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Section J – 0200000 Management and Administration
| Attachment Number |
| Attachment Title |
| J-0200000-01 |
| Definitions and Acronyms |
| J-0200000-02 |
| Wage Determinations |
| J-0200000-03 |
| Directives, Instructions, and References |
| J-0200000-04 |
| Invoice Form |
| J-0200000-06 |
| Contractor Quality Inspection & Surveillance Report |
| J-0200000-07 |
| Labor Report |
| J-0200000-08 |
| Replacement System and Equipment Log |
| J-0200000-09 |
| Exhibit Line Item Numbers |
Attachment J-0200000-01 Definitions and Acronyms
| Assessment |
| A general term referring to either a survey or inspection of a facility to determine condition. |
| Asset |
| A general term used to refer to an item, such as a component, system, building or facility, which is managed by an automated data management program. |
| Competent Person |
| A person who has the professional experience and training necessary to identify existing and predictable hazards at a work or service environment, and who has the authority to take prompt and corrective action to eliminate or remove dangers from the environment. |
One who can identify existing and predictable hazards in the working environment or working conditions that are dangerous to personnel and who has authorization to take prompt corrective measures to eliminate them.
| Component Inventory Management Unit (CIMU) |
| An organization of like-kind real property into manageable maintenance units. CIMU is a building component, group of components or component assemblies, serving a specific purpose in a facility that can be expected to follow a common and predictable lifecycle behavior. This class of non-equipment will include items such as exterior walls, exterior windows, interior finish, and roofs. This class of equipment will include items such as fan coil units, air handling units, lighting, and water closets. CIMUs can include one or more items of installed equipment typically subject to routine scheduled maintenance. |
| Confined Work Space |
| A space that is large enough and so configured that a person may bodily enter a space (such as in tanks, vessels, silos, storage bins, hoppers, vaults, pits, and like spaces where there is limited means of entry) and is hindered or restricted from escaping during an emergency. |
| Construction Equipment |
| Construction equipment refers to specialized heavy machinery that covers one industry and is specifically designed for executing construction work. Construction equipment requirements shall include a list of equipment establishing the size, quality, number of units, and unit prices. Construction equipment prices provided by the Contractor shall be the lowest price available considering the availability of equipment and the time constraints of the job. The direct equipment price shall be adjusted by all discounts and rebates that accrue to the Contractor. |
All indirect cost associated with construction equipment, such as: the Contractor’s hourly composite trade wage, adjusted to allow for workforce productivity; sub-contractor cost, costs for pre-expended bin materials, shipping and handling, union agreements, crew sizes, hand tools, universal equipment (excluding construction equipment), mobilization, demobilization, payroll burdens and fringes, overtime, job (field) overhead (including clerical support, supervision, inspection, fees, taxes, licenses, permits, and insurance), general and administrative (home office) overhead, profit, and all other associated markups shall not be included in the equipment price since the cost for these items were included in the labor hour unit price bid. Additionally, time for job preparation, safety standby personnel, and similar indirect labor elements shall not be included.
| Contracting Officer (KO) |
| That individual with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings. The term includes certain authorized representatives of the Contracting Officer acting within the limits of their authority as delegated by the Contracting Officer. |
| Contracting Officer’s Representative (COR) |
| The individual appointed by the KO responsible for monitoring the Contractor’s technical compliance and progress, relative to assigned contract(s)/orders(s), based on the contract requirements specified in the PWS and in accordance with the PAP. The COR performs a variety of contract administration duties that includes oversight of PA, documenting and rating Contractor performance, reviewing invoices, and acceptance of work. Assignment as a COR is a collateral duty typically performed by the FSCM or SPAR. |
| Contractor |
| That entity or its representative responsible for the delivery of the services or materials specified in this contract, as designated by contract award. The term Contractor as used herein refers to both the prime Contractor and any subcontractors. The prime Contractor shall insure that subcontractors comply with the provision of this contract. |
| Contractor Representative |
| That individual appointed by the Contractor, either orally or in writing, who has been assigned responsibility for executing the requirements of this contract. |
| Direct Material Costs |
