A001-Contractor's_Personnel_Roster.pdf

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Attached to
Landline Telecommunication Services Federal contract opportunity
Solicitation number
N63394-15-T-0096
Issued by
Department of the Navy Naval Sea Systems Command

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CDRL A001

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Text version

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications 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.

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

TDP ________ TM _______ OTHER

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page of Pages

1_DATA_ITEM_NO: A001
2_TITLE_OF_DATA_ITEM: Contractor's Personnel Roster
3_SUBTITLE:
4_AUTHORITY_Data_Acquisit: DI-MGMT-81834A
5_CONTRACT_REFERENCE: SOW para. 5.3.2
6_REQUIRING_OFFICE: NSWC PHD, Code 1022
7_DID_250_REQ: LT
8_APP_CODE: N/A
DIST_STATEMENT: C
10_FREQUENCY: See BLK 16
11_AS_OF_DATE: N/A
12_DATE_OF_FIRST_SUBMISSI: 10DAC
13_DATE_OF_SUBSEQUENT_SUB: See BLK 16
addressee1: COR
draft1: 0
reg1: 1
repro1: 0
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16_REMARKS: BLK 9: Distribution Statement C: Distribution authorized to U.S. Government agencies and their contractors; Operational Use, December 2015. Other request for this document shall be referred to Code 1022, NAVSURFWARCEN, 4363 Missile Way, Port Hueneme, CA 93043-4307.

WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979, as amended, Title 50, U.S.C., App. 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE - For classified documents, follow the procedures in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR COMMERCIAL PURPOSES IS FORBIDDEN.

BLK 10, 12 & 13: The Contractor's Personnel Roster shall be submitted 10 days after contract awarded and 10 days after each contract years thereafter or when an amendment is required.

BLK 14: Media Requirement: The report shall be submitted electronically via an E-Mail attachment utilizing Microsoft Office version 2003-2010.

E-mail Addresses:

COR - sharon.sanders@navy.mil

17_PRICE_GROUP:
ESTIMATED_TOTAL_PRICE:
G_PREPARED_BY: J.D. Monzon
H_DATE:
1_APPROVED_BY: K. F. Twyman
J_DATE:
Page: 1
reg38t: 1
A_CONTRACT_LINE_ITEM_NO:
B_EXHIBIT: A
TDP:
TM:
OTHER: MGMT
DSYSTEMITEM: NSWC PHD Telecommunication Services
E_CONTRACTPR_NO: N6339415SNU04
FCONTRACTOR:
of_pages: 3
Reset:
2015-07-29T15:48:53-0700
MONZON.JUSTO.DEJESUS.1171789482
2015-07-30T07:31:23-0700
TWYMAN.KARL.F.1230465882
2015-07-30T07:32:02-0700
TWYMAN.KARL.F.1230465882

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