Exhibit A - Contract Data Requirements List (CDRLs).pdf

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 26 Pages

C O N T R A C T D A T A R E Q U I R E M E N T S L I S T (1 Data Item)

Form Approved OMB No. 0704-0188

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 this bur den, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security and Access Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Technical Report- Study Services

3. SUBTITLE

Contingency Plan

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS para 1.4.4 & 2.29.12

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Contractor format is acceptable.

Contractors providing services designated as essential contractor services shall be prepared to continue providing such services, in accordance with the terms and conditions of their contracts, during periods of crisis. As a general rule, the designation of services as essential contractor services will not apply to an entire contract but will apply only to those service functions that have been specifically identified as essential contractor services by the functional commander or civilian equivalent. Contractors who provide Government-determined essential contractor services shall provide a written plan to be incorporated in the contract to ensure the continuation of these services in crisis situations. Contracting officers shall consult with a functional manager to assess the sufficiency of the contractor-provided written plan. Contractors will activate such plans only during periods of crisis, as authorized by the contracting officer, who does so at the direction of the appropriate functional commander or civilian equivalent.

The plan shall also include a canine contingency plan section to include the Contractor providing immediate response (responding within 5 minutes or less).

The Contingency Plan shall be submitted to the PCO, ACO, & COR within 30 days after contract award.

PCO 0 1 0

ACO 0 1 0

COR 0 1 0

15. TOTAL 0 3 0

G. PREPARED BY H. DATE

I. APPROVED BY J. DATE

DEBATES.JONATHAN.

JAMES.1275659548

Digitally signed by

DEBATES.JONATHAN.JAMES.1275659548

Date: 2020.07.02 10:43:12 -07'00' 7/2/20

08 October 2020

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 2 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security and Access Control

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Technical Report- Study Services

3. SUBTITLE

Electronic Badging System Reports

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

PWS para 1.4.6

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Contractor format acceptable.

Electronic Badging System Reports shall be submitted as requested by the COR. If the COR is unavailable, these reports can be requested by the Chief of Police, any Police Lieutenant or the DES NCO.

This report shall show the personnel granted access to the USAG-KA for the time period specified in the request IAW USAG-KA Regulations and Policies. This report shall be detailed to include all personnel granted access to the island regardless of status. This report will be broken down by organization and tenant units to include all dependents and identifiable information.

These systems contain personally identifiable information that must be protected and controlled IAW with FAR Part 24 and Army/DOD Regulations and Policies.

Submit report in latest Government approved electronic media.

COR 0 1 0

15. TOTAL 0 1 0

G. PREPARED BY

H. DATE: I. APPROVED BY

J. DATE

DEBATES.JONATHAN

.JAMES.1275659548

Digitally signed by

DEBATES.JONATHAN.JAMES.1275659548

Date: 2020.07.07 07:04:09 -07'00' 7/7/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 3 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including sugge stions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the

A003

2. TITLE OF DATA ITEM

Training Reports

3. SUBTITLE

Training Records/Certifications/IRP Packet

9. DIST

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Training curriculum and certificates for the following required training shall be submitted as stated below:

PWS para 1.4.6.: Personally Identifiable Information/DOD component Privacy Act training shall be completed within 90 days after contract award and annually thereafter.

PWS para 3.2: Anti-Terrorism Awareness Training shall be completed within 90 days after contract award and annually thereafter.

PWS para 3.6: i-Watch Training results shall be completed within 120 days after contract award and within 60 calendar days of new employees commencing performance with the results reported to the COR no later than 120 days after contract award. Certifications shall be submitted via email to the COR and ACO.

PWS para 3.11: Documentation of company sponsored locally structured training for contractor security guards shall be provided prior to being assigned to security guard duties.

PWS para 3.17.1: The Contractor shall provide the COR and the Government’s IRP certifying official all training records, certificates, and DA Form 7708 for each perspective security guard and obtain certifying official’s approval of the individual for full employment.

PWS para 3.17.3: The Contractor shall provide all task, conditions, and standards for the training of the tasks to the COR for review and approval prior to training.

Submit reports/documentation in latest Government approved electronic media.

