0200000_Section-F_REV_1_19SEP2023.pdf

Section F – 0200000 Management and Administration

Section F 0200000 Deliveries or Performance

DELIVERABLES

Spec Item

Form Attachment

Number Deliverable Title Date (s) of Submission

Distribution

Frequency Original

Copies (including original)

0200000/ 2.2.1.2

N/A Request to Work Outside Government’s Regular Working Hours

At least seven calendar days prior to requested day

KO and

COR

1 As required

0200000/ 2.3.1

N/A Sign-in Sheets and Minutes for Review and Comments

Within two working days

KO, COR

and all attendees

1 As Required

0200000/ 2.3.1

N/A Sign-in Sheets and Minutes Final Revision

Within two working days

KO, COR

and all attendees

1 As Required

0200000/ 2.3.4

N/A Permits and Licenses

Before work commences and as requested by the KO

KO and

COR

1 As specified

0200000/ 2.3.5

N/A Certificate of Insurance

Within 15 calendar days prior to contract start

KO and

COR

1 As specified

0200000/ 2.6.5

N/A Work Schedules Within 15 calendar days prior to contract start, 10 days prior to the beginning of the month in which services are scheduled to be performance, and within two calendar days of changes

COR 1 Monthly

0200000/ 2.6.7

N/A Service Interruptions

At least five working days in advance

KO and

COR

1 As required

0200000/ 2.6.8.1

J-0200000-06 USMC Maximo Method of Data Entry

Within 30 calendar days after completion of work and condition assessment

KO and

COR

1 Quarterly

0200000/ 2.6.8.2

N/A USMC Maximo Access

At least 30 calendar days prior to contract start

KO and

COR

1 As required

Page 1 of 46, F-0200000

Section F 0200000 Deliveries or Performance

DELIVERABLES

Spec Item

Form Attachment

Number Deliverable Title Date (s) of Submission

Distribution

Frequency Original

Copies (including original)

0200000/ 2.6.9.1

N/A Quality Management Plan

Within 15 calendar days prior to contract start

KO and

COR

1 As specified

0200000/ 2.6.9.2

N/A QC Inspection File Within five calendar days of completion/ termination of the contract

KO and

COR

1 As specified

0200000/ 2.6.9.3

N/A Contractor Quality Inspection and Surveillance Report

First workday of each month

KO and

COR

1 Monthly

0200000/ 2.7.1

N/A List of Key Personnel and Qualifications

Within 15 calendar days prior to contract start

KO and

COR

1 As specified

0200000/ 2.7.1

N/A Organizational Chart

Within 15 calendar days prior to contract start

KO and

COR

1 As specified

0200000/ 2.7.2.6

N/A Proof of Legal Residency

Prior to be admitted to site of work.

KO and

COR

1 As specified

0200000/ 2.7.3

N/A Service Contract Reporting (SCR)

No later than 31 October

KO and

COR

1 Annually for labor executed during the period of performanc e during each Governmen t fiscal year

(FY)

0200000/

2.8.1 N/A Employee List Within 15

calendar days prior to contract start and within seven calendar days of changes

KO and

COR

1 As required

0200000/ 2.8.2

N/A Vehicles List Within 15 calendar days prior to contract start and within seven calendar days of changes

KO and

COR

1 As required

Page 2 of 46, F-0200000

Section F 0200000 Deliveries or Performance

DELIVERABLES

Spec Item

Form Attachment

Number Deliverable Title Date (s) of Submission

Distribution

Frequency Original

Copies (including original)

0200000/ 2.8.8

N/A Access to Government Information Technology (IT), Operation Technology (OT), and Facility Related Control Systems (FRCS)

Within 15 days prior to contract starts or when Maximo is available

KO and

COR

1 As required

0200000/ 2.9.2

N/A Accident Prevention Plan

Within 15 calendar days prior to contract start and within seven calendar days of changes

KO and

COR

1 As specified

0200000/ 2.9.3

N/A Activity Hazard Analysis

Together with the Accident Prevention Plan and within seven calendar days of changes

KO and

COR

1 As specified

0200000/ 2.9.4.7

N/A Control of Hazardous Energy

Every year KO and

COR

1 Annually

0200000/ 2.9.6

J-0200000-06 NAVFAC

Contractor Incident Reporting System

(CIRS)

Within five calendar days of accident.

