N0003918R0081_TO_Taiwan_11.16.19.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

TBD

B. EXHIBIT

A

C. CATEGORY

TDP________ TM_________ OTHER X

D. SYSTEM / ITEM

Taiwan Inventory Manager

E. CONTRACT / PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Contractor's Progress, Status and Management Report

3. SUBTITLE

Monthly Status Report (MSR)(Rev. 052113)

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80227 and BLK16

5. CONTRACT REFERENCE

PWS 5.1

6. REQUIRING OFFICE

PEO C4I PMW 740

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

MTHLY

12. DATE OF FIRST SUBMISSION:

See Block 11

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

DRAFT

Final 8. APP CODE

N /A

11. AS OF DATE:

15th day of following period

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 11 Reg Repro

16. REMARKS

BLOCK 4: The MSR shall be submitted electronically and consist of three parts. The first two parts shall be provided in the Excel format of CDRL Attachments 1 and 2 with all cells filled in. The third part shall be provided in Word format and consist of a narrative addressing, at a minimum:

a. Performance Status – Identify significant accomplishments and progress made during the affected reporting period by PWS paragraph. Also identify significant challenges or risks encountered that impact the successful delivery of required services.

b. Schedule Status – Identify schedule for and status of all deliverables. If the efforts are not on schedule, indicate the reason for the delay and provide a revised completion /delivery date.

c. Financial Status –Identify at a summary level and by PWS paragraph the total amount planned by appropriation, total amount received to date by appropriation, planned vs actual burn by appropriation and Estimate At Completion (EAC). In addition to the reporting requirements identified in Attachment 1, identify any travel accomplished with sufficient detail to support costs and provide a detailed description fo the ODC’s authorized at time of award and ODC costs incurred to date. This description does not waive the requirement for formal Limitation of Funds/Cost notifications, when warranted.

Personnel Status/Staffing Plan – Identify labor hours planned for each employee charging to the contract/task order by PWS paragraph, the actual cumulative total to date, CAC and training status per Attachment 1. Identify by Employee Code, labor category, fully burdened labor rate per Attachment 2. This reqiurement applies to the Prime and any sub-contractors supporting this effort. Subcontractors may provide the information directly to the Contracting Officer and COR.

BLOCK 12 & 13: The Contractor shall deliver the initial monthly report 45 Days After Contract Award (DACA). Subsequent submissions due no later than 15 days after the end of the prior month. No Government response to the Report within 30 days of submission constitutes approval.

Contracting Officer’s Representative (COR)

Contracting Officer 1

Contract Specialist 1

15. TOTAL

G. PREPARED BY

David Chao

H. DATE

8 May 2018

I. APPROVED BY

David Chao

J. DATE

8 May 2018

DD Form 1423-1 JUN 90 Previous editions are obsolete Page 1 of 5

Form Approved OMB No. 0704-0188

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

TBD

B. EXHIBIT

A

C. CATEGORY

TDP________ TM_________ OTHER X

D. SYSTEM / ITEM

Taiwan Inventory Manager

E. CONTRACT / PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Report, Record of Meeting/Minutes

3. SUBTITLE

Meeting Minutes

4. AUTHORITY (Data Acquisition Document No.)

DI-ADMN-81505 and BLK16

5. CONTRACT REFERENCE

PWS 5.1, 5.2e

6. REQUIRING OFFICE

PEO C4I PMW 740

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION:

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

DRAFT

Final 8. APP CODE

N /A

11. AS OF DATE:

BLK16

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ Reg Repro

BLOCK 4: Contractor’s format is acceptable. Submit electronically in native word format not PDF, compatible with Microsoft Office 2010 or later. Submit hard copies upon request only.

BLOCK 11: Command Control Interoperability Board (CCIB) minutes shall be recorded and delivered to the USG within five working days after completion of the CCIB meeting or review for the Inventory Manager portion of the meeting. An action list shall be developed and maintained throughout the meeting or review.

Non-CCIB Minutes shall be recorded and delivered to the USG within three working days after meeting.

Contracting Officer’s

David Chao

H. DATE

8 May 2018

I. APPROVED BY

David Chao

J. DATE

DD Form 1423-1 JUN 90 Previous editions are obsolete Page 2 of 5

Form Approved OMB No. 0704-0188

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

TBD

B. EXHIBIT

A

C. CATEGORY

TDP________ TM_________ OTHER X

D. SYSTEM / ITEM

Taiwan Inventory Manager

E. CONTRACT / PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

Report, Record of Meeting/Minutes

3. SUBTITLE

Trip Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81505 and BLK16

5. CONTRACT REFERENCE

PWS 5.2e

6. REQUIRING OFFICE

PEO C4I PMW 740

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION:

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

DRAFT

Final 8. APP CODE

N /A

11. AS OF DATE:

BLK16

13. DATE OF SUBSEQUENT

SUBMISSION

Contractor’s format is acceptable. Submit electronically in native word format not PDF, compatible with Microsoft Office 2010 or later. Submit hard copies upon request only.

BLOCK 11: Trip report shall be recorded and delivered to the USG within five working days after completion of the trip.

Contracting Officer’s

David Chao

H. DATE

8 May 2018

I. APPROVED BY

David Chao

J. DATE

DD Form 1423-1 JUN 90 Previous editions are obsolete Page 3 of 5

Form Approved OMB No. 0704-0188

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

TBD

B. EXHIBIT

A

C. CATEGORY

TDP________ TM_________ OTHER X

D. SYSTEM / ITEM

Taiwan Inventory Manager

E. CONTRACT / PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Contractor’s Standard Operating Procedures (SOP)

3. SUBTITLE

Distribution Plan

4. AUTHORITY (Data Acquisition Document No.)

DI-ADMN-81580 and BLK16

5. CONTRACT REFERENCE

PWS 5.2f

6. REQUIRING OFFICE

PEO C4I PMW 740

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION:

180DACA

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

DRAFT

Final 8. APP CODE

N /A

11. AS OF DATE:

ASERQ

13. DATE OF SUBSEQUENT

SUBMISSION

Contractor’s format is acceptable. Submit electronically in native Word or PowerPoint

David Chao

H. DATE

8 May 2018

I. APPROVED BY

David Chao

J. DATE

DD Form 1423-1 JUN 90 Previous editions are obsolete Page 4 of 5

Form Approved OMB No. 0704-0188

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

TBD

B. EXHIBIT

A

C. CATEGORY

TDP________ TM_________ OTHER X

D. SYSTEM / ITEM

Taiwan Inventory Manager

E. CONTRACT / PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

Technical Report – Study/Services

3. SUBTITLE

Inventories, Findings and Recommendations

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B and BLK16

5. CONTRACT REFERENCE

PWS 5.2b

6. REQUIRING OFFICE

PEO C4I PMW 740

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION:

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

DRAFT

Final 8. APP CODE

N /A

11. AS OF DATE:

ASREQ

13. DATE OF SUBSEQUENT

SUBMISSION

Contractor’s format is acceptable. Submit electronically in native Word or PowerPoint

David Chao

H. DATE

8 May 2018

I. APPROVED BY

David Chao

J. DATE

DD Form 1423-1 JUN 90 Previous editions are obsolete Page 5 of 5

ATTACHMENTS

MSR - Att 1.XLS (MSR CDRL Staffing Plan Spreadsheet - Attachment 1)(Rev. 052113)

MSR - Att 2.XLS (MSR CDRL Staffing Plan Spreadsheet – Attachment 2)(Rev. 052113)