Technical Exhibits 1 - 7.pdf

TECHNICAL EXHIBIT 1

Performance Requirements Summary Description The contractor service requirements are summarized into performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success. Each performance standard for the various required services (tasks) are included within each required service (task) in the PWS.

PRS

Number

Performance Standard Acceptable Level of Performance (ALP)

Maximum Allowable Degree of Deviation From The

Requirement

Method of Surveillance

Consequences of Failure to Meet Performance

Standard

01-A

A. The Contractor shall unload from delivery vehicle, receive, store, unpack, track, and safeguard New Stock Replacement Furnishings and/or OSI in designated Government-Owned Facilities as specified by the

DGR.

0% 100% Inspection

Reduce Monthly Payment by the Number of Defects times the price per each Workload Indicator from the contractor’s final proposal. Results will be reported in CPARS.

01-B B. The Contractor shall accurately complete and submit all Shortage/ Damage/ Fair Wear and Tear (FWT) report forms for damage or shortage of:

-Delivery of New Stock Replacement, -Issuing or Clearing, -OSI replacement, -Furnishing Replacement, No later than one (1) business day after discovery.

0% 100% Inspection

Reduce Monthly Payment by the Number of Defects times the price per each Workload Indicator from the contractor’s final proposal. Results will be reported in CPARS.

01-C C. The Contractor shall receive and sign the Bill of Lading for delivered New Stock Replacement Furnishings and/or OSI and submit to the DGR no later than one (1) business day after delivery.

0% 100% Inspection

Reduce Monthly Payment by the Number of Defects times the price per each Workload Indicator from the contractor’s final proposal. Results will be reported in CPARS.

PRS

Number

Performance Standard Acceptable Level of

Performance

(ALP)

Maximum Allowable Degree of

Deviation From The

Requirement

Method of Surveillance

Consequences of Failure to Meet Performance Standard

02-A A. The Contractor shall be present no later than 30 minutes (+/-) of scheduled time to issue and/or receive facilities as agreed upon with the customer.

1 per month Customer Complaint

Results will be reported in

CPARS.

02-B B. The Contractor shall ensure all available facilities are clean and contain required furnishings and OSI.

1 per month Customer Complaint

Results will be reported in

CPARS.

02-C C. The Contractor shall conduct a joint inspection / inventory, issue & receive facilities using accurately completed Hand Receipts and corresponding Facility Inspection Checklists for all furnishings, OSI, and/or equipment issued.

2.5% Random Sampling

Reduce Monthly Payment by the Number of Defects times the price per each Workload Indicator from the contractor’s final proposal. Results will be reported in CPARS.

02-D D. The Contractor shall forward an electronic copy of each completed facility inspection checklist and corresponding hand receipt to the DGR no later than one (1) business day of the following month after clearance or as requested by the DGR.

2.5% Random Sampling

Reduce Monthly Payment by the Number of Defects times the price per each Workload Indicator from the contractor’s final proposal. Results will be reported in CPARS.

02-E E. The Contractor will complete surface cleaning, sweeping, and mopping of floors in the kitchen area and dish room of Dining Facilities not issued for more than 4 consecutive months.

0% 100% Inspection

Reduce Monthly Payment by the Number of Defects times the price per each Workload Indicator from the contractor’s final proposal. Results will be reported in CPARS.

03-A The Contractor shall not secure the entry door of any barracks in the unlocked position by installing government furnished lock plug until the actual time of issue to the customer.

2.5% Random Sample

Reduce Monthly Payment by the Number of Defects times the price per each Workload Indicator from the contractor’s final proposal. Results will be reported in CPARS.

TECHNICAL EXHIBIT 2

CONTRACT DATA REQUIREMENTS LIST

(CDRL)

CDRL

Paragraph Deliverable Frequency # of Copies Medium/Format Submit To

1. 2.1.9 Quality Control Plan Within thirty(30) days of contract start & Annual

1 digital PDF/Email KO,COR

2. 2.5.1.8 Key Custodians, Primary & Alternate.

No later than five (5) workdays of any changes.

1 digital PDF/Email KO,COR

3. 2.5.1.8.1 Report of Missing/Lost Keys

Immediately 1 digital PDF/Email KO,COR

4. 7.5.2.1 Operator Qualifications Prior to start of work. 1 digital PDF/Email COR

5. 2.1.11.1.1 Project Manager No later five (5) workdays of start of contract

1 digital PDF/Email KO

6. 2.1.11.1.6.1 Employee Roster No later than 48 hours after the Contract start date, and prior to the first day of each new employee brought on-board, or day of employee release

1 digital PDF/Email KO,COR

7. 2.1.11.1.7 Dress Code Within ten (10) business days after contract start date.

1 digital PDF/Email KO

8. 2.1.11.1.9 Potential Organization Conflicts of Interest Plan

Immediately. 1 digital PDF/Email KO

9. 2.5.2.1 AT Level I Training Certificates

Within thirty (30) calendar days of completion of training.

