Attachment_2._CDRLs_and_DiDs.pdf

PDF 8 MB Posted Aug 3, 2016

Attached to: YRR-11 Repair and Re-designation
Solicitation number: N4523A-16-R-0030
Issued by: Department of the Navy Naval Sea Systems Command

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Attachment 2. CDRLs and DiDs

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File	Type	Posted
WORK_SPEC_PACKAGE_08.15.2016.pdf	PDF	Aug 16, 2016
N4523A-16-R-0030_Solicitation.pdf	PDF	Aug 3, 2016
Attachment_4._Request_for_Specification_Clarifications.docx	DOCX document	Aug 3, 2016
Attachment_3._5-Way_Breakdown.xlsx	XLSX spreadsheet	Aug 3, 2016
Attachment_1._Work_Specification_Package_NWRMC_001-17.pdf	PDF	Aug 3, 2016

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CONTRACTDATAREQUIREMENTSLIST

(1 Data Item)

Form Approved OMB No. 0704-0188

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

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Request for Deviation for Shipyard Standard Work Item

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT 82051

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

ASREQ*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft Final

Reg Repro

16. REMARKS

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 12 and 13: The Request for Deviation Report shall be delivered within one day of identifying the need for a deviation.

BLOCK 14: Media requirement. The report shall be delivered electronically in Microsoft Office, Version 2007-2010, e-mail attachment to all addressees.

Block 14(a): C/440 Contracting Officer, Charles R. Smith (charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative (COR), TBD.

PSNS&IMF, C/440* 0 1 0

PSNS&IMF, C/412* 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY

Robert J Varney, PSNS&IMF C/412

H. DATE

7/21/16

I. APPROVED BY

Lorraine J Henry, PSNS&IMF C/412

J. DATE

7/22/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 46 Pages Adobe Professional 8.0

LJH

End of DI-MGMT-82051

DATA ITEM DESCRIPTION

Title: REQUEST FOR TECHNICAL DEVIATION OF SHIPYARD STANDARD WORK

ITEM REQUIREMENT(S)

Number: DI-MGMT-82051 Approval Date: 20160712

AMSC Number: N9681 Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Office of Primary Responsibility: SH Project Number: MGMT-2016-038

Applicable Forms: N/A

Use/relationship: This DID will identify the required information needed to obtain authorization to deviate from the references of any work item.

This DID contains the format content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

Requirements:

1. Format. The report shall be in the contractor’s format.

2. Content. The report shall contain the following information:

a. Ship’s Name/Hull Number

b. Contractor/Subcontractor

c. Name of deviation requestor

d. Identification as an existing condition and result of repair

e. Duration of repair with and without the deviation

f. System, component as indicated in the applicable selected record drawing

g. Location by compartment, frame and deck

h. Description of the deviation and degree of non-compliance

i. Document deviated from

j. Technical justification for the deviation

k. Alteration number if applicable

l. Date supervisor response is needed by

Source: https://assist.dla.mil -- Downloaded: 2016-07-21T13:18Z Check the source to verify that this is the current version before use.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

YRR-11 Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Contractor Furnished Material (CFM) Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-82049

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

MTHLY

12. DATE OF FIRST SUBMISSION

30DAC

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft Final

Reg Repro

16. REMARKS

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 12 and 13: The report shall be delivered 30 days after contract award Revisions to be submitted monthly until end of availability.

BLOCK 14: Media requirement. The report shall be in Microsoft Office format and submitted electronically as an e-mail attachment to the C/440 Contracting Officer, Charles R.

Smith(charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative (COR), TBD.

PSNS&IMF, C/440* 0 1 0

PSNS&IMF, C/412* 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY

Robert J. Varney, PSNS&IMF C/412

H. DATE

7/21/16

I. APPROVED BY

Lorraine J. Henry, PSNS&IMF C/412

J. DATE

7/22/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 2 of 46 Pages

Title: Contractor Furnished Material (CFM) Report

Number: DI-MGMT-82049 Approval Date: 20160705

AMSC Number: N9678 Limitation: N/A

DTIC Applicable: N/A GIDEP Applicable: N/A

Preparing Activity: SH Project Number: MGMT-2016-041

Use/Relationship: This DID will be used to identify Contractor Furnished Material (CFM) to accomplish the Work Items that are not already on hand.

