Exhibit_A_PSSC_CDRLs.docx

REQUIRED REPORTS

A Contract Data Requirement List (CDRL) list with corresponding Data Item Description can be used – if used the CDRL must be listed as a Contract Line Item and marked as a Not Separately Priced Item.

CMB 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 222202-2302, 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 A C. Category

D. System/Item

PAD SAFETY SUPPORT SERVICES

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A100

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3.Subtitle:

CONTRACT WORK BREAKDOWN STRUCTURE

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference

PWS 1.1

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

ONCE

12. Date of First Submission

SEE BLOCK 16

14. Distribution

8. APP Code

11. As of Date

13. Date of Subsequent Submission

AS REQUIRED

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

Contractor format is acceptable.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

(A100)

BLOCK 12 and 13: Draft submission will be due 30 days after contract start.

Final submission will be due NLT 60 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Work Breakdown Structure - Contractor format is acceptable.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

45 CONS/LGCZ

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A101

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

ACTIVITY REPORT

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference

PWS 1.4.1

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

MONTHLY

12. Date of First Submission

14. Distribution

8. APP Code

AN

11. As of Date

END OF MO.

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

45 SW/SE

BLOCK 12: Provide initial report NLT 45 days after contract start.

BLOCK 13: Within 10 days after each month throughout the contract.

CONTENT: The contractor shall provide a monthly activity report summarizing work performed over the preceding month that will include financial totals by CLIN for the month being addressed. Contractor format is acceptable.

(1) Information shall include, but not be limited to: total charges by CLIN made over the month to include any new work awarded and/or identification of any potential funding shortfalls or funding excesses. This will include charges pending by CLIN. Cumulative numbers that cover the entire reporting period shall be included. The intent should be to identify financial problems and allow time to address these problems before mission impacts can occur. This report shall be provided directly to the program manager and need not be included in the “Activity Report.”

(2) The report shall contain metric information to include, but not limited to, the ability of the contractor to respond to short notice requests to support operations, meetings, procedure reviews, etc.

(3) Information shall include, but not be limited to, narrative of noteworthy events for each task category for the month, to include all PWS non-compliances.

(4) The report shall contain pertinent trend analysis, where appropriate. The intent should be to measure how the operations safety program is making a difference to the safety of the eastern range, recognizing that mishap data in itself is not a valid measure of operations safety performance if not presented in the proper context.

(5) The general format and content of this report is subject to periodic process improvement review by the contractor and the PM.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

15. TOTAL

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A102

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

CHECKLIST FOR OPERATIONS

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference

PWS 1.2.4.1 & 1.2.10

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

AS REQ’D

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

AS REQ’D

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

BLOCK 12: Within one year of contract start or as required by the program manager (PM).

BLOCK 13: Annually, or as required by the PM.

BLOCK 14: Completed checklist will normally not be required to be submitted; however, they shall be maintained on file, and narrative reports may require submission. Completed checklists shall be entered into the contractor’s database. The hard-copy shall be maintained until disposition instructions are provided by PM.

CONTENT:

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

NOTE: The contractor shall coordinate a preliminary draft with the PM prior to providing a final draft (signed by the Pad Safety Manager (PSM) to the PM for review.

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A103

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

TRAINING & CERTIFICATION

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference PWS 1.2.1, 1.2.4(a), 1.2.10

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

AS REQ’D

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

AS REQ’D

13. Date of Subsequent Submission

AS REQUIRED

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

BLOCK 12: Within 30 days of contract start.

CONTENT:

(1) The contractor shall submit a draft training and certification plan to the program manager for review within 45 days of contract award. This initial draft should mainly be a “talk-back” of the PWS, with details being provided as appropriate for compliance with AFSPCMAN 91-710 V1 Attachment 7.

(2) The contractor shall certify each employee to the requirements of employment as described in Appendix K and provide this certification to the PM or SE designated representative. This list will be re-submitted upon any personnel changes made, or when requested by the PM.

(3) The plan shall undergo an annual review and update. Resubmission required when personnel changes occur.

(4) If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

(5) Training material including, but not limited to, technical information binders, slide presentations, and videos are considered part of the plan.

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A104

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

REPORTS

OPERATIONS / INCIDENTS

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference

PWS 1.2.5, 1.2.9,

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

AS REQ’D

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

AS REQ’D

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

45 SW/SE

BLOCK 12: NLT 5 days after contract start.

