18Q0024 CDRL.docx

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item) 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 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.

TDP _ _ TM _ _ OTHER __X__

D. SYSTEM/ITEM

SSC Pacific Security Alarm

E. CONTRACT/PR NO.

N66001-18-P-0024

F. CONTRACTOR

17. PRICE GROUP

«PRICEG

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Monthly Status Report

3. SUBTITLE

Security Alarm Maintenance

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80227

5. CONTRACT REFERENCE

PWS 3.4

6. REQUIRING OFFICE

Code 8332018. ESTIMATED TOTAL PRICE

«ESTTO

7. DD 250 REQ

LT

9. DIST

STATEMENT

B.

10. FREQUENCY

Mthly

12. DATE OF 1ST SUBMISSION

See Blk 16

14. DISTRIBUTION

8. APP CODE

N/A

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See Blk 16

16. REMARKS

Blk 4 Contractor format acceptable. Monthly report for each System (System 1 & System 2), in Microsoft Office Format, of Maintenance performed and any Emergency Service and/or Material provided.

Blk 12/13 Report is due within fifteen days of end of month.

Blk 14 Please distribute the contracting officer and contract specialist.

Blk 16 Monthly Reports to be used to track progress of Preventive Maintenance and Testing required per OPNAV INSTRUCTION 5530.14C. Monthly Reports will also be used to provide Validation, Receipt, and Acceptance of Material and Emergency Services provided during Non-Business hours.

COR

ACOR

Code 22710

15. TOTAL ---------

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE