Exhibit_A_Deliverables.pdf

Exhibit A - Deliverables

The Contractor shall provide deliverables as described in subsequent task orders. Deliverables shall be specified by the Government. Format and delivery schedule for deliverables shall be outlined in deliverable.

Number Name Frequency A001 PMR Slides Quarterly

a. Purpose: Review of previous quarter’s performance.

b. Distribution: Submit electronic copies to CO and

PMO

c. Due Date: 7 business days after the end of the quarter

d. Preparation Instructions: Must be compatible with latest version of Microsoft Office.

A002 SAN Log Monthly

a. Purpose: Review of previous month’s Site Arrivals and process all new SANs

b. Distribution: Submit electronic copies to PMO

c. Due Date: 10th business day of each month

d. Preparation Instructions: Must be compatible with latest version of Microsoft Office.

A003 Incident Report Within 24 hours

a. Purpose: Document any security incident or event that may affect the installation or its personnel.

b. Distribution: Post on the CDS and Email notification to 611 ASUS/SFM.

c. Due Date: Immediately, not to exceed 24 hours of incident.

d. Preparation Instructions: Fill out all applicable sections of AF Form 3545.

A004 Emergency Response Plan Annually and within business day of any changes

a. Purpose: Develop a Government approved emergency response plan.

b. Distribution: Post on the CDS and Email notification to PMO

c. Due Date: Initial submittal due by within 60 days following start of first option year. Submit subsequent submittals on first business day of each fiscal year.

d. Preparation Instructions: Must be compatible with latest version of Microsoft Office.

A005 ECMRA Manpower Report Annually

a. Purpose: Purpose: Ensures compliance with Section 2330a of title 10, United States Code (10 USC23301a)

b. Distribution: Submit to http://www.ecmra.mil and provide notification to CO an PM offices

c. Due Date: Data shall be reported no later than 31 Oct for the previous fiscal year

d. Preparation Instructions:

The Contractor is required to completely fill in all required data fields at http://www.ecmra.mil.

Reporting inputs will be for the labor executed during the period of performance for each Government FY, which runs 1 October through 30 September.

Contractors need to direct questions to the CMRA help desk.

A006 Aircraft Arrival/Departure Report Monthly

a. Purpose: Record aircraft support information to include information necessary for billing support agreement agencies.

b. Distribution: Post on the CDS and Email notification to the PMO http://www.ecmra.mil/ http://www.ecmra.mil/

c. Due Date: 10th business day of each month.

d. Preparation Instructions: Report shall be in Microsoft EXCEL format with the following information for each aircraft by date arrived:

Aircraft Owning Agency (e.g. Navy, USMC, USCG, USAF, ATI, etc.)

Prior Permission Request (PPR) Number

Aircraft Unit (e.g. VMFA533)

Aircraft Tail Number (e.g. 164656)

Call Sign (e.g. DIRC23, FEUD 23)

Aircraft Type (e.g. F-18, KC-135)

Mission Number (e.g. CW536)

Number of Aircraft (e.g. 6 for six F-18s, 2 for two

KC-135)

From Location Designator (e.g. PWAK for Wake Island)

To Location Designator (e.g. PHIK for Hickam

AFB)

Date and Actual Time of Arrival (ATA), ZULU (e.g. Sep 30 22:46)

Date and Actual Time of Arrival (ATA), Wake Island local (e.g. Oct 1 10:46)

ATA day of the week (e.g. Monday, Tuesday, etc.)

Date and Actual Time of Departure (ATD), ZULU (e.g. Sep 30 22:46)

Date and Actual Time of Departure (ATD), Wake Island local (e.g. Oct 1 10:46)

ATA day of the week (e.g. Monday, Tuesday, etc.)

Amount of fuel issued in gallons.

Number of PAX on aircraft upon arrival

Number of PAX on aircraft upon departure

Visit purpose/Remarks

Start Time (local time), for Airfield (AF) overtime support by to include: Tower Tech (TT), Aircraft Services Supervisor (AOT), Ground Support (GS), Aircraft Servicer (AS), Fuel Distribution (POL), Liquid Fuels Maintenance, (LFM), Fire Chief (FC), and Fire Fighters (FF).

Stop Time (local time), for Airfield (AF) overtime support.

Number of AF overtime hours expended between start and stop of AF overtime.

Number of airfield (AF) overtime crewpersons (e.g. 6, 5, 3,etc)

Total number overtime hour expended (number of overtime hours multiplied by total number of overtime crewpersons.

Make-Up of overtime crew (e.g. TT, AOT, GS, POL, POL, FC, FF)

Start Time (local time), for Services support overtime support by to include: Admin/Cashier (AD), Dining Hall (DH), Billeting (BD), Transportation (TR) and Other (OT).

Stop Time (local time), for Services support overtime.

Number of Services support overtime hours expended between start and stop of AF overtime.

Number of Services support overtime crewpersons (e.g. 6, 5, 3,etc)

Total number overtime hour expended (number of overtime hours multiplied by total number of services overtime crewpersons.

