Exhibit CDRL A003 MOB CONTRACTOR PERFORM STATUS REPORT SURFACE COMS FINAL DRAFT RFP R2 13 OCT 2023.pdf

N61340-23-R-0064

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A LOT I-V TDP TM OTHER LOGISTICS DATA/COMS/CMS/TSM

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

FTSS V - SURFACE COMS N61340-23-R-0064 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A003 TECHNICAL REPORT – STUDY/SERVICES

MOBILIZATION COMS/CMS CONTRACTOR

PERFORMANCE REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MISC-80508B PWS ADDENDUM A, PARA 4.5 NAWCTSD COMS

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED BI-WE SEE BLK 16

a. ADDRESSEE

b. COPIES

8. APP CODE

B

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

SEE BLK 16 Reg Repro

16. REMARKS SEE BLK 16 (Cont)

1. BLK 4: ONLY DID PARAGRAPH 3(C)(2) APPLIES.

2. SEE ANNEX TO EXHIBIT A003 FOR SAMPLE REPORT CONTENTS. ALL ANNEX PARAGRAPHS

APPLY.

3. SUBMISSION SHALL INCLUDE ALL ASPECTS OF THE MOBILIZATION PLAN. FOR EXAMPLE, THE

STATUS OF ANY PERSONNEL (NUMBER, DOL CATEGORY, FULL-TIME/PART TIME), INVENTORY

STATUS, TRAINING REQUIREMENTS/STATUS, ETC.

4. BLKS 12/13: MOBILIZATION COMS/CMS CONTRACTOR PERFORMANCE REPORTS ARE

REQUIRED DURING THE MOBILIZATION PERIOD AND SHALL BE SUBMITTED TO THE COR FOR

SIGNATURE THE FRIDAY OF THE 2ND AND 4TH FULL, FIVE-DAY (MONDAY THROUGH FRIDAY)

WORKING WEEK OF EACH MOBILIZATION MONTH. DISTRIBUTION OF COPIES VIA E-MAIL ARE

DUE WITHIN 3 DAYS AFTER RECEIPT OF COR SIGNATURE.

5. THE GOVERNMENT WILL HAVE FIFTEEN (15) WORKING DAYS FOR REVIEW AND

ACCEPTANCE/REJECTION OF EACH SUBMISSION. NO RESPONSE WILL INDICATE ACCEPTANCE.

6. BLK 14: REPORTS FOR COR ADDRESSEES SHALL BE DISTRIBUTED TO ONLY THE

RESPECTIVE COR’S SITE. SUBMITTED REPORTS SHALL BE SENT VIA E-MAIL. E-MAIL SUBJECT

LINE SHALL INCLUDE CONTRACT/TASK ORDER NUMBER, CDRL DATA ITEM NUMBER, LOCATION

AND PERIOD (E.G., E.G. N61340-14-D-0000-TO0003-A003-LEMOORE-21MAY14). ALL REPORTS

SHALL BE ATTACHMENT FILES TO THE EMAIL. ALL REPORTS SHALL BE IN MICROSOFT© EXCEL

2016 OR LATER SOFTWARE FORMAT. FILES AND DATA CELLS SHALL NOT BE LOCKED OR

PASSWORD PROTECTED. FILES SHALL NOT INCLUDE HIDDEN DATA AND SHALL BE PREPARED

AT UNDER ONE MEGABYTE SIZE WHERE PRACTICAL. E-MAIL ADDRESSES ARE PROVIDED IN

THE CONTRACT SCHEDULE AND/OR THE CDRL ADDRESSEE LIST (ATTACHMENT 4 OF THE

CONTRACT).

7. BLK 9: THE FOLLOWING STATEMENT SHALL BE THE ONLY RESTRICTION MARKING

INCLUDED ON THE DELIVERABLE

DISTIBUTION B: DISTRIBUTION AUTHORIZED TO – U.S. GOVERNMENT AGENCIES ONLY,

(ADMINISTRATIVE OR OPERATIONAL USE), (4 JULY 2023). OTHER REQUESTS FOR THIS

DOCUMENT SHALL BE REFERRED TO THE COMMANDING OFFICER, NAVAL AIR WARFARE

CENTER, TRAINING SYSTEMS DIVISION, (CODE GT43200), 12350 RESEARCH PARKWAY, ORLANDO, FL 32826-3275.