This DID contains the format and content preparation instructions for the data product generated by the discrete task requirement as delineated in the contract.

2. Content. The report shall contain the following information:

a. Contract number

b. Contractor’s purchase order number

c. Description of material

d. Quantity ordered

e. Date scheduled to be ordered

f. Date ordered

g. Date required to meet production schedule

h. Proposed receipt date

i. A summary listing any problem areas

j. Date submitted to the SUPERVISOR

k. Alteration number

l. Drawing and piece number

m. Date received

n. Work Item number

End of DI-MGMT-82049

Source: https://assist.dla.mil -- Downloaded: 2016-07-12T13:40Z

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

List of Chief of Naval Operations (CNO) Availability

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-82047

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

ASREQ*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft Final

Reg Repro

16. REMARKS

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 12 and 13: Initial report shall be delivered NLT 15 days prior to availability start date and then weekly thereafter to End of Availability (EOA).

BLOCK 14: Media requirement. The report shall be delivered electronically in Microsoft Office, Version 2007-2010, e-mail attachment to all addressees.

Block 14(a): C/440 Contracting Officer, Charles R. Smith (charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative (COR), TBD.

PSNS&IMF, C/440* 0 1 0

PSNS&IMF, C/412* 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY

Robert J Varney, PSNS&IMF C/412

H. DATE

7/21/16

I. APPROVED BY

Lorraine J Henry, PSNS&IMF C/412

J. DATE

7/22/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 3 of 46 Pages

Title: List of Chief of Naval Operations (CNO) Availability Reports

Number: DI-MGMT-82047 Approval Date: 20160705

AMSC: N9674 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2016-042

Use/Relationship: This DID will identify all required Chief of Naval Operations (CNO)

Availability required reports.

by the specific discrete task requirements delineated in the contract.

1. Format. The format shall be in the contractor’s format.

2. Content. The reports required for the CNO Availability shall contain the following information:

a. Work Item number

b. Work Item paragraph

c. Delivery data

d. Actual submission date

e. Completion date

f. NMD serial number

End of DI-MGMT-82047

Source: https://assist.dla.mil -- Downloaded: 2016-07-09T18:43Z

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM

OTHER SAFT

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Toxic and Hazardous Substances Process Procedure Reports

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

OT-16-20057

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

DFDEL*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLOCK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft Final

Reg Repro

16. REMARKS

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 11, 12 and 13: The Process/Procedure Report delivery is deferred and delivery instructions will be provided by the SUPERVISOR when date has been determined.

BLOCK 14: Media requirement. The report shall be delivered electronically in Microsoft Office, Version 2007-2010, e-mail attachment to all addressees.

Block 14(a): C/440 Contracting Officer, Charles R. Smith (charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative (COR), TBD.

PSNS&IMF, C/440* 0 1 0

PSNS&IMF, C/412* 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY

Robert J Varney, PSNS&IMF C/412

H. DATE

7/21/16

I. APPROVED BY

Lorraine J Henry, PSNS&IMF C/412

J. DATE

7/22/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 4 of 46 Pages

Data Item Description (DID)

Title: Toxic and Hazardous Substances Process Procedure

Number: OT-16-20057 dsw

AMSC Number: N/A

DTIC Applicable: N o

Preparing Activity: SH

Applicable Forms:

Approval Date: 20160721 dsw

Limitation: N4523A-16-R-0030

GIDEP Applicable: No

Project Number: N/A

Use/Relationship: The Toxic and Hazardous Substances Process Procedure will be used to identify materials that may contain toxic or hazardous substances that are to be used, removed, or disturbed during work operations and the process/procedure for the removal or disruption of existing toxic or hazardous substances.

This DID contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

This DID is for one-time use on solicitation N4523A-16-R-0030 only. dsw

1. Format. The report shall be in contractor’s format.

2. Content. The report shall include the following:

a. Toxic or hazardous substance

b. Exposure monitoring

c. Method of compliance

d. Respiratory protection

e. Protective clothing

f. Housekeeping

g. Hygiene facilities and practices

h. Medical surveillance

i. Employee information and training

j. Signs

k. Recordkeeping

End of OT-16-20257. dsw

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER MISC

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

Purchase Order (PO)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81616

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

DFDEL*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft Final

Reg Repro

16. REMARKS

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 11, 12 and 13: Report delivery is deferred and delivery instructions shall be provided by SUPERVISOR when date has been determined.

