DRAFT_Attach_3,_CDRLs.pdf

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Attached to
JPPSO Request for Proposal Federal contract opportunity
Solicitation number
FA2517-18-R-6000
Issued by
Department of the Air Force Space Command

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Draft Attachment 3 CDRLs

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JPPSO_FA251718R6000_AMD_01.docx DOCX document
Attach_3,_CDRLs.pdf PDF
Exhibit_A_Pricing_Schedule.xls XLS spreadsheet
Attach_4,_Scenario.docx DOCX document
Attach_2,_Basic_Insurance_Compliance.doc DOC document
FA251718R6000_FINAL.docx DOCX document
Attach_1,_Performance_Work_Statement_11_Jan_18.docx DOCX document
DRAFT_Attach_4,_Scenario.docx DOCX document
DRAFT_Attach_1,_Performance_Work_Statement.pdf PDF
DRAFT_Exhibit_A_Pricing_Schedule.xls XLS spreadsheet
DRAFT_Attach_2,_Basic_Insurance_Compliance.doc DOC document
DRAFT_Request_for_Proposals.docx DOCX document
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Attachment 3 - Contract Data Requirements Lists (CDRL)

JPPSO-NC

Solicitation #: FA2517-18-R-6000

DRAFT

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package; TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref.

DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15. Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13;

Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423 (BACK), AUG 96

DD FORM 1423, AUG 96

CONTRACT DATA REQUIREMENTS LIST

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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 (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 of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER _________________________

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page ____ of ____ Pages

0001 A

0001 CONTRACTOR'S QUALITY CONTROL PROGRAM

PWS, PART III PARA 5.a. COR

YES

ONE/R

N/A

COR 1

0 1 0

16. REMARKS

BASIC VERSION SUBMITTED PRIOR TO CONTRACT START DATE.

REVISED VERSIONS SUBMITTED TO COR WITHIN 3 BUSINESS DAYS OF

REVISION. SCHEDULES I, II AND III

0002 WEIGHT TICKETS

PWS, PART I PARA 2.b. JPPSO

YES

EAS

N/A

JPPSO 1

0 1 0

TURN IN WEIGHT TICKETS AS FOLLOWS: HHG-4 WORKDAYS, UB-3

WORKDAYS FROM PICK UP DATE. WEIGHT TICKETS NO REQUIRED ON

INBOUND (SCHEDULE II) UNLESS REWEIGH IS ORDERED.

0003 HOUSEHOLDS GOODS DESCRIPTIVE INVENTORY

PWS, PART I PARA 5.i. JPPSO

YES

EAS

N/A

JPPSO 1

MEMBER 1

CARRIER 3

0 5 0

INVENTORY NOT REQUIRED ON SCHEDULE II. SCHEDULE I AND III TURN IN

HOUSEHOLDS GOODS DESCRIPTIVE INVENTORY AS FOLLOWS: HHG-4

WORKDAYS, UB-3 WORKDAYS FROM PICK UP DATE.

0004 EXCEPTION SHEET REMOVAL FROM NTS

PWS, PART I PARA A.5.i.

ASREQ

NO

EAS

N/A

CONTRACTOR 1

NTS FACILITY 1

0 2 0

Exception Sheet will remain an internal industry document.

Adobe Professional 8.0

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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 (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 of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER _________________________

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page ____ of ____ Pages

0001 A

0005 REPORT OF GOVERNMENT OWNED CONTAINERS

DID PWS, PART I PARA 8.k.2. JPPSO

YES

MTHLY

SEE 16

JPPSO 1

COR 1

0 2 0

INITIAL REPORT DUED 15 DAYS AFTER START OF CONTRACT. SUBSEQUENT

REPORTS ARE DUE THE 5TH OF EACH MONTH. SCHEDULE I AND III

0006 JOINT STATEMENT OF LOSS & DAMAGE

PWS, APPENDIX 5 PARAs 4 b,c JPPSO

YES

EAS

N/A

JPPSO 1

CONTRACTOR 1

MEMBER 3

0 5 0

DD 1840 SCHEDULE II AND III

THE DD 1840 WILL BE PREPARED IN FIVE (5) COPIES BY CONTRACTOR

0007 CLAIMS CORRESPONDENCE

DID PWS, APPENDIX 5 PARA 4

YES

EAS

N/A

JPPSO 1

0 1 0

Each time any correspondence regarding a claim is received from anyone other than the JPPSO, the contractor must furnish JPPSO an information copy

0008 GOVERNMENT BILL OF LADING SF 1203

DID PWS, PART I PARA 9 d JPPSO

YES

EAS

N/A

CARRIER 4

JPPSO 1

MEMBER 1

0 6 0

Original and copies 2, 3, and 4 of the PPGBL/BL to carrier when the shipment is picked up.

The contractor will return copy 5 to the ordering officer not later than the close of business the next workday after the shipment is picked up. Copy 6 provided to member at pick-up.

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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 (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 of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER _________________________

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page ____ of ____ Pages

0001 A

0009 CONTRACTORS WEEKLY REPORT

DID PWS, PART 1 PARA 9.j. JPPSO

YES

WKLY

SEE Box 16

JPPSO 1

COR 1

0 2 0

BLOCK 11 FIRST MONDAY

BLOCK 12 FIRST MONDAY AFTER CONTRACT START DATE

BLOCL 13 WEEKLY EVERY MONDAY THEREAFTER. SCHEDULE I

0010 REPORT OF SHIPMENT ON HAND

DID PWS, PART I PARA 10.h. JPPSO

MTHLY

N/A

JPPSO 1

COR 1

0 2 0

DUE THE 5TH OF EVERY MONTH. NEGATIVE REPORTS ARE REQUIRED

0011 OUTSIZED AIR CARGO REPORT

DID PWS, PART I PARA 9.g. JPPSO

YES

SEE Box 16

SEE Box 16

ASREQ

ASREQ

JPPSO 1

0 1 0

If any container being prepared to enter the DTS has an outside measurement greater than 84 inches, the contractor is required to prepare an Outsized Air Cargo Report.

0012 Service Delivery Summary Performance Threshold

PWS, PART III PARA 5.b. JPPSO

YES

MTHLY

N/A

JPPSO 1

COR 1

0 2 0

The contractor will provide monthly metrics measuring the Service Delivery Summary Performance Threshold

DATA ITEM DESCRIPTION

Title: Service Delivery Summary Performance Threshold

CDRL Number: 0012 Approval Date:

AMSC Number: Limitation:

DTIC Applicable: GIDEP Applicable:

Office of Primary Responsibility: JPPSO Applicable Forms:

Use/relationship:. The contractor will provide monthly metrics measuring the Service Delivery Summary Performance Threshold . These statistics will be used in the monthly evaluation of the contractor and also as a part of the annual performance report.

Requirements: The contractor will provide a report of each item contained in the table on page 21 of the Performance Work Statement, Part III, Service Delivery Summary, how many occurrences of each and number of failures to provide service properly.

Distribution:

1. One copy forwarded to JPPSO.

2. The contractor retains one copy.

DATA ITEM DESCRIPTION

Title: REPORT OF ACTUAL COST

CDRL Number: 0013 Approval Date:

AMSC Number: Limitation:

DTIC Applicable: GIDEP Applicable:

Office of Primary Responsibility: JPPSO Applicable Forms:

Use/relationship: Contractor will provide an electronic monthly report of actual costs identified by Zone and Schedule (I, II, III), invoiced during reporting month, to include cumulative total by Zone and Schedule (I, II, III) for year to date, and total contract costs to date. Report will be furnished to the JPPSO by the 5th of the next month. Report must contain the following:

Requirements: The report is must contain:

a. each Zone and Schedule (I, II, III) invoiced during month

b. invoiced date

c. actual sum total by Zone and Schedule (I, II, III) invoiced during report month

d. cumulative total by Zone and Schedule (I, II, III) for year to date

e. total contract costs for year to date

Distribution:

1. One copy forwarded to JPPSO.

2. The contractor retains one copy.

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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 (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 of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER _________________________

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page ____ of ____ Pages

0001 A

0013 REPORT OF ACTUAL COST

PWS, PART III PARA 4 JPPSO

YES

MTHLY

N/A

JPPSO 1

CONTRACTO 1

0 2 0

An electronic monthly report of actual costs, invoiced during reporting month, identified by Zone and Schedule I, II, III.

0 0 0

0 0 0

0 0 0

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CDRL1-4 redact
CDRL5-8 redact
CDRL 9-12 redact
CDRL12, 13 Instrux
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