1 digital PDF/Email COR

10. 2.5.2.3 iWATCH Training Certificates.

Within thirty (30) calendar days of contract performance start date and within 30 calendar days of new employees’ commencing performance

1 digital PDF/Email KO,COR

11. 2.5.2.2 OPSEC Training Certificates

Within thirty (30) calendar days of completion of training.

1 digital PDF/Email COR

12. 2.1.7.2.1 Invoicing Within ten (10) business days following the month of service.

1 digital As directed by the Government.

COR

13. 2.5.3.1 Safety Plan within ten (10) workdays of commencement of work

1 digital PDF/Email KO & COR

14. 3.1.3 Accident/Injury Reporting

Within three (3) business days of accident.

1 digital PDF/Email KO,COR

15. 3.1.3 Traffic Accident Reporting

Verbally within four (4) hours of incident, contact the COR within eight

(8) hours and complete written report within

1 digital PDF/Email KO, COR, Fort McCoy Installation Safety Office, and Fort

CDRL

Paragraph Deliverable Frequency # of Copies Medium/Format Submit To three (3) business days of incident.

McCoy Directorate of Emergency Services

16. 2.2.1 2.2.4 2.2.5 2.3

Shortage/Damage/Fair Wear and Tear (FWT) Report Form for:

Delivery New Stock Replacement.

Issuing or Clearing.

OSI Replacement.

Furnishings Replacement.

No later than one (1) business day after discovery.

1 digital PDF/Email COR

17. 2.3 Bill of Lading- Delivery of New Stock Replacement.

No later than one (1) business day after delivery.

1 digital PDF/Email COR

18. 5.3.1 Facility Inspection Checklist/Hand Receipt.

No later than the first (1st) business day of the following month after clearance, or as requested by the COR

1 digital PDF/Email COR

TECHNICAL EXHIBIT 3

PROJECTED WORKLOAD DATA

See Attachment 1 for “Technical Exhibit 3 Projected Workload Data”.

Transient Training Facility Support Services

FORT MCCOY, WISCONSIN

WORKLOAD INDICATOR

Source / Description (Where /

What)

Jun Jul Aug Sept Oct Nov Total Dec Jan Feb Mar Apr May Total Grand Total

# of New Replacement Stock furnishings and/or operational stock items received and inspected

Manual count/Bill of Lading 200 2208 0 0 575 200 3183 360 0 0 0 235 0 595 3778

# of facilities issued & received

Barracks Manual count / Automated

Scheduling Management Tool 218 215 146 190 223 74 1066 20 14 48 91 373 260 806 1872

BOQ Rooms Manual count / Automated

Scheduling Management Tool 307 264 228 371 228 46 1443 87 76 62 83 487 360 1154 2597

Dining Facilities (Each side of Dining

Facility is counted as one Facility)

Manual count / Automated

Scheduling Management Tool 29 36 3 12 19 10 109 0 0 3 9 48 18 78 187

Maintenance Manual count / Automated

Scheduling Management Tool 28 23 10 15 25 7 108 1 0 4 0 25 20 51 158

Admin Co./Classroom Manual count / Automated

Scheduling Management Tool 75 92 48 74 53 26 369 11 3 12 1 31 23 81 450

Admin Bn./Bde.

Manual count / Automated

Scheduling Management Tool 4 9 1 4 2 1 22 1 0 0 2 8 2 13 35

Other (FOB Dining/Serving, Refrigerators/Freezers, etc)

Manual count / Automated

Scheduling Management Tool 10 6 2 0 2 0 20 0 0 2 0 1 9 12 32

# of operational stock items replaced in facilities

Manual count / of shortage/damage documents 107 18 57 0 6 59 247 11 16 7 21 208 149 412 659

# of furnishings assembled and replaced in facility

Manual count / of

Shortage/Damage/FWT Lists 105 7 35 0 42 15 204 12 30 9 67 17 18 153 357

PWS PARAGRAPH

N/A

5.2 Transient Training

Furnishings/OSI Receipt, Inventory and Storage

5.4 OSI/Furnishings Replacement

5.3 Issue and Receive Transient

Training Facilities

5.4 OSI/Furnishings Replacement

Technical Exhibit 3, Attachment 1, Projected Workload Data

TECHNICAL EXHIBIT 4

MAP AND WORK AREA LOCATION

Building 2880 is located within the cantonment area of Fort McCoy, Wisconsin, on East K Street north of East 14th Avenue.

Note: A full cantonment area map of Fort McCoy showing all transient training facilities supported by this contract will only be provided to the winning contractor. All transient training facilities are located within 3 miles of Building 2880.

