Atch6.pdf

PDF 332 KB Posted Jul 1, 2011

Attached to: Award Notice Federal contract opportunity
Solicitation number: HTC71111RC002
Issued by: Department of Defense United States Transportation Command

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Attachment 6

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File	Type	Posted
FY12 Final Uniform Rates and Rules Revision 1 - 1 Jul 12.pdf	PDF	Jun 28, 2012
1 Jul 12 Revision FY12 Final Uniform Rates and Rules.pdf	PDF	Jun 20, 2012
FY12 JA Signed_FBO.pdf	PDF	Jan 13, 2012
FY12 JA Signed_FBO.pdf	PDF	Jan 13, 2012
FY12 Final Aeromedical Airlift Uniform Rates and Rules.pdf	PDF	Dec 16, 2011
FY12 Proposed Aeromedical Airlift Uniform Rates and Rules.pdf	PDF	Nov 22, 2011
FY12 Final Uniform Rates and Rules.pdf	PDF	Nov 17, 2011
HTC711-11-R-C002-0005 .pdf	PDF	Oct 13, 2011
HTC711-11-R-C002-0004.pdf	PDF	Sep 21, 2011
FY12 Proposed Uniform Rates and Rules.pdf	PDF	Aug 26, 2011
HTC711-11-R-C002-0003.pdf	PDF	Aug 2, 2011
HTC711-11-R-C002-0003.pdf	PDF	Aug 2, 2011
HTC711-11-R-C002-0002.pdf	PDF	Jul 29, 2011
HTC711-11-R-C002-0001.pdf	PDF	Jul 22, 2011
HTC711-11-R-C002.pdf	PDF	Jul 1, 2011
FY12 Int'l Award Fee Plan.pdf	PDF	Jul 1, 2011
Section K.doc	DOC document	Jul 1, 2011
FY12 Atch1.pdf	PDF	Jul 1, 2011
EVIDENCE OF INSURANCE.doc	DOC document	Jul 1, 2011
Attachments.pdf	PDF	Jul 1, 2011
HTC711-11-R-C002 Cover Letter.pdf	PDF	Jul 1, 2011
Fuel Purchase Agreement.pdf	PDF	Jul 1, 2011
sf33.pdf	PDF	Jul 1, 2011
Atch8a.xls	XLS spreadsheet	Jul 1, 2011
STATEMENT OF LEASE CONFORMANCE.doc	DOC document	Jul 1, 2011
LIST OF AIRCRAFT.doc	DOC document	Jul 1, 2011
Atch 12.pdf	PDF	Jul 1, 2011
REQUEST FOR INDEMNIFICATION.doc	DOC document	Jul 1, 2011

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CARRIER NAME

a. Key Management Personnel (Please attach a brief resume)

AMC IMT 207, 20060430, V2 FOR OFFICIAL USE ONLY (When filled in) PAGE 1 OF 6 PAGES REPLACES AMC FORM 207, Apr 03, WHICH IS OBSOLETE

DOD STATEMENT OF INTENT

(To Provide Airlift Services to the Department of Defense)

OMB NUMBER: 0701-0137

SECTION I. GENERAL INFORMATION

The general purpose of this form is to assist Headquarters Air Mobility Command (HQ AMC) in the overall evaluation of commercial airlift procured by the Department of Defense (DOD). This document is intended to aid in the evaluation of air carrier acceptability for airlift contracts and agreements. This document is not designed to be all inclusive, but rather to serve as a tool to be used by DOD inspection and safety activities in the early phases of the procurement process. We recognize that the breadth of information provided will vary according to the complexity of the proposed operations and size of carrier.

SECTION II. MANAGEMENT

NAME TITLE TELEPHONE/FAX NUMBER DATE OF EMPLOYMENT

comply with a collection of information if it does not display a currently valid OMB control number.

The public reporting burden for this collection of information is estimated to an average 20 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 Department of Defense, Washington Headquarters Services (WHS), Directorate for Information Operations and Reports (DIOR), (0701-0137), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provisions of law, no person shall be subject to any penalty for failing to

NOTE

HQ AMC/A34B, 402 Scott Drive, Unit 3A1, Scott AFB IL 62225-5302.completed form to

: Do not return your form to the above address. Return

ADDRESS DATE COMPLETED

EXPIRES: 20090731

audited, personnel performing audits, and audit frequency.

b. Briefly describe company's internal audit program or other method capable of identifying in-house deficiencies, including operational and maintenance areas

(Attach sample documentation to track accomplishment and discrepancy followup.)

c. Briefly describe company's flight safety program, to include safety points of contact and lines of communication.

SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.)

Part 135

Part 121

Part 133

Domestic carrier operations

Flag carrier operations

Supplemental carrier operations

Long-range international operations

Short-range international operations

Passengers only

Passengers and cargo

Cargo only

Aerial surveillances or photography

Aeromedical services

General Services Administration city pairs

HAZMAT authorization

On-demand air taxi services

Category II instrument approach and landing operations

Category III instrument approach and landing operations

Single pilot-in-command operations

Individually ticketed DOD passengers

Whole planeload DOD charter flights

Continued Next Page

FOR OFFICIAL USE ONLY (When filled in)

(Check)

Asia

Central and South America the DOD? Were these hours flown under your current certificate?

TYPE OF TRAINING

SECTION VII. PRIMARY AIRCREW TRAINING FACILITIES AND VENDORS

a. Number and types of aircraft you operate and are presently on your operations specifications.

AMC IMT 207, 20060430, V2 PAGE 2 OF 6 PAGES

burn rates, range, etc.

c. Provide performance data on aircraft offered for DOD service. Include basic aircraft operating weight, maximum ramp weight, maximum cargo weight, fuel

(Attach to the Statement of Intent.)

SECTION IV. AIRCRAFT DATA.

No (If"Yes", how high can the pallets be built to fit in your aircraft?)

(If you fly large cargo aircraft, can they accommodate the 463L pallet (88 inches by 108 inches)

Yes

MAKE, MODEL, SERIES PAYLOAD: CARGO (PAX) / RANGE OWNER NUMBER OF AIRCRAFT TYPE

b. Number and types of aircraft you would like to operate for the DOD ( specifications, and available for DOD inspection at the time of airlift capability survey. For AMC Contracts, see solicitation for further clarification.)

Aircraft must be approved by the FAA FSDO, on your operations

MAKE, MODEL, SERIES PAYLOAD: CARGO (PAX) / RANGE OWNER NUMBER OF AIRCRAFT TYPE

SECTION III. FLIGHT OPERATIONS: (Continued)

Scheduled military channel operations

Operations into areas of magnetic unreliability

Extended Range Operations with Twin-Engined Airplanes

North Pacific Operations (NOPAC)

(ETOPS)

Central Pacific Operations (CEPAC)

North Atlantic Operations (NAT)

Operations with autopilot in lieu of second-in-command

Block seat sales to the DOD

Civil Reserve Air Fleet Stage I Stage II Stage III

a. Will the service you anticipate performing for the DOD require any additional aircrew training events or programs? If so, briefly explain.

SECTION VI. CREW MEMBERS (Excluding management)

SECTION V. GEOGRAPHIC AND CLIMATOLOGICAL DATA (Check the geographic area of operations/climates in which you intend to operate for the DOD) Extended Overwater

North Atlantic North Pacific

Continental US

Europe, Africa, and Middle East Alaska Tropical

Desert

Arctic Mountainous of continuous service. Attach additional documentation as required.)

(If yes, please provide documentation to show 12 months

SERVICE/ROUTE TYPE AIRCRAFT OPERATION

NUMBER MONTHS OF ROUTE

OF FLIGHTS PER MONTH

APPROXIMATE NUMBER

b. For international routes, how many hours of international operations have you flown during the preceding 12 months over routes similar to the service sought by

QUALIFICATION TOTAL NUMBER QUALIFIED

INTERNATIONALLY NUMBER WITH MILITARY

RESERVE/NATIONAL GUARD

CAPTAINS

FIRST OFFICERS

SECOND OFFICERS

FLIGHT ATTENDANTS

LOCATION VENDOR

Other:

YES NO

a. Have you performed service continuously for the past 12 months along a comparable route structure?

FOR OFFICIAL USE ONLY (When filled in) AMC IMT 207, 20060430, V2

d. Describe your training program for: (1) Mechanic indoctrination to company policies and procedures, (2) Aircraft Systems, (3) List all initial and recurrent training,

(4) Training for any contract personnel, (5) Inspector initial/recurrent training.

b. Location and description of maintenance facilities, including line stations. Include company-owned and/or major contracted maintenance.

