Exhibit_J-1_-_CDRLs_and_DIDs_A001_through_A022.pdf

PDF 2 MB Posted May 26, 2017

Attached to: Maintenance on IX-546 Federal contract opportunity
Solicitation number: N4523A17R0012
Issued by: Department of the Navy Naval Sea Systems Command

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Exhibit_J-1_CDRLs and DIDs_A001 through A022

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Other files attached to Maintenance on IX-546, newest first.
File	Type	Posted
N4523A17R00120003_Amendment_0003.pdf	PDF	Jun 21, 2017
N4523A17R00120002_Amendment_0002.pdf	PDF	Jun 21, 2017
IX_546_References.zip	ZIP file	Jun 2, 2017
Attachment_J-5_Vessel_Pictures.zip	ZIP file	Jun 1, 2017
N4523A-17-R-0012-0001.pdf	PDF	Jun 1, 2017
Attachment_J-4_Compensating_Barge_IX-546_Contract_Performance_Data_Sheet.pdf	PDF	May 26, 2017
Attachment_J-2_Compensating_Barge_IX-546_5-Price_Proposal_Worksheet.xls	XLS spreadsheet	May 26, 2017
N4523A-17-R-0012_Compensating_Barge_IX-546.pdf	PDF	May 26, 2017
Attachment_J-3_Compensating_Barge_IX-546_Request_for_Clarification_Form.pdf	PDF	May 26, 2017
Attachment_J-1_Compensating_Barge_IX-546_Statement_of_Work.pdf	PDF	May 26, 2017
SOW_IX_546_-_Draft.pdf	PDF	Apr 18, 2017

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DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications 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

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MGMT

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A001 CONTRACTOR'S PROGRESS, STATUS AND

MANAGEMENT REPORT

N/A

DI-MGMT-80227 SOW PARAGRAPH 1.5.1 PSNS & IMF C/411

N/A D(SEE BLK16)

WEKLY*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BLOCK 4: Paragraph 10.2: Delete "This report shall be typewritten on standard size (e.g. 8 1/2" by 11'") white paper, and securely stapled.".

Delete Paragraphs 10.3.d; 10.3.g; 10.3.i; 10.3.j; 10.3.k; 10.3.l.

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (February 2016). Other requests shall be referred to PSNS&IMF, C/411, Bremerton, WA 98314.

BLOCK 10, 12, and 13: Submit report 24 hours prior to each weekly scheduled production meeting.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Contracting Officer's Representative (COR) specified in the contract.

11/30/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.30 13:28:56 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=TIEMEYER.JOHN.DAVID.1044537105 Date: 2016.11.30 14:02:13 -08'00'

Source: https://assist.dla.mil -- Downloaded: 2016-05-07T22:28Z Check the source to verify that this is the current version before use.

Source: https://assist.dla.mil -- Downloaded: 2016-05-07T22:28Z

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MISC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A002 COATING SYSTEM DATA REPORT N/A

OT-DID-17-20089 SOW PARAGRAPH 1.5.5 PSNS & IMF C/411

N/A D(SEE BLK16)

OTIME*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BLOCK 12: Report shall be submitted 5 business days after contract award.

11/18/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.18 12:21:03 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 14:04:49 -08'00'

Title: Coating System Data Report

Number: OT-17-20089 dsw Approval Date:20161118 dsw

AMSC Number: N/A Limitation:N4523A-17-R-0012

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

Office of Primary Responsibility: SH/PNSY Project Number: N/A

Applicable Forms: N/A

Use/Relationship: Coating System data report is used by the Government to define product requirements.

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.

The Reference document cited in this DID can be accessed at:

http://www.nstcenter.biz/tech-documents/astm-f718s/

This DID is for one time use on solicitation N4523A-17-R-0012 only. dsw

Requirements:

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 contractor’s format.

3. Content. The Report shall include all of the information specified in

The American Society of Testing and Materials, Standard Specification for Shipbuilders and Marine Paints and Coatings Product/Procedure Data

Sheet(ASTM)F-718.

End of OT-17-20089. dsw http://www.nstcenter.biz/tech-documents/astm-f718s/

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MISC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A003 SAFETY DATA SHEET REPORT N/A

OT-DID-17-20084 SOW PARAGRAPH 1.5.6 PSNS & IMF C/411

N/A D(SEE BLK16)

OTIME*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BLOCK 12: Report shall be submitted 5 business days after contract award.

