J-6 CDRLs.pdf

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Attached to
USNS APACHE (T-ATF 172) FY20 Mid-Term Availability (MTA) - Solicitation Federal contract opportunity
Solicitation number
N3220520R7001
Issued by
Department of the Navy Military Sealift Command

About this file

This document package includes a solicitation for the USNS APACHE (T-ATF 172) FY20 Mid-Term Availability (MTA). The solicitation seeks maintenance and repair services for the vessel and includes the solicitation document, Justification and Approval document, and attachments with additional requirements. Interested parties must sign a non-disclosure agreement to receive the work package and associated drawings. The work package will include maintenance and repair requirements across various systems and specialties, with data items required before, during, and after the availability period. The Navy Military Sealift Command is the contracting agency. Responses are due by the specified date, and award will occur thereafter. Pricing is to be included in responses.

View the file

Other files for this federal contract opportunity

Other files attached to USNS APACHE (T-ATF 172) FY20 Mid-Term Availability (MTA) - Solicitation, newest first.
File Type Posted
N3220520R70010005.docx DOCX document
N3220520R7001_0004.docx DOCX document
N3220520R7001_0003.docx DOCX document
1 RFCs 050-052.docx DOCX document
1 RFCs 052 Revised 053-054.docx DOCX document
N3220520R7001_0002.docx DOCX document
1 RFCs 026 027 040 - 045.docx DOCX document
1 RFCs 019 - 023.pdf PDF
1 RFCs 033 037 046 - 049.pdf PDF
1 APACHE RFCs 001 - 016.pdf PDF
1 RFCs 024 025 028-032 034-036 038-039.pdf PDF
1 Apache RFCs 017-018.pdf PDF
N3220520R70010001.pdf PDF
JA APACHE FY20 MTA_REDACTED.pdf PDF
J-3 Category B Items.xlsx XLSX spreadsheet
N3220520R7001.pdf PDF
J-4 GFM List.xlsx XLSX spreadsheet
J-13 Past Performance Questionnaire.docx DOCX document
J-12 Past Performance Data.docx DOCX document
J-15 OPCON Form JEB Pier Access.xlsx XLSX spreadsheet
J-10 Interport Differential.docx DOCX document
J-14 Technical Data Non-Disclosure.docx DOCX document
J-9 Disclosure of Lobbying Activities SF-LLL.docx DOCX document
J-8 Request for Spec Clarification.docx DOCX document
J-2 Category A Items.xlsx XLSX spreadsheet
Show all 25

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DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page 1 of _2_0 Pages Adobe Professional 8.0

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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18. ESTIMATED

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Reset

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Scope, General Requirements, and Definitions

3. SUBTITLE

Regulatory agency contacts

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0001 para 7.2.3

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

Draft Final

Reg Repro

16. REMARKS MSC OMT 0 1 0

15. TOTAL 0 1 0

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Scope, General Requirements, and Definitions

3. SUBTITLE

Compliance and Approval Certificates

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0001 para 7.2.5

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

MSC OMT 0 1 0

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

<THIS SECTION INTENTIONALLY LEFT BLANK>

3. SUBTITLE

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

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft Final

16. REMARKS

15. TOTAL 0 0 0

<THIS SECTION INTENTIONALLY LEFT BLANK>

3. SUBTITLE

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

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft Final

G. PREPARED BY

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:18:18 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:21:26 -04'00'

J. DATE

04/21/20

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page 2 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

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

<THIS SECTION INTENTIONALLY LEFT BLANK>

3. SUBTITLE

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

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft Final

A003

2. TITLE OF DATA ITEM

Scope, General Requirements, and Definitions

3. SUBTITLE

As-found report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0001 para 7.3.4 & WI 0013 para 7.6

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

A004

2. TITLE OF DATA ITEM

Scope, General Requirements, and Definitions

3. SUBTITLE

As-released report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0001 para 7.3.5 & WI 0013 para 7.6

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

A005

2. TITLE OF DATA ITEM

Scope, General Requirements, and Definitions

3. SUBTITLE

Request substitution

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0001 para 7.3.30

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:30:44 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:22:35 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page 3 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Scope, General Requirements, and Definitions

3. SUBTITLE

Work Item reports, drawings, and other docum

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0001 para 8.1.4

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

The Government has 3 days to respond

A007

2. TITLE OF DATA ITEM

Technical and Manufacturers Representatives

3. SUBTITLE

OEM authorized technical representative

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0002 para 7.2.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

A008

2. TITLE OF DATA ITEM

Approach, Berth, and Mooring Requirements

3. SUBTITLE

Resubmission of berthing facilities informatio

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0003 para 7.3.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

N/A

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: One-day before POP starts.

