TE_2_-_Deliverables_LRC_PW_Laundry_Services_v2.pdf

TECHNICAL EXHIBIT 2

DELIVERABLES SCHEDULE

DELIVERABLE FREQUENCY

# OF

COPIES MEDIUM/FOR

MAT SUBMIT TO

Quality Control Plan

To be provided to the KO not later than the pre-work conference. An updated copy will be provided on the contract start date and as changes occur.

One Copy

Hard Copy

Mission and Installation Contracting Command ATTN: Contracting Officer Macomb Street, FBNC

Monthly Reports: All reports will be in excel format and properly aligned and printed on 81/2 X 11 paper. See attached examples.

1. Cover Sheet: Contractor’s Letterhead, Contract Number, total cost for each CLIN/TE, Delivery Order Number, COR, Date, Sub/Grand totals of all CLIN/TE’s, Signature of Contractor or Facility Manager.

2. Monthly Services/Expenditures Report: CLIN/TE number, date, item description, total number of pieces/bundles laundered, total cost per CLIN/TE. Reimbursable Organizations will be identified and totaled together.

Total Cost/pieces/bundles will be listed at end of report, added together for total payment due (CBS/IPR will be subtracted from total work)

3. Monthly Consolidated Report: Unit price/total price, number of pieces/bundles laundered, listed by CLIN/TE.

4. Weekly Abstract: Each CLIN will be listed on a separate sheet. Included will be number of pieces/cost for each week, and total pieces/cost. With the exception of the

5th day of each Month

Logistics Readiness Center

ATTN: COR (L&DC)

Bldg F4213, 2619 Howell St

FBNC

# OF

COPIES MEDIUM/FOR

MAT SUBMIT TO

rags and coveralls, all organizations will be listed separately.

a. CLIN 0002 (OCIE) – Organizational items will be listed on separate sheets with DA Form 1974s (DFAC Items, and Coveralls)

b. CLIN 0003 (Food Handler Items)

c. CLIN 0004 (Direct Exchange) -Linen and Rags will be listed on separate sheets with DA Form 1974s attached.

d. CLIN 0005 (72 Hour Dry Cleaning) – Attach DA Form 1974 for each entry.

5. Reimbursable/Non-reimbursable Reports: Prepared on separate sheets:

a. Reimbursable: List organization, total pieces and total cost.

b. Nonreimbursable: List by CLIN.

1. CLIN 0002 – Aprons, coverall, etc.

2. CLIN 0002 – Aprons, shirts, trousers

3. CLIN 0003 – List organization and items (Motorpools –coveralls, NCOA – linen, etc.)

4. CLIN 0004 – Organization and item

Completed DD Form 250, Material Inspection and Receiving Report for Laundry, The form will contain the complete date, order number, total number of pieces and total amount due for each

CLIN.

5th day of each Month

Monthly Automated Installation Entry (AIE) Status Report

5th day of each Month

Property Control Plan Five (5) days prior to the contract start date for approval.

# OF

COPIES MEDIUM/FOR

MAT SUBMIT TO

Government Furnished Property Listing. Initial listing to be forwarded within five (5) work days of contract approval. All subsequent updates will be annually unless otherwise specified. Listing for all linen issued by the Government will be inventoried on a quarterly basis.

Appointment Orders for On-Site Project/Facility Manager/Responsible Officer and Primary/Alternate Fire Marshall

Five (5) days prior to the contract

ATTN: Contracting Officer Macomb Street, FBNC

Safety Control Plan Five (5) days prior to the contract

ATTN: Contracting Officer Macomb Street, FBNC

Repair/Reimbursement: Procedures for settlement of.

Five (5) days prior to the contract

ATTN: Contracting Officer Macomb Street, FBNC

Certificate of Insurance Five (5) days prior to the contract start date.

MONTHLY REPORTS

CLIN 0002-OCIE -DFAC ITEMS -NONREIMBURSABLE

DATE:

ORGANIZATION AND UNIT CODE LISTING

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

Apron $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Cap, Food Handler $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Coat Food Handler $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Miscellaneous: Small $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Miscellaneous: Medium $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Miscellaneous: Large $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Napkin Table $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Tablecloth, Small $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Tablecloth, Medium $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Tablecloth, Large $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Trousers, Food Handler $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

TOTAL 0 $ -

CLIN 0002-OCIE- COVERALLS- NONREIMBURSABLE

DATE:

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

Cov eralls -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Cov eralls -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Cov eralls -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Cov eralls -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

CLIN 0003 FOOD HANDLER ITEMS - NONREIMBURSABLE

DATE

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

Apron $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Coat Food Handler $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Trousers, Food Handler $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

