Attachment_J.6_DD1155.pdf

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Corporate Operations Support Services
Solicitation number
N61331-20-R-0005
Issued by

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This solicitation package includes a DD Form 1155, Contract Data Requirements List (CDRL), and Statement of Work (SOW) for Corporate Operations Department Managers' Internal Control (MIC) Program Support services. The Navy seeks to award a firm-fixed price contract for program management, risk assessment, training, and compliance support. The base year and four option years are valued at approximately $5 million. The solicitation is set aside for 8(a) small businesses and responses are due by the date specified in the amendment incorporating the CDRL. The awardee will provide internal controls oversight, documentation, and reporting to help NSWC Panama City programs achieve intended results. The contractor must submit plans and reports in accordance with the CDRL, which identifies six data items requiring risk assessments, training materials, meeting minutes, and assurance statements to document program compliance.

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ORDER FOR SUPPLIES OR SERVICES

1. CONTRACT/PURCH ORDER/AGREEMENT NO. 2. DELIVERY ORDER/CALL NO. 3. DATE OF ORDER/CALL

(YYYYMMMDD)

PAGE 1 OF

4. REQUISITION/PURCH REQUEST NO. 5. PRIORITY

N61331-20-R-0005 Attachment J.6 TBD TBD

6. ISSUED BY CODE

NSWC Panama City (K. Shaw )

110 Vernon Avenue

Panama City, FL 32407-7001

N61331 7. ADMINISTERED BY (If other than 6) CODE

TBD

TBD 8. DELIVERY FOB

DESTINATION

OTHER

(See Schedule if other)

9. CONTRACTOR CODE

TBD

NAME

AND

ADDRESS

TBD FACILITY

10. DELIVER TO FOB POINT BY (Date)

(YYYYMMMDD)

SEE SCHED

12. DISCOUNT TERMS

11. X IF BUSINESS IS

SMALL

SMALL DISAD-

VANTAGED

WOMEN-OWNED

13. MAIL INVOICES TO THE ADDRESS IN BLOCK

SEE SECTION G

14. SHIP TO

NSWC Panama City c/o NSA PC - N61008

CODE N61331 15. PAYMENT WILL BE MADE BY CODE

TBD

TBD MARK ALL

PACKAGES AND

PAPERS WITH

IDENTIFICATION

101 Vernon Ave. Panama City, FL 32407-7001 NUMBERS IN

BLOCKS 1 AND 2.

16.

TYPE

OF

ORDER

DELIVERY/

CALL

PURCHASE

This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract.

Reference your furnish the following on terms specified herein.

ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME.

NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE DATE SIGNED

If this box is marked, supplier must sign Acceptance and return the following number of copies:

17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE

18. ITEM NO. 19. SCHEDULE OF SUPPLIES/SERVICES

20. QUANTITY

ORDERED/

ACCEPTED*

21.

UNIT

22. UNIT PRICE 23. AMOUNT

0.00

*If quantity accepted by the Government is same as quantity ordered, indicate by X.

If different, enter actual quantity accepted below quantity ordered and encircle.

27a. QUANTITY IN COLUMN 20 HAS BEEN

24. UNITED STATES OF AMERICA 25. TOTAL

26.

DIFFERENCES

BY: CONTRACTING/ORDERING OFFICER

0.00

INSPECTED RECEIVED

ACCEPTED, AND CONFORMS TO

THE CONTRACT EXCEPT AS NOTED:

b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE c. DATE

(YYYYMMMDD)

d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 28. SHIP. NO. 29. D.O. VOUCHER NO. 30. INITIALS

f. TELEPHONE NUMBER g. E-MAIL ADDRESS

PARTIAL

FINAL

31. PAYMENT

32. PAID BY 33. AMOUNT VERIFIED CORRECT FOR

34. CHECK NUMBER

36. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT. COMPLETE

a. DATE

37. RECEIVED

AT

b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

38. RECEIVED BY (Print) 39. DATE RECEIVED

PARTIAL

FINAL

40. TOTAL CON-

TAINERS

41. S/R ACCOUNT NUMBER

35. BILL OF LADING NO.

42. S/R VOUCHER NO.

DD FORM 1155, DEC 2001 PREVIOUS EDITION IS OBSOLETE. Reset Adobe Professional 8.0

RFP N61331-20-R-0005

Attachment J.6 – DD1155

CORPORATE OPERATIONS DEPARTMENT

MANAGERS’ INTERNAL CONTROL (MIC) PROGRAM SUPPORT

Section B - Supplies or Services and Prices

ITEM

NO

SUPPLY/SERVICES

QUANTITY

PRICE

AMOUNT

0001 12 MO $ $

Direct Labor –Base Year IAW the Statement of Work (SOW) in

Section C - Firm Fixed Price (FFP).

FOB: Destination

ITEM NO

0002 12 MO $ $

OTHER DIRECT COSTS(ODC's)

FFP – Base Year - Material and Travel in support of CLIN 0001 IAW

Section C – Statement of Work (SOW). See Section B Notes, See

Section L - 3.3.2, FOB: Destination

0003 12 LOT NSP NSP

CONTRACT DATA REQUIREMENTS LIST

(CDRL'S) – Base Year - Technical Information and Data in accordance with Section J, Exhibit A, Contract Data

Requirements List (CDRL) DD Form 1423-1 and as further delineated in individual orders.

1001 12 MO $ $

Direct Labor –Opt I Year IAW the Statement of Work (SOW) in

CORPORATE OPERATIONS DEPARTMENT

1002 12 MO $ $

OTHER DIRECT COSTS(ODC's)

FFP – Opt I - Material and Travel in support of CLIN 1001 IAW Section

C – Statement of Work (SOW). See Section B Notes, See Section L -

3.3.2, FOB: Destination

1003 12 LOT NSP NSP

CONTRACT DATA REQUIREMENTS LIST

(CDRL'S) – Opt I - Technical Information and Data IAW with Section J, Exhibit A, Contract Data Requirements

List (CDRL) DD Form 1423-1 and as further delineated in individual orders.

2001 12 MO $ $

Direct Labor –Opt II - IAW the Statement of Work (SOW) in Section

C - Firm Fixed Price (FFP).

2002 12 MO $ $

OTHER DIRECT COSTS(ODC's)

FFP – Opt II - Material and Travel in support of CLIN 2001 IAW

2003 12 LOT NSP NSP

CONTRACT DATA REQUIREMENTS LIST

(CDRL'S) – Opt II - Technical Information and Data

IAW with Section J, Exhibit A, Contract Data

3001 12 MO $ $

Direct Labor –Opt III - IAW the Statement of Work (SOW) in

3002 12 MO $ $

OTHER DIRECT COSTS(ODC's)

FFP – Opt III - Material and Travel in support of CLIN 3001 IAW

3003 12 LOT NSP NSP

CONTRACT DATA REQUIREMENTS LIST

(CDRL'S) – Opt III - Technical Information and Data

IAW with Section J, Exhibit A, Contract Data

4001 12 MO $ $

Direct Labor –Opt IV- IAW the Statement of Work (SOW) in

4002 12 MO $ $

OTHER DIRECT COSTS(ODC's)

FFP – Opt IV - Material and Travel in support of CLIN 4001 IAW

4003 12 LOT NSP NSP

CONTRACT DATA REQUIREMENTS LIST

(CDRL'S) – Opt IV - Technical Information and Data in accordance with Section J, Exhibit A, Contract Data

Section C – Descriptions and Specifications

Statement of Work (SOW)

FOR

1.0 SCOPE

The goal of the NSWC PCD MIC Program is to assess and mitigate risks in order for programs to achieve their intended results in support of the command’s mission. Programs, or Assessable Units, that are part of the MIC Program include those related to security, comptroller/financial management, contract administration, environmental, information technology, personnel management, property management, research, development, test and evaluation, and safety. Each Program Manager (called an Assessable Unit Manager) ensures compliance readiness, making sure mitigation strategies for risk are appropriately implemented and executed, implementing and/or enhancing internal controls as needed, and ensuring clear processes and responsibilities for their program. This Statement of Work (SOW) specifies the requirements for Contractor support to the NSWC PCD MIC Program.

2.0 APPLICABLE DOCUMENTS

The following documents, of the exact issue shown, form a part of this SOW to the extent specified herein. In the event a conflict between the documents referenced herein and the contents of this SOW, the contents of this SOW shall take precedence. The second tier and lower reference documents (i.e., documents referenced in the primary references) shall be for guidance only.

2.1 Military Standards: None

2.2 Military Specifications: None

2.3 Other Documents:

(a) SECNAV M-5200.35, Department of the Navy Managers’ Internal Control Manual dated 01 Jun 2008

(b) SECNAVINST 5200.35F, Department of the Navy Managers’ Internal Control Program dated 21 Jul 2014

(c) SECNAV M-5210.1 CH-1, Records Management Manual dated Aug 2017

3.0 REQUIREMENTS

The Contractor shall provide technical support regarding Section C (Statement of Work - SOW) Section 3.2 Manager

Internal Control (MIC) Program Support of the Basic IDIQ.

3.1 Plans

The Contractor shall submit the Transition Plan, the Quality Assurance Program Plan (QAPP) and the Safety Plan as required by the basic contract SOW and Contract Data Requirements List (CDRL DD Form 1423).

