Appendix_B_-_Contract_Data_Requirements_List_(CDRL).docx

PRECISION MEASUREMENT EQUIPMENT LABORATORY (PMEL)

PWS

FA4890-17-R-0011

APPENDIX B – CONTRACT DATA REQUIREMENTS LIST (CDRL)

1. CDRL A001 Reimbursable Expense Report

2. CDRL A002 Financial Management Report

3. CDRL A003 Technical Report

4. CDRL A004 Quality Manual

5. CDRL A005 Property Control Plan

6. CDRL A006 Quality Program Activity Summary

7. CDRL A007 Environmental Protection Plan

8. CDRL A008 Pollution Incident Spill Report

9. CDRL A009 Environmental Health and Safety Plan

10. CDRL A010 Mishap Report

PMEL PWS

D – 1 image1.emf

PMEL CDRL A001 - Reimbursable Expense Documentation Report.pdf

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 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

data_item: A001 title: Program Management Report sub: Reimbursable Expense Documentation Report auth: DI-MGMT-80898 ref: PWS, Section A, Para 2.2.1 req_ofc: ACC AMIC/PMSP dd250: LT appcode:

dist: A freq: Quarterly asof: EOFQ firstsub: 90 DAC subsub: Block 16 addressee1: ACC AMIC/PMSP draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PKB draft2:

reg2:

repro2: 1 addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 0 total_repro: 2 remarks: 4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A001 – Reimbursable Expense Documentation Report. The delivery method is e-mail notification to receivers in block 14.

5) PWS, Section A Para 2.2.1 "Reimbursable Expense Documentation Report" At a minimum, the contractor shall identify each reimbursable organization, PMEL providing support, support agreement number, organization address, local point to contact with the individual’s phone number, man-hour expenditures and on-site travel expenditures.

8) The document will be accepted or rejected by the Government within 5 working days after receipt. Contractor shall revise and resubmit the document within 5 working days after receipt unless otherwise directed by the CO.

9) Distribution is authorized to U.S. Government agencies only (administrative or operational data, 29 May 02). Other requests for this document shall be referred to ACC AMIC/PKB.

10 - 13) All subsequent reports shall be provided as specified in PWS, Section A Para 2.2.1

15) Repro is via e-mail.

group:

total_price:

prep_name:

prep_sign:

prep_date:

app_by:

app_sign:

app_date:

Page:

app: Adobe Professional 7.0 line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system: Precision Measurement Equipment Lab ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

image2.emf

PMEL CDRL A002 - Financial Management Report.pdf

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 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 data_item: A002 title: Program Management Reports sub: Financial Management Report (FMP) auth: DI-MGMT-80898 ref: PWS, Section A, Para 2.2.2 req_ofc: ACC AMIC/PMSP dd250: LT appcode:

dist: A freq: Quarterly asof: EOFQ firstsub: 90 DAC subsub: Block 16 addressee1: ACC AMIC/PMSP draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PKB draft2:

reg2:

repro2: 1 addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 0 total_repro: 2 remarks: 4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A002 – Financial Management Report (FMR). The delivery method is e-mail notification to receivers in block 14.

5) PWS, Section A Para 2.2.2 "Financial Management Report (FMR)" Report shall contain the following:

• Summary listing of all cost reimbursable expenditures

• Contract identification data

• Funding authorized to date

• Cumulative billings

• Actual cumulative costs to date

• Actual costs incurred since last reporting period

• Estimated costs through end of fiscal year

• Cost variances comparing the estimated cost of completion to amount of funds authorized

8) The document will be accepted or rejected by the Government within 10 working days after receipt. Contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO.

9) Distribution is authorized to U.S. Government agencies only (administrative or operational data, 29 May 02). Other requests for this document shall be referred to ACC AMIC/PKC.

10 - 13) All subsequent reports shall be provided quarterly to the Government NLT 15 business days after the end of the quarter.

group:

total_price:

prep_name:

prep_sign:

prep_date:

app_by:

app_sign:

app_date:

Page:

app: Adobe Professional 7.0 line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system: Precision Measurement Equipment Lab ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

image3.emf

PMEL CDRL A003 - Technical Report.pdf

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 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 data_item: A003 title: Program Management Reports sub: Technical Reports auth: DI-MGMT-80898 ref: PWS, Section A, Para 2.2.3 req_ofc: ACC AMIC/PMSP dd250: LT appcode:

dist: A freq: Block 16 asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: ACC AMIC/PMSP draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PKB draft2:

reg2:

repro2: 1 addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 0 total_repro: 2 remarks: 4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A003 – Technical Reports. The delivery method is e-mail notification to receivers in block 14.

5) PWS, Section A Para 2.2.3 "Technical Reports" The requirements for subject report will be explained within the Contracting Officer Request Letter

8) The document will be accepted or rejected by the Government within 10 working days after receipt. Contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO.