CLIN 0004 -DIRECT EXCHANGE - LINEN - NONREIMBURSABLE

ORGANIZATION AND UNIT CODE LISTING

DATE

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

Bedspread $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Blanket, Wool $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Pad, Mattress $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Pillow $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Pillow Case $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Sheets $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

CLIN 0004 --DIRECT EXCHANGE –RAGS - NONREIMBURSABLE

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags -UCL $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

CLIN 0005 72 HOUR DRY CLEANING-NONREIMBURSABLE:

ORGANIZATION - UCL

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

Alter Cloth 1PC $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Ascot $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Chaplin/Choir $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Coat, Dress Uniform $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Flag $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Tow el, Finger $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Shirt, Dress Uniform $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Stole $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Streamers $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Table Cloth Small $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Table Cloth Medium $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Table Cloth Large $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Trousers ,Dress Uniform $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Table Skirt Small $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Table Skirt Medium $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Table Skirt Large $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

NON-REIMBURSABLE REPORT

PIECES COST

CLIN 0002 OCIE

DFAC (TABLECLOTHS LRG) 0 $ -

DFAC (TABLECLOTHS MED) 0 $ -

DFAC (TABLECLOTH SML) 0 $ -

DFAC (MISC SMALL-CHAIR COVER) 0 $ -

DFAC (NAPKINS) 0 $ -

DFAC (TROUSERS FOOD HANDLERS) 0 $ -

MOTORPOOL (COVERALL) 0 $ -

TOTAL 0 $ -

CLIN 0003 FOOD HANDLERS ITEMS

APRONS, FOOD HANDLER 0 $ -

COAT, FOOD HANDLER 0 $ -

TROUSERS, FOOD HANDLER 0 $ -

TOTAL 0 $ -

CLIN 0004 DIRECT EXCHANGE

ORGANIZATION-UCL (LINEN) 0 $ -

MOTORPOOL (RAGS) 0 $ -

TOTAL 0 $ -

CLIN 0005 72 HOUR DRY CLEAN

ORGANIZATION-UCL (FLAGS) 0 $ -

DFAC-(TABLESKIRTS) 0 $ -

TOTAL NON-REIMBURSABLE COST 0 $ -

MONTHLY REPORT (SERVICES/EXPENDITURES)

BUNDLES PIECES COST

CLIN 0002 OCIE BULK 0 $0.00

CLIN 0003 FOOD HANDLER UNIFORMS 0 $0.00

CLIN 0004 DIRECT EXCHANGE RAGS 0 $0.00

CLIN 0004 DIRECT EXCHANGE LINEN 0 $0.00

CLIN 0005 72 HOUR DRY CLEANING 0 $0.00

TOTAL 0 $0.00

Attachment 1 CLIN 0005 INDIVIDUAL PIECE RATE (IPR) 72 HOUR SERVICE 0 $0.00

INDIVIDUAL PIECE RATE (IPR) NEXT DAY SERVICE 0 $0.00

TOTAL IPR COST 0 $0.00

TE6 CASH BUNDLE SERVICE (CBS)

11 PIECE 0 0 $0.00

26 PIECE 0 0 $0.00

TOTAL CBS COST 0 0 $0.00

REIMBURSEABLES:

ORGANIZATION - UCL 0 $0.00

ORGANIZATION - UCL 0 $0.00

TOTAL REIMBURSABLE COST 0 $0.00

TOTAL CASH 0 $0.00

TOTAL REIMBURSABLE 0 $0.00

TOTAL NON-REIMBURSABLE 0 $0.00

TOTAL WORK 0 $0.00

TOTAL (MINUS CASH SALES) 0 $0.00

TOTAL PAYMENT DUE 0 $0.00

COMPANY NAME

COMPANY ADDRESS

CITY/STATE ZIPCODE

CONTRACT# W91247-XXXXXXXX DATE:

BLDG 2-2055

STURGIS STREET

FORT BRAGG, NC 28310-5000

COR: PRINTED NAME

DELIVERY ORDER#

CLIN 0002 OCIE $ -

CLIN 0003 COOKWHITES $ -

CLIN 0004 DIRECT EXCHANGE LINEN $ -

CLIN 0004 DIRECT EXCHANGE RAGS $ -

CLIN 0005 72 HOUR DRY CLEANING $ -

ATT1 INDIVIDUAL PIECE RATE- 72 HOUR $ -

ATT 1 INDIVIDUAL PIECE RATE- NEXT DAY SERVICE $ -

TE6 CASH BUNDLE SERVICES (11 PIECE) $ -

TE6 CASH BUNDLE SERVICES (26 PIECE) $ -

SUBTOTAL $ -

TOTAL (MINUS CASH SALES TE6-TE8) $ -

PAYMENT DUE $ -

PRINTED NAME

PROJECT MANAGER

REIMBURSABLE REPORT:

