DD14231_A005_CSR.pdf
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- Program Support Services for DARPA's Tactical Technology Office (TTO) Federal contract opportunity
- Solicitation number
- N65236-16-R-0021
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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
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:
TDP ________ TM _______ OTHER
D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR
16. REMARKS (Continued)
DD FORM 1423-1, FEB 2001 Page of Pages
Employees&Labor
Type (Per) michelle.deforest: govt:
Personnel Type:
N = New addition C = Currently working R = Released Employee Name (Last, First) Company Name Task Order # Name of Pgrm/Proj Supporting Task Order COR PWS Para # Total Proposed Labor Hrs michelle.deforest: govt:
Proposed Labor Hrs = estimated hours that were proposed prior contract/TO award; may only be adjusted during contract/TO modification.
Number should correspond to hours reported in CSR-TOSR CDRL Attachment 2 Monthly Actual Labor Hrs worked michelle.deforest: govt:
Number should correspond to hours reported in CSR-TOSR CDRL Attachment 2 Cummulative Actual Labor Hrs worked % Hours Used to date
N LastA, First1 ABCDwarf Co. 0021 Green River ISEA Brown 3.5 700 90 380 54%
C LastB, First2 ABCDwarf Co. 0021 Green River Sys Smith 5.1 300 20 120 40%
R LastC, First3 PoisonApple Inc 0021 XYZ Project Brown 3.2 1080 150 660 61%
C LastB, First2 ABCDwarf Co. 0004 ABC Pgrm Allen 5.1 200 12 50 25%
N65236-##-D-####/ TO ####
Period of Performance: mm/dd/yy to mm/dd/yy
| TO Completion Date: mm/dd/yy | Staffing Plan -- Employees and Labor |
| COR: John Doe Engineer |
COR contact phone #: ###-###-#### File Name: &F
* FOR OFFICIAL USE ONLY -- Privacy sensitive.
Any misuse or unauthorized disclosure can result in both Civil and Criminal Penalties. Page &P of &N
Key Personnel
Employee Name (Last, First) Company Name Task Order # Key Pesonnel Labor Category (Y) Resume Approval Date (mm/dd/yy) Release Date (mm/dd/yy)
LastA, First1 ABCDwarf Co. 0 Y 06/20/96
LastB, First2 ABCDwarf Co. 0 Y 06/20/96
LastC, First3 PoisonApple Inc 0 09/05/97 02/21/99
LastB, First2 ABCDwarf Co. 0 Y 06/20/96
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
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0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
| N65236-##-D-####/ TO #### | Key Personnel |
| &D |
Any misuse or unauthorized disclosure can result in both Civil and Criminal Penalties. &P of &N
Security
Employee Name (Last, First) Company Name Task Order # Security Clearance Required (Y/N) Investigation Type (NACI, SBI) NACI Equiv (Y/N) Date (mm/dd/yy) COR Approval
LastA, First1 ABCDwarf Co. 0 Y NACI Y 02/22/99 Y
LastB, First2 ABCDwarf Co. 0 Y SBI Y Y
LastC, First3 PoisonApple Inc 0 N
LastB, First2 ABCDwarf Co. 0 Y SBI Y Y
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
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0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
N65236-##-D-####/ TO #### Security Personnel Tracking &D
&10* FOR OFFICIAL USE ONLY -- Privacy sensitive.
