JF-1 _Exhibit_A_CDRL.pdf

EXHIBIT A

1.0

1.1

Code Frequency

DAILY

WEEKLY

BI-WE

MTHLY

BI-MO

QRTLY

2/MTH

XTIME

2TIME/R

ANNLY

SEMIA

OTIME

ONE/R

ASREQ

CP/RQ

2TIME

*DFDEL

ONE/P

1.2

1.3

1.4

Weekly Each two weeks

Each two months

Annually

Two separate submittals

Monthly

2 separate submittals

One time One time with revisions as required As required

Each six months

The NAVCRANECEN Project Manager shall be notified by email when a submission is

References include subordinate paragraphs.

Distribution addresses for the submission of data are provided on page 2.

Deferred delivery (rarely used)

Contracts Data Requirements List DD Forms 1423

The data items included in this Section are required by the applicable clauses of Federal Acquisition Regulations (FAR) 52.2 and Defense Federal Acquisition Regulations (DFAR) 252.227

Daily

Data to be delivered under this contract is identified in Exhibit A (DD Forms 1423) and further described in Exhibit B (DD Forms 1664) and technical specification. All data submitted shall utilize British System units of measure and the English language exclusively.

Quantities/distribution points listed in block 14 of DD Forms 1423 shall apply to all submissions. Latest edition of referenced document noted in block 4 is required. Codes used in blocks 8 and 10 are described as follows:

60T Portal Cranes NNSY, PSNSY, and PNSY

Change pages as required when procuring

One time preliminary & revisions draft

Quarterly Semimonthly X separate submittals

Exhibit A Page 1 N62470-14-R-5001

NAVCRANECEN Navy Crane Center, Naval Facilities Engineering Command

SupCmd

DCMA

NAVCRANECEN: Director, Navy Crane Center Naval Facilities Engineering Command Attn: Dave Cadieux Code 01 Norfolk Naval Shipyard, Bldg 491 Portsmouth VA 23709-5000 email: david.cadieux@navy.mil phone; 757.967.3814

NNSY Norfolk Naval Shipyard Attn: Rob Steiner Code 700 Portsmouth VA 23709 email: robert.d.steiner@navy.mil phone: 757-396-1316

PSNSY Address provided after contract award

PNSY Address provided after contract award

DCMA: Address provided after contract award

60T Portal Cranes NNSY, PSNSY, and PNSY

Distribution addresses for the submission of data:

Abbreviations used:

Supported Command

Defense Contract Management Agency

Exhibit A Page 2 N62470-14-R-5001

Data Item Page

A001 STATUS REPORTS 4

A002 DESIGN DRAWINGS & CALCULATIONS 5

A003 MANUFACTURER'S CATALOG DATA 6

A004 CONTRACTOR CHANGE REQUESTS 7

A005 OPERATION AND MAINTENANCE MANUAL 8

A006 CERTIFICATION, WIRE ROPE 9

A007 CERTIFICATION, PERIODIC LOAD TESTING 10

A008 CERTIFICATION, EPA EMISSION 11

A009 CERTIFICATION, NON-HAZARDOUS MATERIAL 12

A010 CERTIFICATION, LOSS OF POWER 13

A011 CERTIFICATION, SHAFT / COUPLING ALIGNMENT REPORT 14

A012 POST-AWARD INSPECTION DOCUMENTATION 15

A013 CERTIFICATION, WELDING 16

A014 CERTIFICATION, PROFESSIONAL ENGINEER REVIEW 17

A015 CONTRACTOR CRANE ENTRY PACKAGE 18

A016 CONTRACTOR SIGNIFICANT INCIDENT REPORTING 19

A017 TEST PROCEDURES & REPORTS 20

A018 INSTALLATION, LIFT & RIGGING PLAN 21

A019 ACCIDENT PREVENTION PLAN 22

A020 TRAINING OUTLINE 23

A021 BRAKE SHOE ADJUSTMENT, SET 24

A022 CONTROL SYSTEM PARAMETER RECORD 25

A023 PROPERTY TRANSFER VERIFICATION 26

A024 CONFERENCE MINUTES 27

CONTRACT DATA REQUIREMENTS LIST

TABLE OF CONTENTS

60T Portal Cranes NNSY, PSNSY, and PNSY

Exhibit A Page 3 N62470-14-R-5001

TDP X TM

7. DD 250 REQ

LT

8. APPL CODE

A 0 1 0 1 0 1 0 1

0 4

H. DATE

12/4/2013

1059/183

16. REMARKS NAVCRANECEN

NNSY

PSNSY

Provide initial schedule within 15 days of contract award, and monthly status report and schedule thereafter by the 1st of the month. Provide a submission in accordance with blocks 4 and 5. The contractor will be notified within 14 days if revision and resubmission is required. Resubmittals, if required, shall be provided to NAVCRANECEN within 7 days after return of Government review comments.

In addition to the narrative report described in block 4, the crane contractor shall prepare and submit a detailed graphic and tabular schedule showing design, manufacturing, delivery and acceptance activities. Initial schedule submission shall be the baseline from which monthly progress shall be measured.

Each monthly report after the initial submission should address issues that will potentially delay or has delayed the schedule previously provided. This report shall also identify all NCC to Contractor issues that have not been resolved.

The status report and schedule may be submitted electronically.

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

See Block 16

10. FREQUENCY

MTHLY a. ADDRESSEE

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

STATUS REPORT

6. REQUIRING OFFICE

NAVCRANECEN

3. SUBTITLE

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

4. AUTHORITY

DI-MGMT-80368A

5. CONTRACT REFERENCE

Para. 1.4 , SD-01

60T Portal Crane Modernization N62470-14-R-5001

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

F. CONTRACTOR

A

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT

15. TOTAL

Reg Electronic

PNSY

Exhibit A Page 4 N62470-14-R-5001

LT

8. APPL CODE

A

0 1 0 1

FINAL

0 1 0 1

AS-BUILT

Prints:

NAVCRANECEN 0 1

0 1 2 0

1 0 1 0 2 0

6 6

H. DATE

12/4/2013

1059/183

Provide engineering drawings and supporting calculations in accordance with block 4 and 5. Submit pre-final engineering drawings and calculations (accompanied by a certification letter stating that design has been prepared under the supervision and reviewed by a licensed, registered professional engineer) for government approval in accordance with contractor's design schedule.

NAVCRANECEN will determine acceptability of initial crane design submittal within 28 days after receipt. All subsequent Government review periods shall be complete within 14 days of receipt of resubmission. Initial drawings and calculations may be submitted electronically.

Government approval of final drawings & calculations is required 30 days prior to initial shop inspection. Final drawings shall be submitted 14 days after approval. Structural drawings shall be stamped and sealed by a licensed, registered professional engineer and submitted not less than 5 days prior to shop test. Final drawings and calculations may be submitted electronically.

DCMA

DCMA

SHIPYARD

DCMA

NAVCRANECEN

Submit as-built drawings no later than 30 days after government crane acceptance. All as-built drawings submitted shall be stamped and sealed by a licensed, registered professional engineer.

Note: Drawing review period will not commence until until the entire design package (including all supporting information such as catalog cuts, calculations, etc) are received.

SUBMISSIONS

Drawings submittals for pre-final & final shall be delivered electronically. Submit as-built CD-ROM and hard prints via private courier.

