Atch(1b)_PWS_Section_F,_Deliveries_Kitchen_Exhaust_System_Part2.pdf

S0200000 – Management and Administration

SECTION F: DELIVERIES OR PERFORMANCE

Section F – 0200000 Management and Administration

*Note: When the distribution is to “KO or COR,” the primal recipient shall be COR unless otherwise notified.

DELIVERABLES

Annex/ Spec Item

Form Attachment

Number Deliverable Title Date (s) of

Submission

Distribution

Frequency

Original (*See Note above)

Copies (including original)

0200000/ 2.2.1.2

N/A Request to Work Outside Contractor Working Hours

For Approval: At least 15 calendar days prior to requested day.

Affected divisions and / or activities

1 As required

For Acceptance:

Within three working days after approval and prior to the requested day.

KO or

COR

0200000/ 2.3.1

N/A Sign-In Sheets and Minutes

Initial (for review and comments):

Within two working days.

KO,

COR and all attendees

1 As required

Final Revision (for acceptance): Within two working days from Government Comments.

1 As specified

0200000/ 2.3.4

N/A Permits and Licenses

Within 15 calendar days after contract award, within 7 calendar days after the old ones expire, and as requested.

KO or

COR

1 As specified

0200000/ 2.3.5

N/A Certificate of Insurance

Within 15 calendar days after contract award, prior to the commencement of work, and within 7 calendar days prior to expiration of the existing policy.

KO or

COR

1 Annually

*Note: When the distribution is to “KO or COR,” the primal recipient shall be COR unless otherwise notified.

DELIVERABLES

Annex/ Spec Item

Form Attachment

Number Deliverable Title Date (s) of

Submission

Distribution

Frequency

Original (*See Note above)

Copies (including original)

0200000/ 2.5

N/A Samples, Safety Data Sheets (SDS) or Manufacturer’s Data Cut Sheets of Materials

Within seven calendar days of Government request

KO or

COR

As required When requested

0200000/ 2.6.2 and

2.9.7

J-0200000-04 (Sample)

Daily Report By 10:00 a.m. of the following work day

COR and

PAR

1 Daily

Monthly On-Site Labor Report (Monthly Man Hour Labor Report)

First work day of each month (shall be included in Daily Report)

Monthly

0200000/ 2.6.7.1

N/A Quality Management (QM) Plan

Within 15 calendar days after contract award, and within 7 calendar days of changes.

KO or

COR

1 As specified

0200000/ 2.6.7.2

N/A Quality Inspection and Surveillance File

Within five calendar days of completion or termination of the contract.

KO or

COR

1 As specified

0200000/ 2.6.7.3

N/A Contractor Quality Inspection and Surveillance Report

First work day of each month.

KO or

COR

1 Monthly *Note: The frequency may be adjusted based on the Contractor’s quality of performance.

0200000/ 2.6.8

N/A Property Management Plan

Within 15 calendar days of Government request.

KO or

COR

1 When requested

*Note: When the distribution is to “KO or COR,” the primal recipient shall be COR unless otherwise notified.

DELIVERABLES

Annex/ Spec Item

Form Attachment

Number Deliverable Title Date (s) of

Submission

Distribution

Frequency

Original (*See Note above)

Copies (including original)

0200000/ 2.7.1

N/A List of Key Personnel and Qualifications or Request to Appoint New Key Personnel and Interpreter

Initial (for Government approval):

• First submission:

within 15 calendar days after contract award (Note: first submission may be exempt if included in the proposal submittals.)

• When the Contractor intends to appoint new personnel or when the Government requests to revise personnel: prior to appointment of new personnel

Final (after Government acceptance):

within five calendar days of changes or updates if requested

KO or

COR

1 As specified

0200000/ 2.7.1

N/A Organizational Chart

Within 15 calendar days after contract award and within 5 calendar days of changes, or updates.

(Note: first submission may be exempt if included in the proposal submittals.).

KO or

COR

1 As specified

0200000/ 2.7.1.3

N/A Certificates and/or Proof Documents for 24 Hours of Formal Safety Training

Within one year after the date of contract award.

KO or

COR

1 Every four years from previous training completion date

*Note: When the distribution is to “KO or COR,” the primal recipient shall be COR unless otherwise notified.

DELIVERABLES

Annex/ Spec Item

Form Attachment

Number Deliverable Title Date (s) of

Submission

Distribution

Frequency

Original (*See Note above)

Copies (including original)

0200000/ 2.7.3

N/A Contractor Labor Hours (Enterprise-wide Contractor Manpower Reporting Application (eCMRA)) Report

No later than 31 October.

N/A (direct input)

Annually for labor executed during the period of performance during each Government fiscal year

(FY)

0200000/ 2.8.1 and

2.8.2

N/A Employee List and Vehicle List

15 calendar days after contract award, within 15 calendar days of each option period exercise, and within 7 calendar days of changes or updates.

KO or

COR

1 Annually, and continuous as specified

0200000/ 2.9.1, 2.9.2, and

2.9.3 through 2.9.3.5

J-0200000-07 (Sample AHA) J-0200000-08

(Sample Contractor

Crane Operating

Checklist for Critical Lifts)

Accident Prevention Plan

(APP):

incorporate the Activity Hazard Analyses (AHAs), and Safety and Occupational Health (SOH) Risks and Compliance Plans

[General] Within 15 calendar days after contract award, within 15 calendar days of change, and at least 2 working days prior to start of work for changes and additional plans and programs.

