Exhibit_A_CDRLS_A001_through_A022.pdf

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Attached to
Caisson 3 Federal contract opportunity
Solicitation number
N4523A19R1058
Issued by
Department of the Navy Naval Sea Systems Command

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Exhibit A CDRLs A001-A022 N4523A19R1058

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0003 A

MGMT

Caisson #3 N4523A-19-R-1058 TBD

A001 Contractor's Progress, Status and Management Report N/A

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

LT

N/A D(See Block 16)

WEKLY*

N/A

SEE BLOCK 16*

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 first report 5 working days prior to project start date.

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.

8/27/2018

1 1

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QCIC

Caisson #3 N4523A-19-R-1058 TBD

A002 COATING SYSTEM DATA REPORT N/A

DI-QCIC-82111 SOW PARAGRAPH 1.5.5 PSNS & IMF C/411

LT

N/A D(See Block 16)

OTIME*

N/A

SEE BLOCK 16*

N/A

PSNS & IMF C/411 1

0 1 0

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

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.

DATA ITEM DESCRIPTION

Title: COATING SYSTEM DATA REPORT

Number: DI-QCIC-82111 Approval Date: 20170327

AMSC Number: N9784 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: QCIC-2017-004

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 Website cited in this DID can be accessed at: http://www.nstcenter.biz/tech-documents/astm-f718s/

Requirements:

1. References Documents. 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 DI-QCIC-82111

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SAFT

Caisson #3 N4523A-19-R-1058 TBD

A003 SAFETY DATA SHEET (SDS) REPORT N/A

DI-SAFT-82112 SOW PARAGRAPH 1.5.6 PSNS & IMF C/411

LT

N/A D(See Block 16)

OTIME*

N/A

SEE BLOCK 16*

N/A

PSNS & IMF C/411 1

0 1 0

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

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.

Title: SAFETY DATA SHEET (SDS) REPORT

Number: DI-SAFT-82112 Approval Date: 20170327

AMSC Number: N9785 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: SAFT-2017-004

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

The Website cited in this DID can be accessed at:

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

1. References.

1.1 Occupational Safety and Health Administration (OSHA) Part Number 1910.1200 App D

SDS, Subpart Z Toxic and Hazardous Substances.

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 DI-SAFT-82112

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Caisson #3 N4523A-19-R-1058 TBD

A004 CONDITION FOUND REPORT N/A

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

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

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 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 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.

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.

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

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Caisson #3 N4523A-19-R-1058 TBD

A005 INCIDENT REPORT N/A

DI-MGMT-82071 SOW PARAGRAPH 1.13.2 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

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: Report shall be submitted within 24 hours of investigation completion.

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.

Title: INCIDENT REPORT

Number: DI-MGMT-82071

AMSC Number: N9720

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

GIDEP Applicable: No

Project Number: MGMT-2016-058

Use/Relationship: This DID will be used to describe each accident, electrical shock, and fire that requires medical treatment.

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

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

Content. The report shall contain all the information contained in Figure 1.

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DI-MGMT-82071

Figure 1

INCIDENT REPORT

Report #

INITIAL REPORT REQUESTED UPDATE FINAL REPORT

TYPE OF INCIDENT:

NAME(S) OF INJURED (if applicable):

INCIDENT DATE: TIME: COMPANY:

SUPERVISOR:

LOCATION OF INCIDENT: TYPE OF INJURY OR FIRE:

CAUSE OF INCIDENT: EQUIPMENT INVOLVED:

WORK ITEM NUMBER: CONTRACT NUMBER:

WITNESS AND/OR INDIVIDUALS INVOLVED

NAME(S) DEPT. COMPANY

DESCRIPTION OF INCIDENT

INVESTIGATED BY (NAME): TITLE:

SIGNATURE OF INVESTIGATOR: DATE:

DISPOSITION OF INJURED (if applicable)

IMMEDIATE CORRECTIVE ACTION

FIGURE 1 (continued)

