CDRLs_A002-_Mishap.pdf
PDF 227 KB Posted
- Attached to
- Robotic Paint System Federal contract opportunity
- Solicitation number
- F3QCCM6123A001
About this file
CDRL A002
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| L6WC11__L6WC24_Purchase_Description_7_Sept_16.pdf | ||
| QUESTIONS_FROM_KTR.pdf | ||
| CDRLs_A004-_Chart.pdf | ||
| CDRLs_A003-_COTS.pdf | ||
| CDRLs_A001-_Contrs_SOP.pdf | ||
| L6WC11_Appendix_C.pdf | ||
| CDRLs_A005-_Training.pdf | ||
| CDRLs_A006-_Accept_Plan.pdf | ||
| L6WC11__L6WC24_Purchase_Description_7_Jun_16.pdf |
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Text version
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:
TDP TM OTHER __X__
D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR
1. DATA ITEM NO. 2. TITLE OF DATA ITEM
ACCIDENT/INCIDENT REPORT
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SAFT-81563/T NOT 1
5. CONTRACT REFERENCE
NA
6. REQUIRING OFFICE
WR-ALC/SE
7. DD 250 REQ
NO
9. DIST
STATEMENT
REQUIRED
B
10. FREQUENCY
AS REQUIRED
12. DATE OF 1ST SUBMISSION
AS REQUIRED
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
SEE BLK 16
13. DATE OF SUBSEQUENT
SUBMISSION
AS REQUIRED
Draft
Final
Reg Repro
16. REMARKS
BLOCKS 4,11: Contractor shall submit a report on ALL mishaps,damage to DoD property, and employee injury, to the Installation Safety Office telephonically within four (4) hours after initial notification. Written report shall be submitted within three (3) calendar days of mishap. Electronic submissions are acceptable. Information that is not available at the time of the initial notification shall be provided within 20 calendar days after the mishap.
BLOCK 9: Distribution authorized to US Government agencies only. Other requests for this document shall be referred to WR-ALC/SE.
0 1
15. TOTAL 0 3 0
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page _ _ of __Pages
18. ESTIMATED
TOTAL PRICE
17. PRICE
GROUP
L6WC11 & L6WC24
A002
WR-ALC/SE
420 Richard Ray Blvd, Ste 100 Robins AFB, GA 31098
1 1 Shane Groves 5/5/2016
0 1WR-ALC/OBCA
420 Richard Ray Blvd, Ste 100 Robins AFB, GA 31098
0 1AFSC/PZIO,
375 Perry St, Bldg 255, Robins
AFB, GA 31098
1176235299C Typewritten Text 6/1/2016
1176235299C Typewritten Text
1176235299C Typewritten Text
F3QCCM6123A001
| 2016-06-01T15:46:54-0400 | |
| AQUINO.SONNY.G.1176235299 |
File details come from the government source that posted it. Updated .