Attachment_J.2_-_CDRL_A001_-_A004.pdf

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

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

X003 A

SP3300-14-X-XXXX

A001 Quality Control Plan

N/A SOW Paragraph 5.3

See Block 16 See Block 16 See Block 16

See Block 16 J-7 Contract Spec

COR

0 0 0

Tailored to permit Contractor's format. Submit electronically.

Submit a final site specific QCP not later than 30 calendar days after the start of full performance that details the Contractor's process for a quality system that is a prevention-based outlook and an approach to customer satisfaction that is proactive to meeting the objectives throughout all areas performance IAW paragraph 5.3.

The Contractor's QCP shall be maintained throughout the life of the contract and shall include the Contractor's procedures to routinely evaluate the effectiveness of the plan to ensure the Contractor is meeting the performance standards and requirements of the contract. Subsequent submissions shall be submitted when the Contractor updates or revises the QCP within 30 calendar days of the change.

Block 7 - Inspection and acceptance requirements:

The KO will review and accept the QCP and updates after coordination with the COR review and comments. The accepted plan and subsequent revisions will be incorporated into the contract by modifications.

Block 14 - Distribution - Contractor to submit original to Contract Specialist and copy to the COR.

See C-5.3 Quality Control Plan for required tasks.

24 Feb 2014

1 1

DEEM.NANCYE.S.10

77379521

Digitally signed by DEEM.NANCYE.S.1077379521 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=DLA, cn=DEEM.NANCYE.S.1077379521 Date: 2014.02.24 13:48:19 -05'00'

HODSON.PAUL.WA

RD.JR.1034639872

Digitally signed by

HODSON.PAUL.WARD.JR.1034639872

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=DLA, cn=HODSON.PAUL.WARD.JR.1034639872 Date: 2014.02.24 15:08:43 -05'00'

(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

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

X003 A

SP3300-14-X-XXXX

A002 Safety and Occupational Health (SOH)

N/A SOW paragraph 5.11

See Block 16 See Block 16 See Block 16

See Block 16 J-7 Contract Spec

COR

0 0 0

Tailored to permit contractor's format. Submit electronically. SOH program plan shall be submitted NLT 30 days after the start of full performance for the first submission. Changes to the SOH Plan that address the Contractor’s approach to conform to applicable Safety and Occupational Health Standards shall be submitted within 30 calendar days of the change.

The SOH Plan shall address the Contractor’s approach:

1. Developing and implementing systems to effectively identify, evaluate, prevent, and control occupational hazards to prevent employee injuries and illnesses through: management leadership and employee involvement; worksite analysis;

hazard prevention and control; and safety and health training.

2. For the Safety and Occupational Health Representative(s) to perform safety and occupational health management, surveillance, inspections, and safety program enforcement

3. To establish a Hazard Reporting Program

4. Conforming to the SOH standards consistent with the most stringent of applicable Federal, State, local regulations and the DLA Distribution Occupational Safety and Health Instruction.

5. To use ESAMS

Block 7 - Inspection and acceptance requirements:

The Contract Specialist will review and accept the SOH plans and updates after coordination with the COR and Installation Support Safety Office review and comments.

Block 14 - Distribution - Contractor to submit original to the Contract Specialist and copy to the COR.

24 Feb 2014

1 1

DEEM.NANCYE.S.10

77379521

Digitally signed by DEEM.NANCYE.S.1077379521 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=DLA, cn=DEEM.NANCYE.S.1077379521 Date: 2014.02.24 13:50:03 -05'00'

HODSON.PAUL.WA

RD.JR.1034639872

Digitally signed by

HODSON.PAUL.WARD.JR.1034639872

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=DLA, cn=HODSON.PAUL.WARD.JR.1034639872 Date: 2014.02.24 15:12:38 -05'00'

(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

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

X003 A

SP3300-14-X-XXXX

A003 Monthly Cost Report for CPFF CLIN Labor CLIN

N/A Section G, Paragraph C-4 DLA Distribution J7

See Block 16

B

Monthly

N/A

See Block 16

See Block 16 J-7 Contract Spec 1

COR 1

0 1 1

Tailored to permit contractor's format inclusive of all requirements below.

IAW Section G-4 - Invoicing Instructions - submitted not later than the fifth (5th) working day of each month covering the previous month's charges inclusive of all final subcontractor billings for the prior month.

For CLIN CPFF - Provide data for the following cost elements:

1) Labor; 2) Subcontracts; 3) All Overheads, including G&A ____%; 4) Profit/Fee

For the cost elements above, provide the following measurements on a monthly basis and on a cumulative basis:

1) Budget; 2) Actual Cost; 3) Incurred Cost; 4) Actual Cost of Work Performed (Actual + Incurred); 5) Variance (Budget – Actual)

For the cost elements above, provide the following measurements “At Completion”:

1) Revised Budget at Completion; 2) Revised Estimate at Completion; 3) Revised Variance

Compare Revised Estimate at Completion to Contract Value and provide Variance.

Provide a graphical representation of the above data.

Block 7 - Inspection and acceptance requirements:

The COR will review and accept CDRL A003.

Block 14 - Distribution - Contractor to submit original to COR and copy to the Contract Specialist.

6-17-18 6-17-18

1 1

DEEM.NANCYE.S.10

77379521

Digitally signed by DEEM.NANCYE.S.1077379521 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=DLA, cn=DEEM.NANCYE.S.1077379521 Date: 2014.01.10 14:01:47 -05'00'

DEEM.NANCYE.S.10

77379521

Digitally signed by DEEM.NANCYE.S.1077379521 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=DLA, cn=DEEM.NANCYE.S.1077379521 Date: 2014.01.10 14:02:00 -05'00'

(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

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

X003 A

SP3300-14-X-XXXX

A004 Monthly Cost Report for Material Support CLIN Material Support for FPIF

N/A Section G, Paragraph C-4 DLA Distribution J7

See Block 16

B

Monthly

N/A

See Block 16

See Block 16 J-7 Contract Spec 1

COR 1

0 1 1

Tailored to permit contractor's format inclusive of all requirements below.

IAW Section G-4 - Invoicing Instructions - submitted not later than the fifth (5th) working day of each month covering the previous month's charges inclusive of all final subcontractor billings for the prior month.

For CLIN - Material Support Costs for FPIF CLIN:

Provide data for the following cost elements:

1) Item Description

2) Cost

3) Material Handling OR G&A Rate ____%

4) Total Material Cost

Block 7 - Inspection and acceptance requirements:

The COR will will review and accept CDRL A004.

Block 14 - Distribution - Contractor to submit original to COR and copy to the Contract Specialist.

6/17/14 6/17/14

1 1

DEEM.NANCYE.S.10

77379521

Digitally signed by DEEM.NANCYE.S.1077379521 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=DLA, cn=DEEM.NANCYE.S.1077379521 Date: 2014.01.10 14:01:47 -05'00'

DEEM.NANCYE.S.10

77379521

Digitally signed by DEEM.NANCYE.S.1077379521 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=DLA, cn=DEEM.NANCYE.S.1077379521 Date: 2014.01.10 14:02:00 -05'00'