[AHAs for modification]

• For modifications and when necessary:

within 15 calendar days after modification is signed and at least 2 working days prior to the commencement of work.

KO or

COR

1 Continuous, and updates as required

*Note: When the distribution is to “KO or COR,” the primal recipient shall be COR unless otherwise notified.

DELIVERABLES

Annex/ Spec Item

Form Attachment

Number Deliverable Title Date (s) of

Submission

Distribution

Frequency

Original (*See Note above)

Copies (including original)

0200000/ 2.9.5

J-0200000-09 (Sample)

NAVFAC

Contractor Incident Reporting System (CIRS) Report

Initial Report:

within 12 hours of mishap occurrence.

Follow-up Report:

within five days of mishap occurrence.

Final Report: within 30 days of mishap occurrence.

KO or

COR

1 As required

0200000/ 2.9.5

J-0200000-10 (Sample)

NAVFAC Mishap Notification Report

Initial Report:

within four hours of mishap occurrence.

Follow-up Report:

within 12 hours of mishap occurrence.

KO or

COR

1 As required

0200000/ 2.9.5

J-0200000-11 (Sample)

Weight Handling Equipment (WHE) Accident Report

Within 15 working days of accident.

KO or

COR

1 As required

0200000/ 2.9.5

J-0200000-12 (Sample)

Near Miss Notification Report

Within 24 hours of occurrence.

KO or

COR

1 As required

0200000/ 2.9.5

J-0200000-13 (Sample)

Crane and Rigging Gear Near Miss Report

Within 15 working days of accident.

KO and

COR

1 As required

0200000/ 2.9.7

N/A Monthly On-Site Labor Report

Refer to Spec Item 2.6.2 of this Annex.

0200000/ 2.9.8.1

N/A LSIO Citations and Violations Corrective Action Report

Within 48 hours after receiving a citation.

KO or

COR

1 As required

0200000/ 2.9.10

N/A Safety Certifications

Within 15 calendar days after contract award and prior to expiration of certifications.

KO and

COR

1 As specified

0200000/ 2.10.1.2

N/A Request for Permission to Use High Energy Consuming Tools or Equipment

At least seven calendar days and prior to use of the tools or equipment.

KO or

As required

*Note: When the distribution is to “KO or COR,” the primal recipient shall be COR unless otherwise notified.

DELIVERABLES

Annex/ Spec Item

Form Attachment

Number Deliverable Title Date (s) of

Submission

Distribution

Frequency

Original (*See Note above)

Copies (including original)

0200000/ 2.10.2.7

N/A Spill Prevention and Response Plan

Within 15 calendar days after contract award and prior to commencing work.

ENV via KO or

As specified

0200000/ 2.10.2.8

N/A Request to Bring and/or Use Hazardous Material on Installation

Within 15 calendar days after contract award, and at least 7 calendar days prior to bringing or using the hazardous materials.

KO or

COR

1 As specified

0200000/ 2.10.3

N/A Sustainable Procurement and Practices Plan

Within seven working days of Government request.

KO or

COR

1 When requested

0200000/ 2.10.3

N/A Sustainable Delivery of Services Report

Within seven working days of Government request.

KO or

COR

1 When requested

0200000/ 2.10.3.2

N/A Recovered Material Certification

When a product containing recovered materials is equal to or better than the original and could be used; and at least 14 calendar days prior to use.

KO or

COR

1 As specified

0200000/ 2.12

N/A Technical Library Contents

Upon completion or termination of the contract

KO or

1 As specified

Annex/Spec Item: 0200000/2.2.1.2

Deliverables Form Preparation Instructions

Deliverable Title: Request to Work Outside Contractor Working Hours

Form Attachment No.: N/A Government Approval Required: X Yes No Media: X Hard Copy and X Electronic (PDF/email) ___ Direct System Input Instructions:

1. Required File Format: The request shall be prepared using the form that the Contractor considers appropriate.

2. Purpose: For Government approval and acceptance.

3. Distribution List and Method of Submission: Hard Copy to all affected divisions and/or activities. /

Electronic copy to KO or COR.

1) Take the request letter form (hard copy) to all affected divisions and/or activities for their approval as necessary.

2) The request letter endorsed (approved / acknowledged) by all affected divisions and/or activities shall be converted to PDF file, Adobe Acrobat form, and submitted to the KO or COR via email.

3) If the KO or COR accepts the request, the Government will notify the Contractor of

Government acceptance. If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the request letter to the KO or COR via email. Continue this cycle until the Government notifies the Contractor of the Government acceptance.

4. Content: The request shall contain but not be limited to:

contract number and title, Contractor name, date, day, and time of requesting work day, justification for necessity and occasion of working outside Contractor working hours, affected divisions and/or activities endorsement (if necessary), and as determined by the Contractor to include all applicable regulatory information.

5. Other Requirement: The submitted request shall accurately reflect their intended use.

6. Due Dates:

For approval: The request letter shall be submitted at least 15 calendar days prior to requested day.

For acceptance: The endorsed letter shall be submitted within three working days after the request is approved.

Annex/Spec Item: 0200000/2.3.1

Deliverable Title: Sign-In Sheets and Minutes

Form Attachment No.: N/A Government Approval Required: ___ Yes X No

Media: X Hard Copy X Electronic (PDF/email) ___ Direct System Input

1. Required File Format: The sign-in sheets and minutes shall be prepared using forms that the Contractor considers appropriate.