BLOCK 13: Reports shall be submitted to the program manager (PM) and Wing Safety within 5 days of task completion/event occurrence. Notify Wing Safety or designated representative of incidents or anomalies immediately followed up by a detailed report of the incident/anomaly within 5 days of occurrence. Insignificant items may only require an email message, or only a phone call to Wing Safety leadership, with no PM notification required. If electronic media is utilized and government access is readily available, hard copy submittals may not be required. Completed report information shall be entered into the contractor’s monthly performance history. The hard copy shall be maintained until disposition instructions are provided by the PM.

BLOCK 14: Reports that definitely do require submission include, but are not limited to: lessons learned from a hazardous operations, anomalous items found during a flight termination system (FTS) inspection/operation (safety critical), communication problems during a launch countdown operation, inspection discrepancies, mishaps, and incidents with potential safety consequences.

CONTENT: The contractor shall provide a report which provides the following information, as a minimum, following anomalies, emergencies, mishaps, catastrophes or any other incident with potential safety consequences:

15. TOTAL

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A105

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

DANGER AREA INFORMATION PLAN (DAIP) SUPPORT

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference PWS 1.2.10(a)

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

AS REQ’D

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

AS REQ’D

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

BLOCK 12: As required for launch support or as requested by the program manager (PM).

BLOCK 13: As required for launch support or as requested by the program manager (PM).

BLOCK 14: The DAIP identifies the blast danger area, the flight hazard area, and associated safety clear zones and traffic control for each launch vehicle/launch complex. Reports establishing clear zones shall be provided with the format and content of the existing plan considered to be the baseline (reference AFSPCMAN 91-710, Vol 6, Para 4.3 and Chapter 6, EWR 127-1, paragraph 6.4.3, 45SWI 91-206). The contractor shall provide unique roadblock access information for each launch mission as required.

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A106

2. Title of Data Item:

SCIENTIFIC AND TECHNICAL REPORTS

3. Subtitle:

TECHNICAL REPORTS

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference

PWS 1.3, 1.3.1

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

AS REQ’D

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

AS REQ’D

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

BLOCK 12: As directed by program manager (PM).

BLOCK 13: As directed by PM.

NOTE: The contractor shall deliver scientific and technical reports as required by Wing Safety. The contractor shall also deliver any software (to include source code, algorithms, process, formulas, and flow charts), databases and manuals developed as needed or upon request by Wing Safety. Each identified delivery will have draft submission dates, final submission dates, and distribution requirements.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

NOTE: The format and content of this CDRL is negotiable and will be jointly agreed to by both the government and the contractor at a meeting following contract award.

NOTE: All PVMI database updates are fully owned by the United States Air Force without restriction.

NOTE: PVMI will be worked as work requests when funding becomes available.

45 SW/SEA

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A107

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

PROCESS SAFETY MANAGEMENT PLAN

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference

PWS 1.2.11

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

AS REQ’D

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

AS REQ’D

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

BLOCK 12: Within 60 days after task assignment.

BLOCK 13: Triennially or as required by PM.

CONTENT: The contractor shall provide a Process Management Plan IAW 45SWI 91-101 that supports the 45 SW’s PSM requirements. This plan should describe in sufficient detail, the contractor’s approach to supporting the 45SW PSM program and conducting the triennial audit. This plan should include, but not limited to, PSM element compliance status for all applicable range users, schedule of events for future compliance audits, and status of non-compliance items.

Contractor format is acceptable.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required. Periodic updates to the plan shall be required. This management plan is required to be submitted prior to the Triennial Audit for PSM compliance.

NOTE: This support shall be worked only as a “work request” when/if funding becomes available.

45 SW/SEA

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A108

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

TBD

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference

PWS TBD

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

AS REQ’D

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

AS REQ’D

13. Date of Subsequent Submission

1 JUNE

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

45 SW/SE

This CDRL intentionally left blank

This CDRL is a “place holder” for potential future CDRL.

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A109

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

CONCEPT OF OPERATIONS PLAN

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference

PWS 1.2.3

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

SEE BLOCK 16

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

SEE BLOCK 16

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

BLOCK 10: Initial submission required, subsequent submissions as required/necessary as determined by 45SW/SE BLOCKS 11 AND 12: Within 45 days of contract start.

BLOCK 13: As required by the program manager (PM).

BLOCK 14: The plan shall undergo an initial review and update with comments submitted by 45SW/SE. A fully executed plan shall be submitted for review and approval at the three month point.

CONTENT: The contractor shall provide a concept of operations plan, which details how the contractor will implement the tasks of the performance work statement (PWS). This plan shall provide a “road map” to all other operations safety documentation and shall ensure that all aspects of operation safety and flight safety analyses functions are addressed to include, but not be limited to what tasks are performed, where they are performed, how they are performed, when, for how long and how often. This plan shall include, but not be limited to the following:

(continued next page)

45 SW/SEA

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A109 (cont.)