PCO 0 1 0

ACO 0 1 0

H. DATE

I. APPROVED BY

.JAMES.1275659548

Digitally signed by

DEBATES.JONATHAN.JAMES.127565954

Date: 2020.07.02 10:43:37 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 4 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security and Access Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Technical Report- Study Services

3. SUBTITLE

Military Police Desk Journal and Daily Staff Log

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE PWS para 2.13.1

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall prepare and submit a daily military desk journal/log and daily staff journal covering a 24-hour period that feeds into the blotter in accordance with ATP 3-39 series. Daily oversight will be conducted by Department of the Army Police Officers. Items for the Daily Staff journal will be incorporated into the DACP Law Enforcement Journal.

Format shall be in PDF. Contractor can submit an alerts print out, DA form 1594, or a contractor derived form. This shall be submitted daily to the COR. Electronic transmission is required.

COR 0 1 0

15. TOTAL

G. PREPARED BY H. DATE: I. APPROVED BY J. DATE

DEBATES.JONATHAN

.JAMES.1275659548

Digitally signed by

Date: 2020.07.02 10:43:56 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 5 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington He adquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22 202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the

A005

2. TITLE OF DATA ITEM

Status Reports

3. SUBTITLE

Monthly Activity Report

PWS para 2.13.1

9. DIST

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a Monthly Activity Report that contains a summary of the significant accomplishments and any problems in each major area of the PWS for the month reports, to include administration, central patrol stations, Roi Namur Patrol Station, Entry and Exit, Dock Security Checkpoints, Marine, Army, Training, and any miscellaneous topics not addressed. The report shall include any action initiated by the contractor or their personnel.

The program management section of the report shall include major changes to the contractor’s organization, staff, and staff functions that affect this contract.

Personnel administration: List numbers of personnel broken down by off-site and on-site by location. Further define the on-site personnel as off-island hires, on-island hires, and Marshallese. Further breakdown the Marshallese to how many are grandfathered and how many are not. Each month, indicate for the three categories off/on island Marshallese. The number of new hires and number of terminations. The terminations shall be categorized by contract completion, resignation, or termination for cause. For off-island hires, further divide into accompanied or un-accompanied status categories. Provide the average employment duration in the month, turnover percentage, and absentee percentage.

The report shall provide entry/exit statistics, badging statistics, Dock Security Checkpoint statistics and DEERS/RAPID and CAC service statistics for both Kwajalein and Roi Namur.

Electronic transmission is required.

I. APPROVED BY

DEBATES.JONATHAN.J

AMES.1275659548

Digitally signed by

Date: 2020.07.02 10:44:18 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 6 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security and Access Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Contractor Work Breakdown Structure

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE PWS para 2.13.4

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall develop and maintain a contract work breakdown structure (CWBS). Contractor format is acceptable.

Draft shall be submitted with proposal. Proposal submission shall be updated within 60 days after contract award to include the negotiated levels.

Tailor DID MIL-STD-881 as a guide to develop a services oriented CWBS.

The CWBS dictionary is not required.

Applicable to cost-plus-fixed-fee efforts only.

Report shall be submitted in latest Government approved electronic media.

PCO 0 1 0

ACO 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DEBATES.JONATHAN

.JAMES.1275659548

Digitally signed by

Date: 2020.07.02 10:44:44 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 7 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security and Access Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

Reimbursable Cost Report

3. SUBTITLE

CPFF

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS para 2.13.5

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a Reimbursable Cost Report that provides the funds status and total costs associated with special projects and customer funded missions.

The first report shall be submitted within 15 days after the end of the first full accounting month after contract award. Thereafter, the report shall be submitted by the 4th calendar day of the month.

Applicable to cost-plus-fixed-fee efforts only.

Submit report in latest Government approved electronic media.

PCO 0 1 0

ACO 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DEBATES.JONATHAN

.JAMES.1275659548

Digitally signed by

Date: 2020.07.02 10:45:18 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 8 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security and Access Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

Quality Control Plan

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE PWS para 4.1

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall establish and implement a system of supervisory checks and controls to ensure that the minimum performance requirements and standards outlined in the Performance Work Statement are met. This plan must be reviewed by the COR and approved prior to implementation. The Contractor shall submit a draft copy of its quality control plan with their proposal.