Any misuse or unauthorized disclosure can result in both Civil and Criminal Penalties. &P of &N
ERP-CAC-SPAWAR BADGE
Employee Name (Last, First) Company Name Task Order # ERP ACCESS (Y/N) Type I= Initial R= Renewal T=Terminated O=Other Date CAC Issued (mm/dd/yy) Date CAC Expired (mm/dd/yy) CAC Returned (Y/N) Site Badge Date Issued (mm/dd/yy) Date Expried (mm/dd/yy) Badge returned (Y/N) Escort Priviledge (Y/N)
LastA, First1 ABCDwarf Co. 0 N I 06/20/96 02/21/99 Y
LastB, First2 ABCDwarf Co. 0 N I 06/20/96
LastC, First3 PoisonApple Inc 0 N T Y
LastB, First2 ABCDwarf Co. 0 N I 06/20/96 03/31/66 10/31/02
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
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0 0 0
0 0 0
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0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
N65236-##-D-####/ TO #### ERP, CAC, and SSC LANT Badge Tracking &D
Any misuse or unauthorized disclosure can result in both Civil and Criminal Penalties. &P of &N
Training
Employee Name (Last, First) Company Name Task Order # IA Awarness Training Required (Y/N) Date Due (mm/dd/yy) Date Completed (mm/dd/yy) Date SAAR Form Submitted (mm/dd/yy) Approved Access (Y/N) Privacy and PII Awarness Training Required (Y/N) Date Due (mm/dd/yy) Date Completed (mm/dd/yy)
LastA, First1 ABCDwarf Co. 0 Y 03/11/08 03/22/08 03/04/04 Y Y 03/11/08 03/22/08
LastB, First2 ABCDwarf Co. 0 Y
LastC, First3 PoisonApple Inc 0 N
LastB, First2 ABCDwarf Co. 0 Y
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
0 0 0
N65236-##-D-####/ TO #### Personnel Mandatory Training - IA, SAAR, and Privacy Act &D
Any misuse or unauthorized disclosure can result in both Civil and Criminal Penalties. &P of &N
Sheet1
Employee Code (123… or ABC...)
michelle.deforest: govt:
Contractor can protect Employee identity within this report by providing an Employee Code. If utilized, a separate email (Employee Key List) is required to the COR/OO specifiying Employee Name and corresponding code. Labor Category (IAW Basic Contract) Proposed B_Labor Hourly Rate michelle.deforest: govt:
B_Labor = Fully Burdened Labor
Proposed B_Labor = estimated hourly rate that was proposed prior contract/TO award; maybe adjusted during contract/TO modification. Total Proposed Labor Hrs michelle.deforest: govt:
Proposed Labor Hrs = estimated hours that were proposed prior contract/TO award; maybe adjusted during contract/TO modification.
Number should correspond to hours reported in CSR-TOSR CDRL Attachment 1 Monthly Actual B_Labor Cost Monthly Actual Labor Hrs worked michelle.deforest: govt:
Number should correspond to hours reported in CSR-TOSR CDRL Attachment 1 Actual B_Labor Hourly Rate michelle.deforest: govt:
B_Labor = Fully Burdened Labor
Actual B_Labor Rate = actual B_labor cost/actual B_labor hrs worked
NOTE TO CONTRACTORS:
Highlight employee row (selected row and fill color) if an actual B_labor hourly rate exceeds the specified labor rate threshold in the PWS (see Labor Rate Limitation Notification requirement). Current Month's Actual-to-Proposed Variation michelle.deforest: govt:
Contractor shall monitor monthly average actual labor rates (total actual fully burdened labor costs/total number of hours worked) compared to average negiotiated labor rates (total proposed fully burdened labor costs/total number of hours proposed)
Variation, hourly rate = (actual-proposed)/proposed
Variances greater than 15% in any reporting month are reported to COR through Limitation Notification CDRL.
Variances greater than 15% for 3 consecutive months are reported to COR through Limitation Notification CDRL. Previous Month's Actual-to-Proposed Variation Previous 2 Month's Actual-to-Proposed Variation
0001 Engineer 5 $ 98 700 $ 9,910 90 $ 110 12% 11% 14%
0002 Program Manager $ 110 300 $ 2,282 20 $ 114 4% 5% 7%
0003 Com Sys Analyst 3 $ 100 1080 $ 14,701 150 $ 98 -2% 0% 1%
0004 Program Manager $ 110 200 $ 1,368 12 $ 114 4% 5% 7%
N65236-##-D-####/ TO ####
Period of Performance: mm/dd/yy to mm/dd/yy TO Completion Date: mm/dd/yy Personnel Listing COR: John Doe Engineer COR contact phone #: ###-###-#### File Name: &F
Any misuse or unauthorized disclosure can result in both Civil and Criminal Penalties. Page &P of &N
Template Instructions - Example