TECHNICAL EXHIBIT 5

GOVERNMENT AVAILABLE AUTOMATION EQUIPMENT

ITEM DESCRIPTION NSN Serial Number QTY Unit Price

Computer, Personal Workstation, 210 – AFGK (7040) Dell Optiplex – for front desk

702101C943393 C19DRD2 1 $871.00

Computer, Personal Workstation, 210 – AFGK (7040) – for project manager

702101C943393 C1BJRD2 1 $871.00

Computer, Personal Workstation, 210 – AFGK (7040) – for assistant project manager

702101C943393 C19FRD2 1 $871.00

Monitor, Color IMPE: P2212H 21.5”

DELL

702501D041040 MX04F79G74262295250S 1 $204.72

Monitor, Color IMPE: P2212H 21.5”

DELL

702501D041040 MX04F79G74262295252S 1 $204.72

Monitor, Color IMPE: P2212H 21.5”

DELL

702501D041040

MX04F79G7426229522DS

1 $204.72

Monitor, Color IMPE: P2210t 21.5” DELL 702501C132025 MX0W466K74446117AQ0S 1 $204.72

Printer 702501C029295 JPBDQ18929 1 $1,149.99

Konica Minolta bizhub C458 Copier, Printer, Scanner

LEASED A79M012001262 1 N/A

Note: Item Description may be updated after contract award.

TECHNICAL EXHIBIT 6

FACILITY INSPECTION CHECKLISTS, HAND RECEIPTS, SHORTAGE/DAMAGE/FWT LIST,

FACILITY DISPLAY BOARD LIST, FACILITY CUSTOMER SATISFACTION FEEDBACK SURVEY

See Attachment 2 for “Technical Exhibit 6: Facility Inspection Checklists, Hand Receipts, Shortage/Damage/FWT List, Facility Display Board List, and Facility Customer Satisfaction Feedback Survey”.

Kitchen Issue Iss Ch Ret Dishroom (PIT) Issue Iss Ch Ret Office Issue Iss Ch Ret Pantry Items Issue Iss Ch Ret

Kitchen Entry Rug 1 Dish Washer 1 Outside Bulletin Key 1

Stove w/1 oven rack 1 Silverware Rack (Flat) 2 Shelving Rack 1 Pot Stock w/ Cover 5 gal 1

Oven Convection 2 Tray/Cup Rack (Spiked) 6 Desk w/Chair & Phone 1 Pot Stock w/ Cover 10 gal 1

Oven Racks (5 ea) 20 Dish Washer Rack Dolly 2 File Cabinet 1 Tongs 25

Tilt Grill 1 Serving Tray Storage Rack 1 Trash Can 1 Dipper, Kitchen 1 qt 2

Steamer W/Stand 1 Mess Trays 200 Plastic Chair Floor Protect 1 Ladle 8 oz 2

Warmer/ Proofer 1 Shelving Long Rack 1 Chemical Storage Unit w/Lock 1 Ladle 4 oz 5

Refrigerator 3-Door 1 Salad Bowls (10/stack, 4X5) 200 Ladle 2 oz 5

Refrigerator Racks (3 ea) 3 Tumbler, drink (5/stack, 5X8) 200 Pantry(Room & Walk-In) Issue Iss Ch Ret Steel, Butcher 1

Freezer 2-Door 1 Cup, Coffee (5/stack, 4X10) 200 Shelving Long Racks 5 Knife Paring 2

Freezer Racks (6 ea) 6 Silverware Carriers -6 Hole 3 Freezer 2-Door 1 Peeler, Potato 2

Steam Table 1 Fork Silverware Basket (200) 8 Freezer Racks (6 ea) 6 Knife Boning 2

Steam Table Drain Screens 5/6 Knive Silverware Basket (200) 8 Shelving Racks-Walk-In Refer 6 Knife Slicing (Bread) 1

Grill w/drain/trough 1/2 Spoon Silverware Basket (200) 8 Rubber feet for racks (Walk-In) 24 Knife Cooks 2

Work Table 30 inches 1 Fork, Food Prep 15" 2

Wall Clock 1 Dining Room Issue Iss Ch Ret Crock Pot 1 Spoon, Basting 15" 15

Hand Dolly 1 Diner Entry Way Rugs 2 Crock Pot Lid 1 Spoon, Slotted 15

Rubber Safety Mat 1 Silverware Cart Cambro/Cover 1 Inserts for Crock Pots 2 Skimmer 18" 1

Sink Stoppers 4 Headcount Desk 1 Hot Pads 6 Pan, Roasting & Baking 4

Work Table w/ Utensil Rack 1 Headcount Chair 1 Food Turner 14" 2 Colander 1

Can Opener, Table Mount 1 Toaster with Crumb Tray 1 Pie Server 2 Mixing Pan (Hand) 1