LONG TERM CORRECTIVE ACTION

INVESTIGATED BY (NAME): TITLE:

SIGNATURE OF INVESTIGATOR: DATE:

INCIDENT REPORT

Report #

ROOT CAUSE ANALYSIS

FIGURE 1 (continued) Incident Report Instructions

REPORT NUMBER- Unique tracking number created by contractor

TYPE OF INCIDENT- Injury, fire or near miss

NAME(S) OF INJURED- Self Explanatory

INCIDENT DATE: - Self Explanatory

TIME: - Self Explanatory

COMPANY: - Prime and subcontractors involved

SUPERVISOR – Supervisor of employee(s) involved

LOCATION OF INCIDENT: - Base/Yard, Ship name and hull number, space number and compartment name TYPE OF

INJURY OR FIRE – i.e. broken arm, laceration to head or Class A, B, C fires, smoldering

CAUSE OF INJURY – i.e. Equipment failure, PPE, process

EQUIPMENT INVOLVED – Equipment working on and equipment being used to cause incident WORK

ITEM NUMBER – Work Item being accomplished when incident occurred

CONTRACT NUMBER: - Contract Number assigned by government agency i.e. RMC, Alteration Installation Team

(AIT) Sponsor.

WITNESS AND/OR INDIVIDUALS INVOLVED – Name, company of witnesses and or individuals involved with the incident.

DESCRIPTON OF INCIDENT OR NEAR MISS – Short description of events leading up to incident and extent of injuries and or damage to equipment.

DISPOSITION OF INJURED – i.e. Transported to hospital via ambulance or POV, transported to clinic, released from hospital, name of hospital or clinic, limited duty or loss time (if known).

IMMEDIATE CORRECTIVE ACTION – i.e. Scene/space secured, ship notified (who and when), RMC notified (who and when) clean-up of blood, equipment secured fire debris cleaned up.

INVESTIGATED BY – Self Explanatory.

TITLE – Self Explanatory.

SIGNATURE OF INVESTIGATOR – Self Explanatory.

DATE – Self Explanatory.

LONG TERM CORRECTIVE ACTION – What action(s) were taken so that incident does not reoccur, i.e. training, safety stand down or process/policy change?

ROOT CAUSE ANALYSIS – Process by which you will identify the cause or contributing factors of the incident.

Note: Attach additional information as necessary.

End of DI-MGMT-82071

MISC

Caisson #3 N4523A-19-R-1058 TBD

A006 PAINT PRESERVATION APPENDICES N/A

DI-MISC-82120 SOW PARAGRAPH 1.16.1 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK16*

SEE BLOCK16*

PSNS & IMF C/411 1

0 1 0

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 documents within 1 working day of completion of the following preservation operations: SSPC SP-1, Surface Profiles, Surface Conductivity/ Chloride and Top Coat Cure.

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.

Title: PAINT PRESERVATION APPENDICES REPORT

Number: DI-MISC-82120 Approval Date: 20170410

AMSC Number: N9794 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MISC-2017-006

Use/Relationship: The Preservation Appendices Report will provide the Government with evidence of completed preservation operations.

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

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

Content. The Paint Preservation Appendices Report shall contain all the information contained in

Sample Figures 1 through 9.

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DI-MISC-82120

SAMPLE FIGURE-1

SAMPLE FIGURE-2

SAMPLE FIGURE-3

SAMPLE FIGURE-4

SAMPLE FIGURE-5

SAMPLE FIGURE-6

SAMPLE FIGURE-7

SAMPLE FIGURE-8

End of DI-MISC-82120

SAMPLE FIGURE 9

Caisson #3 N4523A-19-R-1058 TBD

A007 HAZARDOUS WASTE REPORT N/A

DI-MGMT-82129 SOW PARAGRAPH 1.17 PSNS & IMF C/411

LT

N/A D(See Block 16)

OTIME*

N/A

SEE BLOCK 16*

N/A

PSNS & IMF C/411 1

0 1 0

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 and 12: Submit report within 30 calendar days of project completion.