A009

2. TITLE OF DATA ITEM

Approach, Berth, and Mooring Requirements

3. SUBTITLE

Resubmission of tidal ranges

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0003 para 7.3.3.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond Blk 11: One-day before POP starts

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:31:36 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:38:25 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page 4 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A00A

2. TITLE OF DATA ITEM

Testing and Quality Assurance

3. SUBTITLE

Contractor inspection personnel

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0004 para 7.1.2.1.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond Blk 11: First day of POP

A00B

2. TITLE OF DATA ITEM

Testing and Quality Assurance

3. SUBTITLE

Subcontractor inspection personnel

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0004 para 7.1.2.1.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 16: First day of POP

A00C

2. TITLE OF DATA ITEM

Testing and Quality Assurance

3. SUBTITLE

Regulatory agency contacts

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0004 para 7.5.1.3

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASGEN

12. DATE OF FIRST SUBMISSION

ASGEN

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

A00D

2. TITLE OF DATA ITEM

Testing and Quality Assurance

3. SUBTITLE

Copy of all inspection records

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0004 para 7.7.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: 10 days after POP ends.

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, 0 cn=JOHNSON.TERRY.LAWRENCE.1223898080 Date: 2020.03.25 06:02:42 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:42:52 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page 5 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A00E

2. TITLE OF DATA ITEM

Testing and Quality Assurance

3. SUBTITLE

Quality deficiency report response

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0004 para 7.8

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 2 days to review Contractor's response.

Blk 11: Refer to quality deficiency report for response date.

A00F

2. TITLE OF DATA ITEM

Testing and Quality Assurance

3. SUBTITLE

Schedule for key inspection events

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0004 para 7.9

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

0DARP

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

A00G

2. TITLE OF DATA ITEM

Electrical Safety Procedure Requirements

3. SUBTITLE

Electrical safety lock-out/tag-out program

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0005 para 7.1.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: First day of POP

MSC OMT 0 3 0

Master 0 1 0 Chief Engineer 0 1 0

15. TOTAL 0 5 0

1. DATA ITEM NO.

A00H

2. TITLE OF DATA ITEM

Heavy Weather Plan

3. SUBTITLE

Extraordinary measures

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0006 para 7.1.2.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 1 day to concur or deny request for CCO.

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 06:09:45 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:45:24 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page 6 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A00J

2. TITLE OF DATA ITEM

Cold Weather plan

3. SUBTITLE

Extraordinary measures

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0007 para 7.1.5

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 1 day to concur or deny request for CCO.

A00K

2. TITLE OF DATA ITEM

Furnish Office for Overhaul Management Team

3. SUBTITLE

Admin Assistant resumes

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0010 para 7.4.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 16: Seven days before POP starts

A00L

2. TITLE OF DATA ITEM

Furnish General Services

3. SUBTITLE

Electrical Power Meter Reading

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0011 para 7.1.1.4

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

A00M

2. TITLE OF DATA ITEM

Furnish General Services

3. SUBTITLE

Potable Water Meter Reading

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

See Blk 16

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 5: WI 0011 para 7.1.2.2 T-ATF

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 06:16:29 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:46:25 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page 7 of _2_0 Pages

DD FORM 1423 (BACK), AUG 96

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A00N

2. TITLE OF DATA ITEM

Furnish General Services

3. SUBTITLE

Distilled Water Meter Reading

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

See Blk 16

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 5: WI 0011 para 7.1.3.2 T-ATF

A00P

2. TITLE OF DATA ITEM

Furnish General Services

3. SUBTITLE

Bilge Water Meter Reading

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

See Blk 16

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 5: WI 0011 7.1.18.6 T-ATF

A00Q

2. TITLE OF DATA ITEM

Furnish General Services

3. SUBTITLE

Operational Status joint survey report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0011 para 7.4.2.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: Five days after POP starts

A00R

2. TITLE OF DATA ITEM

Furnish General Services

3. SUBTITLE

Crane Life Usage Summary

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

See Blk 16

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 5: WI 0011 para 7.9.2

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 13:55:01 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:47:49 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page 8 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A00S

2. TITLE OF DATA ITEM

Project Planning and Production Status Monitoring Repor

3. SUBTITLE

Production Chart

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0013 para 7.2.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 11: Due 10 days after contract award.

