Atch 5 -CDRL A001 - A007 Combined.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

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 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

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER __MGMT__

D. SYSTEM/ITEM

TCC-FSR

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

TCC Monthly Status Report

3. SUBTITLE

Monthly Status Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A

5. CONTRACT REFERENCE

SOW Paragraph 11.1

6. REQUIRING OFFICE

SOF AT&L-SR/TCC

7. DD 250 REQ

LT

9. DIST

STATEMENT

B

10. FREQUENCY

MTHLY

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16 Draft

Final Reg Repro

16. REMARKS

BLK 4 DID: Contractor format.

In accordance with 5652.242-9002, list contractor employees who departed during the previous month and the date their CACs were returned to the government.

Employee Name Contract Number TO Number Company Name HQ USSCOM Office Symbol TA Name Termination Date Date CAC returned to RAPIDS Site Remarks

BLK 7: Letter of Transmittal only

BLK 9: Distribution authorized to US Government Agencies only (Proprietary Information).

BLKS 11, 12 & 13: Monthly status report shall be delivered no later than the 10th of the following month of performance.

BLK 14: E-mail to the TCC-FSR Contracting Officer and the appointed Contracting Officer's Representative (COR).

SOF AT&L-KH 1

SOF AT&L-SR 1

15. TOTAL ---------→ 0 1 0

G. PREPARED BY

Graybill, Jerry

H. DATE

07/28/2021

I. APPROVED BY J. DATE

08/18/2021

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page _1_ of _8_ Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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 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

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER __MGMT__

D. SYSTEM/ITEM

TCC-FSR

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

TCC-FSR Monthly Technical Report

3. SUBTITLE

Monthly Technical Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A

5. CONTRACT REFERENCE

SOW Paragraph 11.2

6. REQUIRING OFFICE

SOF AT&L-SR/TCC

7. DD 250 REQ

LT

9. DIST

STATEMENT

B

10. FREQUENCY

MTHLY

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16 Draft

Final Reg Repro

16. REMARKS

BLK 7: Letter of Transmittal only

BLK 9: Distribution authorized to US Government Agencies only (Proprietary Information).

BLKS 11, 12 & 13: Monthly technical report shall be delivered no later than the 10th of the following month of performance on the appropriate network (NIPR/SIPR).

BLK 14: E-mail to the TCC-FSR Contracting Officer and the appointed Contracting Officer's Representative (COR).

SOF AT&L-KH 1

SOF AT&L-SR 1

15. TOTAL ---------→ 0 1 0

G. PREPARED BY

Graybill, Jerry

H. DATE

07/28/2021

I. APPROVED BY J. DATE

08/18/2021

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page _2_ of _8_ Pages

18. ESTIMATED

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 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

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER __MGMT__

D. SYSTEM/ITEM

TCC-FSR

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

Government Property Report

3. SUBTITLE

CAP Reporting

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80441D

5. CONTRACT REFERENCE

SOW Paragraph 8.5

6. REQUIRING OFFICE

SOF AT&L-SR/TCC

7. DD 250 REQ

NO

9. DIST

STATEMENT

D

10. FREQUENCY

MTHLY

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

30 Days Post Award

13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16 Draft

Final Reg Repro

16. REMARKS

The Contractor shall provide a Contractor Acquired Property report for all CAP items acquired and associated with the base IDIQ contract as directed by the KO. The report shall be further detailed by Government Property classification (i.e. Equipment, Material, Special Test Equipment and Special Tooling) on separate tabs of the spreadsheet. The report shall be delivered, in accordance with SOW Section 12, electronically in a spreadsheet that is .xls or .xlsx compatible and in a structured order so that spreadsheet can be sorted and/or filtered. The report cannot be scanned or faxed.

The contractor shall include the contractor purchase order number as supporting documentation for every item, to include at the task order level. The contractor will provide the contractor purchase order as requested.

