Attachment 2. CDRL A001-A004.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.

B. EXHIBIT

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER __X__

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

17. PRICE GROUP

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Contractor's progress, Status & Management Report

3. SUBTITLE

ACTIVITY STATUS REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80227

5. CONTRACT REFERENCE

PWS Para. 3.0

6. REQUIRING OFFICE

18. ESTIMATED TOTAL PRICE

7. DD 250 REQ

LT

9. DIST

STATEMENT

D

10. FREQUENCY

MONTHLY

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

16. REMARKS

Block 4: Create reports using MS Office applications. Did para 10.3L does not apply.

BLK 9 - The following information shall be included on the deliverable: DISTRIBUTION STATEMENT D: Distribution authorized to the DoD and U.S. DoD contractors only; (Critical Technology); Other requests shall be referred to SPAWAR Systems Center Pacific (Code 56450).

Blocks 10, 12, & 13: provide first report NLT 45 working days after completion of first full accounting period. Every four weeks thereafter; NLT 10 working days after reporting period.

Blk 14: Submit via email to each addressee in block 14.

Code 52320: Matt Waller matthew.waller@navy.mil

Code 52320

G. PREPARED BY

Elaine Shoemaker

H. DATE

5/24/2018

I. APPROVED BY

Elaine Shoemaker

J. DATE

5/24/2018

CONTRACT DATA REQUIREMENTS LIST

Form Approved

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.

B. EXHIBIT

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER __X__

D. SYSTEM/ITEM

LCS Mission Module Support

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Site Survey Report (SSR)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-82104

5. CONTRACT REFERENCE

PWS para 3.0

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST

STATEMENT

D

10. FREQUENCY

See Blk 16

12. DATE OF 1ST SUBMISSION

See Blk 16

14. DISTRIBUTION

8. APP CODE

N/A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT SUBMISSION See Blk 16

16. REMARKS

Blk 4: Create using MS Office applications in contractor format. The SSR shall contain the following:

Title to include:

CDRL Data Item Number Base Name Identification fo Project Contract Number Date

Results. The Results section shall be the main body of the report. It shall contain a complete listing of the contractor’s findings. This section shall include a summary of all anticipated minor construction required, findings on cable routes, and distances, and other pertinent information. This section shall fully document and explain any other findings concerning on-site conditions in this section.

Conclusions and recommendations. This section shall summarize the results of the survey and present conclusions. The conclusion shall also identify any discrepancies between the contract and survey results. This section shall contain any recommendations that contractor has based on the survey. Any actions required from the Government by the contractor shall be noted here.

BLK 9 - The following information shall be included on the deliverable: DISTRIBUTION STATEMENT D: Distribution authorized to the DoD and U.S. DoD contractors only; (Critical Technology). Other requests shall be referred to SPAWAR Systems Center Pacific (Code 56450).

Blk 10, 11, 12, 13: One report per site. Submission shall be NLT 5 Days after site survey.

Blk 14: Provide electronic copies to each addressee in block 14.

Code 52320: Matt Waller matthew.waller@navy.mil

Code 52320

G. PREPARED BY

Elaine Shoemaker

H. DATE

5/24/2018

I. APPROVED BY

Elaine Shoemaker

J. DATE

5/24/2018

CONTRACT DATA REQUIREMENTS LIST

Form Approved

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.

B. EXHIBIT

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER __X__

D. SYSTEM/ITEM

LCS Mission Module Support

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Management Plan

3. SUBTITLE

Plan Of Action and Milestones (POAM)

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-8004A

5. CONTRACT REFERENCE

PWS para 3.1

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST

STATEMENT

D

10. FREQUENCY

MTHLY

12. DATE OF 1ST SUBMISSION

45 DAC

14. DISTRIBUTION

8. APP CODE

N/A

11. AS OF DATE

See blk 16

13. DATE OF SUBSEQUENT SUBMISSION See Blk 16

16. REMARKS

Blk 4: Create using MS Office applications in contractor format.

The POAM shall consist of the organizational structure, the assignment of functions, duties, and responsibilities, the procedures and policies and the reporting requirements that are established for the initiation, monitoring, control, completion, test and verification, and reporting of contractual tasks, projects, and programs.

The plan include a narrative description of the technical approach or methods the contractor will employ to accomplish contractual tasks, projects, and programs, including, as applicable, development, tests, manufacture, construction, formulation, installation, logistics support, training, maintenance documentation, and configuration controls.

The plan shall include a milestone chart graphically depicting the schedule of events associated with accomplishing each contractual commitment.

The plan shall also describe the staffing required for proper accomplishment of each contractual task by skill type, skill level, number of personnel, and security clearance. When submitted as part of a proposal, the plan shall state how many such personnel are currently available and how many new hires are required to staff fully to accomplish each task as scheduled.

BLK 9 - The following information shall be included on the deliverable: DISTRIBUTION STATEMENT D: Distribution authorized to the DoD and U.S. DoD contractors only; (Critical

Blocks 10, 11, 12, & 13: Provide POAM NLT 45 Days after contract award. Report shall be updated every 30 calendar days after the initial submission.

Blk 14: Provide electronic copies to each addressee in block 14.

Code 52320

G. PREPARED BY

Elaine Shoemaker

H. DATE

5/24/2018

I. APPROVED BY

Elaine Shoemaker

J. DATE

5/24/2018

CONTRACT DATA REQUIREMENTS LIST

Form Approved

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.

B. EXHIBIT

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER __X__

D. SYSTEM/ITEM

LCS Mission Module Support

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

Progress Report

3. SUBTITLE

Daily Site Activity Report

4. AUTHORITY (Data Acquisition Document No.)

DI-ADMIN-81313A

5. CONTRACT REFERENCE

PWS para 3.0

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST

STATEMENT

D

10. FREQUENCY

Daily

12. DATE OF 1ST SUBMISSION

3 DAC

14. DISTRIBUTION

8. APP CODE

N/A

11. AS OF DATE

3 DAC

13. DATE OF SUBSEQUENT Daily

16. REMARKS

Blk 4: Create using MS Office applications in contractor format.

The report will include:

The work accomplished on the project during the reporting period, including theoretical studies conducted, results of these studies, and how they apply to the project. This discussion shall be broken down by functional component in the same manner as is done on program charts or other reports required.

A summary of the status of the project including statement(s) as to whether the work is on schedule and if not, efforts planned to meet the schedule.

Other information which may cause a significant change in the work schedule

Graphs, drawings, photographs, and other graphic material showing results/statusof the study for the period of time covered by the report.

Recommendations and proposals.

BLK 9 - The following information shall be included on the deliverable: DISTRIBUTION STATEMENT D: Distribution authorized to the DoD and U.S. DoD contractors only; (Critical

Blk 14: Provide electronic copies to each addressee in block 14 .

Code 52320

G. PREPARED BY

Elaine Shoemaker

H. DATE

5/24/2018

I. APPROVED BY

Elaine Shoemaker

J. DATE

5/24/2018