3.2 Managers’ Internal Control (MIC) Program Support

The Contractor shall, using the guidance of SECNAV M-5200.35 and SECNAVINST 5200.35F, provide support for the monitoring, oversight and functionality of the NSWC PCD Managers’ Internal Control (MIC) program, and reporting to higher echelons of the DoN chain of command in a timely manner. Offerors are encouraged to refer to the overall Basic/IDIQ Statement of Work (SOW) regarding each functional area for the MIC Program Support. MIC

Functional areas in the Basic/IDIQ - Section C – Statement of Work (SOW) 3.2. and CDRL requirements are as follows:

(a) Annual Plan/Assessable Unit (AU) Inventory Support (CDRL A001)

(b) Risk Assessment Support (CDRL A002)

(c) Website Update Support

(d) Training Requirement and Support (CDRL A003)

(e) Community of Practice Support (CDRL A004)

(f) Compliance Assessment Support (CDRL A005)

(g) Internal Review Assessment Support (CDRL A005)

(h) Corrective Action Tracking (CAT) Support

(i) Statement of Assurance (SOA) Support (CDRL A006)

(j) MIC Program Management Records Support

3.3 Safety and Quality

The Safety and Quality requirements of the basic contract Statement of Work paragraphs 3.7 and 3.8 respectively apply to this task order.

3.4 Travel

None Anticipated

3.5 Progress Reporting

The Contractor shall report progress in accordance with basic contract Statement of Work paragraph 3.6.

4.0 GOVERNMENT FURNISHED PROPERTY (GFP)

See BASIC/IDIQ Statement of Work for further details.

5.0 DATA DELIVERABLES

All data generated by this Task Order shall be delivered in accordance with the attached Contract Data Requirements

List (CDRL DD Form 1423).

6.0 PERIOD OF PERFORMANCE

The total period of performance will be one base year of twelve (12) months and Four –Options Periods of twelve (12) months each for a total of five (5) years.

7.0 SECURITY

See BASIC/IDIQ Statement of Work for further details.

8.0 PERFORMANCE BASED REQUIREMENTS

The task order service requirements are summarized below into Performance Objectives, Performance Standards and

Acceptable Quality Levels (AQLs) that relate directly to mission essential items. The performance thresholds describe the minimally acceptable levels of service required for each requirement and are considered critical to mission success.

Procedures as set forth in the FAR 52.246-4, Inspection of Services – Firm Fixed Price shall be utilized to remedy all deficiencies.

Work Area Performance Objective

Performance Standard

Acceptable

Quality Level

(AQL)

Quality Assurance

Surveillance Plan

(QASP) Surveillance

Method

SOW paragraph 3.2 Provides management internal control program support documentation and transactions

100% of Documents and transactions are reviewed/completed by due dates

Data are accurate, complete, timely, and require no more than 1 review cycle to complete.

In accordance with 52.246-4 Inspection of Services—Fixed-Price

9.0 ENTERPRISE-WIDE CONTRACTOR MANPOWER REPORTING APPLICATION (ECMRA)

The Contractor shall make ECMRA reports in accordance with the basic contract Statement of Work requirements.

CORPORATE OPERATIONS DEPARTMENT

Section E – Inspection and Acceptance

CLIN/SLIN INSPECT AT/ACCEPT AT INSPECT BY/ACCEPT BY

0001 Destination Government

0002 N/A Government

0003 N/A N/A

1001 Destination Government

1002 N/A Government

1003 N/A N/A

2001 Destination Government

2002 N/A Government

2003 N/A N/A

3001 Destination Government

3002 N/A Government

3003 N/A N/A

4001 Destination Government

4002 N/A Government

4003 N/A N/A

Section F – Deliveries or Performance

CLINS Delivery Date Quantity Ship To Address DoDAAC

0001, 1001, 3001 and

See SOW para 6.0

1 MO N61331

NSWC Panama City

C/O NSA PC –

N61008

101 Vernon Avenue

Panama City Beach

FL 32407-7001

FOB: Destination

N61331

0002, 1002, 2002, 3002 and

Same As Above Same As Above Same As Above Same As Above

0003, 1003, 3003 and

See Exhibit A Contract Data Requirements List (CDRL’s)

N/A N/A N/A

CORPORATE OPERATIONS DEPARTMENT

Section G – Contract Administration

ACCOUNTING AND APPROPRIATION DATA

Long Line of Accounting (LOA): TBD Cost

Code: TBD

Amount: TBD

ACRN CLIN CIN AMOUNT

TBD TBD TBD TBD

CLAUSES INCORPORATED BY FULL TEXT

See Basic IDIQ

Section J – List of Documents, Exhibits and Other Attachments

Document Type Description Pages Date

Exhibit B Contract Data Requirements

List (CDRL), DD Form

1423-1

6 5 November 2019

Attachment J.13 Price Summary Format 1 N/A

(1 Data Item)

Form Approved

OMB No. 0704-0188

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 this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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:

A TDP TM OTHER MISC

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

Managers’ Internal Control (MIC) Program

Support

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A001 Technical Report – Study / Services Annual Plan/AU Inventory Documentation

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

DI-MISC-80508B SOW Para 3.2(a) NSWC PC Code 1061

18 ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED

ASREQ SEE BLK 16

b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft Final

A SEE BLK 16 SEE BLK 16

Reg Rep

16. REMARKS

NSWC PC Code 1061 1 1 0

Blk 4: DID is cited for guidance only. Contractor format is acceptable unless otherwise specified by the Government.

Blks 9: Data shall be marked in accordance with SOW paragraph 8.0

Blks 8,10,12,13: Submit within 5 calendar days after receipt of GFI requiring preparation of the data unless otherwise specified by the Government. The Government will review each submittal for approval of format and technical content and will provide review comments if required within 5 days after receipt. Comments shall be incorporated and the data resubmitted as final within 3 days after receipt of comments.

Blk 14: MEDA REQUIREMENT - Typically shall be provided in MS Office™ 2016 compatible files or other computer systems standard format via e-mail. E-mail addresses will be provided at award.

(LT ONLY)

NSWC PC Code 022

NSWC PC COR

15. TOTAL SEE BLOCK 16 1 1 0

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

NSWC PC Code 1061

11/05/2019

W.T. Sawyer, NSWC PC Code 0213

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 6 Pages

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 this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/Pr No. listed in Block E.

A002 Technical Report – Study / Services Risk Assessments and Corrective Action Plans

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

DI-MISC-80508B SOW Para 3.2(b) NSWC PC Code 1061

18 ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED

ASREQ SEE BLK 16

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft Final

A SEE BLK 16 SEE BLK 16

Reg Rep

16. REMARKS

NSWC PCD Code 1061 1 1 0 will review each submittal for approval of format and technical content and will provide

Blks 9, 14: Same as A001.

NSWC PC Code 022

NSWC PC COR

NSWC PC Code 1061

W.T. Sawyer, NSWC PC Code 0213

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 2 of 6 Pages

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 this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/Pr No. listed in Block E.

A003 Technical Report – Study / Services MIC Training Materials and Documentation

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

DI-MISC-80508B SOW Para 3.2 (d) NSWC PCD Code 1061

18 ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED

ASREQ SEE BLK 16

b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft Final

A SEE BLK 16 SEE BLK 16

Reg Rep

16. REMARKS

NSWC PCD Code 1061 1 1 0 will review each submittal for approval of format and technical content and will provide

NSWC PCD Code 022

NSWC PCD COR

NSWC PCD Code 1061

W.T. Sawyer, NSWC PCD Code 0213

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 3 of 6 Pages

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 this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/Pr No. listed in Block E.

A TDP TM OTHER ADMN

A004 Report, Record of Meeting/Minutes Community of Practice Meetings

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

DI-ADMN-81505 SOW Para 3.2 (e) NSWC PCD Code 1061

18 ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED

ASREQ SEE BLK 16

b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft Final

N SEE BLK 16 SEE BLK 16

Reg Rep

16. REMARKS

NSWC PCD Code 1061 0 1 0

Blks 10,12,13: Submit within 5 calendar days after attendance at a meeting unless otherwise specified by the Government.

15. TOTAL SEE BLOCK 16 0 1 0

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 4 of 6 Pages

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 this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/Pr No. listed in Block E.

A005 Technical Report – Study / Services Compliance and Internal Review Assessments

Documentation

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

DI-MISC-80508B SOW Para 3.2 (f), 3.2(g) NSWC PCD Code 1061

18 ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED

ASREQ SEE BLK 16

b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft Final

A SEE BLK 16 SEE BLK 16

Reg Rep

16. REMARKS

NSWC PCD Code 1061 1 1 0 will review each submittal for approval of format and technical content and will provide

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 5 of 6 Pages

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 this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/Pr No. listed in Block E.

A006 Technical Report – Study / Services Statement of Assurance (SOA) Documentation

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

DI-MISC-80508B SOW Para 3.2 (i) NSWC PCD Code 1061

18 ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED

ASREQ SEE BLK 16

b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft Final

A SEE BLK 16 SEE BLK 16

Reg Rep

16. REMARKS

NSWC PCD Code 1061 1 1 0 will review each submittal for approval of format and technical content and will provide

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 6 of 6 Pages

File details come from the government source that posted it. Updated .