The report shall include the following fields for the base IDIQ but can be tailored for each individual Task Order to meet the customer's needs:

a. Contract Number

b. Contract Name

c. Commercial/Government Entity Code (CAGE)

d. Contractor DoDAAC (IAW AFI 24-230)

e. Serial Number (if applicable)

f. UII (if applicable)

g. Item Name(Nomenclature)

h. Stock Number (NSN)

i. Part Number

j. Total Quantity

k. Unit of Issue (e.g. EA, PR)

l. Unit Acquisition Cost

m. Date placed in Service (PGI 245.402-70)

n. Condition Code

o. Government Property Classification (DoD 4000.25-2-M AP2)

p. Contract Line Item # for delivered CAP

q. Federal Supply Class (FSC)

r. Controlled Inventory Item Code (CIIC)

s. Demilitarization (DEMIL) Codes

t. Useful Life “Useful Life” data is only required for Capitalized assets that are

$250,000 or greater. When useful life is not available from the manufacturer, DoD

7000.14R shall be used to assign useful life to GFP or CAP.

u. Exhibit Line Item # for delivered CAP

Block 10: Monthly

Block 12: Initial submission within 30 calendar days of CDRL receipt Block 13: Monthly

SOF AT&L-KH

SOF AT&L-SR 1

15. TOTAL ---------→ 0 1 0

G. PREPARED BY

Graybill, Jerry

H. DATE

07/28/2021

I. APPROVED BY J. DATE

08/18/2021

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page _3_ of _8_ Pages

18. ESTIMATED

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 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 __X__

D. SYSTEM/ITEM

TCC-FSR

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Government Furnished Property Report

3. SUBTITLE

GFP Reporting

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80441D

5. CONTRACT REFERENCE

SOW Section 8.4

6. REQUIRING OFFICE

SOF AT&L-SR/TCC

7. DD 250 REQ

*NO

9. DIST

STATEMENT

D

10. FREQUENCY

MTHLY

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

30 Days post award

13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16 Draft

Final Reg Repro

16. REMARKS

The contractor shall provide a report that includes Government Furnished Property (GFP) associated to the base IDIQ contract. The report shall be delivered electronically in a spreadsheet that is .xls or.xlsx compatible and in a structured order so that data can be sorted and/or filtered. The report cannot be scanned or faxed. The report will contain the following information:

a. Contract Number

b. Manufacture CAGE Code (If known)

c. Item Name

d. Item Description

e. Manufacturer Name

f. Manufacture Part number

g. Material Control Number (MCN) (if applicable)

h. Contractor’s Asset Identification Number (if applicable)

i. Contractor’s Alternate Asset Identification Number (if applicable)

j. Serial Number

k. National Stock Number (NSN)

l. Quantity

m. Unit of Measure

n. Unit Acquisition Cost

o. Location

p. Sub Location

q. Unique Item Identifier (as registered in the IUID registry)

r. Type of Government Property (i.e. Government Furnished Property (GFP) or

Contractor Acquired Property (CAP)

s. Classification of Government Property (i.e. Communication Security

(COMSEC), Equipment (EQP), Material (MAT), Special Test Equipment (STE), or Special Tooling (ST)

t. Posting Reference

u. Date of Transaction/Date of Acquisition

v. Date Placed in Service

w. Date of Last Physical Inventory

x. Condition Code

Block 12: Initial submission will be due NLT 10 days after receipt of modification.

Block 13: Subsequent submission will be with the monthly report until the contract has ended.

SOF AT&L-KH

SOF AT&L-SR 1

15. TOTAL ---------→ 0 1 0

G. PREPARED BY

Graybill, Jerry

H. DATE

07/28/2021

I. APPROVED BY J. DATE

08/18/2021

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page _4_ of _8_ Pages

18. ESTIMATED

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 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 __X__

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

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

Training After Action report

3. SUBTITLE

After Action report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-82245

5. CONTRACT REFERENCE

SOW Paragraph 3.2

6. REQUIRING OFFICE

SOF AT&L-SR/TCC

7. DD 250 REQ

*NO

9. DIST

STATEMENT

D

10. FREQUENCY

SEE BLK 16

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16 Draft

Final Reg Repro

16. REMARKS

The contractor shall provide an After-Action Report (AAR) following each training event.

After Action Reports for each training event performed under this base IDIQ contract (Cont. # TBD) shall be delivered electronically to the program office. Each AAR will contain the following information:

1. Type of training performed i.e. New equipment Training (NET), Refresher training, Location

2. Number of students trained

3. Devices trained

4. Any issues or improvements identified during training

5. Student surveys shall be attached to the AAR

Block 10: The frequency of delivery will be dependent on when the training event is held.

Block 12: Each AAR will be due NLT 10 days after the conclusion of the training event.

