Attach 19b Section 11A Operations and Maintenance 18 Jan 2022.pdf

PDF 3 MB Posted

Attached to
Laughlin Air Force Base (LAFB) - Base Operations Support (BOS) Federal contract opportunity
Solicitation number
FA300222R0002
Issued by
Department of the Air Force Air Education and Training Command

About this file

Written by GovTribe AI ·

This document is a Contract Data Requirements List (CDRL) specifying data items required to be delivered under a contract for Base Operations Support (BOS) at Laughlin Air Force Base in Del Rio, Texas. The CDRL includes 1,148 required data items across various categories such as personnel identification cards, safety reports, engineering drawings, equipment inspection logs, and facility maintenance records. Recurring deliverables include monthly generator logs, boiler plant logs, refrigerant reports, and safety forms. Annual deliverables encompass pavement surveys, gas surveys, and lightning protection data. The contract line items specify delivery due dates for draft and final versions as well as distribution requirements to government offices including the Lead Civil Engineer and Base Civil Engineer. Pricing is to be provided by the contractor for each data item.

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Other files for this federal contract opportunity

Other files attached to Laughlin Air Force Base (LAFB) - Base Operations Support (BOS), newest first.
File Type Posted
Solicitation Amendment FA300222R00020009 SF 30.pdf PDF
Attach 22 - Section L - Instructions Conditions and Notices to Offerors 26 Apr 2022 FINAL.pdf PDF
Attach 25 Past Performance Information Worksheet 26 Apr 2022 (LOCKED).docx DOCX document
Attach 23 - Section M - Evaluation Factors for Award 21 Apr 2022.pdf PDF
Attach 26 Past Performance Questionnaire 21 Apr 2022.docx DOCX document
Attach 22 - Section L - Instructions Conditions and Notices to Offerors 21 Apr 2022.pdf PDF
Solicitation Amendment FA300222R00020007 SF 30 Signed.pdf PDF
Attach 22 - Section L - Instructions Conditions and Notices to Offerors 11 Apr 2022 FINAL.pdf PDF
Solicitation Amendment FA300222R00020005 SF 30.pdf PDF
Attach 16 Contract Security Classification Specification DD0254 05 Apr 2022.pdf PDF
Attach 21e - TL OPLANS Combined 18 Jan 2022.pdf PDF
Attach 25 Past Performance Information Worksheet 22 Feb 2022 (LOCKED).docx DOCX document
Attach 27c - Question and Comment 22 Mar 2022.pdf PDF
Attach 30 -PMTL D3035160195001 Details 22 Feb 2022.pdf PDF
Attach 34 - AF PM 01 PMOSS Report 22 Feb 2022.xlsx XLSX spreadsheet
Attach 35 - Vehicle Management Guidebook 27 Sep 2021.pdf PDF
Attach 1 - Performance Work Statement 21 Mar 2022.pdf PDF
Attach 21b TL Laughlin BOS Support Agreement 09 Dec 2021.pdf PDF
Attach 21c TL Playbooks Combined 09 Dec 2021.pdf PDF
Attach 21d TL Sections 11 and 25 Appointment Letters 09 Dec 2021.pdf PDF
Attach 23 - Section M - Evaluation Factors for Award 21 Mar 2022.pdf PDF
Attach 24 - L and M Quick View 21 Mar 2022.pdf PDF
Attach 28 CLIN Structure Section B Worksheet 21 Mar 2022.xlsx XLSX spreadsheet
Attach 33 - AF Final 09 Building System Quick View 22 Feb 2022.xlsx XLSX spreadsheet
Attach 36 - List of Site Visit Attendees 25 Feb 2022.pdf PDF
Attachment 27b - Q and A Round 2 Response 15 Feb 2022.pdf PDF
Solicitation Amendment FA300222R00020002 SF 30.pdf PDF
Attachment 27 A - Q and A Round 1 Response 4 Feb 2022.pdf PDF
Attach 19d Section 13 Grounds Maintenance CDRL 18 Jan 2022.pdf PDF
Attach 19e Section 15 Vertical Transportation Equipment CDRL 18 Jan 2022.pdf PDF
Attach 7 WD DB Residential TX20220108 07 Jan 2022.pdf PDF
Attach 17 Workforce Demographic 01 Dec 2021.pdf PDF
Attach 26 Past Performance Questionnaire 30 Dec 2021.docx DOCX document
Attach 27 Question and Comment Worksheet - 21 Dec 2021.xlsx XLSX spreadsheet
Attach 29 Instructions for Laughlin Pre-Proposal Site Visit 12 Jan 2022.pdf PDF
Attach 15 Statement of Equivalent Rates for Federal Hires 10 Jan 2022.pdf PDF
Attach 4 CBA USW AFL CIO CLC 1 Oct 2021.pdf PDF
Attach 1 Performance Work Statement PWS 09 Dec 2021.pdf PDF
Attach 5 CBA USW AFL CIO CLC MOU 001 1 Nov 2021.pdf PDF
Attach 14 Section H Clauses Special Contract Requirements 29 Dec 2021.pdf PDF
Attach 16 Contract Security Classification Specification DD0254 29 Dec 2021.pdf PDF
Attach 19f Section 23 Material Management CDRL 08 Dec 2021.pdf PDF
Attach 22 - Section L - Instructions Conditions and Notices to Offerors 12 Jan 2022.pdf PDF
Attach 23 - Section M - Evaluation Factors for Award 12 Jan 2022.pdf PDF
Attach 28 CLIN Structure Section B Worksheet 05 Jan 2022.xlsx XLSX spreadsheet
Attach 19b Section 11A Operations and Maintenance 08 Dec 2021.pdf PDF
Solicitation - FA300222R0002.pdf PDF
Attach 6 WD SCA 2015-5303 Rev-19 27 Dec 2021.pdf PDF
Attach 8 WD DB Building TX20220186 07 Jan 2022.pdf PDF
Attach 12 WD DB Highway TX20220008 07 Jan 2022.pdf PDF
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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

