A03 - DD1423_Attachment 3 _signed.pdf
PDF 279 KB Posted
- Attached to
- HubZone Outreach Support Initiative Federal contract opportunity
- Solicitation number
- W911NF-20-R-0002
About this file
This Contract Data Requirements List (CDRL) outlines four required reports for a HubZone Outreach Support initiative contract. The contractor must submit Financial Status Reports, Stipend Status Reports, Applicant Analysis Reports, and Selectee Analysis Reports on a periodic basis per the Performance Work Statement. All reports must be delivered electronically to the Combat Capabilities Development Command Army Research Laboratory Technology Transfer and Outreach Office. The reports will provide expenditure details, stipend management, and applicant/selectee assessments to support the initiative's goal of strengthening STEM education and workforce development networks for the Department of Defense and Army through K-College outreach programs.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| W911NF-20-R-0002_Amendment 0004.pdf | ||
| W911NF-20-R-0002_Amendment 0003_Final.pdf | ||
| W911NF-20-R-0002_Amendment 0002_Final.pdf | ||
| TOR 0001_Outreach Support Initiative_ Final.pdf | ||
| W911NF-20-R-0002_Amendment_Final.pdf | ||
| Past Performance Evaluation Questionnaire - Attachment 1.pdf | ||
| Question Template - Attachment 2.pdf | ||
| Question Format - Attachment 2.docx | DOCX document | |
| TOR Outreach_PRS_Attachment 2.pdf | ||
| TOR Outreach_TD rights_Attachment 4.pdf | ||
| TOR Outreach PWS_Attachment 1_Final.pdf | ||
| W911NF-20-R-0002 Solicitation Final.pdf |
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Text version
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
Form Approved OMB No. 0704-0188
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 collecton of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-1088). 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 if it does not display a currently valid OMB control number.
Please do not return your form to the above organization. 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
A
C. CATEGORY:
TDP_____ TM ______ OTHER: MISC
D. SYSTEM/ITEM
HubZone Outreach Support
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A001
2. TITLE OF DATA ITEM
Financial Status Report
3. SUBTITLE
Financial Expenditures
4. AUTHORITY (Data Acquisition Document No.)
DI-MISC-80711A(T)
5. CONTRACT REFERENCE
PWS, Paragraph C.1
6. REQUIRING OFFICE
FCDD-RLD-PT
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
One Per Iteration
12. DATE OF FIRST
SUBMISSION
SEE PWS C.1
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
SEE PWS C.1
13. DATE OF SUBSEQUENT
SUBMISSION SEE PWS C.1
Draft Final Reg Repro
16. REMARKS
BLK 4: CONTRACTOR FORMAT IS ACCEPTABLE. EACH REPORT SHALL BE
DELIVERED ELECTRONICALLY IN A MEDIA SELECTED BY THE GOVERNMENT AT TIME
OF DELIVERY. MEDIA TYPES WHICH CAN BE ACCEPTED INCLUDE: FTP (FILE
TRANSFER PROTOCOL), CD-ROM AND DVD ROM.
REPORT COPY TO BE SENT TO:
CCDC-ARL
FCDD-RLD-PT (Dr. Vallen Emery) Technology Transfer and Outreach Office
2800 POWDER MILL RD
ADELPHI, MD 20783
Email Address: vallen.l.emery.civ@mail.mil
FCDD-RLD-PT 1 1
15. TOTAL 1 1
G. PREPARED BY H. DATE
03/25/2020
I. APPROVED BY
Dr. Vallen Emery
J. DATE
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 4 Pages
25 March 2020 mailto:vallen.1.emery.civ@mail.mil
Form Approved
OMB No. 0704-0188
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 collecton of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-1088). 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 if it does not display a currently valid OMB control number.
