J-8_CDRLs.pdf

For the best experience, open this PDF portfolio in

Acrobat X or Adobe Reader X, or later.

Get Adobe Reader Now!

http://www.adobe.com/go/reader

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

1_DATA_ITEM_NO: A018

2_TITLE_OF_DATA_ITEM: Structural Inspection Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: DI-MGMT-82065

5_CONTRACT_REFERENCE: SOW PARAGRAPH 3.5.2

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: ASREQ*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLOCK 16

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS: BLOCK 4: USE/RELATIONSHIP BLOCK: Delete the following: ", exposed piping penetration, deck drain,"

Paragraph 2.d delete "including standard item paragraph number" Paragraph 2.e delete "Compartment (number and name)

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12, and 13: Submit each report within 2 working days of test.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 1, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-01T11:59:30-0700

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T12:12:34-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A019

2_TITLE_OF_DATA_ITEM: Ultrasonic Test (UT) Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: OT-DID-17-20040

5_CONTRACT_REFERENCE: SOW PARAGRAPH 3.5.3

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: ASREQ*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLOCK 16

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS: BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12, and 13: Submit each report within 2 working days of test

BLOCK 14: Media requirement. The report shall be delivered electronically in

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 7, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: NDTI

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-07T11:31:32-0800

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T12:16:19-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A001

2_TITLE_OF_DATA_ITEM: Production Schedule Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: DI-MGMT-80227

5_CONTRACT_REFERENCE: SOW PARAGRAPH 1.5.1

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: WEKLY*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLOCK 16

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS:

BLOCK 4: Paragraph 10.2: Delete "This report shall be typewritten on standard size (e.g. 8 1/2" by 11'") white paper, and securely stapled.".

Delete Paragraphs 10.3.d; 10.3.g; 10.3.i; 10.3.j; 10.3.k; 10.3.l.

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12, and 13: Submit report 24 hours prior to each weekly scheduled production meeting.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 1, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-01T10:05:23-0700

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T08:46:06-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A002

2_TITLE_OF_DATA_ITEM: Coating System Data Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: OT-DID-17-20039

5_CONTRACT_REFERENCE: SOW PARAGRAPH 1.5.5

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: OTIME

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: N/A

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS:

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 12: Report shall be submitted 5 business days after contract award.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Government Docking Observer (GDO) and the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 7, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-07T09:17:25-0800

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T08:56:08-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A003

2_TITLE_OF_DATA_ITEM: SAFETY DATA SHEET (SDS) REPORT

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: OT-DID-17-20036

5_CONTRACT_REFERENCE: SOW PARAGRAPH 1.5.6

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: OTIME

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: N/A

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS:

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 12: Report shall be submitted 5 business days after contract award.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 7, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: VESSEL REPAIR SERVICES

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-07T09:51:16-0800

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T09:01:27-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A004

2_TITLE_OF_DATA_ITEM: Condition Found Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: DI-MGMT-81648

5_CONTRACT_REFERENCE: SOW PARAGRAPH 1.11

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: ASREQ*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLOCK 16

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS: BLOCK 4: Delete paragraph 3.2.a.

Paragraph 3.2.b delete "Premium/Acceleration" and "premium".

Paragraph 3.2.c delete "internal milestones" and "and contract".

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12, and 13: Submit report within 5 working days of work item requirement discovery.

Submit report within 24 hours of anticipated difficulty in meeting contract requirements and/or schedule dates.

For required reports that could result in a change in work to be accomplished or additional material to be procured, submit the required report in a time frame to allow the CO, via the COR, to initiate early action, but no later than the first 20 percent of the scheduled availability.

Drydock related inspection reports shall be submitted no later than the first 20 percent of the scheduled docking period. Drydock related reports which contain readings (final, thickness, etc.) clearances, alignments, test results, or other such data for work that has to be completed prior to pre-flood/undocking, shall be submitted to the CO, via the COR, within 24 hours after recording the data but no later than 72 hours prior to pre-flood/undocking, whichever occurs first.

Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 1, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-01T10:06:43-0700

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T09:56:13-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A005

2_TITLE_OF_DATA_ITEM: Accident/Incident Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: DI-SAFT-81563

5_CONTRACT_REFERENCE: SOW PARAGRAPH 1.13.2

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: ASREQ*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLOCK 16

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS:

BLOCK 4: USE/RELATIONSHIP BLOCK: Delete the following: "major"; "one or more fatalities, or two or more disabling"; "exceeding $10,000;".

PARAGRAPH 2.: Delete "serious"; "which will adversely affect capability to meet contractual obligations".

PARAGRAPH 2.G: Delete "disabling"; "exposed to CBR agents".

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12, and 13: Report shall be submitted within 24 hours of investigation completion.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 1, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: SAFT

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-01T10:07:53-0700

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T10:01:20-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A006

2_TITLE_OF_DATA_ITEM: Quality Assurance (QA) Preservation Appendices

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: OT-DID-17-20033

5_CONTRACT_REFERENCE: SOW PARAGRAPH 1.16.1

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: ASREQ*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLOCK16

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS:

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12 and 13: Submit documents within 3 working days of completion of the following preservation operations: SSPC SP-1, Surface Profiles, and Top Coat Cure.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 7, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: QCIC

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-07T10:05:58-0800

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T10:04:17-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A007

2_TITLE_OF_DATA_ITEM: Hazardous Waste Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: OT-DID-17-20038

5_CONTRACT_REFERENCE: SOW PARAGRAPH 1.17

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: OTIME*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: N/A

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS:

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10: Submit report within 30 calendar days of project completion.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 7, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-07T10:44:56-0800

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T10:18:29-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A008

2_TITLE_OF_DATA_ITEM: Gas Free Program Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: OT-DID-17-20034

5_CONTRACT_REFERENCE: SOW PARAGRAPH 1.21.1

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: ASREQ*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: N/A

13_DATE_OF_SUBSEQUENT_SUB: N/A

addressee1: PSNS & IMF C/411 draft1: 1 reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 1 total_repro: 0

16_REMARKS:

BlOCK 8: Product shall be approved for technical content. Government requires 5 work days to review and comment. Contractor has 3 working days to incorporate comments and send back to the Government.

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12, AND 13: BLOCK 10, 12, and 13: Submit report a minimum of 8 working days prior to the start of contract period of performance.

Submit revised report within 2 work days of a change to the Gas Free Program, Personnel, or Certifications/Qualifications.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 7, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-07T10:47:55-0800

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T10:26:27-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A009

2_TITLE_OF_DATA_ITEM: Test and Inspection Plan (TIP)

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: DI-MGMT-82062

5_CONTRACT_REFERENCE: SOW PARAGRAPH 1.22.1

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: A*

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: ASREQ*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLOCK16

addressee1: PSNS & IMF C/411 draft1: 1 reg1: 1 repro1:

addressee2:

draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 1 total_repro: 0

16_REMARKS:

BLOCK 4: USE/RELATIONSHIP BLOCK: Delete the following: ", as well as symbols (I)(V)(Q) test/inspections and (G) government notification identified in the Work item,"

REQUIREMENTS BLOCK: Delete the following: "Standard Item Number"; "Standard Item Paragraph"; "Inspection Symbol (I,V,Q,G)"; "Request Date"; "Request Time"; "Name of Government Representative at Inspection"

BLOCK 8: Government requires 5 days prior to project start date to review and comment. Contractor has 3 days to incorporate any changes and return to Government.

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12 and 13:

Submit TIP 24 hours prior to each weekly scheduled production meeting.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 1, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MGMT

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-01T11:56:59-0700

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T11:06:52-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A010

2_TITLE_OF_DATA_ITEM: Vessel Docking and Undocking Plan

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: OT-DID-17-20041

5_CONTRACT_REFERENCE: SOW PARAGRAPH 3.1

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: A*

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: ASREQ*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLOCK 16

addressee1: PSNS & IMF C/411 draft1: 1 reg1: 1 repro1:

addressee2: PSNS & IMF C/242 draft2: 1 reg2: 1 repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 2 total_repro: 0

16_REMARKS: BlOCK 8: Product shall be approved for technical content. Government requires 5 work days to review and comment.

