Exhibit A Contract Data Requirement List (CDRLs).docx

CONTRACT DATA REQUIREMENTS LIST

Form Approved

(1 Data Item)

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

C. CATEGORY:

A LOTS I-V

MISC

D. SYSTEM|ITEM

FRCMA DET PAX CMSS

3. SUBTITLE

17. PRICE GROUP

Individual Material Readiness List (IMRL) Equipment Inventory Report

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

18. ESTIMATED TOTAL PRICE

DI-MISC-80508B

SOW PARA 3.1.8.1.5, 3.1.8.2.3,

3.1.8.2.5 & 3.4.14.2

COMFRC PJM

REQUIRED

ASREQ

SEE BLOCK 16

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

N/A

SEE BLOCK 16

16. REMARKS

ONLY

1. BLK 4: ONLY DID PARAGRAPH 3 (C). (2) APPLIES. ATTACHED CDRLPARA GRAPHS 1.0 TO 2.2 APPLIES WHICH DELINEATES REPORT FORMAT.

2. THE CONTRACTOR INVENTORY REPORTS THE GOVERNMENT FURNISHED IMRL PROPERTY PROVIDED AND ANY SUBSEQUENT GOVERNMENT AUTHORIZED CHANGES DURING THIS CONTRACT’S PERIOD OF SERVICE.

3. BLK 12: FIRST SUBMISSION (AN INITIAL (BASELINE) MOBILIZATION INVENTORY REPORT FOR IMRL ITEMS PROVIDED IN SUPPORT OF THIS CONTRACT) SHALL BE SUBMITTED 5 WORKING DAYS PRIOR TO CONTRACT SUPPORT DATE (CSD), FOR EACH LOT/OPTION PERIOD WHERE CONTRACTOR MAINENANCE SUPPORT SERVICES (CMSS) ARE PROVIDED, AN IMRL INVENTORY REPORT SHALL BE SUBMITTED TO THE COR FOR SIGNATURE WITHIN FIVE (5) WORKING DAYS AFTER THE END OF EACH LOT/OPTION PERIOD (NORMALLY ANNUALLY). ADDITIONAL SUBMISSIONS MAY BE REQUIRED BY THE GOVERNMENT (NORMALLY ASSOCIATED WITH A COMMANDING OFFICER OR MAINTENANCE OFFICER CHANGE; OR BY DIRECTIVE).

4. BLK 13: FINAL SUBMISSION (TRANSITION CLOSE-OUT) SHALL BE SUBMITTED 5 DAYS PRIOR TO THE END OFCMS SERVICES UNDER THIS CONTRACT. DISTRIBUTION OF FINAL SUBMISSION SHALL BE DUE NLT 2 WORKING DAYS AFTER APPROVAL/SIGNATURE OF COR.

5. THE GOVERNMENT WILL HAVE 60 WORKING DAYS FROM RECEIPT OF SUBMISSION FOR REVIEW AND ACCEPTANCE/REJECTION OF EACH SUBMISSION. GOVERNMENT WILL RESPOND ONLY AS NECESSARY.

6. BLK 14: SUBMISSIONS SHALL BE SENT VIA EMAIL TO RESPECTIVE COR’S SITES. SUBMISSIONS SHALL BE AN EMAIL ATTACHMENT IN MS-WORD/MS- EXCEL 2010 OR LATER FORMAT. EMAIL ADDRESSES ARE PROVIDED IN THE CONTRACT SCHEDULE. UNLESS RESTRICTED BY SIZE, EXCEL REPORTS SHALL BE IN ONE SPREADSHEET WITH MULTIPLE WORKSHEETS FOR EACH APPLICABLE AREA SPECIFIED IN PARAGRAPH 2.0 OF ANNEX A.

7. DISTIBUTION D: DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY, (FOUO - ADMINISTRATIVE OR OPERATIONAL USE), (10 NOV 2009). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE COMMANDING OFFICER, COMMANDER FLEET READINESS CENTERS, (COMFRC PCO, CODE 68520), 47038 MCLEOD ROAD, PATUXENT RIVER, MD 20670-1612.

COMFRC LOG

MGR

FRCMA DET PAX

COR

FRCMA DET PAX

ACOR

15. Total

G. PREPARED BY

H. DATE

M. A. CUSIC, FRCMA DET PAX

28 SEPT 2021

CDRL A001

TECHNICAL REPORT - STUDY / SERVICES IMRL INVENTORY REPORT

FRCMA N61340-17-R-0015 CDRL REQUIREMENT

1.0 REPORT CONTENTS: This report is to document the inventory of government and/or contractor items/equipment required by the contract statement of work. Contract Data Requirements List (CDRL) shall tailor each report’s requirements by applying CDRL annex paragraphs 1.0 through 2.2, as applicable.

1.1 FORMAT. CDRL submissions shall be in hard copy and/or electronic Microsoft Excel 2010 multiple worksheet spreadsheets.

1.1.1 Hard Copy: When specified CDRL Blocks 14b and 16, individual areas shall be prepared as delineated in the contract/task order on 8 ½” by 11” to 11” by 15” size paper.

1.1.2 E-Mail: When specified in CDRL Blocks 14b and 16. reports shall be attached files to Internet Electronic Mail that are compatible to MICROSOFT Office EXCEL 2010 formats as specified in block 16 of the CDRL. (Contractor shall ensure destination addresses are capable of file attachment size).

1.1.2.1 Electronic File Title Format. File names shall include; CDRL number, title ,and report period or applicable LOT for annual submissions (e.g., A002, IMRL Inv LOT I

1.1.2.2 Email Subject Lines Title Format. Internet Electronic-Mail subject line shall include Contract Number, CDRL Data Item Number, Location and period (e.g., N61340-16-C-xxxx -A00x- FRCMA DET PAX -1Oct11-30Sep11).

1.2 REPORT BODY.

1.2.1 HEADER INFORMATION. Inventory hard copies and electronic worksheets shall have the following header information:

a. CDRL # and Title. CDRL Block 1 and Blocks 3 and 4 of DD Form 1423-1 CDRL

b. Contract # Block E or contract number per Order of Supplies and Services DD Form 1155 or Amendment of Solicitation/Modification of Contract SF: 30.

b. Contractor. Enter name of contractor's firm.

c. Reporting Period. Enter the start and completion dates for CDRL reporting period ddmmmyyyy to ddmmmyyyy.

d. Contractor Name: Enter prime contractors name as noted on DD 1155 or SF 30.

e. Contractor Site Manager Date: (Name, phone, Email address)

If report is generated from a government system that precludes capability of the header, the government reporting system format shall be used.

2.0 Report Content Areas. The Contractor IMRL Inventory Report shall consist of the following areas (worksheets) to the detail and format delineated in paragraphs 2.2:

a. Area 1: All FRCMA DET PAX -IMRL items (See Exh A CDRL A001 Annex – IMRL Inventory file for list as of RFP – not warranted to be fully complete by the Government)

b. Area 2: Other areas as defined by the COR (in writing).

