Exh A CDRL A012 MO CMSS PERF MAN PWR RPRT 28 MAR 2011.doc

CONTRACT DATA REQUIREMENTS LIST (CDRL)

(1 Data Item) Form Approved

OMB No. 0704-0188

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

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

NAWCTSD PJM

SEE BLK 16

1. BLK 4: ONLY DID PARAGRAPH 3 (C).(2) APPLIES. REFER TO ANNEX SPREADSHEET WORKSHEETS PART I (COVER) , PART 2 (MSF), PART 3 (QAF), PART 4 (MANNING) AND PART 6 (PREMIUM TIME) FOR REPORT FORMAT. PRIVACY ACT AND PERSONAL INFORMATION PROTECTION REQUIREMENTS AND MARKINGS APPLY FOR MANNING REPORT.

2. BLK 4: DELETE PARA 2. SUBMISSION SHALL BE IN MICROSOFT @ EXCEL 2003 OR LATER SPREADSHEET FORMAT.

3. BLK 12: FIRST SUBMISSION SHALL BE DUE THE 20THTH OF EACH MONTH IN THE MOBILIZATION PHASE. REPORTS DURING THE MOBILIZATION PHASE SHALL ONLY INCLUDE ANNEX SPREADSHEET WORKSHEET PARTS 1 (COVER) AND PART 4 (MANNING).

4. BLK 13: SUBSEQUENT SUBMISSIONS SHALL BE DUE NLT THE 5TH WORKING DAY OF EACH MONTH AFTER CONTRACTOR SUPPORT DATE (CSD) . PART 4 (MANNING) SHALL ALSO BE SUBMITTED AS REQUIRED WHEN THERE IS A GAIN OR LOSS OF AN ON-SITE CONTRACTOR EMPLOYEE. IT SHALL BE DUE WITHIN 24 HRS OF THE GAIN OR LOSS.

5. THE GOVERNMENT WILL HAVE 10 WORKING DAYS FOR REVIEW AND ACCEPTANCE/REJECTION OF EACH SUBMISSION.

6. BLK 14: SUBMISSION SHALL BE AN ELECTRONIC ENCRYPTED COPY SENT VIA EMAIL. EMAIL SUBJECT LINE SHALL INCLUDE CONTRACT NUMBER, CDRL DATA ITEM NUMBER. CONTRACT/CDRL TITLE, AND DATE OF REPORT. (E.G. N61340-11-C-0000 T- A012 FRCMAPAX MOB REPORT – 20 MAY11). EMAIL ADDRESSES FOR BLOCK 14 DISTRIBUTIONS ARE PROVIDED IN THE CONTRACT SCHEDULE SECTION J. FILES SHALL BE ENCRYPTED USING WINZIP AES 256-BIT ENCRYPTION.

7. BLK 9: DISTIBUTION D (FOR PARTS 1, 2, 3, & 6): DISTRIBUTION TO DOD AND DOD CONTRACTORS ONLY (ADMINISTRATIVE/RECOMPETE OR OPERATIONAL USE ONLY), (10 NOV 2009). DISTRIBUTION E (PART 4-MANNING) : DISTRIBUTION TO DOD COMPONENTS ONLY (ADMINISTRATIVE OR OPERATIONAL USE ONLY), (10 NOV 2009). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE COMMANDING OFFICER, NAVAL AIR WARFARE CENTER, TRAINING SYSTEMS DIVISION, (NAWCTSD PCO, CODE 25332), 12350 RESEARCH PARKWAY, ORLANDO, FL 32826-3275.

