Appendix_B_Templates.pdf

Attachment 1

Three Week Look Ahead Schedule

0 0 0 0 0 0 0 0 0 0 11 0 FALSE

NA TRUE

Day 30 Month 11 Year: 2015

Q A SO

SA

Days when the activity work is proposed

NOV-DEC 28 29 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Site Location Maintenance Activitiy Description S S M T W TH F S S M T W TH F S S M T W TH F S S

Site Location Service Orders S S M T W TH F S S M T W TH F S S M T W TH F S S

S S M T W TH F S S M T W TH F S S M T W TH F S S

NOV-DEC 28 29 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20

Work Plan Num.

Date Prepared:

Last Day of Prior Work Plan: (Must be Sunday)

Service Order

Semi-Annual Not Working day

LEGEND:

Quaterly Annual

Project: DLA Fuels Service Orders Support Phase:

Contractor Project Manager:

Contrator Signature

HNC Project Manager:

Contractor:

Attachment 2

Monthly Report

DLA Recurring Maintenance and Minor Repairs Program US Army Corp of Engineers- Engineering and Support Center, Huntsville

Monthly Status Report Contract No. W912DY-13-G-XXXX

Task Order No. XXXX

Task order title

Submission Date:

Submitted By:

Company Name

Monthly Status Report (Dates)

Task Order Title US Army Corps of Engineers- Engineering and Support Center, Huntsville

Contract W912DY-13-G-XXXX, Task Order XXX

Company Name Page 1

TABLE OF CONTENTS

1.0 SERVICE ORDER OVERVIEW ................................... ERROR! BOOKMARK NOT DEFINED.2

2.0 RECURRING MAINTENANCE OVERVIEW

3.0 CURRENT AVAILABLE FUNDS

4.0 QUALITY

5.0 SAFETY

6.0 PHOTOGRAPHS

7.0 SCHEDULE

8.0 TOP 10 REPAIR ITEMS

9.0 HNC POINT OF CONTACT

APPENDICES

Appendix A Safety Report Appendix B Photographs Appendix C Schedule

Task Order Title

Company Name Page 2

Overview: The following Monthly Status Report is provided IAW the Performance Work Statement, Para 4.2, Monthly Status Reporting.

1.0 SERVICE ORDER OVERVIEW

Service Order Overview- As of today current option SO Category Number of SOs Total Cost

Submitted to HNC 93 $532K Approved by HNC 46 $178K Executed 62 $195K Disapproved / Cancelled by HNC 1 $1K Awaiting HNC Approval 100 $859K In-Progress (have not been to HNC) 107 $676K

Service Order Overview- During this Period SO Category Number of SOs Total Cost

Submitted to HNC 93 $532K Approved by HNC 46 $178K Executed 62 $195K Disapproved / Cancelled by HNC 1 $1K

Every SO submitted during this period shall be included in this table.

SO # General Description

NTP

Date

Completed Date days after

NTP

date

# days to complete

# days less than

# days over 30 (from

NTP)

Remarks

Task Order Title

Company Name Page 3

2.0 RECURRING MAINTENANCE OVERVIEW

Table 1 Required & Completed Maintenance Visits Completed as of today current option

Site Name Code Phase Quarterly Semi-Annual Annual Required Completed Required Completed Required Completed

Bryant/Richardson BRY A5 4 4 2 2 1 1 Camp Santiago STG A5 4 4 2 2 1 1 Fort Greely GRE A5 4 4 2 2 1 1 Fort Wainwright WNR A5 4 4 2 2 1 1 Isla Grande IGP A5 4 4 2 2 1 1 Kwajalein Island KWA A5 2 1 2 1 1 1 Pohakuloa PTA A5 4 4 2 2 1 1 Soto Cano SCN A5 2 2 2 2 2 1 Wheeler Army WHL A5 4 4 2 2 1 1