Although all Areas are usually inventoried annually, all or a subset of the Areas listed may be required to be inventoried more often when directed by the COR.

2.1. Each record/report Area shall contain the area data elements as defined by the Local Asset Maintenance System (LAMS), (i.e., AAI, LN, PN, CAGE, SN, BAR CODE, NOMENCLATURE, SC, TEC, LOCATION). The COR may require additional data elements, provided the added data elements are supported under LAMS. Samples of other elements areas are as follows:

a. Item name - Self-explanatory/ Nomenclature.

b. Manufacturer Name –

c. CAGE Code – (Four alphanumeric)

d. Manufacturer’s model number or part number -

e. Serial number –

f. Plant Property number/BAR Code –

g. National Stock Number (NSN) – If available, 13 alpha numeric characters (e.g., _ _ _ _-_ _- )

h. Quantity Allowed- The number of the items that should be in inventory

i. Quantity in Inventory - (includes any officially checked out)

j. Quantity missing or extra from allowance - (-) Missing; (+) Additional

j. Item Owner - G-Government or C-Contractor or Other (specify)

k. Calibration due date - In yymmdd format. N/A if not-applicable.

l. Calibration Cycle - In months. N/A if not-applicable.

m. Bar code - Number assigned to identify item.

n. Location - Location of item (e.g., Site Location, Building number, Room number, Work Center, Bin number, Box, safe number).

o. Work Center

p. AAI – AMMRL Activity Identifier

q. AAI Owner

r. Subcustody

s. Remarks - Indicate status, condition, and quantity of items that are missing from the government issued inventory. Status shall include date part ordered and expected time of arrival date. Note any changes to government issued inventory quantity shall be noted and dated (changed, substituted, removed or added) in remarks. Indicate item security classification and restrictions if applicable (confidential, secret, top secret, NORFORN, etc.) in the remarks. If an item is a kit, list items/parts in kit.

The COR may add other data or remove data items (in writing).

2.2 Summary Memo Format: The COR may require the report contain a full inventory listing and/or a summary memo.

Page 4 or 4

30 August 2016

MEMORANDUM

From: I. M. Worthy, ABC Maintenance, Inc.

Subj: ANNUAL IMRL INVENTORY (or other appropriate title: Change of Command, Change of Charge (OIC), etc.)

Ref: (a) CNAFINST 4790.2B

(b) NAVAIRINST 13650.1

1. IAW Refs. (a) & (b), inventory complete with no discrepancies.

I. M. WORTHY

FRCMA DET Patuxent River Site Manager

OR

1. IAW Refs. (a) & (b), inventory complete with the following missing items:

2. MLSR action initiated with the Material Control Officer.

OR

*Whatever appropriate paragraphs to describe the circumstances discovered in the inventory process.

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 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 LOTS I-V

OTHER MISC

D. SYSTEM|ITEM

FRCMA DET PAX CMSS

E. CONTRACT/PR NO.

N61340-

F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Technical Report – Study/Services

3. SUBTITLE

Non-IMRL/ Plant Property & Contractor Property Inventory Report

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

SOW PARA 3.1.8.1.5, 3.1.8.2.3, 3.1.8.2.5, & 3.4.14.2

6. REQUIRING OFFICE

COMFRC PJM

7. DD 250 REQ

SD

9. DIST STATEMENT REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

SEE BLOCK 16

ONLY

MGR

2. THE CONTRACTOR INVENTORY REPORTS THE GOVERNMENT FURNISHED PROPERTY (GFP) PROVIDED AND ANY SUBSEQUENT GOVERNMENT AUTHORIZED CHANGES DURING THIS

CONTRACT’S PERIOD OF SERVICE.

COR

FRCMA DET PAX

ACOR

3. BLK 12: FIRST SUBMISSION (AN INITIAL (BASELINE) MOBILIZATION INVENTORY REPORT FOR

GFP PROVIDED IN SUPPORT OF THIS CONTRACT) SHALL BE SUBMITTED FIVE (5) WORKING

DAYS PRIOR TO CONTRACT SUPPORT DATE (CSD), FOR EACH LOT/OPTION PERIOD WHERE

CONTRACTOR MAINTENANCE SUPPORT SERVICES (CMSS) ARE PROVIDED, A GFP - NON

IMRL / PLANT PROPERTY INVENTORY REPORT SHALL BE SUBMITTED TO THE COR FOR

SIGNATURE WITHIN FIVE (5) WORKING DAYS AFTER THE END OF EACH LOT/OPTION PERIOD

(NORMALLY ANNUALLY). ADDITIONAL SUBMISSIONS MAY BE REQUIRED BY THE

GOVERNMENT (NORMALLY ASSOCIATED WITH A COMMANDING OFFICER OR MAINTENANCE

OFFICER CHANGE OR BY DIRECTIVE).

4. BLK 13: FINAL SUBMISSION (TRANSITION CLOSE-OUT) SHALL BE SUBMITTED FIVE (5) DAYS

PRIOR TO THE END OF CMSS UNDER THIS CONTRACT. DISTRIBUTION OF FINAL SUBMISSION

SHALL BE DUE NLT 2 WORKING DAYS AFTER APPROVAL/SIGNATURE OF COR.

5. THE GOVERNMENT WILL HAVE 60 WORKING DAYS FROM RECEIPT OF SUBMISSION FOR

REVIEW AND ACCEPTANCE/REJECTION OF EACH SUBMISSION. GOVERNMENT WILL

RESPOND ONLY AS NECESSARY.

6. BLK 14: SUBMISSIONS SHALL BE SENT VIA EMAIL TO RESPECTIVE COR’S SITES.

SUBMISSIONS SHALL BE AN EMAIL ATTACHMENT IN MS-WORD/MS-EXCEL 2010 OR LATER

FORMAT. EMAIL ADDRESSES ARE PROVIDED IN THE CONTRACT SCHEDULE. UNLESS

RESTRICTED BY SIZE, EXCEL REPORTS SHALL BE IN ONE SPREADSHEET WITH MULTIPLE

WORKSHEETS FOR EACH APPLICABLE AREA SPECIFIED IN PARAGRAPH 2.0 OF ANNEX A.

7. DISTIBUTION D: DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY,

(FOUO - ADMINISTRATIVE OR OPERATIONAL USE), (10 NOV 2009). OTHER REQUESTS FOR

THIS DOCUMENT SHALL BE REFERRED TO THE COMMANDING OFFICER, COMMANDER

FLEET READINESS CENTERS, (COMFRC PCO, CODE 68520), 47038 MCLEOD ROAD,

PATUXENT RIVER, MD 20670-1612.

