CDRL_A011_Project_Completion_Report_(Draft_-_24_Oct_14).doc
DOC document 125 KB Posted
- Attached to
- War Reserve Materiels (WRM) Federal contract opportunity
- Solicitation number
- FA4890-15-R-0004
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CDRL A011 - Project Completion Report (Draft - 24 Oct 14)
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Text version
FA4890-08-C-0004
Modification P00085/7Jan11
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. 22202-4302, 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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| B |
| TDP TM OTHER admin/MGMT data |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
WRM
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| AXXX |
| Contract Field Service Report |
| Project Completion Report |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MGMT-81238 |
| PWS Para 4.2.1.3.5, 4.2.3.5.5 |
| HQ ACC AMIC/PCE |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
XX
| asreq |
| ASREQ |
b. COPIES
| 8. APP CODE |
| B |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
| a. ADDRESSEE |
| Draft |
| Final |
| ASREQ |
| ASREQ |
| Reg |
| Repro |
| 16. REMARKS: |
| HQ ACC AMIC/PKB |
4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A011 - CE Completion Report. The delivery method is electronic posting to the MIS with e-mail notification with CE Project Completion Report and photos attached.
5) PWS, Section A, Para 3.5.2.2.4.4. CE Completion Report
The contractor shall provide a CE Project Completion Report within 30 days of project completion. Information will be submitted using a completed Project Completion Report Work sheet (attached). The CE Project Completion Report shall include a library of photos showing conditions before, during and after construction to thoroughly document the work performance.
8) The document will be accepted or rejected by the Government within 30 working days after receipt. If rejected the contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the PCO.
9) Distribution authorized to U.S. government agencies only (administrative or operational data, 29 May 02). Other requests for this document shall be referred to HQ ACC AMIC/PKB.
//////Continued on Word Document - CDRL-A011: Project Completion Report Work Sheet///////
HQ ACC AMIC/PCE
HQ ACC AMIC/PMSW
HQ ACC AMIC/DRQ
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
CDRL-A011: Project Completion Report
SITE
WORK REQUEST NUMBER:
PROJECT TITLE:
PROJECT TYPE (WORK CLASS):
PROJECT COMPLETION DATE:
COMPLETION REPORT SUBMISSION DATE:
ACTUAL LABOR COST (FUNDED):
ACTUAL LABOR COST (UNFUNDED):
ACTUAL MATERIAL COST (FUNDED):
ACTUAL MATERIAL COST (UNFUNDED)
PROFIT/OVERHEAD/HANDLING FEE (FUNDED):
TOTAL COST (FUNDED):
TOTAL COST (UNFUNDED):
SITE MANAGER:
If this project did not impact or change any real property records so comment following NOTE: below and do not submit the Completed Project Checklist (remaining pages).
NOTE:
DATE:
COMPLETED PROJECT CHECKLIST
Building/Facility No.:
Project Title:
Project Number:
Work Order Number:
Total SF (of new construction):
Total Project Cost (includes everything):
Project Inspector Name and Phne Number
* NOTE: Please list Type, Model Number, and Serial Number for A/C, Boilers, Auto Fire Detection, Generators, and
Security Systems.
Systems Added or Increased:
Unit of
Cat. Code
Measure
Amount
Cost
880-211
Closed Head Auto Sprinklers
SF
(need both units of measure)
HD
880-212
Open Head Deluge System
SF
(need both units of measure)
HD
880-221
Auto Fire Detection System
SF
(need both units of measure)
EA
880-222
Manual Fire Alarm System
EA
(Interior System)
880-231
CO2 Fire System
EA
880-232
Foam Fire System
EA
880-233
Other Fire System
EA
880-234
Halon 1301 Fire System
EA
872-841
Security Alarm System
EA
890-126
A/C Window Units
TN
(need both units of measure)
SF
890-125
A/C Plant Less than 5 Ton
TN
(need both units of measure)
SF
Systems Added or Increased (con'td):
Unit of
Measure
Amount
Cost
890-121
A/C Plant 5 to 25 Ton
TN
826-122
A/C Plant 25 to 100 Ton
TN
826-123
A/C Plant Over 100 Ton
TN
821-115
Heating Plant 750/3500 MBTU
MBTU
811-147
Electric Emergency Power
Generator
KW
Diesel Fuel tank for generator
GA
INFRASTRUCTURE
813-231
Transformers
812-223
Primary Electrical Distribution
Line OH
LF
812-224
Secondary Electrical Distibution
Line OH
LF
812-225
Primary Electrical Distribution
Line UG
LF
812-226
Secondary Electrical Distibution
Line UG
LF
812-923
Exterior Area Lights
EA
824-464
Gas Mains
LF
831-169
Sewage Septic Tank
KG
832-266
Sanitary Sewer Main
LF
842-245
Water Distribution Mains
LF
843-315
Fire Hydrants
EA
851-143
Curb and Gutters
LF
851-145
Driveway
SY
Type:
(concrete, bituminous, stabilized, other)
851-147
Road
SY
(need both units of measure
LF
Type:
(concrete, bituminous, stabilized, other)
Systems Added or Increased (con'td):
Unit of
Measure
Amount
Cost
852-261
Vehicle Parking, Operational
SY
N/A
852-262
Vehicle Parking, Non-oganizational
SY
N/A
871-183
Storm Drain Disposal
LF
N/A
872-247
Security Fence / Vehicle Barrier
LF
N/A
872-248
Interior Fence
LF
N/A
852-289
Sidewalk
SY
N/A
890-158
Load/Unloading Platform
SF
N/A
832-255
Industrial Waste Main
LF
N/A
890-144
Compressed Air Distribution
LF
N/A
Hoist; Cranes
(Permanently Installed)
EA
N/A
Hydraulic Lifts
(Permanently Installed)
EA
l
N/A
Paint Spray Booth
(Permanently Installed)
EA
N/A
Please list all Real Property that was Demolished:
Total estimated cost of demolition of a facility/building (whole or part):
Supervision and/or administration:
Total estimated cost:
List unit of measure and cost (estimated or actual) of any system increased or added to a structure that is NOT listed above.
Unit of
Nomenclature
Measure
Amount
Cost
EA
EA
EA
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