BLOCK 14: Media requirement. The report shall be delivered electronically in Microsoft Office, Version 2007-2010, e-mail attachment to all addressees.

Block 14(a): C/440 Contracting Officer, Charles R. Smith (charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative (COR), TBD.

PSNS&IMF, C/440* 0 1 0

PSNS&IMF, C/412* 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY

Robert J Varney, PSNS&IMF C/412

H. DATE

7/21/16

I. APPROVED BY

Lorraine J Henry, PSNS&IMF C/412

J. DATE

7/22/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 5 of 46 Pages

Title: PURCHASE ORDER (PO)

Number: DI-MISC-81616 Approval Date: 20010801 AMSC Number: N7446 Limitation:

DTIC Applicable: GIDEP Applicable:

Office of Primary Responsibility: N/PMS377 Applicable Forms: N/A

Use/Relationship: To allow the Government to effectively monitor procurement of Contractor-furnished equipment requiring repair parts support and allowance list development.

a. This Data Item Description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task required as delineated in the contract.

1. Format. The Purchase Order (PO) and Purchase Order Index shall be in the contractor’s format.

2. Content. The POs shall include the following:

a. Vendor Name

b. Address of Vendor

c. Location of Material

d. Time of Completion

e. Applicable specifications and drawings

f. All tests and inspections required

g. PO Number

h. PO Date

i. Design code designator

j. Drawing and Piece Number

k. Federal Supply Code of Manufacturer’s (FSCM) five digit number

l. Quantity Ordered

m. Original PO Number on reissued POs

2.1. The Purchase Orders shall contain an Index. The Index shall be in alpha-numeric sequence and shall include the following information:

DISTRIBUTION STATEMENT A: APPROVED FOR PUBLIC RELEASE;

DISTRIBUTION IS UNLIMITED.

Source: https://assist.dla.mil -- Downloaded: 2016-07-21T19:29Z

a. Purchase Order (PO) Number

b. Identification of all PO line items, by noun description and equipment functional description (EFD)

c. Contractor’s design code designation, drawing number, and piece number

d. PO issue date

e. Vendor’s Name and Federal Supply Code of Manufacturer’s (FSCM) five digit number

f. Quantity ordered per line item

g. Provisioning and technical documentation control number for all line items requiring repair and replacement parts

h. Logistics Support Analysis Control Number (LSACN)

i. Applicable Mil-Spec

j. APL Number

2.1.2 The PO Index shall include all cancelled purchase orders and POs superseded by a vendor change.

2.1.3 The PO Index shall list all PO changes below the PO to which they apply and shall include all updated information.

End of DI-MISC-81616.

Source: https://assist.dla.mil -- Downloaded: 2016-07-21T19:29Z

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER SESS

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Certificate of Quality Audit Compliance

3. SUBTITLE

The Society for Protective Coatings (SSPC) QP-1 Audit Findings Report

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-81922

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

ASREQ*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft

Final

Reg Repro

16. REMARKS

BLOCK 4: Delete paragraph 2.1, 2.2, 2.4, and 2.6. Delete "(Optional)" from paragraph 3.9.

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 12 and 13: The report shall be submitted no later than 10 days after receipt of Final Audit Report.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Reader, Version DC, e-mail attachment to all addressees.

Block 14(a): C/440 Contracting Officer, Charles R. Smith (charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative (COR), TBD.

PSNS&IMF, C/440* 0 1 0

PSNS&IMF, C/412* 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY

Robert J Varney, PSNS&IMF C/412

H. DATE

7/22/16

I. APPROVED BY

Lorraine J Henry, PSNS&IMF C/412

J. DATE

7/22/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 6 of 46 Pages

DATA ITEM DESCRIPTIOtIJ I

FmY14v@8d Oaura 07woIsa

: nlLs- 1. IDENTIFICATION NuMBER

RSPORT , PRODUCTION OR DELIVERY PROBLEM(S) DI-tKM~- al178

-XWW710NJFURFOSE

3.1 The report is used to inform the procuring activity of crises which have developad, or are developing, emd which have the potsmtial to stop, interrupt or severely impact the production or delivery of contract end itsma.