The Contractor shall submit a final copy of its quality control plan to the COR within 30 days after contract award. Any changes to the quality control plan made during the contract performance period shall be submitted and approved by the Contracting Officer prior to implementation.

Submit report in latest Government approved electronic media.

PCO 0 1 0

ACO 0 1 0

COR 0 1 0

I. APPROVED BY J. DATE

DEBATES.JONATHAN.

JAMES.1275659548

Digitally signed by

Date: 2020.07.02 10:45:35 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 9 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 review ing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either o f these addresses. 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

D. SYSTEM/ITEM

Security and Access Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A009

2. TITLE OF DATA ITEM

Technical Report- Study Services

3. SUBTITLE

Accident Prevention Plan

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS para 4.4

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide an Accident Prevention Plan that conforms to the requirements of the Army Regulation 385-10 and the Occupational Safety and Health Care Act of 1970 (OSHA). The plan shall also conform to the requirements set forth by the USAG-KA and the RTS Safety office and their policy and regulations.

The plan shall be submitted within 30 days of contract award.

The Government will review/approve/provide comments within 30 days after receipt of the plan.

Report shall be submitted electronically in the latest Government approved electronic media.

PCO 0 1 0

ACO 0 1 0

COR 0 1 0

15. TOTAL 0 3 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DEBATES.JONATHAN.

JAMES.1275659548

Digitally signed by

Date: 2020.07.02 10:45:54 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 10 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 estimat e or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A010

2. TITLE OF DATA ITEM

Technical Report- Study Services

3. SUBTITLE

Procedures Manual

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS para 4.6

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a Procedures Manual that supplements existing guard related procedures. The manual shall include the Contractor’s standard operating procedures and installation unique procedures.

The plan shall be submitted within 60 days after contract award.

The Government will review/approved/provide comments within 30 days after receipt of plan.

The Contractor shall advise the COR of significant changes. Changes shall be submitted to the KO for approval.

The manual shall be submitted electronically in the latest Government approved electronic media.

PCO 0 1 0

ACO 0 1 0

COR 0 1 0

15. TOTAL 0 3 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DEBATES.JONATHAN.J

AMES.1275659548

Digitally signed by

Date: 2020.07.02 10:46:17 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 11 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A011

2. TITLE OF DATA ITEM

Operations Security (OPSEC) Plan

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE PWS para 3.8

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Contractor format is acceptable.

The Contractor shall submit an OPSEC plan within 90 calendar days of contract award. The OPSEC plan shall be updated as required by the

COR.

The plan shall be submitted electronically in the latest Government approved electronic media.

PCO 0 1 0

ACO 0 1 0

COR 0 1 0

15. TOTAL 0 3 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DEBATES.JONATHAN.JAM

ES.1275659548

Digitally signed by

Date: 2020.07.02 10:46:35 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 12 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A012

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Licenses and Certifications

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS para 3.10

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Contractor format is acceptable.

The Contractor shall provide copies of all licenses and certifications for Security Guard personnel to the COR. These licenses and certifications for the Contractor employees shall be provided prior to the employee’s assumption of duties on USAG-KA.

The documentation shall be submitted electronically in the latest Government approved electronic media.

COR 0 1 0

15. TOTAL 0 1 0

H. DATE I. APPROVED BY J. DATE

.JAMES.1275659548

Digitally signed by

Date: 2020.07.02 10:47:21 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 13 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the

Security Access and Control

A013

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Statement of Medical Screening

PWS para 3.15

9. DIST

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Contractor format is acceptable.

The Contractor shall provide a statement of suitability from a certified physician that states the individual has been medically evaluated and a determination made that the individual can perform the essential functions of the job as outlined in AR 190-56 and with the Army IRP process.

This statement shall be submitted prior to approval of the individual being hired and annually thereafter.

The statement shall be submitted electronically in the latest Government approved electronic media.

H. DATE I. APPROVED BY

DEBATES.JONATHAN.JA

MES.1275659548

Digitally signed by

Date: 2020.07.02 10:48:26 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 14 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A014

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Individual Reliability Screening, Evaluation and Security Checks

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE PWS para 4.11

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Contractor format is acceptable.