QUALIFICATION TOTAL NUMBER FULL-TIME

NUMBER

PART-TIME

NUMBER

A & P

RII / IA

OTHER

SECTION VIII. MAINTENANCE

TYPE OF SERVICE LOCATION VENDOR

a. Primary aircraft overhaul / engine maintenance vendors

c. Describe your documented quality assurance programs: (1) Internal audits. (2) Vendor audits. (3) Mechanical performance monitoring. (4) Tool/test equipment calibration tracking. NOTE: Please include copies of your internal/vendor audit schedules.

e. Describe your reliability program.

f. Type of maintenance programs.

g. Are you an FBO/repair station? If so, please describe authorization. If you use contracted fuel, please describe your fuel vendor audit process.

h. Describe your off-line fuel quality assurance inspection/documantation procedures. Where are these published?

PAGE 3 OF 6 PAGES

i. Will the service you anticipate performing for the DOD require an expansion of your aircraft maintenance capability? If so, briefly explain.

b. Number of spare engines.

the last two fiscal years and year-to-date information. What was the amount of your total revenues for your most recent fiscal year end? If any of that revenue was

b. Are there any bankruptcies, mergers, divestitures, or acquisitions planned?

c. Within the past 10 years, has the company ever declared bankruptcy? If so, briefly explain.

You may be asked to provide financial statements

d. If your company is privately owned, please give names and percentage of ownership. If owned by another privately held company, please detail its ownership.

(i.e., balance sheet, profit and loss) of the company owner (s) at a later date.

SECTION X. FINANCIAL: Failure to provide the requested financial information could result in the company not being approved as a DOD carrier.

SECTION IX. SUPPLY

PAGE 4 OF 6 PAGES

k. Describe your recordkeeping programs (e.g. computerized, manual, etc.)

j. Describe your maintenance and company manuals revision and tracking processes (e.g., computerized, manual, combination computerized/manual, etc).

e. Is there any significant litigation against your company which could affect its overall financial or operational health?

a. Number and types of line items. Please describe receiving, inspection and shelf life monitoring programs.

c. Do you carry fly-away kits? (If so, list type of items - pumps, tires, brakes, etc.)

FOR OFFICIAL USE ONLY (When filled in) AMC IMT 207, 20060430, V2 PAGE 5 OF 6 PAGES

c. Please list any other air transportation contracts you have with the Federal Government.

d. Please provide, as reference, a list of your principal commercial customers, especially those using the services you propose providing to the DOD.

e. Provide the total number of departures for the last four calendar years, by certificate type.

SECTION XII. FAA SAFETY REGULATION

a. When did you receive your operating certificate? What is your certificate number?

b. Has the operating certificate ever been suspended or revoked? If so, explain.

AGENCY TELEPHONE CONTRACT TYPE SERVICE

FIRM'S NAME ADDRESS PHONE CONTACT

YEAR PART 121 OTHER OPERATIONS TOTAL DEPARTURES135

SECTION XI. PAST PERFORMANCE

briefly explain circumstances.

a. Within the past 5 years, have any key company personnel been arrested, indicted, convicted, or had an FAA license suspended, surrendered, or revoked? If so,

b. Within the past 5 years, have you ever defaulted on a contract with the Federal Government? If so, please provide a brief explanation and point of contact.

f. Do you anticipate operating for the DOD as a joint venture with other carriers?

c. Are all of the authorizations in your "Ops Spec" active? If some have been inactive for more than 12 months, please explain.

f. Do you have any open Enforcement Investigation Reports (EIR) with the FAA? If so, briefly explain their nature and your company's position.

PAGE 6 OF 6 PAGES

g. Will the operations you plan on performing for the DOD require any changes to your FAA operating specifications?

e. List all aircraft accidents as defined by NTSB 830 in the last four years. Include date, location, type of aircraft, type of operation (i.e., Part 121, Part 135, Part 91), number of fatalities, and extent of damage.

ADDITIONAL COMMENTS: (Comments you wish to make about your company or its health.)

AVIONICS

d. What is the address of your FAA certificate holding office and the names and telephone numbers of your principal aviation safety inspectors?