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.

Title: Hazardous Waste Report

Number: DI-MGMT-82129 Approval Date: 20170608

AMSC Number: N9814 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2017-026

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.

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

2. Content. The report shall contain:

2.1. Name, title, description, and quantity of each item.

2.2. Analysis used to identify the hazardous waste.

2.3. Copies of paid invoices and receipts for the disposal of hazardous wastes.

End of DI-MGMT-82129

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Caisson #3 N4523A-19-R-1058 TBD

A008 GAS FREE PROGRAM REPORT N/A

DI-MGMT-82093 SOW PARAGRAPH 1.21 PSNS & IMF C/411

LT

*A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1 1

1 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 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 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.

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.

Title: GAS FREE PROGRAM REPORT

Number: DI-MGMT-82093 Approval Date: 20161208

AMSC Number: N9754 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2017-001

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.

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

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

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DI-MGMT-82093

2.6 Entry Permits:

a. Key Elements of Entry Permits

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 DI-MGMT-82093

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Caisson #3 N4523A-19-R-1058 TBD

A009 TEST AND INSPECTION PLAN (TIP) N/A

DI-MGMT-82062* SOW PARAGRAPH 1.22.1 PSNS & IMF C/411

LT

A* D(See Block 16)

ASREQ*

N/A

SEE BLOCK16*

SEE BLOCK16*

PSNS & IMF C/411 1 1

1 1 0

BLOCK 4: In Title Block Delete "and Inspection" and "(TIP)" In Use/Relationship; after the words "used to identify all" delete "inspections";

after the words "as well" delete "symbol (I) (V) (Q) (G) test/inspections and (G) governments notifications identified in the Work Item, and any additional"; after the words "additional tests" delete "and inspections".

In Format Line, Delete "I" in "TIP"

In Content Line, Delete "I" in "TIP"

Delete "as well as symbols (I)(V)(Q) test/inspections and (G)" Delete "Work Item number" Delete "be inspected" Delete "Inspection symbol (I, V, Q, G) Delete "Standard Item Number" Delete "Standard Item Paragraph" Delete "Name of Government Representative at Inspection" Delete "Inspection Date"

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 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 TIP 24 hours prior to each weekly scheduled production meeting. Final TIP submission shall be submitted within 24 hours after all testing is complete.

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.

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

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.

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

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Caisson #3 N4523A-19-R-1058 TBD

A010 RESERVATION TASKING REPORT N/A

DI-MGMT- 82109 SOW PARAGRAPH 1.23.1 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

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 initial reserve tasking request within 24 hours of identification.

Submit weekly report One working day prior to each weekly progress meeting.

Submit tasking completion report within 48 hours of tasking completion.

Submit final report within 5 working days of project completion.

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.

Title: RESERVATION TASKING REPORT

Number: DI-MGMT- 82109 Approval Date: 20170327

AMSC Number: N9782 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2017-017

Use/Relationship: The Reservation Tasking report will be used to monitor Reservation Tasking.

1. Format. The identification and completion of each reservation tasking shall be in accordance with Sample Figure-1.

2. Content. The Reservation Tasking report shall include all of the information specified in

Sample Figure-1.

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DI-MGMT-82109

SAMPLE Figure -1

RESERVATION TASK REQUEST/CONTROL FORM

REQUEST NO: SHIP/HULL:

WORK ITEM NO: CFR #: DATE:

WRITTEN BY:

DESCRIPTION OF SERVICE:

LOCATION:

CONTRACTOR’S ESTIMATE: Labor M/Hs Material $

NEGOTIATED TOTALS: Labor M/Hs Material $_

PM Authorization/ Agreement To Quote: Date:

Contractor Obligation/ Agreement To Quote: Date:

ACO Initial: Date:

COMPLETION SIGN OFFS:

Contractor: Date:

SBS: Date:

PM: Date:

End of DI-MGMT-82109

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Caisson #3 N4523A-19-R-1058 TBD

A011 VESSEL DOCKING AND UNDOCKING PLAN N/A

DI-MGMT-82094 SOW PARAGRAPH 3.1.2 PSNS & IMF C/411

LT

A* D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

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.