KO and

COR

1 As required

0200000/ 2.9.6

J-0200000-06 Weight Handling Equipment Accident Report

Within 15 working days of accident

KO and

COR

1 As required

0200000/ 2.9.6

J-0200000-06 Near Miss Notification Report

Within 24 hours of the near miss occurrence

KO and

COR

1 As required

0200000/ 2.9.6

J-0200000-06 Crane and Rigging Gear Near Miss Report

Within 15 working days of accident

KO and

COR

1 As required

0200000/ 2.9.8

N/A Monthly On-Site Labor Report

First work day of each month.

KO and

COR

1 Monthly

0200000/ 2.9.9

N/A OSHA/LSIO

Citations and Violations Corrective Action Report

Within 48 hours after receiving a citation

KO and

COR

1 As required

0200000/ 2.9.11

N/A Safety Certifications

As specified KO and

COR

1 As specified

0200000/ 2.10.2

N/A Environmental Protection Plan

As specified KO and

COR

1 As specified

Page 3 of 46, F-0200000

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Section F 0200000 Deliveries or Performance

DELIVERABLES

Spec Item

Form Attachment

Number Deliverable Title Date (s) of Submission

Distribution

Frequency Original

Copies (including original)

0200000/ 2.10.2.3

J-0200000-06 Installation Spill Control Plan

Within 30 calendar days of accident

KO and

COR

1 As specified

0200000/ 2.10.2.4

J-0200000-06 Emergency Planning and Community Right- To-Know Act (EPCRA) Report

As specified KO and

COR

1 As specified

0200000/ 2.10.2.4

N/A Contractor Hazardous Material Inventory Log

As specified KO and

COR

1 As specified

0200000/ 2.10.2.7

N/A Asbestos Containing Material (ACM)

Verbally notify the KO and COR within one hour and follow-up with written Notification within 24 hours

KO and

COR

1 As specified

0200000/ 2.10.3

N/A Sustainable Procurement and Practices Plan

As specified KO and

COR

1 As required

0200000/ 2.10.3

N/A Sustainable Delivery of Services Report

Within five calendar days after each contract period.

KO and

COR

1 Annually

0200000/ 2.10.3.2

N/A Recovered Material Certification

As specified KO and

COR

1 When a product containing recovered materials is equal to or better than the original and could be used.

0200000/ 2.11

N/A Mission Essential Contractor Services Plan

Within 15 calendar days prior to contract start and within seven calendar days of changes.

KO and

COR

1 As Required

Page 4 of 46, F-0200000

Section F 0200000 Deliveries or Performance

DELIVERABLES

Spec Item

Form Attachment

Number Deliverable Title Date (s) of Submission

Distribution

Frequency Original

Copies (including original)

0200000/ 2.11

N/A Mission Critical/Mission Essential Personnel

Within 15 calendar days prior to contract start and within seven calendar days of changes

KO and

COR

1 As specified

0200000/ 2.14.2

N/A Notification to the Government for Work Above the Recurring Work Limitations and Rough Order of Magnitude

Within two hours of identification

KO and

COR

1 As required

0200000/ 2.15.2.1

N/A Non-Recurring Work Proposals

Within two working days following receipt of request

KO 1 As required

Page 5 of 46, F-0200000

Deliverables Form Preparation Instructions

Deliverable Title: 0200000/2.2.1.2, Request to Work Outside Contractor’s Regular Working Hours

Form Attachment No.: N/A Government Acceptance 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 Acceptance.

3. Distribution List and Method of Submission: Electronic copy to KO, KS, COR and PAR.

1) If the KO 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 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 workday, justification for necessity and occasion of working outside Contractor‘s regular working hours, 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: The request letter shall be submitted at least 7 calendar days prior to requested day.

7. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000 Deliveries or Performance

Page 6 of 46, F-0200000

Deliverable Title: 0200000/2.3.1, Required Conferences and Meetings (Sign-In Sheets and Minutes)

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

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

2. Purpose: For Government Acceptance.

3. Distribution List and Method of Submission: Electronic copy to KO, KS, COR, PAR and all Attendees.

1) If the KO accepts the minutes, 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 sheets and minutes to the KO via email. Continue this cycle until the Government notifies the Contractor of the Government acceptance.