11/18/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.18 12:22:26 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 14:06:36 -08'00'

Title: Safety Data Sheet (SDS) Report

Number: OT-17-20084 dsw Approval Date:20161118 dsw

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

Use/Relationship: The SDS Report is used by the Government to define product safety and environmental procedures.

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.

The Reference document cited in this DID can be accessed at:

https://www.osha.gov/Publications/OSHA3514.html

2. Format. The Report shall be in contractor’s format.

3. Content. The Report shall include all of the information specified in the Occupational Safety and Health Administration (OSHA) Part Number

1910.1200 App D SDS, Subpart Z Toxic and Hazardous Substances.

End of OT-17-20084. dsw https://www.osha.gov/Publications/OSHA3514.html

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MISC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A004 CONDITION FOUND REPORT N/A

DI-MGMT-81648 SOW PARAGRAPH 1.11 PSNS & IMF C/411

N/A D(SEE BLK16)

ASREQ*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BLOCK 4: Delete paragraph 3.2.a.

Paragraph 3.2.b delete "Premium/Acceleration" and "premium".

Paragraph 3.2.c delete "internal milestones" and "and contract".

BLOCK 10, 12, and 13: Submit report within 5 working days of work item requirement discovery.

Submit report within 24 hours of anticipated difficulty in meeting contract requirements and/or schedule dates.

For required reports that could result in a change in work to be accomplished or additional material to be procured, submit the required report in a time frame to allow the CO, via the COR, to initiate early action, but no later than the first 20 percent of the scheduled availability.

Drydock related inspection reports shall be submitted no later than the first 20 percent of the scheduled docking period. Drydock related reports which contain readings (final, thickness, etc.) clearances, alignments, test results, or other such data for work that has to be completed prior to pre-flood/undocking, shall be submitted to the CO, via the COR, within 24 hours after recording the data but no later than 72 hours prior to pre-flood/undocking, whichever occurs first.

11/30/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.30 13:33:53 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 14:14:55 -08'00'

DATA ITEM DESCRIPTION

Title: CONDITION FOUND REPORT

Number: DI-MGMT-81648 Approval Date: 20040809 AMSC Number: N7531 Limitation: N/A DTIC Applicable: N/A GIDEP Applicable: N/A Office of Primary Responsibility: N PEO SHIPS-FL32 Applicable Forms: N/A

Use/Relationship: The Condition Found Report identifies needed repairs and recommends corrective action for work discovered during the contract performance period which are not covered by the work specifications.

This DID contains the format, content, and intended use information for the data product resulting from the work task described in the contract.

Requirements:

1. Reference documents. N/A.

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

3. Content. The report shall be serialized by CFR Number, and shall include the following:

a. Contract number, ship and hull number

b. Work Item Number to which the CFR relates

c. Date work requirement was discovered

d. Clear description of the work requirement

e. Specific location of the work requirement

f. Recommendation for corrective action

3.1 Recommendation for appropriate/best time to accomplish (i.e. during current availability with or without schedule change, future CNO or Continuous Maintenance Availability), and supporting rationale for the recommendation (such as cost efficiencies, availability of work force, availability of material, premium expenditures, etc.).

3.2 Cost and time estimates and the time frame for which it is valid, including:

a. Class “C” cost estimates. For work requirements which could be estimated within five working days, a class “F” estimate (+/-40%) identifying any potential impact which may affect the current schedule shall be included. The Class “F” estimate shall also contain the date on which a class “C” estimate will be provided.

b. Estimated Premium/Acceleration Costs, including premium costs for; material, subcontractors, man-hours, rework and any additional costs to on going work resulting from inclusion of the CFR work requirement.

c. Identification of related changes, if any, to the internal milestones and production and contract completion dates shall be included. When no changes were required a statement to that fact shall also be included

4. Media. The electronic media requirements shall be as specified in the contract on the DD 1423 CDRL.

5. End of DI-MGMT-81648

Source: https://assist.dla.mil -- Downloaded: 2016-05-07T22:47Z

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

SAFT

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A005 ACCIDENT/INCIDENT REPORT N/A

DI-SAFT-81563 SOW PARAGRAPH 1.13.2 PSNS & IMF C/411

N/A D(SEE BLK16)

ASREQ*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BLOCK 4: USE/RELATIONSHIP BLOCK: Delete the following: "major"; "one or more fatalities, or two or more disabling"; "exceeding $10,000;".

