015_Field_Service_Report_(Fillable_PDF_template).pdf

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Attached to
Army Watercraft Systems (AWS) Services Federal contract opportunity
Solicitation number
W56JSR-17-R-0021
Issued by
Department of the Army Materiel Command Army Contracting Command Aberdeen Proving Ground

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015 Field Service Report (Fillable PDF template)

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Template Revision 7 - OCT 2015

C4ISR SERVICE REPORT

IR NO: Date Opened: Category: (Check Applied Systems)

IBS Radar ECDIS MOBI

UPS VHF DSC NAVTEX

Weather

InMarSat Gyro

Software

GMDSS

Contact Person Contact Telephone No.1

Contact Email Contact Telephone No. 2

Vessel Location Vessel No.

Service Date (Start) Service Date (Finish)

FAULT SUMMARY IAVA Version: Tactical Radio Version:

SERVICE DETAILS

Include: <Fault> <Troubleshoot> <Parts> <Cause> <Additional> & <Communications>

PRODUCT DEFICIENCY INFO

Make: Model: Serial No.

Make: Model: Serial No.

Make: Model: Serial No.

REPLACEMENT PARTS

Make: Model: Serial No.

Make: Model: Serial No.

Make: Model: Serial No.

Make: Model: Serial No.

Date CFSR Labor Hours Travel Hours

S/T O/T S/T O/T CFSR (Print Name)

CFSR

(Signature / Date)

POC/GOVT REP (Printed Name)

NOTE: Any parts that have been replaced during service and have not been identified by the Government for refurbishment will remain on the vessel as Government property. Disposition is the responsibility of the owning Unit.

POC/GOVT REP

(Signature / Date)

POC/GOVT REP physically inspected/verified repair?

YES NO

MTS

DGPS

ECS

Other:

VMAIL/SALTSSPP BGAN/GRRIP

AIS

LoudhailerTactical Radio

BFT

IFF

Template Revision 7 - OCT 2015

IR NO:

SERVICE DETAILS CONTINUED

PRODUCT DEFICIENCY INFO

Make: Model: Serial No.

Make: Model: Serial No.

Make: Model: Serial No.

Make: Model: Serial No.

REPLACEMENT PARTS

Make: Model: Serial No.

Make: Model: Serial No.

Make: Model: Serial No.

Make: Model: Serial No.

C4ISR SERVICE REPORT
IRM NO:
SERVICE DETAILS
PRODUCT DEFICIENCY INFO
REPLACEMENT PARTS
IRM NO:
SERVICE DETAILS CONTINUED
PRODUCT DEFICIENCY INFO
REPLACEMENT PARTS
C4ISR SERVICE REPORT:
Contact Person:
Contact Telephone No1:
Contact Email:
Vessel Location:
Vessel No:
Service DateStart:
Service DateFinish:
IAVA Version:
Tactical Radio Version:
Make:
Serial No:
Make_2:
Serial No_2:
Make_3:
Serial No_3:
Make_4:
Serial No_4:
Make_5:
Serial No_5:
Make_6:
Serial No_6:
Make_7:
Serial No_7:
DateRow1:
CFSRRow1:
STRow1:
OTRow1:
STRow1_2:
OTRow1_2:
DateRow2:
CFSRRow2:
STRow2:
OTRow2:
STRow2_2:
OTRow2_2:
CFSR Print Name:
DateRow3:
CFSRRow3:
STRow3:
OTRow3:
STRow3_2:
OTRow3_2:
DateRow4:
CFSRRow4:
STRow4:
OTRow4:
STRow4_2:
OTRow4_2:
CFSR Signature Date:
DateRow5:
CFSRRow5:
STRow5:
OTRow5:
STRow5_2:
OTRow5_2:
DateRow6:
CFSRRow6:
STRow6:
OTRow6:
STRow6_2:
OTRow6_2:
Make_8:
Serial No_8:
Make_9:
Serial No_9:
Make_10:
Model_8:
Serial No_10:
Make_11:
Model_9:
Serial No_11:
Make_12:
Model_10:
Serial No_12:
Make_13:
Model_11:
Serial No_13:
Make_14:
Model_12:
Serial No_14:
Make_15:
Model_13:
Serial No_15:
IBS: Off
Radar: Off
ECDIS: Off
VHF_DSC: Off
DGPS: Off
AIS: Off
Weather: Off
InMarSat: Off
ECS_INSA: Off
Gyro: Off
Tactical_Radio: Off
Software: Off
SPP: Off
Yes: Off
No: Off
FAULT SUMMARYRow1:
SERVICE DETAILSRow 1:
MOBI: Off
NAVTEX: Off
UPS: Off
BFT: Off
ECS: Off
Loudhailer: Off
IFF: Off
BGAN_GRRIP: Off
VMAIL_SALTS: Off
Other Row1:
OTHER: Off
IRM NO:
SERVICE DETAILSRow2:
Contact Telephone No2:
Model:
Model_7:
Model_2:
Model_3:
Model_4:
Model_5:
Model_6:
MTS: Off

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