4. Content: The sign in and minutes shall contain but not be limited to:

date, day, and time of requesting work day, all Contractor and Government personnel in attendance, thorough notes / minutes of all agenda items discussed, a record of any additional discussions that may take place during the meeting.

5. Due Dates: The minutes shall be submitted within two working days following the meeting.

6. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 7 of 46, F-0200000

Deliverable Title: 0200000/2.3.1, Required Conferences and Meetings (Final Revision of Minutes)

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

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

2. Purpose: For Government Acceptance.

3. Distribution List and Method of Submission: Electronic copy to KO, KS, COR, PAR and all Attendees.

1) If the KO accepts the minutes, 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 sheets and minutes to the KO via email. Continue this cycle until the Government notifies the Contractor of the Government acceptance.

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

date, day, and time of requesting work day, all Contractor and Government personnel in attendance, thorough notes / minutes of all agenda items discussed, a record of any additional discussions that may take place during the meeting.

5. Due Dates: The minutes shall be submitted within two working days following Comments received from the KO.

6. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 8 of 46, F-0200000

Deliverable Title: 0200000/2.3.4, Permits and Licenses

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

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

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: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accept the Permits and Licenses, the Government will notify the Contractor of Government acceptance.

If the KO 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 Government acceptance.

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

Note: As Spec Item 2.6.6, 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 before work commences on contract, within 7 calendar days after the old ones expire, and as required.

6. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 9 of 46, F-0200000

Deliverable Title: 0200000/2.3.5, Certificate of Insurance

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

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

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

2. Purpose: For Government acceptance.

3. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the Certificate of Insurance, 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 Certificate of Insurance via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

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 at least 15 calendar days prior to start of contract performance. 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.

7. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 10 of 46, F-0200000

Deliverable Title: 0200000/2.6.5, Work Schedules

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

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

1. Method of Submission: Via email. The work schedule shall be prepared using the form that the Contractor considers appropriate and be converted to PDF file, Adobe Acrobat form.

2. Purpose: For Government review and acceptance

3. Distribution List: Electronic copy to KO, KS, COR, PAR, and all affected tenants

If the KO or the COR accepts the work schedule, 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 Work Schedule via email to recipients on the distribution list.

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

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

Detail of work schedule, Date and time of work, Name and phone number of Government person with whom was initially coordinated, Alternative date and time, the Government person requested work be accomplished.

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

6. Due Dates: Within 15 calendar days prior to contract start, 10 days prior to the beginning of the month in which are scheduled to be performance, and within two calendar days of changes.

7. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 11 of 46, F-0200000

Deliverable Title: 0200000/2.6.7, Service Interruptions Notification

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

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

1. Method of Submission: Via email. The notifications shall be prepared using the form that the Contractor considers appropriate and be converted to PDF file, Adobe Acrobat form.

2. Purpose: For Government information and acceptance.

3. Distribution List: Electronic copy to KO, KS, COR, PAR and all affected tenants.

If the KO or the COR accepts the outage notification, 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 Service Interruptions Notification via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

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

Date, day, time, and location or requested outage, All tenants or customer affected, The proposed duration of outage.

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

6. Due Dates: At least five working days prior to the schedule outage. If the outage is due to an emergency, the Contractor shall notify the KO, COR, PAR, affected tenants and customers as soon as possible.

7. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 12 of 46, F-0200000

Deliverable Title: 0200000/2.6.8.1, USMC Maximo Method of Entry Data

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

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

Instructions:

1. Method of Submission: Direct system input. The report shall be manually entered directly into USMC Maximo.

2. Purpose: For Government review, information, and acceptance.

3. Distribution List: Via USMC Maximo.

If the KO or the COR accepts the entry, 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 entry via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

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

Required Work Order, Condition Assessment, Date and Time of Completion.

5. Other Requirement: If the Contractor does not have access to USMC Maximo, refer to spec item 2.6.8.1 of section C Annex 0200000.