15. TOTAL ▬▬▬▬► 9 0 33

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

M.A. GREEN, SURFACE COMS S. SANTIAGO SURFACE COMS PJM

10/13/2023

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A-LOT I-V

C. CATEGORY:

TDP TM OTHER LOGISTICS DATA/COMS/CMS/TSM

D. SYSTEM/ITEM

FTSS V - SURFACE COMS

E. CONTRACT/PR NO.

N61340-23-R-0064

F. CONTRACTOR

TBD

16. REMARKS (Cont)

7. BLK 14: DISTRIBUTION

DISTRIBUTION

Appendix Copies

Final

Addressee / Location Draft Reg Repro

NAWCTSD PJM 1 1

NAWCTSD APJM 1 1

NAWCTSD TOM LEAD 1 1

NAWCTSD TOM I 1 1

NAWCTSD TOM II 1 1

NAWCTSD TOM III 1 1

NAWCTSD PCO 1 1

NAWCTSD CS I 1 1

NAWCTSD CS II 1 1

COR EWTGLANT, Little Creek, VA A-1 1

COR SWSC DET Norfolk, VA A-2 1

COR EWTGPAC, Coronado, CA A-3 1

COR SCSTCSD San Diego, CA A-4 1

COR SCSTC Unit, Dam Neck, VA A-5 1

COR NSST/Other Various Loc. A-6 1

COR NSST MSTC EAST Norfolk, VA A-7 1

COR NSST MSTC WEST, San Diego, CA A-8 1

COR SWSC DET San Diego, CA A-9 1

COR SWSC DET, Mayport, FL A-10 1

COR COMS NAVSTA, Great Lakes, IL A-11 1

COR SWSC / SCSTC DET Sasebo, Yokosuka, JP A-12 1

COR SWSC / SCSTC DET PACNORWEST, Everett, WA A-13 1

COR SWSC / SCSTC DET Pearl Harbor, HI A-14 1

COR COMS Newport, RI A-15 1

COR TTE NAVSTA Great Lakes, IL B-1 1

COR TTE San Diego, CA B-2 1

COR TTE Norfolk, VA B-3 1

COR LCS LTF, San Diego, CA C-1 1

COR LCS LTF, Mayport, FL C-2 1

COR MTF, Jacksonville, FL C-3 1

COR RTC Great Lakes, IL C-4 1

COR DDG-1000, ZTF, San Diego, CA C-5 1

COR MWTC, San Diego, CA C-6 1

Total 9 0 33

DD FORM 1423-1, FEB 2001 Page 2 of 2 Page

ANNEX TO EXHIBIT A003

MOBILIZATION COMS/CMS CONTRACTOR PERFORMANCE REPORT

FTSS V CDRL REQUIREMENT

1.0 Report 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 the start and completion dates for the contract/task order period the report is being prepared. Use a MMDDYY numerical format for each date.

1.2 Report Body.

1.2.1 General. This report documents summarizes status and contractor performance of a task order’s period of performance for the Fielded Training Systems Support contract. This report documents performance data relative to Contractor training equipment maintenance, repair and utilization during a specified performance period. The main body of each report shall be completed in accordance with the attached sample format. Block 16 of each Contract Data Requirements List

(CDRL) shall tailor each report’s requirements by applying CDRL annex paragraphs 2.1 and 2.2, with attached sample formats, as applicable. Entry of actual data shall be made in the appropriate column for the period covered by the report.

1.2.2 Format. The report shall contain up to four parts as specified in the contract/task order. The summary portion Part II, Part III, and Part IV shall be presented in columnar format to facilitate reporting of data on multi-station devices/equipment items or where multiple devices/equipment items are collocated (refer to applicable samples). Any of the following formats may apply as per block 14 and 16 of the CDRL:

1.2.2.1 Hard Copy. Where applicable, individual areas shall be prepared as delineated in the contract/task order on 8 ½” by 11” to 11” by 15” size paper.

1.2.2.2 Magnetic Media. Where applicable, individual area files shall be placed on Compact

Disc Recordable/Re-Writable (CD-R/CD-RW; 1x-4x drive capable media) optical disc. Magnetic files shall be compatible to Microsoft® Office formats as specified in block 16 of the CDRL.