| The actual vendor invoice charges for materials used for performance of work under this contract. Direct material costs shall include transportation charges when such charges are included on the invoice by the vendor, as well as any discounts allowed for prompt payment and discounts or rebates for core value or salvage value that accrue to the Contractor. When questions arise concerning the cost of materials, material costs will be based on the lowest of quotes provided by the Contractor from at least three different commercial vendors for the direct material cost. The Government retains the right to obtain additional quotes in questionable situations. The lowest price will be used. |
| Electronic Operation And Maintenance And Support Information (eOMSI) |
| A set of consultant-prepared data and document files that contain detailed, as-built technical information that describes the efficient, economical and safe operation, maintenance and repair of a facility, plant, equipment or system throughout its life cycle. Generally, it is prepared during construction and submitted upon completion of a new facility or major facility upgrade. eOMSI’s typically include asset information, staffing and budgeting information, supply support including critical spare parts, operating procedures, troubleshooting and diagnostic guides, extended warranty data, maintenance task frequencies and documentation, technical data, repair procedures and manufacturer’s product data. eOMSI data and document files are provided in electronic formats. |
| Equipment |
| Tangible asset that is functionally complete for its intended purpose, durable, and non-expendable. |
| Facility |
| A building or structure designed and created to serve a particular function. |
| Fixed Burden Rate (FBR) |
| The additional costs (expressed in percent of direct material cost) for ordering, handling, and stockpiling materials and repair parts. For example, if the offeror's Fixed Burden Rate for materials in the Base Period is 10% then: |
$100,000.00 + ($100,000.00 x 10%) = $110,000.00
The Government will compensate the Contractor for the required parts and materials and not the total amount shown in Schedule of Indefinite Delivery Indefinite Quantity Work.
| Frequency Of Service |
| Annual (A). Services performed once during each 12-month period of the contract at intervals of 335 to 395 days. |
Biennial (B). Services performed once during each 24-month period of the contract at internals of 670 to 790 days.
Daily (D5). Services performed once each calendar day, Monday through Friday, including holidays unless otherwise noted.
Daily (D7). Services performed once each calendar day, seven days per week, including weekends and holidays.
Monthly (M). Services performed 12 times during each 12-month period of the contract at intervals of 28 to 31 calendar days.
Quarterly (Q). Services performed four times during each 12-month period of the contract at intervals of 80 to 100 calendar days.
Semiannual (SA). Services performed twice during each 12-month period of the contract at intervals of 160 to 200 calendar days.
Semimonthly (SM). Services performed 24 times during each 12-month period of the contract at intervals of 14 to 16 calendar days.
Three times weekly (3W). Services performed three times a week, such as Monday, Wednesday, and Friday.
Twice weekly (2W). Services performed twice a week, such as Monday and Thursday or Tuesday and Friday.
Weekly (W). Services performed 52 times during each 12-month period of the contract at intervals of six to eight calendar days.
| Government Furnished Property (GFP) |
| Property in the possession of, or directly acquired by, the Government and subsequently furnished to the contractor for performance of a contract. Government furnished property includes, but is not limited to, spares and property furnished for repairs, maintenance, overhaul, or modification. Government furnished property also includes contractor acquired property if the contractor acquired property is a deliverable under a cost contract when accepted by the Government for continued use under the contract. |
| Hazardous Material (HM) |
| A material that because of its quality, concentration, physical, chemical or infectious nature may pose a threat to human health or the environment if released or spilled into the environment or any material designated by the Department of Transportation (DOT) or any materials that require a SDS form as posing a potential threat while being transported. Hazardous materials are listed in 49 CFR Part 172. |
| Hazardous Waste (HW) |
| Any discarded solid waste (liquid, semi-solid, solid, or gaseous) that meets the definition of a hazardous waste by USEPA, state authorities, or the Navy. In accordance with RCRA, a solid waste is a listed hazardous waste if it is specifically listed, or it is a characteristic hazardous waste if it exhibits the characteristics of ignitability, corrosivity, reactivity, or toxicity. |
| Hazardous Waste Management Plan |
| In accordance with OPNAVINST 5090.1C, every Navy shore activity that generates HW shall develop and use a Hazardous Waste Management Plan or a Hazardous Waste management component in its P2 Plan and EMS. A Hazardous Waste Management Plan shall: |
· Identify applicable federal, state, and local regulations pertaining to the generation and management of hazardous waste.
· Identify training requirements and describe procedures for obtaining training and maintaining training records.
· Assign responsibilities for the generation, designation, handling, storage, treatment, disposal, and all documentation.
· Describe all hazardous waste generation and management procedures.
· Include or reference the hazardous waste minimization plan and goals.
· Include or reference contingency plans and emergency response procedures.