Shelving Long 2 Cereal Dispenser Rack 1 Scraper Steel (Bakers) 2

Shelving Short 1 Condiment Rack, 12 Stack 1 Scraper Rubber 2

Pastry Cabinet 1 Napkin Dispenser 2 Measuring Spoon Set 1 Line Pans 1/2 6" 10

Work Table (mixer sits on) 1 Refrigerator, 1 Door 1 Measuring Cup Set 1 Line Pans 1/2 4" 10

Meat Slicer 0/1 Dining Tables 20 Liquid Measure 1 cup 1 Line Pans 1/3 6" 10

Mixer Table Top w/4 pads 1 Dining Chairs 106 Liquid Measure 1 qt 1 Line Pans 1/3 4" 10

Beater Attachment 1 Hand Can Opener (sm) 1 Line Pans 1/3 2" 5

Dough Hook Attachment 1 Planter Box w/flowers 1 Grill Screen Holder 2 Line Pans/Bullet 6" 5

Whip Attachement 1 Salad Bar 2 China Cap 1 Line Pans/Bullet 4" 10

Bowl Ingredient Slide 1 Salad Bar Dividers 8

White Tray for Attachments 1 Work Table 30 inches 1 Scoop, Ice Cream, Gray 4oz. 4

Icemaker 1 Beverage Tables/Counters 2 Whip 12" 3 Pan, Frying Steel 1

Ice Scoop 1 Bev Table Drain Bucket 0/1 Whip 16" 3 Electric Knife Sharpener 1

# 10 Can Rack 1 Coffee Urn w/Filter Basket 1 Thermometer Refrigerator 5 Scale Dial 1

Rubber Trash Cans 32 Gal 5 Ice/Water Dispenser 1 Thermometer Meat 1 Line Pans/Full 6" 5

Dollies/lids for Trash Cans 5 Thermometer Oven 5 Line Pans/Full 4" 10

Mop Bucket w/Wringer 1 Line Pans/Full 2" 10

Mop Handle 1 Sheet Pans (total in pantry) 25 Line Pan/Full 2" Perforated 10

Sweeping Broom 1 Sheet Pan Rack 1 Line Pan Lids Full 10

Push Broom 1 Line Pan Lids 1/2 10

Dust Pan 1 Line Pan Lids 1/3 10

Hand Broom 1 Cutting Boards 2

Snow Shovel 1 Wire Lid Holder 1

Fire Extinguishers (Inc Hallway) 4/5

POC/PHONE:

UNIT CLEARING REP / DATE:

REV. 1/1/2020

RECEIVED BY / DATE:

ISSUED BY / DATE: CLEARED BY / DATE:

DFAC HAND RECEIPT UNIT:

Rack #2 (top shelf to bottom)

Rack #4 (top shelf to bottom)

Rack #3 (top shelf to bottom)

Rack #1 (top shelf to bottom)

Technical Exhibit 6, Attachment 2

TE 6 Attachment # 2

DINING FACILITIES INSPECTION CHECKLIST

See attached hand receipt for signatures indicating completion of this checklist

UUNIT/ORGANIZATION:

Outside area clean (no pallets or garbage, on dock or directly surrounding the DFAC)

Menu board clear

Loading dock railing attached

All kitchen equipment clean

Kitchen floors clean

Ice machine clean

Garbage disposals (kitchen & dish room) clean

Equipment back to original configuration

Dishwasher clean

Dish Room surfaces/floor clean

Mop closet clean/organized

Pantry area, freezer, walk-in refrigerator clean

Diner entrance ramp clean

Dining area clean

Dining area equipment, tables & chairs back to original configuration

Restrooms clean

All bathroom fixtures work properly

Office are clean and equipment back to original configuration

Fire extinguishers serviceable

All doors/windows secured

Thermostat set at proper temp

COMMENTS:

ISSUE:

CLEAR:

Display Board Contents

Maintenance:

Inventory / inventory map Clearance checklist DPW Help Desk info DPW customer comments flyer TFSB memo After-hours contact flow chart Fire extinguisher inspection Frequently used phone numbers Fort McCoy installation map Oil/antifreeze disposal instructions

Classroom/Supply Admin:

Inventory / inventory map Clearance checklist DPW Help Desk info DPW customer comments flyer TFSB memo After-hours contact flow chart Fire extinguisher inspection Frequently used phone numbers Fort McCoy installation map

Barracks:

Inventory / inventory map Clearance checklist DPW Help Desk info DPW customer comments flyer TFSB memo After-hours contact flow chart Fire extinguisher inspection Frequently used phone numbers Fort McCoy installation map Clearance photos (footlockers, toilet seats, etc.)

FACILITIES INSPECTION CHECKLIST

See attached hand receipt for signatures indicating completion of this checklist

UNIT/ORGANIZATION:

All interior lights and EXIT lights working

Fire extinguishers are serviceable

Telephones working

Bathrooms clean

Bathroom fixtures working

Humidistats off

Thermostat set at proper temp or “OFF” (“low battery” or “check filter” indicator?)