ADDRESS

OPERATIONS

AIRWORTHINESS

TELEPHONE

CARRIER NAME:

ADDRESS:

(NAME, <Row 1>):

(TITLE, <Row 1>):

(TELEPHONE/FAX NUMBER, <Row 1>):

(DATE OF EMPLOYMENT, <Row 1>):

(NAME, <Row 2>):

(TITLE, <Row 2>):

(TELEPHONE/FAX NUMBER, <Row 2>):

(DATE OF EMPLOYMENT, <Row 2>):

(NAME, <Row 3>):

(TITLE, <Row 3>):

(TELEPHONE/FAX NUMBER, <Row 3>):

(DATE OF EMPLOYMENT, <Row 3>):

(NAME, <Row 4>):

(TITLE, <Row 4>):

(TELEPHONE/FAX NUMBER, <Row 4>):

(DATE OF EMPLOYMENT, <Row 4>):

(NAME, <Row 5>):

(TITLE, <Row 5>):

(TELEPHONE/FAX NUMBER, <Row 5>):

(DATE OF EMPLOYMENT, <Row 5>):

(NAME, <Row 6>):

(TITLE, <Row 6>):

(TELEPHONE/FAX NUMBER, <Row 6>):

(DATE OF EMPLOYMENT, <Row 6>):

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 1>):

Part 135:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 2>):

Part 121:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 3>):

Part 133:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 4>):

Domestic carrier operations:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 5>):

Flag carrier operations:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 6>):

Supplemental carrier operations:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 7>):

Long-range international operations:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 8>):

Short-range international operations:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 9>):

Passengers only:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 10>):

Passengers and cargo:

(SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.), <Row 11>):

Cargo only:

TextField1:

DateTimeField1:

TextField2: SOLICITATION NO: HTC711-11-R-C002

TextField3: ATTACHMENT 6

Extended Range Operations with Twin-Engined Airplanes (ETOPS):

North Pacific Operations (NOPAC):

Central Pacific Operations (CEPAC):

North Atlantic Operations (NAT):

Operations with autopilot in lieu of second-in-command:

Other::

(MAKE, MODEL, SERIES, <Row 1>):

(PAYLOAD: CARGO (PAX) / RANGE, <Row 1>):

(OWNER, <Row 1>):

(NUMBER OF AIRCRAFT TYPE, <Row 1>):

(MAKE, MODEL, SERIES, <Row 2>):

(PAYLOAD: CARGO (PAX) / RANGE, <Row 2>):

(OWNER, <Row 2>):

(NUMBER OF AIRCRAFT TYPE, <Row 2>):

(MAKE, MODEL, SERIES, <Row 3>):

(PAYLOAD: CARGO (PAX) / RANGE, <Row 3>):

(OWNER, <Row 3>):

(NUMBER OF AIRCRAFT TYPE, <Row 3>):

(MAKE, MODEL, SERIES, <Row 4>):

(PAYLOAD: CARGO (PAX) / RANGE, <Row 4>):

(OWNER, <Row 4>):

(NUMBER OF AIRCRAFT TYPE, <Row 4>):

(MAKE, MODEL, SERIES, <Row 5>):

(PAYLOAD: CARGO (PAX) / RANGE, <Row 5>):

(OWNER, <Row 5>):

(NUMBER OF AIRCRAFT TYPE, <Row 5>):

b. For international routes, how many hours of international operations have you flown during the preceding 12 months over routes similar to the service sought by:

SECTION VI. CREW MEMBERS (Excluding management):

CAPTAINS:

SECOND OFFICERS:

FLIGHT ATTENDANTS:

CheckBox1: 0

CheckBox3: 0

A & P:

RII / IA:

OTHER:

(TYPE OF SERVICE, <Row 1>):

(LOCATION, <Row 1>):

(VENDOR, <Row 1>):

(TYPE OF SERVICE, <Row 2>):

(LOCATION, <Row 2>):

(VENDOR, <Row 2>):

(TYPE OF SERVICE, <Row 3>):

(LOCATION, <Row 3>):

(VENDOR, <Row 3>):

(TYPE OF SERVICE, <Row 4>):

(LOCATION, <Row 4>):