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 plan a minimum of 5 working days prior to docking and undocking 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.

Title: VESSEL DOCKING AND UNDOCKING PLAN

Number: DI-MGMT-82094 Approval Date: 20161208

AMSC Number: N9755 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2017-002

Use/Relationship: The plan will document a detailed plan to safely dock and undock the vessel(s). It is used by the Government to review, comment, and approve docking and undocking plans prior to each docking and undocking evolution.

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

2. Content. The Plan shall include the following Docking Procedures:

a. Operating Practices

b. Safety and Security Plans

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

d. Pumping/flooding schedule

e. Specific list, trim, and stability requirements

3. The Plan shall contain:

a. Set and align docking blocks

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

c. Docking clearances utilizing references for guidance

d. The use of haul, fixed, or fitted blocks

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

4. The Plan shall show that at least 90 percent of blocks land on longitudinal strength members or main transverse bulkheads.

End of DI-MGMT-82094

Source: https://assist.dla.mil -- Downloaded: 2017-01-10T14:39Z

Caisson #3 N4523A-19-R-1058 TBD

A012 VESSEL FINAL DOCKING REPORT N/A

DI-MGMT-82130 SOW PARAGRAPH 3.1.13 PSNS & IMF C/411

LT

N/A D(See Block 16)

OTIME*

N/A

SEE BLOCK 16*

N/A

PSNS & IMF C/411 1

PSNS & IMF C/242 1

0 2 0

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 and 12: 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.

Title: VESSEL FINAL DOCKING REPORT

Number: DI-MGMT-82130 Approval Date: 20170608

AMSC Number: N9815 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2017-027

Applicable Forms: NAVSEA 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.

2. Content. The Vessel Final Docking Report shall contain completed NAVSEA forms

9997/1 through 9997/5 applicable to each vessel.

End of DI-MGMT-82130

Source: https://assist.dla.mil -- Downloaded: 2017-06-16T14:14Z

Caisson #3 N4523A-19-R-1058 TBD

A013 ZINC ANODE LOCATION RPRT HULL & FREE BRD N/A

DI-MGMT-82108 SOW PARAGRAPH 3.2.3 PSNS & IMF C/411

LT

N/A D(See Block 16)

OTIME*

N/A

SEE BLOCK 16*

N/A

PSNS & IMF C/411 1

0 1 0

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 a minimum of 4 working days prior to an undocking event.

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.

Title: ZINC ANODE LOCATION REPORT

Number: DI-MGMT-82108 Approval Date: 20170327

AMSC Number: N9781 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2017-016

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

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

2. Content. The Zinc Anode Location report shall contain a sketch of the underwater body and freeboard plating surfaces with the following information:

2.1 Specific locations of fixed hull structural members.

2.2 Specific locations of docking block locations.

2.3 Specific locations of hull reference points.

2.4 Specific measurements of zinc anodes to docking block locations.

2.5 Specific measurements of zinc anodes to hull reference points.

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

End of DI-MGMT-82108

Source: https://assist.dla.mil -- Downloaded: 2017-03-30T17:25Z

Caisson #3 N4523A-19-R-1058 TBD

A014 STRUCTURAL INSPECTION RPRT RUBBER SEAL N/A

DI-MGMT-82065* SOW PARAGRAPH 3.2.5 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

BLOCK 4:

Use/Relationship Block: After the phrase "found during", delete "structural".

Use/Relationship Block: After the phrase "inspection of", delete "each exposed piping penetration, deck drain, deck plating and bulkheads for".

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 within 2 working days of completion of each inspection.

