A03_-_DD1423.doc
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- Solicitation number
- W911QX-19-Q-0137
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Contract Data Requirements List
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| File | Type | Posted |
|---|---|---|
| A02-PWS_Exhibit_A.pdf | ||
| B01_-_Provisions_and_Clauses_Full-Text_Attachment.docx | DOCX document | |
| B01_-_Davis_Bacon_Act_Wage_Rates.pdf | ||
| A02_-_PWS_[Garrison]_-_Only_base_year.docx | DOCX document | |
| B01_-_AMENDED_Combination_Synopsis-Solicitation_for_Commercial_Purchases_(Under_SAT).docx | DOCX document | |
| A02-PWS_Exhibit_B.pdf | ||
| A02-PWS_Exhibit_C.pdf | ||
| A02-PWS_Exhibit_B.pdf | ||
| B01_-_Combination_Synopsis-Solicitation_for_Commercial_Purchases_(Under_SAT).docx | DOCX document | |
| B01_-_Davis_Bacon_Act_Wage_Rates.pdf | ||
| B01_-_Provisions_and_Clauses_Full-Text_Attachment.docx | DOCX document | |
| A02-PWS_Exhibit_A.pdf | ||
| A02_-_PWS_[Garrison].docx | DOCX document | |
| A02-PWS_Exhibit_C.pdf |
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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 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 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: MGMT
D. SYSTEM/ITEM
Sewer Camera Inspection
E. CONTRACT/PR NO.
0011347072
F. CONTRACTOR
N/A
1. DATA ITEM NO.
A001
2. TITLE OF DATA ITEM
Operations Security (OPSEC) Plan
3. SUBTITLE
OPSEC Standing Operating Procedure/Plan
4. AUTHORITY (Data Acquisition Document No.)
DI-MGMT-80934
5. CONTRACT REFERENCE
PWS 3.1.1
6. REQUIRING OFFICE
IMAL-PWF
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
N/A
10. FREQUENCY
ONE TIME
12. DATE OF FIRST SUBMISSION
SEE BLK 16
14.
DISTRIBUTION
| a. ADDRESSEE |
| b. COPIES |
8. APP CODE
N/A
11. AS OF DATE
SEE BLK 16
13. DATE OF SUBSEQUENT
SUBMISSION SEE BLK 16
| Draft |
| Final |
| Reg |
| Repro |
16. REMARKS
BLK 4: 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.
BLK 11 AND 12: THE CONTRACTOR SHALL DELIVER THE REPORTS NO LATER THAN THE DELIVERY DATES LISTED WITHIN THE PWS PARAGRAPHS LISTED IN BLOCK 5.
BLK 13: THE CONTRACTOR SHALL REVISE THE REPORTS NO LATER THAN THE DEADLINES DESCRIBED IN THE SOW PARAGRAPHS LISTED IN BLOCK 5 OF THIS DOCUMENT.
IMAL-PWF REPORT COPY TO BE SENT TO:
UNITED STATES ARMY RESEARCH LABORATORY
IMAL-PWF (NAOMI JAMES-SNEAD)
2800 POWDER MILL RD
ADELPHI, MD 20783
| IMAL-PWF |
| 1 |
| 1 |
| 1 |
| 15. TOTAL |
| 1 |
| 1 |
| 1 |
G. PREPARED BY
Mary-Catherine Price
H. DATE
30 April 2019
I. APPROVED BY
James O’Keefe
J. DATE
14 May 2019
DD FORM 1423-1, FEB 2001
PREVIOUS EDITION MAY BE USED.
Page of Pages
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 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 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: QCIC
D. SYSTEM/ITEM
Sewer Camera Inspection
E. CONTRACT/PR NO.
0011347072
F. CONTRACTOR
N/A
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM
Statistical Process Control (SPC) Implementation and Evaluation Aid
3. SUBTITLE
Accident Prevention Plan
4. AUTHORITY (Data Acquisition Document No.)
MIL-HDBK-683
5. CONTRACT REFERENCE
PWS 3.1.2
6. REQUIRING OFFICE
IMAL-PWF
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
N/A
10. FREQUENCY
ONE TIME
12. DATE OF FIRST SUBMISSION
SEE BLK 16
14.
| a. ADDRESSEE |
| b. COPIES |
8. APP CODE
N/A
11. AS OF DATE
SEE BLK 16
13. DATE OF SUBSEQUENT
SUBMISSION SEE BLK 16
| Draft |
| Final |
| Reg |
| Repro |
16. REMARKS
BLK 4: 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.