Please do not return your form to the above organization. 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
A
C. CATEGORY:
TDP_____ TM ______ OTHER: MISC
D. SYSTEM/ITEM
HubZone Outreach Support
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM
Stipend Status Report
3. SUBTITLE
Financial Expenditures
4. AUTHORITY (Data Acquisition Document No.)
DI-MISC-80711A(T)
5. CONTRACT REFERENCE
PWS, Paragraph C.2
6. REQUIRING OFFICE
FCDD-RLD-PT
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
One Per Iteration
12. DATE OF FIRST
SUBMISSION
SEE PWS C.2
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
SEE PWS C.2
13. DATE OF SUBSEQUENT
SUBMISSION SEE PWS C.2
Draft Final Reg Repro
16. REMARKS
BLK 4: CONTRACTOR FORMAT IS ACCEPTABLE. EACH REPORT SHALL BE
DELIVERED ELECTRONICALLY IN A MEDIA SELECTED BY THE GOVERNMENT AT TIME
OF DELIVERY. MEDIA TYPES WHICH CAN BE ACCEPTED INCLUDE: FTP (FILE
TRANSFER PROTOCOL), CD-ROM AND DVD ROM.
REPORT COPY TO BE SENT TO:
CCDC-ARL
FCDD-RLD-PT (Dr. Vallen Emery) Technology Transfer and Outreach Office
2800 POWDER MILL RD
ADELPHI, MD 20783
Email Address: vallen.1.emery.civ@mail.mil
FCDD-RLD-PT 1 1
15. TOTAL 1 1
G. PREPARED BY
H. DATE
03/25/2020
I. APPROVED BY
Dr. Vallen Emory
J. DATE
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 2 of 4 Pages
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 collecton of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-1088). 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 if it does not display a currently valid OMB control number.
Please do not return your form to the above organization. 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
A
C. CATEGORY:
TDP_____ TM ______ OTHER: MISC
D. SYSTEM/ITEM
HubZone Outreach Support
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A003
2. TITLE OF DATA ITEM
Applicant Analysis Report
3. SUBTITLE
Management
4. AUTHORITY (Data Acquisition Document No.)
DI-MISC-80711A(T)
5. CONTRACT REFERENCE
PWS, Paragraph C.4
6. REQUIRING OFFICE
FCDD-RLD-PT
7. DD 250 REQ
LT
One Per Iteration
12. DATE OF FIRST
SUBMISSION
SEE PWS C.4
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
SEE PWS C.4
13. DATE OF SUBSEQUENT
SUBMISSION SEE PWS C.4
Draft Final Reg Repro
16. REMARKS
BLK 4: CONTRACTOR FORMAT IS ACCEPTABLE. EACH REPORT SHALL BE
DELIVERED ELECTRONICALLY IN A MEDIA SELECTED BY THE GOVERNMENT AT TIME
OF DELIVERY. MEDIA TYPES WHICH CAN BE ACCEPTED INCLUDE: FTP (FILE
TRANSFER PROTOCOL), CD-ROM AND DVD ROM.
REPORT COPY TO BE SENT TO:
CCDC-ARL
FCDD-RLD-PT (Dr. Vallen Emery) Technology Transfer and Outreach Office
2800 POWDER MILL RD
ADELPHI, MD 20783
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 3 of 4 Pages
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 collecton of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications Directorate (0704-1088). 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 if it does not display a currently valid OMB control number.
Please do not return your form to the above organization. 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
A
C. CATEGORY:
TDP_____ TM ______ OTHER: MISC
D. SYSTEM/ITEM
HubZone Outreach Support
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A004
2. TITLE OF DATA ITEM
Selectee Analysis Report
3. SUBTITLE
Management
4. AUTHORITY (Data Acquisition Document No.)
DI-MISC-80711A(T)
5. CONTRACT REFERENCE
PWS, Paragraph C.5
6. REQUIRING OFFICE
FCDD-RLD-PT
7. DD 250 REQ
LT
One Per Iteration
12. DATE OF FIRST
SUBMISSION
SEE PWS C.5
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
SEE PWS C.5
13. DATE OF SUBSEQUENT
SUBMISSION SEE PWS C.5
Draft Final Reg Repro
16. REMARKS
BLK 4: CONTRACTOR FORMAT IS ACCEPTABLE. EACH REPORT SHALL BE
DELIVERED ELECTRONICALLY IN A MEDIA SELECTED BY THE GOVERNMENT AT TIME
OF DELIVERY. MEDIA TYPES WHICH CAN BE ACCEPTED INCLUDE: FTP (FILE
TRANSFER PROTOCOL), CD-ROM AND DVD ROM.
REPORT COPY TO BE SENT TO:
CCDC-ARL
FCDD-RLD-PT (Dr. Vallen Emery) Technology Transfer and Outreach Office
2800 POWDER MILL RD
ADELPHI, MD 20783
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 4 of 4 Pages
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