Enviromental_Testing_CDRL_20180813.pdf

Page _____ of _____ Pages

OTHER ____________________TM ______TDP _______

B. EXHIBIT

A

A. CONTRACT LINE ITEM NO.

0 4 0

BLOCK 4: The MSR shall be submitted electronically and consist of three parts. The first part shall be provided in the Excel format of CDRL Attachment 1 and 2 with all cells filled in. The third part shall be provided in Word format and consist of a narrative addressing, at a minimum:

a. Performance Status - Identify significant accomplishments and progress made during the affected reporting period by SOW/PWS paragraph. Also identify significant challenges or risks encountered that impact the successful delivery of required services.

b. Schedule Status - Identify schedule for and status of all deliverables. If the efforts are not on schedule, indicate the reason for the delay and provide a revised completion /delivery date.

c. Financial Status - Identify at a summary level the total amount received to date, planned vs actual burn and Estimate At Completion (EAC) in addition to the reporting requirements identified in Attachment 1. This description does not waive the requirement for formal Limitation of Funds/Cost notifications, when warranted.

d. Personnel Status/Staffing Plan - Identify by name, labor category, labor hours planned for each employee charging to the contract/task order by SOW/PWS paragraph and the actual cumulative total to date per Attachment 1.

e. Travel/ODC Status - Identify any travel accomplished with sufficient detail to support costs listed in Attachment 1. Additionally, provide a detailed description of other direct costs incurred.

BLOCK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests shall be referred to: COMMANDING OFFICER

SPACE AND NAVAL WARFARE SYSTEMS CENTER PACIFIC CODE 56442 SAN DIEGO

CA 92152-5001

BLOCK 10&11: MSR is due the 15th of each month and will include the previous month ending on the last day of the month. It submission should cover the same amount of time (ie 1-30/31 days).

BLOCK 12 & 13: The Contractor shall deliver the initial monthly report 45 DACA. Subsequent submissions due no later than 15 days after the end of the prior month. No Government response to the Report within 30 days of submission constitutes approval. approval.

BLOCK 14: Provide electronic copies via email as follows:

COR: COR See Clause 5252.201-9101 for COR’s email address TPOC: Submit to assigned government TPOC 22560: Contract Specialist. See block 6 of DD1155 for the contract specialists’ email address. Any Contracting Officer at SSC Pacific can change this point of contact via email notification to the contractor and without issuing a formal modification to this contract.

16. REMARKS

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.

C. CATEGORY:

D. SYSTEM/ITEM

UNMANNED MARITIME SUPPORT

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

NTS

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

CONTRACTOR'S PROGRESS, STATUS, AND, MANAGEMENT

REPORT

3. SUBTITLE

Monthly Status Report (MSR)

4. AUTHORITY

DI-MGMT-80227

5. CONTRACT REFERENCE

PWS para 3.0

6. REQUIRING OFFICE

SPAWARSYSCEN PAC 56400

17. PRICE

GROUP

11. AS OF DATE

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

18. ESTIMATED

TOTAL PRICE

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

M/F CODE 56442

COR

TPOC

CS

G. PREPARED BY

Micky Richeson

H. DATE

8/13/2018

I. APPROVED BY

Micky Richeson

J. DATE

8/13/2018

PREVIOUS EDITION MAY BE USEDDD Form 1423-1, FEB 2001 1 4

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

MTHLY

12. DATE OF 1ST SUBMISSION

SEE BLK 16

13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16

(Data Acquisition Document No.)

B. EXHIBIT

A

A. CONTRACT LINE ITEM NO.

0 3 0

BLOCK 4: Shall be submitted electronically and created using MS Office applications

BLOCK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests shall be referred to: COMMANDING OFFICER

SPACE AND NAVAL WARFARE SYSTEMS CENTER PACIFIC CODE 56442 SAN DIEGO

CA 92152-5001

BLOCK 12: Shall be submitted NLT 30 days after completion of contract.

BLOCK 14: See Clause 5252.201-9201 for COR's e-mail address.

