02_Atch3-2DID_pg44-55_090616_FBO.pdf
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- FA5209-09-R-0025
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Draft PWS(3)(Page 44-55/90)
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Performance-based Work Statement (DRAFT)
DATA ITEM DESCRIPTION
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
1. TITLE
RESERVED
2. IDENTIFICATION NUMBER
3. DESCRIPTION/PURPOSE
4. APPROVAL DATE
(YYYYMMDD)
5. OFFICE OF PRIMARY RESPONSIBILITY (OPR)
6a. DTIC APPLICABLE 6b. GIDEP APPLICABLE
7. APPLICATION/INTERRELATIONSHIP
8. APPROVAL LIMITATION
9a. APPLICATION/INTERRELATIONSHIP 9a. AMSC NUMBER
10. PREPARATION INSTRUCTIONS
11. DISTRIBUTION STATEMENT
DD FORM 1664, AUG 96 (EG)
PREVIOUS EDITION MAY BE USED.
Page _____ of ____ Pages
Designed using Perform Pro WHS/DIOR, Aug 96
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
WEIGHT TICKETS
3 DESCRIPTION/PURPOSE
Weight tickets, properly certified, IAW the applicable laws and regulations of Government of Japan (GOJ), are required to support billings for payment.
4 APPROVAL DATE
5 OFFICE OF PRIMARY RESPONSIBILITY (OPR)
7 APPLICATION/INTERRELATIONSHIP
Verification of weight of shipments. Weight tickets are not required on inbound shipments unless a reweight is ordered.
Schedules I, II, and III.
8 APPROVAL LIMITATION
10. REPARATION INSTRUCTIONS
Weight tickets must be certified and prepared in duplicate and must contain the following:
1. Name and address of the weighing station.
2. Date of weighing.
3. Contractor’s name.
4. Van or trailer number
5. Name of property member/employee
6. Signature of weighmaster or an individual who is responsible for weighing IAW applicable GOJ laws and regulations.
7. Order number
PPSO
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
HOUSEHOLD GOODS DESCRIPTIVE INVENTORY
To provide an accurate, legible inventory of shipment contents. Identify quantities, cartons, conditions of articles and other information concerning the items shipped. (See PWS Attachment 1, Figure G1-1)
1. APPROVAL DATE
2. OFFICE OF PRIMARY RESPONSIBILITY (OPR)
Listing of articles shipped.
Schedules I and III.
10. REPARATION INSTRUCTIONS
Schedule I: PPSO – Original; Member/Employee – 1 Copy; Contractor – 1 Copy
Shipment: 1 Copy attached to Number One container; 1 Copy placed inside Number One container
Schedule III: PPSO – Original; Member/Employee – 1 Copy; Contractor – 1 Copy
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
10. .PREPARATION INSTRUCTIONS
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
REPORT OF GOVERNMENT OWNED CONTAINERS
Report how many Government-owned containers are available at the contractor’s or Government facility as applicable.
To determine accountability and location of Government-owned containers.
Schedules I and II.
10 PREPARATION INSTRUCTIONS
Report is submitted to the PPSO fifteen days after the contract start date and the first workday of each month thereafter. The report will reflect the following information but not limited to:
1. Number received during reporting period with member’s name for each container.
2. Number of containers disposed of during the period of report (showing specific disposition).
3. Total number of containers on hand as of the end of the reporting period to include:
a. Number of serviceable containers, by type
b. Number of unserviceable containers, by type
NOTE: Initial report of containers received from previous contractor need not show member’s name.
PPSO will furnish the form for the Contractor’s use.
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
JOINT STATEMENT OF LOSS AND DAMAGE AT DELIVERY
To record loss and/or damage at the time of delivery to the member. (PWS Attachment 1, Figure G1-8)
Used as proof of delivery and as supporting documentation for a claim.
Schedules II and III:
A DD Form 1840 will be prepared to indicate the loss and/or damage revealed during unloading/unpacking. The contractor and member/employee must jointly sign the form upon completion. If available, the member/employee’s copy of the inventory prepared at origin or the copy ofrom the number one container must be used to check count and condition.
Member/Employee – 3 Copies
PPSO – 1 Copy
Contractor – 1 Copy
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
3 DESCRIPTION/PURPOSE
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
TRANSPORATION CONTROL MOVEMENT DOCUMENT
A document issued by the Government to order transportation and related shipment services.
Used for line haul freight movement of personal property.
Schedule I.
The following information will be provided by the Contractor in the blocks are indicated below:
1. Block 22 (Pieces). Enter the total number of pieces in the shipment.
2. Block 23 (Weight). Enter the gross, tare and net weight.
3. Block 24 (Cube). Enter the total cube of the shipment.
The Contractor surrenders the original and copies 2, 3, and 4 to the carrier. The Contractor returns copies 5, 6, and 7, signed by the carrier, to the TO. The Contractor maintains copy 8. In instances where computer generated documents are used, enough copies must be made to ensure the right number of copies will be submitted.
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
CONTRACTOR’S WEEKLY REPORT
Report advises the TO of outbound shipments on hand which were picked up prior to the previous Wednesday.
Reports are prepared each Monday or next working day if Monday is a holiday.
Negative reports are required.
Schedule I
Report must contain:
1. Member’s name, rank/grade and SSN
2. Number of days on hand
3. Order number
Original to PPSO
Copy maintained by the Contractor
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
REPORT OF SHIPMENTS ON HAND
Report advises the TO of outbound and inbound shipments on hand which were picked up prior to the previous Wednesday.
Reports are prepared each Monday or next working day if Monday is a holiday.
Negative reports are required.
Schedules II.
Report must contain:
1. Member’s name, rank/grade and SSN
2. Date of receipt
3. Pieces, weight and cube
4. Order number
One copy forwarded to PPSO.
One copy maintained by contractor
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
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 Department of Defense Washington Headquarters
Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents
Should be aware that notwithstanding any other provision of law, no person will 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 ABVOE ADDRESS.
MONTHYLY SS METRICS REPORT
Provides the PPSO a monthly metrics measuring the Services Summary (SS) Performance Threshold. These statistics will be used in the monthly evaluation of the Contractor and also as a part of the annual performance report.
Report is prepared on a monthly basis.
Schedules I, II, and III.
File details come from the government source that posted it. Updated .