SHIPYARD

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

J. DATE

12/4/2013

ASREQ

10. FREQUENCY

ASREQ

DD Form 1423-1, JUN 90 Previous editions are obsolete

15. TOTAL

16. REMARKS

AS-BUILT

CD-ROM:

NAVCRANECEN

DCMA

NAVCRANECEN

9. DISTRIBUTION

STATEMENT

ASREQ

60T Portal Crane Modernization N62470-14-R-5001

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Design Drawings & Calculations

4. AUTHORITY

DI-SESS-81000D, DI-MCCR-80700

5. CONTRACT REFERENCE

Para 1.4, SD-02, SD-05, SD-11.1

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

0001 A

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

F. CONTRACTOR

3. SUBTITLE

PRE-FINAL

6. REQUIRING OFFICE

NAVCRANECEN

Reg Electronica. ADDRESSEE

14. DISTRIBUTION

Exhibit A Page 5 N62470-14-R-5001

LT

8. APPL CODE

A

0 1 0 1 0 1

AS-BUILT

Prints:

NAVCRANECEN 0 0

2 0 0 0

1 0 2 0 1 0

6 3

H. DATE

12/4/2013

1059/183

NAVCRANECEN

a. ADDRESSEE

Provide required data in accordance with blocks 4 and 5 along with design drawing & calculation submittals, and prior to part/material being ordered. This submittal shall be submitted as one electronic file, and each catalog cut shall be bookmarked within this file .

NAVCRANECEN will determine acceptability of initial crane design submittal within 28 days after receipt. All subsequent Government review periods shall be complete within 14 days of receipt of resubmission. Initial catalog data may be submitted electronically.

Government approval is required 30 days prior to shop inspection, and is necessary for NCC approval of the crane design.

Note:

Pre-Final drawing packages submitted for review shall contain all catalog cuts that support the drawings (Data Item A002) submitted in that package. The Navy review period does not begin until all catalog cuts referenced on a drawing are submitted.

Drawing design will not be approved until all related catalog cuts pertaining to that drawing have been submitted and are approvable.

Final Design Catalog Cuts files should be submitted with final drawings via Submittal A002.

Submit as-built catalog cuts no later than 30 days after government crane acceptance in CD format.

SUBMISSIONS

Catalog cuts submittals for pre-final & final shall be delivered electronically. Submit as-built CD-ROM and hard prints via private courier

SHIPYARD

SHIPYARD

DCMA

DCMA

A. CONTRACT LINE ITEM NO. B. EXHIBIT

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

6. REQUIRING OFFICE

0001 A

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

60T Portal Crane Modernization N62470-14-R-5001

F. CONTRACTOR

3. SUBTITLE

4. AUTHORITY

DI-SDMP-81261

5. CONTRACT REFERENCE

Para 1.4, SD-03, SD-11.4

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

Manufacturer's Catalog Data

10. FREQUENCY

ASREQ

14. DISTRIBUTION

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

ASREQ

Reg See Block 16

9. DISTRIBUTION

STATEMENT

Electronic

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

16. REMARKS

DCMA

NAVCRANECEN

SHIPYARD

PRE-FINAL / Final

NAVCRANECEN

15. TOTAL

AS-BUILT

CD-ROM:

Exhibit A Page 6 N62470-14-R-5001

LT

8. APPL CODE

A 0 1 0 0

0 0

0 1

H. DATE

12/4/2013

1059/183

NAVCRANECEN

SHIPYARD

DCMA

F. CONTRACTOR

3. SUBTITLE

A. CONTRACT LINE ITEM NO. B. EXHIBIT

0001 A

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

60T Portal Crane Modernization N62470-14-R-5001

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Contractor Change Request

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

6. REQUIRING OFFICE

NAVCRANECEN

9. DISTRIBUTION

STATEMENT

4. AUTHORITY

DI-CMAN-80639C/80640C/80642C

5. CONTRACT REFERENCE

Para 1.9

a. ADDRESSEE

10. FREQUENCY

ONE/R

14. DISTRIBUTION

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

Reg ElectronicSee Block 16

J. DATE

16. REMARKS

Contractor Change Requests for engineer changes shall be prepared in accordance with Block 4 & 5. For cost and credit proposals, detailed price information and analysis comparing price of proposal to as specificed, to enable Navy Crane Center to evaluate the price impact of the proposed change.

