DD14231_A006_TOSR.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
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 #### | 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
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 #### 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
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 #### 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: A006 |
| 2_TITLE_OF_DATA_ITEM: Task Order (TO) Status Reports |
| 3_SUBTITLE: |
| 4_AUTHORITY_Data_Acquisit: DI-MGMT-80227/80347 (guidance) |
| 5_CONTRACT_REFERENCE: See BLK 16 |
| 6_REQUIRING_OFFICE: |
| 7_DID_250_REQ: LT |
| 8_APP_CODE: N/A |
| DIST_STATEMENT: N./A |
| 10_FREQUENCY: See BLK 16 |
| 11_AS_OF_DATE: See BLK 16 |
| 12_DATE_OF_FIRST_SUBMISSI: See BLK 16 |
| 13_DATE_OF_SUBSEQUENT_SUB: See BLK 16 |
| addressee1: COR |
| draft1: |
| reg1: 1 |
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| addressee2: TTO ADPM |
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| reg2: 1 |
| repro2: |
| addressee3: DARPA PM |
| draft3: |
| reg3: 1 |
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| addressee4: As reqd, GFP list |
| draft4: |
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| addressee5: shall be emailed |
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| addressee6: to functional |
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| 16_REMARKS: NOTE: The CDRL includes Attachment 1 -- Staffing Plan, Attachment 2 -- Personnel Listing, and Attachment 3 -- GFP Template which are templates that contain the minimum data fields to be collected at the TO level as applicable. Latest version of all Attachments will be provided by the Ordering Officer (OO). Although there may be some pre-set cell configuration, formulas, and/or links established within the templates, the validity of the information reported to the govt is ultimately the contractor's responsibility. |
BLK 5: PWS Para 5.2.1.#2(a) is Monthly TOSR; PWS Para 5.2.1.2(b) is Weekly TOSR; PWS Para 5.2.1.2(c) is Data Calls; PWS Para 8.1.2; 11.2.5.1
BLK 10: As specified by TO -- MTHLY, WKLY, and/or ASREQ
BLK 11: (a) MTHLY, reporting period ends at end of each month;
(b) WKLY, reporting period ends at end of each week;
(c) ASREQ, as specified by TO
BLK 12: (a) MTHLY, due at least 30 days after TO award date (15th of month);
(b) WKLY, due first Friday following first full week after TO award;
(c) ASREQ, as specified by TO
BLK 13: (a) MTHLY, due NLT 15th of each month;
(b) WKLY, due COB Friday of each week;
(c) ASREQ, as specified by TO
BLK 14: COR will perform CDRL inspection and acceptance and report any discrepancies to the KO/Ordering Officer and the contractor. Additional recipients/addressees of CDRL may be identified at TO level.
The TOSR 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-TO number]_[contractor name]_TOSR_[yyyymmdd (end date of reporting period)].
Example: N6523613D2000-TO 0065_ABC Acme Inc_TOSR_20130430
Any deviations to the information collected, distribution, frequency, and due dates of reporting shall be specified by TO. If a TO 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 TOSR.
| 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: (i). Performance [NOTE: If applicable, reporting shall be specific to appropriate funding CLIN.] |
• Contract Number & Title; Contract Period of Performance
• TO Number & Title
• TO Period of performance & Current Month Reporting period dates
• List all TO level Modifications, date of modification, sentence summary for each modification
• List total labor hours expended (current and cumulative) per company
• Identify and itemize specifics if travel, other direct cost (ODC), equipment/material (CAP), and subcontracting were required
• If GFP is applicable, 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 contractors outside govt spaces shall be listed separately. File name shall follow the following format: [contract number-TO number]_[COR name]_GFP_[yymmdd]. Unless otherwise directed, the GFP report shall be sent to the following mailbox: SSCLANT_GFP_reporting.FCM@navy.mil
• Summary of work performed during reporting period, problems noted, status of previously identified problems from last reporting period; and effort to be completed during next reported period
(ii). Schedule [NOTE: If applicable, reporting shall be specific to appropriate funding CLIN.]
• IAW TO QASP and/or CWBS, develop/update Plan of Action and Milestone (POA&M) that outlines and identifies schedule/dates for all major/critical tasks and sub-tasks
• Identify meeting specified milestones and action items
• Identify schedule slippage and problems areas that may affect schedule
• List all CDRL's due and status of deliverables
(iii). Financial [NOTE: If applicable, reporting shall be specific to appropriate funding CLIN.]
• List the Not-to-Exceed (NTE) TO amount and the balance of funds received to date – list any increase of NTE and additional funds received by TO Modification number
• List total labor cost (current and cumulative) per company
• List total Other Direct Costs (ODCs) expended (current and cumulative) per company
• List total Subcontracting (current and cumulative) itemized by company
• List total Travel expended (current and cumulative) per company
• List total Material expended (current and cumulative) per company
• List total Fee expended (current and cumulative) per company
• List total remaining TO ceiling amounts: labor hours, costs, fee, and total NTE
• List estimated total cost to complete; noting shortages or overages
• Applicable for cost reimbursement type TOs – identify when obligated costs have exceeded 75% of the amount authorized (Note: Identifying cost overruns in the monthly status reports does not preclude a Contractor from the 75% notification requirement as applicable in accordance with FAR clause 52.232-20/22, Limitation of Cost/Funds or for immediate notification to the government when all funds have been expended prior to work being completed on a task order)
(iv). Business Relations
• List names of all subcontractors approved for use on the TO, the effective date of approval, and the type business firm (LB, SB/HBCU/MI, 8(a), SDB, HUBZONE, WOSB, VOSB, or SDVOSB)
(v). Staffing Plan/Key Personnel [NOTE: If applicable, reporting shall be specific to appropriate funding CLIN.]
• Utilize the Staffing Plan document, CDRL Attachment 1 (Excel workbook) - list all personnel charging to the TO, including subcontractors. Data subsets shall include the following but not limited to: Employee and labor hours, Key Personnel, Security clearance, CAC/SPAWAR/ facility Badge if applicable, and Training (Privacy Act, IA, etc.). For wholly cost-type, labor-hour service TOs (n/a for wholly FFP), utilize Personnel Listing document, CDRL Attachment 2 (Excel spreadsheet), identify employees charging to the TO by Name or Employee Code, labor category, proposed and actual burdened labor rate (highlight employee's name if actual burdened labor rate exceeds labor rate as specified in the PWS). If an employee coding system is utilized in Attachment 2, the contractor shall provide by separate encrypted e-mail, an Employee Key List that identifies the Employee by name and by employee code to the COR and KO. Note 1: Due to sensitivity of information between prime and subcontractor, subcontractor’s employee names and loaded hourly rates as specified in Attachment 2 can be e-mailed directly to COR and KO. The document file name and e-mail subject line shall conform to the following format: [contract number]_[subcontractor name]_Staffing Plan_[yyyymmdd (end date of reporting period)]. Note 2: Although the staffing plan & personnel listing are TO specific, the COR and OO have the right to review the comprehensive staffing plan and personnel listing for the whole contract at any time.
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File details come from the government source that posted it.