The plan shall be kept up to date to include changes in hazardous waste generation and management procedures, as well as changes in applicable federal, state, and local hazardous waste regulations. The plan shall include or reference minimization procedures sufficient to achieve DOD minimization goals. Tenant activities are covered by the host CO's Hazardous Waste Management Plan.
| Hazardous Waste Manifest |
| A hazardous waste manifest as defined in 40 CFR 260 is required for the transport of hazardous waste. The installation commanding officer (ICO) or the ICO’s designated representative shall retain signature authority for hazardous waste manifests. |
| Infrastructure Condition Assessment Program (ICAP) |
| A Navy automated data management program that utilizes historical asset lifecycle data and a structured assessment process to evaluate the condition facilities and their components. |
| Inspection |
| A rigorous, detailed assessment of the condition of a facility performed to generate a fundable scope and cost estimate for prioritization and funding of maintenance and repair. |
| Integrated Maintenance Program (IMP) |
| IMP is a recurring state-of-the-art, reliability-centered inspection, testing, maintenance and repair program that determines best practices for managing the functions and consequences of failures of facilities equipment and system components. IMP encompasses accepted commercial practices, including reactive, preventive, predictive and proactive maintenance, into one optimal program. The IMP approach gives the Contractor full responsibility to maintain systems and equipment and perform repairs whenever necessary to ensure equipment and systems are operational and remain in a constant state of readiness. Service orders will not be issued for accomplishment of repairs on systems and equipment maintained under IMP. |
| Job or Work Order |
| An authorization for work that requires planning and estimating and has an individual line of accounting for financial and performance evaluation. |
| Less-than-90-day Accumulation Areas or Storage Facilities |
| Temporary HW storage areas where HW may be stored for up to 90 days without a RCRA permit. |
| Maintenance And Repair |
| The preservation or restoration of a piece of equipment, system, or facility to such condition that it may be effectively used for its designated purposes. Maintenance/repair may be adjustment, overhaul, reprocessing, or replacement of constituent parts or materials that are missing or have deteriorated by action of the elements or usage, or replacement of the entire unit or system if beyond economical repair. |
| Monthly On-Site Labor Report |
| A compilation of all Contractor and subcontractor employee-hours involved in delivering contract services on a Government property. |
| NAVFAC MAXIMO |
| A specially configured software version of MAXIMO®, a commercially available computerized maintenance management system (CMMS), adopted by NAVFAC for enterprise facility asset data management. The terms “MAXIMO”, “NAVFAC MAXIMO” or “Government’s MAXIMO” shall be used interchangeably in the document. |
| Non-RCRA Regulated Waste |
| Waste that is not regulated as a hazardous waste under RCRA; however, is waste may be regulated by other federal, state or local regulations including but not limited to TSCA, Clean Air Act, Clean Water Act or other regulations and statues. Examples include Used Oil, Universal Waste, Oily Water, antifreeze, etc. |
Non-RCRA regulated waste (while not meeting the definition of a Hazardous Waste) must be managed according to its applicable regulations and may not be discarded into the general trash.
| Non-Regulated Solid Waste (Debris and Rubbish) |
| Waste not associated with an industrial process such as refuse and scraps resulting from preparation, cooking, dispensing, and consumption of food. Non-hazardous construction and demolition wastes such as dimension and non-dimension lumber, plywood, chipboard, and hardboard are included. |
| Partnering |
| The terms “partnering” and “partnership” used herein shall mean a relationship of open communication and close cooperation that involves both Government and Contractor personnel working together for the purpose of establishing a mutually beneficial, proactive, cooperative environment within which to achieve contract objectives and resolve issues and implementing actions as required. |
| Performance Assessment |
| A method used by the Government to provide some measure of control over the quality of purchased goods and services received. |
| Performance Assessment Representative (PAR) |
| The individual(s) assigned as a Technical Point of Contact (TPOC) / Subject Matter Expert (SME) to the COR to perform duties as the on-site representative who assesses Contractor performance. The PAR periodically observes Contractor performance, reviews delivered services, reviews quality management corrective actions, periodically assesses and documents Contractor performance on PAWs and the MPAS, and communicates findings as necessary with the Contractor, SPAR, and COR. |