15. Total

G. PREPARED BY

M. A. CUSIC, FRCMA DET PAX

H. DATE

28 SEPT 2021

DD FORM 1423-1, JUN 90 (EG) Previous editions are obsolete Page 1 of 4 Pages

CDRL A002

NON-IMRL / PLANT PROPERTY & CONTRACTOR PROPERTY INVENTORY REPORT

FRCMA N61340-17-R-0015 CDRL REQUIREMENT

1.0 REPORT CONTENTS: This report is to document the inventory of government and/or contractor items/equipment required by the contract statement of work. Contract Data Requirements List (CDRL) shall tailor each report’s requirements by applying CDRL annex paragraphs 1.0 through 2.2, as applicable.

1.1 FORMAT. CDRL submissions shall be in hard copy and/or electronic Microsoft Excel 2010 multiple spreadsheets.

1.1.1 Hard Copy: When specified CDRL Blocks 14b and 16, individual areas shall be prepared as delineated in the contract/task order on 8 ½” by 11” to 11” by 15” size paper.

1.1.2 E-Mail: When specified in CDRL Blocks 14B and 16. Reports shall be attached files to email that are compatible to MICROSOFT Office EXCEL 2010 formats as specified in block 16 of the CDRL. (Contractor shall ensure destination addresses are capable of file attachment size).

1.1.2.1 Electronic File Title Format. File names shall include; CDRL number, title ,and report period or applicable LOT for annual submissions (e.g., A002, IMRL Inv LOT I)

1.1.2.2 Email Subject Lines Title Format. Email subject line shall include Contract Number, CDRL Data Item Number, Location and period (e.g., N61340-16-C- xxxx -A00x- FRCMA DET PAX -1Oct11-30Sep11).

1.2 REPORT BODY.

1.2.1 HEADER INFORMATION. Inventory hard copies and electronic worksheets shall have the following header information:

a. CDRL # and Title. CDRL Block 1, 2, & 3 of DD Form 1423-1 CDRL

b. Contract #: Block E or contract number per Order of Supplies and Services DD Form 1155 or Amendment of Solicitation/Modification of Contract SF30.

b. Contractor. Enter name of contractor's firm.

c. Reporting Period. Enter the start and completion dates for CDRL reporting period ddmmmyyyy to ddmmmyyyy.

d. Contractor Name: Enter prime contractors name as noted on DD 1155 or SF 30.

e. Contractor Site Manager Date: (Name, phone, Email address

2.0 Report Content Areas. The Contractor Inventory/Utilization Report shall consist of the following areas (worksheets) to the detail and format delineated in detail in below:

a. Area 1: Contractor provided tools and equipment/furnishings.

b. Area 2: Items and Equipment identified by the COR.

Although all Areas are usually inventoried annually, all or a subset of the Areas listed may be required to be inventoried more often when directed by the COR.

2.1. Each record/report shall contain the following area data elements:

a. Item name - Self-explanatory/ Nomenclature.

b. Manufacturer Name –

c. CAGE Code – (Four alphanumeric)

d. Manufacturer’s model number or part number -

e. Serial number –

f. Plant property number/BAR Code -

g. National Stock Number (NSN) – If available, 13 alpha numeric characters (e.g., _ _ _ _-_ _- )

h. Quantity Allowed - The number of the items that should be in inventory

i. Quantity in Inventory - (includes any officially checked out)

j. Quantity Missing or Extra from Allowance - (-) Missing; (+) Additional

j. Item Owner - G-Government or C-Contractor or Other (specify)

k. Calibration due date - In yymmdd format. N/A if not-applicable.

l. Calibration Cycle - In months. N/A if not-applicable.

m. Bar code - Number assigned to identify item.

n. Location - Location of item (e.g., Site Location, Building number, Room number, Work Center, Bin number, Box, safe number).

o. Remarks - Indicate status, condition, and quantity of items that are missing from the government issued inventory. Status shall include date part ordered and expected time of arrival date. Note any changes to government issued inventory quantity shall be noted and dated (changed, substituted, removed or added) in remarks. Indicate item security classification and restrictions if applicable (confidential, secret, top secret, NORFORN, etc.) in the remarks. If an item is a kit, list items/parts in kit.

The COR may add other data items (in writing).

2.2 Summary Memo:

MEMORANDUM

From: I. M. Worthy, ABC Maintenance, Inc.

Subj: ANNUAL NON- IMRL PLANT PROPERTY INVENTORY (or other appropriate title: Change of Command, Change of Charge (OIC), etc.)

Ref: (a) CNAFINST 4790.2B

(b) NAVAIRINST 13650.1

1. IAW Refs. (a) & (b), inventory complete with no discrepancies.

30 August 2010

OR

1. IAW Refs. (a) & (b), inventory complete with the following missing items:

2. MLSR action initiated with the Material Control Officer.

FRCMA DET Patuxent River Site Manager

OR

*Whatever appropriate paragraphs to describe the problem circumstances discovered in the inventory process.

CONTRACT

DATA

REQUIREMENTS

LIST

Form

Approved (1

Data

Item)

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:

A

LOTS

I-V

TDP

TM

OTHER

MISC

D.

SYSTEM|ITEM

E.

CONTRACT/PR

NO.

F.

CONTRACTOR

FRCMA

DET

PAX

CMSS

N61340- 1.

DATA

ITEM

NO.

2.

TITLE

OF DATA

ITEM

3.

SUBTITLE

A003 Technical

Report –

Study/Services Contractor

Quality

Assurance

Plan 4.

AUTHORITY

(Data

Acquisition

Document

No.)

5.

CONTRACT REFERENCE

6.

REQUIRING

OFFICE

DI-MISC-80508B

SOW

PARA

3.1.8.1.5, 3.1.8.2.5, 3.2.7.7.1, 3.4.14.2;

CNAFINST

4790.2

CHPT

COMFRC PJM

7.

DD

250 REQ

9.

DIST

STATEMENT

REQUIRED

10.

FREQUENCY

12.

DATE

OF

FIRST

SUBMISSION

14.

DISTRIBUTION

SD

C

ASREQ

SEE

BLOCK 16

a.

ADDRESSEE

b.

COPIES

8.

APP

CODE

11.

AS

OF

DATE

13. DATE OF SUBSEQUENT

SUBMISSION

DRAFT

FINAL

N/A N/A

SEE

BLOCK 16

Re g Repr o 16.

REMARKS

COMFRC

PCO

LTR

ONLY

BLK 4:

ONLY DID PARAGRAPH 3 (C). (2) APPLIES.

CONTRACTOR FORMAT IS

ACCEPTABLE

AS

APPLICABLE

WITH

COR

FORMAT

APPROVAL.

THE CONTRACTOR QUALITY ASSURANCE (QA) PLAN SHALL BE A LIVING

DOCUMENT CHANGED

AS

REQUIRED.

BLK 12: FIRST SUBMISSION (AN INITIAL CONTRACTOR QA PLAN) SHALL BE

SUBMITTED NLT 5 WORKING DAYS PRIOR TO CONTRACT SUPPORT DATE (CSD).

