Technical Exhibit 1 - PRS L&DC.pdf

Contract Requirement Contract Paragraph Number(s)

Standard Incentive/Disincentive

1.5. Customer Satisfaction 1.5.2. Contractor shall obtain a 90% AQL of customer satisfaction based on comment cards and/or ICE comments.

Contractor shall address all negative comments within twenty four hours (24) of notification.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

1.6.2. Quality Control 1.6.2.1. Contractor shall provide a copy of their Quality Control Plan (QCP) to the KO/COR within thirty (30) days of contract award.

AQL: 100%

Contractor’s non-compliance to regulatory requirement may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

1.6.5. Property Management

System

1.6.5. Contractor shall provide a copy

of their Property Control Plan (PCP) to the PA within thirty

(30) days of contract award.

AQL: 100%

Contractor’s non-compliance to regulatory requirement may

1.6.6. Contractor Planning and

Resource Management

1.6.6.1. Contractor shall be in

compliance with hours of operation listed in PWS.

AQL: 100%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

1.6.8. Security Requirements 1.6.8.1(h) Contractor shall prepare the monthly AIE status report and forward it to the COR NLT the 5th business day of each month.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

1.6.8.2. Physical Security 1.6.8.2.6. Contractor shall complete applicable areas of the SF 701 at the end of each business day.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

1.6.14. Contractor Personnel

Requirements, Disciplines, and Specialties

1.6.14.1. Contractor employees shall be

clearly Identified. Contractor shall provide identification badges that display the employee’s name, and company’s name. Contractor employees shall place badge on the exterior clothing, above the waist.

AQL: 100%.

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

1.6.15. Training 1.6.15.1.2. Contractor and employees shall

complete Anti-Terrorism (AT) Level 1 Training within 30 calendar days after commencing performance Contractor shall forward copy of certificates of completion to the COR within three (3) business days after completion.

AQL: 100%

Contractor’s non-compliance to regulatory requirement may

1.6.19. Safety 1.6.19.3. Contractor shall provide their

written Safety Plan to the KO and COR within thirty (30) days of contract award.

AQL: 100%

Contractor’s non-compliance to regulatory requirement may

1.6.19.5.1.1(a) Contractor shall have an Evacuation plan and diagram that shows primary and secondary evacuation routes for the building. Diagram shall be posted in the facility where it is visual to employees and customers. Contractor shall have a written plan and posted diagram within thirty (30) days of contract award.

AQL: 100%

Contractor’s non-compliance to regulatory requirement may

1.6.19.5.1.1(c) Contractor shall appoint in writing a Primary/Alternate Fire Safety Marshall for the facility place within thirty (30) days of contract award. A copy of appointment letter will be placed in the Fire Safety Marshall Binder (FSMB) within three (3) business days of appointment.

AQL: 100%

Contractor’s non-compliance to regulatory requirement may

1.6.19.5.1.1(d) Contractor employees shall complete mandatory Fire Safety Marshall (FSM) Training Class within ninety (90) days of contract award and place a copy of course completion certificate in the FSMB within three (3) business days of class completion.

AQL: 100%

Contractor’s non-compliance to regulatory requirement may

1.6.19.5.1.1(e2) Contractor shall conduct a monthly walk-through survey of the facility and complete FB Form 6030-3E by the fifth (5th) business day of each month.

Completed form will be placed in the FSMB.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

1.6.19.5.1.1(e3) Contractor’s FSM shall conduct a fire evacuation drill within thirty (30) days of contract award. All subsequent drills shall be conducted annually.

Copy of the completed FB Form 6030-2E shall be placed in the FSMB within three (3) business days of the completed drill

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

1.6.19.5.1.1(e4) Contractor shall complete FB Form 6003-E (Building Information Sheet) within ten

(10) days of contract award.

Completed copy shall be placed in the FSMB within three

(3) business days of completion.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

1.6.19.5.1.2. Contractor’s FSM shall conduct

an initial inspection of all fire extinguishers in the facility within thirty (30) days of contract award and complete FB Form 6031-E and place a copy in the FSMB. All subsequent inspections shall be conducted monthly. FSM shall date and initial service tag.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

3. Government Furnished Property

3.6.3. The Contractor shall conduct

an initial inventory and inspection on all assigned GFP within ten (10) business days of contract award for serviceability and to ensure all quantities are on hand.

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

3.6.3(a) The Contractor shall furnish a written statement to the Property Administrator containing all relevant facts, such as cause or condition and a recommended course(s) of action, if overages, shortages, or damages and/or other discrepancies are discovered upon receipt of Government-furnished property. A copy of the inventory and any documentation to account for increases or decreases shall be forwarded to the PA within three (3) business days from the date of inventory.

