Exhibit (A4) CDRL A004 Monthly Rpt (1423 and Annex only)_FF_DC COMS_23 Oct 2019.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

LT

SEE BLK 16

1. BLK 4: A) FOR COMS FF/DC, ANY REFERENCE TO “DEVICE” MEANS “TRAINING SYSTEM AND EQUIPMENT”. FOR TTE, ANY REFERENCE TO “DEVICE” MEANS “EQUIPMENT AND PARTS”.

B) ANY REFERENCE TO “CALENDER YEAR” OR “FISCAL YEAR” MEANS “BASE OR OPTION YEAR” (COMMENCING WITH CSD).

C) PARA. 10.2.3.1 SECTION 1, DEVICE OPERATIONAL STATUS, APPLIES TO “DAILY” REPORTS. DAILY REPORTS ARE EXEMPT FROM TRANSMITTAL OF NAWC FORM 4330/60 SUBMISSION. FIG 1 INCLUDE STATUS CODE C -"TI" = TRAINING IMPACTED & D - "NET" = NO EFFECT ON TRAINING.

D) PARA 10.2.3.2 SECTION II THROUGH PARA 10.2.3.5 SECTION V APPLY TO THE “MONTHLY” REPORTS. ADDITIONAL MONTHLY REPORT REQUIREMENTS ARE PROVIDED IN THE ANNEX (PARTS 1-4). MONTHLY REPORTS REQUIRE THE ELECTRONIC DATA ITEM TRANSMITTAL (NAWCTSD FORM 4330/60) WITH EACH SUBMISSION.

E) PARA 10.2.3.2 PERFORMANCE. USE THE EXAMPLE PROVIDED IN SECTION II: PERFORMANCE, PG 3 OF 11 PAGES, OF THE DID AS A GUIDE.

F) PARA 10.2.3.3 MANPOWER. IDENTIFY THE NUMBER OF FULL AND PART-TIME PERSONNEL UTILIZED IN MEETING PERFORMANCE REQUIREMENTS BY “DOL CODE/LABOR CATEGORY.” USE ANNEX FIGURE 2, SECT III MANPOWER FOR FORMAT.

G) PARAS 10.2.3.4.5.5 TIME TO REPAIR; 10.2.3.4.5.7 MTTR TO DATE; AND 10.2.3.4.5.8 MTBF TO DATE - CALCULATE AND EXPRESS IN WHOLE NUMBER OF DAYS AND MAINTAIN HISTORICAL DATA CUMULATIVE THROUGH THE END OF THE CONTRACT.

H) DI-MISC-81392 IS FURTHER TAILORED AS FOLLOWS: (REFER TO ANNEX CDRL A004)

1) PARA 10.2.3.4 SEC IV: “MAINTENANCE ACTIONS" SEVERAL SUBPARAGRAPHS ARE TAILORED TO INCLUDE, “REPAIR OR REPLENISH” MONTHLY STATUS REPORT. SEE ANNEX A004 PARA 2.4 AND ANNEX FIGURES 3 AND 4.

2) PARA 10.2.3.5 SEC V: “FIRE FIGHTER CONSUMABLES”, SEVERAL SUBPARAGRAPHS ARE TAILORED TO INCLUDE CONSUMABLE DATA AND CLASS STATISTICS. CLASS STATISTCS SHALL INCLUDE CUMULATIVE TOTALS OF CLASSES AND STUDENTS TAUGHT FOR THE REPORTING BASE/OPTION YEAR EXERCISED FOR ALL TRAINING DEVICES LISTED IN ALL APPENDICES OF THE PWS. SEE ANNEX A004 PARA 2.5 AND ANNEX FIGURE 5.

I) THREE ADDITIONAL MONTHLY REPORTS SHALL BE DELIVERED (PART 1, PERFORMANCE REPORT SUMMARY; PART 2, PREMIUM TIME (PT)/ADDITIONAL INSTRUCTION UTILIZATION REPORT; AND PART 3, DC TRAINER WATER TESTING REPORT FOR THE MONTH OF). SEE ANNEX A004 PARAs 2.1, 2.6 AND ANNEX A004 FIGURES 1, 6 AND 7.

