A.07.23_Attachment_G_-_Sample_SO_Submission_Form.xlsm

XLSM spreadsheet 50 KB Posted Sep 17, 2018

Attached to: Fuel Systems Recurring Maintenance and Minor Repair (RMMR) Services
Solicitation number: W912GB18R0039
Issued by: Department of the Army Corps of Engineers Engineering District Europe

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Attachment G - Sample SO Submission Form

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Other files

File	Type	Posted
A.07.24_W912GB18R0039-0006.pdf	PDF	Dec 21, 2018
A.07.24_W912GB18R0039-0005.pdf	PDF	Dec 17, 2018
A.07.24_W912GB18R0039-0004.pdf	PDF	Dec 7, 2018
A.07.24_W912GB18R0039-0003.pdf	PDF	Oct 15, 2018
W912GB18R00390002.pdf	PDF	Oct 10, 2018
W912GB18R0039-0001.pdf	PDF	Oct 2, 2018
Appendix_C_-_PPQ.PDF	PDF	Oct 2, 2018
A.07.23_Appendix_A_Schedule_of_Items_and_Prices_9.26.18.xlsx	XLSX spreadsheet	Oct 2, 2018
A.07.23_Appendix_B_Experience_Information_Sheet.pdf	PDF	Sep 17, 2018
A.07.23_Attachment_E_-_Sample_SO_Request_Form.docx	DOCX document	Sep 17, 2018
A.07.23_Attachment_F_-_SO_SSJ_Form.pdf	PDF	Sep 17, 2018
A.07.23_Attachment_C_-_Army_Europe_EBS_Facilities_by_DOD_Site_Excel-_2_Jul_18.xlsx	XLSX spreadsheet	Sep 17, 2018
A.07.23_Attachment_B_-_Sample_Operational_ISR.xlsx	XLSX spreadsheet	Sep 17, 2018
A.07.23_Attachment_D_-_Air_Force_EBS_Facilities_by_DOD_Site_Excel_-_27_June_18.xls	XLS spreadsheet	Sep 17, 2018
A.07.23_Attachment_A_-_Sample_Bulk_ISR.xlsx	XLSX spreadsheet	Sep 17, 2018
A.07.23_Appendix_A_Schedule_of_Items_and_Prices_1_August_2018.xlsx	XLSX spreadsheet	Sep 17, 2018
A.07.23_W912GB18R0039_Germany_RMMR.pdf	PDF	Sep 17, 2018

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Service Order

CORRECTIVE MAINTENANCE SERVICE ORDER FORM
PART I - SERVICE ORDER INFORMATION
CONTRACTOR:	CONTRACT NO.:	W912GB-XX-D-XXXX
CUSTOMER ORGANIZATION:	SERVICE ORDER NAME:
FACILITY NAME/NUMBER:	SO REQUEST NO:
SERVICE ORDER DATE:	CLIN TO BE CHARGED:
SO DESCRIPTION: (include LOCATION - attach additional sheets as required):