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

5 Specific Task 5.1. Contractor shall clean Organizational Clothing and Individual Equipment (OCIE) for authorized customers.

Performance Standards

a) STD: All items shall be laundered in accordance with customer/manufacturer's instructions.

AQL: 100%

b) STD: Each item shall be clean (free of soil, spots, water-soluble stains, bacteria, fungi, and other microorganisms, including pathogens or disease-producing organisms), odor and lint free.

AQL: 100%

c) STD: All items shall be thoroughly dried.

AQL: 100%

d) STD: All items turned in for laundry will be completed within five (5) business days.

AQL: 90%

will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

e) STD: Finished products shall be protected from any contaminants that would require items to be re-cleaned.

AQL: 100%

f) STD: Items shall be packaged to provide ease of item count and in a manner to preserve the sanitary condition of the finished work during all phases of handling and transit.

AQL: 100%

g) STD: The contractor shall comply with federal, state, local and Department of Health regulations, and the Center for Disease control (CDC) and the Healthcare Infection control Practices Advisory Committee (HICPAC) regulations.

AQL: 100%

h) STD: All items that fail to meet quality standards shall be returned for re-cleaning at no additional costs.

AQL: 100%

5.1.1. Contractor shall provide laundry

services for Food Handler Uniforms.

Performance Standards

a) STD: All uniforms shall be clean (free of soil, spots, water-soluble stains, bacteria, fungi, and other microorganisms, including pathogens or disease-producing organisms), odor and lint free. Uniforms shall be cleaned in accordance with care label and instructions.

AQL: 100%

b) STD: The Contractor shall clean and dry the GFSU..

(GFSU SHALL NOT BE

PRESSED OR BLEACHED).

GFSU shall be neatly folded to minimize wrinkling during transport.

AQL: 100%

c) STD: The Contractor shall press Cook White Uniform to provide adequate body without excessive stiffness and place on hangers. Each item shall be placed on separate hangers and hangers placed on rods to minimize wrinkling in transport.

AQL: 90%

d) STD: Finished products shall be protected from any contaminants that would require items to be re-cleaned.

AQL: 100%

e) STD: All items turned in for laundry will be completed within five (5) business days.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

5.1.2. Contractor shall operate a linen

Direct Exchange (DX) Point.

Performance Standards

a) STD: The contractor shall direct exchange sheets, pillows, pillowcases, blankets, mattress covers/pads, and bedspreads.

AQL: 100%

b) STD: Soiled items will be exchanged for clean, serviceable like items at time of turn in.

will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

c) STD: All clean linens shall be returned to the DX point in like-item bundles protected from contaminants that would require items to be re-cleaned.

AQL: 90%

d) STD: Clean sheets are to be returned to the DX point in bundles of ten (10) each.

AQL: 90%

e) STD: Clean pillowcases are to be returned to the DX point in bundles of ten (10).

AQL: 90%

f) STD: Clean mattress covers/pads are to be returned to the DX point in bundles of five (5).

AQL: 90%

g) STD: Clean bedspreads shall be returned to the DX point in bundles of five (5).

AQL: 90%

h) STD: Clean blankets are to be returned to the DX point in bundles of five (5).

AQL: 90%

i) STD: The contractor shall maintain strict accountability of Government-owned items.

AQL: 90%

j) STD: Contractor shall maintain a minimum stockage of 50% of weekly issued items at the exchange point.

AQL: 90%

5.1.3. a. The Contractor shall dry clean and press coats and trousers or skirts of Dress Uniforms, Ceremonial uniforms and items, Chaplin Robes, Organizational Flags/Streamers, and Table Linens.

AQL: 100%

b. Each item shall be clean (free of soil, spots, water-soluble stains, bacteria, fungi, and other microorganisms, including pathogens or disease-producing organisms), odor and lint free.

AQL: 100%

c. All items turned in for dry cleaning will be completed within five (5) business days.

AQL: 90%

d. All items shall be dry cleaned in accordance with customer/manufacturer's instructions.

AQL: 100%

e. All items that fail to meet quality standards shall be returned for re-cleaning at no additional costs.

AQL: 100%

f. Finished products shall be protected from any contaminants that would require items to be re-cleaned.

AQL: 100%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

5.1.4. The Contractor shall clean

Specialty Items

a. Processing time shall be five

(5) business days.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

b. Shall clean specialty items in accordance with customer/manufacturer's instructions.

AQL: 100%

c. The contractor shall provide the Government representative with professional advice concerning the advisability and possible outcome of drapery processing.

AQL: 100%

d. Draperies accepted by the Contractor for processing shall be invoiced by the Contractor at the established rate per square foot. This price shall include appropriate processing, ironing, and delivery of the completed work to the requiring organization.