| Pre-Expended Bin Materials And Supplies |
| The minor materials and supplies that are incidental to the job, for which the total direct cost of any one material line item shown on the material estimate is $10.00 or less. Examples of pre-expended bin materials and supplies include, but are not limited to, solder, lead, flux, electrical connectors, electrical tape, fuses, nails, screws, bolts, nuts, washers, spacers, masking tape, sand paper, solvent, cleaners, lubricants, grease, oil, rags, mops, glue, epoxy, spackling compound, joint tape, plumbers tape and compound, clips, welding rods, and touch up paint. |
| Property Administrator |
| An authorized representative of the Contracting Officer who is responsible for administering contract property requirements, terms and conditions of the contract |
| Property Management Program |
| A Government program established for the purpose of reviewing and approving the Contractor’s Property Management Plan and System through performance of a system analysis whenever government property is in the possession of the Contractor. |
| Quality Assurance (QA) |
| The planned and systematic activities implemented in a quality system so that quality requirements for a product or service will be fulfilled. |
| Quality Control (QC) |
| The observation techniques and activities used to fulfill requirements for quality. |
| R. S. Means |
| A data collection and organization system developed by R. S. Means Company which can be used to prepare accurate, dependable construction estimates and budgets in a variety of ways. The Contractor shall use the latest edition. Material prices are based on a national average and computed labor costs are based on a 30-city national average. An estimate prepared using this data is called a "Means estimate"; data may simply be referred to as "Means". |
| Real Property Inventory Equipment (RPIE) |
| A Government owned or leased individual pieces of equipment, apparatus, or fixture that are essential to the function of the real property (i.e. plumbing, electrical, heating, cooling and elevators). It is physically attached to, integrated into, and built in or on the property. |
Individual RPIE’s can be combined to make a CIMU to facilitate facilities management. An individual RPIE can also be a CIMU if the equipment is complex enough to require its own management planning.
| Regulated Waste |
| Any hazardous, non-hazardous, industrial process waste (aka special waste), e-waste, and/or off-specification HM, which because of its physical characteristics, chemical make-up or biological nature requires either special handling procedures and permitting, or poses an unusual threat to human health, equipment, property, or the environment. Examples include (but are not limited to) liquid sludge, pastes, and/or filter cakes, chemical compounds and/or petroleum products, fine powders or highly dusty materials, spent blast media and/or grit, demolition wastes from industrial facilities, debris and/or residues from spill cleanup work, underground storage tank remediation materials, pollution control wastes, ash from fires, furnaces, boilers or incinerators, off-specification products, other materials that have the potential to be a hazardous waste. All RW may be used or unused excess hazardous materials. Laboratory analysis may be required to verify the waste is not a RCRA-regulated hazardous waste. |
| Response Time |
| The time allowed the Contractor after initial notification of a work requirement to be physically on the premises at the work site with appropriate personnel, tools, equipment, and materials, ready to perform the work required. |
| Sampling Plan |
| Plan and procedures to conduct sampling, field testing and laboratory analysis for a defined testing objective. |
| Satellite Accumulation Areas |
| Designated approved areas, at or near the point of generation and under the control of the operator generating the waste, where no more than 55 gallons (cumulative total) of all types of HW or 1 quart of acutely HW may be accumulated. The 55-gallon limit does not include non RCRA regulated waste, universal waste and used oil etc. |
| Spill Prevention Control and Countermeasure (SPCC) Plan |
| The SPCC Plan establishes engineering controls including procedures, methods, equipment and other requirements to prevent the discharge of oil into or upon navigable waters. The Plan includes procedures for oil spill prevention, measures to contain spills and an established spill drill exercises to ensure effective countermeasures in the event of oil spill. |
| System |
| An assemblage of mechanically and/or electrically interlocked parts, equipment and/or components forming a unitary whole. |
| Unit Priced Labor (UPL) Hour |
