Appendix_B_-_CDRLs__9_Dec_15.pdf

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DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER

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

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

Page of Pages

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

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

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

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

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

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

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

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

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

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

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

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

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

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

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

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

Item 12. Specify when first submittal is required.

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

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

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

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

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

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

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

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

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

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

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and

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

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

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

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

DD FORM 1423-1 (BACK), FEB 2001

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

TDP:

TM:

OTHER: ADMN/MGMT DATA

DSYSTEMITEM: T-38 Aircraft Maintenance Program

E_CONTRACTPR_NO:

FCONTRACTOR:

of_pages:

Reset:

1_DATA_ITEM_NO: A001

2_TITLE_OF_DATA_ITEM: Management Plan

3_SUBTITLE: Management Plan

4_AUTHORITY_Data_Acquisit: DI-MGMT-80004A

5_CONTRACT_REFERENCE: PWS, Section A, Paragraph 2.2.1

6_REQUIRING_OFFICE: ACC AMIC/PMAN

7_DID_250_REQ: XX

8_APP_CODE:

DIST_STATEMENT: A

10_FREQUENCY: ONE/R

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: 30 DAC

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: ACC AMIC/PMAM draft1: 1 reg1:

repro1: 1 addressee2: ACC AMIC/PKC draft2: 1 reg2:

repro2: 1 addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

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repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 1 total_repro: 3

16_REMARKS: Block #s 7,8: Contractor's management plan will be reviewed and 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 CO. Approval is the responsibility of the DOM.

Block #s 10,12,13: Contractor to submit first drafts exactly 30 days after commencement of contract start. Review the plan annually for currency, and if needed, resubmit to the Government any desired changes for acceptance. If rejected, the contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO.

Block #14: Report shall be in electronic format compatible with Microsoft Office XP® or higher software or unless otherwise directed by the Government with the following file name structure: CDRL A00X + “Name”. The delivery method is emailing.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Stephen M. Brannen, GS-13, DAF

H_DATE: 8 Dec 15

1_APPROVED_BY:

J_DATE: 8 Dec 15

Page:

reg38t: 0

16_REMARKS_Continued:

Page2:

2015-12-08T13:08:29-0500

BRANNEN.STEPHEN.M.1070592327

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

TDP:

TM:

OTHER: FINANCIAL

DSYSTEMITEM: T-38 Aircraft Maintenance Program

E_CONTRACTPR_NO:

FCONTRACTOR:

of_pages:

Reset:

1_DATA_ITEM_NO: A002

2_TITLE_OF_DATA_ITEM: Finance Management & Contract Cost Report

3_SUBTITLE: Cost Performance Report

4_AUTHORITY_Data_Acquisit: DI-MGMT-80227

5_CONTRACT_REFERENCE: PWS, Section A, Paragraph 2.4.2.

6_REQUIRING_OFFICE: ACC AMIC/PMA

7_DID_250_REQ: XX

8_APP_CODE:

DIST_STATEMENT: A

10_FREQUENCY: MTHLY

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: 30 DAC

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: ACC AMIC/PMA draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PKC draft2:

reg2:

repro2: 1 addressee3: ACC AMIC/DRF draft3:

reg3:

repro3: 1 addressee4:

draft4:

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total_draft: 0 total_repro: 4

16_REMARKS:

Block #5: The Financial Management Report (FMR) shall document financial information that reflects current and previous fiscal year contract cost data, and projected funding requirements. The contractor shall include the following information in the FMR:

a) Summary listing of all cost reimbursable Contract Line Item Numbers (CLINs)

b) Funding authorized to date

c) Cumulative billings

d) Actual cumulative costs to date

e) Actual costs incurred since last reporting period

f) Cost variances comparing the estimated cost of reimbursables to contractor provided estimates

g) Estimated costs through end of fiscal year

h) Summary detailing FFP cost line items with descriptive data and total fiscal year funding for each line item with a cumulative listing of applicable modifications affecting each item

j) Quarterly fiscal year cost projections for each cost reimbursable cost element

k) List all daily CR expenditures itemized by functional description including:

local purchase parts and equipment, travel related, utilities, software, training, travel, overtime, and other items submitted to the Government for reimbursement. Include charge code, description and amount.