1.2.2.3 E-Mail. Reports shall be attached files to E-Mail that are compatible to Microsoft®

Office formats as specified in block 16 of the CDRL.

2.0 Report Content. The Mobilization Contractor Performance Report shall consist of the following areas:

2.1 Part I – Performance Report Summary. The main body of the report shall contain information on the distribution, work accomplished, manning, and problem areas encountered.

Data elements not applicable to a specific device/equipment item shall be marked “NA” for alphanumeric fields and “0” (zero) for numeric fields. Data elements to be addressed are as follows, in the order shown. (See Figure 1 for a sample Contractor Device/Equipment Performance

Report.)

a. To. Addressees shall be in accordance with the contract/task order.

b. From. Name of contractor providing services.

c. Title. Data shall be titled the same as the data item description.

d. Device/Equipment nomenclature. Identify by nomenclature the trainer(s) which is/are the subject of the report (e.g., OFT or Pioneer UAV).

e. Device/Equipment Number. Identify alphanumeric training device/equipment designation number assigned to the device/equipment and weapon system. If the device/equipment does not have a device number, enter device/equipment name and weapon system (e.g., CBT/F/A-18 or 2F132/F/A-18).

f. Serial Number. Enter alphanumeric serial number or Bureau Numbers (BUNO) assigned to the device/equipment. To enable alphanumeric sorting, leading zeros

(e.g., 000001, 000002) are required for numeric serial numbers.

g. Training Equipment/Device Designator Prefix. Enter as a separate alpha character the initial character (prefix) of the training device designator. The default is “blank”, which is the Cog 2”O” designator. Typical designators are prototype (“X”), Army (“A”), Air Force (“B”), non-Cog 2”O” (“S”), Interactive

Courseware Hardware (“I”).

h. Contract Number and Task Order Number. Self-explanatory. A character alphanumeric field contract number. A character alphanumeric task order number.

i. Contract Support Period. Enter the start and completion dates of the contract.

Use a MMDDYY numerical format for each date.

j. Date of Report. Enter the date that the report is completed. Use a MMDDYY numerical format.

k. Report Period. Enter the ending date of the period covered by the report using a

YYYYMMDD numerical format. When data is reported on a quarterly basis, use the last month in the quarter.

l. Activity Serviced/Device/Equipment Location. Enter by character alphanumeric field the activity assigned as the device/equipment custodian.

m. Activity Unit Identification Code (UIC). Enter the 5 digit Unit Identification

Code (UIC) assigned to the custodian activity.

n. Report No. Number the reports consecutively throughout the contract period.

Use a 3 digit numeric field.

o. CASREP. Identify whether or not the device was CASREP during the reporting period (“Yes” or “No”).

p. Personnel Time Distribution. The time distribution of all contractor personnel for the report period covered shall be classified in the following categories:

(1) Operation

(2) Scheduled Maintenance

(3) Unscheduled Maintenance

(4) Supply Support

(5) Authorized Contractor Modification

(6) Training of Contractor Personnel

(7) Verification of Documentation

(8) Other

For each category, enter the number of hours to the nearest hour, a numeric field limited to 99999.

q. Trainer Downtime. The number of hours the trainer/Equipment was down and not available for scheduled training shall be reported. Downtime hours shall be classified as follows:

(1) Maintenance

(2) Device Modifications

(3) Parts/Supply Problems

(4) Facility Problems

(5) Lack of Instructors/Operators

(6) Lack of Setup Times

(7) Miscellaneous Other

The sum of all such categorizations shall equal Total Trainer/Equipment Downtime for the reporting period, a numeric field limited to 99999.9 (rounded to the nearest tenth of an hour).

r. Course Identification Numbers (CINs). Enter the nine or ten digit alphanumeric code used to identify the course the device is used to support. If multiple courses are supported, enter the primary CINs up to a total of 5, with additional CIN data to be separately provided as may be requested.

s. Summary of Work Accomplished. Include, at the end of the report, a narrative summary containing the following:

(1) Mobilization Status. Provide a brief summary of major work items accomplished and status, citing any problem areas encountered.

(2) Training Requirements/Status. Describe the nature and extent of training provided by the contractor to its on-site personnel. Mobilization training status shall be addressed during mobilization period.