9) Distribution is authorized to U.S. Government agencies only (administrative or operational data, 29 May 02). Other requests for this document shall be referred to ACC AMIC/PKC.

10 - 13) Up to twelve per fiscal year.

group:

total_price:

prep_name:

prep_sign:

prep_date:

app_by:

app_sign:

app_date:

Page:

app: Adobe Professional 7.0 line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system: Precision Measurement Equipment Lab ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

image4.emf

PMEL CDRL A004 - Quality Manual.pdf

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 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 data_item: A004 title: Quality Management System (QMS) sub: Quality Manual (QM) auth: DI-MGMT-80898 ref: PWS, Section A, Para 2.4.1 req_ofc: ACC AMIC/PMSP dd250: LT appcode:

dist: A freq: ANNLY asof: Block 16 firstsub: 90 DAC subsub: Block 16 addressee1: ACC AMIC/DRQ draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PKB draft2:

reg2:

repro2: 1 addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 0 total_repro: 2 remarks: 4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A004 – Quality Manual. The delivery method is e-mail notification to receivers in block 14.

5) PWS, Section A Para 2.4.1 "Quality Manual" The QM shall address the requirements of TO 00-20-14, as well as policies, procedures which include a formal preventive action process, and document control at a minimum.

8) The document will be accepted or rejected by the Government within 30 working days after receipt. Contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO. The contractor shall be responsible for the quality of products and services regardless of an accepted QMS.

9) Distribution is authorized to U.S. Government agencies only (administrative or operational data, 29 May 02). Other requests for this document shall be referred to ACC AMIC/PKC.

10 - 13) The Contractor shall submit their Quality Manual (QM) NLT 90 days after the start of the transition period of performance. The contractor's comprehensive QMS shall be in place and performing NLT 180 days after the start date of the transition period of performance. All subsequent plans shall be reviewed updates to the plans shall be submitted to the Government NLT 15 business days after the end of the fiscal year for each year of the contract. Any revisions to the plan made during the year shall be submitted to the CO prior to implementation.

group:

total_price:

prep_name:

prep_sign:

prep_date:

app_by:

app_sign:

app_date:

Page:

app: Adobe Professional 7.0 line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system: Precision Measurement Equipment Lab ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

image5.emf

PMEL CDRL A005 - Property Control Plan.pdf

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 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 data_item: A005 title: Property Control Plan sub:

auth: DI-MGMT-80004A ref: PWS, Section A, Para 6.2 req_ofc: ACC AMIC/DRQQ dd250: LT appcode:

dist: A freq: One-Time asof: Block 16 firstsub: 90 DAC subsub: Block 16 addressee1: ACC AMIC/PMSP draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PLG draft2:

reg2:

repro2: 1 addressee3: ACC AMIC/DRQQ draft3:

reg3:

repro3: 1 addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 0 total_repro: 3 remarks: 4) Plan shall be in an electronic format compatible with Microsoft Office or Adobe Acrobat with the following file name structure: CDRL A005 – Property Control Plan. The delivery method is e-mail notification to receivers in block 14.

5) PWS, Section A Para 6.2 "Property Control Plan" At a minimum, the contractor shall address the property management functions identified in FAR Part 52.245-1 Paragraphs (f) and (j). Those functions are: Acquisition of Property, Receipt of Property, Records of Property, Physical Inventory, Property Reports, Relief of Stewardship Responsibility, Utilization of Property, Maintenance Program, Property Closeout, Inventory Disposal. All inventory listings shall be generated in an electronic format compatible with Microsoft Office Excel.

8) The document will be accepted or rejected by the Government within 5 working days after receipt. Contractor shall revise and resubmit the document within 5 working days after receipt unless otherwise directed by the CO.

9) Distribution is authorized to U.S. Government agencies only (administrative or operational data, 29 May 02). Other requests for this document shall be referred to ACC AMIC/PKC.

10 - 13) All subsequent reports shall be provided as specified in PWS, Section A Para 6.2.

group:

total_price:

prep_name:

prep_sign:

prep_date:

app_by:

app_sign:

app_date:

Page:

app: Adobe Professional 7.0 line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system: Precision Measurement Equipment Lab ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

image6.emf

PMEL CDRL A006 - Quality Program Activity Summary.pdf

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 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 data_item: A006 title: Quality Program sub: Quality Program Activity Summary auth: DI-MGMT-80898 ref: PWS, Section A, Para 7.11.1 req_ofc: ACC AMIC/PMSP dd250: LT appcode:

dist: A freq: MNTHLY asof: EOM firstsub: Block 16 subsub: Block 16 addressee1: ACC AMIC/DRQ draft1:

reg1:

repro1: 1 addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 0 total_repro: 1 remarks: 4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A006 – Quality Program Activity Summary. The delivery method is upload of the report into the company's Management Information Data Storage (MIDS) system

5) PWS, Section A Para 7.11.1 "Quality Program Activity Summary" The requirements for subject report are detailed in TO 00-20-14.