L) Deployment specific costs by cost category with any variances from cost estimate identified

Block #s 7, 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 CO.

Block #s 10, 12, 13: Contractor to submit first report exactly 30 days after commencement of contract start. Each subsequent submission will occur NLT then 15 days after the end of the month, for the life of the contract.

Block # 14: Report shall be in electronic format compatible with Microsoft Office Windows 7® or higher software or unless otherwise directed by the Government with the following file name structure: CDRL A003 + “Name”. The delivery method is emailing.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Stephen M. Brannen, GS-13, DAF

H_DATE: 8 Dec 15

1_APPROVED_BY:

J_DATE: 8 Dec 15

Page:

reg38t: 0

16_REMARKS_Continued:

Page2:

2015-12-08T13:11:05-0500

BRANNEN.STEPHEN.M.1070592327

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

TDP:

TM:

OTHER: ADMIN/MGMT DATA

DSYSTEMITEM: T-38 Aircraft Maintenance Program

E_CONTRACTPR_NO:

FCONTRACTOR:

of_pages:

Reset:

1_DATA_ITEM_NO: A003

2_TITLE_OF_DATA_ITEM: Operating Instructions

3_SUBTITLE: Operating Instructions/Procedures/Checklists

4_AUTHORITY_Data_Acquisit: DI-MISC-80392

5_CONTRACT_REFERENCE: PWS paragraph 2.4.10.

6_REQUIRING_OFFICE: ACC AMIC/PMAM

7_DID_250_REQ: XX

8_APP_CODE:

DIST_STATEMENT: A

10_FREQUENCY: ONE/R

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: 30 DAC

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: ACC AMIC/PMAN draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/DRQ draft2:

reg2:

repro2: 1 addressee3: ACC AMIC/PKC draft3:

reg3:

repro3: 1 addressee4: ACC AMIC/PLG draft4:

reg4:

repro4: 1 addressee5: ACC AMIC DRQA draft5: 1 reg5:

repro5: 1 addressee6:

draft6:

reg6:

repro6:

addressee7:

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total_draft: 2 total_repro: 5

16_REMARKS: Block #s 7 and 8: Contractor's Operating Instructions will be reviewed and 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 CO. Approval is the responsibility of the DOM.

Blocks #10-13: Contractor to submit first drafts no later than 30 days after commencement of contract start. Review the plan annually for currency, and if needed, resubmit to the Government any desired changes for acceptance. If rejected, the contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO.

Block #14: Report shall be in electronic format compatible with Microsoft Office Windows 7® or higher software or unless otherwise directed by the Government with the following file name structure: CDRL A00X + “Name”. The delivery method is emailing

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Stephen M. Brannen, GS-13, DAF

H_DATE: 8 Dec 15

1_APPROVED_BY:

J_DATE: 8 Dec 15

Page:

reg38t: 0

16_REMARKS_Continued:

Page2:

2015-12-08T13:12:40-0500

BRANNEN.STEPHEN.M.1070592327

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any

1_DATA_ITEM_NO: A004

2_TITLE_OF_DATA_ITEM: Property Control Report

3_SUBTITLE: Property Control Plan

4_AUTHORITY_Data_Acquisit: DI-MISC-81420

5_CONTRACT_REFERENCE: PWS Section A, Paragraph 4.4.2

6_REQUIRING_OFFICE: ACC AMIC/PMA

7_DID_250_REQ: XX

8_APP_CODE:

DIST_STATEMENT: A

10_FREQUENCY: ANNLY

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: 90 DAC

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: ACC AMIC/PKC draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PMAM draft2:

reg2:

repro2: 1 addressee3: ACC AMIC/DRQ draft3:

reg3:

repro3: 1 addressee4: ACC AMIC/PLG draft4:

reg4:

repro4: 1 addressee5:

draft5:

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repro38:

total_draft: 0 total_repro: 4

16_REMARKS: Block #4: All Para's of DI-MISC-81420 apply.