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

Title: STRUCTURAL INSPECTION REPORT

Number: DI-MGMT-82065

AMSC Number: N9714

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

Project Number: MGMT-2016-052

Use/Relationship: This DID will report the conditions found during structural inspection of each exposed piping penetration, deck drain, deck plating and bulkheads for structural integrity, deterioration, pitting, cracks, and areas of damage or distortion.

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

2. Content. The report 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. Material condition

h. Deficiencies noted

i. Recommendation for repairs

End of DI-MGMT-82065

Source: https://assist.dla.mil -- Downloaded: 2016-10-13T13:23Z

Caisson #3 N4523A-19-R-1058 TBD

A015 STRUCTURAL INSPECTION RPRT HULL & FR BRD N/A

DI-MGMT-82065* SOW PARAGRAPH 3.2.8.1 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

BLOCK 4:

Use/Relationship Block: After the phrase "found during", delete "structural".

Use/Relationship Block: After the phrase "inspection of", delete "each exposed piping penetration, deck drain, deck plating and bulkheads for".

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 within 2 working days of completion of each inspection.

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

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

c. Work Item

d. Paragraph numbers including standard item paragraph number

e. Compartment (number and name)

f. Date of inspection

g. Material condition

Caisson #3 N4523A-19-R-1058 TBD

A016 STRUCTURAL INSPECTION REPORT TANKS N/A

DI-MGMT-82065* SOW PARAGRAPH 3.4.3.1 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

BLOCK 4:

Use/Relationship Block: After the phrase "found during", delete "structural".

Use/Relationship Block: After the phrase "inspection of", delete "each exposed piping penetration, deck drain, deck plating and bulkheads for".

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 within 2 working days of completion of each inspection.

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

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

c. Work Item

d. Paragraph numbers including standard item paragraph number

e. Compartment (number and name)

f. Date of inspection

g. Material condition

Caisson #3 N4523A-18-R-1058 TBD

A017 ZINC ANODE LOCATION REPORT TANKS N/A

DI-MGMT-82108 SOW PARAGRAPH 3.4.4.2 PSNS & IMF C/411

LT

N/A D(See Block 16)

OTIME*

N/A

SEE BLOCK 16*

N/A

PSNS & IMF C/411 1

0 1 0

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 a minimum of 4 working days prior to an undocking event.

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.

Title: ZINC ANODE LOCATION REPORT

Number: DI-MGMT-82108 Approval Date: 20170327

AMSC Number: N9781 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MGMT-2017-016

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

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

2. Content. The Zinc Anode Location report shall contain a sketch of the underwater body and freeboard plating surfaces with the following information:

2.1 Specific locations of fixed hull structural members.

2.2 Specific locations of docking block locations.

2.3 Specific locations of hull reference points.

2.4 Specific measurements of zinc anodes to docking block locations.

2.5 Specific measurements of zinc anodes to hull reference points.

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

End of DI-MGMT-82108

Source: https://assist.dla.mil -- Downloaded: 2017-03-30T17:25Z

Caisson #3 N4523A-19-R-1058 TBD

A018 STRUCTURAL INSPECTION REPORT Weather Deck N/A

DI-MGMT-82065* SOW PARAGRAPH 3.5.3.1 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

BLOCK 4:

Use/Relationship Block: After the phrase "found during", delete "structural".

Use/Relationship Block: After the phrase "inspection of", delete "each exposed piping penetration, deck drain, deck plating and bulkheads for".

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 within 2 working days of completion of each inspection.

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

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

c. Work Item

d. Paragraph numbers including standard item paragraph number

e. Compartment (number and name)

f. Date of inspection

g. Material condition

NDTI

Caisson #3 N4523A-19-R-1058 TBD

A019 DEWATERING PUMP OP TEST REPORT N/A

DI-NDTI-82110 SOW PARAGRAPH 3.7.7 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

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 each report within 2 working days of test.

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.

Title: AIR TEST REPORT

Number: DI-NDTI-82110 Approval Date: 20170327

AMSC Number: N9783 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: NDTI-2017-003

Use/Relationship: The report will be used to provide Objective Quality Evidence (OQE) evidence of the contractor’s Air Test and to evaluate the need for vessel repairs that are not covered by the work specifications.