6. Due Dates: Within 30 calendar days after every quarter.

7. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 13 of 46, F-0200000

Deliverable Title: 0200000/2.6.8.2, List of Personnel Requiring Access to Government Maximo

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

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

Instructions:

1. Method of Submission: Via email. The list shall be prepared using the form that the Contractor considers appropriate and be converted to PDF file, Adobe Acrobat form.

2. Purpose: For Government review and acceptance.

3. Distribution List: Electronic copy to KO, KS, and COR

If the KO or the COR accepts the list, 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 list via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

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

To be provided once determination is made to that Contractor shall use USMC Maximo

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

6. Due Dates: At least 30 calendar days prior to contract start.

7. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 14 of 46, F-0200000

Deliverable Title: 0200000/2.6.9.1, Quality Management (QM) Plan

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

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

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

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

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the QM 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 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.

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

7. Due Dates: The QM Plan shall be submitted at least 15 calendar days prior to start of contract performance and within 10 calendar days prior to any changes.

8. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 15 of 46, F-0200000

Deliverable Title: 0200000/2.6.9.2, Quality Inspection and Surveillance File

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

Media: Hard Copy X Electronic (PDF/CD) Direct System Input Instructions:

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.

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

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 Government acceptance.

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.

6. Due Dates: Within five calendar days of completion/ termination of the contract.

7. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 16 of 46, F-0200000

Deliverable Title: 0200000/2.6.9.3, Quality Inspection and Surveillance Report

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

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

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

2. Method of Submission: Via email. The Quality Inspection and Surveillance Report shall be converted to PDF file, Adobe Acrobat form.

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the Quality Inspection and Surveillance Report, 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 Report via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content

The Contractor Quality Inspection and Surveillance 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).

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

6. Other Requirement: The submitted Quality Inspection and Surveillance Report shall accurately reflect their intended use.

7. Due Dates: The Quality Inspection and Surveillance 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.

8. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 17 of 46, F-0200000

(Page 1 of 2)

Deliverable Title: 0200000/2.7.1 , List of Key Personnel and Qualifications or Request to Appoint New Key Personnel and Interpreter

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

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

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.

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the qualifications, and/or 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 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.

* Note: These instructions continue on the following page.

Section F - 0200000

Page 18 of 46, F-0200000

(Page 2 of 2)

Deliverable Title: 0200000/2.7.1, List of Key Personnel and Qualifications or Request to Appoint New Key Personnel and Interpreter

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

* Note: Continued from the previous page.

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.

7. Due Dates

Initial (for Government approval): At least 15 calendar days prior to start of contract performance and prior to appointing new personnel. (Note: first submission may be exempt when required to be included in the proposal submittals.)

Final (after Government approval): 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.

Page 19 of 46, F-0200000

Deliverable Title: 0200000/2.7.1, Organizational Chart

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

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

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.

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

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.

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

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 at least 15 calendar days prior to start of contract performance and within five calendar days when revised or updated. (Note: first submission may be exempt when required to be included in the proposal submittals.

8. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 20 of 46, F-0200000

Deliverable Title: 0200000/2.7.2.6, Proof of Legal Residency

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

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

2. Purpose: For Government acceptance.

3. Distribution List: Electronic copy to KO, KS, COR and PAR.

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

4. Content: Proof Documents for employee legal residency.

5. Due Dates: At least 30 days prior to start of work on this contract / prior to being admitted to the work site.

6. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 21 of 46, F-0200000

Deliverable Title: 0200000/2.7.3, Service Contract Reporting (SCR)

Form Attachment No.: N/A Government Acceptance Required: Yes X No Media: Hard Copy Electronic (PDF/email) X Direct System Input Instructions: Contractor Labor Hours

1) Method of Submission: via a secure data collection site. web address: https://www.sam.gov.

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.

5) Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 22 of 46, F-0200000

Deliverable Title: 0200000/2.8.1 & 2.8.2, Employee List and Vehicle List

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

1. Required File Format: The plan shall be prepared using Microsoft Office ® software.

2. Method of Submission: Via email. Attach either the specific Excel form or converted PDF file, Adobe Acrobat form.

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

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

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 cycle until the Government notifies the Contractor of Government acceptance.

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. Due Dates: The list shall be submitted at least 15 calendar days prior to contract start, upon request by KO, within 15 calendar days of each option period exercise, and within 7 calendar days of updates or changes.

7. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 23 of 46, F-0200000

Deliverable Title: OF-306 Declaration for Federal Employment and Digital Fingerprints and

List of personnel requiring access to and the justification for their access to Government IT, OT, and FRCS

Annex/Spec Item: 0200000/2.8.8 and 2.8.9

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

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

Instructions:

To be provided upon determination contractor will access Government IT such as USMC Maximo.

Section F - 0200000

Page 24 of 46, F-0200000

(page 1 of 2)

Deliverable Title: 0200000/2.9.2 & 2.9.3, Accident Prevention Plan (APP): incorporate the Activity Hazard Analyses (AHAs), and Safety and Occupational Health (SOH) Risks and Compliance Plans

Form Attachment No.: N/A

Government Acceptance Required: X Yes No

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

Instructions:

1. Required File Format: The APP shall incorporate the AHAs and SOH Risks and Compliance Plans, and be formatted as addressed in Appendix A of the EM-385-1-1. The AHAs shall follow format of Figure 1-2 of the EM-385-1-1. The Government will provide the blank AHA form after contract award.

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

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the APP, 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 APP via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content

The APP shall include, as a minimum, elements addressed in paragraph 3 of Appendix A in the EM385-1-1.

* Note: These instructions continue on the following page.

Section F - 0200000

Page 25 of 46, F-0200000

(page 2 of 2)

Deliverable Title: 0200000/2.9.2 & 2.9.3, Accident Prevention Plan (APP): incorporate the Activity Hazard Analyses (AHAs), and Safety and Occupational Health (SOH) Risks and Compliance Plans

Form Attachment No.:

Government Acceptance Required: X Yes No

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

Instructio ns:

* Note: Continued from the previous page.

6. Other Requirements

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.

Per Spec Item 2.10.2.6, 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.

7. Due Dates

General: The APP including AHAs and SOH Risks and Compliance Plans shall be submitted at least 15 calendar days prior to start of contract performance, within 7 calendar days of any changes, and at least 2 working days prior to the start of work for changes and additions.

AHAs for modifications, non-recurring UPL work and one-time work occurrences:

For modifications and where changes are germane to the original Recurring Work and/or

Non- recurring UPT work portion of the contract: within 15 calendar days after the modification is signed and at least 2 working days prior to the commencement of work.

For UPL work task orders to include construction task orders: submit with the associated proposal (within seven calendar days from the issuance of each potential Task Order RFP).

Section F - 0200000

Page 26 of 46, F-0200000

Deliverable Title: Control of Hazardous Energy (lock-out/tag-out)

Annex/Spec Item: 0200000/2.9.4.7

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

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

Instructions:

1. Cover Sheet: Not required. Specify Contract Number and title.

2. Method of Submission: Via Email

3. Purpose: Comply with OSHA 1910.147

4. Distribution List: KO, KS, COR, and PAR

5. Content: See OSHA 1910.147

6. Other Requirement: none

7. Due Dates: Annually

8. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 27 of 46, F-0200000

Form Attachment No.: J-0200000-06 Government Acceptance Required: X Yes No

Instructions:

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-0200000-06.

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

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the report, 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 report via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

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.

Section F - 0200000 Deliveries or Performance

Page 28 of 46, F-0200000

Deliverable Title: 0200000/2.9.6, NAVFAC Contractor Incident Reporting System (CIRS) Report

Form Attachment No.: J-0200000-06 Government Acceptance Required: Yes X No

Instructions:

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-0200000-06.

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

3. Purpose: For Government information.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the report, 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 report via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content: Refer to the form provided in J-0200000-06 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.

Section F - 0200000 Deliveries or Performance

Page 29 of 46, F-0200000

Deliverables Form Preparation Instructions

Deliverable Title: 0200000/2.9.6, Weight Handling Equipment (WHE) Accident Report

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

Instructions:

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-0200000-06.

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

3. Purpose: For Government information.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the report, 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 report via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content: Refer to the form provided in J-0200000-06 and the blank form provided after contract award.

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

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

Section F - 0200000 Deliveries or Performance

Page 30 of 46, F-0200000

Deliverable Title: 0200000/2.9.6, Near Miss Notification Report

Instructions:

1. Required File Format: The Crane and Rigging Gear Near Miss Report shall be prepared using the specific form provided in J-0200000-06. The Government will provide the blank form after contract award.