(continued on page 2)

5.OFFICEOP Pai66enYFfEFwJslelu’Tv(em 6b.GIDEP R5WIRE0

910328

‘4Pn.KaTloN/lNleRRElN10N5iaP

7.1 This data item description (DID) contains the format-and content prapsration instructions for the data prodnct generated by the specific sad discrete task requirsmemt sc delineated in the contract.

7.2 This DID is applicable to the acquisition of both hardvare and software systama, aubsystams, components and sqnipmant. It mey be applied to sny contract covering the acquisition of enpplies/sertices, the delivery of which, if stopped

(continwl Oa page 2) “VPROVAL UMITAIION 98. APPLICABLEFORME 9h AMECNUMBER i PREPaaAnori INSTRUCTION

10.1 FormSt. The report shell ha in contractor format.

10.2 Content. The report still confein the following:

10.2.1

10.2.2

Idamtificatioa. Tbe first page of the ieport shall contain the following:

n. Identification of the system/eampanemt/program/project/hull/ectivity involved.

b. Contract f7umber.

c. Preparing activity.

d. 8srial/idantific.stion mnmbar (assignsd by the preparin8 activity), and the date.

e. “’Securityclassification, when required.

Sady of Report. The report shall “contain .Scamplete, but concise, explemation as to the nature and cause of the crisis or problsm snd the current or potential In addition, impact on contract end itsm production, delivery, cost or sckdding.

the report ehall include the following as applicable snd appropriate:

(continued on page 2) i rIIETRISmON 57ATEMEW

Distribution Statement A: Approved for public release; distribution is 1imited.

i Form 1S60.JIJNSS m.iau ddo s am 017s01em PAGE ~ Or ~ PAGEs <m ,,m. .-.301-$ 641 lr— .nna,n-,w/cc,.,..,..“ICI,..,,, -’”- ‘---

I Source: https://assist.dla.mil -- Downloaded: 2016-01-28T14:57Z

DI-MGNT- 81178 “

Block 3, DESCRIPTION/PORPOSE (centirmed)

3.2. !ixamplesof such crises are: accidents, strikes, %bkontracto’r” “or vendor difficulties or slippage, shortage of material, transportation tie-ups, or othez petential kttlenecks which may impact ceatract snd item production or delivery. . .

Bliick7, APPLIcATION/I NTERRSMTIONSRIP (continued) or interrupted, will adversely effect e military program, project or operation, or the constnction, conversion, overhaul, alteration or maintenance of military ships, systems or equipment.

Block 10, PREPARATION INSTRUCTIONS (centinued) a.

10.2.3 the re

Action(.s) Taken. Describe contractor action(s) taken to remedy the crisis or problem. If no contractor action has been taken, provide a brief explanation.

Action(s) Required. Clearly indicate the action(s) required, the date by which the action is required, and tbe respa-ibl~ party. e.g., contractor, procurina activity, other agency or actznty. ● Revised Data. Revised/updated product ion, delivery, cost or scheduling data should be provided, if available.

Contractor Recommendations. Delineate contractor recommendation(s), if any, to solve the turrent crisis or problcm, to prevent a recurrence, or for procuring activity follow-up.

Appandicss. Tables, references, cherts or other descriptive material or informctiun that vill clarify the crisis or probl~m, or that will support tbe rationale for contractor recomrnmdations, if any, should be prnvided as appendices. Each appendix shall be identified and referenced in the expropriate area of tbe repnrt.

RnDort Preparer. Name and telephone number of the person(s) preparing port.

page 2 of 2 pages

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

Work Completion Certification Certificate

3. SUBTITLE

Certificate of Completion for Work Item

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-82050

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

ASREQ*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft Final

Reg Repro

16. REMARKS

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 12, and 13: The report shall be submitted within 3 days of Work Item completion. Revisions shall be submitted with 4 days of work completion or correction of discrepancies.

BLOCK 14: Media requirement. The report shall be delivered electronically in Acrobat Adobe Reader, Version DC, e-mail attachment to all addressees.

Block 14(a): C/440 Contracting Officer, Charles R. Smith (charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative (COR), TBD.