2. Method of Submission:

Sign-in sheets shall be printed out and provided (hard copy) at the meetings. After the meetings, the sign-in sheets shall be converted to PDF and electronically submitted with the meeting minutes.

Meeting minutes shall be converted to PDF and electronically submitted.

3. Purpose: For Government review, comments and acceptance.

4. Distribution List: KO, COR and all attendees

If the KO or the COR accepts the minute, the Government will notify the Contractor of

Government acceptance.

If the KO or the COR responds to the minute with review comments, then incorporate the

Government’s comments and resubmit the minute via email to recipients on the distribution list.

Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content:

Sign-in Sheet: At a minimum, sign-in sheets shall contain the following:

Contract Number and Title Date and Location of the meeting Columns for attendees’ names, units/organizations, signatures and e-mail addresses.

Minute: At a minimum, minutes shall contain the following:

Contract Number and Title Date, Time and Location of the meeting Descriptions of the meeting (e.g., topics discussed, determinations made, etc.)

As determined by the Contractor to include all applicable regulatory information.

6. Other Requirements The submitted minute shall accurately reflect its intended use.

7. Due Dates

A. Initial: The Contractor shall submit the meeting minute along with the sign-in sheet within two working days after the meeting for review and comments.

B. Final: After first submission, if comments are received from the Government, the Contractor shall submit the revised minute within two working days after receiving Government comments for acceptance.

Annex/Spec Item: 0200000/2.3.4

Deliverable Title: Permits and Licenses

Form Attachment No.: N/A Government Approval Required: Yes X No

Media: ___ Hard Copy X Electronic (PDF/email) ___ Direct System Input

1. Method of Submission: Via email. The copies of Permits and Licenses shall be converted to PDF file, Adobe Acrobat form.

2. Purpose: For Government acceptance.

3. Distribution List: KO or COR

If the KO or the COR accept the Permits and Licenses, the Government will notify the

Contractor of Government acceptance.

If the KO or COR respond with review comments, then incorporate the Government’s comments and resubmit the copies of Permits and Licenses via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of

4. Other Requirement: The submitted copies of Permits and Licenses shall accurately reflect their intended use.

Note: As Spec Item 2.6.4, Deliverables of Annex 2 specifies that all submittals shall be translated in English, the Contractor shall submit the copies of Permits and Licenses with English translation.

5. Due Dates: The copies of Permits and Licenses shall be submitted within 15 calendar days after contract award, within 7 calendar days after the old ones expire, and as required.

Annex/Spec Item: 0200000/2.3.5

Deliverable Title: Certificate of Insurance

Form Attachment No.: N/A Government Approval Required: Yes X No

1. Method of Submission: Via email. The Certificate of Insurance shall be converted to PDF file, Adobe Acrobat form.

If the KO or the COR accepts the Certificate of Insurance, the Government will notify the

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the Certificate of Insurance via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government

4. Content: Copies of certificate of insurance listed under Spec Item 2.3.5.2, Minimum Insurance

Amounts of Annex 2.

5. Other Requirement: The submitted Certificate of Insurance shall accurately reflect their intended use.

6. Due Dates: The Certificate of Insurance shall be submitted within 15 calendar days after contract award and prior to the start of work. Also, the Certificate of Insurance shall be submitted within 7 calendar days prior to expiration of the existing policy when the option period is exercised.

Annex/Spec Item: 0200000/2.5

Deliverable Title: Samples, Safety Data Sheets (SDS), or Manufacturer’s Data Cut Sheets of Materials

Form Attachment No.: N/A Government Approval Required: Yes X No

1. Method of Submission: Via email. The Samples, SDS, or Manufacturer’s Data Cut Sheets of Materials shall be converted to PDF file, Adobe Acrobat form.

If the KO or the COR accepts the Samples, SDS, or Manufacturer’s Data Cut Sheets of

Materials, the Government will notify the Contractor of Government acceptance.

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the Samples, SDS, or Manufacturer’s Data Cut Sheets of Materials via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

4. Other Requirements: The submitted Samples, SDS, or Manufacturer’s Data Cut Sheets of Materials shall accurately reflect their intended use.

Note: As required in Spec Item 2.6.4, Deliverables of Annex 2, all submittals shall be translated in English. The Contractor shall submit the Samples or Manufacturer’s Data Cut Sheets of Materials with English translation.

5. Due Dates: The Samples, SDS, or Manufacturer’s Data Cut Sheets of Materials shall be submitted within seven calendar days of Government request.

Annex/Spec Item: 0200000/2.6.2

Deliverable Title: Daily Report

Form Attachment No.: J-0200000-04 (Sample) Government Approval Required: ___ Yes X No

1. Required File Format: The report shall be prepared in accordance with the sample form provided in J-0200000-04.

2. Method of Submission: Via email. The report form shall be converted to PDF file, Adobe

Acrobat form and burnt on to a CD with digital photos and/or videos.

3. Purpose: For Government acceptance.

4. Distribution List: KO or COR

If the KO or the COR accepts the report, the Government will notify the Contractor of

If the KO or the COR responds to the report with review comments, then incorporate the Government’s comments and resubmit the report via email to recipients on the distribution list.