Government Contractor Officer Representative e.g., DMR, GCCS-M 17 characters. No special characters. Enter 4 zero's when no task or delivery exists. Contract Modification Number that added item to contractor's stock as GFP. If was prime contract, enter zero. Contractor holding activity. Geographical location (address) and bldg/bin. Sample: San Diego, CA 92110; Old Town; Bldg 3, Bin 246A. Purchased, constructed, transferred in, loaned, etc. If item is a sub-category of GFE, enter "ST" or "STE" (Speccial Tooling or Special Test Equipment). If not, leave blank. Manufacturer's CAGE Code Part Number, usually found on the nameplate or receiving document. Serial Number, usally found on thenameplate or receiving document. Transaction Date for when item was received or shipped or when it was changed to 'on hand'. Sample: 01/10/2010 Quantity in (e.g., received) Quantitiy - Balance on hand. Quantity Out (e.g., shipped/issued/consumed/ disposed of) Original acquisition or historical cost. On Hand Subtotal $. Equals quantity on hand multiplied by $ value. Cognizance Code. 2-digit alphanumeric code prefixed to the NSN Part of the NSN, Federal Supply Class. Part of the NSN; National Item Identification Number. Noun Name, Description or Nomenclature. Accountable owner. Samples: SSC LANT 41354, PMW160, PMS485 e.g., DD1149, DD1348, receiving report number, purchase order, invoice number. Unit of Measure, Sample: EA For example: active or inactive (retired) staged, stored, in-transit, transferred, excess, awaiting disposal, disposed of. IUID Unique Item Identifier (UII)
COR email PGM Contract # and D.O. # Contract Mod # CTR Name Location ACQ Method ST/STE Mfr CAGE Code Part Number Serial No. Trans Date Qty Rcvd Qty O/H Qty Issued Value$ OH SBTL$ COG FSC NIIN DESCRIPTION SPONSOR Posting Ref UI Status UII john.henry@navy.mil ETVS FA877104D0004V726 0 Northrop Grumman 7040A Troy Hill Dr, Elkridge, MD 21075-7040 Purchased 25512 110023-023 Not Serialized 3/27/13 18 18 0 $1,240.84 $22,335.12 9T 5930 01-408-7577 FOOT SW ASSY, LINEMASTER 23 PMA213 DD1149 EA Active N/A john.henry@navy.mil ETVS FA877104D0004V726 0 Northrop Grumman 7040A Troy Hill Dr, Elkridge, MD 21075-7040 Loaned ST 25512 110666-001 Not Serialized 3/27/13 29 29 0 $3,951.48 $114,592.92 7E 5895 01-478-5179 POTS MODULE ASSY, NON-SPLIT PMA213 DD1149 EA Active N/A john.henry@navy.mil ETVS FA877104D0004V726 0 Northrop Grumman 7040A Troy Hill Dr, Elkridge, MD 21075-7040 Constructed STE 25512 110679-001 Not Serialized 3/27/13 41 41 0 $533.31 $21,865.71 5965 01-478-5202 SPEAKER MODULE ASSY, BEIGE PMA213 DD1149 EA Excess N/A
File name: Contract # and D.O. #_COR_YRMODA
GFP Report Template
COR email PGM Contract # and D.O. # Contract Mod # CTR Name Location ACQ Method ST/STE Mfr CAGE Code Part Number Serial No. Trans Date Qty Rcvd Qty O/H Qty Issued Value$ OH SBTL$ COG FSC NIIN DESCRIPTION SPONSOR Posting Ref UI Status UII
| 1_DATA_ITEM_NO: A005 |
| 2_TITLE_OF_DATA_ITEM: Contract Status Reports (CSR) |
| 3_SUBTITLE: |
| 4_AUTHORITY_Data_Acquisit: DI-MGMT-80227/80368 (guidance) |
| 5_CONTRACT_REFERENCE: PWS Para #5.2.1.1 |
| 6_REQUIRING_OFFICE: |
| 7_DID_250_REQ: LT |
| 8_APP_CODE: N/A |
| DIST_STATEMENT: N./A |
| 10_FREQUENCY: MTHLY |
| 11_AS_OF_DATE: See BLK 16 |
| 12_DATE_OF_FIRST_SUBMISSI: See BLK 16 |
| 13_DATE_OF_SUBSEQUENT_SUB: See BLK 16 |
| addressee1: CRM |
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| reg1: 1 |
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| addressee2: TO COR's |
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| addressee3: TTO ADPM |
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| addressee5: As reqd, GFP list |
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| addressee6: shall be emailed |
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| 16_REMARKS: NOTE: This CDRL includes Attachment 1 - Staffing Plan and Attachment 2 - Personnel Listing, and Attachment 3 - GFP Template which are templates that contain the minimum data fields to be collected (as applicable) throughout the contract life and updated monthly. Latest version of all Attachments will be provided by the KO. Although there may be some pre-set cell configurations, formulas, and/or links established within the templates, the validity of the information reported to the govt. is ultimately the contractor's responsibility. |
BLK 11: Reporting period ends at end of each month
BLK 12: Due at least 30 days after Contract award date and on the 15th of the following month.