Total number of overtime hours expended (total number of AF overtime expended, plus total number of services overtime hours expended.

A007 Environmental Release Report Within 24 hours

a. Purpose: Identifies the release of petroleum products and other hazardous materials and substances to the environment. Identifies all corrective actions taken, planned, and subsequently reports all necessary follow- up actions, including final clean-up, and regulatory reporting requirements.

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: As Required: Immediate verbal notification whenever a petroleum product or hazardous substance is released to the environment; written notification within 72 hours of discovery.

d. Preparation Instructions: The immediate verbal notification shall include “Immediate Release Response” information as identified below. Other Environmental Release Report information (Subsequent Response, Release Response Personnel, Release Narrative and Release Related Reports) as applicable shall be reported in follow-on written reports.

Person who discovered release

Time and date of release

Substance or type of fuel released

General location of release

Estimated amount of substance released

Corrective action to prevent further release

Actions taken to collect or remove released substance h. Estimated amount of substance recovered

Assistance required beyond the resources available on-site

Estimated completion time and date of remedial actions k. Known or suspected cause of the release

Weather conditions at the time of discovery?

Weather conditions at the time of release if known.

Environmental damage which has occurred or might reasonably occur to plant life, wildlife, fish, ground water, drinking water, surface water, navigable water, land, or other

Anticipated or actual reaction by news media and public to the incident

Report environmental releases to Federal, State, and Local environmental agencies. This reporting shall be done IAW applicable regulations and this contract. In all cases, the Air Force shall be copied with written regulatory reports.

A008 Authorized Restricted Area Access List Quarterly

a. Purpose: Document all personnel authorized to access restricted areas.

b. Distribution: Post on the CDS and Email notification to 611 ASUS/SFM.

c. Due Date: 10th Business day after close of previous quarter or as changes are made.

d. Preparation Instructions:

This listing will be the basis for PRSC/CC to grant unescorted access to the PL1 RAs. The listing will contain the following information: Full name, SSN, Clearance, and sites authorized RA access.

A009 Security container listing Annually

a. Purpose: Track all security containers on current contract with PRSC.

b. Distribution: Distribution: Post on the CDS and Email notification to 611 ASUS/SFM.

c. Due Date: January 10th of each calendar year.

d. Preparation Instructions: Provide a security container listing by site, with the make/model of the container and the last container inspection date.

A010 Asset Management Plan (AMP) Report

a. Purpose: Obtain data to facilitate Government management of facilities, installed equipment and utility systems life cycle cost. Report will not include scheduled maintenance.

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: 15th of each month

d. Preparation Instructions:

Provide the following data:

Section 1 Repairs Requiring Approval (requirements roll over from month to month/remain on the report until approved by PMO):

Column 1- Month Requirement Entered on Report

Column 2 - Job Order (J/O) Number

Column 2- Work Description (e.g. Repair Overhead Door)

Column 3- Facility Number

Column 4- Estimated Labor Hours

Column 5- Estimated Material Cost

Column 6- Estimated Other Cost

Column 7- Total Estimated J/O Cost

Bottom Row Total Estimate: Total of columns 4-7

2. Section 2 Contractor Completed Emergency Repairs:

Column 1- J/O Order Number

Column 2- Work Description

Column 3- Facility Number

Column 4- Actual Labor Hours

Column 5- Actual Material Cost

Column 6- Actual Other Cost

Column 7- Actual J/O Total Cost

Bottom Row Total Cost for columns 4-7

Monthly

3. Section 3 Running Annual Total of Contractor Completed J/O Repairs (Includes approved J/Os):

Show individual columns with same headings as columns 4-7 in Sec. 2

Show rows beginning with individual monthly headings for the year, e.g.

April, May, June, etc. through Sep.

Show bottom with title of “Totals” with running total for each column.

A011 Scheduled Maintenance Plan Quarterly

a. Purpose: Maintenance of real property and real property installed equipment.

b. Distribution: Post on the CDS and Email notification to the PMO and 611 CES/CEOE.

c. Due Date: 10th business day after close of previous quarter.

d. Preparation Instructions: Must be compatible with latest version of Microsoft Office. Plan shall include all aspects and timing of scheduled maintenance is support of real property and real property installed equipment.

A012 Employee Listing Quarterly

a. Purpose: Provide a listing to 611 ASUS/SF of all employees working under this contract using the Government provided template.

b. Distribution: Post on the CDS and Email notification to the 611 ASUS/SFM

c. Due Date: 10th business day after close of previous quarter.

d. Preparation Instructions: This listing will include the following: Program lead name, Full name of each employee, SSN, Clearance level, and FSO name, phone number, and Email address.

A013 GFE Vehicle Work Report Annually

a. Purpose. Provides vehicle maintenance information.

b. Distribution: Submit electronic copies to PMO

c. Frequency: Annually: Initial submittal due by within 60 days following start of first option year.