2. BLK 12: A) FIRST “DAILY” FIRE FIGHTING AND DC WATER REPORTS SHALL BE DUE ONE HOUR PRIOR TO THE START OF THE NORMAL OPERATING WINDOW ON THE CONTRACTOR SUPPORT DATE (CSD).

B) FIRST “MONTHLY” REPORTS SHALL BE DUE THE 10TH WORKING DAY FOLLOWING THE FIRST FULL MONTH AFTER THE CSD. FIRST “MONTHLY” REPORT SHALL BE SUBMITTED IN DRAFT TO THE COR FOR REVIEW, PERFORMANCE COMPUTATIONS AND COMMENTS AS APPROPRIATE, PRIOR TO FINAL REPORT SUBMISSION.

3. BLK 13: A) SUBSEQUENT “DAILY” FIRE FIGHTING REPORTS SHALL BE DUE ONE HOUR PRIOR TO THE START OF THE NORMAL OPERATING WINDOW THROUGH THE END OF THE CONTRACT, UNLESS DIRECTED OTHERWISE BY THE COR.

B) SUBSEQUENT: DC “DAILY” WATER REPORTS SHALL BE DUE TO THE TA ONE HOUR PRIOR TO THE START OF THE TRAINING EVOLUATION AND ONE HOUR AFTER THE TRAINING EVOLUTION IS COMPLETED THROUGH THE END OF THE CONTRACT (TWO DAILY SUBMISSIONS), UNLESS DIRECTED OTHERWISE BY THE COR. NOTE - WATER TESTING IS A DAILY AND MONTHLY REPORT. (SEE CONTINUATION SHEET 2 OF 8)

NAWCTSD PCO**

NAWCTSD PJM**

CONTRACT SPECIALIST**

COR*:

MAYPORT

NORFOLK

SAN DIEGO

NEWPORT

PEARL HARBOR

RTC GREAT LAKES

SWOSU GREAT LAKES

DD FORM 1423-1, FEB 2001

PREVIOUS EDITION MAY BE USED

Page 1 of 8 Pages

CONTRACT DATA REQUIREMENTS LIST

(I Data Item)

A. CONTRACT LINE ITEM NO.

A004 (Con’t)

B. EXHIBIT

A

D. SYSTEM/ITEM

FF / DC COMS

16. REMARKS (Continued)

BLK 13: (CON’T) C) SUBSEQUENT “MONTHLY” REPORTS SHALL BE SUBMITTED TO THE COR FOR REVIEW, PERFORMANCE COMPUTATIONS AND COMMENTS PRIOR TO FINAL REPORT SUBMISSION. SUBSEQUENT MONTHLY REPORTS SHALL BE DUE NO LATER THAN THE 10TH WORKING DAY OF EACH MONTH FOLLOWING THE REPORT PERIOD THROUGH THE END OF THE CONTRACT. REPORT DISTRIBUTION SHALL BE DUE TWO (2) WORKING DAYS AFTER THE COR SIGNATURE.

4. BLK 14: COR* RECEIVES REPORTS FOR THEIR SITES ONLY. COMS MANAGER**, PCO**, PJM** AND CONTRACT SPECIALIST** RECEIVE MONTHLY REPORTS FROM EACH SITE.

5. BLK 14: SUBMISSIONS SHALL BE AN EMAIL ATTACHMENT IN MS-WORD 2016. EMAIL SUBJECT LINE SHALL INCLUDE CONTRACT, CDRL DATA ITEM NUMBER, LOCATION AND PERIOD (E.G., N61340-XX-X-XXXX-A004-MAYPORT-1-31MAR19).

ADDRESSES FOR ADDRESSEES ARE LISTED IN CDRL ADDRESSEE LIST.

6. THE GOVERNMENT WILL HAVE 15 WORKING DAYS FOR REVIEW AND ACCEPTANCE/REJECTION OF EACH SUBMISSION.

7. BLK 9: THE FOLLOWING STATEMENT SHALL BE INCLUDED ON THE DELIVERABLE:

DISTIBUTION D: DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY, (ADMINISTRATIVE OR OPERATIONAL USE), (23 OCT 2019). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE COMMANDING OFFICER, NAVAL AIR WARFARE CENTER, TRAINING SYSTEMS DIVISION, (CODE GT43200), 12211 SCIENCE DRIVE, ORLANDO, FL 32826-3224.