PSNS&IMF, C/440* 0 1 0

PSNS&IMF, C/412* 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY

Robert J Varney, PSNS&IMF C/412

H. DATE

7/25/16

I. APPROVED BY

Lorraine J Henry, PSNS&IMF C/412

J. DATE

7/25/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 7 of 46 Pages

Title: Work Completion Certification Certificate

Number: DI-MGMT-82050 Approval Date: 20160705

AMSC Number: N9679 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2016-043

Use/relationship: This DID will certify that all contracted work has been performed and completed.

by the specific and discrete task requirement as delineated in the contract.

1. Format. The report shall be similar to that of Sample Figure 1.

2. Content. The report shall contain all the information specified in Sample Figure 1.

Source: https://assist.dla.mil -- Downloaded: 2016-07-20T19:16Z

DI-MGMT-82050

End of DI-MGMT-82050

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

Work Completion Certification Certificate

3. SUBTITLE

Certificate of Completion for Key Event

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-82050

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

ASGEN*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft Final

Reg Repro

16. REMARKS

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 12, and 13: The report shall be submitted 5 days prior to scheduled Key Event.

Revisions shall be submitted with 4 days of work completion or correction of discrepancies.

BLOCK 14: Media requirement. The report shall be delivered electronically in Acrobat Adobe Reader, Version DC, e-mail attachment to all addressees.

Block 14(a): C/440 Contracting Officer, Charles R. Smith (charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative (COR), TBD.

PSNS&IMF, C/440* 0 1 0

PSNS&IMF, C/412* 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY

Robert J Varney, PSNS&IMF C/412

H. DATE

7/25/16

I. APPROVED BY

Lorraine J Henry, PSNS&IMF C/412

J. DATE

7/25/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 8 of 46 Pages

Title: Work Completion Certification Certificate

Number: DI-MGMT-82050 Approval Date: 20160705

AMSC Number: N9679 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2016-043

Use/relationship: This DID will certify that all contracted work has been performed and completed.

by the specific and discrete task requirement as delineated in the contract.

1. Format. The report shall be similar to that of Sample Figure 1.

2. Content. The report shall contain all the information specified in Sample Figure 1.

End of DI-MGMT-82050

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER QCIC

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A009

2. TITLE OF DATA ITEM

Test and Inspection Plan (TIP)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

OT-2016-20207

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

WEKLY*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft Final

Reg Repro

16. REMARKS

BLOCK 8: Government requires 5 days prior to availability to review and comment.

Contractor has 3 days to incorporate any changes and return to Government.

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 12 and 13: The TIP shall be delivered prior to the start of production work and updated weekly. Final TIP shall be submitted upon completion of availability and shall contain all required objective quality evidence (OQE).

BLOCK 14: Media requirement. The report shall be delivered electronically in a searchable Microsoft Office Excel, Version 2007-2010, e-mail attachment to all addressees.

Block 14(a): C/132 Quality Assurance Specialist, TBD, C/440 Contracting Officer, Charles R. Smith (charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative

(COR), TBD.

PSNS&IMF, C/132* 1 0 0

PSNS&IMF, C/412* 0 1 0

PSNS&IMF, C/440* 0 1 0

15. TOTAL 1 2 0

G. PREPARED BY

Robert J Varney, PSNS&IMF C/412

H. DATE

7/25/16

I. APPROVED BY

Lorraine J Henry, PSNS&IMF C/412

J. DATE

7/27/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 9 of 46 Pages

Title: Test and Inspection Plan (TIP)

Number: OT-2016-20207 dsw

DTIC Applicable: N o

Preparing Activity: SH

Applicable Forms:

Approval Date: 20160714 dsw

Limitation: N4523A-16-R-0030

Use/Relationship: This DID will be used to identify all inspections and tests required by zero-tier references and first tier references, as well as symbols (I)(V)(Q) test/inspections and (G) government notification identified in the Work Item, and any additional tests and inspections the contractor deems necessary to substantiate product conformance.

This DID contains the format and content preparation instructions for the data product generated by the

1. Format. The TIP shall be in the contractor’s format.

2. Content. The TIP shall include the following information:

a. Ship’s name/hull number

b. Job Order number

c. Work Item number

d. Work Item Paragraph number

e. Identification of item/component to be inspected/tested by name, number, and location (e.g. number 3 main feed pump, 5-180-0-E)

f. Standard Item Number

g. Standard Item Paragraph

h. Location

i. Sub-Contractor (if applicable)

j. Inspection Symbol (I, V, Q, G)

k. Accept/Reject Criteria

l. Test Result (Accept or Reject)

m. Notify Date

n. Notify Time

o. Request Date

p. Request Time

q. Inspection Date

r. Name of Person Notified

s. Name of Government Representative at Inspection

t. Name of Contractor’s authorized representative who witnessed/performed test.