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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1101 Air Force Motor Vehicle Operator Identification Card AF Form 2293

PWS 11.1.2.2.21.5. 47 CONS/PKB

NA

A D

ASREQ

N/A

After Award

Per PWS Veh Ops 47 LRF

Lead COR

0 0 0

Submission: Prior to Driving a GOV

1102 Self-Inspection Checklist Management Int Control Toolsets (MICT)

PWS 11.2;11.1.2.1; 11.1.2.1.3.1 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS (HHQ) via COR

0 0 0

IAW AFI 90-201, Submit to Higher Headquarter (HHQ) via COR IAW CCs Inspection Program.

1103 Industrial Control System (ICS) Report Government approved spreadsheet and Schem

PWS 11.1.1;11.1.2.2.17-1 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS (HHQ) via COR

0 0 0

Send whenever a new system comes on line and as directed by HHQ.

1104 Electrical System Vulnerability Government approved Spreadsheet

PWS 11.1.2.2.2 47 CONS/PKB

LT

A D

ANNLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

IAW UFC 3-550-07.

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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1105 Customer Service: Service Requests AF Form 332

PWS 11.1.2.2.3; 11.1.2.2.3.7; 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS Lead CE COR

0 0 0

Submission: upon request.

1106 Safety AF Form 457

PWS 11.1.1; 11.1.2.1. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS Base Safety Office

Base Civil Engineer (B

0 0 0

Submit whenever an Accident Occurs.

1107 Base Civil Engineering Work Clearance Request AF Form 103

PWS11.1.2.2.3;11.1.2.2.3.1,7 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS Lead CE COR

0 0 0

Send as required.

1108 Monthly Steam/Boiler Plant Operating Log AF Form 1464

PWS 11.1.2.4.8.5. 47 CONS/PKB

LT

A D

MTHLY

N/A

After Award

Per PWS HHQ via COR

0 0 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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1109 Boiler or Pressure Vessel Inspection Report AF Form 1222

PWS 11.1.2.4.8.5. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS HHQ via COR

0 0 0

Send every three years.

1110 Water Treatment Operating Log for Steam/Hot Water AF Form 1459

PWS11.1.2.4.2.1; 11.1.2.4.8.5 47 CONS/PKB

LT

A D

MTHLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

Send monthly.