5. Content: Any item of work must be reported and the report shall contain the below-listed items;

All items included in the sample form provided in J-0200000-04;

dates, times, locations, descriptions of work performed;

all required and applicable items stated in this Annex e.g.;

• Spec Item 2.6.3, Work Schedule,

• Monthly On-Site Labor Hours required under Spec Item 2.9.7,

• Copies of warranty documents in English when components are replaced per Spec Item

2.13, Warranty Management; and all required and applicable items stated in technical sub-annex 1502000, e.g.;

• identified systems and equipment which differ from the current facility inventory list and any items not in this contract (Spec Item 3.1, Recurring Services Program);

• Graphic Images (Spec Item 3.1.1, Exhaust Hoods and Ducts): refer to the following paragraph, 6 – A, listed under the “Other Requirements” for more requirements and information;

• any identified abnormality from the inspection services (Spec Item 3.1.1.1, Inspection);

and

* Note: These instructions continue on the following page.

Annex/Spec Item: 0200000/2.6.2

Deliverable Title: Daily Report

Form Attachment No.: J-0200000-04 (Sample) Government Approval Required: ___ Yes X No

Media: ___ Hard Copy X Electronic (PDF/email) ___ Direct System Input

* Note: Continued from the previous page.

6. Other Requirements: The submitted report shall accurately reflect their intended use

A. Reports and Graphic Images: Requirements indicated below are applicable to Spec Item 3.1.1, Exhaust Hoods and Ducts of technical sub-annex 1502000 and all subordinate spec items (3.1.1.1 thru 3.1.1.2).

The Contractor shall submit reports with detailed CLEAR digital photos and/or videos

(hereinafter collectively called graphic images) including but not limited to all the items described below to the extent that shall be sufficient for the Government to ensure the services have fully met the contract requirements. Submitted graphic Images must clearly walk the Government through the entire system (hoods, filters, exhaust duct lines, bonnets, roof mounted fans, etc.). It is required to have the correct date on all photos and/or videos. All submitted graphic images must clearly define all hood related components with schematic drawings showing the ducting layout.

Provide before and after work graphic images of followings:

Safety related procedures (e.g., Lockout/Tagout, fall protection, etc.)

All hood components The roof area around exhaust fans (including fans and bonnets) from at least two adjustable sides (Identify all pre-existing conditions) The back-side of fan blades Clearly identified all sides of vertical and horizontal runs and rises The back of the filter rail’s top and bottom Both the completed hoods with filters out and filters properly in place Shots up ducts for each vertical run from the hood which clearly shows all sides of the entire run from the hood to the roof Shots down any horizontals from the hood that clearly show all sides of the entire run from the hood to the wall

B. Monthly On-Site Labor Hours: Refer to the following requirements and applicable section in J-0200000-04.

Content: The Monthly On-Site Labor Hours shall contain total number of hours worked for the previous month, including any subcontractors.

Daily Report: When any item of work is performed, the Daily Report shall be submitted by 10:00 am on the following work day.

Monthly On-Site Labor Hours: This data shall be included in the Daily Report on the first day of each month the work performed.

Annex/Spec Item: 0200000/2.6.7.1

Deliverable Title: Quality Management (QM) Plan Form Attachment No.: N/A Government Approval Required: Yes X No Media: Hard Copy X Electronic (PDF/email) ___ Direct System Input

1. Required File Format: The QM Plan shall be prepared using a form that the Contractor considers

2. Method of Submission: Via email. The QM Plan shall be converted to PDF file, Adobe Acrobat form.

If the KO or the COR accepts the QM Plan, the Government will notify the Contractor of

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the QM Plan via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content: The QM Plan shall describe the QMS methodology and approaches used under this contract and include, at a minimum, the following:

Policy and objectives of QMS Quality organization

• List of personnel

• Responsibilities & lines of authority

• Training and qualifications

Approach to assuring quality of services provided and conformance with performance objectives and standards

Methods and procedures for effective planning, operation and control of processes and performance of work

Procedures for inspection and surveillance of services

• Scheduling and performance of inspection and surveillance

• Measurement, data collection and analysis

• Corrective action, preventive action, and continuous improvement

• Oversight of subcontracted work

Documentation and records management Communication with government (supported commands, etc.)

6. Other Requirement: The submitted QM Plan shall accurately reflect its intended use.

7. Due Dates: The QM Plan shall be submitted within 15 calendar days after contract award, and within

7 calendar days of any change during the period of performance.

Annex/Spec Item: 0200000/2.6.7.2

Deliverable Title: Quality Inspection and Surveillance File

Form Attachment No.: N/A Government Approval Required: Yes X No Media: Hard Copy X Electronic (PDF/CD) ___ Direct System Input

1. Required File Format: The Quality Inspection and Surveillance File shall be prepared using a form that the Contractor considers appropriate.

2. Method of Submission: The Quality Inspection and Surveillance File shall be converted to PDF file, Adobe Acrobat form, and burnt on to a CD or DVD.

If the KO or the COR accepts the Quality Inspection and Surveillance File; the Government will notify the Contractor of Government acceptance.

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the Quality Inspection and Surveillance File via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of

5. Content: The Quality Inspection and Surveillance File shall contain all scheduled and performed inspections and surveillances, inspection and surveillance results, dates, and details of corrective and preventive actions.

The Quality Inspection and Surveillance File shall be made available during the Government’s regular working hours.

The submitted Quality Inspection and Surveillance File shall accurately reflect their intended use.

7. Due Dates: Within five calendar days of completion or termination of the contract.

Annex/Spec Item: 0200000/2.6.7.3

Deliverable Title: Contractor Quality Inspection and Surveillance Report

Form Attachment No.: N/A Government Approval Required: ____Yes X No

1. Required File Format: The Contractor Quality Inspection and Surveillance Report shall be prepared using a form that the Contractor considers appropriate.