Blocks #s 7,8: Contractor Plan will be reviewed and 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 CO.

Block #s 10,12,13: Contractor to submit first drafts no later than 90 days after commencement of contract start. Review annually, as a minimum, for currency and if needed, resubmit to the Government any desired changes for acceptance. If rejected, the contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO. Submit updated Property Control Plan, with a revision page clearly explaining updates made, 30 days prior to the end of each contract year.

Block # 14: Report shall be in electronic format compatible with Microsoft Office Windows 7® or higher software or unless otherwise directed by the Government with the following file name structure: CDRL A004 + “Name”. The delivery method is emailing.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Stephen. M. Brannen GS-13, DAF

H_DATE: 8 Dec 15

1_APPROVED_BY:

J_DATE: 8 Dec 15

Page:

reg38t: 0

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

TDP:

TM:

OTHER: MISC DATA

DSYSTEMITEM: T-38 Aircraft Maintenance Program

E_CONTRACTPR_NO:

FCONTRACTOR:

16_REMARKS_Continued:

Page2:

of_pages:

Reset:

2015-12-08T13:14:06-0500

BRANNEN.STEPHEN.M.1070592327

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

TDP:

TM:

OTHER: ADMIN/MGMT DATA

DSYSTEMITEM: T-38 Aircraft Maintenance Program

E_CONTRACTPR_NO:

FCONTRACTOR:

of_pages:

Reset:

1_DATA_ITEM_NO: A005

2_TITLE_OF_DATA_ITEM: Personnel Report

3_SUBTITLE: Personnel Report

4_AUTHORITY_Data_Acquisit: DI-MISC-80392

5_CONTRACT_REFERENCE: PWS Section A, paragraph 2.2.1.4

6_REQUIRING_OFFICE: ACC AMIC/PMAN

7_DID_250_REQ: XX

8_APP_CODE:

DIST_STATEMENT: A

10_FREQUENCY: Monthly

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: 10 DAC

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: ACC AMIC/PMAN draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PKC draft2:

reg2:

repro2: 1 addressee3: ACC AMIC DRQA draft3:

reg3:

repro3: 1 addressee4:

draft4:

reg4:

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reg38x:

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total_draft: 2 total_repro: 5

16_REMARKS:

Block #4: Provide listing of all employees performing work under this contract. Provide as requested a report identifying the number of all personnel by Department of Labor (DOL) labor rate classifications, assigned function or repair shop and/or management support for this contract in electronic format compatible with Microsoft Office 7® or higher software or unless otherwise directed by the Government.

Block#8: Approvals/Disapprovals/Comments will be given by ACC AMIC/PMAN through ACC AMIC/DRQ prior to implementation

Block #s 10-13 CDRL shall be submitted NLT 10th business day of each month

Block#14: Report shall be in electronic format compatible with Microsoft Office Windows 7® or higher software or unless otherwise directed by the Government with the following file name structure: CDRL A003 + “Name”. The delivery method is emailing.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Stephen M. Brannen, GS-13, DAF

H_DATE: 8 Dec 15

1_APPROVED_BY:

J_DATE: 8 Dec 15

Page:

reg38t: 0

16_REMARKS_Continued:

Page2:

2015-12-08T13:16:49-0500

BRANNEN.STEPHEN.M.1070592327

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any

1_DATA_ITEM_NO: A006

2_TITLE_OF_DATA_ITEM: Environmental Protection Program

3_SUBTITLE: Environmental Protection Plan (EPP)

4_AUTHORITY_Data_Acquisit: DI-MGMT-80898

5_CONTRACT_REFERENCE: PWS Section A, Paragraph 2.5.3.