DD FORM 1423-1, FEB 2001 Page 2 of 8 Pages

ANNEX TO EXHIBIT A004

DAILY AND MONTHLY REPORTS

N61340-20-R-0005 CDRL REQUIREMENT

1.0 Report Contents.

1.1 Header Information. Data elements to be provided as header information are as follows, in the order shown.

a. Contract No. Enter appropriate contract number.

b. Contractor. Enter name of contractor's firm

c. Monthly Ending. Self-explanatory.

d. Reporting Period. Enter the start and completion dates for the contract period the report is being prepared. Use a MMDDYY numerical format for each date.

1.2 Report Body.

1.2.1 General. This report augments and provides clarification to DI-MISC-81392 used to document and summarize status for contractor performance Training Systems Support contract. This report documents performance data relative to Contractor training equipment maintenance, repair and utilization during a specified performance period. The main body of each report shall be completed in accordance with the attached sample format. Block 16 of the Contract Data Requirements List (CDRL) shall tailor each report’s requirements by applying CDRL annex paragraphs 2.1 - 2.6, with attached sample formats, as applicable. Entry of actual data is to be made in the appropriate column for the period covered by the report.

1.2.2 Format. The report shall contain up to five sections per the DID (section I, Device Operational Status, Section II, Performance, section III, Manpower, section IV, Maintenance Actions, and section V, Fire Fighter Consumables) plus three additional reports (part 1 Performance Report Summary, part 2, Premium Time (PT)/Additional Instruction Utilization Report and part 3, DC Trainer Water Testing Report for the Month of:) as specified in the contract. The data shall be presented in columnar format to facilitate reporting of data on multi-station devices/equipment items or where multiple devices/equipment items are collocated (refer to applicable samples). Any of the following formats may apply as per block 14 and 16 of the CDRL:

1.2.2.1 Hard Copy. Where applicable, individual areas shall be prepared as delineated in the contract on 8 ½” by 11” to 11” by 15” size paper.

1.2.2.2 Magnetic Media. Where applicable, individual area files shall be placed on Compact Disc Recordable/Re-Writable (CD-R/CD-RW; 1x-4x drive capable media) optical disc. Magnetic files shall be compatible to Microsoft Office 2016 formats as specified in block 16 of the CDRL.

1.2.2.3 E-Mail. Reports shall be attached files to Internet Electronic Mail that are compatible to Microsoft Excel 2016 formats as specified in block 16 of the CDRL.

2.0 Report Content. The Contractor Daily and Monthly Reports shall consist of the following:

2.1 Part I - Performance Report Summary. The main body of the report shall contain information on the distribution, work accomplished, manning, and problem areas encountered. Data elements not applicable to a specific device/equipment item shall be marked “NA” for alphanumeric fields and “0” (zero) for numeric fields. Data elements to be addressed are as follows, in the order shown. (See Exhibit (A4-1), Part 1 of Annex to Exhibit A004 for a Sample Report.)

a. Device/Equipment Nomenclature. Identify by nomenclature the trainer(s) which is/are the subject of the report (e.g., Advanced Shipboard Fire Fighter Trainer).

b. Device/Equipment Number. Identify alphanumeric training device/equipment designation number assigned to the device/equipment and weapon system. If the device/equipment does not have a device number, enter device/equipment name and weapon system (e.g., 19F1B, 19F3B, DCWT).

c. Serial Number. Enter alphanumeric serial number assigned to the device/equipment.

d. Designator Prefix. Enter as a separate alpha character the initial character (prefix) of the training device designator. The default is “blank”, which is the Cog 2”O” designator. Typical designators are prototype (“X”), Army (“A”), Air Force (“B”), non-Cog 2”O” (“S”), Interactive Courseware Hardware (“I”).

e. Contract Number. Self-explanatory. A character alphanumeric field contract number.

f. Contract Support Period. Enter the start and completion dates of the contract. Use a MMDDYY numerical format for each date.

g. Date of Report. Enter the date that the report is completed. Use a MMDDYY numerical format.

h. Period Covered. Enter the ending date of the period covered by the report using an YYYYMMDD numerical format. When data is reported on an annual basis, use the last month in the annual period.