Submit subsequent submittals 1 Oct

d. Preparation Instructions: Report format is optional. A separate report shall be submitted for maintenance “actions completed/closed” and for those “started not completed”. Each report shall include a copy of the Contractor developed work order, per vehicle maintenance action, with applicable work order vendor invoices.

At a minimum the Contractor’s work order shall include to the following information as applicable:

1. Vehicle Registration Number

2. Time and date work order was opened

3. Mileage/Hours

4. Description of action performed

5. System codes (Provided by PM)

6. Hours taken to perform action

7. Mechanic number (Provided by the PM)

8. Copy of vendor invoices for all parts purchased for the action performed, per vehicle, not including shop stock items.

A014 Mishap Response Report Within 24 hours

a. Purpose: Document mishaps resulting in damage to Government property and injuries or serious illness to personnel.

b. Distribution: Submit electronic copies to CO and PMO.

c. Due Date: As required. Within 24 hours of event.

d. Preparation Instructions:

Provide the following information:

Date and time of occurrence

Location of mishap (building, area)

Name, grade, age, occupation, and unit of individual(s) involved

Current status of injured persons (bed rest, local clinic, life flight, etc.)

Type of civilian and/or Government property involved: Type, Year, Make, Model, Facility, and Equipment

Damage; total estimated repair cost (labor &

materials)

Description of injuries

Status of individual on duty or off duty

Synopsis of mishap (detailed description of what happened)

Was personal protective equipment required, available and used?

Name of witnesses and employer’s name

Name of individual reporting the mishap

A015 Emergency Response Report As required

a. Purpose: Document all emergency responses

b. Distribution: Submit electronic copies to CO and PM.

c. Due Date: Verbal due within two hours of discovery with written report posted in three calendar days.

d. Preparation Instructions:

Provide the following information:

Date and time of occurrence

Type of occurrence

Cause of incident

Corrective actions taken or required

Equipment red time

Names of personnel involved

Assistance required

Time returned to operational status

Location of emergency

Other pertinent data

b. Preparation Instructions (For Fire Incidents or Hazards):

Prepare initial and follow-up reports and investigations for all fire incidents and/or emergencies on NFIRS and/or DoD Fire Incident Reporting System

(DFIRS) and AFI 32-2001, Fire Emergency Services Program, Attach. 3 and AFI 91-204, Safety Investigations and Reports. Track and report all associated costs.

Prepare and submit Fire and Emergency Services Weapons of Mass Destruction (WMD) Response Notification and Message, Adverse Public Reaction (e.g. Unidentified Substances and Other Potential WMD) IAW AFI 32- 2001, Fire Emergency Services Program, and HQ AFCESA/CEX Fire Protection Headquarters policies.

A016 Covered Wagon Report As Required

a. Purpose: Provide notification of potential hostile events that could affect PL1-PL3 resources.

b. Distribution: Post on the CDS and Email notification to 611 ASUS/SFM.

c. Due Date: Immediately, not to exceed 24hrs.

Provide verbal summary of the event to the Alaska Regional Air Operations Control Center (RAOC) Mission Crew Commander (MCC) or designated representative and 611 ASUS/SFM. Include date, time, location, personnel status and mission impact of event (building, area).

Report unannounced alarms that cannot be immediately visually assessed and provide the 611 ASUS/SFM with an estimated response time for Contractor personnel to visually assess the resource and determine the cause of alarm.

Request termination of the Covered Wagon report through the RAOC to PRSC/CC.

Follow up Covered Wagon reports with a written report on AF 3545, Incident Report, by the close of the following business day. NOTE: Include the Covered Wagon Number provided by the RAOC

MCC.

A017 Criminal Incident Report As Required

a. Purpose: Record facts about an incident or complaint for the proper military authority.

b. Distribution: Post on the CDS and Email notification to 611 ASUS/SFM.

c. Due Date: Immediately, not to exceed 24 hours.

d. Preparation Instructions:

Complete AF Form 3545A, Incident Report. The use of the AF Form 3545A is mandatory for all incidents which are reportable under the DoD 7730.47, Defense Incident Based Reporting System (DIBRS), National Incident Based Reporting System (NIBRS) and Federal Bureau of Investigation (FBI) Uniform Crime Reporting Handbook. Include in the report all available facts, names of personnel involved and a summary of the initial on- scene investigation. For additional information, refer to AFI 31-203, Security Forces Standards and Procedures

A018 Classified Security Incident Report As required

a. Purpose: Document any security incident(s) involving classified material.

b. Distribution: Post on the CDS and Email notification to 611 ASUS/SFM.

c. Due Date: Immediately, not to exceed 24 hours.

d. Preparation Instructions: Provide as applicable and available, information required in blocks 1-14 of DD Form 1569, Incident/Complaint Report. Use of DD Form 1569, Incident/Complaint Report is optional, Contractor may use Contractor-developed form to report applicable/available information.