Equipment/furniture back to original configuration

Mop closet clean/organized

All floors clean

Stairwells swept

Outside area clean

Exterior of building in good repair

All doors and windows secured

Check oil and antifreeze levels in barrels in maintenance facilities

COMMENTS:

ISSUE:

CLEAR:

Building Keys Issue Issued Ret Serving Area Issue Issued Ret Pantry Items Issue Issued Ret Pantry Items Issue Issued Ret

Serving Building Keys 2 Rubber Trash Cans, 32 Gal 10 Hot Pads 14 Line Pans/Bullet 6" 15

Key # Dollies/Lids for Trash Cans 10 Food Turner 14" 10 Line Pans/Bullet 4" 15

Key # Pie Server 4 Line Pans 1/2 6" 10

Steam Table 2 Scraper Steel (Bakers) 4 Line Pans 1/2 4" 15

Dining Building Keys 2 Steam Table Drain Screens 12 Scraper Rubber 4 Line Pans 1/3 6" 25

Key # Hand Can Opener (sm) 5

Key # Warmer, 2-Door 2 Grill Screen Holder 2

Work Table, 30" X 30" 5 China Cap 2 Dining Area Issue Issued Ret

Work Table, 96" X 30" 7 Scoop, Ice Cream, Gray #8 8

Table, HD Beverage 4 Whip 16" 5 Cold Bar (4-Pan) 2

Refrigerator Themometer 5

Cold Bar (7-Pan) 2 Oven Thermometer 4 Toaster 2

Cold Bar (7-Pan) Dividers 28 Thermometer Meat 5

Cutting Board 2 Dining Picnic Tables 110

Refrigerator, 3-Door 4 Sheet Pans 50

(w/3 Racks Each) Perforated Pan 5 Work Table 84" X 30" 2

Pot Stock w/Cover 10 gal 2 Work Table 96" X 30" 2

Tongs 25

Coffee Urn w/Filter Basket 2 Dipper, Kitchen 1 qt 6 Beverage Drain Bucket 2

Ladle 8 oz 8

Ladle 4 oz 5 Condiment Rack, 12-Stack 4

Can Opener, Table Mount 1 Ladle 2 oz 8

Steel, Butcher 2 Hallway Area Issue Issued Ret

Knife Paring 5 Chemical Wall Locker 1

Shelving, Plastic 10 Peeler, Potato 4 Mop Bucket w/Wringer 3

Knife Boning 4 Mop Handle 5

Knife Slicing (Bread) 2 Push Brooms 3

Knife Cooks 4 Dust Pan 3

Fork, Food Prep 21" 10 Corn Broom 3

Icemaker 2 Spoon, Basting 20 Personal StorageLocker 1

Ice Scoop 2 Spoon, Slotted 20

Skimmer 18" 4

Headcount Desk 2 Pan, Roasting & Baking 5

Headcount Chair 2 Colander 4

Mixing Pan (Hand) 5 Outside Area Issue Issued Ret

Hand Pallet Jack 1 Line Pans/Full 6" 10 Stand Alone Refer/Lock 1

Line Pans/Full 4" 24 Refer Shelving Racks 5

100 Ft Industrial Hose 2 Line Pans/Full 2" 20 Dunnage Rack Cambro 2

Line Pan Lids Full 24

Black Rubber Mats 2 Line Pan Lids 1/2 15 Ice Freezers 2

Line Pan Lids 1/3 25

Bullet Pan Lids 10

Form Dated: Jan 2023 Wire Lid Holder 2

TE 6 Attachment # 2

Unit Clearing Rep ______________

Date: ________________________

FOB Serving & Dining Building Hand Receipt_________________________________Unit ______________________________________________________

Date: ____________________________Date: ____________________________

Cleared By: ____________________

Date: ____________________________

Issued By: _______________________Received By: _______________________

FacNo

2565 BOQ RM 01 TS-46-2, TS-46-3

2565 BOQ RM 02 TS-47-3, TS-47-5

2830 BARRACKS

HAND RECIEPT

EXAMPLE

RCN

Combination

Down:

0,0,0

Combination/Key

Up:

0,0,0

Start Date End Date

14-Mar-23 18-Mar-23

14-Mar-23 18-Mar-23

11-Mar-23 14-Mar-23

Status

RES

RES

RES

I have received and accept responsibility for these facilities, the installed engineer property, and inventory indicated on the attached form(s). I agree that prior to clearance from Fort McCoy that all inventories will be accounted for and facilities are cleaned and suitable for issue.

A joint Facility Issue inventory was accomplished using the Master Facilities Inventory List as reference.

RECEIVED BY UNIT POC: (PRINT SIGNATURE/DATE:

POC CELL PHONE NUMBER:

ISSUED BY: (PRINT NAME) SIGNATURE/DATE:

A joint facility Clearance inventory was accomplished using the Master Facilities Inventory List as reference.