The contractor shall ensure that all personnel meet the suitability requirements as set forth in AR 190-56, Chapter 2, The Army Civilian Police and Security Guard Program, as well as appropriate security clearances requirements of AR 380-67, Personnel Security Program, or DOD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), if applicable. Contract security guard positions require a secret security clearance. Access control officer positions require a national agency check with inquiries (NACI). The contractor shall furnish to both the KO and the PMO a record of the results of each employee's security screening prior to entry on duty and to resolve any discrepancies in the investigations to the satisfaction of the COR. If security clearances are required, requests for security clearances should be made to the supporting Defense Security Service Office (see DOD 5220.22-M).

Results of the NACI shall be furnished to the KO and to the COR. The costs of any and all such checks and inquiries shall be the responsibility of the contractor. The security requirements are in accordance with the DD254 which is an attachment to Section J of the contract.

PCO 0 1 0

ACO 0 1 0

COR 0 1 0

15. TOTAL 0 3 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DEBATES.JONATHAN

.JAMES.1275659548

Digitally signed by

Date: 2020.07.02 10:48:47 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 16 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A015

2. TITLE OF DATA ITEM

Mobilization Plan

3. SUBTITLE

Phase In

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE

Section H

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Contractor format is acceptable.

Contractor shall provide a Mobilization Plan within 30 days after contract award.

The mobilization plan shall include any site unique Government required training. To minimize any decreased in productivity and to prevent possible negative impacts on services, the contract shall have personnel on board during the 60 day mobilization period.

The plan is subject to Government review and approval.

The plan shall be submitted electronically in the latest Government approved electronic media.

PCO 0 1 0

ACO 0 1 0

15. TOTAL 0 2 0

H. DATE I. APPROVED BY J. DATE

.JAMES.1275659548

Digitally signed by

Date: 2020.07.02 10:50:00 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 17 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A016

2. TITLE OF DATA ITEM

Demobilization Plan

3. SUBTITLE

Phase Out

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE

Section H

6. REQUIRING OFFICE

7. DD250 REQ

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Contractor format is acceptable.

Contractor shall provide a Demobilization Plan within 60 days after contract award.

Final demobilization plan shall be submitted 30 days after Government comments are received.

The plan shall be implemented 60 days prior to the end of contract performance.

The plan is subject to Government review and approval.

The plan shall be submitted electronically in the latest Government approved electronic media.

PCO 0 1 0

ACO 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DEBATES.JONATHAN.

JAMES.1275659548

Digitally signed by

Date: 2020.07.02 10:50:21 -07'00' 7/2/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 18 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A017

2. TITLE OF DATA ITEM

Property Management Plan/Property Management Control System

3. SUBTITLE

Property Management System (PMS)

4. AUTHORITY (Data Acquisition Document No.)

WERS-008.01

5. CONTRACT REFERENCE

PWS para 5.5.3

6. REQUIRING OFFICE

7. DD250 REQ

N/A

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

ASREQ

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Contractor format is acceptable.

DID tailoring is delineated as the following:

Change all references to "FAR Subpart 45.5" to "FAR 52.245-1(b)(1)-(4)" Delete ALL reference to DoD Manual 4161.2-M Delete All Reference to "CRC", Not applicable.

Delete: From Para 7.0 "Additionally, any site specific procedures of processes necessary to ensure that all Government property is controlled, protected a, or maintained properly, shall be submitted not later than 30 days after the award of the Task Order".

Delete Para 8.0 thru 8.13"ALL", Not applicable.

BLK 12. Property Management System (PMS) shall be in writing and maintained (retained) by the Contractor and submitted electronically to the Contracting Officer, ACO, and GPA within 90 days after contract award.

BLK 13. Re-submission will be made IAW FAR 52.245-1(b)(1)-(4) as changes occur, But Not Later Than annually for last submission, (re-submission annually minimum).

PCO 0 1 0

ACO 0 1 0

GPA 0 1 0

15. TOTAL 0 3 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

FICHOT.JONATHON.R

ICHARD.1031739248

Digitally signed by

FICHOT.JONATHON.RICHARD.1031739248

Date: 2020.07.03 07:47:25 +12'00' 7/3/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 19 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A018

2. TITLE OF DATA ITEM

Government Furnished Property Inventory and Forecasting Report

3. SUBTITLE

Contract Government Furnished Property Listing

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81947A

5. CONTRACT REFERENCE

PWS para 5.4

6. REQUIRING OFFICE

7. DD250 REQ

N/A

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

60DAC

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

ASREQ

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Master Report (MR) will be a multi-part report that includes discernible section Government Property types/Government Furnished Property (GFP). Each type of GFP section shall be further detailed by Government Property classification (i.e. Equipment, Material, Special Test Equipment and Special Tooling).