6_REQUIRING_OFFICE: ACC AMIC/PCE

7_DID_250_REQ: LT

8_APP_CODE:

DIST_STATEMENT: A

10_FREQUENCY: ANNLY

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: 90 DAC

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: ACC AMIC/PKC draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PMAM draft2:

reg2:

repro2: 1 addressee3: ACC AMIC/PCE draft3:

reg3:

repro3: 1 addressee4:

draft4:

reg4:

repro4:

addressee5:

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addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 3

16_REMARKS: Block # 5: Base–specific plans shall include, but not limited to: Hazardous Waste Program, Hazardous Waste Collection and Disposal, Pollution Prevention Program, Hazardous Materials (HAZMAT) Program, Petroleum, Oils & Lubricants (POL) Management, Air Emissions to include Air Quality Ozone Depleting Chemicals (ODCs), Toxic Substances, Water Quality, Wastewater, Storage Tanks, Spill Prevention and Response.

Block #7,8: Contractor's EPP will be reviewed and 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 CO. Approval is the responsibility of the DOM.

Block #s 10,12,13: Contractor to submit first drafts NLT 90 days after commencement of contract start. Review annually, as a minimum, for currency and if needed, resubmit to the Government any desired changes for acceptance. If rejected, the contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO. Submit updated S&HP, with a revision page clearly explaining updates made, 30 days prior to the end of each contract year.

Block #14: Report shall be in electronic format compatible with Microsoft Office Windows 7® or higher software or unless otherwise directed by the Government with the following file name structure: CDRL A003 + “Name”. The delivery method is emailing.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Stephen M.Brannen, GS-13, DAF

H_DATE: 8 Dec 15

1_APPROVED_BY:

J_DATE: 8 Dec 15

Page:

reg38t: 0

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

TDP:

TM:

OTHER: ENVIRONMENTAL

DSYSTEMITEM: T-38 Aircraft Maintenance Program

E_CONTRACTPR_NO:

FCONTRACTOR:

16_REMARKS_Continued:

Page2:

of_pages:

Reset:

2015-12-08T13:18:56-0500

BRANNEN.STEPHEN.M.1070592327

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any

1_DATA_ITEM_NO: A007

2_TITLE_OF_DATA_ITEM: Environmental Safety and Occupational Health Program

3_SUBTITLE: ESOH Program

4_AUTHORITY_Data_Acquisit: DI-ENVR-81375

5_CONTRACT_REFERENCE: PWS Section A, Paragraph 2.5.1

6_REQUIRING_OFFICE: ACC AMIC/PCE

7_DID_250_REQ: LT

8_APP_CODE:

DIST_STATEMENT: A

10_FREQUENCY: ANNLY

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: 90 DAC

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: ACC AMIC/PKC draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PMAM draft2:

reg2:

repro2: 1 addressee3: ACC AMIC/PCE draft3:

reg3:

repro3: 1 addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

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total_draft: 0 total_repro: 3

16_REMARKS:

(5) Base-specific plans shall include, but not limited to: Confined Space Management, Lock/Out-Tag/Out (LOTO), Machine Guarding, Electrical, Personal Protection Equipment (PPE), Respiratory Protection, Ventilation Systems, Chemical Hazards, Hazardous Communication (HAZCOM), Weapons Safety, Aircraft Parking Programs/Plans, Job Safety Training, Safety Inspections, Mishap Notification, Investigation & Reporting Procedures, Hazard Abatement Procedures, and Hazard Prevention & Control Procedures, Safety Supplies and Equipment, Safety Reviews, and Mishap Prevention as applicable.

(7,8) Contractor's EPP will be reviewed and 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 CO. Approval is the responsibility of the DOM.