i. Activity Service. Enter by character alphanumeric field the activity assigned as the device/equipment custodian.

j. Activity Location. Enter city and state.

k. Report No. Number the reports consecutively throughout the contract period. Use a 3 digit numeric field. Example: CDRL #-Base Year/Option-Lot Seq# (e.g., A004-19-01). See COR for numbers.

l. CASREP. Identify whether or not the device was CASREP during the reporting period (“Yes” or “No”).

m. Personal Time Distribution. The time distribution summary of all contractor personnel for the report period covered shall be classified in the following categories:

(1) Operation

(2) Scheduled Maintenance

(3) Unscheduled Maintenance

(4) Supply Support

(5) Authorized Contractor Modification

(6) Training of Contractor Personnel

(7) Verification of Documentation

(8) Other

For each category, enter the number of hours to the nearest hour, a numeric field limited to 99999.

n. Trainer Downtime. The number of hours the trainer/equipment was down and not available for scheduled training shall be reported. Downtime hours shall be classified as follows:

(1) Maintenance

(2) Device Modifications

(3) Parts/Supply Problems

(4) Facility Problems

(5) Lack of Instructors/Operators

(6) Lack of Setup Times

(7) Miscellaneous Other

The sum of all such categorizations shall equal Total Trainer/Equipment Downtime for the reporting period, a numeric field limited to 99999.9 (rounded to the nearest tenth of an hour).

o. Course Identification Numbers (CINs). Enter “See SECTION V, Part (3)” in block 13. Submit corresponding training data in Section V, Part (3), Class Statistics (see paragraph 2.5).

p. Summary of Work Accomplished. Include, at the end of the report, a narrative summary containing the following:

(1) Operation, Maintenance, Supply Support. Provide a brief summary of major work items accomplished and status, citing any problem areas encountered.

(2) Mobilization/Transition Status. Provide a brief summary of major work items accomplished and status, citing any problem areas encountered.

(3) Modification. Describe all Government approved changes made to the device configuration.

(4) Training. Describe the nature and extent of training provided by the contractor to its on-site personnel. Mobilization training status shall be addressed during mobilization period.

(5) Premium Time (PT) Utilization. List the amount of premium time (also referred to as Additional Time) associated with each funding agent by site for the reporting period.

q. Signature of Contractor Site Manager/Date and Contracting Officer’s Representative (COR)/Date. The report shall be signed by the Site Manager and by the COR. The Alternate COR (ACOR) shall sign in lieu of the COR. Signature authority shall be delegated to a designated Technical Assistant (TA) in writing by the COR when applicable.

r. Classification of Report. Report originator shall ensure proper classification of the report in accordance with existing Navy regulations.

s. Remarks. Self-explanatory.

2.2 Section II - Performance . The report containing the summary of the contractor performance shall be submitted IAW the DID. (See Exhibit (A4-1), Section II of Annex to Exhibit A004 for a Sample Report.)

2.3 Section III - Manpower. The report containing the summary of the contractor performance shall be submitted IAW the DID. The report shall contain the following: (1) Personnel On Site, (2) Total Manhours Expended, and (3) Cumulative Distribution of Expended Manpower. (See Exhibit (A4-1), Section III of Annex to Exhibit A004 for a Sample Report.)

2.4 Section IV - Maintenance Actions. The report containing the summary of the contractor performance shall be submitted IAW the DID. The report shall contain the following: (1) Corrective Maintenance Actions, (2) Mean Time to Repair (MTTR) and Mean Time Between Failure (MTBF) and (3) Repair of Replenishment. (See Exhibit (A4-1), Section IV of Annex to Exhibit A004 for a Sample Report.) The following additional data elements shall be included:

a. Training System. Identify alphanumeric training device/equipment designation number assigned to the device/equipment and weapon system. If the device/equipment does not have a device number, enter device/equipment name and weapon system (e.g., 19F1B, 19F3B, DCWT).

b. Part Number/NSN and Nomenclature. Self explanatory.

c. Cause for Failure. Provide a short description of the cause for the failure.

d. MAF Number. Enter Maintenance Action Document.

