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
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.
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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
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
17. PRICE GROUP
TOTAL PRICE
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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