NAWCTSD PJM

FRCMA PAX COR

FRCMA-PAX ACOR

FRCMA TYCOM

DD FORM 1423-1, FEB 2001

PREVIOUS EDITION MAY BE USED

Page 1 of 2 Pages

ANNEX TO CDRL A012

MONTHLY CMSS MEASUREMENT AND MANPOWER REPORT

REPORT FORMAT. This report shall use the formats in the following spreadsheet’s worksheets Part I, II, III, IV and VI:

PART 1 COVER SHEET

PART 2 MSF MEASUREMENT

PART 3 QA MEASUREMENT

PART 4 MANNING REPORT

PART 6 PREMIUM TIME SUMMARY

_1362824027.xls Pt 1 CDRL Cover

PART 1: COVER SHEET Ver 15 Feb 11

Title: FRCMA-PAX Monthly Measurement Report Contractor Maintenance Support Hours Measurement and Manning Report

Contract #: N61340-11-C-xxxx

Report Period: 1-31 May 2010

CDRL #: A010 NOTE: GOVT ONLY/FOUO RELATIVE TO THE FRCMA-PAX CONTRACT.

Contractor: ABC Inc [ ] CONTAINS PRIVACY ACT STATEMENT DATA - SAFEGAURD RQRD

Contractor Signature: Date: Email: Phone:

John Contractor, Site Mgr ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks:

COR Signature: Date: Email: Phone:

Bill COR, FRCMA-Pax ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks (note any attachments):

Contractor Summary of Contractor Milestones/ Accomplishments/ Comments:

CHECK APPLICABLE CONTENTS OF THIS REPORT:

[ X ] PART 1 COVER SHEET *

[ X ] PART 2 MSF MEASUREMENT *

[ X ] PART 3 QA MEASUREMENT *

[ X ] PART 4 MANNING REPORT *

[ ] PART 5 CVS STATUS * AND **

[ X ] PART 6 PREMIUM TIME REPORT

[ ] Other_____________

NOTE * : NOTE: PRIVACY ACT INFORMATION statement SAFEGAURDS . If transmitted electronically. It must be encrypted using WINZIP AES 256-BIT encryption

NOTE ** : ALL REPORT DATA WILL AND SHALL BE STORED IN A SECURE MANNER.

ALL REPORT DATA IS FOUO AND NOT FOR DISTRIBUTION OUTSIDE CDRL DISTRIBUTION LIST. ALL OUTSIDE REQUESTS MUST GO

THROUGH NAWCTSD ORL FREEDOM OF INFORMATION ACT PROCESS.

xxx@ctxtcom

Pt 2 MSF Measurement

PART 2: MSH REPORT

Title: FRCMA-PAX Monthly Measurement Report Ver 15 Feb 11

Contract #/Name: N61340-11-C-xxxx / ABC, Inc Contractor Maintenance Support Factor Measurement Report

Report Period: 1-31 May 2010

CDRL #: A010 NOTE: GOVT ONLY/FOUO RELATIVE TO THE FRCMA-PAX CONTRACT.

Contractor Signature: Date: Email: Phone:

John Contractor, Site Mgr ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks:

COR Signature: Date: Email: Phone:

Bill COR, FRCMA-Pax ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks (note any attachments):

LOT MSF ARCHIVE:

Summary: Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep

MSH =

Cumulative MSF =

Workdays in Report Perod (days): 21

Monthly MSH FACTOR: Std Sched. MSH for Report Period (Hrs)= 168

NAME Work Ctr: Position/Qual/ Certif Title On-site Maint Hrs: Training Hrs: Vacation / Sick Lv Hrs: Other Hrs: MSHF (Failure/ No show) Hrs: Premium Time Hrs Rprt Period Total SMSH Hrs: MSHF (%) Remarks: (Notecompleted vacation/sick times)

SAMPLE, Fed 0F8 AMI 100.0 34.0 24.0 8.0 2.0 1.0 169 98.8% 8 hrs off CO authorized closure