(VENDOR, <Row 4>):

b. Location and description of maintenance facilities, including line stations. Include company-owned and/or major contracted maintenance.:

d. Describe your training program for: (1) Mechanic indoctrination to company policies and procedures, (2) Aircraft Systems, (3) List all initial and recurrent training, (4) Training for any contract personnel, (5) Inspector initial/recurrent training.:

e. Describe your reliability program.:

f. Type of maintenance programs.:

g. Are you an FBO/repair station? If so, please describe authorization. If you use contracted fuel, please describe your fuel vendor audit process.:

h. Describe your off-line fuel quality assurance inspection/documantation procedures. Where are these published?:

i. Will the service you anticipate performing for the DOD require an expansion of your aircraft maintenance capability? If so, briefly explain.:

j. Describe your maintenance and company manuals revision and tracking processes (e.g., computerized, manual, combination computerized/manual, etc).:

k. Describe your recordkeeping programs (e.g. computerized, manual, etc.):

SECTION IX. SUPPLY a. Number and types of line items. Please describe receiving, inspection and shelf life monitoring programs.:

b. Number of spare engines.:

c. Do you carry fly-away kits? (If so, list type of items - pumps, tires, brakes, etc.):

a. Please provide financial statements, including balance sheets, income statements, and statements of change in financial position (or statement of cash flow) from DOD business, indicate amount and procuring activity. the last two fiscal years and year-to-date information. What was the amount of your total revenues for your most recent fiscal year end? If any of that revenue was:

b. Are there any bankruptcies, mergers, divestitures, or acquisitions planned?:

c. Within the past 10 years, has the company ever declared bankruptcy? If so, briefly explain.:

You may be asked to provide financial statements d. If your company is privately owned, please give names and percentage of ownership. If owned by another privately held company, please detail its ownership. (i.e., balance sheet, profit and loss) of the company owner(s) at a later date.:

e. Is there any significant litigation against your company which could affect its overall financial or operational health?:

briefly explain circumstances. a. Within the past 5 years, have any key company personnel been arrested, indicted, convicted, or had an FAA license suspended, surrendered, or revoked? If so,:

b. Within the past 5 years, have you ever defaulted on a contract with the Federal Government? If so, please provide a brief explanation and point of contact.:

(AGENCY TELEPHONE CONTRACT TYPE SERVICE, <Row 1>):

(AGENCY TELEPHONE CONTRACT TYPE SERVICE, <Row 2>):

(AGENCY TELEPHONE CONTRACT TYPE SERVICE, <Row 3>):

(AGENCY TELEPHONE CONTRACT TYPE SERVICE, <Row 4>):

(FIRM'S NAME, <Row 1>):

(ADDRESS, <Row 1>):

(PHONE, <Row 1>):

(CONTACT, <Row 1>):

(FIRM'S NAME, <Row 2>):

(ADDRESS, <Row 2>):

(PHONE, <Row 2>):

(CONTACT, <Row 2>):

(FIRM'S NAME, <Row 3>):

(ADDRESS, <Row 3>):

(PHONE, <Row 3>):

(CONTACT, <Row 3>):

e. Provide the total number of departures for the last four calendar years, by certificate type.:

(YEAR, <Row 1>):

(PART 121, <Row 1>):

(135, <Row 1>):

(OTHER OPERATIONS, <Row 1>):

(TOTAL DEPARTURES, <Row 1>):

(YEAR, <Row 2>):

(PART 121, <Row 2>):

(135, <Row 2>):

(OTHER OPERATIONS, <Row 2>):

(TOTAL DEPARTURES, <Row 2>):

(YEAR, <Row 3>):

(PART 121, <Row 3>):

(135, <Row 3>):

(OTHER OPERATIONS, <Row 3>):

(TOTAL DEPARTURES, <Row 3>):

(YEAR, <Row 4>):

(PART 121, <Row 4>):

(135, <Row 4>):

(OTHER OPERATIONS, <Row 4>):

(TOTAL DEPARTURES, <Row 4>):

a. When did you receive your operating certificate? What is your certificate number?:

b. Has the operating certificate ever been suspended or revoked? If so, explain.:

c. Are all of the authorizations in your "Ops Spec" active? If some have been inactive for more than 12 months, please explain.:

ADDRESS:

OPERATIONS:

TELEPHONE:

AIRWORTHINESS:

TELEPHONE:

AVIONICS:

TELEPHONE:

f. Do you have any open Enforcement Investigation Reports (EIR) with the FAA? If so, briefly explain their nature and your company s position.:

g. Will the operations you plan on performing for the DOD require any changes to your FAA operating specifications?:

File details come from the government source that posted it. Updated Nov 14, 2017.