End of OT-16-20207. Dsw Page 1 of 1 Page

Form Approved

OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A010

2. TITLE OF DATA ITEM

Quality Management System (QMS) Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

OT-16-20208

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

ASREQ*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

Draft

Final

Reg Repro

16. REMARKS

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of

Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412 Bremerton, WA 98314.

BLOCK 10, 12, and 13: Initial QMS report shall be submitted 14 days prior to start of availability. Subsequent submissions shall be submitted within 7 days of revision.

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

Office, Version 2007-2010, e-mail attachment to all addressees.

Block 14(a): C/440 Contracting Officer, Charles R. Smith (Charles.r.smith13@navy.mil) and C/412 Contracting Officer’s Representative (COR), Shawn P. Konkler

(shawn.p.konkler@navy.mil).

PSNS&IMF, C/440* 0 1 0

PSNS&IMF, C/412* 0 1 0

15. TOTAL 1 2 0

G. PREPARED BY

Robert J Varney, PSNS&IMF C/412

H. DATE

7/25/16

I. APPROVED BY

Lorraine J Henry, PSNS&IMF C/412

J. DATE

7/28/16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 0 of 46 Pages

Title: Quality Management System (QMS) Report

Number: OT-16-20208 dsw

DTIC Applicable: N o

Preparing Activity: SH

Applicable Forms:

Approval Date: 20160714 dsw

Limitation: N4523A-16-R-0030

Use/Relationship: This DID describes the methodology that will be used to meet the quality requirements needed for the specific and discrete task requirement as specified in International Organization for

Standardization (ISO) 9001-2008, (available at International Organization for Standardization website http://www.iso.org/iso/en/ISOOnline.frontpage).

This DID contains the format and content preparation instructions for the data product generated by the specific requirement as specified in International Organization for Standardization (ISO) 9001-2008.

1. References. The applicable issue of the documents cited herein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

2. Format. The report shall be in the contractor’s format.

3. Content. The report shall have a Title page specifying the following information:

a. Title

b. CDRL exhibit number

c. Revision level

d. Approval/submission

e. Date

f. Program name

g. Contract number

h. Contractor’s name and address

i. Data item author

j. Signature

k. Approval record

Page 1 of 2 Pages http://www.iso.org/iso/en/ISOOnline.frontpage

OT-16-20208

3.1 The report shall address all the documented procedures specified in ISO 9001-2008 and shall include the following Management Responsibnilities:

a. Customer Related Processes

b. Purchasing

c. Production and Service Provision

d. Monitoring and Measurement of Product

e. Control of Monitoring and Measurement of Devices

f. Measurement, Analysis, and Improvement

3.2 The report shall contain a table of contents.

3.3 The report shall contain a revision status log page which includes the various revision levels, dates, and summary description of the changes made.

3.4 The report shall reference any Industry standard in which the contractor has a current certification.

3.5 The report shall reference the contractor’s current Quality Manual, number and identification, and date.

3.6 The report shall contain details of any changes, deletions and additions to the contractor’s standard requirements, and shall specify the specific Industry workmanship standards and levels for soldering, printed wiring assembly, etc., that are to be applied to the program.

3.7 The report shall include an organizational chart identifying the Product Assurance (PA) organization, names and titles of key PA personnel assigned to the program, and how the PA organization relates to the corporate structure.

3.8 The report shall briefly address the following topics if different from and not included in the quality manual: quality audit frequency, depth, and independence; process certification and control of automated processes; “cannot duplicate” (CND) and nonconforming material processes;

incoming inspection/test, certified supplier program and parts control; and any unique requirements for the program.

End of OT-16-20208. dsw Page 2 of 2 Pages

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 11 of 46 Pages

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved

OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A011

2. TITLE OF DATA ITEM

Temporary Access Cut Drawing/Sketch

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

OT-16-20210

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

ASREQ*

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

Draft Final

Reg Repro

16. REMARKS

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of

Defense and U.S. DoD contractors only for Administrative or Operational use (July 2016).