PARAGRAPH 2.: Delete "serious"; "which will adversely affect capability to meet contractual obligations".

PARAGRAPH 2.G: Delete "disabling"; "exposed to CBR agents".

BLOCK 10, 12, and 13: Report shall be submitted within 24 hours of investigation completion.

11/30/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.30 13:35:53 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 14:18:11 -08'00'

Title: Accidertflncident Report

Number DI-SAFT-8 1563 Approved Date: 2 Jun 98 AMSC Numbec A7315 Limitation:

DT3C Applicable: GIDEP Application:

Office of Primary Respomibility A/AR Applicable Fornw Use/relationship: This reportprovides tAeprocuring agency with immediate notification and information concerning any mrjor acciderrthncident (including fire) resulting in any one or more of the following: causing one or more fatalities, or two or snore disabling injuries; damaging government property exceeding $10,000; atTecting program planning or production schedules;

degrading the safety of the equipment under contract, such that persomel injury or property darnage may be involved, identi@ng a potential hazard requiring corrective action.

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

b. This Data Item Description replaces DI-H-I 329A.

Requirements:

1. Format. Contractor format is acceptable

2. Content. Report without delay any serious accident or incident (i.e. explosioq fire, flood pressure rupture, major rndfunction) which will adversely affect capabtity to meet contractual obligations. The report shall be made by the fkstest means, giving the following information.

Name, organization, telephone number, and location of the contractor and general manager Name and title of the person(s) reporting Date and time of accidenthcident Location of accidentiiciden~ i.e., building number, fkcility name Brief summary of accidentkscidcnt giving pertinent details”iircludihgtype ‘md qtiti~”of -materiel Cause of accidentliicident Camalties (fatalities, disabling irjuries, exposed to CBR agents) Estimated property damage, if applicable Nature of darnage; effect on production, operations, training or other activity Action taken by contractor Other damage or injuries sustained (public or private) Other pertinent information

Source: https://assist.dla.mil -- Downloaded: 2016-05-07T21:16Z

DI-SAFT-81563

3. Malfunction. If a malfunction of equipment is involved, the following additional information shall be finmished:

a. Equipment nomenclature

b. @@ity illvokd

c. Production lot number(s)

d. Brief teehnieal description of malfunction

I 4. End of DI-SAFT-8 1563

Source: https://assist.dla.mil -- Downloaded: 2016-05-07T21:16Z

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

QCIC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A006 PAINT PRESERVATION APPENDICES REPORT N/A

OT-DID-17-20083 SOW PARAGRAPH 1.16.1 PSNS & IMF C/411

N/A D(SEE BLK16)

ASREQ*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BLOCK 10, 12 and 13: Submit documents within 3 working days of completion of the following preservation operations: SSPC SP-1, Surface Profiles, and Top Coat Cure.

11/15/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.18 12:24:24 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 14:42:52 -08'00'

Title: Paint Preservation Appendices Report

Number: OT-17-20083 dsw Approval Date:20161118 dsw

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

Use/Relationship: The Preservation Appendices Report will provide the

Government with evidence of completed preservation operations.

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

1. Format. The Paint Preservation Appendices Report shall be in contractor’s format.

2. Content. The Paint Preservation Appendices Report shall contain all the information contained in SAMPLE Figures 1 through 9.

OT-17-20083 dsw

SAMPLE FIGURE 1

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MISC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A007 HAZARDOUS WASTE REPORT N/A

OT-DID-17-20081 SOW PARAGRAPH 1.17.1 PSNS & IMF C/411

N/A D(SEE BLK16)

OTIME*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BLOCK 10: Submit report within 10 calendar days of project completion.

11/18/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.18 12:26:10 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 14:45:53 -08'00'

Title: Hazardous Waste Report

Number: OT-17-20081 dsw Approval Date: 20161118 dsw

AMSC Number: N/A Limitation: N4523A-17-R-0012 DTIC Applicable: N/A GIDEP Applicable: N/A

Use/Relationship: The Hazardous Waste Report will identify type, amount, and disposal cost of hazardous waste removed during the period of performance. It will provide the Government with evidence of proper hazardous waste disposal.

product generated by the specific and discrete task requirement as delineated

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

2. Content. The report shall contain:

a. Name of each item.

b. Title of each item.

c. Description of each item.

d. Quantity of each item.

e. Analysis used to identify the hazardous waste.

f. Copies of paid invoices for the disposal of hazardous wastes.

g. Copies of paid receipts for the disposal of hazardous wastes.