SUBSEQUENT SUBMISSIONS SHALL BE PROVIDED TO AMEND THE PLAN AS

NEEDED.

THE GOVERNMENT WILL HAVE 15 WORKING DAYS FROM RECEIPT OF

SUBMISSION FOR REVIEW OF DRAFT AND/OR ACCEPTANCE/REJECTION OF EACH

SUBMISSION.

THE CONTRACTOR SHALL SUBMIT FINAL SUBMISSION AFTER

GOVERNMENT REVIEW OF DRAFT WITHIN 10 WORKING DAYS FROM RECEIPT

FROM

THE

GOVERNMENT.

BLK 14:

SUBMISSIONS SHALL BE SENT VIA EMAIL.

SUBMISSIONS SHALL BE AN

EMAIL ATTACHMENT IN MS-WORD/MS-EXCEL 2010 OR LATER FORMAT. EMAIL

SUBJECT LINE SHALL BE CONTRACT NUMBER, CDRL NUMBER, TITLE, DATE OF

DOCUMENT (E…G.,

N61340-16-C-XXXX,

A003

QA

PLAN 15

JUN

16.)

DISTIBUTION C:

DISTRIBUTION AUTHORIZED TO U.S. GOVERNMENT AGENCIES

AND THEIR CONTRACTORS, (FOUO - ADMINISTRATIVE OR OPERATIONAL USE),

(10 NOV 2009).

OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED

TO THE COMMANDING OFFICER, COMMANDER FLEET READINESS CENTERS,

(COMFRC PCO, CODE 68520), 47038 MCLEOD ROAD, PATUXENT RIVER, MD 20670-

1612.

ACCEPTANCE OF ANY REPORT THAT INCLUDES INFORMATION CONCERNING

CHANGES IN CONTRACT REQUIREMENTS/STANDARDS/SPECIFICATIONS DOES

NOT CONSTITUTE GOVERNMENT AGREEMENT TO THOSE CHANGES.

ONLY BY

DIRECTION

OF

THE

CONTRACTING OFFICER

CAN

SUCH

CHANGES

BE

MADE.

COMFRC

LOG

MGR

FRCMA

DET

PAX

COR

FRCMA

DET

PAX

ACOR

15.

Total G.

PREPARED

BY

H.

DATE

I.

APPROVED

BY

J.

DATE

M. A.

CUSIC,

FRCMA

DET

PAX

SEPT

17. PRICE

GROUP

18. ESTIMATED

TOTAL

PRICE

DD FORM 1423-1, FEB 2001 Previous editions are obsolete Page 1 of 1 Pages

CONTRACT

DATA

REQUIREMENTS

LIST

Form

Approved (1

Data

Item)

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:

A

LOTS

I-V

TDP

TM

OTHER

MISC

D.

SYSTEM|ITEM

E.

CONTRACT/PR

NO.

F.

CONTRACTOR

FRCMA DET

PAX

CMSS

N61340- 1.

DATA

ITEM

NO.

2.

TITLE

OF DATA

ITEM

3.

SUBTITLE

A004 Technical

Report –

Study/Services Contractor

Safety

Plan

4. AUTHORITY

(Data Acquisition Document

No.)

5.

CONTRACT

REFERENCE

6.

REQUIRING

OFFICE

DI-MISC-80508B

SOW

PARA

3.1.8.1.5, 3.1.8.2.5, 3.2.7.10.2

3.4.14.2;

CNAFINST

4790.2

COMFRC

PJM

7.

DD

250 REQ

9.

DIST

STATEMENT

REQUIRED

10.

FREQUENCY

12.

DATE

OF

FIRST

SUBMISSION

14.

DISTRIBUTION

SD

C

ASREQ

SEE

BLOCK

a.

ADDRESSEE

b.

COPIES

8.

APP

CODE

11.

AS

OF

DATE

13. DATE OF SUBSEQUENT

SUBMISSION

DRAFT

FINAL

N/A N/A

SEE

BLOCK

Re g Repr o 16.

REMARKS

COMFRC

PCO

LTR

ONLY

BLK 4:

ONLY DID PARAGRAPH 3 (C). (2) APPLIES.

CONTRACTOR FORMAT IS

ACCEPTABLE

AS

APPLICABLE

WITH COR

FORMAT

APPROVAL.

THE CONTRACTOR SAFETY PLAN SHALL BE A LIVING DOCUMENT AND CHANGED

AS

REQUIRED.

BLK 12: FIRST SUBMISSION (AN INITIAL CONTRACTOR SAFETY PLAN) SHALL BE

SUBMITTED NLT FIVE (5) WORKING DAYS PRIOR TO CONTRACT SUPPORT DATE

(CSD).

SUBSEQUENT SUBMISSIONS SHALL BE SUBMITTED AS REQUIRED TO AMEND

THE

PLAN

AS

NEEDED.

THE GOVERNMENT WILL HAVE 15 WORKING DAYS FROM RECEIPT OF

SUBMISSION FOR REVIEW OF DRAFT AND/OR ACCEPTANCE/REJECTION OF EACH

SUBMISSION.

THE CONTRACTOR SHALL SUBMIT FINAL SUBMISSION AFTER

GOVERNMENT REVIEW OF DRAFT WITHIN 10 WORKING DAYS FROM RECEIPT FROM

THE GOVERNMENT.

BLK 14:

SUBMISSIONS SHALL BE SENT VIA EMAIL.

SUBMISSIONS SHALL BE AN

EMAIL ATTACHMENT IN MS-WORD/MS-EXCEL 2010 OR LATER FORMAT. EMAIL

SUBJECT LINE SHALL BE CONTRACT NUMBER, CDRL NUMBER, TITLE, DATE OF

DOCUMENT (E…G.,

N61340-16-C-XXXX, A004 SAFETY

PLAN 15

JUN 16.)

DISTIBUTION C:

DISTRIBUTION AUTHORIZED TO U.S. GOVERNMENT AGENCIES

AND THEIR CONTRACTORS, (FOUO - ADMINISTRATIVE OR OPERATIONAL USE), (10

NOV 2009).

OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE

COMMANDING OFFICER, COMMANDER FLEET READINESS CENTERS, (COMFRC PCO,

CODE 68520),

47038

MCLEOD

ROAD,

PATUXENT

RIVER,

MD 20670-1612.

ACCEPTANCE OF ANY REPORT THAT INCLUDES INFORMATION CONCERNING

CHANGES IN CONTRACT REQUIREMENTS/STANDARDS/ SPECIFICATIONS DOES NOT

CONSTITUTE GOVERNMENT AGREEMENT TO THOSE CHANGES.

ONLY BY

DIRECTION

OF

THE

CONTRACTING

OFFICER

CAN

SUCH CHANGES

BE

MADE.

COMFRC

LOG

MGR

FRCMA

DET

PAX

COR

FRCMA

DET

PAX

ACOR

15.

Total G.

PREPARED

BY

H.

DATE

I.

APPROVED

BY

J.

