A003_Contractor's_Monthly_Status_Report.pdf

DD FORM 1423-1, Feb 2001 Previous editions are obsolete Page of Pages

17. PRICE

GROUP

18. ESTIMATED

TOTAL PRICE

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved

OMB No. 0704-0188

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget. Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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

TANKS, COLLAPSIBLE, FUEL

10,000, 50,000, & 210,000 U.S.

GALLONS

E. CONTRACT/PR NO.

FD2060-14-30126

F. CONTRACTOR

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

Contractor’s Progress, Status, and Management Report

3. SUBTITLE

Monthly Status Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80227

5. CONTRACT REFERENCE

SOW para 3.1.3

6. REQUIRING OFFICE

AFLCMC/WNZEB

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

Mthly

12. DATE OF FIRST SUBMISSION

5th of First Month ARO

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

11. AS OF DATE

BLK 13

13. DATE OF SUBSEQUENT

SUBMISSION

5th of the Month

DRAFT FINAL

Reg Repr o

16. REMARKS

BLK 4: Contractor format acceptable. Shall be submitted by the 5th of the first month after receipt of order for approval. Approval required for first submittal only.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests for this document shall be referred to AFLCMC/WNZEB.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Documents shall be submitted via e-mail to:

Support Equipment & Vehicles Division

ATTN: AFLCMC/WNZEB

235 Byron Street, Suite 19A Robins AFB GA 31098-1813 e-mail: william.likos@us.af.mil

Notification of submission shall be provided to the PCO via e-mail.

AFLCMC/

WNZEB 0 2 0

15. Total 2

G. PREPARED BY

H. DATE

I. APPROVED BY J. DATE

mailto:william.likos@us.af.mil 1287748988C Typewritten Text A003

1287748988C Typewritten Text 07/22/2015