Table 2 Number & Total Costs of Maintenance Visits- During this period

Effort Number of Maintenance Visits this Month Total Cost Quarterly Maintenance 14 $102,654.00 Semi-Annual Maintenance 15 $103,479.00 Annual Maintenance 5 $133,036.00

Table 1 Required & Completed Maintenance Visits Completed during this period

Site Name Code Phase Quarterly Semi-Annual Annual Required Completed Required Completed Required Completed

Bryant/Richardson BRY A5 4 0 2 0 1 0 Camp Santiago STG A5 4 0 2 0 1 0 Fort Greely GRE A5 4 0 2 0 1 1 Fort Wainwright WNR A5 4 1 2 0 1 0 Isla Grande IGP A5 4 2 2 0 1 1 Kwajalein Island KWA A5 2 3 2 1 1 0 Pohakuloa PTA A5 4 4 2 0 1 1 Soto Cano SCN A5 2 2 2 1 2 1 Wheeler Army WHL A5 4 4 2 1 1 1

Task Order Title

Company Name Page 4

3.0 CURRENT AVAILABLE FUNDS

CLIN Amount Balance

(Approved SOs) Balance

(Submitted SOs) Comments

4.0 QUALITY

Customer Feedback Surveys

Sixty-three (63) customer quality feedback surveys were sent for recurring maintenance and repair actions during the reporting period. As of the close of this reporting period, 20 surveys were received. These surveys reflected neutral to positive comments on the JVs performance to date.

Total Number of Responses

Average of

Responses

Response

Question 1 2 3 4 5 On a scale from 1 to 5 with five being the best, please rate your OVERALL satisfaction with the way Tetra Tech/Maytag performed Recurring Maintenance/Repair activities at your location.

Were timely in reporting to my location

Completed activities according to schedule

Complete the task properly

Effectively communicated with you prior to and during our site visit

Maintained proper housekeeping and left the work area clean and functional

The following comments were received on the surveys:

Task Order Title

Company Name Page 5

5.0 SAFETY

a. Reportable Incidents this period:

b. Safety training/briefings this period and (attendees):

Safety reports are included in Appendix A.

6.0 PHOTOGRAPHS

Representative photographs of maintenance repair work are included in Appendix B.

7.0 SCHEDULE

The updated schedule for anticipated RM and MR/ER work is included in Appendix C.

8.0 TOP 10 MAINTENANCE REPAIR ITEMS

Rank Maintenance/Repair Number

9.0 POINTS OF CONTACT

Contract Administrators – Program Manager – Project Manager – Project Engineer –

Monthly Progress, Status, and Management Report (1 – 31 October 2015) Recurring Maintenance and Minor/Emergency Repair Services at

USA Phase 4 Army Installations US Army Engineering and Support Center, Huntsville

Contract W912DY-13-D-0010, Task Order 0004 October 2015

Appendix A

Safety Report

Monthly Progress, Status, and Management Report (1 – 31 October 2015) Recurring Maintenance and Minor/Emergency Repair Services at

USA Phase 4 Army Installations US Army Engineering and Support Center, Huntsville

Contract W912DY-13-D-0010, Task Order 0004 October 2015

Company Name Page 2

Appendix B

Photographs

Appendix C

Schedule

Attachment 3

Maintenance Report

Page # of #

RECURRING MAINTENANCE REPORT

LOCATION

Contract Year ##, Maintenance Activity #

Contract No. #####

Installation

Site Name

Report # of # Operational Area

Facilities List facilities below

Contacts Emergency SO Routine SO E-mail QAE

Phone Number SO email address for requests Contractor Onsite Personnel

Date of Visit Date of Next Visit

MAINTENANCE REQUIREMENTS

Maintenance Requirement Frequency Summary of Maintenance Tasks and Equipment NOTES

DEFICIENCY LIST

Installation Name

DEFICIENCIES

Operational Area

Deficiency Number Initial Finding

Date SO Number Status Deficiency Facility No.