A019 Weapons Safety Plan

a. Purpose: Provide a comprehensive plan for the weapons safety program.

b. Distribution: Post on the CDS and Email notification to PMO.

c. Due Date: Initial submittal due by within 60 days following start of first option year. Submit subsequent submittals on 1 Oct.

d. Preparation Instructions: Provide in a Microsoft office compatible format.

Annually

A020 Bird Depredation Reporting: As required

a. Purpose: Reporting requirement for USFWS and state permits (where applicable) for the take of migratory birds for BASH safety.

b. Distribution: Post on the CDS and Email notification to PMO

c. Due Date: As required

d. Preparation Instructions: As Required by BASH Permit.

A021 Inspection Report Quarterly

a. Purpose: Report findings and corrective action plans for self-inspection and Government QA inspection deficiencies.

b. Distribution: Post on the CDS and Email notification to PMO and CO

c. Due Date: 10th business day after close of previous quarter.

d. Preparation Instructions:

The following shall be provided and organized by facility:

1. Part A: Quarterly Audit and Self inspections.

Report shall contain results from all self-inspections accomplished during the quarter.

2. Part B: Corrective Action Reports--Open Deficiencies. Report shall address all self-inspection and Government QA deficiencies reported in previous quarters which remain open.

Open deficiencies will include information showing progress towards correcting the deficiency, expected completion date (ECD), and if the ECD has changed, an explanation on the reason for the change.

3. Part C: Corrective Action Reports--Closed Deficiencies. Report shall address all previously open deficiencies which were closed during the quarter. Include date closed and the final actions taken to close the deficiency. Note: Deficiencies identified by a COR are not officially closed until validated by a COR.

A022 Diesel Generator/Alternator Report Monthly

a. Purpose: Tracking of generator use and maintenance.

b. Distribution: Post on the CDS and Email notification to the PMO and 611 CES/CEOFP

c. Due Date: 10th business day after close of previous month.

The report should be formatted, with latest version of Microsoft Office.

By unit, report the following (include primary and emergency units):

a. The total hours operated during the calendar month covered.

b. Total engine hours accumulated since the unit was installed.

c. Total maintenance hours expended during the month performing maintenance.

d. Detailed maintenance actions completed during the month.

e. The number of gallons of lubricating oil between oil changes, and the amount of oil used.

f. List by nomenclature and quantity the parts used, estimated re-supply date, and date replacement took place.

g. List date, time and duration of all power failures, bus affected and whether the failure was partial or complete.

h. Provide the laboratory analysis of the diesel engine lubrication oil on all oil analysis' performed during the month covered.

i. For the power plant, report the following:

j. Number of operational units, dead lined units, detail reasons units are dead lined, date dead lined, and estimated repair date.

k. Kilowatt (KWH) hours generated by each plant.

l. Gallons of fuel consumed for the entire plant. If no fuel oil meters are installed, estimate the fuel consumption by dividing the KWH generated by

10. Identify this quantity as an estimate in the report.

m. The KWH per gallon of fuel consumed. Report as a plant average, except when KWH and fuel meters are installed on each unit. If fuel consumption was estimated (above), do not list KWH per gallon of fuel consumed.

n. The maximum and minimum demands sustained for a 15-minute period during the month covered.

o. The average demand generated by the plant.

A023 Operational Status Report Monthly

a. Purpose: Monthly status of real property and real property installed.

b. Distribution: Post on the CDS and Email notification to the PMO and 611 CES/CEOE

c. Due Date: 10th business day after close of previous month.

d. Preparation Instructions:

1. List of all Recurring Work Program tasks accomplished during the previous month.

2. Provide a list of uncompleted recurring work program tasks and estimated completion date.

3. Operational status of fire protection systems including date of last test and test results, repairs made to the system, and estimated repair date. Test results shall include the following:

a. Periodic inspection and test results for fire alarm systems as described in NFPA 72 and 72E.

b. Periodic inspection and test results for carbon dioxide (CO2) fire extinguishing systems as described in NFPA 12.

c. Periodic inspection and test results for Halon 1301 fire extinguishing systems as described in

NFPA 12A.

d. Periodic inspection and test results for sprinkler systems as described in NFPA 13A.

e. Periodic inspection and test results for standpipe and hose systems as described in NFPA 14.

f. Inspection, maintenance, recharging, and test results of dry chemical and wet chemical fire extinguishing systems as described in NFPA 17 and NFPA 17A.

A024 Energy Management and Utility Consumption Report

Monthly

a. Purpose: Status of utility usage.

b. Distribution: Post on the CDS and Email notification to the PMO and 611 CES/CEN

c. Due Date: Initial submittal due by within 60 days following start of first option year. Submit subsequent submittals last Friday of each month.

d. Preparation Instructions:

Provide the following data in Microsoft EXCEL:

Section 1: Energy Management

Fuel consumption by system (e.g., power plant, vehicles, boilers, etc.).

The number of heat degree-days for each month.

The information in this section shall be based on the last day of each month.