2. Method of Submission: Via email. The report shall be converted to PDF file, Adobe Acrobat form.

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the report via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content

The report shall include a summary and results of the quality inspection and surveillance events performed and surveillance-driven corrective actions and process adjustments during the previous month(s).

6. Other Requirement: The submitted report shall accurately reflect their intended use.

7. Due Dates: The report shall be submitted first work day of each month. The Government may adjust the frequency of the submittal based on the Contractor’s quality of performance.

Annex/Spec Item: 0200000/2.6.8

Deliverable Title: Property Management Plan

Form Attachment No.: N/A Government Approval Required: ____Yes X No

1. Required File Format: The plan shall be prepared using a form that the Contractor considers

2. Method of Submission: Via Email. The plan shall be converted to PDF file, Adobe Acrobat form.

If the KO or the COR accepts the plan, the Government will notify the Contractor of Government acceptance.

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the plan via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content: The plan shall contain but not be limited to:

contract number and title;

Contractor name;

Contractor’s policies, procedures, and practices in repairing, maintaining, preserving, protecting, and reporting any damage of the government property; and

6. Other Requirement: The Contractor shall establish and maintain a plan that meets the contract clause requirements of Spec Item 2.4, Government-Furnished Property, Materials and Services, of this Annex. The submitted request shall accurately reflect its intended use.

7. Due Dates: The request shall be submitted within 15 calendar days of Government request.

Annex/Spec Item: 0200000/2.7.1 (Page 1 of 2)

Deliverable Title: List of Key Personnel and Qualifications or Request to Appoint New Key Personnel and Interpreter

Form Attachment No.: N/A Government Approval Required: Yes X No

1. Required File Format: The Key Personnel and Qualifications (Resume) or Request to Appoint New Key Personnel and Interpreter shall be prepared using a Government specified form; The Resume Form will be provided by the Government after contract award.

2. Method of Submission: Via Email. The resume form, qualifications (certificates and licenses if applicable), and/or request shall be converted to PDF file, Adobe Acrobat form.

If the KO or the COR accepts the qualifications, and/or request; the Government will notify the

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the qualifications, and/or request via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content: The List of Key Personnel and Qualifications or Request to Appoint New Key Personnel and

Interpreter shall contain the following:

First Submission and when the Government requests to revise the personnel: all items included in the Resume Form; their qualifications (copies of their certificates and licenses, and credentials of the Competent Person(s)); and any additional information requested by the KO or the COR to certify their qualifications.

When the Contractor intends to revise or appoint new personnel: request and justification of revising or appointing new Key Personnel and Interpreter; all items included in the Resume Form and their qualifications (copies of their certificates and licenses, and credentials of the Competent Person(s)); and any additional information requested by the KO or the COR to certify their qualifications.

Annex/Spec Item: 0200000/2.7.1 (Page 2 of 2)

Deliverable Title: List of Key Personnel and Qualifications or Request to Appoint New Key Personnel and Interpreter

Form Attachment No.: N/A Government Approval Required: Yes X No

Media: Hard Copy X Electronic (PDF/email) ___ Direct System Input

6. Other Requirement

Technically, the interpreter is not included in the Key Personnel member, but the Contractor shall submit a resume for the interpreter as part of this deliverable when revised.

The submitted qualifications, and/or request shall accurately reflect their intended use.

Initial (for Government acceptance): within 15 calendar days after contract award and prior to appointing new personnel. (Note: first submission may be exempt when required to be included in the proposal submittals.)

Final (after Government acceptance): The Government may or may not require the Contractor to submit the Final revised list. If requested, the Contractor shall submit the list and their qualifications within five calendar days of changes and updates.

Annex/Spec Item: 0200000/2.7.1

Deliverable Title: Organizational Chart

Form Attachment No.: N/A Government Approval Required: ___ Yes X No

1. Required File Format: The Organizational Chart shall be prepared using a form that the Contractor considers appropriate.

2. Method of Submission: Via Email. The Organizational Chart shall be converted to PDF file, Adobe

Acrobat form.

If the KO or the COR accepts the Organizational Chart, the Government will notify the Contractor of Government acceptance.

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the Organizational Chart via email to recipients on the distribution list.

5. Content: The Organizational Chart shall contain:

lines of authority of the Key Personnel and on-site supervisor(s), and the interpreter for this contract;

names of personnel including any subcontractors to be used, their position titles and qualifications in this contract; and as a minimum, include the Key Personnel, on-site supervisor(s), interpreter and who they will report directly to for this contract.

6. Other Requirement: The submitted chart shall accurately reflect their intended use.

7. Due Dates: The Organizational Chart shall be submitted within 15 calendar days after contract award and within five calendar days when revised or updated. (Note: first submission may be exempt when required to be included in the proposal submittals.)

Annex/Spec Item: 0200000/2.7.1.3

Deliverable Title: Certificates and/or Proof Documents for 24 Hours of Formal Safety Training

Form Attachment No.: N/A Government Approval Required: ___ Yes X No

1. Method of Submission: Via email. The certificate(s) and/or proof documents shall be converted to

PDF file, Adobe Acrobat form.

If the KO or the COR accepts the Certificates and/or Proof Documents for 24 Hours of Formal Safety Training, the Government will notify the Contractor of Government acceptance.

