PHAP_CDRL_A006.pdf

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Psychological Health Advocacy Program Services
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FA664319RA003
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CDRL A006

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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: A006
2_TITLE_OF_DATA_ITEM: CRISIS MANGEMENT PLAN
3_SUBTITLE: NA
4_AUTHORITY_Data_Acquisit: DI-MGMT-80004A
5_CONTRACT_REFERENCE: PWS Para. 1.4.4
6_REQUIRING_OFFICE: AFRC/A1R Yellow Ribbon
7_DID_250_REQ:
8_APP_CODE:
DIST_STATEMENT: A
10_FREQUENCY: 1 TIME
11_AS_OF_DATE: 10 DADO
12_DATE_OF_FIRST_SUBMISSI: See Block 16
13_DATE_OF_SUBSEQUENT_SUB: NONE
addressee1: CO
draft1: 1
reg1: 1
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16_REMARKS: The Contractor shall establish written protocol for addressing crisis and/or emergency situations about the population being served. Crisis Management Plan should take into account all identified problem areas and suggest possible solution for personnel involved. Contractor shall ensure the plans are realistic and resolve the issues of personnel seeking help.

See PWS Section 1.4.4 Crisis Management for full details.

All written guidelines will comply with DI-MGMT-80004A. The following sections of DI-MGMT-80004A applies:

DID Para 2 a-e DID Para 3.5 a & b DID Para 3.6 a & b DID Para 3.7 a-c

Block 12: Crisis Management Plan will be requested at the Post Award meeting. One Time Deliverable. Finalized after approval of Gov.

Submittal of the plan will be electronically or written. Acceptable electronic formats are:

Microsoft Word 2003, Microsoft Excel 2003, Microsoft Power Point 2003, and Microsoft Project 2003, or other formats agreed to by the FAA. Hard copies may delivered if necessary

Report to be delivered 30 days ARO. Comprehensive Crisis Management Report detailing the the initial crisis, the follow ups, and final disposition. The plan should include an outline of all steps taken to mitigate crisis situation from the initial intake to the point of referral.

17_PRICE_GROUP:
ESTIMATED_TOTAL_PRICE:
G_PREPARED_BY:
H_DATE:
1_APPROVED_BY:
J_DATE:
Page: 1
reg38t: 2
A_CONTRACT_LINE_ITEM_NO: 0001
B_EXHIBIT: NA
TDP:
TM:
OTHER: NA
DSYSTEMITEM: HQ AFRC/A1R Yellow Ribbon
E_CONTRACTPR_NO: F5BFDP9155AW01
FCONTRACTOR: Goldbelt Glacier Health Services
of_pages: 1
Reset:
2019-08-07T13:21:36-0400
HARRIS.DANTHONY.TEON.1286867770
2019-07-30T15:24:11-0400
HILL.MARY.Z.1068819560

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