(3) Inventory Progress. Provide a brief summary of remaining/accomplished inventory at each site, citing any problem areas encountered.

t. Signature of Contractor Site Manager and Contracting Officer’s Representative

(COR). The report shall be signed by the Site Manager and by the COR. The

Alternate COR (ACOR) shall sign in lieu of the COR. Signature authority shall be delegated to a designated Technical Assistant (TA) in writing by the COR, when applicable.

u. Classification of Report. Report originator shall ensure proper classification of the report in accordance with existing Navy regulations.

2.2 Part II – Contractor Personnel. The report shall also contain a list of all currently employed on-site contractor personnel by name and Department of Labor category associated with this contract (e.g., Electronics Technician, Maintenance III). Indicate if full time (“F”) or part time

(“P”). Describe position assignment and/or nature and date of any change in employment status of contractor personnel. Identify Government accepted qualification specialties (i.e., site manager, shift supervisor, “V” tech, “H” tech), any special qualifications/training that is required and date qualified (MM/DD/YY). Indicate Department of Labor Anniversary date (MM/DD/YY). (See

Figure 2 for sample report.)

Example: H. Smith (Full-Time); DOL Code 23183/Electronics Technician, Maintenance

III/”Visual” Tech/”Laser Optics” Tech; hired as Tech II 01/01/99 and promoted to Tech III

11/01/99; ANSI Z136.1 Class IIIB qualified Laser Safety Officer (LSO) 11/01/99. DOL

Anniversary Date: 09/99

3.0 SEE ATTACHED SAMPLE REPORTS:

PERFORMANCE REPORT SUMMARY:

To:

1. DEVICE /EQUIP

NOMENCLATURE:

2 DEV/EQUIP NO./SER/PREFIX

DESIG:

3. CONTRACT #/TO #

4. CONTRACT

SUPPORT PERIOD:

FROM: TO:_______

From:

5. DATE OF REPORT:

6. PERIOD COVERED:

7. ACTIVITY SERVICE:

8. ACTIVITY

LOCATION:

9. REPORT #:

10. CASREP THIS

PERIOD:

YES [ ] NO [ ]

11. PERSONNEL DISTRIBUTION

HRS

12. TRAINER DOWN TIME

HRS

OPERATION

MAINTENANCE

SCHEDULED MAINTENANCE

DEVICE MODIFICATION

UNSCHEDULED MAINTENANCE

PARTS/SUPPLY PROBLEMS

SUPPLY SUPPORT

FACILITY PROBLEMS

MODIFICATIONS

LACK OF INSTR/OPER

TRAINING

LACK OF SETUP TIME

VERIFICATION OF DOCUMENTATION

MISCELLANEOUS

OTHER

TOTAL

TOTAL

13. COURSE IDENTIFICATION No.(s)

14. SUMMARY OF WORK ACCOMPLISHED.

Mobilization Status:

Training Requirements/Status:

Inventory Progress:

15. SIGNATURE OF SITE MANAGER DATE:

16. SIGNATURE OF COR/ACOR/TA DATE:

17. CLASSIFICATION OF REPORT:

18. REMARKS:

FIGURE 1. Sample MOB COMS/CMS PERFORMANCE REPORT SUMMARY

CONTRACTOR PERSONNEL:

Signature

Site Manager :

Date:

Signature COR:

Date:

COR Remarks:

Contract/Task Order

Site/CMD: Report

Period:

DOL CATEGORY/

TECH QUALS

FULFILLED

CONTRACTOR

EMPLOYEE NAME

STATUS

F-FULL

P-PART TIME

NATURE AND DATE OF ANY CHANGE IN

EMPLOYMENT TRAINING, STATUS OR

ASSIGNMENT

Example:

DOL Code

23183/

Electronics Tech, Maintenance III, V (Visual) & LO

(Laser Optics)

Tech

H. Smith

(F)

H. Smith (Full-Time); Electronics Tech

III/”Visual” Tech/”Laser Optics” Tech;

hired as Tech II 01/01/99 and promoted to

Tech III 11/01/99; ANSI Z136.1 Class IIIB qualified Laser Safety Officer (LSO)

11/01/99. DOL Anniversary Date: 09/99

FIGURE 2. Sample MOB COMS/CMS PERFORMANCE REPORT SUMMARY

[CONTRACTOR PERSONNEL]