Block 13: : Each AAR will be due NLT 10 days after the conclusion of the training event.

SOF AT&L-KH

SOF AT&L-SR 1

15. TOTAL ---------→ 0 1 0

G. PREPARED BY

Graybill, Jerry

H. DATE

07/28/2021

I. APPROVED BY J. DATE

08/18/2021

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page _5_ of _8_ Pages

18. ESTIMATED

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 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 __X__

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

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Training Program Of Instruction (POI)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

MIL-STD-2361C NOT 2

5. CONTRACT REFERENCE

SOW Paragraph 3.2

6. REQUIRING OFFICE

SOF AT&L-SR/TCC

7. DD 250 REQ

*NO

9. DIST

STATEMENT

D

10. FREQUENCY

SEE BLK 16

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16 Draft

Final Reg Repro

16. REMARKS

The contractor shall provide each Program of Instruction for each device that is developed under this base IDIQ contract (Cont. # TBD). The POI shall be delivered electronically to the program office.:

Block 10: The frequency of delivery will be dependent on when the POI is developed.

Block 12: Each POI will be due NLT 10 days after POI has been finalized.

Block 13: Each POI will be due NLT 10 days after POI has been finalized.

SOF AT&L-KH

SOF AT&L-SR 1

15. TOTAL ---------→ 0 1 0

G. PREPARED BY

Graybill, Jerry

H. DATE

07/28/2021

I. APPROVED BY J. DATE

08/18/2021

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page _6_ of _8_ Pages

18. ESTIMATED

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 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

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER __MGMT__

D. SYSTEM/ITEM

TCC-FSR

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

System Security Plan and Associated Plans of Action for a Contractor's Internal Unclassified Information System

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-82247

5. CONTRACT REFERENCE

SOW Paragraph 12.1

6. REQUIRING OFFICE

SOF AT&L-SR/TCC

7. DD 250 REQ

LT

9. DIST

STATEMENT

B

10. FREQUENCY

See Below

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16 Draft

Final Reg Repro

16. REMARKS

Block 4: The System Security Plan shall include a description of system boundaries, system environments of operation, how security requirements are implemented or how organizations plan to meet the requirements, and the relationships with or connections to other systems. Any plans of action shall include a description how the Contractor will correct deficiencies and reduce or eliminate vulnerabilities in the Contractor’s information system.

Block 8: Government acceptance. Documents not approved as submitted, or approved with comments, must be corrected and resubmitted within two (2) business days after receipt of Government comments.

Block 14: Electronic transmission of data is required / Microsoft Office 2016.

SOF AT&L-KH

SOF AT&L-SR 1

15. TOTAL ---------→ 0 1 0

G. PREPARED BY

Graybill, Jerry

H. DATE

07/28/2021

I. APPROVED BY J. DATE

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page _7_ of _8_ Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

Blocks 10, 12, 13: Initial shall be delivered 30 days after Post Award, all subsequent submissions, shall be submitted in accordance with Integrated Master Schedule.

08/18/2021

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 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

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER __MGMT__

D. SYSTEM/ITEM

TCC-FSR

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

Contractor's Record of Tier 1 Level Suppliers Receiving/Developing Covered Defense Information

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-82247

5. CONTRACT REFERENCE

SOW Paragraph 12.2

6. REQUIRING OFFICE

SOF AT&L-SR/TCC

7. DD 250 REQ

LT

9. DIST

STATEMENT

B

10. FREQUENCY

See Below

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16 Draft

Final Reg Repro

16. REMARKS

Block 4: Hard-copy or Electronic submission is permissible if sent with encryption.

Block 7: Letter of Transmittal only.

Block 9: The following information shall be included on the deliverable: DISTRIBUTION STATEMENT D: Distribution authorized to the DoD and U.S. DoD contractors only; in order to protect technical/operational data or information. Other requests shall be referred to USSOCOM SOF AT&L-SR.

Blocks 10, 12, 13: Initial shall be delivered 30 days after Post Award, all subsequent submissions, shall be submitted in accordance with Integrated Master Schedule.

SOF AT&L-KH

SOF AT&L-SR 1

15. TOTAL ---------→ 0 1 0

G. PREPARED BY

Graybill, Jerry

H. DATE

07/28/2021

I. APPROVED BY J. DATE

08/18/2021

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page _8_ of _8_ Pages

18. ESTIMATED