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12, and 13: Submit plan a minimum of 5 working days prior to docking and undocking the vessel.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Government Docking Observer (GDO) and the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 7, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 2

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-07T11:21:50-0800

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T11:13:07-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A011

2_TITLE_OF_DATA_ITEM: Vessel Final Docking Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: OT-DID-17-20035

5_CONTRACT_REFERENCE: SOW PARAGRAPH 3.1.11

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D(SEE BLK16)

10_FREQUENCY: OTIME*

11_AS_OF_DATE: N/A

12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16

13_DATE_OF_SUBSEQUENT_SUB: N/A

addressee1: PSNS & IMF C/411 draft1:

reg1: 1 repro1:

addressee2: PSNS & IMF C/242 draft2:

reg2: 1 repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

reg5:

repro5:

addressee6:

draft6:

reg6:

repro6:

addressee7:

draft7:

reg7:

repro7:

addressee8:

draft8:

reg8:

repro8:

addressee9:

draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

repro10:

addressee11:

draft11:

reg11:

repro11:

addressee12:

draft12:

reg12:

repro12:

addressee13:

draft13:

reg13:

repro13:

addressee14:

draft14:

reg14:

repro14:

addressee15:

draft15:

reg15:

repro15:

addressee16:

draft16:

reg16:

repro16:

addressee17:

draft17:

reg17:

repro17:

addressee18:

draft18:

reg18:

repro18:

addressee19:

draft19:

reg19:

repro19:

addressee20:

draft20:

reg20:

repro20:

addressee21:

draft21:

reg21:

repro21:

addressee22:

draft22:

reg22:

repro22:

addressee23:

draft23:

reg23:

repro23:

addressee24:

draft24:

reg24:

repro24:

addressee25:

draft25:

reg25:

repro25:

addressee26:

draft26:

reg26:

repro26:

addressee27:

draft27:

reg27:

repro27:

addressee28:

draft28:

reg28:

repro28:

addressee29:

draft29:

reg29:

repro29:

addressee30:

draft30:

reg30:

repro30:

addressee31:

draft31:

reg31:

repro31:

addressee32:

draft32:

reg32:

repro32:

addressee33:

draft33:

reg33:

repro33:

addressee34:

draft34:

reg34:

repro34:

addressee35:

draft35:

reg35:

repro35:

addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_repro: 0

16_REMARKS:

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10: Submit report within 5 working days of final undocking of the vessel.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Government Docking Observer (GDO) and the Contracting Officer's Representative (COR) specified in the contract.

17_PRICE_GROUP:

ESTIMATED_TOTAL_PRICE:

G_PREPARED_BY:

H_DATE: NOV 7, 2016

1_APPROVED_BY:

J_DATE: NOV 28, 2016

Page: 1 reg38t: 2

A_CONTRACT_LINE_ITEM_NO: 0001/0002

B_EXHIBIT: A

TDP:

TM:

OTHER: MISC

DSYSTEMITEM: Vessel Repair Services

E_CONTRACTPR_NO: N00024-17-C-4437

FCONTRACTOR: TBD

of_pages: 1

Reset:

2016-11-07T11:23:47-0800

STUBBLEFIELD.MATTHEW.COREY.1166829778

2016-11-28T11:18:38-0800

TIEMEYER.JOHN.DAVID.1044537105

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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

1_DATA_ITEM_NO: A012

2_TITLE_OF_DATA_ITEM: Zinc Anode Location Report

3_SUBTITLE: N/A

4_AUTHORITY_Data_Acquisit: OT-DID-17-20042

5_CONTRACT_REFERENCE: SOW PARAGRAPH 3.2.3.2

6_REQUIRING_OFFICE: PSNS & IMF C/411

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_ST…