AQL: 100%

e) In the event the Contractor recommends against processing draperies but the Government representative insists upon such processing, the Contractor shall obtain a written release from the Government representative prior to beginning any processing.

AQL: 100%

5.1.5. a. The Contractor shall replace missing buttons on garments.

Small rips and tears (one (1) inch or less) shall be mended unless they are identified as being damaged at time of turn-in.

AQL: 100%

b. Thread, material, zippers and buttons of the same type, texture, manufacture quality, color, and colorfastness used for repair and replacement shall match and be equal to or better than those used in the manufacture of the article.

AQL: 100%

c. The contractor at their expense shall repair (minor snags, holes, open seams, replacement of buttons, and repair or replacement of broken zippers) or replace items damaged during the cleaning process. Any existing damages discovered at the time of turn in shall be so noted on the laundry or dry cleaning ticket.

will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

5.1.6. a. Contractor has a marking system in place to identify the items being turned in to ensure that the customer is receiving only their laundered items.

Organizational customers are assigned unit code numbers.

Unit code number is listed on laundry form. Items are inspected for serviceability prior to tagging. Laundry forms for items that are deemed to be unacceptable, unserviceable or cannot be safely laundered

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report have been annotated and item(s) returned to customer.

AQL: 100%

b. Maintain a valid DA Form 1687, Notice of Delegation of Authority – Receipt for Supplies, on file IAW DA Pam 710-2-1 for all organizational and bulk services. Issue and receive items to be laundered from only those individuals listed on the DA 1687. Verifies the identity of personnel receiving and turning in items that are not in uniform for all provided services.

AQL: 100%

c. Utilize DA Form 1974 (Laundry List – Medical Treatment Facility and Organization) to process all Organizational Clothing and Equipment, Direct Exchange, Food Handler items, and 72 Hour Dry Cleaning items DA Form 2741 (Laundry List – For Piece Rate Patrons) to process Individual Piece Rate (IPR) items, DA Form 2886 (Laundry List For Military Personnel) to process Cash Bundles.

Laundry form is completed accurately, date and time stamped, and signed by the contractor’s employee and the customer.

5.3. Contractor shall develop a Unit

Code Listing for organizational laundry and forward a copy to the COR by the fifth (5th) business day of each month.

AQL: 90%.

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

5.4. Contractor shall forward a

completed Invoice by the fifth (5th) business day of each month to the COR.

AQL: 100%

Contractor’s compliance to having invoice prepared on time will ensure monthly payments are submitted in a timely manner.

Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance.

Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

5.5. Contractor shall forward

monthly reports consisting of:

(a) Monthly Services/Expenditures

(b) Monthly Consolidated Contract Line Item Number (CLIN Report.

(c) Reimbursable and Non- Reimbursable Report.

(d) Weekly Abstract/Workload Data Report.

Contractor shall prepare a worksheet for each organization/activity that received L&DC services for the month. The Contractor shall attach all laundry forms to the appropriate worksheet. The Contractor shall forward a copy of all worksheet and the laundry forms to the COR for validation NLT the fifth (5th) business day of the month.

AQL: 100%

Contractor’s compliance to having reports generated and forwarded in a timely manner will ensure all items, quantities, and cost are verified against monthly invoice. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

5.5.1. Contractor shall only apply the

cost of specified organizational items against the direct fund account (non-reimbursable).

The Contractor shall ensure that monies have been applied to the correct account and CLIN when preparing the monthly abstract report.

AQL: 100%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Failure to monitor account status may require the contractor to incur cost to the Government in over spent accounts. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

5.6.1. Contractor shall verify the

availability of funds (through the COR) for organizations that have been identified by the AFSBn-Bragg’s Budget Analyst as reimbursable accounts prior to accepting their laundry.

AQL: 100%

Contractor’s performance may be noted during the CPAR reporting periods. Failure to check the availability of funds may result in the Government assessing the incurred cost against the contractor. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

5.7 Contractor shall have an

employee at the service counter to greet the customer, assist in completing the correct laundry form (to include name, telephone number, date), and ensure quantity listed on laundry form coincides with items being turned in.

AQL: 100%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

5.9. Contractor shall be responsible

for maintaining the grounds within fifty (50) feet around Government buildings and employee parking areas. Areas shall be neatly maintained to include cutting of grass and trimming of bushes, and snow removal. Grounds shall be kept free of trash at all times.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

5.10.1. Contractor shall re-clean items

that fail to meet the satisfaction of the customer at no additional cost. Contractor shall annotate each re-cleaning on the laundry form.