e. Seq No. Sequence Number is number of failed Repairable or Repair Part (R/RP) sequentially. R/RPs not returned to the MSP in RFI condition at the end of the month are carried over to the following month, with its appropriate sequence number for tracking purposes. R/RPs shown repaired or replenished and returned to the MSP in an RFI condition during this period will drop from the next month’s report

f. Training System or Equipment. Identify alphanumeric training device/equipment designation number assigned to the device/equipment and weapon system. If the device/equipment does not have a device number, enter device/equipment name and weapon system (e.g., 19F1B, 19F3B, DCWT).

g. S/N. Enter Serial Number associated with the Training System.

h. Description. Enter system being repaired.

i. Failed Repairable or Repair Part (Part # / NSN and Nomenclature). Enter failed part number or NSN and Nomenclature.

j. Date Repairable or Repair Part Failed. Enter date part failed.

k. Date Repaired or Replenished. Enter date part was fixed or replenished.

l. # Days to Repair or Replenish. Enter number of days it took to repair or replenish.

m. Remarks. Self-explanatory.

2.5 Section V - FIRE FIGHTER CONSUMABLES. The report containing the summary of the contractor performance shall be submitted IAW the DID. The report shall contain the following: (1) Fire Fighter Consumables, (2) Other Consumption and (3) Class Statistics. Paragraph 10.2.3.5.15, Other Consumption of the DID refers to Oxygen Breathing Apparatus (OBA) canisters. OBAs are no longer used for this trainer; they have been replaced by Self Contained Breathing Apparatus (SCBA). Replace SCBA for OBA. (See Exhibit (A4-1), Section V of Annex to Exhibit A004 for a Sample Report.) The following additional data elements shall be included:

a. Balance. Enter balance remaining at the end of the reporting period.

b. Units Purchased. Enter quantity purchased during the reporting period.

c. Training System. Identify alphanumeric training device/equipment designation number assigned to the device/equipment and weapon system. If the device/equipment does not have a device number, enter device/equipment name and weapon system (e.g., 19F1B, 19F3B, DCWT).

d. Cumulative # Class Taught this Base/Option Year. Enter the sum of the classes taught to date from the start of the base/option year exercised for the 12 month period.

e. Cumulative # Students Taught this Base/Option Year. Enter the sum of the students taught to date from the start of the base/option year exercised for the 12 month period.

f. Total xxx. Enter Training System vice xxx and provide sub Totals for each of the following: Number Classes Taught this Month, Number Students Taught this Month, Cumulative # Classes Taught this Base/Option Year, Cumulative @ Students Taught this Base Option Year.

g. Total of All Devices. Enter cumulative total of all sub totals.

h. Contractor Comments (Use add’l sheets, if required). Self-explanatory.

i. COR Comments (Use add’l sheets, if required). Self-explanatory.

2.5 Part 2 - Premium Time (PT) Utilization. List the amount of premium time (also referred to as Additional Time) associated with each funding agent by site for the reporting period and the total cumulative amount of premium time provided for each funding agent by site for that base/option year (MMM-MMM). Specify premium time applicable C/SLIN, PT used during the reporting period, cumulative PT utilized to date, unit price, funds expended that reporting period, cumulative PT to date, PT funding to date, funding balance, and percent of funds remaining. (See Exhibit (A4-1), Part 2 of Annex to Exhibit A004 for a Sample Report.)

2.6 Part 3 - DC Trainer Water Testing Report. The main body of the report shall contain information on the results of the water testing. Data elements not applicable to a specific device/equipment item shall be marked “NA” for alphanumeric fields and “0” (zero) for numeric fields. Data elements to be addressed are as follows, in the order shown. (See Exhibit (A4-1), Part 3 of Annex to Exhibit A004 for a Sample Report.)

a. Date. Enter date water sample was taken.

b. Time. Enter the time the water sample was taken.

c. PH (1.5 ~ 5.5 ppm). Enter the results of the PH level.

d. Free Chlorine (1.5 ~ 5.5 ppm). Enter the results of the Free Chlorine level.

e. Total Chlorine (1.5 ~ 5.5 ppm). Enter the results of the Total Chlorine level.

f. Combined Chlorine O. Enter the results of the Combined Chlorine level.

g. Water Temp f. Enter the results of the water temperature.

h. Test Administered By: Enter the name of the person who did the testing.

i. Comments. Self-explanatory.