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

3. Purpose: For Government information.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the report, 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 report via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content: Refer to the form provided in J-0200000-06 and the blank form provided after contract award.

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

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

Section F - 0200000 Deliveries or Performance

Page 31 of 46, F-0200000

Deliverables Form Preparation Instructions

Deliverable Title: 0200000/2.9.6, Crane and Rigging Gear Near Miss Report

Deliverable Title: 0200000/2.9.8, Monthly On-Site Labor Report

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

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

Instructions:

1) Method of Submission: The report shall be prepared using Microsoft Office ® software.

2) Distribution List: Electronic copy to KO, KS, COR and PAR.

3) Content: The purpose of this report is to document the hours performed by contractor employees (prime and sub-contract) as required by NAVFAC Safety Office.

All labor hours for the previous month’s performance (Prime and Sub KTR’s).

Labor hours will be broken down per spec item in Section F, Deliveries and Performance

1502000 – Facility Investment.

4) Due Dates: The report shall be submitted first work day of each month. Shall be included with the contractors monthly invoice package.

5) Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 32 of 46, F-0200000

Deliverable Title: 0200000/2.9.9, OSHA Citations and Violations Corrective Action Report

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

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

Instructions:

1. Required File Format: The OSHA Citations and Violations Corrective Action 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.

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the report, 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 report via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content:

Copy of the OSHA Citation 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 an OSHA citation.

8. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 33 of 46, F-0200000

Deliverable Title: 0200000/2.9.9, LSIO Citations and Violations Corrective Action Report

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

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

Instructions:

1. Required File Format: The LSIO Citations and Violations Corrective Action 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.

3. Purpose: For Government acceptance.

4. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the report, 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 report via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content:

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:

a. The submitted report shall accurately reflect its intended use.

b. 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.

8. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000

Page 34 of 46, F-0200000

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

Instructions:

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

2. Purpose: For Government information.

3. Distribution List: Electronic copy to KO, KS, COR and PAR.

If the KO or the COR accepts the Safety Certification, 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 copies of Safety Certification via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

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 prior to start of contract performance and prior to expiration of certifications.

6. Refer to DoDI 5200.48 for marking requirements (as applicable).

Section F - 0200000 Deliveries or Performance

Page 35 of 46, F-0200000

Deliverable Title: 0200000/2.9.11, Safety Certifications

Deliverables Form Preparation Instructions

Deliverable Title: 0200000/2.10.2 Environmental Protection Plan

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

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

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

3. Purpose: For Government review and acceptance.

4. Distribution List: Electronic copy to KO & Environmental Branch via COR or PAR.

If the KO and the Environmental Branch accepts the plan, the Government will notify the

Contractor of Government acceptance.

If the KO and the Environmental responds with review comments, then incorporate the

Government’s comments and resubmit the request via email to recipients on the distribution list. Continue this cycle until the Government notifies the Contractor of Government acceptance.

5. Content: The request shall contain the Contractors plan for environmental during the performance of work under this contract.

6. Due Dates: The request shall be submitted at least 15 calendar days prior to start of contract performance and 7 calendar days prior to any changes.

7. Refer to DoDI 5200.48 for marking requirements (as applicable).

Page 36 of 46, F-0200000

Deliverable Title: 0200000/2.10.2.3 Spill Prevention and Response Plan

Form Attachment No.: J-0200000-06 Government Acceptance Required: X Yes No

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

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

10. Purpose: For Government review and acceptance.

11. Distribution List: Electronic copy to KO & Environmental Branch via COR or PAR.

If the KO and the Environmental Branch accepts the plan, the Government will notify the

If the KO and the Environmental responds with review comments, then incorporate the

Government’s comments and resubmit the request via email to recipients on the distribution

12. Content: The request shall contain the Contractors plan for water conservation during the performance of work under this contract.

13. Due Dates: The request shall be submitted at least 30 calendar days prior to start of contract performance and 15 calendar days prior to any changes.

14. Refer to DoDI 5200.48 for marking requirements (as applicable).

Page 37 of 46, F-0200000

Deliverable Title: 0200000/2.10.2.4, Emergency Planning and Community…