DATE

M. A.

CUSIC,

FRCMA

DET

PAX

SEPT

17. PRICE

GROUP

18. ESTIMATED

TOTAL

PRICE

DD FORM 1423-1, feb 2001 Previous editions are obsolete Page 1 of 1 Pages

CONTRACT DATA REQUIREMENTS LIST (CDRL)

(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 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.

C. CATEGORY:

A LOTS I-V

D. SYSTEM/ITEM

FRCMA DET PAX CMSS

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

17. PRICE GROUP

A005

TECHNICAL REPORT – STUDY/SERVICES

INFORMATION TECHNOLOGY (IT) PERSONNEL SECURITY REPORT

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

18. ESTIMATED TOTAL PRICE

DI-MISC-80508B

SOW PARAs 3.1.8.1.5, 3.1.8.2.5, & 3.4.14.2

FRCMA-DET PAX SECURITY OFFICER

b. COPIES

8. APP CODE

C

Draft Final

N/A

SEE BLK 16

16. REMARKS

1. BLK 4: ONLY DID PARAGRAPH 3 (C). (2) APPLIES. REFER TO ATTACHED ANNEX FORMAT. SUBMISSIONS SHALL BE A SECURITY REPORT FOR ALL EMPLOYEES (PRIME, SUBCONTRACTOR, CONSULTANTS AND TEMPORARY EMPLOYEES) REQUIRING ACCESS TO GOVERNMENT INFORMATION TECHNOLOGY (IT) SYSTEMS. FREEDOM OF INFORMATION ACT, PRIVACY ACT AND PERSONAL INFORMATION PROTECTION REQUIREMENTS AND MARKINGS APPLY.

2. BLK 4: DELETE PARA 2. SUBMISSION SHALL BE A MICROSOFT @ EXCEL 2010 SPREADSHEET FORMATTED IN ACCORDANCE WITH ANNEX TO EXHIBIT A (NOTE: SOCIAL SECURITY NUMBERS (SSNs) SHALL ONLY APPEAR ON REPORT SUBMITTED TO FRCMA-PAX SECURITY OFFICER). SUBMISSION TO FRCMA-PAX SECURITY OFFICER SHALL ALSO INCLUDE A COMPLETED SYSTEM AUTHORIZATION ACCESS REQUEST-NAVY (SAAR-N OPNAV 5239/14 FORM (IN .PDF FORMAT) FOR EACH EMPLOYEE. BLANK FORM MAY BE DOWNLOADED FROM THE FOLLOWING WEBSITE: https://navalforms.documentservices.dla.mil/web/public/home

3. BLK 12: FIRST SUBMISSION SHALL BE DUE NO LATER THAN 5 WORKING DAYS PRIOR TO CONTRACTOR SUPPORT DATE (CSD) OR PRIOR TO LOGGING ON ACCESS TO GOVT ASSETS, WHICHEVER COMES FIRST.

4. BLK 13: UPDATED SUBMISSIONS DUE AS REQUIRED WITHIN (3) WORKING DAYS OF GAIN OR LOSS OF EMPLOYEE(S) THAT HAVE OR WILL ACCESS GOVERNMENT INFORMATION TECHNOLOGY (IT) SYSTEMS. ANNUAL SUBMISSIONS SHALL BE DUE 12 MONTHS AFTER CONTRACT AWARD THROUGH END OF CONTRACT.

5. THE GOVERNMENT WILLHAVE 20 WORKING DAYS FOR REVIEW AND ACCEPTANCE/REJECTION OF EACH SUBMISSION.

6. BLK 14: SUBMISSION SHALL BE AN ELECTRONIC ENCRYPTED COPY SENT VIA EMAIL. EMAIL SUBJECT LINE SHALL INCLUDE CONTRACT NUMBER, CDRL DATA ITEM NUMBER. CONTRACT, TITLE, AND DATE OF REPORT. (E.G. N61340-17-R-0015 IT FRCMA CMSS- A005-MAY-16). EMAIL ADDRESSES ARE PROVIDED IN THE CONTRACT SCHEDULE. FILES SHALL BE ENCRYPTED USING WINZIP AES 256-BIT ENCRYPTION.

Note *: DO NOT RECEIVE SAAR-N FORMS, ONLY SPREADSHEET DATA WITH NO SSN.

Note: ** RECIEVES SPREADSHEET WITH SSN’S AND SAAR-N FORMS.

7. DISTIBUTION F: DISTRIBUTION AUTHORIZED ONLY AS DIRECTED BY THE CONTROLLING OFFICE (FRCMA-PAX SECURITY OFFICER), (FOUO ADMINISTRATIVE OR OPERATIONAL USE ONLY), (10 NOV 2009). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE COMMANDING OFFICER, COMMANDER FLEET READINESS CENTERS, (COMFRC PCO, CODE 68520), 47038 MCLEOD ROAD, PATUXENT RIVER, MD 20670-1612.

FRCMA-DET PAX

SECURITY OFF * *

G. PREPARED BY

H. DATE

M. A. CUSIC, FRCMA DET PAX

28 SEPT 2021

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 2 Pages

ANNEX TO EXHIBIT A - CDRL A005 Page 2 of 2

IT Personnel Security Report

The following Excel Spreadsheet shall be completed and submitted to FRCMA DET PAX SECURITY OFFICER along with the completed SAAR-N forms with full SSN (Needed for JPAS entry):

CDRL A005 IT

Security Report Blank.

The following Excel Spreadsheet shall be completed and submitted to all other BLK 14a distribution addressees whose report is identified to be WITHOUT the SAAR-N forms and “NO” SSN’s:

CDRL A005 IT

Security Report No SS

CONTRACT DATA REQUIREMENTS LIST (CDRL)

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.

C. CATEGORY:

A LOTS I-V

D. SYSTEM/ITEM

FRCMA DETPAX CMSS

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

17. PRICE GROUP

A006

TECHNICAL REPORT – STUDY/SERVICES

CVS-TA CAC REPORT

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

18. ESTIMATED TOTAL PRICE

DI-MISC-80508B

SOW PARA 3.1.8.1.5, 3.1.8.2.5,

3.4.14.2

FRCMA DET PAX CVS-TA

b. COPIES

8. APP CODE

F

Final

N/A

SEE BLK 16

16. REMARKS

1. BLK 4: ONLY DID PARAGRAPH 3 (C). (2) APPLIES. REFER TO ATTACHED FOR CVS REGISTRATION FORM AND THE ATTACHED ANNEX SPREADSHEET WORKSHEET PART 5 FOR REPORT FORMAT. SUBMISSIONS SHALL BE FOR ALL ON-SITE EMPLOYEES (PRIME, SUBCONTRACTOR, CONSULTANTS AND TEMPORARY EMPLOYEES) REQUIRING A COMMON ACCESS CARD (CAC). PRIVACY ACT AND PERSONAL INFORMATION PROTECTION REQUIREMENTS AND MARKINGS APPLY FOR THIS REPORT.