1111 Generator Inventory

PWS 11.1.2.5.2. 47 CONS/PKB

LT

A D

ANNLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

Format is government approved spreadsheet.

1112 Generator Revalidation

PWS 11.1.2.5.2. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS HHQ via COR

0 0 0

Format is government approved spreadsheet. Send every five years.

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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1113 Generator Operating Log (Inspection Checklist) AF Form 487

PWS 11.1.2.5.2. 47 CONS/PKB

LT

A D

MTHLY

N/A

After Award

Per PWS

COR

0 0 0

Send Monthly Per Generator.

1114 Historical Records - Diesel Electric Generator and Sys AF Form 719

PWS 11.1.2.5.2 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Send Annually or Part Change.

1115 Lightning Protection for Munitions

PWS 11.1.2.2.2.1.9.1.1.4.3; 11.1.2.4.1.2 47 CONS/PKB

LT

A D

ANNLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

Format is government approved spreadsheet.

1116 Cathodic Protection Annual Performance Booklet Report

PWS 11.1.2.2.2.1.9.1.1.4.3; 11.1.2.4.1.3 47 CONS/PKB

LT

A D

ANNLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

Format is Booklet and electronic format. Send NLT 1 Feb of Each Year.

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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1117 Electrical System Tab

PWS 11.1.2.1.2. 47 CONS/PKB

LT

A D

ANNLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

Send update as-built drawings annually.

1118 High Voltage Vehicle Test

PWS 11.1.2.2.21.4. 47 CONS/PKB

LT

A D

ANNLY

N/A

After Award

Per PWS

COR

0 0 0

Send Government approved spreadsheet.

1119 Cathodic Protection Operating Log for Impressed Current AF Form 491

PWS 11.1.2.2.2.1.9.1.1.4.3; 11.1.2.4.1.3 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Send every 60 days.

1120 Cathodic Protection Operating Log for Sacrificial Anode AF Form 1686

PWS 11.1.2.2.2.1.9.1.1.4.3; 11.1.2.4.1.3 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Send Annually and as directed by HHQ.

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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1121 High Voltage Rubber Gloves/ Sleeves Test and In Use Sti

PWS 11.1.2.4.1.1. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Send Government approved spreadsheet Every 6 Months.

1122 High Voltage Blankets/Hoods/ Hoses/Stick

PWS 11.1.2.4.1.1. 47 CONS/PKB

LT

A D

ANNLY

N/A

After Award

Per PWS

COR

0 0 0

Send Government approved spreadsheet Annually.

1123 Grounding System Test

PWS 11.1.2.2.2.1.9.1.1.4.3; 11.1.2.4.1.2 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Send Government approved spreadsheet as needed.

1124 Airfield Pavements Condition Survey

PWS 11.1.2.3.1.2 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS HHQ via COR

0 0 0

Send Government approved spreadsheet report every 5 Years.

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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1125 Airfield Pavement Sustainment Plan

PWS 11.1.2.2.2; 11.1.2.2.2.1.1. 47 CONS/PKB

LT

A D

ANNLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

Send Government approved Plan

1126 Aircraft Arresting Report

PWS 11.1.2.5.2.1. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS HHQ via COR

0 0 0

Submit Aircraft Engagement Information and all Missed Engagement Attempts as soon as possible after Engagement or Missed Engagement.

1127 Aircraft Arresting System (AAS) Certification AF Form 483

PWS 11.1.2.5.2.1. 47 CONS/PKB

N/A

A D

ANNLY

N/A

After Award

Per PWS

0 0 0

Certificate of Competency for all Non-Power Production Personnel Engaged in Daily Aircraft Arresting System Activities. Keep Locally in Each Personnel’s Training Records.

1128 Call for CEMIRT Requirements

PWS 11.1.2.2. 47 CONS/PKB

LT

A D

MTHLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

Identify Requirement for HVAC Re-commissioning, Generator Rebuilds, etc.; IAW HHQ.

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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1129 Status of Corrective Actions Identified by CEMIRT HVA

PWS 11.1.2.4.8.2. 47 CONS/PKB

LT

A D

MTHLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

Justify Expense of CEMIRT Activity, IAW HHQ Call Letter.