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

CONCEPT OF OPERATIONS PLAN

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference

PWS 1.2.3

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

SEE BLOCK 16

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

SEE BLOCK 16

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

45 SW/SE

Note: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

PAD SAFETY SUPPORT SERVICES (PSSC)

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A110

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

COST DETAIL REPORT

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference PWS 1.4.1 (g)

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

WEEKLY

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

END OF MO.

13. Date of Subsequent Submission

WEEKLY

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

45 SW/SE

BLOCK 12: Within 10 calendar days of contract start.

The contractor is required to upload financial reports once a week to the JOCAS Server (IP 147.74.225.45) located at Patrick Air Force Base, Fl. These reports are needed to track contract cost metrics and allow for reimbursement to the 45th Space Wing for support provided to external customers.

A File Transport Program (FTP) upload is completed in which the government server, doing the upload (IP 147.74.225.45) is authenticated on the Patrick LAN inside the firewall. The IP address is recorded and accepted by the JOCAS Server. Unique user names and passwords are used for each contract.

Content: See attachment.

45 CONS/LGCZ

45 CPTS/FM

15. TOTAL

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CDRL A110 PSSC

PAGE

NAME OF OFFEROR OR CONTRACTOR

DD Form 1423-1, Contract Date Requirements List (CDRL) Date Item Number A110 Block 16, Attachment

Contractor File Format

JOCAS II

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A111

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

MEETING AND TRIP REPORTS

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference PWS 1.4.7 (c)

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

AS REQ’D

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

AS REQ’D

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

45 SW/SE

BLOCK 12 and 13: Within 5 days of trip or at the request from the Program Manager.

The report shall describe the reason for the travel including the cost of the trip. Contractor format is acceptable. The trip detail report can be satisfied by adding the information to the Monthly Activity Report as described in CDRL A101 or can be provided directly to the program manager separately.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required

15. TOTAL

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

CMB 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 222202-2302, 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

E. Contract/PR NO.

F. Contractor

1. Data Item No.

A112

2. Title of Data Item:

RANGE SAFETY STANDARDS & OPERATING PROCEDURES

3. Subtitle:

COST MANAGEMENT

4. Authority (Data Acquisition Document No.)

N/A

5. Contract Reference PWS 1.4.1(d)(h)

6. Requiring Office

45 SW/SE

7. DD 250 Req

LT

9. Dist Statement Required

10. Frequency

AS REQ’D

12. Date of First Submission

14. Distribution

8. APP Code

11. As of Date

AS REQ’D

13. Date of Subsequent Submission

SEE BLOCK 16

a. Addressee

b. Copies

16. REMARKS

BLOCK 12 and 13: Draft submission will be due with contractor’s proposal.

Final submission will be due NLT 30 days after contract start.

CONTENT: The contractor shall provide a work breakdown structure that adequately addresses the work tasks associated with the PWS. This breakdown structure should adequately address each paragraph, down to the three digit subparagraph, of the PWS.

Reference MIL-HDBK-881, Work Breakdown Structure.

NOTE: If electronic media is utilized and government/range user access is readily available, hard-copy submittals may not be required.

BLOCK 12:

(PWS 1.4.1(d)) NLT 1 June or anytime upon request, the contractor will provide a cost proposal based upon anticipated work as identified by the launch manifest that will focus on all external customer support. This proposal will cover, at a minimum, work that includes hazardous operations support, launch support, travel and all known customer support for the upcoming fiscal year. (RBA Projection Report)

BLOCK 13:

a) (PWS 1.4.1(d)) NLT 1 June or anytime upon request, the contractor will provide a cost proposal based upon anticipated work as identified by the launch manifest that will focus on all external customer support for the upcoming fiscal year. This proposal will cover, at a minimum, work that includes hazardous operations support, launch support, travel and all known customer support for the upcoming fiscal year. (RBA Projection for Customer Support)

b) (PWS 1.4.1(h)) The contractor will create a spreadsheet detailing funds obligated and funds expended by CLIN. This spreadsheet will be updated at least monthly or upon request (contractors format OK). NLT 31 October or upon request, the contractor will provide detailed cost breakout of prior fiscal year charges for all work provided via CLIN. This will include charges by CLIN and remaining funding on all task orders that are still being worked. (EXPENDED REPORT)

c) (PWS 1.4.1(g) ) NLT 60 days after work is completed, invoices will be submitted via the Wide Area Work Flow for payment. Adjustments later than 60 days due to changes with rates associated with cost contracts are allowable.

These cost reports shall be submitted to the program manager (PM) and the…