BLK 11 AND 12: THE CONTRACTOR SHALL DELIVER THE REPORTS NO LATER THAN THE DELIVERY DATES LISTED WITHIN THE PWS PARAGRAPHS LISTED IN BLOCK 5.
BLK 13: THE CONTRACTOR SHALL REVISE THE REPORTS NO LATER THAN THE DEADLINES DESCRIBED IN THE SOW PARAGRAPHS LISTED IN BLOCK 5 OF THIS DOCUMENT.
IMAL-PWF REPORT COPY TO BE SENT TO:
UNITED STATES ARMY RESEARCH LABORATORY
IMAL-PWF (NAOMI JAMES-SNEAD)
2800 POWDER MILL RD
ADELPHI, MD 20783
| IMAL-PWF |
| 1 |
| 2 |
| 2 |
| 15. TOTAL |
| 1 |
| 2 |
| 2 |
G. PREPARED BY
Mary-Catherine Price
H. DATE
30 April 2019
I. APPROVED BY
James O’Keefe
J. DATE
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 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 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: MGMT
D. SYSTEM/ITEM
Sewer Camera Inspection
E. CONTRACT/PR NO.
0011347072
F. CONTRACTOR
N/A
1. DATA ITEM NO.
A003
2. TITLE OF DATA ITEM
Contractor Roster
3. SUBTITLE
Contractor Personnel
4. AUTHORITY (Data Acquisition Document No.)
DI-MGMT-81596
5. CONTRACT REFERENCE
PWS 3.1.3
6. REQUIRING OFFICE
IMAL-PWF
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
N/A
10. FREQUENCY
ONE TIME/
AS NEEDED
12. DATE OF FIRST SUBMISSION
SEE BLK 16
14.
| a. ADDRESSEE |
| b. COPIES |
8. APP CODE
N/A
11. AS OF DATE
SEE BLK 16
13. DATE OF SUBSEQUENT
SUBMISSION SEE BLK 16
| Draft |
| Final |
| Reg |
| Repro |
16. REMARKS
BLK 4: 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.
BLK 11 AND 12: THE CONTRACTOR SHALL DELIVER THE REPORTS NO LATER THAN THE DELIVERY DATES LISTED WITHIN THE PWS PARAGRAPHS LISTED IN BLOCK 5.
BLK 13: THE CONTRACTOR SHALL REVISE THE REPORTS NO LATER THAN THE DEADLINES DESCRIBED IN THE SOW PARAGRAPHS LISTED IN BLOCK 5 OF THIS DOCUMENT.
IMAL-PWF REPORT COPY TO BE SENT TO:
UNITED STATES ARMY RESEARCH LABORATORY
IMAL-PWF (NAOMI JAMES-SNEAD)
2800 POWDER MILL RD
ADELPHI, MD 20783
| IMAL-PWF |
| 0 |
| 1 |
| 1 |
| 15. TOTAL |
| 0 |
| 1 |
| 1 |
G. PREPARED BY
Mary-Catherine Price
H. DATE
30 April 2019
I. APPROVED BY
James O’Keefe
J. DATE
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 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 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: 5836
D. SYSTEM/ITEM
Sewer Camera Inspection
E. CONTRACT/PR NO.
0011347072
F. CONTRACTOR
N/A
1. DATA ITEM NO.
A004
2. TITLE OF DATA ITEM
Tape, Video Recording, Cassette
3. SUBTITLE
Video
4. AUTHORITY (Data Acquisition Document No.)
A-A-55481
5. CONTRACT REFERENCE
PWS 3.1.4
6. REQUIRING OFFICE
IMAL-PWF
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
N/A
10. FREQUENCY
ONE TIME
12. DATE OF FIRST SUBMISSION
SEE BLK 16
14.
| a. ADDRESSEE |
| b. COPIES |
8. APP CODE
N/A
11. AS OF DATE
SEE BLK 16
13. DATE OF SUBSEQUENT
SUBMISSION SEE BLK 16
| Draft |
| Final |
| Reg |
| Repro |
16. REMARKS
BLK 4: 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.