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the Certificates and/or Proof Documents for 24 Hours of Formal Safety Training via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

4. Content: Certificates and/or Proof Documents for 24 hours of competent and qualified safety training from sources such as Japan Construction Occupational Safety and Health Association (JCOSHA).

5. Other Requirement: The submitted certificate(s) and/or proof documents shall accurately reflect their

6. Due Dates: Within one year after contract award and every four years from previous training completion date.

Annex/Spec Item: 0200000/2.7.3

Deliverable Title: Contractor Labor Hours (Enterprise-wide Contractor Manpower Reporting Application (eCMRA)) Input Form Attachment No.: N/A Government Approval Required: Yes X No Media: Hard Copy __ Electronic (PDF/email) X Direct System Input Instructions: Contractor Labor Hours (eCMRA) Input

1) Method of Submission: via a secure data collection site, eCMRA (direct system input).

2) Content: the Contractor is required to report all Contractor labor required for performance of services provided under this contract. Refer to the above web address and completely fill in all required data fields.

Labor hours during the period of performance during each Government fiscal year (FY), October 1st through September 30th of each calendar year.

3) Other Requirements: The submitted invoice shall accurately reflect their intended use.

4) Due Dates: Annually, no later than the 31st of October.

Annex/Spec Item: 0200000/2.8.1 and 2.8.2

Deliverable Title: Employee List and Vehicle List

Form Attachment No.: N/A Government Approval Required: ____Yes X No Media: Hard Copy X Electronic (Excel or PDF/email) ___ Direct System Input

1. Required File Format: The list shall be prepared using the specific form that the Government will provide after contract award.

2. Method of Submission: Via email. Attach either the specific Excel form or converted PDF file, If the KO or the COR accepts the list, the Government will notify the Contractor of Government

If the KO or the COR responds with review comments, incorporates any of the Government’s comments and resubmit the list via email to recipients on the distribution list. Continue this

5. Content: The list shall include all employees’ names, titles, pass numbers, positions in the contract, contact numbers (in case of emergency), license numbers and insurance expiration dates of any vehicles to be used.

6. Other Requirement

The submitted list shall accurately reflect their intended use.

7. Due Dates: The list shall be submitted within 15 calendar days after contract award, within 15 calendar days of each option period exercise, and within 7 calendar days of updates or changes.

Annex/Spec Item: 0200000/2.9.1, 2.9.2, and Spec Item 2.9.3 through 2.9.3.5 (page 1 of 2)

Deliverable Title: Accident Prevention Plan (APP): incorporate the Activity Hazard Analyses (AHAs), and Safety and Occupational Health (SOH) Risks and Compliance Plans Form Attachment No.: J-0200000-07 (Sample form for AHA, Spec Item 2.9.2) and J-0200000-08 (Sample Contractor Crane Operating Checklist for Critical Lifts, Spec Item 2.9.3.4) Government Approval Required: Yes X No

1. Required File Format: The APP shall incorporate the AHAs and SOH Risks and Compliance Plans, and be formatted as addressed in paragraph 3.k. of Appendix A of the EM-385-1-1. The AHAs shall follow format of Figure 1-2 of the EM-385-1-1. Sample form for the AHA is provided in J-0200000-07. The Government will provide the blank AHA form after contract award. Sample Contractor Crane Operating Checklist for Critical Lifts is provided in J-0200000-08. The Government will provide the blank form after contract award when requested.

2. Method of Submission: Via email. The APP shall be converted to PDF file, Adobe Acrobat form.

3. Purpose: For Government review and acceptance.

If the KO or the COR accepts the APP, the Government will notify the Contractor of Government

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the APP via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

The APP shall include, as a minimum, elements addressed in paragraph 3.k. of Appendix A of

EM385-1-1.

The AHAs shall explain the following as detailed in the EM-385-1-1:

• The steps of the service process;

• Identify potential hazards that exist as a result of the Contractor’s service process within the environment;

• Measures or plans of actions to safely remove potential hazards away from people in and around the service process and environment;

• Specific materials and equipment necessary to safely remove potential hazards away from people in and around the service process and environment;

• Inspection requirements to assure service activity is safe; and

• Training of service personnel to be aware of potential hazards and measures or plans of actions to be used to remove hazards from service environment.

Annex/Spec Item: 0200000/2.9.1, 2.9.2, and Spec Item 2.9.3 through 2.9.3.5 (page 1 of 2)

Deliverable Title: Accident Prevention Plan (APP): incorporate the Activity Hazard Analyses (AHAs), and Safety and Occupational Health (SOH) Risks and Compliance Plans Form Attachment No.: J-0200000-07 (Sample form for AHA, Spec Item 2.9.2) and J-0200000-08 (Sample Contractor Crane Operating Checklist for Critical Lifts, Spec Item 2.9.3.4) Government Approval Required: Yes X No Media: ___ Hard Copy X Electronic (PDF/email) ___ Direct System Input

APP

The APP shall incorporate AHAs (refer to the Spec Item 2.9.2 of Annex 2) and SOH Risks and Compliance Plans (Spec Item 2.9.3 through 2.9.3.5) that are relevant to the site specific hazards and controls for each activity and type of work that may be encountered in the performance of this contract.

The APP shall be revised and resubmitted for any changes.

The Contractor shall review, update, and submit revisions to the APP whenever a change in work conditions, hazards, or activities occur.

• Updated as situations change.

• Additional SOH Risks and Compliance Plans shall be developed as applicable when new types of work are required under this contract.

• Other instruction(s) will be provided when required.

