Exhibit_A_-_Contract_Data_Requirements_List_Final_SIGNED.pdf

EXHIBIT A – HARDWARE SOFTWARE INTEGRATION FACILITY

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C009 BRIEFING MATERIAL IN PROCESS REVIEW (IPR)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MGMT-81605 SEE BLK 16 AMSEL-SEC-EHB

INSERT IN

SECTION B

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

LT

QRTLY SEE BLK 16

b. COPIES

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

a. ADDRESSEE Draft Final

A

N/A

Reg

Repro

16. Remarks:

Block 5:

PWS REF: 3.1.10.1

BLOCK 9: Distribution Statement D. Distribution authorized to the

DoD and DoD contractors only. Reason: To protect technical/operational data or information. Other requests shall be referred to AMSEL-SEC-EHB

BLOCK 12: Shall be submited 3 business days prior to IPR.

BLOCK 7 & 14: Report shall be submitted via e-mail to the following:

-Contracting Officer's Representative

-Chief HSIF

The e-mailed Letter of Transmittal shall include:

-Task Order/Contract Identification

-Date of Delivery.

FORMAT: Briefing Materials shall be delivered in MS Powerpoint format using the current Software Engineering Center slide template, to be provided upon award. The Government will provide updates to the slide template as required.

AMSEL-SEC-EHB

15. TOTAL 0 2 0

G. PREPARED BY

D. Lee Tomberlin

H. DATE

21 October 2015

I. APPROVED BY

J. DATE

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page # of #

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

C010 CONTRACTOR PERSONNEL ROSTER AFTER HOURS CONTACT LIST

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MGMT-81834A SEE BLK 16 AMSEL-SEC-EHB

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

ASREQ SEE BLK 16

PWS REF: 3.2.9.1

BLOCK 4: The list will be used for building emergencies after duty hours. The list shall contain at a minimum:

Name

Phone Numbers (home and mobile)

Contact Sequence

BLOCK 10: Reviewed annually and updated as required within one business day of changes.

BLOCK 12: Shall be provided at time of award and updated as required within one business day of changes.

BLOCK 7 & 14: Report shall be submitted encrypted via e-mail to the following:

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD B TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

B001 PERFORMANCE AND COST REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-FNCL-80912 SEE BLK 16 AMSEL-SEC-EHB

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

MTHLY 30DAC

SEE BLK 16

PWS REF: 3.1.1 / 3.2.11.1

BLOCK 4: Report shall be provided for all SEC contracts and task orders. It shall include a projected, by month, funding profile/spend plan for the fiscal year. Where applicable, this profile will be based on the supported program’s master program schedule as provided by the

SEC. Cost data shall be identified according to source of funding (e.g.

Direct, Supplemental, Reimbursable ( OMA, OPA, R&D, et cetera). If contract is Cost Plus Fixed Fee (CPFF), then provide the status of expiring funds (fund type in their last year of availability (e.g. three year Other Procurement Army (OPA) funds in the third year), and separately report on the status of Operational and Maintenance, Army -

OMA ( Base and Overseas Contingency Operations - OCO) funds.

Department of Defense (DoD) and DoD contractors only. Reason: To protect technical/operational data or information. Other requests shall be referred to AMSEL-SEC-EHB.

BLOCK 13: Ten (10) working days after the end of the month.

BLOCK 14: Reports shall be disseminated via electronic mail to:

-Procuring Contracting Officer

COST REPORT DATA: The following data is required with each

Monthly Cost Report. It shall be provided in the format using Cost

Report spread sheet format.

COST REPORTING META DATA (Provided by the Government):

The following information is to be provided with each Monthly Cost

Report. This information will be provided by the Government at the beginning of the period of performance. The Contractor shall incorporate this information in to the Monthly Cost Report.

Contract Number:

Description of work: Summary description of the work to be performed under the contract.

Total Negotiated Value: The value of the contract as awarded (and amended via modifications).

Period of Performance by Base, by Options: The contract period of performance identified by the base period and any subsequent option periods.

Program/System Supported (as represented in the associated Source

Selection Evaluation Plan (SSEP)):

General Fund Enterprise Business System (GFEBS) Work Breakdown

Structure ( WBS) Number (DoD financial tracking system):

Project Registry Number (SEC system tracking system):

Line Directorate:

Contract Leader:

COR:

COST REPORT FINANCIAL DATA (Provided by the Contractor):

The following data is required with each Monthly Cost Report. It shall be provided in the format using Cost Report spread sheet format.

Estimated Carry-In: When the Contract has a continuing requirement and crosses fiscal years, identify the amount of funds estimated that will be remaining at the end of the current reporting fiscal year. These are funds which have been obligated through award of the contract or modification to the contract, but have not been expensed or estimated to be expensed for labor or Other Direct Cost (ODCs) by the end of the reporting fiscal year. These carry-over funds will then be available for utilization on the contract in the subsequent fiscal year Note: the actual funds remaining at the end of the fiscal year will be reported as 'Carry-

In' for the continued requirement at the beginning of next fiscal year.