AQL: 100%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Failure to satisfy the customer may require the contractor to incur cost for re-cleanings. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

5.10.2 Contractor shall post a sign

visible to the customer upon entry to the facility to inform them of the policies and procedures associated with re-laundering items within ten (10) days of contract award. The sign should be made of Poster Board material at a minimum of 11X14 with a font size Arial 22.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Failure to satisfy the customer may require the Contractor to incur cost for re-cleanings. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early

5.11.3. Contractor shall resolve claims

for lost or damaged items of clothing within ten (10) business days following the date the claim is received by the Contractor. The Contractor shall provide to the KO/COR a completed copy of the complaint record within three

(3) business days of occurrence.

AQL: 95%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

5.11.4. Contractor shall post a sign

visible to the customer upon entry to the facility to inform them of the policies and procedures associated with submitting claims for lost or damaged items within ten (10) business days of contract award. The sign should be made of Poster Board material at a minimum of 11X14 with a font size Arial 22. Contractor shall provide a complaint form to the customer. AQL: 90%

Failure to be in compliance with regulatory requirements may result in the Contractor incurring the cost for damaged or lost items and reimbursing the customer. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract

5.13.1. The Contractor shall provide a

written notice, on Contractor letterhead and mail it to the customer’s address listed on the laundry ticket, at the end of each thirty (30) day holding period for unclaimed bundles and items. The Contractor shall provide the COR with a record copy of each thirty (30) day.

AQL: 100%

Compliance with regulatory requirements may prevent future claims assessed against the Contractor. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract

5.13.1.2. Contractor shall return

organization clothing and equipment to CIF.

AQL: 100%

Compliance with regulatory requirements may prevent the Government assessing charges against the Contractor for failure to return organizational items to the Central Issue Facility.

Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance.

Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report (CDR) being initiated and/or early termination of the agreement in full or in part.

5.13.2 Contractor shall post a sign

visible to the customer upon entry to the facility to inform them of the policies and procedures associated with the disposition of unclaimed/abandoned items within ten (10) business days of contract award. The sign should be made of Poster Board material at a minimum of 11X14 with a font size Arial 22.

AQL: 90%

Compliance with regulatory requirements may prevent claims being initiated against the Contractor at a later time. Facility.

Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance.

Failure to be in compliance with regulatory requirements may

5.14. Contractor shall have a price

listing for IPR/CBS posted, visible to the customer. The sign should be made of Poster Board material at a minimum of 18X28 with a minimal font size of Arial 22. Sign shall be posted within three (3) business days of contract award

AQL: 100%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Failure to post the price listings may result in the customer complaints of over pricing and/or the Government suspending/early termination of the cash sales agreement in full or in part.

5.18.2. Contractor shall forward a

Contract Manpower Endstrength Report (CME) to the KO/COR within ten (10) business days of contract award. If Contractor has an increase/decrease or change to position title, the Contractor shall forward a new copy to the COR within three (3) business days of the change.

AQL: 90%

Contractor’s non-compliance to regulatory requirement may

5.18.2.1. The Contractor shall forward a

monthly AFSBn-Bragg CME report to the COR no later than the fifth (5th) business day of each month.

AQL: 90%

Contractor’s compliance to requirement may be used for CPAR reporting periods. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

5.18.3. Contractor shall forward a

monthly status report to the COR no later than the fifth (5th) business day of each month. If there has been a change in personnel status it will be annotated. If there has been no change, annotate “No Change”.

AQL: 95%

Contractor’s compliance to this requirement will ensure monthly payments are submitted in a timely manner. Monthly Status Reports are needed to verify the cost listed on the Contractor’s invoice. Trends of less than acceptable performance will be used to substantiate objective ratings of Contractor’s performance. Failure to be in compliance with regulatory requirements may result in a Contract Discrepancy Report

DES FORM 118 paragraph 1.11.1(a)

Performance Requirement Summary (PRS) Table TE-1

AIE REPORT paragraph 1.6.11.1(h)

Annex B FB 15- 003 Updated Personal Identity Verification of Contractor Personnel for Automated Installations Entry (AIE) 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 COR/Sponsoring Agency Issue Date

Card Termination Date

Date AIE Pass Returned

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.

SF 701 – ACTIVITY SECURITY CHECKLIST paragraph 1.6.11.2.6

Accident Report paragraph 1.6.19.3

ACCIDENT INVESTIGATION REPORT

1. Name of injured: _______________________________________________

2. Sex [ ] M [ ] F Age: ________ Date of accident: _______________

3. Time of accident: ___________a.m. __________p.m.

4. Employee's job title: _____________________________________

5. Length of experience on job: (years) (months)

6. Address of location where the accident occurred:

7. Nature of injury, Injury type, and Part of the body affected:

8. Describe the accident and how it occurred:

9. Was personal protective equipment required? [ ] Yes [ ] No? Was it provided? [ ] Yes [ ] No? Was it being used? [ ] Yes [ ] No If "No", Explain.