1 0.0 N/A

2 0.0 N/A

3 0.0 N/A

4 0.0 N/A

5 0.0 N/A

6 0.0 N/A

7 0.0 N/A

8 0.0 N/A

9 0.0 N/A

10 0.0 N/A

11 0.0 N/A

12 0.0 N/A

13 0.0 N/A

14 0.0 N/A

15 0.0 N/A

16 0.0 N/A

17 0.0 N/A

18 0.0 N/A

19 0.0 N/A

20 0.0 N/A

21 0.0 N/A

22 0.0 N/A

23 0.0 N/A

24 0.0 N/A

25 0.0 N/A

26 0.0 N/A

27 0.0 N/A

28 0.0 N/A

29 0.0 N/A

30 0.0 N/A

31 0.0 N/A

32 0.0 N/A

33 0.0 N/A

34 0.0 N/A

35 0.0 N/A

36 0.0 N/A

37 0.0 N/A

38 0.0 N/A

39 0.0 N/A

40 0.0 N/A

41 0.0 N/A

42 0.0 N/A

43 0.0 N/A

44 0.0 N/A

45 0.0 N/A

46 0.0 N/A

47 0.0 N/A

48 0.0 N/A

49 0.0 N/A

50 0.0 N/A

51 0.0 N/A

52 0.0 N/A

53 0.0 N/A

54 0.0 N/A

55 0.0 N/A

56 0.0 N/A

57 0.0 N/A

58 0.0 N/A

59 0.0 N/A

60 0.0 N/A

61 0.0 N/A

62 0.0 N/A

63 0.0 N/A

64 0.0 N/A

65 0.0 N/A

66 0.0 N/A

67 0.0 N/A

68 0.0 N/A

69 0.0 N/A

70 0.0 N/A

71 0.0 N/A

72 0.0 N/A

73 0.0 N/A

74 0.0 N/A

75 0.0 N/A

76 0.0 N/A

77 0.0 N/A

78 0.0 N/A

0.0 N/A

SUMMARY: Contractor Maintenance Support Factor Measurement Report

TOTALS = 0.0 0.0 0.0 0.0 0.0 0.0 0.0 N/A

On-site Maint Hrs: Training Hrs: Vacation / Sick Lv Hrs: Other Hrs: MSHF (Failure/ No show) Hrs: Premium Time Hrs Total SMSH Hrs: MSHF (Failure) Hrs:

REPORT PERIOD MAINTENANCE SUPPORT FACTOR (MSF) = N/A

EXPLAIN IN REMARKS COLUMN

SAMPLE

SAMPLE

Pt 3 QA Measurement

PART 3: FQAF and NFQAF REPORT Ver 15 Feb 11

Title: FRCMA-PAX Monthly Measurement Report

Contract #/ Name: N61340-11-C-xxxx / ABC, Inc Quality Assurance Factor Report

Report Period: 1-31 May 2010 NOTE: GOVT ONLY/FOUO RELATIVE TO THE FRCMA-PAX CONTRACT.

CDRL #: A010

Contractor Signature: Date: Email: Phone:

John Contractor, Site Mgr ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks:

COR Signature: Date: Email: Phone:

Bill COR, FRCMA-Pax COR ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks (Note any attachments):

Monthly SAFETY OF FLIGHT QAF LOT FQAF ARCHIVE:

Work Center: FCN FCU FCD Report Period Work Ctr FQAF Cumulative FQAF to Date Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep

Monthly NON-SAFETY OF FLIGHT QAF: LOT NFQAF ARCHIVE:

Work Center: NFCN NFCU NFCD Report Period Work Ctr NFQAF Cumulative NFQAF to Date Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Sep

ENTER FOR EACH WORK CENTER WHERE APPLICABLE

ENTER FOR EACH WORK CENTER WHERE APPLICABLE

Pt 4 Manning Report

PART 4: MANNING STATUS REPORT Ver 15 Feb 11

Title: FRCMA-PAX Monthly Measurement Report FRCMA-PAX MANNING STATUS REPORT

Contract #/ Name: N61340-11-C-xxxx/ ABC, Inc

Report Period: 1-31 May 2010 NOTE: PRIVACY ACT INFORMATION / PERSONAL IDENTITY INFO SAFEGAURDS MARKINGS REQRD.

