PHAP_CDRL_A004.pdf

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Psychological Health Advocacy Program Services
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FA664319RA003
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CDRL A004

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DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

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

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

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page of Pages

1_DATA_ITEM_NO: A004
2_TITLE_OF_DATA_ITEM: CONFERENCE MINUTES

CONTRACTOR’S PROGRESS AND STATUS REPORT

3_SUBTITLE: NA
4_AUTHORITY_Data_Acquisit: DI-ADMN-81250B
5_CONTRACT_REFERENCE: PWS 1.4.14
6_REQUIRING_OFFICE: AFRC/A1R Yellow Ribbon
7_DID_250_REQ:
8_APP_CODE:
DIST_STATEMENT: A
10_FREQUENCY: Bi Weekly
11_AS_OF_DATE:
12_DATE_OF_FIRST_SUBMISSI: See Block 16
13_DATE_OF_SUBSEQUENT_SUB: See Block 16
addressee1: CO
draft1: 1
reg1: 1
repro1:
addressee2: COR
draft2: 1
reg2: 1
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total_draft: 2
total_repro: 0
16_REMARKS: The contractor shall record all teleconference minutes. The Government will participate in the teleconference and the Contractor shall forward recorded minutes within five days after the teleconference.

1. Reference documents: None. 2. Format. Contractor format is acceptable. 3. Content. The minutes shall include the following information: a. A title page containing the following: (1) Title – type of meeting and date. (2) Identification of the acquisition (system, equipment, contract number) for which the meeting was held. (3) Space for signatures of the designated representatives of the contractor and acquisition activity. (4) The name of the contractor and address to which the acquisition activity should acknowledge receipt of comments. b. The purpose and objective of the conference. c. The conference location. d. A summary of the discussions, decisions, agreements reached, and directions of the conference or individual subcommittees thereof. e. A list of attendees by name, rank, grade or position, activity represented, activity symbol/code, phone numbers, and emails, as appropriate. f. Action items resulting from the conference. g. Briefing charts, if presented, shall be attached to the minutes for information only. End of DI- ADMN-81250B

Block 12 - 14 Days ARO.

Block 13 - Subsequent submissions will occur 14 days after each previous submission.

17_PRICE_GROUP:
ESTIMATED_TOTAL_PRICE:
G_PREPARED_BY:
H_DATE:
1_APPROVED_BY:
J_DATE: 10 June 2019
Page: 1
reg38t: 2
A_CONTRACT_LINE_ITEM_NO: 0001
B_EXHIBIT: NA
TDP:
TM:
OTHER: NA
DSYSTEMITEM: CONFERENCE MINUTES
E_CONTRACTPR_NO: F5BFDP9155AW01
FCONTRACTOR: Goldbelt Glacier Health Services
of_pages: 1
Reset:
2019-06-10T10:57:23-0400
HARRIS.DANTHONY.TEON.1286867770
2019-06-10T11:59:18-0400
HILL.MARY.Z.1068819560

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