The Contractor shall use the Contractor Change Request form as noted in Specification paragraph 1.9. This form shall be submitted in .pdf file electronically or via hard copy.

Navy Crane Center will review and evaluate the submitted engineering change request. NAVCRANECEN will determine acceptability within 30 days after receipt. All subsequent Government review periods shall be complete within 14 days of receipt of resubmission. Determination of the request will be provided upon completion of NCC evaluation.

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

15. TOTAL

Exhibit A Page 7 N62470-14-R-5001

TDP TM X

LT

8. APPL CODE

A

0 0 1 0

PREFINAL

NAVCRANECEN 0 1

SHIPYARD 0 1

0 0 2 0

CD-ROM VERSION

NAVCRANECEN 0 1

SHIPYARD 0 2

3 5

H. DATE

12/4/2013

1059/183

SHIPYARD

SHIPYARD

NAVCRANECEN

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

10. FREQUENCY

ONE/R

14. DISTRIBUTION

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

9. DISTRIBUTION

STATEMENT

See Block 16

5. CONTRACT REFERENCE

Para. 1.4, SD-10, SD-11.2, SD-11.4

N62470-14-R-5001

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

Operations & Maintenance Manual

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

A. CONTRACT LINE ITEM NO. B. EXHIBIT

3. SUBTITLE

60T Portal Crane Modernization

ElectronicReg

6. REQUIRING OFFICE

NAVCRANECEN

a. ADDRESSEE

A

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

4. AUTHORITY

DI-TMSS-80527B

16. REMARKS DRAFT PAPER COPIES

FINAL PAPER VERSION

NAVCRANECENDRAFT SUBMISSIONS

Furnish draft paper copies of the technical manual in accordance with blocks 4 and 5 prior to mobilization. Draft technical manual must be on site prior to beginning field testing.

PRE-FINAL SUBMISSIONS

Furnish pre-final electronic copies of the technical manual in accordance with blocks 4 and 5 no later than 30 days after crane acceptance. NAVCRANECEN will determine acceptability within 21 days after submittal. All subsequent Government review periods shall be complete within 14 days of receipt of resubmission.

FINAL CD-ROM VERSION

Provide manuals on CD-ROM in accordance with blocks 4 and 5 no later than 30 days after acceptance of the crane. Provide data in PDF format and this submittal shall be bookmarked as a minimum based on the manual information required categories of SD 10.

FINAL PAPER VERSION

Furnish final copies of the manual in accordance with blocks 4 and 5 no later than 30 calendar days after acceptance of the crane. Paper copies of the FINAL manual shall be bound in durable, water-resistant, hard-cover binders and shall include record (as-built) drawings reduced in size to 11-in x 17-in, and shall include a spare parts list.

ALL HARD COPY SUBMISSIONS

Submit all printed manuals via non-government overnight delivery.

15. TOTAL

Exhibit A Page 8 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

16. REMARKS NAVCRANECEN

SHIPYARD

DCMA

Provide data prior to shop inspection in accordance with blocks 4 and 5.

NAVCRANECEN will determine acceptability within 14 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

The crane serial number, contract number, CDRL number and CLIN number shall be included on submitted documentation.

Certification shall be submitted electronically.

Note: Government approval is required a minimum of 1 day prior to shipment of the crane.

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

See Block 16

10. FREQUENCY

ONE/R a. ADDRESSEE

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Certification, Wire Rope

6. REQUIRING OFFICE

NAVCRANECEN

3. SUBTITLE

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

4. AUTHORITY

DI-MISC-80678, para 10.3.2

5. CONTRACT REFERENCE

Para. 1.4, SD-07.1

60T Portal Crane Modernization N62470-14-R-5001

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

F. CONTRACTOR

A

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT

15. TOTAL

Reg Electronic

Exhibit A Page 9 N62470-14-R-5001

LT

8. APPL CODE

A 0 1 0 1 0 0

0 2

H. DATE

12/4/2013

1059/183

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

15. TOTAL

G. PREPARED BY I. APPROVED BY J. DATE

Dave Cadieux, P.E. Chuck Cotton, P.E. 12/4/2013

Provide data prior to shop inspection in accordance with blocks 4 and 5.