• The form provided in J-0200000-08 is a specific form for Spec Item 2.9.3.4, Critical Lift

Plan. The Contractor shall refer the form and requirements specified in Spec Item 2.9 and

2.9.3.4 of Annex 2 to develop the Critical Lift Plan.

Per Spec Item 2.10.2.8, Hazardous Material Management of this Annex, include the plan if any hazardous materials will be brought on the Installation.

The submitted APP and SOH Risks and Compliance Plans shall accurately reflect their intended use.

AHA

AHAs shall be updated as work activities or conditions change and additional AHAs prepared as new work activities are required.

Whenever the service environment or required task is different from the Recurring Work services;

and for modifications where changes are germane to the original Recurring Work portion of the contract, the Contractor shall revise applicable AHAs or prepare new AHAs and submit to recipients on the distribution list.

If changes to the AHAs are required, such changes shall be submitted to recipients on the distribution list for Government review and acceptance.

The submitted AHA shall accurately reflect their intended use.

General: The APP including AHAs and SOH Risks and Compliance Plans shall be submitted within 15 calendar days after contract award, within 15 calendar days of any changes, and at least 2 working days prior to the start of work for changes and additions.

AHAs for modifications and where changes are germane to the original Recurring Work:

within 15 calendar days after the modification is signed and at least 2 working days prior to the commencement of work.

Annex/Spec Item: 0200000/2.9.5

Deliverable Title: NAVFAC Contractor Incident Reporting System (CIRS) Report Form Attachment No.: J-0200000-09 (Sample) Government Approval Required: ___ Yes X No

1. Required File Format: The NAVFAC CIRS Report shall be prepared using the specific form, which will be provided by the Government after contract award. A sample form is provided in J-0200000- 09.

2. Method of Submission: Via email. The form shall be converted to PDF file, Adobe Acrobat form.

If the KO or the COR responds with review comments, then incorporate the Government’s

5. Content: The items in the NAVFAC CIRS Report form where applicable.

6. Other Requirement: The submitted reports shall accurately reflect their intended use.

7. Due Dates:

Initial CIRS Report: within 12 hours of mishap occurrence.

Follow-up CIRS Report: within five days of mishap occurrence.

Final CIRS Report: within 30 days of mishap occurrence.

Deliverable Title: NAVFAC Mishap Notification Report

Form Attachment No.: J-0200000-10 (Sample) Government Approval Required: ___ Yes X No

1. Required File Format:

Initial Report: The NAVFAC Initial Mishap Notification Report shall be prepared using the specific form, which will be provided by the Government after contract award. A sample form is provided in J-0200000-10.

Follow-up Report: The Follow-up Mishap Notification Report form shall be prepared using a form that the Contractor considers appropriate.

2. Method of Submission: Via email. The form shall be converted to PDF file, Adobe Acrobat form.

If the KO or the COR responds with review comments, then incorporate the Government’s

Initial Report: Refer to the form provided in J-0200000-10 and the blank form provided after contract award.

Follow-up Report:

Any updates and additional information, Information on primary cause of the mishap (unsafe conditions, personal error, etc.)

Light or Restricted Duty offered and performed by the employee, if applicable, and Photos of mishap site including sources of injury such as tools, equipment, materials, etc., if not included in the initial report.

6. Other Requirement: The submitted report shall accurately reflect its intended use.

7. Due Dates:

Initial Report: within four hours of mishap occurrence.

Follow-up Report: within 12 hours of mishap occurrence.

Deliverable Title: Weight Handling Equipment (WHE) Accident Report Form Attachment No.: J-0200000-11 (Sample) Government Approval Required: ___ Yes X No

1. Required File Format: The WHE Accident Report shall be prepared using the specific form, which will be provided by the Government after contract award. A sample form is provided in J-0200000- 11.

If the KO or the COR responds with review comments, then incorporate the Government’s

5. Content: Refer to the form provided in J-0200000-11 and the blank form provided after contract award.

6. Other Requirement: The submitted report shall accurately reflect their intended use.

7. Due Dates: This report shall be submitted within 15 working days of the WHE accident.

Deliverable Title: Near Miss Notification Report

Form Attachment No.: J-0200000-12 (Sample) Government Approval Required: ___ Yes X No

1. Required File Format: The Near Miss Notification Report shall be prepared using a form that the Contractor considers appropriate or the sample form for the Initial Near Miss Notification Report Form provided in J-0200000-12.

If the KO or the COR responds with review comments, then incorporate the Government’s

5. Content: Refer to the form provided in J-0200000-12 and the blank form provided after contract

7. Due Dates: The Near Miss Notification Report shall be submitted within 24 hours of the near miss occurrence.

Deliverable Title: Crane and Rigging Gear Near Miss Report Form Attachment No.: J-0200000-13 (Sample) Government Approval Required: ___ Yes X No

1. Required File Format: The Crane and Rigging Gear Near Miss Report shall be prepared using the specific form provided in J-0200000-13. The Government will provide the blank form after contract

If the KO or the COR responds with review comments, then incorporate the Government’s

5. Content: Refer to the form provided in J-0200000-13 and the blank form provided after contract

7. Due Dates: This report shall be submitted within 15 working days of the near miss.

UNCLASSIFIED/FOR OFFICIAL USE ONLY

Annex/Spec Item: 0200000/2.9.8.1

Deliverables Form Preparation Instructions

Deliverable Title: LSIO Citations and Violations Corrective Action Report

Form Attachment No.: N/A Government Approval Required: ___ Yes X No

1. Required File Format: The LSIO Citations and Violations Corrective Action Report shall be prepared using a form that the Contractor considers appropriate.