2. BLK 4: DELETE PARA 2. SUBMISSION SHALL BE A MICROSOFT @ EXCEL 2010 SPREADSHEET FORMATTED (NOTE: SOCIAL SECURITY NUMBERS (SSNs) SHALL ONLY APPEAR ON REPORT SUBMITTED TO FRCMA-PAX CVS-TA. COMPLETED CVS REGISTRATION REQUEST FORMS SHALL ONLY BE PROVIDED TO THE FRCMA DET PAX CVS-TA.

3. BLK 12: FIRST SUBMISSION SHALL BE DUE PRIOR ISSUANCE OF A CAC CARD TO ANY CONTRACTOR EMPLOYEE.

4. BLK 13: UPDATED SUBMISSIONS DUE AS REQUIRED PRIOR TO ISSUANCE OR REMOVAL/SUSPENSION/TERMINATION OF ANY CONTRACTOR PERSONNELS CAC CARD (GAIN OR LOSS OF EMPLOYEE(S). .

5. THE GOVERNMENT WILL HAVE 10 WORKING DAYS FOR REVIEW AND ACCEPTANCE/REJECTION OF EACH SUBMISSION.

6. BLK 14: SUBMISSION SHALL BE AN ELECTRONIC ENCRYPTED COPY SENT VIA EMAIL. EMAIL SUBJECT LINE SHALL INCLUDE CONTRACT NUMBER, CDRL DATA ITEM NUMBER. CONTRACT, TITLE, AND DATE OF REPORT. (E.G. N61340-16-C-xxxx

- A006- CVS 14 JUL-16). EMAIL ADDRESSES ARE PROVIDED IN THE CONTRACT SCHEDULE. FILES SHALL BE ENCRYPTED USING WINZIP AES 256-BIT ENCRYPTION.

Note *: DO NOT RECEIVE CVS REGISTRATION REQUEST FORMS, ONLY PART 5 SPREADSHEET DATA WITH NO SSN.

Note: ** RECIEVES ANNEX SPREADSHEET PART 5 WITH SSN’S AND COMPLETED ANNEX CVS REGISTRATION REQUEST FORM(S).

7. DISTIBUTION F: DISTRIBUTION AUTHORIZED ONLY AS DIRECTED BY THE CONTROLLING OFFICE (FRCMA-PAX CVS-TA), (FOUO ADMINISTRATIVE OR OPERATIONAL USE ONLY), (10 NOV 2009). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE COMMANDING OFFICER, COMMANDER FLEET READINESS CENTERS, (COMFRC PCO, CODE 68520), 47038 MCLEOD ROAD, PATUXENT RIVER, MD 20670-1612.

8. ACCEPTANCE OF ANY REPORT THAT INCLUDES INFORMATION CONCERNING CHANGES IN CONTRACT REQUIREMENTS/STANDARDS/ SPECIFICATIONS DOES NOT CONSTITUTE GOVERNMENT AGREEMENT TO THOSE CHANGES. ONLY BY DIRECTION OF THE CONTRACTING OFFICER CAN SUCH CHANGES BE MADE.

FRCMA DET PAX ACOR

FRCMA DET PAX CVS-TA

G. PREPARED BY

M. A. CUSIC, FRCMA DET PAX

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 3 Pages

Report format shall be as follows:

EXHIBIT A - CDRL A006

CVS-TA / CAC Report

a. CVS Registration Request (below) (also in Exhibit A) shall be completed for each Contractor employee requiring a CAC. .

e

b. Data from the above forms shall be consolidated in alphabetical order using the Part 5 worksheet of the following spreadsheet.

PART 1 COVER SHEET

PART 5: CVS STATUS REPORT

CDRL A006

CVS-TA-CAC Status.xls

CONTRACT DATA REQUIREMENTS LIST (CDRL)

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.

C. CATEGORY:

A LOTS I-V

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

FRCMA DET PAX CMSS

N61340-

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

17. PRICE GROUP

A007

TECHNICAL REPORT – STUDY/SERVICES

MONTHLY MAINTENANCE PLAN INPUTS

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

18. ESTIMATED TOTAL PRICE

DI-MISC-80508B

SOW PARA 3.4.14.2

FRCMA DET PAX MMCO

b. COPIES

8. APP CODE

F

Final

N/A

SEE BLK 16

16. REMARKS

1. BLK 4: ONLY DID PARAGRAPH 3 (C). (2) APPLIES. CONTRACTOR FORMAT IS ACCEPTABLE AS APPLICABLE. REFER TO ATTACHED CDRL FOR CONTENT/ AREAS OF APPLICATION.

2. BLK 12: SUBMISSIONS DUE DAILY. FIRST SUBMISSION SHALL BE DUE NO LATER THAN THE FIRST WORKING DAY OF EACH MONTH AFTER CONTRACTOR SUPPORT DATE (CSD).

3. BLK 13: SUBSEQUENT SUBMISSIONS DUE DAILY AS CHANGES OCCUR UP UNTIL THE 16TH OF EACH MONTH FOR THE MONTHLY MAINTENANCE PLAN.

4. THE GOVERNMENT WILL HAVE 10 WORKING DAYS FOR REVIEW AND ACCEPTANCE/REJECTION OF EACH SUBMISSION.

5. BLK 14: SUBMISSIONS SHALL BE MADE ON THE WORKING COPY MMP IN PRODUCTION CONTROL OR AS DETERMINED BY MMCO/COR.

6. ACCEPTANCE OF ANY REPORT THAT INCLUDES INFORMATION CONCERNING CHANGES IN CONTRACT REQUIREMENTS/STANDARDS/SPECIFICATIONS DOES NOT CONSTITUTE GOVERNMENT AGREEMENT TO THOSE CHANGES. ONLY BY DIRECTION OF THE CONTRACTING OFFICER CAN SUCH CHANGES BE MADE.

7. DISTIBUTION F: DISTRIBUTION AUTHORIZED ONLY AS DIRECTED BY THE CONTROLLING OFFICE (FRCMA DET PAX MMCO), (FOUO ADMINISTRATIVE OR OPERATIONAL USE ONLY), (10 NOV 2009). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE COMMANDING OFFICER, COMMANDER FLEET READINESS CENTERS, (COMFRC PCO, CODE 68520), 47038 MCLEOD ROAD, PATUXENT RIVER, MD 20670-1612.