End of OT-17-20081. dsw

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MISC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A008 GAS FREE PROGRAM REPORT N/A

OT-DID-17-20085 SOW PARAGRAPH 1.20.1 PSNS & IMF C/411

N/A D(SEE BLK16)

OTIME*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BlOCK 8: Product shall be approved for technical content. Government requires 5 work days to review and comment. Contractor has 3 working days to incorporate comments and send back to the Government.

BLOCK 10, 12, AND 13: BLOCK 10, 12, and 13: Submit report a minimum of 8 working days prior to the start of contract period of performance.

Submit revised report within 2 work days of a change to the Gas Free Program, Personnel, or Certifications/Qualifications.

11/18/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.18 12:27:19 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 14:54:59 -08'00'

Title: Gas Free Program Report

Number: OT-17-20085 dsw Approval Date:20161118 dsw

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

Use/Relationship: The Gas Free Program Report will provide the Government with proof of the Contractor’s confined space entry/gas free certification processes and qualified personnel, including sub-contractors.

product generated by the specific and discrete task requirements as delineated

2. Content. The Gas Free Program Report shall contain the following Sections:

2.1 Objective.

2.2 Background.

2.3 Assignment of Responsibility for:

a. Employer

b. Program Manager

c. Entry Supervisors

d. Attendants

e. Rescue Team

f. Entrants/Affected Employees

2.4 Training:

a. Training Frequency

b. General Training

c. Specific Training

d. Verification of Training

2.5 Identification of Hazards and Evaluation of Confined Spaces:

a. Survey

b. Hazard Reevaluation

c. Pre-Entry Hazard Assessment

d. Hazard Controls

2.6 Entry Permits:

a. Key Elements of Entry Permits

OT-17-20085 dsw

b. Permit Scope and Duration

2.7 Entry Procedures:

a. Prior to Entry

b. Opening a Confined Space

c. Atmospheric Testing

d. Isolation and Lockout/Tagout Safeguards

e. Ingress/Egress Safeguards

f. Warning Signs and Symbols

2.8 Maintenance of Safe Conditions:

a. Conditions

b. Tests required

2.9 Emergency Response:

a. Emergency Response Plan

b. Retrieval Systems and Methods of Non-Entry Rescue

2.10 Current Roster of the following personnel:

a. Certified National Fire Protection Association (NFPA) Marine Chemists

b. Certified Industrial Hygienists

c. Qualified Competent Persons

End of OT-17-20085. dsw

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MISC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A009 TEST AND INSPECTION PLAN (TIP) N/A

DI-MGMT-82062 SOW PARAGRAPH 1.21.1 PSNS & IMF C/411

N/A D(SEE BLK16)

WEKLY*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BLOCK 8: Government requires 5 days prior to project start date to review and comment. Contractor has 3 days to incorporate any changes and return to Government.

BLOCK 10, 12 and 13:

Submit TIP 24 hours prior to each weekly scheduled production meeting.

11/30/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.30 13:39:07 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 14:59:35 -08'00'

Title: TEST AND INSPECTION PLAN (TIP)

Number: DI-MGMT-82062

AMSC Number: N9711

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

GIDEP Applicable: No

Project Number: MGMT-2016-049

Use/Relationship: This DID is 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 specific and discrete task requirement as delineated in the contract.

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

Content. The TIP shall include the following information:

Ship’s name/hull number

Work Item number

Work Item Paragraph number

Identification of item/component to be inspected/tested

Standard Item Number

Standard Item Paragraph

Location

Sub-Contractor (if applicable)

Inspection Symbol (I, V, Q, G)

Accept/Reject Criteria

Test Result (Accept or Reject)

Notify Date

Notify Time

Request Date

Request Time

Inspection Date

Name of Person Notified

Name of Government Representative at Inspection

Name of Contractor’s authorized representative who witnessed/performed test.

End of DI-MGMT-82062

Source: https://assist.dla.mil -- Downloaded: 2016-10-13T13:29Z

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MISC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A010 VESSEL DOCKING AND UNDOCKING PLAN N/A

OT-DID-17-20082 SOW PARAGRAPH 3.1 PSNS & IMF C/411

N/A D(SEE BLK16)

ASREQ*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1 1

PSNS & IMF C/242 1 1

2 2 0

BlOCK 8: Product shall be approved for technical content. Government requires 5 work days to review and comment. Contractor has 3 working days to incorporate comments and return to the Government.