2. Section 2: Utility Consumption

Customer

Meter number

Multiplier

Date meter readings/estimates were taken/made

Prior month’s meter reading and/or estimated utilities consumed (for each utility)

Current month’s meter reading and/or estimated utili each utility)

Total consumption used for each metered utility

3. Section 3: Installation Utilities

Utility

Meter number

Multiplier

Date meter readings/estimates were taken/made

Prior month’s meter reading and/or estimated utilities consumed (for each utility)

Current month’s meter reading and/or estimated utilities consumed (for each utility)

Total consumption used for each metered utility

A025 Hazardous Waste Generation Report Monthly

a. Purpose: Provide inventory of all hazardous waste.

b. Distribution: Post on the CDS and Email notification to the PMO and 611 CES/CEN

c. Due Date: Initial submittal due by within 60 days following start of first option year. Submit subsequent submittals the 10th Business day of each month

d. Preparation Instructions:

Provide data in spreadsheet format. Provide a complete and accurate inventory of all hazardous waste present on site. Inventory shall include:

Type of waste and quantity in pounds

Type of container

Accumulation Start Date

Container number

Number of containers per waste stream

Date sampled

A026 Pollution Prevention Metrics Report Monthly

a. Purpose: HQ PACAF requires this metric for HQ Air Force information IAW Executive Order 12088

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: Initial submittal due by within 60 days following start of first option year. Submit subsequent submittals 10th Business day of each month

d. Preparation Instructions:

The following metrics are required to be submitted on a quarterly basis:

EPA 17 industrial toxins on-hand and for which purpose they’re used

Ozone depleting chemicals. Class I on-hand to include line items and quantity.

Hazardous Waste generated (Types + Quantity) + shipped (Types + Quantity).

Pollution Prevention Non-Hazardous Solid Waste Measure of Merit.

A027 CAP CLIN Expenditure Report Monthly

a. Purpose: Support the Government’s ability to validate expenditures for parts and materials.

b. Distribution: Post on the CDS and Email notification to the PM and CO.

c. Due Date: Initial submittal due by within 60 days following start of first option year. Submit subsequent submittals 10th business day of each month.

Submit as EXCEL Spreadsheet:

Part 1 (CAP CLIN Expenditure report)

Columns:

Order Date

Received Date

Item Description e.g. barrier fan belt

Job/Work Order Tracking Number

Work Location e.g. Bldg. Nbr

Quantity Ordered

Cost Each

Quantity Cost

Other Cost e.g. freight

Total Cost

2. Rows:

Enter heading listed information for job order items ordered. List all items received which will be invoiced for payment in same month.

Last row title as “Monthly Total” and with totals of columns 6-10.

3. Tabs:

Provide a spreadsheet tab for each month of the year

Each tab will contain the monthly expenditure data, June tab will have June data, July tab will have July data.

Include a thirteenth tab titled as “Yr Total”. This tab will include the “Monthly Total” row of each monthly submittal. List monthly totals in order from Oct thru Sep with rows 6-10 being total

Part 2 (GFP report)

Note: Only applicable if unit acquisition cost is $5,000 or more

Submit as EXCEL Spreadsheet, separated into 4 tabs (Contract information, Serially Managed items, Non-serially managed items, and Requisitioned items). Label each tab by month as well (eg. July Contract information tab). Include a “Yr” tab that is a total for the fiscal year.

Contract Information tab:

a. Contract Number

b. Contract Name

c. Contractor DoDAAC (IAW AFI 24-230)

d. Contract Start Date

e. Contract Expiration Date

f. Contractor Address

g. Contractor City

h. Contractor State or Country

i. Contractor Zip Code

j. Contractor POC

k. Contractor POC Phone

l. GP Classification (DoD 4000.25-2-M AP2)

Serially Managed Items tab:

a. Item Line Number

b. Item Name

c. Item Description

d. National Stock Number

e. Manufacturer CAGE

f. Part Number

g. Model Number

h. Serial Number

i. Unique Item Identifier

j. Item Quantity

k. Unit of Measure

l. Unit Acquisition Cost

m. Use As-Is (Serviceable/Unserviceable)

n. Delivery Date (CCYY-MM-DD format)

o. GFP/CAP ID Number

Non-Serially Managed Items tab:

a. Item Line Number

b. Item Name

c. Item Description

d. National Stock Number

e. Manufacturer CAGE

f. Part Number

g. Model Number

h. Item Quantity

i. Unit of Measure

j. Unit Acquisition Cost

k. Use As-Is (Serviceable/Unserviceable)

l. Delivery Date (CCYY-MM-DD format)

m. GFP/CAP ID Number

Requisitioned Items tab:

a. Item Line Number

b. Item Name

c. Item Description

d. National Stock Number

e. Manufacturer CAGE

f. Part Number

g. Item Quantity

h. Unit of Measure

i. Unit Acquisition Cost

j. Use As-Is (Serviceable/Unserviceable)

k. GFP/CAP ID Number

A028 Man-day Accounting Report Monthly

a. Purpose: Support the Government’s ability to audit/validate the number of man- days and support-days. Provided report showing all man-days/support-days provided to include but not limited to all categories of visitor’s (e.g. ISSA visitors, non-ISSA DoD visitors, Third Party Contractors, etc.)