Carry-In: When the Contract has a continuing requirement and crosses fiscal years, at the beginning of the fiscal year, identify funds that were obligated through award of the contract or modification to the contract in any previous fiscal year, but not actually expensed/burned by the contractor by the end of the previous fiscal year. Note: there is no

Carry-In at the time of award of the contract.

Funds obligated by Sub-Contract Line Item Number (SLIN): Total funds obligated on a specific contract reported by SLIN (with SLINs for each type of money), and with modifications identified for funds obligated after the base award.

Prime/Subcontractor status: Identification as to whether they are a large business, Small Disadvantaged Business (SDB), Small 8(a), Small

Veteran Owned, etc.

Labor Rate by Person, by Labor Category: Negotiated labor rate per negotiated labor category.

PPSS Priorities categories: The following categories are to be reported in each Monthly Cost Report as required below. Note that the PPSS

Priorities Category definitions are identified in theCost Report spread sheet.

- Commercial-Off-The-Shelf (OTS) Software License

- Category 1 & 2 Software fixes

- COTS Software Maintenance Agreements

- Information Assurance Vulnerability Alert (IAVAs)

- Security Certification & Accreditations (C&A)

- Critical In-Theater Field Support Engineering

- Category 3, 4, 5, Software fixes

- Interoperability Testing

- Non-Critical Field Support

Labor Hours and Labor Dollars: by person, labor category/rate, location, funding SLIN(s), month expenses that were expended with a cumulative total (CUM) for the respective base/option period of performance, system on which the labor hours were performed, WBS element and Post Production Software Support (PPSS) Priority

Category associated with the labor effort, performed by Prime or specific Subcontractor, and the type of funds (e.g. direct, supplemental, reimbursable). The associated WBS representing the contractor’s methodology for executing the contract requirements shall also be mapped to the respective PWS section, the

PPSS Priority Category, the associates system, and if performed by the

Prime or Subcontractor.

ODC Materials/Hardware by Subcontractor, by SLIN, by hardware purchased by the Prime contractor or a subcontractor in the performance of the contract as authorized by the contract.

ODC Software by Subcontractor, by SLIN, by Month, by CUM, to include 'burn rate': Software purchased by the Prime contractor or a subcontractor in the performance of the contract as authorized by the contract.

ODC Travel by Prime/Subcontractor, by SLIN, by Month, by CUM, to include 'burn rate': Travel completed by the Prime contractor or a subcontractor in the performance of the contract as authorized by the

ODC Estimated Outstanding: Amount of ODC cost of subcontractors, which is known by the Prime contractor to be completed by the

Subcontractor; but, it has not invoiced by the

Subcontractor at the time of the report.

Funds Available: Funds obligated minus total Labor Dollars expended and total ODC expended, and are available to be utilized on the

Labor Dollars Burn Rate by SLIN, by Month, by CUM: The monthly average of all dollars expended (total labor dollars plus total ODC dollars) represented by the average of the total CUM of dollars divided by the total periods (months), which is used to set the expectation for future expenditures and estimates.

Labor Hours Burn Rate by SLIN, by Month, by CUM: The trend of all hours expended (total labor dollars plus total ODC dollars for Prime contractor and all subcontractors) represented by the average of the

CUM of hours divided by the total periods (months), which is used to set the expectation for the future expenditures and estimates.

Labor Dollars and Labor Hours Project Burn Rate to End-Of-Fiscal-

Year (EOFY) by Labor Cost and ODCs: The burn rate that the contractor expects to incur from the point of the report to the end of the fiscal year.

Estimated cost to complete: The amount of cost (total labor dollars and total ODC dollars) anticipated by the Prime contractor to be incurred in the completion of the contract requirements, in addition to the funds currently obligated.

Hours and Labor Dollars Certified, by Invoice, by SLIN: The COR's certification of invoice as authorized under the contract, as submitted by the Prime contractor.

15. TOTAL 0 3 0

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD E TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD TBD

E002 QUALITY ASSURANCE PROGRAM PLAN

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-QCIC-81794 SEE BLK 16 AMSEL-SEC-EHB

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SEE BLK 16 SEE BLK 16

30DAC

PWS REF: 3.2 / 3.2.10.3

BLOCK 10: Review annually and update as required.

BLOCK 12: Shall be provided with contractor's proposal, updated 30 calendar days after award of contract, then updated as required.

-Task Order Identification

-Date of Delivery

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD E TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD TBD

E001 QUALITY DEFICIENCY REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-QCIC-80736 SEE BLK 16 AMSEL-SEC-EHB

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

PWS REF: 3.2.1.2

BLOCK 4: Format is Standard Form -354, Report of Discrepancy

(ROD)

BLOCK 12: SF-368 shall be submitted within 1 business day after deficiency is noted.

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD A TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

A001 REPORT, RECORD OF MEETING MINUTES

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-ADMN-81505 SEE BLK 16 AMSEL-SEC-EHB

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

ASGEN SEE BLK 16

PWS REF: 3.2.11.1

BLOCK 12: Meeting Minutes shall be delivered no later than 3 business days following the Government scheduled meeting.