Other requests shall be referred to PSNS&IMF, C/412, Bremerton, WA 98314.

BLOCK 10, 12 and 13: Submit sketch 3 days prior to making the cuts or removing the bolted/riveted access.

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

Excel, Version 2007-2010, e-mail attachment to all addressees.

BLOCK 14(a): C/440 Contracting Officer, Charles R. Smith (charles.r.smith13@navy.mil) and

C/412 Contracting Officer’s Representative (COR), Shawn P. Konkler

(shawn.p.konkler@navy.mil)

PSNS&IMF, C/412* 0 1 0

PSNS&IMF, C/440* 0 1 0

15. TOTAL 0 2 0

G. PREPARED BY

Lorraine Henry, PSNS&IMF C/412

H. DATE

7/28/16

I. APPROVED BY

Robert Varney, PSNS&IMF C/412

J. DATE

7/29/16

RJV

Title: Temporary Access Cut Drawing/Sketch

Number: OT-16-20210 dsw

DTIC Applicable: N o

Preparing Activity: SH

Applicable Forms:

Approval Date: 20160714 dsw

Limitation: N4523A-16-R-0030

Use/Relationship: This DID will identify each proposed access cut to the ship structure and engine enclosure and a list of each proposed bolted/riveted access removal. The drawing/sketch shall not contain authorized access cuts on NAVSEA-approved drawings.

This DID contains the format and content preparation instructions for the data product generated by the

2. Format. The Drawing/Sketch shall be in the contractor’s format.

3. Content. The Drawing/Sketch shall include the following information:

a. A plan and elevation view specifying the location of the access by deck, frame, and distance from the center line or deck edge and showing location of adjacent penetrations, bulkheads, framing, welds, and riveted joints within 12 inches of the proposed cut.

b. Location and number of previous cuts visible in each plate and the cutback of existing welds.

c. Temporary structural reinforcement required to prevent distortion of ship structure.

d. Thickness and type of material of plating and structural members to be cut. Include source or document/drawing number which identifies material requirements.

e. A description of the temporary access closure and enclosures.

f. A copy of the weld approved weld procedure number with the proposed access sketch.

g. List of bolted/riveted access covers shall include location, designation, and classification as identified on ship's damage control book.

h. All drawing titles and numbers (including applicable sub-tier), and technical documentation that will used to accomplish the requirements of MIL-STD-1689.

End of DI-OT-16-20210. dsw Page 1 of 1 page

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 12 of 46 Pages

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved

OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Valve Repair Barge (YRR-11)

E. CONTRACT/PR NO.

N4523A-16-R-0030

F. CONTRACTOR

A012

Compartment Inspection Report

4. AUTHORITY (Data Acquisition Document No.)

OT-16-20217

5. CONTRACT REFERENCE

SOW para 3.4

6. REQUIRING OFFICE

PSNS&IMF, C/412

7. DD 250 REQ

ASREQ*

12. DATE OF FIRST SUBMISSION

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

BLOCK 10, 12 and 13: Submit report prior to commencement of contamination-producing operations.

Lorraine J. Henry, PSNS&IMF C/412

H. DATE

7/28/16

I. APPROVED BY

Robert J. Varney, PSNS&IMF C/412

Title: Compartment Inspection Report

Number: OT-16-20217 dsw

DTIC Applicable: N o

Preparing Activity: SH

Applicable Forms:

Approval Date: 20160714 dsw

Limitation: N4523A-16-R-0030

Use/Relationship: This DID will provide results of each compartment inspection, including discrepancies found, and provides objective quality evidence (OQE) for the work accomplished within the compartment.

This DID contains the format and content preparation instructions for the data product generated by the

2. Content. The reports shall contain the following information:

a. Name and hull number of ship

b. Job Order

c. Work Item

d. Paragraph numbers including standard item paragraph number

e. Compartment (number and name)

f. Date of inspection

g. List the discrepancies and the identity of the contractor responsibility and Government responsibility.

h. Signature of contractor representative

i. Signature of SUPERVISOR

j. Signature of Commanding Officer’s designated representative

End of OT-16-20217. dsw

Page 1 of 1 Page

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 13 of 46 Pages

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved

OMB No. 0704-0188

This is the start of the file's text. The full file is on GovTribe.

File details come from the government source that posted it. Updated Nov 14, 2017.