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: Initial submittal due 60 days following start first option year. Submit subsequent submittals 10th business day of each month.

d. Preparation Instructions:

Part I: Man-days–Provide the following information, in separate columns, for each individual:

Last name, First name

Date arrived

Date departed

Organization or Agency (Navy, MDA, PRSC, etc.

Organization’s billing address

Mission (PPR -02-09MA, FTO-01, QAE, etc.

Total number of day’s member stayed for the month

Daily rate charged

Document must be signed and verified by the Station Chief or Services Manager

Total hours to complete the job

A029 ISSA Support Cost Report Monthly

a. Purpose: Support the Government’s need to track agencies supported in Appendix 1,2, and 3.

Provide the monthly cost for differing types of support by month, by quarter and for the year.

Yearly total being a running total.

b. Distribution: Post on the CDS and Email notification to the PMO.

c. Due Date: Initial submittal due 60 days following start first option year. Submit subsequent submittals 10th business day of each month.

d. Preparation Instructions:

In Excel spreadsheet provide the monthly cost for types of ISSA support by month, by quarter and for the year. Yearly total being a running total.

List the following types of ISSA support in rows:

Row 1 - Aerial Port Operations

Row 2 - Airfield Management

Row 3 - Shuttle

Row 4 - Fuels/labor

Row 5 - Weather

Row 6 - Transient Alert

Row 7 - Vehicle Maintenance

Row 8 - Fire Support(Disaster-contingency)

Row 9 - Grounds/Roads

Row 10 - Heat/Boiler

Row 11 - Electrical

Row 12 - Water/Waste Water

Row 13 - Seawall/Barge/Dock Maintenance

Row 14 - Security

Row 15 - G & A Fees & Profit

Row 16 - Contractor Directed Travel &

Training

Row 17 - Communications

Row 18 - Transportation (shipping &

packing)

Row 19 - Entomology

Row 20 - Environmental Cleanup

Row 21 - Custodial Fees (common areas)

Row 22 - Maintenance/Repair

Row 23 - Environmental Compliance

Row 24 - Maintenance (MDA Direct Support)

Row 25 - Health/Medical

Row 26 - Mail Services

List months of the year in columns each with a sum total for the month for all types of ISSA support, at the bottom of the column. After the third, month of each quarter provide a column with quarter’s total. After the fourth quarter, provide a column totaling all quarter totals for a running annual total.

A030 Aircraft Arresting BAK-12 Report Quarterly

a. Purpose: Provide barrier certification and maintenance information and status. Reference AFI 32-1043, Managing, Operating, and Maintaining Aircraft Arresting Systems.

notification to the PMO

c. Due Date: 10th business day following the close of the previous quarter.

d. Preparation Instructions:

Submit the following System Data information in Microsoft WORD or EXCEL table format.

Due date of next required certification engagement

Monthly Brake Wear

Tape to reel clearance

Pendant support

Date Complied With

Date Due

A031 Hazardous Materials Inventory Report Quarterly

a. Purpose: Provides inventory of all on site hazardous materials

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: 10th business day following the close of the previous quarter.

d. Preparation Instructions:

Report hazardous materials inventory IAW 40 CFR 370. The following shall be provided and organized by facility:

Trade name, chemical name, or common name, as applicable, of each substance inventoried

Amount present, and size of each container

Name of manufacturer

Manufacturer-specific MSDS identification number

Ozone depleting chemicals (Class I) on-hand to include line items and quantity

For any unmarked containers or unknown substance: sample date, and date analysis results are expected

Refrigerant use

Location and type of equipment (make, model, serial number) using refrigerants

Amount of refrigerant or removed–running annual total

Amount of new, used and contaminated refrigerant

A032 Landfills and Effluent Summary Report Quarterly

a. Purpose: Ensure landfills and effluents are in operated and inspected in accordance regulatory and approved permit requirements. Ensure individual monthly reports are established as required by regulatory and approved permit requirements.

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: 10th business day following the close of the previous quarter.

d. Preparation Instructions:

Obtain and provide the following information for each location and inspection:

Asbestos and Inert Landfill: inspections and reports on:

Ambient temperature

Wind direction

Precipitation falling (yes or no)

Estimated snow depth

Evidence of settlement or frost jacking within landfill (yes or no)

Evidence of discolored vegetation within or surrounding the landfill (yes or no)

Evidence of unauthorized excavations within or surrounding the landfill (yes or no)

Evidence of windblown litter within landfill (yes or no)

Evidence of odors from the landfill (yes or no)

Condition of landfill gate, barricades and restrictive structures designed to prohibit unauthorized landfill entry (poor, fair, or good)

Conditions of signs identifying landfill area (poor, fair, or good)

Dates of random inspections

Results of random inspections to include Governmental notifications.

