EXHIBIT_B.pdf

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DRUM HAULER & EXTERNAL CHARGER
Solicitation number
SPMYM2-18-Q-1291
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EXHIBIT B

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CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB

No. 0704-0188

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 Department of Defense, Washington Headquarters

Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Please DO NOT RETURN your form to either of these address. 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

B

C. CATEGORY TBD

TDP TM OTHER x

D. SYSTEM/ITEM

DRUM HAULER

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

B001

2. TITLE OF DATA ITEM

Certification/Data Report

3. SUBTITLE

OSHA Compliance Statement

4. AUTHORITY (Data Acquisition Document No.) DI-MISC-

80678 7.

5. CONTRACT REFERENCE

SEE PARA 3.5.1

6. REQUIRING OFFICE

PSNS & IMF, S/31

DD 250 REQ xx 9. DIST STATEMENT

REQUIRED

NIR

10. FREQUENCY

OTIME

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

See Block 16

b. COPIES

17. PRICE GRC

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

A. ADDRESSEE

Draft

Final

18.

ESTIMATE[

TOTAL PRI' Reg Repr

16. REMARKS

Block 3: The OSHA compliance statement shall be in the contractors format.

BLOCK 12: The contractor shall provide one copy of the OSHA statement 10 days prior to delivery of equipment.

Blocks 14: the contractor shall provide one copy of the OSHA compliance statement in electronic unprotected searchable PDF to the following government POC Nicole Martinez S/31 Puget Sound Naval Shipyard

1400 Farragut Ave

Bremerton, WA 98314

PSNS S/31 1

G. PREPARED BY H. DATE

TOTAL 1

Nicole Martinez 2/1/18

I APPROVED BY J. DATE

DD Form 1423-1, FEB 2001 previous edition may be used. Page 1 of 3 Pages

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