Technical Eval Attachment - Service Order Form-v9_20250614 A.pdf

SERVICE ORDER FORM INSTRUCTIONS

FMSR Form: SO Validation

All service order information should be put into this sheet. All other sheets will be populated from this sheet

PART I

Block C3: Service Order number will be provided by the government. It is the three letter site code, contractor three letter abbreviation, and service order number.

Block D3: Insert the SO initiation Revision # if any Block C4: Insert the full Prime Contractor's name.

Block C5: Insert Facility Number(s). Use Alt-Enter to add rows.

Block D5: Insert Facility Name(s). Use Alt-Enter to add rows.

Block C6: Insert the three letter site code.

Block D6: Insert the Site Name.

Block C7: Insert the date that the service order was initiated by the FMSR.

Block C8: Select Yes or no depending if the service order is required due to a Notice of Violation (NOV) or to prevent a NOV.

Block D8: Insert the description of the NOV.

Block C9: Select Yes or no depending if the service order is related to a Natural Disaster Block D9: Insert Name of the disaster (e.g., Hurricane, Tsunami, Flood, etc.)

Block H3: Select the service order type from the drop down menu. Normally this is determined by the FMSR on the service order initiation form.

Block H4: Insert the contract number.

Block H5: Insert the Contract number.

Block H6: Select the military service from the drop down menu. This will be the service that actually owns the real property fuel systems.

Block I6: Insert the abbreviated Army Corps Military District such as POD-H, POD-J, NAD-AF, SPD-N1, etc.

Block H7: Insert the funding CLIN for the particular service order.

Block H8: Insert the maintenance category (DLA Work Category) that most represents the majority of the work being performed under this service order. This can be found in the Facility Block H9: Select service order priority level as designated by the FMSR.

Block A11: Insert service order description and utilize SO description continuation sheet at bottom of form as necessary. As part of SO description, please list the required safety documents.

Use Alt-Enter to add rows.

PART II

Block D29: Insert FMSR full Name Block D30: FMSR digitally signs/dates initial validation of Service Order authorizing repair.

Block D33: FMSR digitally signs/dates final validation of satisfactory completion of Service Order repair.

PART III

Rows 36-44: FMSR should use this section to report on Contractor's Quality of Work. Part III will be used for final evaluation of Contractor performance.

Block A47: Use the comment section for any box checked "NO" to explain Contractor deficiency in the quality of work. Other comments negative or positive are encouraged.

Additional Instructions for Contractor:

1. Once sheet is filled out it must be converted to stand alone PDF document.

2. The PDF FMSR sheet needs to have text boxes, check boxes, and Digital signature fields added to the appropriate area.

3. The FMSR Form is the only form to be sent to the FMSR.

KO Form: SO Submission

PART I

Block C3: Populates from FMSR Form Block D3: Insert the SO submission Revision # if any. Block A25 will be the log of all revisions for this SO.

Block C4: Populates from FMSR Form Block C5: Insert the full Sub-Contractor's name Block E5: Populates from FMSR Form Block C6: Populates from FMSR Form Block D6: Populates from FMSR Form Block C7: Populates from FMSR Form Block D7: Populates from FMSR Form Block B8: Insert the date that the service order was submitted by the Contractor.

Block E8: Select Yes or No depending if the service order contains a long lead item as described in PWS Appendix A.

Block B9: Insert the estimated time of arrival of the long lead item Block E9: Insert expected start work date for the service order Block C10: Populates from FMSR Form Block D10: Populates from FMSR Form Block C11: Populates from FMSR Form Block D11: Populates from FMSR Form Block H3: Populates from FMSR Form Block H4: Populates from FMSR Form Block H5: Populates from FMSR Form Block H6: Populates from FMSR Form Block I6: Populates from FMSR Form Block H7: Populates from FMSR Form Block H8: Populates from FMSR Form Block H9: Insert the UFC 3-460-03 Section Reference Number associated with the Maintenance Category as described in the Facility Maintenance Plan.

Block G10: Insert the Component Unique Identifier(s) (CUID) associated with the component as described in the Facility Maintenance Plan. Use Alt-Enter to add rows Block J10: Insert the Contractor's Deficiency Unique Identifier (DUID) as identified on the deficiency report. Use Alt-Enter to add rows.

Block G11: CEHNC will select Yes or No if a WP has been approved based on the Contractor's request.

Block J11: Populates from FMS Form Block E11: Populates SO complexity Block B12: Populates if any RITM items were used in the SO Block D12: Populates the RITM item used Block G12: Populates the quantity of RITM items used

Block J12: Populates the total quantity of RITM items within that category for the option year

PART II

Block C13: Insert the name of the Contract Safety Manager.

Block H13: Insert the name of the expected person who will perform the duties of the on-site safety and health officer (SHO). If the actual person on-site changes redline this block with the

Block C14: Select the level of the required on-site SHO from the drop down menu (Based on TOSM determination). The levels are defined in the contract PWS. If the actual the actual SHO on-site changes redline this block with the actual person (same level) on-site.

Block H14: Designate whether supporting documents for the jobsite SHO are included in the service order, already accepted in the APP, or not applicable.

Block C15: Provide a justification for the selected level of on-site SHO. The contractor is required to have an individual responsible for safety on all jobsites. The Task Order Safety Manager shall make this determination and provide justification to the Government Designated authority (GDA) for acceptance.

Block C16: Enter Qualified / Competent Person's name.

Block H16: Designate whether supporting documents for the Qualified / Competent Person are included in the service order, already accepted in the APP, or not applicable.

Block C17: Select yes if there are new, or updated plans added to the service order that were not included in the APP. Reference EM385-1-1 APPENDIX A for a list of plans requiring an

Block A19: List all safety plans required for SO (See Appendix A).

Block H17: Select Yes if all AHAs on this service order have been pre-accepted. Select No if there are new AHAs (not previously accepted).

Block F19: List all AHAs required for this service order. Every Service order submitted must have AHA/s tailored to the service order.

Block D22: The Contract Safety Manager needs to e-sign and date this form prior to submittal. Signature verifies SO safety documentation has been reviewed and approved. Approved means documentation meets all contract, OSHA, and regulatory requirements prior to submittal.

Block A25: Service Order Revision Log ADD or DELETE ROW. This allows the Contractor to click the button to add cells or remove cells from this section.

Block A26: Insert the Revision Number and small description of what was revised.

Block K26: Insert Date of submission for each revision.

Block A30: Populates from FMSR Service Order Form

PART III

Instructions for Contractor

1. The form allows the Contractor to add or delete cells by clicking the ADD or DELET ROW buttons in each section.

2. All labor rates shall be fully burdened labor rates in accordance with Contractor's accepted proposal documents.

3. The contractor will include Material/Equipment/Other pricing in the cells provided to perform repair. All cells must be filled in. Markup (%) will be in accordance with Contractor's accepted proposal documents. Markup is calculated on material costs only and must be in accordance with their accepted price proposal. Contractor shall identify if equipment is from a rental company.

Open market procedures apply to rental equipment if not listed on GSA Schedule

4. Travel/Travel Labor/Per Diem will be included on the Travel Expense Report and submitted in accordance with the PWS Appendix A.

5. Taxes on the KO form are dependent upon work location and shall be input in the appropriate cell for the work location.

6. Cells not applicable should be left blank.

7. When ready to submit for approval the Contractor will convert this to a pdf document and the Contractor's authorized representatives (including the Safety Manager) will digitally sign the form

COMPLEXITY MATRIX:

This is a guide to help the contractor determine the amount of supporting information that will be required as part of the SO

When form is complete it will be converted to a pdf document to be included with the service order

SUBMITTING THE SERVICE ORDER:

The contractor will make a PDF Portfolio and add the following PDF documents to the portfolio:

FMSR Form with initial validation signature

KO Form with all required Contractor's signatures

Complexity matrix

AHA Sheet

This Excel file will also be included in its raw filled out state

Work Plan-If approved by Government