General comments

2. Pollution Prevention: Provide following status:

All EPA-17 Target Chemicals purchased.

The weight of all Municipal Solid Waste (MSW) generated.

The weight of MSW recycled.

The weight of MSW disposed.

The weight of MSW before incineration.

The weight of MSW composted.

Hazardous waste generated.

3. Environmental Permits: Provide status report to include a comprehensive list of all environmental permits indicating:

Permit issue date

Permit expiration date

Current compliance status with respect to individual permits: In Compliance/Out of Compliance

Samples required/taken and status of results: In Compliance/Out of Compliance

4. Landfill Operations Summary, tallied by monthly inputs to include quantity of wastes placed in landfill broken out by type (solid, sewage sludge, asbestos, construction and demolition debris, incinerated ash, etc.)

5. Waste Water Summary to include date and results of required influent/effluent samples.

A033 Bird Monitoring Report Quarterly

a. Purpose: Ensure the collection of data on the Wake Island biodiversity and assist the Air Force in accomplishing tasks prescribed in the Wake Atoll INRMP

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: 10th business day following the close of the previous quarter:

d. Preparation Instructions:

In Microsoft or Adobe format provide current existing information on breeding and reproductive success of seabird populations.

A034 Base Civil Engineering Cost Report, HAF-

PRE(A)

Annually

a. Purpose: Annual cost tracking for Civil Engineering expenditures.

b. Distribution: Post on the CDS and Email notification to the PMO and 611 CES.

c. Due Date: Post no later than the 25th day of the each November, after start of first option year.

d. Preparation Instructions:

PART A:

Report for each installation shall be forwarded in two copies to the CO. The report shall include data for the following detail accounts, as applicable:

CAC DESCRIPTION

21010 Purchased Electricity

23010 Heating Plant Operation, 3,500,000 or greater Mil BTUH capacity 23020 Fuel Oil Issued (Plant Operations over 3,500,000 Mil BTUH) 26000 Electric Generating Plants (Prime)

42000 Refuse Collection and Disposal

44000 Entomology Services

48000 Fire Protection

49000 Other Services

50100 Contractor Maintenance, other than utilities

53010 Maintenance Prime Power

53015 Maintenance Power Transmission

53020 Maintenance Heat System, 3,500,000 or greater Mil BTUH 53030 Maintenance Heat System, hot water distribution lines 80010

Minor Construction

99999 Total

A035 Real Property Report Annually

a. Purpose: Provides updated site-specific information for use by the Government in evaluating future site requirements and verifying real property records and systems

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: Annual: post not later than the 15th day of the each September, after start of first option year.

d. Preparation Instructions:

In Microsoft format provide line item summary identifying changes and/or additions to real property.

A036 Toxic Release Inventory (TRI) and Emergency Planning & Community Right to Know (EPCRA) Report

Annually

a. Purpose: Complies with the Emergency Planning and Community Right-to-Know Act (EPCRA) including the TRI.

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: Annual: post not later than the 25th day of the each May, after start of first option year.

d. Preparation Instructions:

Provide information IAW TRI EPCRA Sec. 311- 313.

A037 Air Quality Facility Monitoring Report Annually

a. Purpose: Complies with Federal and or State Air Monitoring Requirements.

b. Distribution: Post on the CDS and Email notification to the PM, 611CES and CO.

c. Due Date: Semi-Annual and Annual, as required by permit, after start of first option year.

d. Preparation Instructions: As required by permit.

A038 Air Quality Annual Compliance Certification Report

Annually

a. Purpose: Complies with Federal and or State Air Monitoring Requirements

b. Distribution: Post on the CDS and Email notification to the PMO, 611CES and CO.

c. Due Date: as required by permit, after start of first option year.

d. Preparation Instructions: As required by permit.

A039 Quality Control Plan

a. Purpose: Quality Control Plan (QCP) describes the inspection system to cover all services identified in the PWS

b. Distribution: Post on the CDS and Email notification to the PMO, 611 ASUS/QA and CO.

c. Due Date: 1 Oct

d. Preparation Instructions: A description of the methods to be used to identify, prevent, and eliminate recurrence of defective services.

The quality control program shall be designed to promptly detect and correct conditions which adversely affect quality. To be acceptable, corrective action plans shall include as a minimum:

1. Analysis of data and records to determine the extent and cause of non-conformance. The Contractor will use Root Cause Analysis as outlined in QCP.

2. Recording and analysis of trends in the performance of work under the contract to provide early detection and prevention of non-conformance.

3. Introduction of required improvements and corrections, to include an initial review of the adequacy of such measures and monitoring of the effectiveness of corrective action taken.