NAVCRANECEN will determine acceptability within 14 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

The crane serial number, contract number, CDRL number and CLIN number shall be included on submitted documentation.

Certification shall be submitted electronically.

Note: Government approval is required a minimum of 10 days prior to shop inspection of the crane.

SHIPYARD

DCMA

NAVCRANECEN

9. DISTRIBUTION

STATEMENT

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

ONE/R See Block 16 a. ADDRESSEE Reg Electronic

11. AS OF DATE 13. DATE OF SUBSEQUENT SUBM.

See Block 16

16. REMARKS

4. AUTHORITY 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MISC-80678, para 10.2.4 Para. 1.4, SD-07.2 NAVCRANECEN

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

A007 Certification, Periodic Load Testing

60T Portal Crane Modernization N62470-14-R-5001

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) OMB No. 0704-0188

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

0001 A

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

Exhibit A Page 10 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

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

15. TOTAL

G. PREPARED BY I. APPROVED BY J. DATE

Dave Cadieux, P.E. Chuck Cotton, P.E. 12/4/2013

Provide data prior to shop inspection in accordance with blocks 4 and 5.

NAVCRANECEN will determine acceptability within 14 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

The crane serial number, contract number, CDRL number and CLIN number shall be included on submitted documentation.

Certification shall be submitted electronically.

Note: Government approval required a minimum of 10 days prior to shop inspection.

SHIPYARD

DCMA

NAVCRANECEN

9. DISTRIBUTION

STATEMENT

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

ONE/R See Block 16 a. ADDRESSEE Reg Electronic

11. AS OF DATE 13. DATE OF SUBSEQUENT SUBM.

See Block 16

16. REMARKS

4. AUTHORITY 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MISC-80678, para 10.2.4 Para. 1.4, SD-07.7 NAVCRANECEN

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

A008 Certification, EPA Emissions

60T Portal Crane Modernization N62470-14-R-5001

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) OMB No. 0704-0188

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

0001 A

Exhibit A Page 11 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

16. REMARKS NAVCRANECEN

SHIPYARD

DCMA

Provide data prior to shop inspection in accordance with blocks 4 and 5.

NAVCRANECEN will determine acceptability within 14 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

The crane serial number, contract number, CDRL number and CLIN number shall be included on submitted documentation.

Certification shall be submitted electronically.

Note: Government approval required a minimum of 10 days prior to shop inspection.

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

See Block 16

10. FREQUENCY

ONE/R a. ADDRESSEE

1. DATA ITEM NO.

A009

2. TITLE OF DATA ITEM

Certification, Non-hazardous Materials

6. REQUIRING OFFICE

NAVCRANECEN

3. SUBTITLE

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

4. AUTHORITY

DI-MISC-80678, para 10.2.4

5. CONTRACT REFERENCE

Para. 1.4, SD-07.3

60T Portal Crane Modernization N62470-14-R-5001

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

F. CONTRACTOR

A

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT

15. TOTAL

Reg Electronic

Exhibit A Page 12 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

15. TOTAL

16. REMARKS

Provide data prior to shop inspection in accordance with blocks 4 and 5.

NAVCRANECEN will determine acceptability within 14 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

The crane serial number, contract number, CDRL number and CLIN number shall be included on submitted documentation.

Certification shall be submitted electronically.

Note: Government approval required a minimum of 10 days prior to shop inspection.