BLOCK 10, 12, and 13: Submit plan a minimum of 8 working days prior to docking and undocking each vessel.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Government Docking Observer (GDO) and Contracting Officer's Representative (COR) specified in the contract.

11/18/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.18 12:28:42 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 15:01:36 -08'00'

Title: Vessel Docking and Undocking Plan

Number: OT-17-20082 dsw Approval Date: 20161118 dsw

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

Use/Relationship: The plan will provide the Government with planned instructions to safely dock and undock the vessel(s).

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

2. Content. The Plan shall contain the following:

a. Operating Practices.

b. Safety and Security.

c. Special precautions and actions required by the characteristics of the dock, marine railway, and any other docking methods.

d. Pumping/flooding schedule.

e. Specific list, trim, and stability requirements.

f. Set and align docking blocks.

g. A scaled drawing including block size, block spacing, and location of vessel with respect to the blocks at landing.

h. Docking clearances utilizing references for guidance.

i. The use of haul, fixed, and fitted blocks.

OT-17-20082 dsw

j. The number, distance from centerline, and square footage of the side blocks per side sufficient to resist overturning moments.

3. The Plan shall show that at least 90 percent of blocks land on primary strength members.

End of OT-17-20082. dsw

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MISC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A011 VESSEL FINAL DOCKING REPORT N/A

OT-DID-17-20090 SOW PARAGRAPH 3.1.11 PSNS & IMF C/411

N/A D(SEE BLK16)

OTIME*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

PSNS & IMF C/242 1

0 2 0

BLOCK 10: Submit report within 5 working days of final undocking of the vessel.

BLOCK 14: Media requirement. The report shall be delivered electronically in Adobe Acrobat Version DC, as an e-mail attachment to the Government Docking Observer (GDO) and the Contracting Officer's Representative (COR) specified in the contract.

11/23/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.23 05:54:18 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 15:03:01 -08'00'

Title: Vessel Final Docking Report

Number: OT-17-20090 dsw Approval Date:20161123 dsw

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

Applicable Forms: NAVSEA Forms forms 9997/1 through 9997/5

Use/Relationship: The report will document the results of various vessel drydocking evolutions. It will provide the Government with historical information to be applied to future drydockings.

The NAVSEA forms 9997/1 through 9997/5 can be obtained as specified in the contract.

1. Format. The Report shall be presented on NAVSEA forms 9997/1 through

9997/5.

2. Content. The Report shall contain all the information specified in NAVSEA forms 9997/1 through 9997/5 as applicable to each vessel.

End of OT-17-20090. dsw

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0001 A

MISC

VESSEL REPAIR SERVICES N4523A-17-R-0012 TBD

A012 ZINC ANODE LOCATION REPORT N/A

OT-DID-17-20087 SOW PARAGRAPH 3.2.3.2 PSNS & IMF C/411

N/A D(SEE BLK16)

OTIME*

N/A

SEE BLOCK 16

PSNS & IMF C/411 1

0 1 0

BLOCK 10, 12, and 13: Submit report a minimum of 4 working days prior to an undocking event.

11/18/2016 NOV 30, 2016

1 1

LANGHAM.MATTHEW.ALLEN.1095218454

Digitally signed by LANGHAM.MATTHEW.ALLEN.1095218454 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LANGHAM.MATTHEW.ALLEN.1095218454 Date: 2016.11.18 12:50:19 -08'00' TIEMEYER.JOHN.DAVID.1044537105 Digitally signed by TIEMEYER.JOHN.DAVID.1044537105

Date: 2016.11.30 15:04:41 -08'00'

Title: Zinc Anode Location Sketch

Number: OT-17-20087 dsw Approval Date:20161118 dsw

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

Use/Relationship: The Zinc Anode Location Sketch will provide detailed current zinc anode locations of the underwater hull of vessel(s).

1. Format. The Zinc Anode Location Sketch shall be in contractor’s format.

2. Content. The Sketch shall contain the underwater body and freeboard plating surfaces and shall also include the following:

a. Specific locations of fixed hull structural members.

b. Specific locations of docking block locations.

c. Specific locations of hull reference points.

d. Specific measurements of zinc anodes to docking block locations.

e. Specific measurements of zinc anodes to hull reference points.

f. Specific measurements of zinc anodes to fixed hull structural members.

End of OT-17-20087. dsw

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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.