A018_-_DBA_Insurance_Reporting_CLIN_X007.pdf
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- Attached to
- DLA Distribution Bahrain, Southwest Asia Contractor Owned Contractor Operated (COCO) Distribution Center
- Solicitation number
- SP330017R5010
- Issued by
-
Defense Logistics Agency Distribution
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J.7, CDRL A018 - DBA Insurance Reporting CLIN X007
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Text version
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
| 1_DATA_ITEM_NO: A018 |
| 2_TITLE_OF_DATA_ITEM: Monthly Cost Report for CLIN X007 |
| 3_SUBTITLE: |
| 4_AUTHORITY_Data_Acquisit: N/A |
| 5_CONTRACT_REFERENCE: Section G, Paragraph G-4 |
| 6_REQUIRING_OFFICE: DLA Distribution J-7 |
| 7_DID_250_REQ: See Block 16 |
| 8_APP_CODE: |
| DIST_STATEMENT: B |
| 10_FREQUENCY: Monthly |
| 11_AS_OF_DATE: N/A |
| 12_DATE_OF_FIRST_SUBMISSI: See Block16 |
| 13_DATE_OF_SUBSEQUENT_SUB: See Block 16 |
| addressee1: J-7 Contract Spec |
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| 16_REMARKS: Tailored to permit contractor's format inclusive of all requirements below. |
IAW Section G-5 - 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 X007 - Defense Base Act Insurance:
Provide data for the following cost elements:
1) Item Description
2) Total Defense Base Insurance Cost
Block 7 - Inspection and acceptance requirements:
The COR will review and accept CDRL A018.
Block 14 - Distribution - Shall be included in the Wide Area Workflow system as supporting documentation for the invoice.
Block I - Approved By - Signature of Government official accepting the Contractor's reporting requirements of this CDRL will be the the COR.
| 17_PRICE_GROUP: | |
| ESTIMATED_TOTAL_PRICE: | |
| G_PREPARED_BY: | |
| H_DATE: | |
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| J_DATE: | |
| Page: 1 | |
| reg38t: 1 | |
| A_CONTRACT_LINE_ITEM_NO: | |
| B_EXHIBIT: Attachment J.2 | |
| TDP: | |
| TM: | |
| OTHER: | |
| DSYSTEMITEM: | |
| E_CONTRACTPR_NO: SP3300-17-C-XXXX | |
| FCONTRACTOR: | |
| of_pages: 1 | |
| Reset: | |
| 2017-02-27T14:21:01-0500 | |
| POWERS.CULLEN.MARTIN.1093893227 |
| 2017-04-04T11:39:06-0400 | |
| FLICK.CLIFFORD.C.1032268311 |
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