1130 Quarterly HVAC Refrigerant Report

PWS 11.1.2.4.8. 47 CONS/PKB

LT

A D

MTHLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

AFPIMS Report Indicating Refrigerant Consumptions/Usage/ Equipment Leakage for All Equipment.

1131 Annual Gas Survey Report

PWS 11.1.2.4.3. 47 CONS/PKB

N/A

A D

ANNLY

N/A

After Award

Per PWS HHQ via COR

0 0 0

Developed Identifying/Indicating Status of Natural Gas Distribution Systems; IAW AFI 32-1067, US Dept. of Trans; PHMSA. Submit Annually (Each January for the Previous Business Yr).

0 0 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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1133 Backflow Prevention Inspection Data

PWS 11.1.2.4.2.; 11.1.2.4.2.2. 47 CONS/PKB

N/A

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Provide Permanent Records in a Computer Database; Electronic AF Forms 843, 845, 848 or state mandated form(s). Database Updated with Current Inspection/ Testing.

1134 Backflow Device and Cross- Connection Information/Inv

PWS 11.1.2.4.2.;11.1.2.4.2.2. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Provide Consolidated Survey Inventory Data with Cross Connection Information; Records in a Computer Database; Electronic AF Forms 843, 845, 848 or state mandated form(s), Periodically.

1135 Backflow Prevention Cross- Connection Survey

PWS 11.1.2.4.2.2. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Accomplish a complete and full survey of all assets. All Assets Surveyed Within Contract’s 3rd Period of Performance. Afterwards Revalidate/ Reschedule All Assets within a 5 Year Span. Provide Monthly Report Indicate Facilities/Sys Surveyed.

1136 Valve and Hydrant Maintenance Record

PWS 11.1.2.4.2. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Facility Operating Logs (Locally Developed), Electronic Spreadsheet for Annual Report As Inspected./ Report Provided Annually

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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1138 Above Ground Storage Tank Inventory

PWS 11.1.2.4.2; 11.1.2.4.2.5. 47 CONS/PKB

LT

A D

ANNLY

N/A

After Award

Per PWS

COR

0 0 0

Submit to Government approved spreadsheet.

1139 Swimming Pool Operational Log Electronic AF Form 708

PWS 11.1.2.4.2; 11.1.2.4.2.4. 47 CONS/PKB

LT

A D

Daily

N/A

After Award

Per PWS

COR

0 0 0

Submit Electronic AF Form 708 to Daily.

0 0 0

0 0 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

CLIN X007 PWS

Base Operations Support (BOS) Laughlin

1142 Inspection, Test and Maintenance Documentation of Fire Electronic AF Form 1459

PWS 11.1.2.4.2.1. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS Gov.Rep/Fire Dept

0 0 0

SP Locally Derived Inspection/Test Form; FY Annual Report (spreadsheet) Listing Equip Svcs; AFCEC’s Standardized PMTL Series per each type of Sys. Submit Inspection/ Test Form on Date Services Are Provided; Provide a FY Annual

1143 Tank Inspection Summary AF Form 172

PWS 11.1.2.4.4; 11.1.2.4.4.1. (NEED COR OFFICE SYMBOL)

LT

A D

MTHLY

N/A

After Award

Per PWS

COR

0 0 0

Submit AF Form 172

1144 Tank Entry Supervisor Certification AF Form 483

PWS 11.1.2.4.4. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Submit every five years.

0 0 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

CLIN 00 PWS

Base Operations Support (BOS) Laughlin

1145 Liquid Fuels Tank Cleaning Certificate of Competency AF Form 483

PWS 11.1.2.4.4. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Submit every five years.

1146 Leak/Failure Data Record AF Form 1687

PWS 11.1.2.4; 11.1.2.4.3; 11.1.2.4.4. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Submit as needed.

1147 Pest Control Report DD Form 1532

PWS 11.1.2.4.7. 47 CONS/PKB

LT

A D

MTHLY

N/A

After Award

Per PWS

COR

0 0 0

1148 Confined Space Entry Permit AF Form 1024

PWS 11.1.2.1. 47 CONS/PKB

LT

A D

ASREQ

N/A

After Award

Per PWS

COR

0 0 0

Submit as needed.

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File details come from the government source that posted it. Updated .