A040 Planned Work Report

a. Purpose: Provide a report for all direct scheduled work and planned direct scheduled work for the previous month.

b. Distribution: Post on the CDS and Email notification to the PMO and CO.

c. Due Date: 10th business day following the close of the previous quarter:

d. Preparation Instructions: In Contractor’s format, listing of all direct scheduled work and Planned Direct Scheduled Work performed for the previous month by site:

1. Facility Number

2. Facility Title

3. Scope of project (e.g. replace window)

4. Approved 332 number (if required)

5. Year requested and approved

6. Comments

7. Total Amount (transportation, labor, materials) 7A. Amount expended (by month and year to date) 7b. Amount remaining

A041 Phase-In Plan

a. Purpose: Provide a plan that allows for an orderly and expeditious contract changeover.

b. Distribution: Post on the CDS and Email notification to the PMO and CO.

c. Due Date: 90 days after start of phase-in period.

d. Preparation Instructions

1. The ability to preposition, store and transport all Contractor equipment, personnel and supplies.

2. A joint inventory of Government furnished equipment shall be conducted with incoming Contractor, outgoing Contractor, and the Government.

3. A joint assessment of all Government Property/Facilities shall be conducted with the incoming Contractor, outgoing Contractor, and the Government.

As Needed

A042 Phase-out Plan

a. Purpose: Provide a plan that allows for an orderly and expeditious contract changeover.

b. Distribution: Post on the CDS and Email notification to the PMO and CO

c. Due Date: 48 months prior to end of period of performance

Preparation Instructions:

1. The ability to preposition, store and transport all Contractor equipment, personnel and supplies.

2. A joint inventory of Government furnished equipment shall be conducted with incoming Contractor, outgoing Contractor, and the Government.

3. A joint assessment of all Government Property/Facilities shall be conducted with the incoming Contractor, outgoing Contractor, and the Government.

A043 Snow Removal Plan

a. Purpose: Provide a plan for prevention and removal of snow and ice of EAS and King Salmon.

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: Post no later than 1 Oct each year

d. Preparation Instructions: Identify all buildings/roads/flightlines/taxiways/etc that will require snow and ice removal and identify priority.

A044 Electrical Systems Maintenance Plan

a. Purpose: Ensure all generators, associated switch gears, and components are operated, maintained, and repaired per manufacturer’s recommendations.

notification to the PMO.

c. Due Date:

d. Preparation Instructions: In Microsoft Office, develop an electrical systems maintenance plan, that defines the maintenance tasks, when those tasks are to be performed or frequency for all the equipment, and systems per manufacturer’s recommendations.

A045 Hazardous Waste Management Plan

a. Purpose: Ensure compliant management and minimal requirement for hazardous materials.

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: Post no later than 1 Oct each year

d. Preparation Instructions: Provide procedures for handling, storage, inventory, disposal and minimization of hazardous material requirements and local purchase of hazardous materials.

A046 Fuels Management Maintenance Plan

a. Purpose: Ensure all maintenance for fuel system is IAW TO 37-1-1, UFC3-460-03, and UFC3-460- 01.

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: 180 days after phase-in period begins and within 180 days after any reference change/update.

d. Preparation Instructions: Plan shall include all aspects and timing of maintenance of the fuels management system.

A047 Travel Accounting Report Monthly

a. Purpose: Support the Government’s ability to validate the number of Contractor passenger tickets and expenses to EAS and WI.

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: 10 business day of each month.

d. Preparation Instructions

Part I:

-Travel “Future Month”– List the following information for each individual traveling the next future month (i.e. current report for Oct, travel data for Nov):

-Last names, First name

Travel Route Entry (as applicable): JBER/JBPHH to EAS or WI

Travel Route Entry (as applicable): EAS or WI to JBER/JBPHH

Reimbursement Amount/Tickets

Number of bags (e.g. $114 expense charge for each bag over two bags)

Reimbursement Amount Bags

Departure Date

Arrival Date

“Monthly Total Line” (bottom of Part 1): Total number of tickets purchased, reimbursement amount for tickets and bags.

Part II:

Travel “Previous Month”– List the following information for each individual who did not travel as programmed in Part I.

Last name, First name

Travel Route Entry (as applicable): JBER/JBPHH to EAS or WI

Travel Route Entry (as applicable): EAS or WI to JBER/JBPHH

Provided Reimbursement Amount Tickets

Number of bags (e.g. $114 expense charge for each bag over two bags)

Provided Reimbursement Amount Bags

Programmed Departure Date

Programmed Arrival Date

“Monthly Total Line” (bottom of Part II): Total number of tickets purchased and not used, reimbursement amount for tickets and bags purchased but not used.

A048 Hazardous Waste Generation Report

a. Purpose: Provide inventory of all hazardous waste or incursions of toxic/hazardous waste.

b. Distribution: Post on the CDS and Email notification to the PMO

c. Due Date: 10 business day of each month.

d. Preparation Instructions: Provide date in spreadsheet format. Provide a complete inventory of hazardous waste present on it. Inventory shall include:

1. Type of waste and quantity in pounds

2. Type of container

3. Accumulation Start date

4. Container number

5. Number of containers per waste stream

6. Date sampled