DATE: PIECES COST

ORGANIZATION - UCL 0 $ -

ORGANIZATION - UCL 0 $ -

TOTAL REIMBURSABLE COST 0 $ -

ORGANIZATION-UCL

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

Bag Helmet $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Bag, Duffel $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Bag, Kit $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Bag, Laundry , Small $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Bag, Sleeping $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Biv y Cover $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Blanket, Wool $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Compressed Stuff Sack $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Cov eralls $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Helmet Cov er $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Jacket, Nomex/Gore $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Liner, Poncho $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Pack, Alice $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Pad, Mattress $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Pillow $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Pillow Case $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - PJ Bottoms $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - PJ Tops $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Poncho Liner $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Sheets $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - Trouser Black $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

DATE

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

Miscellaneous: Small $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Miscellaneous: Medium $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Miscellaneous: Large $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Napkin Table $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Tablecloth, Small $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Tablecloth, Medium $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Tablecloth, Large $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Table Skirt Large $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

Blanket, Wool $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Pad, Mattress $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Pillow $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Pillow Case $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Sheets $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Attachment 1 INDIVIDUAL PIECE RATE (IPR) 72 HOUR: 08/03/2015

WK1 WK2 WK3 WK4 WK5 TOTAL

Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Attachment 1 INDIVIDUAL PIECE RATE (IPR) NEXT DAY SERVICE: 08/03/2015

Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

TE6 CASH BUNDLE SERVICE (CBS)10 PIECE PLUS LAUNDRY BAG: 08/03/2015

11 PIECE Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

OPTION#1 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

OPTION#2 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

OPTION#3 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

TOTAL 0 $ -

ITEM WK1 WK2 WK3 WK4 WK5 TOTAL

26 PIECE Unit Price Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost Pieces Cost

$ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

MONTHLY CONSOLIDATED LINE ITEM REPORT:

CLIN 0002- OCIE BULK

Apron $ - 0 $ -

Bag, Duffel $ - 0 $ -

Bag, Helmet $ - 0 $ -

Bag, Kit $ - 0 $ -

Bag, Laundry , Small $ - 0 $ -

Bag, Sleeping $ - 0 $ -

Biv y Cover $ - 0 $ -

Cap, Food Handler $ - 0 $ -

Coat Food Handler $ - 0 $ -

Compressed Stuff Sack $ - 0 $ -

Cov er, Helmet $ - 0 $ -

Bag, Helmet $ - 0 $ -

Cov eralls $ - 0 $ -

Glov es $ - 0 $ -

Glov es, Insert $ - 0 $ -

Jacket, NOMEX/Gore $ - 0 $ -

Liner, Poncho $ - 0 $ -

Miscellaneous: Small $ - 0 $ -

Miscellaneous: Medium $ - 0 $ -

Miscellaneous: Large $ - 0 $ -

Napkin Table $ - 0 $ -

Pack, Alice $ - 0 $ -

PJ Bottoms $ - 0 $ -

PJ Tops $ - 0 $ -

Shirt, Black BDU $ - 0 $ -

Tablecloth, Small $ - 0 $ -

Tablecloth, Medium $ - 0 $ -

Tablecloth, Large $ - 0 $ -

Trouser BDU Black $ - 0 $ -

Trousers, Food Handler $ - 0 $ -

Trousers, Utility $ - 0 $ -

CLIN 0003 - FOOD HANDLER

ITEM UNIT PRICE PIECES TOTAL COST

Apron, Food Handler $ - 0 $ -

Coat Food Handler $ - 0 $ -

Trousers, Food Handler $ - 0 $ -

CLIN 0004 - DIRECT EXCHANGE

ITEM UNIT PRICE PIECES TOTAL COST

Blanket, Wool $ - 0 $ -

Bedspread $ - 0 $ -

Cov er Mattress $ - 0 $ -

Pad, Mattress $ - 0 $ -

Pillow $ - 0 $ -

Pillow Case $ - 0 $ - Rags $ - 0 $ -

Sheets, Fitted $ - 0 $ - Sheets $ - 0 $ -

CLIN 0005- DRY CLEANING

ITEM UNIT PRICE #PIECES TOTAL COST

Alter Cloth 1PC $ - 0 $ -

Ascot $ - 0 $ -

Chaplin/Choir $ - 0 $ -

Coat, Dress Uniform $ - 0 $ -

Flag $ - 0 $ -

Tow el, Finger $ - 0 $ -

Shirt, Dress Uniform $ - 0 $ -

Stole $ - 0 $ -

Streamers $ - 0 $ -

Table Cloth Small $ - 0 $ -

Table Cloth Medium $ - 0 $ -

Table Cloth Large $ - 0 $ -

Trousers, dress Uniform $ - 0 $ -

Table Skirt Small $ - 0 $ -

Table Skirt Medium $ - 0 $ -

Table Skirt Large $ - 0 $ -

Attachment 1 INDIVIDUAL PIECE RATE (IPR) 72 HOUR

#PIECES TOTAL COST

0 $ -

Attachment 1 INDIVIDUAL PIECE RATE (IPR) NEXT DAY SERVICE

#PIECES TOTAL COST

0 $ -

TE6 CASH BUNDLE SERVICE (CBS)

BUNDLES PIECES TOTAL COST

11 PIECE

OPTION#1-$20.00 0 0 $ -

OPTION#2-$26.00 0 0 $ -

OPTION#3-$32.00 0 0 $ -

TOTAL# OF BUNDLES

26 PIECE 0 0 $ -

GRAND TOTAL CBS 0 0 $ -

Annex B FB 15-003 Updated Personal Identity Verification of Contractor Personnel for Automated Installations Entry (AIE) Cards/Pass (Friends of Fort Bragg Cards/Pass)

Unclassified//For Official Use Only Date:

52.204-9 Personal Identity Verification of Contractor Personnel. As prescribed in 4.1303, insert the following clause:

1. Personal Identity Verification of Contractor Personnel (JAN 2011)

(a) The Contractor shall comply with agency personal identity verification procedures identified in the contract that implement Homeland Security Presidential Directive-12 (HSPD-12), Office of Management and Budget (OMB) guidance M-05-24, and Federal Information Processing Standards Publication (FIPS PUB) Number 201.

(b) The Contractor shall account for all forms of Government-provided identification issued to the Contractor employees in connection with performance under this contract. The Contractor shall return such identification to the issuing agency at the earliest of any of the following, unless otherwise determined by the Government:

(1) When no longer needed for contract performance.

(2) Upon completion of the Contractor employee's employment.

(3) Upon contract completion or termination.

(c) The Contracting Officer may delay final payment under a contract if the Contractor fails to comply with these requirements.

(d) The Contractor shall insert the substance of this clause, including this paragraph (d), in all subcontracts when the subcontractor`s employees are required to have routine physical access to a Federally-controlled facility and/or routine access to a Federally-controlled information system. It shall be the responsibility of the prime Contractor to return such identification to the issuing agency in accordance with the terms set forth in paragraph (b) of this section, unless otherwise approved in writing by the Contracting Officer.

(End of clause)

(e) In addition to the aforementioned, the contractor will provide the Contractor Officer Representative (COR) a monthly status report on all forms of Government-provided identification issued to the contractor employees in connection with performance under this contract.

(1) The COR will provide the Installation Physical Security Division a copy of the monthly status report for any termination requirements.

(2) Monthly status reports will be maintained on file for one year after contract completion by the Sponsoring Agency.

(f) The template below will be used for the monthly status report submission.

Company Name:

Contract Number:

Employee Name Date of Birth AIE Pass Number

COR/Sponsoring Agency Card Issue Date Card Termination

Date

Date AIE Pass Returned

Remarks

PRINT NAME

SIGNATURE

2. Penalties: Contractor failure to submit the monthly CAC and/or AIE Badge report will result in one of the following penalties levied against the contract:

(a) US Government withholding payment on the contract.

(b) A fine of $500.00 – $3,000.00 will be assessed per incident, based upon the severity and frequency of which they occur and will continue for each calendar day until compliance is met.

(c) If the Government terminates the Contractor’s right to proceed, fines continue to accrue until compliance is met.

COMPANY NAME

COMPANY ADDRESS

CONTRACT# W91247-XXXXXX DATE: ____________

BLDG 2-2055

STURGIS STREET

FORT BRAGG, NC 28310-5000

SUBJECT: Quarterly Linen Inventory

1. In accordance with contract ________________________, and the contract performance work statement 100% physical inventory of all Government issued linen was conducted.

NSN ITEM QTY

7210002312373 PILLOWCASE _______

7210010155190 PILLOW BED _______

7210007157985 BLANKET BED WOOL O-G _______

7210011196416 SHEET BED _______

7210002271526 PAD MATTRESS _______

** No Shortages since last update/Shortages noted and support documents attached.

2. Point of contact is the undersigned.

Attach __________________________ __________________________ as Signature, Unit Signature, Contractor

Printed Name Printed Name

UNIT CODE

LISTING

UC# ORGANIZATION SECTION POC PHONE#

EXPIRATION DATE