NAVCRANECEN

SHIPYARD

DCMA

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

4. AUTHORITY

DI-MISC-80678, para 10.2.4

5. CONTRACT REFERENCE

a. ADDRESSEE

10. FREQUENCY

ONE/R

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

Para. 1.4, SD-07.4

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

See Block 16

60T Portal Crane Modernization N62470-14-R-5001

1. DATA ITEM NO.

A010

2. TITLE OF DATA ITEM

Certification, Loss of Power

A

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Reg Electronic

F. CONTRACTOR

3. SUBTITLE

NAVCRANECEN

6. REQUIRING OFFICE

Exhibit A Page 13 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

15. TOTAL

16. REMARKS

Provide coupling alignment data for all couplings in accordance with blocks 4 and 5 submitted a minimum of 10 days after alignment. Data shall be submitted on the required official data form.

NAVCRANECEN will determine acceptability after data verification. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

The crane serial number, contract number, CDRL number and CLIN number shall be included on submitted documentation.

Certification shall be submitted electronically.

NAVCRANECEN

SHIPYARD

DCMA

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

4. AUTHORITY

DI-MISC-80678, para 10.3.2

5. CONTRACT REFERENCE

a. ADDRESSEE

10. FREQUENCY

ONE/R

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

Para. 1.4, SD-07.8

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

See Block 16

60T Portal Crane Modernization N62470-14-R-5001

1. DATA ITEM NO.

A011

2. TITLE OF DATA ITEM

Certification Shaft / Coupling Alignment Report

A

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Reg Electronic

F. CONTRACTOR

3. SUBTITLE

NAVCRANECEN

Exhibit A Page 14 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

J. DATE

Dave Cadieux, P.E. Chuck Cotton, P.E. 12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY I. APPROVED BY

15. TOTAL

The contractor shall be responsible for recording and submitting report. Provide data in accordance with blocks 4 and 5 within 5 days after inspection.

NAVCRANECEN will determine acceptability within 7 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

Data shall be submitted electronically.

SHIPYARD

DCMA

NAVCRANECEN

9. DISTRIBUTION

STATEMENT

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

ASREQ See Block 16 a. ADDRESSEE Reg Electronic

11. AS OF DATE 13. DATE OF SUBSEQUENT SUBM.

See Block 16

16. REMARKS

4. AUTHORITY 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-ADMIN-81250A Para. 1.4, SD-06.1, SD-06.2 NAVCRANECEN

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

A012 Work Inspection Reports

60T Portal Crane Modernization N62470-14-R-5001

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) OMB No. 0704-0188

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

0001 A

Exhibit A Page 15 N62470-14-R-5001

LT

8. APPL CODE

A 1 1 1 1 1 1

3 3

H. DATE

12/4/2013

1059/183

15. TOTAL

16. REMARKS

Provide welding certifications 30 days prior to shop inspection in accordance with blocks 4 and 5. NAVCRANECEN will determine acceptability within 14 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

The crane serial number, contract number, CDRL number and CLIN number shall be included on submitted documentation.

Certification shall be submitted electronically.

Note: Government approval required a minimum of 10 days prior to shop inspection of the crane.

NAVCRANECEN

SHIPYARD

DCMA

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

4. AUTHORITY

DI-MISC-80678, para 10.3.2

5. CONTRACT REFERENCE

a. ADDRESSEE

10. FREQUENCY

ONE/R

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

Para. 1.4, SD-07.5

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

See Block 16

60T Portal Crane Modernization N62470-14-R-5001

1. DATA ITEM NO.

A013

2. TITLE OF DATA ITEM

Certification, Welding

A

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Reg Electronic

F. CONTRACTOR

3. SUBTITLE

NAVCRANECEN

Exhibit A Page 16 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

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

60T Portal Crane Modernization N62470-14-R-5001

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

0001 A

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) OMB No. 0704-0188

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

A014 Certification, Professional Engineer Review

4. AUTHORITY 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MISC-80678, para 10.2.4 Para. 1.4, SD-02, SD-07.6 NAVCRANECEN

9. DISTRIBUTION

STATEMENT

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

ONE/R See Block 16 a. ADDRESSEE Reg Electronic

11. AS OF DATE 13. DATE OF SUBSEQUENT SUBM.

See Block 16

16. REMARKS NAVCRANECEN

SHIPYARD

DCMA

Provide certification along with the initial design submittal as required by blocks 4 and

5. NAVCRANECEN will determine acceptability within 21 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

The crane serial number, contract number, CDRL number and CLIN number shall be included on submitted documentation.