BLK 11 AND 12: THE CONTRACTOR SHALL DELIVER THE REPORTS NO LATER THAN THE DELIVERY DATES LISTED WITHIN THE PWS PARAGRAPHS LISTED IN BLOCK 5.
BLK 13: THE CONTRACTOR SHALL REVISE THE REPORTS NO LATER THAN THE DEADLINES DESCRIBED IN THE SOW PARAGRAPHS LISTED IN BLOCK 5 OF THIS DOCUMENT.
IMAL-PWF REPORT COPY TO BE SENT TO:
UNITED STATES ARMY RESEARCH LABORATORY
IMAL-PWF (NAOMI JAMES-SNEAD)
2800 POWDER MILL RD
ADELPHI, MD 20783
| IMAL-PWF |
| 0 |
| 1 |
| 1 |
| 15. TOTAL |
| 0 |
| 1 |
| 1 |
G. PREPARED BY
Mary-Catherine Price
H. DATE
30 April 2019
I. APPROVED BY
James O’Keefe
J. DATE
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 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 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: NDTI
D. SYSTEM/ITEM
Sewer Camera Inspection
E. CONTRACT/PR NO.
0011347072
F. CONTRACTOR
N/A
1. DATA ITEM NO.
A005
2. TITLE OF DATA ITEM
Test/Inspection Report
3. SUBTITLE
Determination of Findings
4. AUTHORITY (Data Acquisition Document No.)
DI-NDTI-80809
5. CONTRACT REFERENCE
PWS 3.1.5
6. REQUIRING OFFICE
IMAL-PWF
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
N/A
10. FREQUENCY
ONE TIME
12. DATE OF FIRST SUBMISSION
SEE BLK 16
14.
| a. ADDRESSEE |
| b. COPIES |
8. APP CODE
N/A
11. AS OF DATE
SEE BLK 16
13. DATE OF SUBSEQUENT
SUBMISSION SEE BLK 16
| Draft |
| Final |
| Reg |
| Repro |
16. REMARKS
BLK 4: 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.
BLK 11 AND 12: THE CONTRACTOR SHALL DELIVER THE REPORTS NO LATER THAN THE DELIVERY DATES LISTED WITHIN THE PWS PARAGRAPHS LISTED IN BLOCK 5.
BLK 13: THE CONTRACTOR SHALL REVISE THE REPORTS NO LATER THAN THE DEADLINES DESCRIBED IN THE SOW PARAGRAPHS LISTED IN BLOCK 5 OF THIS DOCUMENT.
IMAL-PWF REPORT COPY TO BE SENT TO:
UNITED STATES ARMY RESEARCH LABORATORY
IMAL-PWF (NAOMI JAMES-SNEAD)
2800 POWDER MILL RD
ADELPHI, MD 20783
| IMAL-PWF |
| 0 |
| 1 |
| 1 |
| 15. TOTAL |
| 0 |
| 1 |
| 1 |
G. PREPARED BY
Mary-Catherine Price
H. DATE
30 April 2019
I. APPROVED BY
James O’Keefe
J. DATE
EXHIBIT A – ATTACHMENT 1
ARMY RESEARCH LABORATORY
Report Title Goes Here
Any Subtitles Go Here
By Some Author and Another Author
Month XXXX
Prepared by
Whatever Technology Corporation
0000 Research Drive
Anywhere, ST 20006-1000
Under contract
W911QX-XX-C-XXXX
DISTRIBUTION STATEMENT GOES HERE
EXHIBIT A – ATTACHMENT 2
The findings in this report are not to be construed as an official Department of the Army position unless so designated by other authorized documents.
Citation of manufacturer's or trade names does not constitute an official endorsement or approval of the use thereof.
DESTRUCTION NOTICE: For classified documents, follow the procedures in DoD 5220.22-M, National Industrial Security Program Operating Manual, Chapter 5, Section 7. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
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