2014_PWS_Waterborne_Program_Manager-10_Jun.pdf

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Waterborne Equipment Manager Federal contract opportunity
Solicitation number
W912PQ-14-T-0049
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Department of the Army New York Army National Guard

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Guardian Angel Weapons System (GAWS) Waterborne Project Manager (WPM) Performance Work Statement 10 June 2014

1.0 Organizational Analysis:

Air National Guard (ANG):

Source: (http://www.ang.af.mil/mission.asp)

Vision is to be a "Ready, reliable, and accessible force that maintains its relevancy now and through the millennium"

Mission is "To provide combat capability to the war fighter and security to the homeland.” Specifically, to provide ready units to the state and nation in three critical roles:

• Federal Role: To support national security objectives

• State Role: To protect life and property, and to preserve peace, order, and public safety.

• Community Role: To participate in local, state, and national programs that add value to America

2.0 Technical Specifications

The following technical specifications are provided to demonstrate the environment in which the services will be delivered. The following specifications are not directives on how the services are to be provided but an example of what traditionally has been required to successfully support the contract objective. The contractor is encouraged to surpass the minimal technical specifications as well as demonstrate technical, Objective: The objective of this Performance Work Statement (PWS) is to provide the 103rd RQS Commander (CC) with Dive Locker Maintenance support in order to fulfill their mission in an efficient and cost-effective manner. The Contractor shall be responsible for providing on-site Dive Locker maintenance support as they assist in providing technical expertise in the operation and maintenance of the dive locker program, support development, and implementation of waterborne operations procedures designed to rapidly enhance the combat readiness and collective skills of Combat Rescue Officers and Pararescuemen. Place of performance will be Westhampton Beach, NY.

Maintenance Performance Standard Acceptable Quality Level (AQL) Method Used /

Frequency

Perform inventories of 103rd RQS diving equipment, watercraft, outboard motors, and associated maritime equipment

Technical Specification 2.1, 2.2.5.2-2.2.5.3, and 2.3.2

• Accountability of all equipment to include serviceability status of equipment is 98% complete.

• Equipment identified by US Navy 3M systems is loaded and tracked in US Navy 3M system 99% of the time.

Periodic Inspection /

Spot Checks / Monthly

Perform functional tests, and analyses of performance and malfunctions of electrical and mechanical assemblies

Technical Specification 2.1, and 2.2.5.1, and 2.2.5.3-2.2.5.5

• Test and analysis are performed as required or scheduled 98% of the time.

Performs routine and field sustainment maintenance.

Technical Specification

2.2.5.1, 2.2.5.4,

2.2.6.3 and 2.2.6.4

• Maintenance is performed as required or scheduled 95% of the time

• Equipment serviceability status is maintained 95% of the time.

http://www.ang.af.mil/mission.asp operational, and administrative expertise to support the customer in exceeding organizational and departmental objectives.

2.1 Waterborne Equipment Manager:

Waterborne Equipment Manager (WPM) will provide maintenance, troubleshooting, testing and management of all GAWS marine and water operations equipment, specifically: maritime support vessels, GAWS rescue watercraft (Zodiacs, Alternative Rescue Craft, DIBs Boats, GARC’s etc.), as well as trailers for all watercraft, and all sets of SCUBA equipment and accessories.

2.1.1 Contractor shall perform in depth equipment checks and provide all needed maintenance and repairs, or shall declare the equipment unserviceable. All maintenance and repairs must be performed in accordance with (IAW) DoD guidelines, or IAW the manufacturer’s specifications, if DoD guidelines are not available.

Contractor shall provide reports concerning the maintenance and repairs needed or performed.

2.2 This position is located in the 103rd Rescue Squadron (RQS) Logistics Section (LG). The mission of the 103rd Rescue Squadron is to organize, provide training for, equip, and sustain SERE (Survival, Evasion, Resistance and Escape) and Pararescue operations, Combat Rescue Officers, and various support personnel to support State and National Civil Search and Rescue, and worldwide employment of Combat Search and Rescue (CSAR) and the full range of Personnel Recovery and Special Operations missions. The force, known as the Guardian Angel Weapon System (GAWS), is required to rapidly deploy in support of joint operations in all physical environments, both at night and day, and to provide the war fighting commanders the ability to project both air and ground forces to any region of the world in support of our national objectives. Rescue Squadrons provide unique and special skills required for support of these joint operations and are equipped and tailored to support specific missions. Per DOD Instruction 3224.04, the US Navy is the DOD single point manager and proponent for all military diving matters. The Navy Safety Center or Command designated agent will biennially inspect each of the RQs dive lockers to ensure mission success and personnel safety. It is imperative that RQS dive lockers and associated mission support equipment are compliant and maintained at peak operational readiness levels IAW with Navy guidelines. If US Navy guidelines are not available for certain types of equipment, manufacturer’s specifications will be adhered to. Furthermore, the US Navy’s guidelines are very stringent in regards to SCUBA diving equipment and diving mission support, and the 103 RQS dive locker must be in compliance. Must have extensive and practical knowledge of: US Navy Maintenance and Material Management (3M) system; maintenance and repair of SCUBA and oxygen diving systems; maintenance and repair of assigned boats and outboard motors; and working knowledge of general diving/maritime operations training procedures IAW US Navy/ANG standards. The contractor shall perform to the standards in this contract.