CDRL #: A010 If transmitted electronically. It must be encrypted using WINZIP AES 256-BIT encryption

Contractor Signature: Date: Email: Phone:

John Contractor, Site Mgr ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks:

COR Signature: Date: Email: Phone:

Bill COR, FRCMA-Pax ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks (note any attachments):

Submit in order of Work Centers:

FY-__ CLIN/ SLIN: NAME (* New Hire/ ** Terminated) Work Ctr: Hire Aniv Date: On-Site Date: Qual/ Certif Title Planned Vacation/ Leave License and Certifictions w/Exp Dates CAC Card Exp Date Security Clearance (Y or N) /Exp date) Employment Termination Date: (ddmmmyy) Remarks: (Note vacation times; employment terminations dates; destruction/turn-in of CAC card)

1 SAMPLE, Fred X5O SM

2 X5O SMC

3 X5O SQI

4 X5O QI-AP

5 X5O QI-ALSS

6 X5O QI-AV

7 X5M ST-IMRL

8 X5M ST-IMRL

9 X5M ST-IMRL

10 X5M ST-IMRL

11 X5M ST-IMRL EXP

12 X5H/ X5S HMWS

13 X5H ST-H

14 X5H ST-H

15 X5S ASW

16 X5L /X5E EWS-56

17 X5L AM-T56

18 X5L AM-T56

19 X5L AM-T56

20 X5L AM-T56

21 X5L AM-T56

22 X5L AM-T56

23 X5L AM-T56

24 X5L AM-T56

25 X5L AM-T56

26 X5L AM-T56

27 X5L AM-T56

28 X5L PCC-T56

29 X5E ETTC

30 X5B/ X5A/ X5C AVWS

31 X5B ETBS

32 X5B ETBS

33 X5B ETBS

34 X5A ETATE

35 X5A ETATE

36 X5C ETCAL

37 X5C ETCAL

38 X58/ X5D/ X5F/ X5P ALSSWS

39 X58 ST-ALSS

40 X58 PCC-ALSS

41 X58 PCC-ALSS

42 X5D AM-ALSS

43 X5D AM-ALSS

44 X5D AM-ALSS

45 X5F AM-ALSS

46 X5F AM-ALSS

47 X5F AM-ALSS

48 X5F AM-ALSS

49 X5F AM-ALSS

50 X5F AM-ALSS

51 X5P AM-ALSS

52 X5P AM-ALSS

53 X5P AM-ALSS

54 X5T/ X55 TPWS

55 X5T AW

56 X5T AW

57 X5T AW

58 X55 PSWS2

59 X55 AP

60 X55 AP

61 X55 AP

62 X55 AP 2nd

63 X55 AP 2nd

64 X59 SEWS

65 X59 MVMSE

66 X59 MVMSE

67 X59 MVMSE

68 X59 MVMSE

69 X59 MVMSE

70 X59 MVMSE

71 X59 MVMSE

72 X59 MVMSE

73 X59 AWSE

74 X59 AWSE

75 X59 PCC-SE

Pt 5 CVS Status

PART 5: CVS SUMMARY REPORT Ver 08 Oct 10

Title: FRCMA-PAX Monthly Measurement Report NOTE: PRIVACY ACT INFORMATION / PERSONAL IDENTITY INFO SAFEGAURDS MARKINS REQRD.

Contract #: N61340-11-C-xxxx If transmitted electronically. It must be encrypted using WINZIP AES 256-BIT encryption

Report Period: 1-31 May 2010 FRCMA-PAX CVS SUMMARY REPORT

CDRL #: A010

Contractor: ABC, Inc NOTE: GOVT ONLY/FOUO RELATIVE TO THE FRCMA-PAX CONTRACT.

Contractor Signature: Date: Email: Phone:

John Contractor, Site Mgr ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks:

COR Signature: Date: Email: Phone:

Bill COR, FRCMA-Pax ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks (note any attachments):

CVS REGISTATION REQUEST FORM DATA:

SECTION I (Applicant Data) Section II: Elegibility Rqrmts Section III: Backgrd Vetting Section IV: Sponsor Responsibility