10. Witness(es): _________________________________, _________________________________, __________________________________, _______________________________

11. Safety training provided to the injured? [ ] Yes [ ] No If "No", explain.

12. Interim corrective actions taken to prevent recurrence: _____________________________________________________________________________________________________

13. Permanent corrective action recommended to prevent recurrence: ___________________________________________________________________________________________

Contractor/Project Manager (Signature): __________________________________ Printed Name: ________________________________________________________ Date: _______________

Facility Manager (Signature): ____________________________________________ Printed Name: ________________________________________________________ Date: _______________

Employee (Signature): _________________________________________________ Printed Name: ________________________________________________________ Date: _______________

Fire Safety Marshall Appointment Memo – paragraph 1.6.19.5.1.1(c)

COMPANY NAME

COMPANY ADDRESS

Date: _______________.

Memorandum For Record

Title: Primary and Alternate Fire Safety Marshall

1. Effective immediately, the following individuals are hereby appointed as the Primary and Alternate Fire Safety Marshalls for the Installation Laundry and Dry Cleaning Facility, Building 2-2055, Sturgis Street, Fort Bragg, NC:

Primary: ___________________________________________________ Print/Sign Name and Date Alternate: ___________________________________________________ Print/Sign Name and Date

2. Governing Authority: FB Reg 420-1, Fire Prevention Program.

3. Period: Until relieved or released from appointment in writing

4. Special Instructions: Appointed individual(s) will adhere to and take actions according to all regulations, guidelines, polices, documented procedures and requirements that are specific to the position and title listed in section 1 of this appointment order.

Contractor Company Fayetteville, NC 28301

DISTRUBTION:

1-original Contractor 1-copy Appointed Employee 1-copy Fire Safety Marshall Binder

Fire Safety Marshall Binder (Requirements Documents) paragraph 1.6.19.5.1.1(e)

Request for services and supplies paragraph 3.4(a)

FB FORM 1349

REQUEST FOR SUPPLIES

DATE:________________

TO:AFSBn-Bragg Requiring Contract Activity Section

FROM:D&S Textiles (Laundry Support (Name of Activity) SLOC Number: GFP Fiduciary (ENRW)

1. NATIONAL STOCK NUMBER 2. NAME AND DESCRIPTION OF ITEM REQUESTED

3. QUANTITY _____ 4. UNIT OF ISSUE ____ 5. COLOR_______ 6. SIZE_____

7. DODAAC ______ 8. APC _______ 9. FUND CODE _______

PARA_______

10. URGENCY OF NEED *B C 11. *AUTHORITY LIN ______

*ALL “B” PRIORITIES MUST BE JUSTIFIED

JUSTIFICATION

IF REQUESTED ITEM IS FOR A COMPONENT/ACCESSORY ITEM, COMPLETE THE

FOLLOWING:

11.END ITEM_______________________________ 12. MAKE & MODEL OF END ITEM

(Nomenclature/NSN/LIN) ________________________

13. REQUESTOR (Print Name) _______________________________________

14. SIGNATURE OF REQUESTOR_______________________________________

15. UNIT COST ________________ 16. TOTAL COST $__________________

(17-19 CONTRACTORS ONLY)

17. DEPARTMENT MGR APPROVAL:_______________________, DATE:__________

18. WORKCENTER SUPERVISOR APPROVAL:_______________________, DATE:__________

19. COR APPROVAL::_______________________, DATE:__________

20. SIGNATURE OF PERSON APPROVING FUNDS

CONTROL NUMBER REQUISITION NUMBER

Request for services and supplies paragraph 3.4(b)

GFP Inventory paragraph 3.6.3.

CONTRACT# W91247-XXXXXX

DATE: ___________

BLDG 2-2055

STURGIS STREET

FORT BRAGG, NC 28310-5000

SUBJECT: Quarterly GFP/GFE Inventory/Inspection

1. Under the provision of paragraph 3.6.3. in the PWS, an 100% physical inventory/inspection of all Government Furnished Property/Equipment was conducted.

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

2. Point of contact is the undersigned.

Attach ________________________ as Signature Printed Name

Storage Location

LIN

Number

Material Material Description Unit of Issue

Serial Number Qty on Record

Qty Inventoried

ENRW 98152N 667001C035664 SCALE DIGITAL READOUT PTBL EA 7D200110007605

ENRW KB1001 7210002312373 PILLOWCASE CTN/PLY EA

ENRW KB1002 7210010155190 PILLOW BED EA

ENRW KB1027 721001C086427 SHEET BED EA

ENRW KB1028 7210002271526 PAD MATTRESS (18 PER BOX) BX

ENRW KB106A 7210007157985 BLANKET BED WOOL O-G EA

ENRW LC100H 351001C135082 TRUCK HAND BOX EA

ENRW LC100U 3510010092853 CONVEYOR AND STORAGE RACK

EA 21744A4K009, 21744A4K033

ENRW LC100U 351001X409267 CONVEYOR AND STORAGE RACK

AP320

EA

ENRW SA401C 414001C073022 PORT-A-COOL FAN PAC2K36 SN: EA 13570/07, 145459/07

ENRW SA404X 414001C161062 FAN 48” BELT DRIVEN BLACK GLOBAL

INDUSTRIES

EA

Turn-In Unserviceable Government Furnished property paragraph 3.6.7.2.