Contact the Troop Facility Support Branch in B 2880 to clear this hand receipt prior to departing Fort McCoy at 608-388-3800.

CLEARED BY UNIT POC: (PRINT NAME) SIGNATURE/DATE:

POC CELL PHONE NUMBER:

CLEARED BY TFSB POC: (PRINT SIGNATURE/DATE:

Fort McCoy, Wisconsin

Transient Troop Training Facility Support Services

SHORTAGE/DAMAGE/FAIR WEAR AND TEAR REPORT

PWS# 5.2.1

PWS# 5.3.2

PWS# 5.4

7. BLDG 8. QTY

13. BUILDING INSPECTOR (PRINT NAME):

15. UNIT POC (PRINT NAME):

14. SIGN/DATE:

16. SIGN/DATE:

12. DA 3161 INITIATED:

1. UNIT/POC: 2. DATE:

6. TRAINING STATUS:

4. REPORT TYPE:

SHORTAGES DETECTED DURING BUILDING CLEARANCE ARE FINAL

9. ITEM DESCRIPTION 10. DETAILS 11. FURNISHING OR

OPERATIONAL STOCK ITEM

5. COMPONENT TYPE:

3. ADDRESS:

ACTIVE

NG

RES

CONTRACTOR

OTHER:

BDT

ECT

EXERCISE:

OTHER:

FURNISHING OSI

FURNISHING OSI

FURNISHING OSI

FURNISHING OSI

FURNISHING OSI

FURNISHING OSI

FURNISHING OSI

FURNISHING OSI

ISSUING/CLEARING UNIT

NEW STOCK DELIVERY

Damage

Shortage Fair wear & tear

CONTRACTOR REPLACEMENT

YES NO N/A

Damage

Shortage Fair wear & tear

Damage

Shortage Fair wear & tear

Damage

Shortage Fair wear & tear

Damage

Shortage Fair wear & tear

Damage

Shortage Fair wear & tear

Damage

Shortage Fair wear & tear

Damage

Shortage Fair wear & tear

Fort McCoy, Wisconsin

Transient Troop Training Facility Support Services

SHORTAGE/DAMAGE/FAIR WEAR AND TEAR REPORT

BLOCK 1: Enter the Unit POC Name for Shortage, Damage or FWT.

BLOCK 2: Date

BLOCK 3. Enter the full mailing address for the Responsible Unit.

BLOCK 4. Select the corresponding check box for Report Type.

BLOCK 5. Select the Component Type of the Responsible Unit.

BLOCK 6. Select the Training Status of the Responsible Unit, Battle Drill Training (BDT), Extended Combat. Training (ECT), Exercise (Enter the Exercise Name if applicable) or other for all other training.

BLOCK 7. Enter the Building Number (BLDG) that the shortage, damage or FWT occurred in.

BLOCK 8: Enter the quantity (QTY) of the item short, damaged or FWT.

BLOCK 9: Enter missing/damaged item description.

BLOCK 10: Select the corresponding check box to indicate if the item is a result of damage, shortage, or fair wear and tear.

BLOCK 11: Select the corresponding check box to indicate if the item is a furninshing or operational stock item.

BLOCK 12: Select the corresponding check box to indicate the initiation requirement of DA 3161.

BLOCK 13: Enter the name (printed) of the Building Inspector.

BLOCK 14: Building Inspector signature and date.

BLOCK 15: Enter the name (printed) of the Unit POC.

BLOCK 16: Unit POC signature and date.

Note: Submit original copy for processing and provide a copy to Unit POC.

ADDITIONAL INFORMATION FOR FORT MCCOY FORM

Receiving Area ISS IssCh RET Office - 116 ISS IssCh RET ISS IssCh RET Cold Storage ISS IssCh RET

Platform Carts 4 Key Box Key (Bulletin Board) Direct Steam Tilting Kettles 1 Cooler #1 Wire Rack 8

Hand Pallet Jack 1 Kettle Lids 2 Cooler #1 Speed Racks 3

Wall Clock 1 Splash Guard Clean-up Pan 1 Cooler #2 Wire Rack 8

Fire Extinguisher Class ABC 1 Gas Tilting Skillets 2 Cooler #2 Speed Racks 3

Waste Can (small) 2 Freezer Wire Rack 8

Janitorial Closet- 108 ISS IssCh RET Cloth Guest Chair 2 DoubleStacked Convection Oven 2 Freezer Metal Dunnage Rack 1

Rotary Desk Chair 2 Oven Racks (5 per oven) 20

Sweeping Broom 4 White Surge Power Protector 2 Oven Side Rails (2 per oven) 8 Metal T-Bar Rack 10