							2
							FALSE
One of these boxes must be checked:		ROUTINE				EMERGENCY
Safety Verification to be completed by Contractor						CENAU Safety Initial
One of these boxes must be checked:		Contractor confirms there is an AHA associated with the work being performed in this SO included in the Accident Prevention Plan (APP)				NA
		Contractor acknowledges there is NOT an AHA associated with the work being performed in this SO included in the APP. AHA is attached for review with the SO.
Check if applicable:		Contractor acknowledges there is an activity associtated with the SO that requires an additional plan or program that will be included in an APP addendum.
PART II - COST SUMMARY
LABOR UTILIZED
Labor Classification	Reg Labor Hours	Reg Labor Rate	Reg Labor Amount	OT Hours	Contr O/T Rate	OT Amount
Program Manager	2.00	$0.00	$0.00	0.00	$0.00	$0.00
	0.00	$0.00	$0.00	0.00	$0.00	$0.00
	0.00	$0.00	$0.00	0.00	$0.00	$0.00
	0.00	$0.00	$0.00	0.00	$0.00	$0.00
	0.00	$0.00	$0.00	10.00	$0.00	$0.00
		$0.00	$0.00		$0.00	$0.00
Labor Notes:				Total Regular Labor		$0.00
Safety Officer will inspect before, during and after work. Quality Control Officer will inspect during testing.				Total OT Labor		$0.00
				Profit On Labor: 0%		$0.00
				TOTAL LABOR COST		$0.00
MATERIALS/SUPPLIES/EQUIPMENT
Description			Qty	Unit	Unit Price	Amount
						$0.00
						$0.00
						$0.00
MSE Notes:				Freight/Shipping
				Subtotal MSE		$0.00
				MSE Charge Rate: 0%		$0.00
				Tax: 0%		$0.00
				Fully Burdened MSE		$0.00
				Profit On MSE: 0%		$0.00
NOTE: Profit shall not be applied to GSA/JCI Catalog Materials.				TOTAL MSE COST		$0.00
SUBCONTRACTOR COSTS
Description						Amount
						$0.00
						$0.00
SUB Notes:				Freight/Shipping		$0.00
				SUB Charge Rate: 0%		$0.00
				TOTAL SUB COST		$0.00
OTHER DIRECT COSTS
Description						Amount
						$0.00
						$0.00
						$0.00
						$0.00
ODC Notes:				G&A: 0%		$0.00
Equipment room flooded. Need to remove excess water for safety purposes.				Profit on Outside Vendor: 0%		$0.00
				TOTAL ODC COST		$0.00
TRAVEL
Description						Amount
						$0.00
						$0.00
						$0.00
Travel Notes:				G&A: 0%		$0.00
				TOTAL TRAVEL COST		$0.00
		TOTAL SO COSTS TO BE INVOICED			$0.00
PART III - AUTHORIZATION
CONRACTOR: Receipt & Acceptance Acknowledged.
E-SIGNED & DATED:
CUSTOMER: SO is accepted and requests NTP from USACE.
E-SIGNED & DATED:
CENAU COR: May approve SOs up to $10,000 or as otherwise authorized by the Contracting Officer.
E-SIGNED & DATED:
CONTRACTING OFFICER: Service Orders over $10,000 or as otherwise specified by Contracting Officer.
E-SIGNED & DATED:
This is a cost reimbursable service order and the initial prices submitted reflect the Contractor's best estimate to complete the work necessary to satisfy the requriement. This SO is considered technically acceptable and within scope.
PART IV - CERTIFICATION OF SERVICES
I certify that the services under the above Service Order have been satisfactorily completed.

QUAILITY ASSURANCE EVALUATOR:

E-SIGNED & DATED:

DATE/TIME WORK COMPLETED

Add Row Add Row Add Row Add Row Add Row

Admin Page

Rates:	Non-Emergency	Emergency
Profit on Labor:	0.0%	0.0%
Profit on MSE:	0.0%	0.0%
Profit on Outside Vendor:	0.0%	0.0%
Indrect Rate (applied to Direct Labor):	0.00%	<-- year 1
Escalation Rate (applied to Direct Labor):	0.00%	<-- year 1

Country:
Tax Rate:	0.00%
MSE Handling Charge Rate:	0.00%
SUB Handling Charge Rate:	0.00%
G&A Rate:	0.00%
Labor Classification	BASE RG	BASE OT
Program Manager	€ - 0	€ - 0
Project Manager	€ - 0	€ - 0
Contract Administrator	€ - 0	€ - 0
Maintenance Manager	€ - 0	€ - 0
Administrative Assistant	€ - 0	€ - 0
General Engineer	€ - 0	€ - 0
Mechanical Engineer	€ - 0	€ - 0
Electrical Engineer	€ - 0	€ - 0
Electronic Security Engineer	€ - 0	€ - 0
Systems Engineer	€ - 0	€ - 0
Network Specialist	€ - 0	€ - 0
Data Manager	€ - 0	€ - 0
CADD Operator	€ - 0	€ - 0
Engineering Technician/Technical Writer	€ - 0	€ - 0
Estimator	€ - 0	€ - 0
Quality Control Officer	€ - 0	€ - 0
Safety Officer	€ - 0	€ - 0
Planner/Scheduler	€ - 0	€ - 0
General Clerk	€ - 0	€ - 0
Maintenance Supervisor	€ - 0	€ - 0
Trades Supervisor	€ - 0	€ - 0
Active Vehicle Barrier Technician	€ - 0	€ - 0
Electronic Security Systems Technician	€ - 0	€ - 0
Electrical Technician	€ - 0	€ - 0
Mechanical Technician	€ - 0	€ - 0
Fire Alarm Technician	€ - 0	€ - 0
	€ - 0	€ - 0

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