2. Content. The Report shall contain:

2.1 Test result.

2.2 Recommendation for corrective action.

2.3 Estimated costs, including labor, subcontractors, material, rework, and any additional costs to on-going work resulting from the inclusion of the proposed work.

2.4 Identification of related changes, if any, to production completion dates.

End of DI-NDTI-82110

Source: https://assist.dla.mil -- Downloaded: 2017-03-28T14:41Z

Caisson #3 N4523A-19-R-1058 TBD

A020 SUPERFLOOD PUMP OP TEST REPORT N/A

DI-NDTI-82110 SOW PARAGRAPH 3.7.13 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

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 each report within 2 working days of test.

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.

DTIC Applicable: No GIDEP Applicable: No

Caisson #3 N4523A-19-R-1058 TBD

A021 STRUCTURAL INSPECTION REPORT EXT. SHAFTS N/A

DI-MGMT-82065* SOW PARAGRAPH 3.8.2.1 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

BLOCK 4:

Use/Relationship Block: After the phrase "found during", delete "structural".

Use/Relationship Block: After the phrase "inspection of", delete "each exposed piping penetration, deck drain, deck plating and bulkheads for".

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 within 2 working days of completion of each inspection.

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

DTIC Applicable: No

Preparing Activity: SH

Applicable Forms: N/A

Approval Date: 20161003

Limitation: N/A

c. Work Item

d. Paragraph numbers including standard item paragraph number

e. Compartment (number and name)

f. Date of inspection

g. Material condition

Caisson #3 N4523A-19-R-1058 TBD

A022 VALVE OPERATION TEST REPORT N/A

DI-NDTI-82110 SOW PARAGRAPH 3.8.5 PSNS & IMF C/411

LT

N/A D(See Block 16)

ASREQ*

N/A

SEE BLOCK 16*

SEE BLOCK 16*

PSNS & IMF C/411 1

0 1 0

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 each report within 2 working days of test.

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.

DTIC Applicable: No GIDEP Applicable: No

A001
A001 DID DI-MGMT-80227 Progress and Status Report
A002
A002 DI-QCIC-82111 Coating Ststem Data Report
A003
A003 DI-SAFT-82112 Safety Data Sheets
A004
A004 DID DI-MGMT-81648 Condition Found Report
DATA ITEM DESCRIPTION
A005
A005 DID DI-MGMT-82071 Incident Report
A006-1
A006 DID DI-MISC-82120 Paint Preservation Appendices
A007
A007 DID DI-MGMT-82129 Hazardous Waste Report
A008
A008 DID DI-MGMT-82093 Gas Free Program
A009
A009 DID DI-MGMT-82062 Test & Inspection Plan
A010
A010 DID DI-MGMT-82109 Reservation Tasking Report
A011
A011 DID DI-MGMT-82094 Docking and Undocking Plan
A012
A012 DID DI-MGMT-82130 Final Docking Report
A013
A013 DID DI-MGMT-82108 Zinc Hull Anode Location Report
A014
A014 DID DI-MGMT-82065 Structural Inspection Rubber Seal
A015
A015 DID DI-MGMT-82065 Structural Inspection Hull & FB
A016
A016 DID DI-MGMT-82065 Structural Inspection Tanks
A017
A017 DID DI-MGMT-82108 Zinc Tanks Anode Location Report
A018
A018 DID DI-MGMT-82065 Structural Inspection Weather Deck
A019
A019 DID DI-NDTI-82110 Dewatering Pump Op Test Report
A020
A020 DID DI-NDTI-82110 Superflood Pump Op Test Report
A021
A021 DID DI-MGMT-82065 Structural Inspection Reach Rods-Ext. Shafts
A022
A022 DID DI-NDTI-82110 Valve Actuator Op Test

File details come from the government source that posted it.