16. REMARKS

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.

C. CATEGORY:

D. SYSTEM/ITEM

UNMANNED MARITIME SUPPORT

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

NTS

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

CONTRACT SUMMARY REPORT

3. SUBTITLE

4. AUTHORITY

DI-ADMN-80447A

5. CONTRACT REFERENCE

PWS para 3.0

6. REQUIRING OFFICE

SPAWARSYSCEN PAC 56400

17. PRICE

GROUP

11. AS OF DATE

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

18. ESTIMATED

TOTAL PRICE

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

M/F CODE 56442

COR

TPOC

G. PREPARED BY

Micky Richeson

H. DATE

8/13/2018

I. APPROVED BY

Micky Richeson

J. DATE

8/13/2018

PREVIOUS EDITION MAY BE USEDDD Form 1423-1, FEB 2001 2 4

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

1TIME

12. DATE OF 1ST SUBMISSION

EOC

13. DATE OF SUBSEQUENT

SUBMISSION N/A

B. EXHIBIT

A

A. CONTRACT LINE ITEM NO.

0 3 0

BLOCK 4: Shall be submitted electronically and created using MS Office applications

BLOCK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests shall be referred to: COMMANDING OFFICER

SPACE AND NAVAL WARFARE SYSTEMS CENTER PACIFIC CODE 56442 SAN DIEGO

CA 92152-5001

BLOCK 14: See Clause 5252.201-9201 for COR's e-mail address.

16. REMARKS

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.

C. CATEGORY:

D. SYSTEM/ITEM

UNMANNED MARITIME SUPPORT

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

NTS

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

TEST PROCEDURE

3. SUBTITLE

4. AUTHORITY

DI-NDTI-80603A

5. CONTRACT REFERENCE

PWS para 3.0

6. REQUIRING OFFICE

SPAWARSYSCEN PAC 56400

17. PRICE

GROUP

11. AS OF DATE

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

18. ESTIMATED

TOTAL PRICE

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

M/F CODE 56442

COR

TPOC

G. PREPARED BY

Micky Richeson

H. DATE

8/13/2018

I. APPROVED BY

Micky Richeson

J. DATE

8/13/2018

PREVIOUS EDITION MAY BE USEDDD Form 1423-1, FEB 2001 3 4

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

1TIME

12. DATE OF 1ST SUBMISSION

30DAC

13. DATE OF SUBSEQUENT

SUBMISSION N/A

B. EXHIBIT

A

A. CONTRACT LINE ITEM NO.

0 3 0

BLOCK 4: Shall be submitted electronically and created using MS Office applications

BLOCK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests shall be referred to: COMMANDING OFFICER

SPACE AND NAVAL WARFARE SYSTEMS CENTER PACIFIC CODE 56442 SAN DIEGO

CA 92152-5001

BLOCK 10, 12 & 13: Shall be submitted NLT 30 days after completion of each test.

BLOCK 14: See Clause 5252.201-9201 for COR's e-mail address.

16. REMARKS

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.

C. CATEGORY:

D. SYSTEM/ITEM

UNMANNED MARITIME SUPPORT

E. CONTRACT/PR NO.

TBD

F. CONTRACTOR

NTS

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

SCIENTIFIC AND TECHNICAL REPORTS

3. SUBTITLE

4. AUTHORITY

DI-MISC-80711A

5. CONTRACT REFERENCE

PWS para 3.0

6. REQUIRING OFFICE

SPAWARSYSCEN PAC 56400

17. PRICE

GROUP

11. AS OF DATE

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

18. ESTIMATED

TOTAL PRICE

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

M/F CODE 56442

COR

TPOC

G. PREPARED BY

Micky Richeson

H. DATE

8/13/2018

I. APPROVED BY

Micky Richeson

J. DATE

8/13/2018

PREVIOUS EDITION MAY BE USEDDD Form 1423-1, FEB 2001 4 4

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

SEE BLK 16

12. DATE OF 1ST SUBMISSION

SEE BLK 16

13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16