8) The document will be accepted or rejected by the Government within 5 working days after receipt. Contractor shall revise and resubmit the document within 5 working days after receipt unless otherwise directed by the CO.

9) Distribution is authorized to U.S. Government agencies only (administrative or operational data, 29 May 02). Other requests for this document shall be referred to ACC AMIC/PKC.

10 - 13) Submitted monthly no later than the 10th day of the subsequent month.

group:

total_price:

prep_name:

prep_sign:

prep_date:

app_by:

app_sign:

app_date:

Page:

app: Adobe Professional 7.0 line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system: Precision Measurement Equipment Lab ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

image7.emf

PMEL CDRL A007 - Environmental Protection Plan.pdf

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 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 data_item: A007 title: Environmental Compliance Assessment and Management Program (ECAMP) Action Plan Report sub: Environmental Protection Plan (EPP) auth: DI-MGMT-80898 ref: PWS, Section A, Para 8.1.3 req_ofc: ACC AMIC/PMSP dd250: LT appcode:

dist: A freq: ANNLY asof: EOFY firstsub: 90 DAC subsub: Block 16 addressee1: ACC AMIC/PMSP draft1:

reg1:

repro1: 1 addressee2: ACC AMIC/PCE draft2:

reg2:

repro2: 1 addressee3: ACC AMIC/PKB draft3:

reg3:

repro3: 1 addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 0 total_repro: 3 remarks: 4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A007 – Environmental Protection Plan (EPP). The delivery method is e-mail notification to receivers in block 14.

5) PWS, Section A Para 8.1.3 "Environmental Protection Plan (EPP)" The contractor shall include but not limited to: Hazardous Material Handling and Storage (HAZMAT) Program, Hazardous Waste Program, Hazardous Waste and Collection Procedures, Pollution Prevention Program to include Recycling, POL, Air Quality Ozone Depleting Chemicals (ODCs), Special Health Considerations, Spill Prevention and Response, and Training, as applicable.

8) The document will be accepted or rejected by the Government within 30 working days after receipt. Contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO.

9) Distribution is authorized to U.S. Government agencies only (administrative or operational data, 29 May 02). Other requests for this document shall be referred to ACC AMIC/PKC.

10 - 13) All subsequent plans shall be reviewed annually and updates to the plans shall be submitted to the Government NLT 15 business days after the end of the fiscal year for each year of the contract. Any revisions to the plan made during the year shall be submitted to the CO prior to implementation.

group:

total_price:

prep_name:

prep_sign:

prep_date:

app_by:

app_sign:

app_date:

Page:

app: Adobe Professional 7.0 line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system: Precision Measurement Equipment Lab ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

image8.emf

PMEL CDRL A008 - Pollution Incident Spill Report.pdf

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 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

CDRL-A008 Spill Report

Spill Report Form

Site Reporting Spill:

Reporter's Name, Organization, Duty Phone:

Date and Time of Release:

Location of release:

Notification of Host Base Fire Department

Yes

No

Notification of Host Base Environmental Flight

Yes

No

Notification of National Response Center:

Yes

No

Notification of State Environmental Regulators:

Yes

No

Equipment/Facility involved:

Root cause of release (when determined, not necessary with initial report):

Type of material released:

Release Classification (circle one)

Class I

Class II

Class III

Class I - Involves an area less than 2 lineal feet in any plane dimension

Class II - Involves area not over 10 lineal feet in any plane dimension, or not over 50 square feet, and not of a continuous nature

Class III - Involves an area over 10 lineal feet in any plane dimension, or over 50 square feet, or of a continuous nature

Estimated quantity in gallons:

Released:

Recovered:

Spills on a hard surface: 2 ft. diameter = .25 gal; 4 ft. diameter = 1 gal; 6 ft. diameter = 2 gal; 8 ft. diameter = 4 gal; 10 ft. diameter = 6 gal

Corrective action taken:

Was the release contained on a hard surface (concrete, asphalt)?

Yes

No

Est. Quantity (gallons)

Did the release enter the storm drain or surface water?

Yes

No

Est. Quantity (gallons)

Did the release enter the sanitary drain?

Yes

No

Est. Quantity (gallons)

Did the spill reach and soak into any soil?

Yes

No

Est. Quantity (gallons)

Was the spill cleaned with in 24 hours?

Yes

No

Did the process owner have sufficient cleanup capabilities?

Yes

No

Is the spill reportable?

Yes

No

Any continuing threat to the environment?

Yes

No

Estimated cost to cleanup (including man hours):

data_item: A008 title: Pollution Incident Report sub: Pollution Incident Spill Report auth: DI-SAFT-80494A ref: See Block 16 req_ofc: ACC AMIC/PMSP dd250: LT appcode:

dist: C freq: Block 16 asof: Current firstsub: Block 16 subsub: Block 16 addressee1: ACC AMIC/PMSP draft1:

reg1: 1 repro1:

addressee2: ACC AMIC/PCE draft2:

reg2: 1 repro2:

addressee3: ACC AMIC/PKB draft3:

reg3: 1 repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 3 total_repro: 0 remarks: 4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A008 – Spill Report. The delivery method is e-mail notification to receivers in block 14 with a copy of the Spill Report attached.

5) PWS, Section A Para 8.1.3.1., "Pollution Incident Spill Report" The contractor shall report all spills. The pollution spill report, with the addition of categories "actual damage/potential threat, findings and causes, management actions taken to prevent reoccurrence, casualties or injuries including personnel information, and assistance required," shall constitute submission. Report all fields in the attached "CDRL-A008 Spill Report".

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 ACC AMIC/PKB.

10 - 13) Report shall be submitted NLT COB next business day and updates shall be provided as an addendum to the CDRL.

///////////////////////////////// See attached CDRL-A008 Spill Report///////////////////////// group:

total_price:

prep_name:

prep_sign:

prep_date:

app_by:

app_sign:

app_date:

Page:

app: Adobe Professional 7.0 line_item:

exhibit:

xtdp: Off xtm: Off othercat: SAFT system: Precision Measurement Equipment Lab ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

image9.emf

PMEL CDRL A009 - Safety and Health Plan.pdf

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 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 data_item: A009 title: Environmental Health and Safety Program (HSP) sub: Safety and Health Plan (S&HP) auth: DI-ENVR-81375 ref: PWS, Section A, Para 8.2.2 req_ofc: ACC AMIC/PMSP dd250: LT appcode:

dist: C freq: Block 16 asof: Block 16 firstsub: 30 DAC subsub: Block 16 addressee1: ACC AMIC/PMSP draft1:

reg1: 1 repro1:

addressee2: ACC AMIC/PCE draft2:

reg2: 1 repro2:

addressee3: ACC AMIC/PKB draft3:

reg3: 1 repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 3 total_repro: 0 remarks: 4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A009– Safety and Health Plan (S&HP). The delivery method is e-mail notification to receivers in block 14 with a copy of the S&HP attached.

5) PWS, Section A Para 8.2.2 "Safety and Health Plan (S&HP)" The contractor shall include but not limited to: Hazardous Communications (HAZCOM), Job Safety Training, Safety Inspections, Mishap Notification and Reporting Procedures, Hazard Abatement Procedures, Hazard Prevention and Control Procedures, Safety Supplies and Equipment, Safety Reviews, Mishap Prevention, Fire Prevention, and the Voluntary Protection Program, as applicable.

8) The document will be accepted or rejected by the Government within 30 working days after receipt. Contractor shall revise and resubmit the document within 10 working days after receipt unless otherwise directed by the CO.

9) Distribution is authorized to U.S. Government agencies and their contractors (administrative or operational data, 29 May 02). Other requests for this document shall be referred to ACC AMIC/PKB.

10, 11, 13) The contractor shall review and update their plans IAW with the approved QMS. When a plan is revised it shall be submitted to the CO for approval NLT 10 business days after revision. Revised plans shall include a revision page clearly delineating what has changed.

group:

total_price:

prep_name:

prep_sign:

prep_date:

app_by:

app_sign:

app_date:

Page:

app: Adobe Professional 7.0 line_item:

exhibit:

xtdp: Off xtm: Off othercat: ENVR system: Precision Measurement Equipment Lab ctr_no:

contr:

remarksb:

Page2:

of_pages:

Reset:

image10.emf

PMEL CDRL A010 - Mishap Report.pdf

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 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 data_item: A010 title: Accident/Incident Report sub: Mishap Report auth: DI-SAFT-81563 ref: See Block 16 req_ofc: ACC AMIC/PMSP dd250: LT appcode:

dist: C freq: As Req asof: Current firstsub: 90 DAC subsub: Block 16 addressee1: ACC AMIC/PMSP draft1:

reg1: 1 repro1:

addressee2: ACC AMIC/PCE draft2:

reg2: 1 repro2:

addressee3: ACC AMIC/PKB draft3:

reg3: 1 repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 3 total_repro: 0 remarks: 4) Report shall be in an electronic format compatible with Microsoft Office with the following file name structure: CDRL A010 – Mishap Report. Reportable mishaps/events shall be reported to the Government, including 1-7 below, as soon as possible but not later than the first hour of the next duty day. The initial written report, including 1-13 below, shall be submitted within 24 hours of the reportable mishap/event occurrence.