| The unit price bid by the Contractor to perform one hour of work-in-place. With the exception of direct material and construction equipment costs, the unit priced labor hour price shall include all indirect and direct costs associated with performing work, such as: the Contractor’s hourly composite trade wage, adjusted to allow for workforce productivity; sub-contractor cost, costs for pre-expended bin materials, shipping and handling, wage determinations, union agreements, crew sizes, hand tools, equipment, universal equipment (excluding construction equipment), mobilization, demobilization, payroll burdens and fringes, overtime, job (field) overhead (including clerical support, supervision, inspection, fees, taxes, licenses, permits, and insurance), general and administrative (home office) overhead, profit, and all other associated markups. Any indirect cost or additional markups not allowed in the definition of direct materials shall be included in the UPL price. Additionally, time for job preparation, safety standby personnel, and similar indirect labor elements are included. |
| Universal Equipment |
| Universal equipment refers to equipment that can cover two or more industries and is commercially employed in execution of operation, maintenance, and repair work, such as: Aerial Work Platforms, Backhoes, Cranes, Dump Trucks, Excavators, Generators, Graders, Lifts, Loaders, Man Lifts, Monitoring and Test Equipment, Pumps, Tractors, Trailers, etc. |
| Universal Waste (UW) |
| Universal Waste (UW) (defined in 40 CFR Part 273) means batteries, fluorescent lamps, some pesticides, and mercury-containing equipment formally classified as a HW, but that are now subject to less stringent regulations, when recycled if recycling is available. |
| Utility Infrastructure Condition Assessment Program (UICAP) |
| A comprehensive assessment processes for planning, managing, and executing Navy utility infrastructure inspections. |
Attachment J-0200000-01 Definitions and Acronyms
| ACO |
| Administrative Contracting Officer |
| CDR |
| Contract Discrepancy Report |
| CIA |
| Controlled Industrial Area |
| CIMU |
| Component Inventory Management Unit |
| CMMS |
| Computerized Maintenance Management System |
| CNSSI |
| Committee on National Security Systems Instruction |
| COR |
| Contracting Officer Representative |
| COR |
| Condition of Readiness |
| DBH |
| Diameter at Breast Height |
| DCR |
| Direct Condition Rating |
| DoD |
| Department of Defense |
| DoDI |
| Department of Defense Instruction |
| DRMO |
| Defense Reutilization Management Office |
| EPA |
| Environmental Protection Agency |
| EPCRA |
| Emergency Planning and Community Right-to-Know Act |
| FAR |
| Federal Acquisition Regulation |
| FIFRA |
| Federal Insecticide, Fungicide, and Rodenticide Act |
| FSC |
| Facility Support Contract |
| FSCM |
| Facility Support Contract Manager |
| GIS |
| Geospatial Information System |
| GFE |
| Government-furnished Equipment |
| GFF |
| Government-furnished Facilities |
| GFM |
| Government-furnished Materials |
| HCA |
| Head Contracting Agency |
| ICAP |
| Infrastructure Condition Assessment Program |
| ICP |
| Integrated Contingency Plan |
| IDIQ |
| Indefinite Delivery Indefinite Quantity |
| iNFADS |
| Internet Navy Facilities Asset Data Store |
| IPM |
| Integrated Pest Management |
| IPMIS |
| Integrated Pest Management Information System |
| IPMP |
| Integrated Pest Management Plan |
| MAP |
| Maintenance Action Plan |
| MDI |
| Mission Dependency Index |
| MEP |
| Mechanical, Electrical and Plumbing |
| MPAS |
| Monthly Performance Assessment Summary |
| MRI |
| Mission Readiness Index |
| MSDS |
| Material Safety Data Sheets |
| NAVFAC |
| Naval Facilities Engineering Command |
| NIST |
| National Institute of Standards and Technology |
| NIST SP |
| National Institute of Standards and Technology Special Publication |
| NMCI |
| Navy Marine Corps Intranet |
| NOSC |
| Navy-On-Scene Coordinator |
| PAP |
| Performance Assessment Plan |
| PAR |
| Performance Assessment Representative |
| PAW |
| Performance Assessment Worksheet |
| PM |
| Planned Maintenance or Preventative Maintenance |
| PRCSP |
| Permit Required Confined Space Program |
| PWS |
| Performance Work Statement |
| RPIE |
| Real Property Inventory Equipment |
| RSL |
| Remaining Service Life |
| SPAR |
| Senior Performance Assessment Representative |
| VIQ |
| Variation in Quantity |
| WBS |
| Work Breakdown Structure |
Attachment J-0200000-02 Wage Determinations
Attachment J-0200000-03 Directives, Instructions, and References
| EM 385-1-1 |
| U.S. Army Corps of Engineers Safety and Health Requirements |
| P.L. 91-596 |
| Occupational Safety and Health Act |
Attachment J-0200000-04 Invoice Form
Attachment J-0200000-05 Forms
Attachment J-0200000-05
Directions for Process Material Log Sheets
Chemical Description:
· Material Name - List the brand or generic name of the chemical material.
· Manufacturer - List the name of the manufacturer of the product.