Unit Code Listing paragraph 5.3

UNIT CODE LISTING

UC# ORGANIZATION SECTION POC TELEPHONE# EXPIRATION DATE

Invoice paragraph 5.4.

CONTRACT# W91247-XX-X-XXXX DATE:

BLDG 2-2055

STURGIS STREET

FORT BRAGG, NC 28310-5000

COR: ________________________

DELIVERY ORDER# _________________________

INVOICE# ______________

Services for the below listed CLINs were provided for the month of ______________ 20____. Copies of the weekly abstracts and laundry forms are attached for your review.

CLIN 3001 OCIE $ -

CLIN 3002 FOOD HANDLER UNIFORMS $ -

CLIN 3003 DIRECT EXCHANGE $ -

CLIN 3004 72 HOUR DRY CLEANING $ -

CLIN 3005 PICK-UP/DROP-OFF $ -

TOTAL $ -

TE6 INDIVIDUAL PIECE RATE- NEXT DAY SERVICE $ -

TE7 CASH BUNDLE SERVICES (11 PIECE) $ -

TE8 CASH BUNDLE SERVICES (26 PIECE) $ -

TOTAL $ -

SUBTOTAL SERVICES RENDERED $ -

PAYMENT DUE (MINUS CASH SERVICES) $ -

V/R

CONTRACTOR’S PRINTED NAME AND SIGNATURE

FAYETTEVILLE, NC 28310

Monthly Consolidated CLIN Report paragraph 5.5(a)

MONTHLY REPORT (SERVICES/EXPENDITURES): DATE: MM/DD/YR

BUNDLES PIECES COST

NON-REIMBURSEABLES:

CLIN ________ OCIE $ -

CLIN ________ FOOD HANDLER $ -

CLIN ________ DIRECT EXCHANGE - LINEN $ -

CLIN ________ 72 HOUR DRY CLEANING $ -

CLIN ________ LABOR P/U AND DROP OFF OPERATIONS

0 $ -

REIMBURSEABLES:

CLIN ________ OCIE $ -

CLIN ________ DIRECT EXCHANGE - LINEN $ -

CLIN ________ DIRECT EXCHANGE - RAGS

CLIN ________ 72 HOUR DRY CLEANING $ -

TE6 INDIVIDUAL PIECE RATE (IPR) 72 HOUR SERVICE $ -

TE7 INDIVIDUAL PIECE RATE (IPR) NEXT DAY SERVICE $ -

TE8 CASH BUNDLE SERVICE (CBS)

11 PIECE $ -

26 PIECE $ -

0 0 $ -

TOTAL IPR/CBS 0 $ -

TOTAL REIMBURSABLE 0 $ -

TOTAL NON-REIMBURSABLE 0 $ -

PICK-UP/DROP OFF POINT 0 $ -

TOTAL (MINUS CASH SALES) 0 $ -

TOTAL DUE 0 $ -

Monthly Abstract/Workload paragraph 5.5(b)

MONTHLY ABSTRACT/WORKLOAD DATA REPORT:

DATE:

CLIN __________ OCIE BULK

ITEM UNIT PRICE #PIECES TOTAL COST

Apron $ - 0 $ -

Bag, Duffel $ - 0 $ -

Bag, Helmet $ - 0 $ -

Bag, Kit $ - 0 $ -

Bag, Laundry, Small $ - 0 $ -

Bag, Sleeping $ - 0 $ -

Bivy Cover $ - 0 $ -

Cap, Field $ - 0 $ -

Cap, Food Handler $ - 0 $ -

Carrier Hydration $ - 0 $ -

Coat Food Handler $ - 0 $ -

Case Ammo $ - 0 $ -

Compressed Stuff Sack $ - 0 $ -

Cover, Canteen $ - 0 $ -

Cover, Chair (DFAC) $ - 0 $ -

Cover, Helmet $ - 0 $ -

Coveralls $ - 0 $ -

Gloves $ - 0 $ -

Gloves, 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 $ -

Scarf, Wool $ - 0 $ -

Shirt, Black BDU /Utility $ - 0 $ -

Tablecloth, Small $ - 0 $ -

Tablecloth, Medium $ - 0 $ -

Tablecloth, Large $ - 0 $ -

Throat Protector $ - 0 $ -

Trouser BDU Black /Utility $ - 0 $ -

Trousers Camo ECWCS/Gortex $ - 0 $ -

Trousers, Food Handler $ - 0 $ -

TOTAL 0 $ -

CLIN ____________ FOOD HANDLER ITEMS

ITEM UNIT PRICE PIECES TOTAL COST

Apron, Food Handler $ - 0 $ -

Coat Food Handler $ - 0 $ -

Napkin $ - 0 $ -

Tablecloth, Small $ - 0 $ -

Tablecloth, Large $ - 0 $ -

Trousers, Food Handler $ - 0 $ -

CLIN __________ DIRECT EXCHANGE

ITEM UNIT PRICE PIECES TOTAL COST

Bedspread $ - 0 $ -

Blanket, Wool $ - 0 $ -

Pad, Mattress $ - 0 $ -

Pillow $ - 0 $ -

Pillow Case $ - 0 $ -

Rags $ - 0 $ -

Sheets $ - 0 $ -

CLIN ____________ 72 HOUR DRY CLEANING

ITEM UNIT PRICE #PIECES TOTAL COST

Alter Cloth 1PC $ - 0 $ -

Ascot $ - 0 $ -

Chaplin/Choir $ - 0 $ -

Coat, Band Uniform $ - 0 $ -

Coat, Dress Blue Uniform $ - 0 $ -

Drapes $ - 0 $ -

Flag $ - 0 $ -

Towel, Finger $ - 0 $ -

Shirt, Dress Uniform $ - 0 $ -

Stole $ - 0 $ -

Streamers $ - 0 $ -

Table Cloth Small $ - 0 $ -

Table Cloth Medium $ - 0 $ -

Table Cloth Large $ - 0 $ - Trousers, Band Uniform $ - 0 $ -

Trousers, Dress Blue Uniform $ - 0 $ -

Table Skirt Small $ - 0 $ -

Table Skirt Medium $ - 0 $ -

Table Skirt Large $ - 0 $ -

TE6 INDIVIDUAL PIECE RATE (IPR) 72 HOUR

#PIECES TOTAL COST

TE7 INDIVIDUAL PIECE RATE (IPR) NEXT DAY SERVICE

#PIECES TOTAL COST

TE8 CASH BUNDLE SERVICE (CBS)

#OF BUNDLES PIECES TOTAL COST

11 PIECE (TOTAL# OF BUNDLES) 0 0 $ -

OPTION#1-$21.00 0 0 $ -

OPTION#2-$27.00 0 0 $ -

OPTION#3-$33.00 0 0 $ -

26 PIECE 0 0 $ -

0 0 $ -

CONSOLIDATED NONREIMBURSABLE REPORT: DIRECT FUNDING

DATE: paragraph 5.5(c)

NONREIMBURSABLE CONSOLIDATED REPORT: DATE: MM/DD/YR

CLIN _____________ OCIE PIECES COST

AFSBn-BRAGG - ADMIN/SSMO- 1B (TABLE CLOTHS) 0 $ -

92G SKILL TRAINING CENTER - 1A 0 $ -

CLIN_____________ FOOD HANDLER PIECES COST

APRONS, FOOD HANDLER 0 $ -

COAT, FOOD HANDLER 0 $ -

TROUSERS, FOOD HANDLER 0 $ -

NAPKINS 0 $ -

TABLECLOTHS SMALL 0 $ -

TABLECLOTHS LARGE 0 $ -

CLIN_____________ DIRECT EXCHANGE PIECES COST

FBRC- 167 (LINEN) 0 $ -

MOBILAZATION (MDB) - 1 (LINEN) 0 $ -

NCOA-56 (LINEN) 0 $ -

SWTG (CO 1ST BN – (CAMP MACKALL) - 249A (LINEN ONLY) 0 $ -

SWTG (A) D CO 2ND BN – 255D (LINEN) 0 $ -

SWTG (A) CO 3RD BN – 256C (LINEN) 0 $ -

1 SWTG (A) 5TH BN - 256E (LINEN) 0 $ -

MILITARY POLICE 293A (LINEN) 0 $ -

CLIN_____________ 72 HOUR DRY CLEAN PIECES COST

92G SKILLS TRAINING CENTER - 1A (TABLESKIRTS) 0 $ -

AFSBn-BRAGG - ADMIN/SSMO -1B (TABLESKIRTS) 0 $ -

CASUALTY AFFAIRS - 5 (FLAGS) 0 $ -

ORGANIZATION - UC# (ITEMS TURNED IN) 0 $ -

ORGANIZATION - UC# (ITEMS TURNED IN) 0 $ -

ORGANIZATION - UC# (ITEMS TURNED IN) 0 $ -

CLIN_____________ PICK-UP/DROP OFF POINT $ -

TOTAL NONREIMBURSABLE COST 0 $ -

CONSOLIDATED REIMBURSABLE REPORT DATE:

paragraph 5.5(c)

