TE-05_Elevator_CDRLs_A001_-_A005.pdf

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 (0704-0188). 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 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 C. CATEGORY:

TDP ________ TM _______ OTHER

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0006, 1006, 2006, 3006, 4006 TE 5

Elevator Contract Reporting

A001 Elevator maintenance & Service Work Schedule

See Block 16 Performance Work Statement (PWS) USAG-Natick-DPW

See Block 16

USAG-Natick-DPW

Initial 1

0 1 0

Block 16: The Contractor shall establish a monthly scheduled maintenance program which shall be submitted to the COR for approval within five (5) calendar days after contract award. The Contractor shall provide a work schedule for each machine room. The work schedules shall be designed for each type of equipment to be serviced, such as geared elevators, hydraulic elevators, etc., and shall conform to the manufacturer’s recommended practice for the particular equipment concerned. (Annex H, Section 2.26.8)

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COFFIN.BRUCE.A.1281078867

Date: 2019.03.26 14:08:37 -04'00'

3/14/19 PONTILLO.LOUIS.TIMOTH

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PONTILLO.LOUIS.TIMOTHY.1039060775

Date: 2019.03.26 15:27:04 -04'00'

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1 1 Adobe Professional 8.0

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 (0704-0188). 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 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 C. CATEGORY:

TDP ________ TM _______ OTHER

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0010 TE 5

Elevator Contract Reporting

A002 Elevator Maintenance & Service Quality Control Plan

See Block 16 Performance Work Statement (PWS) USAG-Natick-DPW

See Block 16

USAG-Natick-DPW

Initial 1

0 1 0

Block 16: The contractor shall develop and maintain an effective Quality Control Program (QCP) to ensure services are performed in accordance with (IAW) this PWS. The QCP must be forwarded to and accepted by the Contracting Officer. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of deficiencies. The contractor’s QCP is the means by which the contractor assures that the work complies with the requirement of the contract. The Contractor shall submit a comprehensive Quality Control Program along with the proposal for evaluation. (Annex A, Section 2.1.9 - Annex H, Section 2.25.5).

COFFIN.BRUCE.A.1281078867

Digitally signed by

COFFIN.BRUCE.A.1281078867

Date: 2019.03.26 14:09:57 -04'00'

3/26/19 PONTILLO.LOUIS.TIMOTH

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PONTILLO.LOUIS.TIMOTHY.1039060775

Date: 2019.03.26 15:30:12 -04'00'

3/26/19

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 (0704-0188). 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 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 C. CATEGORY:

TDP ________ TM _______ OTHER

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0007, 1007, 2007, 3007, 4007 TE 5

Elevator Contract Reporting

A003 Elevator Maintenance, Yearly Inspections

See Block 16 Performance Work Statement (PWS) USAG-Natick-DPW

See Block 16

USAG-Natick-DPW

Initial 1

0 1 0

Block 16: The Contractor shall provide yearly inspection of the elevator systems from a 3rd party certified elevator inspector. The Contractor shall prepare and submit a written report within one (1) week after the inspection/test is completed. The report shall include the date and time of the inspection/test, the location of the elevator, the inspection/test performed and the results, and the name of the technician(s) performing the inspection/test.

(Annex H, Section 2.26.1)

When the State of Massachusetts does not allow testing on federal facilities:

The Contractor shall be responsible for full compliance under the NFPA and ASME elevator code, to provide all labor and materials for a third party certified elevator inspection of all elevators and chair lifts. All results will be documented on forms 00347CAT1 and 00348CAT5 attached for each elevator and chair lift. (Annex H, 2.26.2)

COFFIN.BRUCE.A.1281078867

Digitally signed by

COFFIN.BRUCE.A.1281078867

Date: 2019.03.26 14:11:08 -04'00'

3/26/19 PONTILLO.LOUIS.TIMOTH

Y.1039060775

Digitally signed by

PONTILLO.LOUIS.TIMOTHY.1039060775

Date: 2019.03.26 15:31:56 -04'00'

3/26/19

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 (0704-0188). 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 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 C. CATEGORY:

TDP ________ TM _______ OTHER

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0008, 1008, 2008, 3008, 4008 TE 5

Elevator Contract Reporting

A004 Elevator Maintenance & Service, Other Services, Emergency & Damage Service Reports

See Block 16 Performance Work Statement (PWS) USAG-Natick-DPW

See Block 16

USAG-Natick-DPW

Initial 1

0 1 0

Block 16: If repairs are needed due to malicious damage, damage from accident, or damage from emergency extrication, the Contractor shall give full details in writing regarding the extent of such damages, and the repairs necessary to return the elevator(s) to normal operation. (Annex H, Section 2.26.7)

COFFIN.BRUCE.A.1281078867

Digitally signed by

COFFIN.BRUCE.A.1281078867

Date: 2019.03.26 14:11:56 -04'00'

3/26/19 PONTILLO.LOUIS.TIMOTH

Y.1039060775

Digitally signed by

PONTILLO.LOUIS.TIMOTHY.1039060775

Date: 2019.03.26 15:34:24 -04'00'

3/26/19

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 (0704-0188). 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 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 C. CATEGORY:

TDP ________ TM _______ OTHER

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

0009, 1009, 2009, 3009, 4009 TE 5

Elevator Contract Reporting

A005 Elevator Maintenance & Service, Service Reports

See Block 16 Performance Work Statement (PWS) USAG-Natick-DPW

See Block 16

USAG-Natick-DPW

Initial 1

0 1 0

Block 16: The Contractor shall prepare and submit a report within 3 days of the service performed and any findings. The report shall identify each elevator, the location, maintenance work performed, repairs needed, date of inspection/service, name of technician, and overall condition of the elevator. (Annex H, Section 2.26.9)

The Contractor shall submit all invoices for any items replaced on equipment.

The Contractor shall submit documents electronically in PDF format.

COFFIN.BRUCE.A.1281078867

Digitally signed by

COFFIN.BRUCE.A.1281078867

Date: 2019.03.26 14:12:53 -04'00'

3/26/19 PONTILLO.LOUIS.TIMOTH

Y.1039060775

Digitally signed by

PONTILLO.LOUIS.TIMOTHY.1039060775

Date: 2019.03.26 15:35:39 -04'00'

3/26/19