G. PREPARED BY

H. DATE

M. A. CUSIC, FRCMA DET PAX

28 SEPT 2023

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 2 Pages

EXHIBIT A - CDRL A007

Monthly Maintenance Plan Input

1.0 CDRL FORMAT. This CDRL shall use the FRCMA DET PAX Monthly Maintenance and Training Plan format. Unless the MMCO requires a specific format media, hard copy or electronic copy shall be the choice of the Contractor. Contractor shall make input into the following as applicable:

a. Program Managers / Monitors

b. Signature Authorizations

c. Quality Assurance Representatives / Collateral Duty Inspectors

d. Special Qualifications / Certifications / Team Member Assignments / NAMP Collateral Duties

e. AIRSpeed

f. Support Equipment License Qualifications

g. NDI Lab Requirements / NDI Technician Qualifications / RSO Tickler

h. Support Equipment / Facilities Maintenance Schedule

i. Outstanding Technical Directives / Support Equipment Planned Maintenance System & AWSE Test and Check / GSE Division Hours of Operation / Shop Installed SE / Calibration Requirements

j. ALSS Projected Major Inspections & Projected Schedule of Items to be Inducted for Test and Check

k. Hydrostatic Test Due Dates

l. Recurring Meetings / Reports Due / QA Audit Schedule

m. Local MRCs List / CDI Stamped MRC Cards

n. Program Cross Reference and Local Command Procedures / Memorandums of Agreement

o. Support Equipment Phase 1 Training Schedule

p. Monthly Training Plan / DBA Training

Note: Format content may be changed by the MO, MMCO, or COR.

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 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

A

LOTS

I-V

TDP

TM

OTHER

MISC

D.

SYSTEM/ITEM

E.

CONTRACT/PR

NO.

F.

CONTRACTOR

FRCMA DET

PAX

CMSS

N61340- 1.

DATA

ITEM

NO

2.

TITLE

OF

DATA

ITEM

3.

SUBTITLE

17.

PRICE

GROUP

A009

PROGRESS,

STATUS AND MANAGEMENT

REPORT

DAILY

EQUIPMENT (BENCH)

STATUS REPORT

4.

AUTHORITY

(Data

Acquisition

Document

No.)

5.

CONTRACT

REFERENCE

6.

REQUIRING

OFFICE

DI-MGMT-81928

SOW

Par

3.4.14.2

FRCMA

DET

PAX

MMCO

18. ESTIMATED

TOTAL

PRICE

7.

DD

REQ

9. DIST STATEMENT

REQUIRED

10.

FREQUENCY

12.

DATE

OF

FIRST

SUBMISSION

14.

DISTRIBUTION

SD

DAILY

SEE BLK

a.

ADDRESSEE

b.

COPIES

8.

APP

CODE

D

11. AS

OF

DATE

13.

DATE

OF

SUBSEQUENT

SUBMISSION

Draft Final N/A

SEE BLK

Reg Repro 16.

REMARKS

FRCMA

DET

PAX

MMCO

BLK

4:

CONTRACTOR

FORMAT IS

ACCEPTABLE,

AS

APPLICABLE.

BLKS 12/13:

SUBMISSIONS SHALL BE DUE DAILY NLT

0700 ON WORK DAYS. INITIAL

SUBMISSION SHALL BEGIN ON THE CONTRACTOR

SUPPORT DATE (CSD) AND CONTINUE

UNTIL

END

OF

CONTRACT.

BLK

14:

SUBMISSION SHALL BE BY ELECTRONIC MAIL

IN A FORMAT THAT IS COMPATIBLE

WITH MICROSOFT© OFFICE 2010 OR LATER FORMAT

AND SHALL

INCLUDE

IN THE SUBJECT

LINE:

CONTRACT NUMBER, CDRL DATA ITEM NUMBER, TITLE, AND DATE OF REPORT (E.G.

N61340-16-C-xxxx-A009-BENCH STATUS- 06 JUL 16).

BLOCK 14 DISTRIBUTION EMAIL

ADDRESSES

ARE

PROVIDED

IN

THE

CONTRACT

SCHEDULE.

THE

GOVERNMENT WILL

HAVE

WORKING

DAYS

FOR

REVIEW

AND

ACCEPTANCE/REJECTION

OF

EACH

SUBMISSION.

THE REPORT SHALL IDENTIFY ANY GFP/GFE THAT IS NOT OPERATING PROPERLY AND

IMPACTING

MAINTENANCE.

REPORT

SHALL

INDICATE

IMPACT

ON

MAINTENANCE

AND

NOTE

ANY

ACTIONS

TAKEN

TO

REPAIR THE

ITEMS

AND

ITS

ECA.

ACCEPTANCE

OF

ANY

REPORT

THAT

INCLUDES

INFORMATION

CONCERNING

CHANGES

IN

CONTRACT

REQUIREMENTS/STANDARDS/SPECIFICATIONS DOES NOT CONSTITUTE GOVERNMENT

AGREEMENT

TO

THOSE

CHANGES.

ONLY

BY

DIRECTION

OF

THE

CONTRACTING

OFFICER

CAN

SUCH

CHANGES

BE

MADE.

DISTIBUTION

D:

DISTRIBUTION

AUTHORIZED

TO

DOD

AND

U.S.

DOD

CONTRACTORS

ONLY, (FOUO-ADMINISTRATIVE OR OPERATIONAL USE), (10 NOV 2009). OTHER REQUESTS

FOR

THIS

DOCUMENT SHALL

BE

REFERRED

TO

THE

COMMANDING

OFFICER,

COMMANDER

FLEET READINESS CENTERS, (COMFRC PCO, CODE 68520), 47038 MCLEOD ROAD,

PATUXENT

RIVER,

MD

20670-1612.

ACCEPTANCE OF ANY REPORT

THAT

INCLUDES INFORMATION CONCERNING CHANGES

IN

CONTRACT

REQUIREMENTS/STANDARDS/SPECIFICATIONS

DOES

NOT

CONSTITUTE

GOVERNMENT

AGREEMENT

TO

THOSE

CHANGES.

ONLY

BY

DIRECTION

OF

THE

CONTRACTING

OFFICER

CAN SUCH

CHANGES

BE

MADE

FRCMA

DET

PAX

COR

FRCMA

DET

PAX

ACOR

G.

PREPARED

BY

H.

DATE

I.

APPROVED BY

J.

DATE

M.

A.

CUSIC,

FRCMA

DET

PAX

SEPT

CONTRACT DATA REQUIREMENTS LIST

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

C. CATEGORY

A LOTS I-V

OTHER

MISC

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

FRCMA DET PAX CMSS

N61340-

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

17. PRICE

GROUP

A010

Technical Report – Study/Services

MAINTENANCE ACTION SUMMARY REPORT

6. REQUIRING OFFICE

SOW Para 3.1.8.2.5, & 3.4.14.2

FRCMA DET PAX COR

18. ESTIMATED TOTAL PRICE

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

SUBMISSION

14. DISTRIBUTION

SD

b. COPIES

8. APP CODE

D

Final

N/A

SEE BLK 16

16. REMARKS

1. BLK 4: ONLY DID PARAGRAPH 3 (C). (2) APPLIES. CONTRACTOR FORMAT IS ACCEPTABLE AS APPLICABLE WITH COR FORMAT APPROVAL.

2. BLKS 12/13: SUBMISSIONS SHALL BE DUE WEEKLY BY WEDNESDAY OR AS REQUIRED. INITIAL SUBMISSION SHALL BE DUE WEDNESDAY THE FIRST WEEK BEGINNING WITH THE CONTRACTOR SUPPORT DATE (CSD) AND WILL CONTINUE UNTIL END OF CONTRACT.