REIMBURSABLE CONSOLIDATED REPORT: DATE: MM/DD/YR

PIECES COST

82ND DIV PROTOCOL - 219E 0 $ -

82ND DIV (RAGS ONLY) - 217 0 $ -

USASOC PROTOCOL - 432 0 $ -

1ST SFC (A) PROTOCOL - 236C 0 $ -

USACAPOC (A) G8 - 238 0 $ -

SWTG (CO 1ST BN - CAMP MACKALL) - 249A 0 $ -

419TH CSB - 244F 0 $ -

FORSCOM PROTOCOL - 360 0 $ -

JSOC - 438 0 $ -

NATIONAL GUARD (HQ 139TH REGT) - 601 0 $ -

WTB - 602 0 $ -

18TH ABN CORP (RAGS) - 959 0 $ -

ORGANIZATION - UC# 0 $ -

ORGANIZATION - UC# 0 $ -

ORGANIZATION - UC# 0 $ -

ORGANIZATION - UC# 0 $ -

ORGANIZATION - UC# 0 $ -

ORGANIZATION - UC# 0 $ -

TOTAL REIMBURSABLE COST 0 $ -

WEEKLY ABSTRACT/WORKLOAD NON-REIMBURABLE REPORT: (DIRECT

FUNDING) paragraph 5.5(d)

WEEKLY NON-REIMBURSABLE REPORT: DIRECT FUNDING

CLIN__________ - ORGANIZATIONAL CLOTHING AND EQUIPMENT

DATE:___________________

ORGANIZATION:________________________________________

UC# ________

WK1 WK2 WK3 WK4 WK5 TOTAL

ITEM 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 $ -

Jacket Chef $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Jacket Band Uniform $ - 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 $ -

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 $ -

Trouser , Food Handler $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Trouser , Band Uniform $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

WEEKLY NONREIMBURSABLE REPORT: DIRECT FUNDING

CLIN ____________ - FOOD HANDLER UNIFORMS : DIRECT FUNDING

DATE: MM/DD/YR

WK1 WK2 WK3 WK4 WK5 TOTAL

ITEM

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

Apron, Food Handler $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

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

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

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

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

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

WEEKLY NON-REIMBURSABLE REPORT: DIRECT FUNDING

CLIN___________ - DIRECT EXCHANGE (LINEN)

DATE:___________________

UC# _____________

Bed Spread $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Blanket $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

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

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

Pillowcase $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

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

WEEKLY NON-REIMBURSABLE REPORT: DIRECT FUNDING

CLIN___________ - 72 HOUR DRY CLEAN

DATE:___________________

UC# ______________

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

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

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

Coat Band Uniform $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

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

Drapes $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

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

Finger Towel $ - 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 $ -

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 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 $ -

Trousers, Band Uniform $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

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

Weekly Abstract/Workload Report Reimbursable paragraph 5.5(d)

CLIN _________ - REIMBURSABLE-ORGANIZATIONAL - DIRECT EXCHANGE (RAGS)

DATE:MM/DD/YR

WK1 WK2 WK3 WK4 WK5 TOTAL

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

Rags (UC#) $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags (UC#) $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags (UC#) $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags (UC#) $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags (UC#) $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags (UC#) $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags (UC#) $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags (UC#) $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Rags (UC#) $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

ORGANIZATION - UC#_________ - REIMBURSABLE - DATE: MM/DD/YR

CLIN ________ OCIE #Pieces $0.00

CLIN ________ DIRECT EXCHANGE #Pieces $0.00

CLIN ______ 72 HOUR DRY CLEAN #Pieces $0.00

WK1 WK2 WK3 WK4 WK5 TOTAL

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

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

Bag, Helmet $ - 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 $ -

Bivy Cover $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Compressed Stuff Sack $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Coveralls $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Cover, Helmet $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Hydration Carrier $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Jacket, NOMEX/Gore $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Liner, Poncho $ - 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 $ -

Pack, Alice $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

PJ Bottoms $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

PJ Tops $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Scarf Wool $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Shirt, Black/Utility $ - 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 SM $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Table Skirt MED $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Table Skirt LRG $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Trouser, Black/Utility $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Trouser Gortex $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Bed Spread $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

Blanket $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

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

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

Pillowcase $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ - 0 $ -

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

Weekly Abstract/Workload Report (Cash Sales) paragraph 5.5(d)

TE6 INDIVIDUAL PIECE RATE (IPR) 72 HOUR: DATE: MM/DD/YR

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

0 $ - 0 $ -…