CDRL_A004_Contractors_Personnel_Roster.RA30.DID.pdf

CONTRACT DATA REQUIREMENTS LIST

(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 the 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 Contractor Officer for the Contract/PR No. Listed in Block E.

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY:

TDP _________ TM- _________ OTHER MGMT

D. SYSTEM / ITEM

Environmental Resource Service

E. CONTRACT / PR NO.

TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

CONTRACTOR’S PERSONNEL ROSTER

3. SUBTITLE

Personnel Roster

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81834 (see blk 16)

5. CONTRACT REFERENCE

SOW PARA 6.6

6. REQUIRING OFFICER

NSWC Corona RA30

7. DD 250 REQ.

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

LT MTHLY SEE BLK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE

Draft

Final

N/A N/A SEE BLK 16 Reg Repro

16. REMARKS

Blk 4 – The contractor shall use the excel spreadsheet provided by the COR/POC to deliver the requested information.

Blk 9 - "DISTRIBUTION STATEMENT C: Distribution authorized to U. S.

Government agencies and their contractors only (Administrative Use). (08 May

2013). Other requests for this document shall be referred to the Naval Surface

Warfare Center, Corona Division, CA, RA30"

Blk 10, 12, 13 - The reporting period for the personnel roster shall be within 30 calendar days after effective date of order. Subsequent reports shall be submitted monthly thereafter, not later than the 10th day of the reporting month.

Blk 14 - Electronic copy shall be by e-mail in Microsoft Excel format.

RA30 COR or

POC

15. TOTAL 1

G. PREPARED BY

M.Tao

H. DATE

8/28/2014

I. APPROVED BY

Kimberly Brayton

J. DATE

09/11/2014

DD Form 1423–1, FEB 2001 Previous editions are obsolete Page __1__ of __1__ Pages

DATA ITEM DESCRIPTION

Title: CONTRACTOR'S PERSONNEL ROSTER

Number: DI-MGMT-81834A Approval Date: 20130118

AMSC Number: N9316 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: N/A

Office of Primary Responsibility: SH/MS10

Applicable Forms: N/A

Use/relationship:

This roster shall be used to list all contractor personnel assigned to the contract.

This Data Item Description (DID) contains the content and preparation instructions for data product resulting from the work task specified in the contract.

Requirements:

1. Format. The Roster shall be in contractor’s format.

2. Content. The Roster shall contain an alphabetical listing of the names of all contractor personnel assigned to the contract.

2.1 The roster shall identify the following for each employee:

a. Change Status: Add/Change/Remove

b. Start Date

c. End Date

d. First Name

e. Middle Name

f. Last Name

g. Position Title

h. Email Address

i. Work Phone Number

j. Physical Work Location – Base Name

k. Physical Work Location - City

l. Physical Work Location - State

m. Physical Work Location – Building Number

n. Physical Work Location – Room Number

o. Contract Number

p. Contract Name

q. Contracting Supervisor

r. Government Support POC

s. Supporting Code

2.2 The roster shall identify work schedules for full time and part time employees and shall include current CAC and clearance information for each.

3. End of DI-MGMT-81834A.