: Monthly Work Schedule

4_AUTHORITY_Data_Acquisit: DI-MISC-81419

5_CONTRACT_REFERENCE: PWS 2.5.2.1.7

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: CS draft2:

reg2: 1 repro2:

addressee3: COR draft3:

reg3: 1 repro3:

addressee4: ACOR draft4:

reg4: 1 repro4:

addressee5: GFR draft5:

reg5: 1 repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

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repro7:

addressee8:

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reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS: Daily Reports.

- Shall be submitted by 1200 SAST 25th of the month preceding the schedule.

- Contractor shall recommend format to approved upon first submission.

- Report shall be submitted electronically.

- The report shall contain at a minimum:

- Summary of personnel indicating total requirements versus on-hand fill.

- Delineated by location and work schedule, user/supported unit, labor category, with totals, by-order number, scheduled times, indicated on a summary page.

- Detailed information on any necessary travel or scheduled leave.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: TSS-AVN

E_CONTRACTPR_NO: W90BRJ-2#-R-####

FCONTRACTOR: TBD

of_pages: 1

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 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

1_DATA_ITEM_NO: A008

2_TITLE_OF_DATA_ITEM: Personnel Report

3_SUBTITLE: Daily Headcount - Access Roster

4_AUTHORITY_Data_Acquisit: DI-MISC-81419

5_CONTRACT_REFERENCE: PWS 2.2.4.4.4; 2.5.2.1.8

6_REQUIRING_OFFICE: OPM-SANG/IMSS/Eskan Village KSA

7_DID_250_REQ: N/A

8_APP_CODE: See BLK 16

DIST_STATEMENT: B

10_FREQUENCY: See Block 16

11_AS_OF_DATE: See Block 16

12_DATE_OF_FIRST_SUBMISSI: See Block 16

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: KO draft1:

reg1: 1 repro1:

addressee2: CS draft2:

reg2: 1 repro2:

addressee3: COR draft3:

reg3: 1 repro3:

addressee4: ACOR draft4:

reg4: 1 repro4:

addressee5: GFR draft5:

reg5: 1 repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

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reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS: Daily Headcount - Access Roster

- Shall be submitted by 1000 SAST daily.

- Report shall be submitted electronically.

- Report may be in contractor format.

- The headcount report shall contain at a minimum:

- All personnel entering a controlled area(s).

- Access Log for Security Operations.

The Contractor shall maintain daily headcount record for 90 days.

- The Contractor shall provide a roster no later than the third working day of the month of all employees who have access to MNG airfields and facilities.

- The Access Roster is to be provided to MNG AVN G2.

- Report shall be submitted to the KO, CS, COR, ACOR and GFR.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Rafael Torres Jr, COR

H_DATE:

1_APPROVED_BY: Samuel M. Feleke, DAPM AVN

J_DATE:

Page: 1 reg38t: 5

A_CONTRACT_LINE_ITEM_NO: XXXX

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: TSS-AVN

E_CONTRA…