RMAS_EXHIBIT_E_CDRL E001_CCIR_Draft.pdf

DRAFT

PREVIOUS EDITION MAY BE USED.

DD FORM 1423, FEB 2024 Page 1 of 2

UNCLASSIFIED

UNCLASSIFIED

CONTRACT DATA REQUIREMENTS LIST

A. CONTRACT LINE ITEM NO. B. EXHIBIT

E

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Recruiting, Mgmt, &Admn Support Services

E. CONTRACT/PR NO.

W15QKN-26-R-A014

F. CONTRACTOR

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

Accident Incident Report

3. SUBTITLE

Commander's Critical Incident Report (CCIR)

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-82188

5. CONTRACT REFERENCE

See Block 16

6. REQUIRING OFFICE

SFAE-PSE-HS

7. DD 250 REQ

DD

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

N/A

12. DATE OF FIRST SUBMISSION

ASREQ

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

16. REMARKS

KO = Contracting Officer COR-RA = Contracting Officer's Representative at the Requiring Activity COR-HRS = Contracting Officer's Representative at HR Solutions R-MAS = Recruiting, Management, and Administrative Support TO = Task Order All submissions shall be electronic (email).

Block 5: RMAS Base Contract PWS paragraphs 4.1.4.4 & 4.1.9 Block 10: Frequency is one email report per reportable incident Block 12: Submission is required one (1) business day after the incident occurred, except for incidents of breach of sensitive information (PII or classified), which shall be reported immediately upon discovery.

Block 13: Weekly follow-up submissions are required until the issue is resolved/position is filled.

Data Item Description Revisions:

1. Format: Figure 1 is replaced with the following format:

a. Report Date:

b. Type/Nature of Incident/Event: (Any Matter, Development, Serious Concern or Issue that May Require the Input or Awareness of HR Solutions Leadership)

c. Date/Time of Incident/Event:

d. Location(s): (The location where the incident took place)

e. Personnel Involved:

f. Description of Incident/Issue: (What and how the incident happened, and the impact)

g. Actions Taken:

h. Actions Needed to Close the Incident Report:

i. Additional Remarks:

j. Media Coverage:

k. Point of Contact: (Include full name, title, telephone and email address)

l. Individual Reporting: (Include full name, title, telephone and email address)

2. Content: The report shall contain all of the information in the revised Figure 1.

3. Section 2.1 is replaced with the following:

2.1 The Report shall identify incidents resulting in any one or more of the following:

2.1.1 Death/serious injury to contractor personnel while on duty

2.1.2 Allegations of sexual assault/harassment involving contractor personnel

2.1.3 Allegations of assault/harassment involving contractor personnel

2.1.4 Any reports/allegations of inappropriate or unprofessional behavior of contractor personnel

2.1.5 Allegations of inappropriate Government interference in contractor operations

2.1.6 Loss or damage of Government property

2.1.7 Any incident/accident that significantly impacts contractor performance

2.1.8 Any change in contractor task order key personnel

2.1.9 Any breach of sensitive information (PII or classified)

2.1.10 Drug/Controlled Substance related activity

2.1.11 Media Issues that are urgent, compelling that could affect Soldiers, Army, PEO EIS, HR Solutions' image

4. Sections 2.2 through 2.5 are deleted.

KO 1

COR-RA 1

COR-HRS 1

HR Solutions Portal 1

HRS Director 1

15.TOTAL 5

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY

Monika Watkins

H. SIGNED ON 20260408 I. APPROVED BY

Maria B Bird

J. SIGNED ON 20260409

WATKINS.MONI

KA.1394925825

Digitally signed by

WATKINS.MONIKA.1394925825

Date: 2026.04.08 13:29:35 -04'00'

BIRD.MARIA.BERN

ADETTE.1140358726

Digitally signed by

BIRD.MARIA.BERNADETTE.114035

Date: 2026.04.09 16:25:40 -04'00'

DRAFT

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoDM 5010.12 for detailed instructions.)

DD FORM 1423, FEB 2024 Page 2 of 2

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package; TM - Technical Manual; Other - other category of data, such as "Provisioning," "Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support (e.g., Mission Design Series (MDS) designator).

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Name of preparer of CDRL.

Item H. Date CDRL was prepared and signature of preparer of CDRL.

Item I. Name of CDRL approval authority.

Item J. Date CDRL was approved and signature of CDRL approval authority.

Item 1. See DFARS Subpart 204.71 for proper numbering. To add or delete additional data items, point and click the plus or minus sign to the right of Block J.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Identify only one Data Acquisition Document No. If a single work task generates more than one deliverable data product, prepare a separate data item for each deliverable data product.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work/Performance Work Statement paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data and computer software, specify the contractor's requirement to mark the appropriate distribution statement on the technical data or computer software (ref. DoDI 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14; Desired medium for delivery of the data item.

Identify for which data item additional remarks are provided. When tailoring the Data Acquisition Document invoked in Item 4, identify which portions of that Document are being tailored.

Identify any referenced attachments to the form. Attachments can be added using the button at the bottom of page 1.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government’s rights to use the data shall be governed by the pertinent provisions of the contract.