Active Issued CAC? (A,D,I,T) Purpose Last Name (In Alphabetical Order)) First Name MI Cadency Name SSN xxx-xx-xxxx Birth Date ddmmmyy EMAIL Address Personnel Category Card Exp Date ddmmmyy Contract End Date ddmmmyy State Applicable Rqrmt: Favorable FBI Fingerprint Chk? NACI Submitted to OPM? Approved / In DEERS? Termination Date ddmmmyy CAC Expire Date: ddmmmyyy Sponsor Name / Email/Phone Type and Date of NACI (BI) CAC Confiscated and Destroyed ddmmmyyy Destruction Confirmation POC

A = ACTIVE CAC

D = DESTROYED CAC

I = INPROCESS OF ACQUIRING CAC

T = TRANSFERRED CAC TO OTHER CVS TA

INITIAL, REISSUE, OR 6 MO REVERIFICATION

NAVY DOD CONTRACTOR, VOLUNTEER, Other FED AGENCY (specify)

USE DARK GRAY BACKGROUND FOR INACTIVE; LIST ACTIVE AND INACTIVE TOGETHER SEPARATELY

A=ACTIVE CAC; D=DESTROYED CAC

I= INPROCESS OF ACQUIRING CAC

T=TRANSFERRED CAC

TO OTHER CVS TA

ALPHABETICAL ORDER

PT 6 Premium Time Summary

Ver 15 Feb 11

PART 6: CONTRACTOR PREMIUM TIME SUMMARY

Title: FRCMA-PAX Monthly Measurement Report CONTRACTOR PREMIUM TIME SUMMARY

Contract #/Name: N61340-11-C-xxxx / ABC, Inc

Report Period: 1-31 May 2010

CDRL #: A010

Contractor Signature: Date: Email: Phone:

John Contractor, Site Mgr ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks:

COR Signature: Date: Email: Phone:

Bill COR, FRCMA-Pax ddmmmyy xxx@ctxtcom (###)###-#####

Signature: Remarks (note any attachments):

Work Center: Qualification Premium Time this Report Period (Hrs)) Cummulative Premium Time this LOT Period (hrs)

1 X5O SM

2 X5O SMC

3 X5O SQI

4 X5O QI-AP

5 X5O QI-ALSS

6 X5O QI-AV

7 X5M ST-IMRL

8 X5M ST-IMRL

9 X5M ST-IMRL

10 X5M ST-IMRL

11 X5M ST-IMRL EXP

12 X5H/ X5S HMWS

13 X5H ST-H

14 X5H ST-H

15 X5S ASW

16 X5L /X5E EWS-56

17 X5L AM-T56

18 X5L AM-T56

19 X5L AM-T56

20 X5L AM-T56

21 X5L AM-T56

22 X5L AM-T56

23 X5L AM-T56

24 X5L AM-T56

25 X5L AM-T56

26 X5L AM-T56

27 X5L AM-T56

28 X5L PCC-T56

29 X5E ETTC

30 X5B/ X5A/ X5C AVWS

31 X5B ETBS

32 X5B ETBS

33 X5B ETBS

34 X5A ETATE

35 X5A ETATE

36 X5C ETCAL

37 X5C ETCAL

38 X58/ X5D/ X5F/ X5P ALSSWS

39 X58 ST-ALSS

40 X58 PCC-ALSS

41 X58 PCC-ALSS

42 X5D AM-ALSS

43 X5D AM-ALSS

44 X5D AM-ALSS

45 X5F AM-ALSS

46 X5F AM-ALSS

47 X5F AM-ALSS

48 X5F AM-ALSS

49 X5F AM-ALSS

50 X5F AM-ALSS

51 X5P AM-ALSS

52 X5P AM-ALSS

53 X5P AM-ALSS

54 X5T/ X55 TPWS

55 X5T AW

56 X5T AW

57 X5T AW

58 X55 PSWS2

59 X55 AP

60 X55 AP

61 X55 AP

62 X55 AP 2nd

63 X55 AP 2nd

64 X59 SEWS

65 X59 MVMSE

66 X59 MVMSE

67 X59 MVMSE

68 X59 MVMSE

69 X59 MVMSE

70 X59 MVMSE

71 X59 MVMSE

72 X59 MVMSE

73 X59 AWSE

74 X59 AWSE

75 X59 PCC-SE

Sheet1