If the KO or the COR responds with review comments, then incorporate the Government’s

• Copy of the LSIO Citation

• The contents in the LSIO citation translated in English

• Corrective Action to be taken

• Preventive Action to be taken

• Any other information considered necessary by the Contractor

6. Other Requirement:

The submitted report shall accurately reflect its intended use.

The Contractor may be required to submit follow-up documentation.

7. Due Dates: This report shall be submitted within 48 hours after receiving a LSIO citation.

Annex/Spec Item: 0200000/2.9.10

Deliverables Form Preparation Instructions

Deliverable Title: Safety Certifications Form Attachment No.: N/A Government Approval Required: Yes X No

1. Method of Submission: Via email. The Safety Certification shall be converted to PDF file, Adobe

If the KO or the COR accepts the Safety Certification, the Government will notify the

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the copies of Safety Certification via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of

4. Other Requirements

The Contractor shall submit new versions of certifications as the old certifications expire.

The submitted copies of Safety Certification shall accurately reflect their intended use.

5. Due Dates: The copies of Safety Certification shall be submitted within 15 calendar days after contract award and prior to expiration of certifications.

Annex/Spec Item: 0200000/2.10.1.2

Deliverables Form Preparation Instructions

Deliverable Title: Request for Permission to Use High Energy Consuming Tools or Equipment Form Attachment No.: N/A Government Approval Required: ___ Yes X No Media: Hard Copy and X Electronic (PDF/email) ___ Direct System Input

1. Required File Format: The request shall be prepared using a form that the Contractor considers

2. Method of Submission: Electronic (one copy via Email) - The plan shall be converted to PDF file, (Note: The request letter will be routed internally to the Utilities Director from the FSC branch.)

If the KO or the COR accepts the request, the Government will notify the Contractor of

If the KO or the COR responds with review comments, then incorporate the Government’s comments and resubmit the request via email to recipients on the distribution list. Continue this

5. Content: The request shall contain, but not be limited to, the following:

contract number and title, Contractor name, work description and justification for the request, work schedule and location to be used, and

6. Other Requirement: The submitted request shall accurately reflect its intended use.

7. Due Dates: The request shall be submitted at least seven calendar days prior to the use of the tools or equipment.

Annex/Spec Item: 0200000/2.10.2.7

Deliverables Form Preparation Instructions

Deliverable Title: Spill Prevention and Response Plan

Form Attachment No.: N/A Government Approval Required: Yes X No

1. Required File Format: The Spill Prevention and Response Plan shall be prepared using a form that a Contractor considers appropriate.

2. Method of Submission: Electronic (one copy via Email) - The plan shall be converted to PDF file, Adobe

3. Purpose: for Government acceptance.

4. Distribution List: Environmental Branch via KO or COR

If the Environmental Branch and KO or the COR accept the plan, the Government will notify the

If the Environmental Branch, the KO or the COR respond with review comments, then incorporate the Government’s comments and resubmit the plan via email to recipients on the distribution list.

5. Content: The plan shall include, as a minimum, elements indicated below:

Contract number, Project title, and Contractor Information;

Identify potential spills including hazardous material information that exist as a result of the

Contractor’s service process within the environment;

Measures, procedures, and/or plans of actions to prevent, containment, clean-up, and report spills

(both in oral and written) including specific materials and equipment to be used;

Training of service personnel to be aware of potential spills and measures or plans of actions to be used to prevent, containment, clean-up, and report spills from service environment; and

7. Other Requirements

The plan shall include the notification to the EDC by calling 911 or 119 (from an on base telephone), or 0827-21-7700 (from a mobile phone) in the event of a reportable spill incident (such as spills that may contain POLs) which activates the Installation Spill response apparatus.

The submitted plan shall accurately reflect their intended use.

8. Due Dates: The plan shall be submitted within 15 calendar days after contract award and prior to commencing work.

Annex/Spec Item: 0200000/2.10.2.8 Deliverables Form Preparation Instructions

Deliverable Title: Request to Bring and/or Use Hazardous Material on Installation

Form Attachment No.: N/A Government Approval Required: X Yes _ No

Media: Hard Copy or X Electronic (PDF/email) ___ Direct System Input

1. Required File Format: The request shall be prepared using the form that the Contractor considers

2. Cover Sheet: The Government specified cover sheet is required. The cover sheet will be provided by the Government after contract award.

3. Purpose: For Government approval.

4. Method of Submission: Via email. The request form/letter shall be converted to PDF file, Adobe

5. Distribution List: KO or COR

If the KO or COR approves or disapproves the request, the Government will notify the Contractor of Government approval or disapproval.

If the KO or COR responds with review comments, then incorporate the comments and resubmit the request via email to recipient on the distribution list. Continue this cycle until the Government notifies the Contractor of Government approval.

6. Content: The request shall contain but not be limited to:

List of the Hazardous Materials the Contractor requests to bring and/or use on Installation Product names Purpose Areas where the materials will be stored and / or used, and

7. Other Requirement: The submitted request shall accurately reflect its intended use.

8. Due Dates: The request shall be submitted at least 15 calendar days after contract award, and at least 7 calendar days prior to bringing or using the hazardous materials on the Installation.

Annex/Spec Item: 0200000/2.10.3

Deliverables Form Preparation Instructions

Deliverable Title: Sustainable Procurement and Practices Plan Form…