· Constituents of Concern - List the constituents (ingredients) as listed on the Material Safety Data Sheet (MSDS).
· CAS # - List the Chemical Abstract Service (CAS) Number for each Constituent of Concern listed. This information is found on the MSDS. If no CAS number is listed, state “N/L”.
· % - List the concentration of each Constituent of Concern listed. This information is found on the MSDS. If the concentration is not listed, state “N/L”.
· Product Weight - List the weight of material contained in one container of the product. This information is normally listed on the MSDS or can be determined from the density or specific gravity of the product listed on the MSDS.
· In addition, check all the boxes that apply to this chemical:
· Pure or Mix - choose only one.
· Solid, Liquid or Gas - choose only one.
· Extremely Hazardous Substance (EHS), Ozone Depleting Substance (ODS), SARA TITLE III Chemical (SARA III), Air Toxic Chemical (AIR TOX) or Carcinogen
· (CARC) - based on the information provided by the material’s MSDS. Choose all that apply.
· HM exempt - per EPCRA section 312 and based upon user knowledge, choose this box if the material would normally be exempt from reporting for hazardous material storage.
· Tri exempt - per EPCRA section 313 and based upon user knowledge, choose this box if the material would normally be exempt from reporting for the Toxic Release Inventory (TRI).
Physical and Chemical Hazards:
· For each material listed, check all the physical and health hazard boxes that apply. These hazard categories are defined in 40 CFR 370.2.
· Fire Hazard - flammable, combustible liquid, pyrophoric, oxidizer.
· Sudden Release of Pressure - explosive, compressed gas.
· Reactive - unstable reactive, organic peroxide, water reactive.
· Immediate (acute) Health Hazard - highly toxic, toxic, irritant, sensitizer, corrosive.
· Delayed (chronic) Health Hazard - carcinogens, mutagens, other long-term health hazards.
Storage Description: Storage Code:
· List the appropriate storage type, pressure and temperature condition codes for the material based upon the codes listed below. List the storage type in the first box, the applicable pressure code in the second box and the applicable temperature code in the third box. More than one storage code may apply if material is stored in different types of containers.
Storage Type:
A - Above Ground Storage Tank F Can L Cylinder B - Below Ground Storage Tank G Carboy M Glass Bottle or Drum C - Tank Inside Building I Fiber Drum N Plastic Bottle or Drum D - Steel Drum J Bag R Other E - Plastic/Non-metallic Drum K Box
Pressure and Temperature Conditions:
1 - Ambient Pressure 4 Ambient Temperature 2 - Greater than Ambient Pressure 5 Greater than Ambient Temperature 3 - Less than Ambient Pressure 6 Less than Ambient Temperature but not Cryogenic 7 - Cryogenic Conditions
Inventory in Pounds:
· Maximum Amount - List the maximum amount of a material that was on-hand (stored) at any one time. Amount must be recorded in pounds.
· Average Amount - List the average amount of a material that was on-hand during the reporting period. Amount must be recorded in pounds.
· Days on Site - List the number of days during the reporting period each material was on-site. If the material was present for the whole year, record as 365.
Amount Used in Pounds:
· List the amount of each material used during the reporting period. Amount must be recorded in pounds. Amount used is the best estimate based on the contractor material tracking system.
Attachment J-0200000-05
Contractor Hazardous Material Inventory Log
(EPRCA)
PRIME COMPANY NAME: ______________________________CONTRACT NO: ______________________
PROJECT TITLE / LOCATION: ________________________________________________________________
| Material Name |
| Manufacturer |
| SDS Number |
| State |
(Liquid, Solid, Gas)
| Storage Quantity |
| Quantity (lbs/gals) used in Calendar Year [ ] |
| Average Daily |
| Maximum Daily |
Contractor(s) certifies that the hazardous material(s) removed from installation will be used/reused for its intended purpose.
Company Using Material Listed Above Company Representative’s Signature
Submitted By: ________________________ Phone: ______________ Fax: __________ Date: _________ Printed Name
Contracting Officer _____________________Phone: ______________ Fax: __________ or ROICC Representative
Page ____ of ____
Attachment J-0200000-06 Contractor Quality Inspection & Surveillance Report
See attached form
Attachment J-0200000-07 On-Site Labor Report
Attachment J-0200000-08 Replacement System and Equipment Log
Attachment J-0200000-09 Exhibit Line Item Numbers
See Attached ELINS