2.2.1. Research/Technical. The contractor shall research available and emerging technologies and work with the

103 RQS personnel to identify areas where technology advances can benefit the squadron. Specifically, the contractor should look for solutions to technology gaps, resource protection, and enhanced equipment training methodology that will save training time, funding, or enhance combat survivability of Pararescuemen and Combat Rescue Officers during water operations.

2.2.2. 103 RQS GAWS Waterborne Equipment Manager required skills and experience pertaining to Diving

Operations:

2.2.2.1 The contractor shall be a DoD certified Master Diver or commercial equivalent.

2.2.2.2 The contractor shall have experience and qualifications in the operation of US Navy approved under water breathing equipment, support systems, and recompression chamber operations and have a thorough familiarity with recognition and treatment of diving emergencies as outlined in the US Navy Diving Manual.

The contractor shall have three years of experience knowledge and demonstrate familiarity in certification and maintenance of high-pressure air systems and US Navy approved under water breathing equipment and support systems.

The contractor shall have three years of experience knowledge in implementation and employment with the US Navy Dive/Jump Reporting System, US Navy Planned Maintenance System, and the 3M system as it applies to diving for near, mid, and long-term equipment requirements.

The contractor shall have three years of experience knowledge in reading blue-prints and schematic drawings, understand specifications, and interpret illustrated parts breakdowns and other publications used in the field of maritime equipment and dive related specialization.

The contractor shall have three years of experience knowledge of US Navy dive regulations, MAJCOM and USAF regulatory guidelines and instructions to maximize the commands capability to provide Guardian Angel with interoperability with Special Operations Forces, Joint Services and/or coalition services.

2.2.3 It is required for the contractor to have actual work experience managing the equipment used for Air

Deployable Equipment Bundle Rigging Process, including Rigging Alternate Method (RAM) Zodiac (Z), RAM-Q, and ARC packages. Furthermore, the contractor will have experience in the planning, coordinating, and support of Guardian Angel training in open-water diving, waterborne operations, rough water operations, and low visibility diving/underwater mechanical dexterity training. Experience may include, but is not limited to, the support of tactical diving, RAM-Z, ARC (alternate rescue craft) airdrop, and low-altitude low-speed helicopter deployed inflatable (T-DUCK).

2.2.3.1 The WPM Contractor will be certified and experienced in the maintenance and repair of marine outboard engines and demonstrate experience and certification in all 103 RQS GAWS water craft maintenance and operation.

2.2.3.2 The contractor must have extensive experience in small vessel operation, and provide a Coast Guard

(civilian) or DOD equivalent documentation expressing its expertise as a small vessel Boat Master.

2.2.3.3 Contractor must be trained in the maintenance of Self Contained Underwater Breathing Apparatus

(SCUBA) regulators used by the 103rd RQS.

2.2.3.4 Contractor must provide along with their proposal the documentation (e.g. resume, diploma, certificate) that reflect the required qualification skills indicated.

2.2.4 The contractor will execute the following activities:

2.2.4.1 Schedule and monitor 3M system while keeping abreast of changes/directives issued by the US Navy.

Administer all daily, weekly, monthly, quarterly, and annual or greater US Navy Maintenance and Material Management (3M) system maintenance requirements for assigned waterborne equipment and accessories.

Maintain master files for Government Furnished Equipment (GFE) inventory and dive related programs.

The contractor shall maintain and update government furnished regulations, publications, and directives required by MAJCOMS, Naval Sea Systems Command (NAVSEA) and the Naval Safety Center pertaining to waterborne operations.

The contractor shall advise users concerning equipment capabilities and maintenance requirements, and work to resolve maintenance problems and advise users of problems outside the contractor’s ability to overcome.

When requested, the contractor shall advise/assist in Air Force investigations and analysis of accidents, incidents, and failures. Provide technical expertise and assistance in report writing.