A00T

2. TITLE OF DATA ITEM

Project Planning and Production Status Monitoring Repo

3. SUBTITLE

Production Chart

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0013 para 7.2.4

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

3DARP

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 12/13: Due 24 hours prior to progress meeting.

A00U

2. TITLE OF DATA ITEM

Project Planning and Production Status Monitoring Repor

3. SUBTITLE

PSDPN Response

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0013 para 7.2.7

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 2 days to review Contractor's response.

Blk 11: Refer to PSDPN for response date.

A00V

2. TITLE OF DATA ITEM

Project Planning and Production Status Monitoring Repo

3. SUBTITLE

Progress Report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0013 para 7.4.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 13:58:54 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:49:25 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page 9 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A00W

2. TITLE OF DATA ITEM

Project Planning and Production Status Monitoring Repo

3. SUBTITLE

Plan of the Day

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0013 para 7.3.2 & 7.5.1.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

DAILY

12. DATE OF FIRST SUBMISSION

DAILY

8. APP CODE

N/A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS MSC OMT 0 6 0

15. TOTAL 0 6 0

A00X

2. TITLE OF DATA ITEM

Project Planning and Production Status Monitoring Repo

3. SUBTITLE

Manning Chart

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0013 para 7.5.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

See Blk 16

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

See Blk 16

<THIS SECTION INTENTIONALLY LEFT BLANK>

3. SUBTITLE

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

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft Final

<THIS SECTION INTENTIONALLY LEFT BLANK>

3. SUBTITLE

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

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft Final

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:00:13 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:50:46 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page _1_0 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

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

<THIS SECTION INTENTIONALLY LEFT BLANK>

3. SUBTITLE

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

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft Final

A00Y

2. TITLE OF DATA ITEM

Preparation of Weight and Moment Report

3. SUBTITLE

Preliminary Weight Report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0014 para 7.6.4

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: Seven days before end of POP.

MSC OMT 0 2 0

15. TOTAL 0 2 0

A00Z

2. TITLE OF DATA ITEM

Preparation of Weight and Moment Report

3. SUBTITLE

Final Weight Report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0014 para 7.6.5

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: Fourteen days after end of POP.

MSC OMT 0 3 0

Tech Library 0 1 0

15. TOTAL 0 4 0

1. DATA ITEM NO.

A010

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Technical Manual

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.1.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

Blk C: TM

MSC OMT 0 4 0

15. TOTAL 0 4 0

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:06:55 -04'00'

H. DATE

03/25/20

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:51:41 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page _1_1 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A011

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Technical Support Data

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.1.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

A012

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Alternate Submission of TSD

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.1.3

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

A013

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Purchase Orders for CFM

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.1.4

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

A014

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Provisioning Guidance Conference Minutes

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.1.5.3

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 16: Following Provisioning Guidance Conference.

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:32:29 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:58:23 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page _1_2 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A015

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Drawings

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

MSC OMT 0 1 0

Tech Library 0 1 0

15. TOTAL 0 2 0

1. DATA ITEM NO.

A016

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Receipt of GFM

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.1.3

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

A017

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Material and equipment designated for turnove

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.3.4.5 & 7.3.4.8

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS ILS REP 0 2 0

A018

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

GFM/GFE/CFM Summary list

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.3.5.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEKLY

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:33:22 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 13:59:17 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page _1_3 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A019

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

GFM Damage Report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.3.5.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

A01A

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Scrap Report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.3.5.3

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: Last day of POP

A01B

2. TITLE OF DATA ITEM

ILS GFM

3. SUBTITLE

Residual asset report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0015 para 7.3.5.4

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

A01C

2. TITLE OF DATA ITEM

Fire Protection and Ships Safety Program

3. SUBTITLE

Fire and Flooding Protection Plan

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0016 para 7.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 16: Seven days after issuance of award.