BLK 13: Due NLT 15th of each month following the end of each reporting period.
BLK 14: CRM will perform inspection and acceptance and report any discrepancies to KO and contractor. Additional recipients/addressees of CDRL are all COR's identified at TO level and the DARPA/TTO ADPM.
The CSR CDRL shall be e-mailed to the addressee(s) identified in BLK 14. The document file name and e-mail subject line shall conform to the following format: [contract number]_[contractor name]_CSR_[yyyymmdd (end date of reporting period)].
Example: N6523613D2000_ABC Acme Inc_CSR_20130430
Any deviations to the information collected, distribution, frequency, and due dates of reporting shall be specified in the PWS. If a contract is funded with multiple funding CLINs, contractor shall be prepared to present data based on funding CLIN.
The following sheet lists the required data to be delivered for the monthly CSR.
| 17_PRICE_GROUP: |
| ESTIMATED_TOTAL_PRICE: NSP |
| G_PREPARED_BY: |
| H_DATE: |
| 1_APPROVED_BY: |
| J_DATE: |
| Page: 1 |
| reg38t: 4 |
| A_CONTRACT_LINE_ITEM_NO: |
| B_EXHIBIT: |
| TDP: |
| TM: |
| OTHER: MGMT |
| DSYSTEMITEM: DARPA/TTO Program Support |
| E_CONTRACTPR_NO: N65236-16-R-0021 |
| FCONTRACTOR: TBD |
| 16_REMARKS_Continued: (a) Description [NOTE: If applicable, reporting shall be specific to appropriate funding CLIN.] |
• Contract Number and Title
• Contract Period of performance
• Current Month Reporting period dates
• List all contract Modifications, date of modification, summary sentence for each modification
• If GFP is applicable (at the basic contract level only), list GFP (use CDRL Attachment 3 - GFP Template) and include electronic copies of any new or revised paperwork (e.g., SGFP form, DD1149, snap shot of WAWF screen, etc.) validating official transfer and acceptance of GFP. Any NMCI assets assigned & used by the contractor outside govt spaces shall be separately listed. File name shall follow the following format: [contract number]_[COR name]_GFP_[yymmdd]. Unless otherwise directed, the GFP report shall also be sent to the following mailbox: SSCLANT_GFP_reporting.FCM@navy.mil NOTE: To avoid duplicate reporting -- for IDIQ contracts, GFP that is TO specific is specified in the TOSR CDRL; TO GFP should not be included in the CSR CDRL.
• List brief summary of contract status – note any basic contract problems and status of previously identified problems from last reporting period
(b) Schedule [NOTE: If applicable, reporting shall be specific to appropriate funding CLIN.]
• List each active TO, the associated PoP, and if it is currently on schedule, ahead of schedule, or behind schedule (with the projected "out of funds" date).
(c) Financial [NOTE: If applicable, reporting shall be specific to appropriate funding CLIN.]
• List all TO awarded, total NTE for each task order (by CLIN), funded amount, costs to date, and funds remaining.
(d) Business Relations
• list names of all subcontractors approved for use on contract, the effective date of approval, pending approval, and the type business firm (LB, SB/HBCU/MI, 8(a), SDB, HUBZONE, WOSB, VOSB, or SDVOSB)
(e) Staffing Plan/Key Personnel [NOTE: If applicable, reporting shall be specific to appropriate funding CLIN.]
• List all key personnel - include labor category, start date, and end date (if applicable). Note: The staffing plan/key personnel information is supplied in the TOSR CDRL; submittal of Attachment 1 and 2 is not required in the CSR CDRL.
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| STARNES.PRIDE.KEATON.1268511977 |
| 2016-08-22T14:10:57-0400 | |
| LIVINGSTON.JASON.M.1229881368 |
File details come from the government source that posted it.