Certification shall be submitted electronically.

Note: Government approval is required 30 days prior to shop inspection of the crane.

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

15. TOTAL

G. PREPARED BY I. APPROVED BY J. DATE

Dave Cadieux, P.E. Chuck Cotton, P.E.

Exhibit A Page 17 N62470-14-R-5001

LT

8. APPL CODE

A 0 1 0 0

0 1

H. DATE

12/4/2013

1059/183

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) OMB No. 0704-0188

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

0001 A

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

60T Portal Crane Modernization N62470-14-R-5001

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

A015 Contractor Mobile Crane Entry Package

4. AUTHORITY 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

OT-24206 Appendix E & Section H NAVCRANECEN

9. DISTRIBUTION

STATEMENT

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

ONE/R See Block 16 a. ADDRESSEE Reg Electronic

13. DATE OF SUBSEQUENT SUBM.

See Block 16

11. AS OF DATE

16. REMARKS NAVCRANECEN

15. TOTAL

G. PREPARED BY I. APPROVED BY

Provide complete entry package in accordance with Blocks 4 and 5 a minimum of 7 days prior to desired entry of a Contrator owned mobile crane to the Government job-site.

The lift plan is a part of this this entry package and requires approval prior to inclusion and forwarding of the Contrator Mobile Crane Entry Package to the Supported Command.

Note: Government acceptance required prior to mobile crane entry inspection.

SHIPYARD

J. DATE

Dave Cadieux, P.E. Chuck Cotton, P.E. 12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

Exhibit A Page 18 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

15. TOTAL

16. REMARKS

SIGNIFICANT INCIDENTS (ACCIDENTS) INVOLVING CONTRACTOR EQUIPMENT

OR PERSONNEL ON THE GOVERNMENT WORKSITE:

Notify the Contracting Officer as soon as practical, but no later than 4 hours after a significant incident. Refer to Appendix E for description of incidents that require immediate reporting. For significant incidents, provide to the Contracting Officer a completed Contractor Significant Incident Report (CSIR) using the CSIR form that can be downloaded from the Navy Crane Center Website. Provide the intial report no later than 24 hours, and final report within 5 days.

SIGNIFICANT INCIDENTS (ACCIDENTS) INVOLVING CONTRACTOR WEIGHT

HANDLING EQUIPMENT ON THE GOVERNMENT WORKSITE:

Notify the Contracting Officer as soon as practical, but no later than 4 hours after a significant incident. Within 30 days of a weight handling accident, provide to the Contracting Officer a completed Crane and Rigging Gear Accident Report using the form provided in Appendix E.

NAVCRANECEN

SHIPYARD

DCMA

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

4. AUTHORITY

OT-24206

5. CONTRACT REFERENCE

a. ADDRESSEE

10. FREQUENCY

ONE/R

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

Appendix E

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

See Block 16

60T Portal Crane Modernization N62470-14-R-5001

1. DATA ITEM NO.

A016

2. TITLE OF DATA ITEM

Contractor Significant Incident Reporting

A

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Reg Electronic

F. CONTRACTOR

3. SUBTITLE

NAVCRANECEN

Exhibit A Page 19 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

15. TOTAL

16. REMARKS

Completed Shop Inspection Record and Deficient Items List shall be submitted within 5 days of completion of Inspection and prior to mobilization. NAVCRANECEN will determine acceptability within 14 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

Completed Field Acceptance Test Record and Final Punchlist shall be submitted within 5 days of completion of test. NAVCRANECEN will determine acceptability within 14 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

The crane serial number, contract number, CDRL number and CLIN number shall be included on submitted documentation.

