Enclosures_A-E.pdf

ENCLOSURE A

SMDP CUSTOMER ACCEPTANCE FORM

Activity Name: Customer Side Number and Location:

Customer POC Phone Number: Customer POC Email Address:

Contract Line Item Numbers

Device Manufacturer: Model #:

Serial Number: Training Date: (MM/DD/YYYY)

Service Date: (MM/DD/YYYY): Service Location (Room):

☐Installation ☐Relocation ☐Maintenance

☐Delivery of Supplies/Parts * ☐Removal (Information Assurance Manager Signature required)

☐Other (Describe here or on Back):

* IAM of Receipt of Hard Drive (Print Name): * IAM of Receipt of Hard Drive (Signature):

contractor Technician Name (Print): Technician Signature:

Customer Accepting Receipt of device (Print): Must be the Shipboard Copier Manager, Supply Officer, ADP/IT Officer, Combat Systems Officer or designated representative.

Customer Signature:

ENCLOSURE A

May Be emailed to smcp.docsvcs@dla.mil

Used for Additional Information

PWS Section 17.1. Installs / Deliveries Report Enclosure B

DLA Purchase Order Number

Ship/Activity’s name Ship Unit Identification Code (UIC)

CLIN # Standard Item Description Serial number (if Applicable)

Date of Installation or Delivery

(MM/DD/YYYY)

Unit Cost Quantity Purchased

Total Cost (auto-populated)

Warranty End Date

(MM/DD/YYYY)

Meter read at time of installation or removal

Shipboard Device Location of equipment, i.e. Engineering Office (if Applicable)

Date of Removal (if Applicable)

((MM/DD/YYYY)

$0.00 $0.00

PWS Section 17.2 Training Report Enclosure C

DLA Purchase Order Number

Ship/Activity’s Name UIC Student’s Rate and Full Name (or civilian rank)

Date Training Completed

(MM/DD/YYYY)

Training location Site

Type of training (initial, refresher, abbreviated etc. )

Class Device Trained On

Total Cost

PWS Section 17.3. Technical Support Services Report Enclosure D

Ship/Activity’s name Ship Unit Identification Code (UIC)

Shipboard Device Location of equipment, i.e. Engineering Office (if Applicable)

Model Class (if Applicable)

Serial number (if Applicable)

Device meter read/Copier Count

Description of Malfunction

Date notified

(MM/DD/YYYY)

Remedial action performed CLIN # Quantity Description of part replaced/CLIN Description

Cost Date of Completion

(MM/DD/YYYY)

Travel Cost Type Support (Shipboard Rider OCONUS Services Technician, CONUS Services Technician)

Technician Name Gov't Authorizer's Name

PWS Section 17.4. Returned Parts Credit Report Enclosure E

Ship/Activity’s Name Ship Unit Identification Code

(UIC)

CLIN #

(If Applicable)

Quantity Part Number(s) Returned

Nomenclature Dates of Received

(MM/DD/YYYY

Credit Amount.

$0.00