3. BLK 14: SUBMISSION SHALL BE BY EMAIL IN A FORMAT THAT IS COMPATIBLE WITH MICROSOFT© OFFICE 2010 OR LATER AND SHALL INCLUDE IN THE SUBJECT LINE: CONTRACT NUMBER, CDRL DATA ITEM NUMBER, TITLE, AND PERIOD OF REPORT (E.G. N61340-16-C-xxxx-A010 -MAINT ACT SUM- 1-13 JUL 16). BLOCK 14 DISTIBUTION EMAIL ADDRESSES ARE PROVIDED IN THE CONTRACT SCHEDULE.

4. THE GOVERNMENT WILL HAVE 5 WORKING DAYS FOR REVIEW AND ACCEPTANCE/REJECTION OF EACH SUBMISSION.

5. ACCEPTANCE OF ANY REPORT THAT INCLUDES INFORMATION CONCERNING CHANGES IN CONTRACT REQUIREMENTS/STANDARDS/ SPECIFICATIONS DOES NOT CONSTITUTE GOVERNMENT AGREEMENT TO THOSE CHANGES. ONLY BY DIRECTION OF THE CONTRACTING OFFICER CAN SUCH CHANGES BE MADE.

6. DISTIBUTION D: DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY, (ADMINISTRATIVE OR OPERATIONAL USE), (10 NOV 2009). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE COMMANDING OFFICER, COMMANDER FLEET READINESS CENTERS, (COMFRC PCO, CODE 68520), 47038 MCLEOD ROAD, PATUXENT RIVER, MD 20670-1612.

G. PREPARED BY

H. DATE

M. A. CUSIC, FRCMA DET PAX

28 SEPT 2021

FORM 1423-1, FEB 2001 Previous editions are obsolete Page 1 of 1 Pages

CONTRACT DATA REQUIREMENTS LIST (CDRL)

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.

C. CATEGORY:

A LOT I-V

TDP

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

FRCMA DET PAX CMSS

N61340-

TBD

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

17. PRICE GROUP

A011

TECHNICAL REPORT – STUDY/SERVICES

CONTRACT FUNDING STATUS REPORT (CFSR)

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

18. ESTIMATED TOTAL PRICE

DI-MISC-80508B

SD

REQUIRED

MTHLY

SEE BLOCK 16

b. COPIES

8. APP CODE

Final

E

N/A

SEE BLOCK 16

16. REMARKS

REPORT CONTENTS.

2. BLK 12: REPORTS SHALL BE SIMULTANEOUSLY SUBMITTED TO THE

NAWCTSD PCO AND DISTRIBUTED NO LATER THAN THE 5TH WORKING DAY

AFTER EACH REPORTING PERIOD. THE FIRST REPORTING PERIOD SHALL

BE DUE the 5th WORKING DAY AFTER CONTRACT SUPPORT DATE (CSD) FOR

THE MOBILIZATION PERIOD.

3. BLK 13: SUBSEQUENT MONTHLY REPORTS SHALL BE DUE BEGINNING THE

CONTRACTOR SUPPORT DATE (CSD) THROUGH THE END OF THE

CONTRACT OR UNTIL ALL BALANCES ARE ZERO (0), AND NO MORE ACTIONS

ARE PENDING (I.E. DOL, CLAIM ETC.)

4. THE GOVERNMENT WILL HAVE 15 WORKING DAYS FOR REVIEW AND

ACCEPTANCE/REJECTION OF EACH SUBMISSION.

5. BLK 14: SUBMISSIONS SHALL BE SENT VIA EMAIL. SUBMISSIONS SHALL BE

AN EMAIL ATTACHMENT IN MICROSOFT-EXCEL 2010 OR LATER FORMAT AND

SHALL INCLUDE IN THE SUBJECT LINE: CONTRACT NUMBER, CDRL DATA

ITEM NUMBER, TITLE, AND PERIOD (E.G. N61340-16-C-xxxx-A011-CFSR- 1-31

May 16). BLOCK 14 DISTIBUTION EMAIL ADDRESSES ARE PROVIDED IN THE

CONTRACT SCHEDULE.

6. DISTIBUTION E: DISTRIBUTION AUTHORIZED TO DOD COMPONENTS ONLY,

(FOUO-ADMINISTRATIVE OR OPERATIONAL USE), (10 NOV 2009). OTHER

REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE

COMMANDING OFFICER, COMMANDER FLEET READINESS CENTERS,

(COMFRC PCO, CODE 68520), 47038 MCLEOD ROAD, PATUXENT RIVER, MD

20670-1612.

G. PREPARED BY

H. DATE

M. A. CUSIC, FRCMA DET PAX

28 SEPT 2021

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 3 Pages

EXHIBIT TO CDRL A011 TECHNICAL REPORT - STUDY / SERVICES CONTRACT FUNDS STATUS REPORT (CFSR)

1. Summary contents:

1.1 HEADER INFORMATION. Data elements to be provided as header information are as follows, in the order shown.

a. Contract. Enter appropriate contract number.

b. Task Order. Enter appropriate task order number.

c. Contractor. Enter name of contractor's firm.

d. Reporting Period. Enter month and year for which report is being prepared.

1.2 REPORT BODY. The main body of the report shall be completed in accordance with the attached sample format. Entry of actual data is to be made in the appropriate column for the period covered by the report.

Data element titles to be included are as follows:

a. CLIN / SLIN. Enter contract line item number / sub-line item number (CLIN / SLIN) which are being performed or have been performed (has funding obligated), as shown in Section B of the task order. (The report is to be cumulative, showing all CLIN / SLIN which are currently active or have been active from start of contract to end date of reporting month.)

b. ACR. Enter appropriate Accounting Classification Requirements (ACR) number for the CLIN / SLIN.

c. Description of Supplies / Services. Enter CLIN / SLIN description as shown in Section B.

d. Total CLIN / SLIN Amount. Enter total CLIN / SLIN amount as shown in Section B.

e. CLIN / SLIN Funded Amount. Enter CLIN / SLIN funded amount as shown in Section B.

f. Invoiced / Expended Amount to Date. Enter cumulative amount invoiced for CLIN / SLIN.

g. CLIN / SLIN Funds Remaining. Enter difference between CLIN / SLIN funded and invoiced amounts.

h. Percent Invoiced of Funded Amount. Enter invoiced amount as a percentage of funded amount.

i. Deductions for Period. Enter amount of any performance deduction taken against the CLIN / SLIN during the reporting period. Enter deduction amount or “N / A” (not applicable), as appropriate.

j. Cumulative Deductions. Enter cumulative total of all deductions taken to date against the CLIN/SLIN.