Data shall be submitted electronically.

Note: Government approval of Shop Inspection Record and Deficient Items List and is required prior to mobilization.

NAVCRANECEN

SHIPYARD

DCMA

J. DATE

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

4. AUTHORITY

DI-NDTI-80809B

5. CONTRACT REFERENCE

a. ADDRESSEE

10. FREQUENCY

ONE/R

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

Para. 1.4, SD-08.3, 09.2, 09.3; Para.

2.8.1, 3.1, 3.6.1, 3.6.2

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

See Block 16

60T Portal Crane Modernization N62470-14-R-5001

1. DATA ITEM NO.

A017

2. TITLE OF DATA ITEM

Test Procedures and Reports

A

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

A. CONTRACT LINE ITEM NO. B. EXHIBIT

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Reg Electronic

F. CONTRACTOR

3. SUBTITLE

NAVCRANECEN

Exhibit A Page 20 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

NAVCRANECEN

SHIPYARD

DCMA

F. CONTRACTOR

3. SUBTITLE

NAVCRANECEN

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

A. CONTRACT LINE ITEM NO. B. EXHIBIT

0001 A

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

60T Portal Crane Modernization N62470-14-R-5001

1. DATA ITEM NO.

A018

2. TITLE OF DATA ITEM

Crane Installation Plan

6. REQUIRING OFFICE4. AUTHORITY

OT-24206

5. CONTRACT REFERENCE

Para. 1.4, SD-08.2: Para. 3.4.3, & Appendix D

a. ADDRESSEE

10. FREQUENCY

ONE/R

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

Reg ElectronicSee Block 16

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

15. TOTAL

16. REMARKS

Provide a detailed removal, installation lift & rigging plan in accordance with blocks 4 and 5 a minimum of 15 days prior to Pre-installation Conference, but no later than 30 days prior to mobilization should the conference be delayed. The pre-installation conference shall be conducted a minimum of 30 days prior to mobilization.

NAVCRANECEN will determine acceptability within 14 days after receipt. All subsequent Government review periods shall be complete within 7 days of receipt of resubmission.

Plans shall be submitted electronically.

Note: Government approval required by earlier event of: 2 days prior to mobilization or 7 days prior to desired entry of Contractor Mobile crane or material handling equipment.

12/4/2013 DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1

G. PREPARED BY

Dave Cadieux, P.E.

I. APPROVED BY

Chuck Cotton, P.E.

J. DATE

Exhibit A Page 21 N62470-14-R-5001

LT

8. APPL CODE

A 1 0 1 0 0 0

2 0

H. DATE

12/4/2013

1059/183

NAVCRANECEN

SHIPYARD

DCMA

F. CONTRACTOR

3. SUBTITLE

NAVCRANECEN

Form Approved OMB No. 0704-0188

C. CATEGORY

Public reporting burden for this 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 govermnent Issuing Contracting Officer for the Contract/PR No. listed in Block E.

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

A. CONTRACT LINE ITEM NO. B. EXHIBIT

0001 A

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

60T Portal Crane Modernization N62470-14-R-5001

1. DATA ITEM NO.

A019

2. TITLE OF DATA ITEM

Accident Prevention Plan

6. REQUIRING OFFICE4. AUTHORITY

OT-24206

5. CONTRACT REFERENCE

Para. 1.4, SD-08.4, Appendix E

a. ADDRESSEE

10. FREQUENCY

ONE/R

14. DISTRIBUTION9. DISTRIBUTION

STATEMENT

Reg ElectronicSee Block 16

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT SUBM.

See Block 16

15. TOTAL

16. REMARKS

Provide an Accident Prevention Plan (APP) written by the contractor for the specific work and hazards of the contract and in accordance with blocks 4 and 5.