Format: Submitted format shall be IAW DFARS PGI 245.103-72, DoD procurement toolbox. MS excel spreadsheets shall be submitted. .The spreadsheet to be used is called the Scheduled Government Furnished Property (SGFP). Altering the spreadsheet is not allowed. This spreadsheet is for Government Furnished Property (GFP) which, are tangible assets (not Government Furnished Information) showing there is an agreement between the Contractor and the Government of what is provided under the contract as GFP.

Excel formats can be obtained by going to the: dodprocurementtoolbox.org website IAW DFARS PGI 245.103-72.

BLOCK 10. Submit as GFP after initial inventory (within 60 days of contract acceptance).

BLOCK 12: Initial submission will be 60 days from contract award.

BLOCK 13: Subsequent submissions will be as required by other effected CDRLs or as requested by the GPA/ACO. Any gains and losses to the GFP listing shall be annotated on a contractor generated spreadsheet utilized the data elements associated IAW DFARS PGI 245.103-72. Final submission will be within 90 days of contract completion/termination and shall include reutilization/disposition recommendations.

PCO 0 1 0

ACO 0 1 0

COR 0 1 0

GPA 0 1 0

DCO 0 1 0

15. TOTAL 0 5 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

FICHOT.JONATHON.RIC

HARD.1031739248

Digitally signed by

Date: 2020.07.03 07:48:21 +12'00' 7/3/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 20 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

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 com ments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A019

2. TITLE OF DATA ITEM

Government Furnished Property Inventory and Forecasting Report

3. SUBTITLE

Monthly CAP Purchase Request Status Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81947A

5. CONTRACT REFERENCE

PWS para 5.7.7

6. REQUIRING OFFICE

7. DD250 REQ

N/A

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

30DAC

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

ASREQ

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Master Report (MR) will be a multi-part report that includes discernible sections Contractor Acquired Property (CAP). Each type of Contractor Acquired Property (CAP) section shall be further detailed by Government Property classification (i.e. Equipment, Material, Special Test Equipment and Special Tooling). The MR shall be delivered electronically IAW DFARS PGI 245.103-72, DoD procurement toolbox. Both the Adobe PDF, and the MS excel spreadsheets shall be submitted. The spreadsheet to be used is called the Scheduled Government Furnished Property (SGFP). Altering the spreadsheet is not allowed. Once CAP is received a new SGFP will also be required as directed by the GPA. PDF and Excel formats can be obtained by going to the: dodprocurementtoolbox.org website IAW DFARS PGI 245.103-72.

BLOCK 10. Submit as CAP Purchase Request Status Report monthly.

BLOCK 12: Initial submission will be 30days from contract award.

BLOCK 13: Subsequent submissions will be every 30 days. If no CAP is receive, a "Negative" report will be submitted. Final submission will be within 90 days of contract completion/termination and shall include reutilization/disposition recommendations.

PCO 0 1 0

ACO 0 1 0

COR 0 1 0

GPA 0 1 0

15. TOTAL 0 4 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

FICHOT.JONATHON.R

ICHARD.1031739248

Digitally signed by

Date: 2020.07.03 07:50:27 +12'00' 7/3/20

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 21 of 26 Pages

(1 Data Item)

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructi ons, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of in formation. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202 -4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

D. SYSTEM/ITEM

Security Access and Control

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A020

2. TITLE OF DATA ITEM

STATUS OF GOVERNMENT FURNISED EQUIPMENT

(GFP) REPORT

3. SUBTITLE

GFP Utilization and Condition Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80269

5. CONTRACT REFERENCE

PWS para 5.18.3

6. REQUIRING OFFICE

7. DD250 REQ

N/A

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

365DAC

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

ASREQ

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

Master Report (MR) will be a multi-part report that includes discernible section Government Property…