Push Broom 4 L- Shaped Desk 2 Ice Making Machine 1

Mop Bucket w/Wringer 4 Metal T-Bar Rack 2 Pot & Pan Dishwasher 1

Mop Handle 4 Wall Safe 1 Coffee Urn 1 Dishwasher Screens 6

Dust Pan 4 Telephone 2 Wire Basket 1 Drain Basket 1

Wet Floor Signs 5 Lid Cover 2 Metal Dishwasher Racks 7

Floor Squeeggies 2 Kitchen Area ISS IssCh RET Alto-Sham Warmer 1

Snow Shovels 2 Alto-Sham Warmer 1 Warmer shelf Racks 6 Sanitizing Sink Utensil Basket 1

Warmer shelf Racks 6 Side Rails 4

Side Rails 4 Drip Pan 2

Drip Pan 2 Food Prep Table 6

Dry Storage Area - 119 ISS IssCh RET Pastry Cabinet 2 Knife Rack 3

Hand Dolly 2 Roll-In Warmer 1 Electric Can Opener 2

#10 Can Rack 4 Roll-In Rack 2

Roll-in Refrigerator 1 Trash Can w/Lid (Tall) 1

Black Tilt Cart 2 Roll-in Rack 2 Dial Scale 2 Fire Extinguisher Class ABC 1

Individual Wire Rack (wide) 9 Robot Coupe-Food Processor 1

Fire Extinguisher Class ABC 1 Ice Making Machine 1 Black Tube Pusher 1 Roll-In Warmer 1

Locker Room ISS IssCh RET DoubleStacked Convection Oven 2 Black Discharge Plate 1 Roll-In Rack 2

Shower Curtain 1 Oven Racks (5 per oven) 20 Slicer Blade Attachment 2 Roll-In Refrigerator 1

Oven Side Rails (2 per oven) 8 Blade Storage Rack 1 Roll-In Rack 2

Storage Area - 118 ISS IssCh RET Pastry Work Table 1 White Tray for Attachments 1

Chemical Metal Lockers w/Lock 1 Knife Rack 1 Fire Extinguisher Class K Wet 1 Wall Clock (over kitchen doors) 2

Wire Rack (narrow shelves) 1 Table Top Mixer w/Stand 1 Meat slicer w/Stand 1

Step Stool 1 Mixer Bowl 1 Digital Scale on Wheels 1

Beater Attachment 1

Dough hook attachment 1

Between 118 & 117 ISS IssCh RET Wire Whip Attachment 1

Rubber Trash Cans-36 Gal 5 Table w/Utensil Rack & Sink 1

Dollies/Lids for Trash Can 5 Trash Can w/Lid (Tall) 1

Office - 117 ISS IssCh RET Gas Titlting Skillets 2 Table w/Utensil Rack & Sink 1

Wall Clock 1 Trash Can w/Lid (Tall) 1

Waste Can (small) 2 Direct Steam Tilting Kettles 1 Roll-in Refrigerator 1

Cloth Guest Chair 2 Kettle Lids 2 Roll-in Rack 2

Rotary Desk Chair 2 Splash Guard Clean-up Pan 1 Blue Metro Max Shelving Rack 1

White Surge Power Protector 2 Roll-in Refrigerator 1

L- Shaped Desk 2 Roll-in Rack 2

Wall Safe 2 Six-Burner Stove Top Range 1

Telephone 2 Convection-Pro Steamers 4

Steamer Rack (6 per steamer) 24

Steamer Rear Drain Screen 8

Six-Burner Stove Top Range 1

Form Dated: July 2022

Issued By/Date:_____________________

Received By/Date:_____________________

Unit:

Date: ____________________________

Warrior Restaurant Hand Receipt WR 1872 & 2472 Kitchen Area

Unit POC/Phone:__________________________

Cleared By:____________________________________________

Date:_________________________________________________

Unit Clearing Rep:_______________

Date:__________________________

Issued By:_________________________

Metal Locker 1

TE 6 Attachment #3

Hot Serving Area ISS IssCh RET Beverage Area - Side A ISS IssCh RET Storage - A /Headcount - A ISS IssCh RET

Grill w/Drain Trough 4 Air Merchandiser 1 Chair Dollies 20

Hot Steam Tables (5-Well) 4 Plexi-Glass Panel 1 Trash Can w/Lid (Tall) 2

SteamTable Drain Screen 20 Shelves 4

Steam Table Dome Covers 20 Pull Down Clear-Shade 1 Waste Can (small) 1

Work Table (on serving line) 4 Bread Display Case 1 Rotary Headcount Chair 2

30" Work Table (on wall) 6 Clear Removable trays 2 Rug, Gray 7

Toaster 1 Fire Extinguisher Class ABC 1

Trash Can w/Lid (Tall) 2 Crumb Tray 1

Silverware Cart 4 Toast Slide Tray 1

Rubber Trash Can - 36 Gal 2 Gray Condiment Stand w/12 Bin 1 Storage - B /Headcount - B ISS IssCh RET

