02_Atch1-2_Atch3-2DID_pg43-54_12Jul12.pdf

Attachment 1 to Solicitation No. FA5209-12-R-0041

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 ABOVE 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 ABOVE 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 ABOVE 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 Appendix A, 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 ABOVE 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 ABOVE 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 ABOVE ADDRESS.

JOINT STATEMENT OF LOSS AND DAMAGE AT DELIVERY

To record loss and/or damage at the time of delivery to the member. (PWS Appendix A, 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 from 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 ABOVE ADDRESS.

CLAIMS CORRESPONDENCE

3 DESCRIPTION/PURPOSE

Monthly status report of claims received by the contractor.

Informs the PPSO of a pending claim.

Schedules I, II and III.

The contractor records the date of receipt on the claim and furnishes status to the 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 ABOVE ADDRESS.

TRANSPORATION CONTROL MOVEMENT DOCUMENT (TCMD)

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 Contractor shall provide the following information to PPSO to complete block 22, 23, and 24:

1. Total number of pieces in the shipment. (Block 22 (Pieces))

2. Gross, tare and net weight. (Block 23 (Weight))

3. Total cube of the shipment. (Block 24 (Cube))

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 ABOVE ADDRESS.

CONTRACTOR’S WEEKLY REPORT (REPORT OF SHIPMENTS ON

HAND)

Report advises the PPSO 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 ABOVE ADDRESS.

REPORT OF SHIPMENTS ON HAND

Report advises the PPSO of 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 ABOVE 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 ABOVE ADDRESS.

MONTHLY 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.

One copy forwarded to PPSO.

One copy maintained by the contractor.