(10,12,13) Contractor to submit first drafts no later than 90 days after commencement of contract start. Review annually, as a minimum, for currency and if needed, resubmit to the Government any desired changes for acceptance. If rejected, the contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO. Submit updated S&HP, with a revision page clearly explaining updates made, 30 days prior to the end of each contract year.

(14) Report shall be in electronic format compatible with Microsoft Office Windows 7® or higher software or unless otherwise directed by the Government with the following file name structure: CDRL A003 + “Name”. The delivery method is emailing.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Stephen M. Brannen, GS-13, DAF

H_DATE: 8 Dec 15

1_APPROVED_BY:

J_DATE: 8 Dec 15

Page:

reg38t: 0

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

TDP:

TM:

OTHER: SAFETY

DSYSTEMITEM: T-38 Aircraft Maintenance Program

E_CONTRACTPR_NO:

FCONTRACTOR:

16_REMARKS_Continued:

Page2:

of_pages:

Reset:

2015-12-08T13:20:22-0500

BRANNEN.STEPHEN.M.1070592327

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any

1_DATA_ITEM_NO: A008

2_TITLE_OF_DATA_ITEM: Accident/Incident Report

3_SUBTITLE: Incident Notification

4_AUTHORITY_Data_Acquisit: DI-SAFT-81563

5_CONTRACT_REFERENCE: PWS Section A, Para 2.5.5.

6_REQUIRING_OFFICE: ACC AMIC/PMA

7_DID_250_REQ: LT

8_APP_CODE:

DIST_STATEMENT: F

10_FREQUENCY: ASREQ

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: ASREQ

13_DATE_OF_SUBSEQUENT_SUB: See Block 16 addressee1: ACC AMIC/PKC draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PMAM draft2:

reg2:

repro2: 1 addressee3: ACC AMIC/PCEV draft3:

reg3:

repro3: 1 addressee4: ACC AMIC/DRQ draft4:

reg4:

repro4: 1 addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

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total_draft: 0 total_repro: 4

16_REMARKS: Notify government program office within one duty day of any mishap, security incident/violation, damage/loss/theft/destruction of government property, and any other significant event the contractor reasonably believes the government should be informed of. The government will provide direction if formal submittal of report is required.

If required by the government, submit report as soon as the facts become known, but NLT 5 work days after initial notification. Include the minimum information required IAW the DID and FAR 52.245-1. The info shall include:

a) Name, organization, telephone number, PM name and location of contractor

b) Contract Number

c) Reporter of incident

d) Date and time of accident/incident

d) Location of accident/incident

f) Name of item, commercial description, manufacturer, model/part number, NSN

g) Casualties/Injuries

h) Quantity of material

i) Unique Item Identifier (if available)

j) Brief summary of accident/incident

k) Nature of damage

l) Estimated property damage

m) Acquisition cost, estimated repair/replacement cost

n) Statement indicated current or future need

o) Cause of accident/incident

p) Other damages

q) Last known location

r) Corrective/preventative measure to prevent recurrence

s) Statement that the Gov will receive any reimbursement

t) Statement that the property did/did not contain sensitive or hazardous material, and if so, that the appropriate agencies were notified

u) Include copies of supporting documents as necessary

Block # 14: Report shall be in electronic format compatible with Microsoft Office Windows 7® or higher software or unless otherwise directed by the Government with the following file name structure: CDRL A003 + “Name”. The delivery method is emailing.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY: Stephen M. Brannen, GS-13, DAF

H_DATE: 8 Dec 15

1_APPROVED_BY:

J_DATE: 8 Dec 15

Page:

reg38t: 0

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

TDP:

TM:

OTHER: SAFTEY DATA

DSYSTEMITEM: T-38 Aircraft Maintenance Program

E_CONTRACTPR_NO:

FCONTRACTOR:

16_REMARKS_Continued:

Page2:

of_pages:

Reset:

2015-12-08T13:21:39-0500

BRANNEN.STEPHEN.M.1070592327

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the

c. Group III.