BLOCK 7 & 14: Report shall be submitted via e-mail to the following:

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C008 STANDARD OPERATING PROCEDURES

(SOP)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MGMT-81580 SEE BLK 16 AMSEL-SEC-EHB

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

ASREQ 90DAC

ASREQ

PWS REF: 3.2.10.2

BLOCK 10: ALL HSIF SOPs shall be reviewed and updated within 90 calendar days after award of contract. Thereafter they shall be reviewed annually and updated as required.

BLOCK 13: The government will have 14 calendar days after submission to provide comments. If no comments are received then the draft copy shall be considered the final.

BLOCK 7 & 14: Report shall be submitted via e-mail to 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

Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C001 STATUS REPORT 10% MONTHLY INVENTORY

REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MGMT-80269 SEE BLK 16 AMSEL-SEC-EHB

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

MTHLY 5DARP

PWS REF: 3.2.3.1

BLOCK 4: Contractor format is acceptable as approved by the

Government for this Warehouse Inventory.

BLOCKS 10 & 12: The Government will select items to be inventoried.

Inventory shall be completed NLT 5 business days after the end of the previous reporting month, unless additional time is requested and granted in writing by the COR.

BLOCK 14: Report shall be submitted via e-mail to the following:

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C002 STATUS REPORT 100% ANNUAL INVENTORY

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

ANNLY 10DARP

PWS REF: 3.2.3.1

Government for this Warehouse Inventory.

BLOCKS 10 & 12: The Government will schedule annual inventory.

Inventory shall be completed NLT 10 business days after the end of the last reporting period of the year unless additional time is requested and

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD TBD

C005 STATUS REPORT COMMERCIAL SHIPPING REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MGMT-80368A SEE BLK 16 AMSEL-SEC-EHB

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

MTHLY 10DARP

PWS REF: 3.2.2.3 /3.2.2.3.1/ 3.2.2.4

Government. The monthly report shall contain summary and details of outgoing shipments by HSIF customers.

referred to AMSEL-SEC-EHB.

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C006 STATUS REPORT EVIDENCE OF MANDATORY

TRAINING

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

PWS REF: 3.1.9 / 6.1/ 6.4 / 6.6 / 6.7 / 6.9

BLOCK 4: Contractor format of certificates or documentation is acceptable.

DoD and DoD contractors only. Reason: To protect personall data or information. Other requests shall be referred to AMSEL-SEC-EHB.

BLOCK 12: Evidendence of Training shall be submitted within 5 business days of Government request

BLOCK 14: Evidence of Training shall be submitted via e-mail to 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

Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C003 STATUS REPORT KEY PERSONNEL CHANGE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

PWS REF: 3.1.2 / 3.1.6

BLOCK 4: All Key Personnel Change Reports shall include the

-Name of individual(s) vacating key positions(s)

-Key Position(s)/Labor Category(s) impacted

-Effective date(s) of change(s) and vancancy(s)

-Justification for change(s) and vacancy(s)

-Mitigation plan for performance rist to fill vacancy(s) within 30 calendar days or until position is filled.

BLOCK 12: At least thirty (30) calendar days prior to diverting any key contractor personnel to other programs or contracts (or as soon as possible, if an individual must be replaced, for example, as a result of leaving the employ of the Contractor), the Contractor shall notify the

PCO, COR and Chief HSIF.

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD TBD

C007 STATUS REPORT MONTHLY STATUS REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

MTHLY 10DARP

PWS REF: 3.2.10.1

Government. The monthly report shall contain critical paths and sufficient detail to judge the progress of the work on a monthly basis.

Critical issues will be identified along with their expected impact and proposed solutions as appropriate. The Monthly Status Report shall include:

Summary of Activity

Metrics Summanry

Upcoming Calendar of Activities

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD C TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

C004 STATUS REPORT STATUS OF GOVERNMENT

FURNISHED EQUIPMENT REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

MTHLY SEE BLK 16

PWS REF: 3.1.1

BLOCKS 10 & 12: Contractor shall submit a 10% monthly inventory report and an annual 100% inventory report. Inventory shall be completed NLT 5 business days after the end of the previous reporting month (for monthly) or 10 days after the end of the last annual reporting period (for annual), unless additional time is requested and

AMSEL-SE-EHB

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 (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 it does not display a currently valid OMB control number. Please DO

NOT RETURN your form to the above 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 C. CATEGORY:

TBD D TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

HSIF TBD

D001 TECHNICAL REPORT-STUDY/SERVICES PHASE-OUT PLAN

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80508B SEE BLK 16 AMSEL-SEC-EHB

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

DD

ONE/R SEE BLK 16

14DARC

PWS REF: 3.1.4.2

BLOCK 12: The contractor shall submit the initial Phase Out Plan not later thanforty-five (45) calendar days prior to the contract end date.

Content: The Phase Out Plan shall detail disposition action for all furnishings, equipment, and documentation outlining the contractor's approach to fulfill the requirements of the contract and applying all relevant factors and information gathered throughout the performance of the contract.