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:44:23 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 14:02:48 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page _1_4 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A01D

2. TITLE OF DATA ITEM

Fire Protection and Ships Safety Program

3. SUBTITLE

Hot work notice

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0016 para 7.9

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

DAILY

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS MSC OMT 0 1 0

Chief Engineer 0 1 0

15. TOTAL 0 2 0

1. DATA ITEM NO.

A01E

2. TITLE OF DATA ITEM

Fire Protection and Ships Safety Program

3. SUBTITLE

Fire report

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0016 para 7.10

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: Submit draft report within 24 hours of occurrence and final report within five business days of occurrence.

MSC OMT 1 1 0

15. TOTAL 1 1 0

A01F

2. TITLE OF DATA ITEM

Fire Protection and Ships Safety Program

3. SUBTITLE

Safety Inspection

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0016 para 7.17.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

DAILY

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

13. DATE OF SUBSEQUENT

A01G

2. TITLE OF DATA ITEM

Handling Ship's Stores

3. SUBTITLE

Temperature reports

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0017 para 7.1.4

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

WEEKLY

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

16. REMARKS

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:21:51 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 14:03:40 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page _1_5 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A01H

2. TITLE OF DATA ITEM

Delivery and Redelivery of the Vessel

3. SUBTITLE

Final Joint Acceptance Survey

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0018 para 7.2.4

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: Five days prior to end of POP.

A01J

2. TITLE OF DATA ITEM

Shipboard Access and Security

3. SUBTITLE

Security Plan

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0019 para 7.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: Fifteen days prior to start of POP.

A01K

2. TITLE OF DATA ITEM

Shipboard Access and Security

3. SUBTITLE

List of personnel onboard

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0019 para 7.2.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: Five days prior to start of POP.

A01L

2. TITLE OF DATA ITEM

Shipboard Access and Security

3. SUBTITLE

List of personnel onboard - weekend work

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0019 para 7.2.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 1 day to respond.

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:25:29 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 14:04:40 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page _1_6 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A01M

2. TITLE OF DATA ITEM

Shipboard Access and Security

3. SUBTITLE

Shipboard Security Log

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0019 para 7.3.8.6.3

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

DAILY

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

13. DATE OF SUBSEQUENT

A01N

2. TITLE OF DATA ITEM

Gas Free Certificates

3. SUBTITLE

Gas Free Certificates

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0020 para 7.3

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

ASGEN

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

16. REMARKS MSC OMT 0 2 0

A01P

2. TITLE OF DATA ITEM

Clean and Gas Free Tanks, Voids, Cofferdams & Spaces

3. SUBTITLE

Tank Unloading Plan

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0021 para 7.1

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8/11: Submit at least two days prior to be approved by the Naval Architect.

A01Q

2. TITLE OF DATA ITEM

Clean and Gas Free Tanks, Voids, Cofferdams & Spaces

3. SUBTITLE

Tank Soundings

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0021 para 7.2

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 8: The Government has 3 days to respond.

Blk 11: First day of POP

Port Engineer JOHNSON.TERRY.LAWRENCE.122389808 Digitally signed by JOHNSON.TERRY.LAWRENCE.1223898080

0 Date: 2020.03.25 14:26:47 -04'00'

H. DATE

03/25/2020

I. APPROVED BY

Contract Specialist

BURCHETT.CHRISTINA.M.12437 Digitally signed by

BURCHETT.CHRISTINA.M.1243746546

46546 Date: 2020.04.21 14:07:53 -04'00'

DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page _1_7 of _2_0 Pages

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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

USNS APACHE MTA

E. CONTRACT/PR NO.

PR# N2109100954001

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A01R

2. TITLE OF DATA ITEM

Clean and Gas Free Tanks, Voids, Cofferdams & Spaces

3. SUBTITLE

Oil Samples Tested

4. AUTHORITY (Data Acquisition Document No.)

N/A

5. CONTRACT REFERENCE

WI 0021 para 7.5

6. REQUIRING OFFICE

N75_

7. DD 250 REQ

NO

1TIME

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

16. REMARKS

Blk 11: When directed by the MSCREP

MSC OMT 0 1 0

Chief Engineer 0 1 0

15. TOTAL 0 2 0

1. DATA ITEM NO.

A01S

2. TITLE OF DATA ITEM

Clean and Gas Free Tanks, Voids, Cofferdams & Spaces

3. SUBTITLE

Missin…

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