Dollies/Lids for Trash Can 2 Ice & Water Dispenser 2 Gray Dunnage Rack 48" 1

General Mill Cereal Rack 1 Metal Drain Rack 2 Wire Rack (narrow) 4

Kellogs Cereal Rack 1 Napkin Dispenser 3 Trash Can w/Lid (Tall) 2

Coffee Urn 1

Mobile Utility Carts 8 Wire Basket 1 Waste Can (small) 1

Lid Cover 2 Rotary Headcount Chair 2

Mobile Condiment Bar 1 Rug, Gray 7

Cold Serving Area ISS IssCh RET Beverage Counter 1 Fire Extinguisher Class ABC 1

30" Work Table 4 Bev Counter Drain Bucket 1

4 Well- Salad Bar Unit 2

Angle Adapter 8

Metal Divider 6 Beverage Area - Side B ISS IssCh RET

Interior Brackets 16 Air Merchandiser 1

5 Well- Salad Bar Unit 2 Plexi-Glass Panel 1

Angle Adapter 10 Shelves 4

Metal Divider 8 Pull Down Clear-Shade 1

Interior Brackets 16 Bread Display Case 1

Pastry Shelf Salad Bar Unit 2 Clear Removable trays 2

Metal Divider 6 Toaster 1

Interior Brackets 16 Crumb Tray 1

Wall Clock 1 Toast Slide Tray 1

Gray Condiment Stand w/12 Bin 1

Ice & Water Dispenser 2

Metal Drain Rack 2

Napkin Dispenser 3

Coffee Urn 1

Wire Basket 1

Lid Cover 2

Mobile Condiment Bar 1

ISS IssCh RET Beverage Counter 1

Bev Counter Drain Bucket 1

Blue Beverage Containers w/lids 10

Black Beverage Risers 10

Fire Extinguisher Class ABC 1

Form Dated: April 2022

Date: ____________________________

Issued By/Date:_____________________

Received By/Date:_____________________

Unit:

Cleared By:____________________________________________

Date:_________________________________________________

Unit Clearing Rep:_______________

Date:__________________________

Warrior Restaurant Hand Receipt WR 1872 & 2472 Serving Area

Unit POC/Phone:__________________________

Cleared By:____________________________________________

Date:_________________________________________________

Unit Clearing Rep:_______________

Date:__________________________

Issued By:_________________________

Dining Room ISS IssCh RET Dining Room Layout Legend

Rubber Trash Cans 32 Gal 10

Dollies/Lids for Trash Cans 10

Folding Dining Tables 78

Stacking Dining Chairs 623

Wall Clock 3

Fire Extinguishers 3

Janitorial Closet ISS IssCh RET

Mop Bucket w/Wringer 3

Mop Handle 3

Sweeping Broom 3

Push Broom 3 ISS IssCh RET

Dust Pan 3

Snow Shovels 2

Wet Floor Signs 5

Wire Storage Rack on Wheels 1

Headend Room ISS IssCh RET

Lectern (Gray Podium) 1

Audio Equipment /Cabinet 1

Bodypack Transmitter wireless 1

Handheld Transmitter Mic 1

DENON Media Remote Control 1

Telephone 1

ISS IssCh RET

Form Dated: April 2022

Received By/Date:_____________________

Issued By/Date:_____________________

Unit:

Women's Latrine

Men's Latrine

Closet

Headend Room

Janitorial

32 gal Trash Can w/lids & dollies

Fire Extinguisher

Exit Location

Tables/Chairs All have 8 Chairs per table

Both sides/8 cloumns across upper level 3 rows tables ecept 2 tables behind brick columns lower level 2 rows tables both sides

Lower LevelUpper Level

Wall Clock

Unit POC/Phone:__________________________

Warrior Restaurant Hand Receipt WR 1872 & 2472 Dining Area

Cleared By:____________________________________________

Date:_________________________________________________

Unit Clearing Rep:__________________________

Date:______________________________________

TECHNICAL EXHIBIT 7

OPERATIONAL STOCK ITEMS (OSI) & FURNISHINGS

OSI

FURNISHINGS

Nomenclature Type

Broom, Push OSI

Broom, Angled OSI

Can, Garbage (Large) OSI

Can, Garbage (Small) OSI

Dustpan OSI

Fire Extinguishers OSI

Handle, Push Broom OSI

Handle, Wet Mop OSI

Mop Bucket/Wringer (Plastic) OSI

Shovel, Snow OSI

Shower Curtains OSI

Shower Hooks OSI

Shower Rods OSI

Toilet Brush (Sanitary) OSI

Toilet Plunger OSI

Nomenclature Type

Bed Frame Furnishing

Fan, Circulating (floor) Furnishing

Fan, Small Furnishing

Foot Locker Furnishing

Mattress Furnishing

Desk, Office Furnishing

Chair, Office Furnishing

Table, Classroom Furnishing