2.2.4.2 The contractor shall maintain the Naval Safety Center Dive/Jump Reporting System, provide quality assurance inspection of dive related information, make entries into the system and provide 103 RQS divers with copies of Personal Dive Logs.

The Contractor shall maintain a squadron database of all types of dives performed, equipment used, and note any dive related injuries/accidents to be entered into the Command database.

Conduct inventories of GAWS waterborne equipment and accessories.

2.2.4.3 Conduct inventories and maintenance of GAWS RQS SCUBA equipment. In addition, visual inspection of

SCUBA, SCBA (self contained breathing apparatus), medical oxygen bottles, and all other high pressure bottles IAW Department of Transportation (DOT) regulations.

2.2.4.4 Maintain and repair assigned boats, small vessels, outboard engines and Alternate Rescue Craft in the most economical way possible based on available facilities and extent of repairs required. Schedule and complete preventative maintenance and repairs as necessary. All maintenance and repairs must be performed in accordance with DoD guidelines or in accordance with the manufacturer’s specifications if DoD guidelines are not available.

2.2.5. The contractor shall provide boat driver and boat operations support and expertise for unit training.

The contractor shall ensure the SCUBA tanks are within hydrostatic test and annual visual inspection dates, filled and serviceable for employment.

The contractor shall function as squadron liaison between MAJCOM and 103 RQS operators to ensure career field standards are applied to all contracted maritime operations.

The contractor shall manage and maintain SCBA’s associated with Technical Rescue/Recovery IAW and in conjunction with the manufactures maintenance programs. These tasks are not to interfere with primary duties.

The contractor shall schedule and perform routine preventive maintenance and minor repairs IAW PMS or manufacturer’s specifications. Major repairs and overhauls are to be accomplished by a manufacturer’s authorized service facility or equivalent.

The contractor shall schedule calibration of all diving related gauges and special instruments.

The contractor shall maintain, inspect, and report on the Diver’s Recall System.

The contractor shall maintain, inspect, and report on unit assigned breathing air compressors including quality assurance of divers breathing air samples.

The contractor shall maintain, inspect, and report on unit assigned search sonar system.

Conduct formal classroom or informal training in the maintenance of assigned equipment/systems and ancillary equipment to members of the 103 RQS/Logistics.

2.2.5.1 The contractor will ensure waterborne equipment such as Zodiacs, outboard motors, support boats, Dibs

Craft, Alternate Rescue Craft, and Guardian Angel Rescue Craft are maintained in a serviceable condition in accordance with (IAW) DoD guidelines, or IAW the manufacturer’s specifications, if DoD guidelines are not available.

2.2.5.2 The contractor will maintain, inspect, and report on unit assigned breathing air compressors including quality assurance air samples in accordance with (IAW) DoD guidelines, or IAW the manufacturer’s specifications, if DoD guidelines are not available.

2.2.6 The following are the required tasks associated with boat operator/ small engine technician support:

Develop and instruct maintenance courses for GA watercraft to include but not limited to all ARC’s, GARC’s, inflatable CRRC’s, and outboard engines.

The contractor shall demonstrate experience and qualifications in the following:

Small craft, inflatable CRRC and outboard engine maintenance as outlined in the US Navy 3M systems.

Small-craft operation, navigation and rules of the road, seamanship, and maritime communications.

2.2.7 Contractor will maintain the Material Safety Data Sheet (MSDS) and administering the Squadron’s

Hazardous Material Program.

2.2.8 The contractor shall keep the LG OIC, NCOIC, and Contracting Officer’s Representative (COR) informed of task status and progress by, as a minimum, monthly correspondence or meetings.

2.3 Deliverables. The contractor shall provide the following:

TITLE DIST DATE FREQ IAW COPIES

Monthly Status/Maintenance Report

RQS/Logistics A/R Monthly AFI110-3501

Chapter 6 1 each

Inventory Report (all waterborne equipment & accessories) 103

RQS/Logistics

A/R

Monthly

OPNAV

INST 4790.8

Ships Maintenance and Material Management Manual (3M)

1 each

Equipment Mishap Report 103 RQS/Standards and Evaluations

72 hours after event

OPNAV

INST

5102.1D

Marine Masters Ops & MX Log (Air Force Technical Order (AFTO) Form 17) 103

RQS/Logistics

AFI 10-3501

Air Force Technical Order

(AFTO)

Form 17

Training Policy 103 RQS/Training A/R A/R

AFI 10-3501

Chapter 4

Cost Analysis 103 RQS LG/ Resource Advisor A/R A/R

NOTE: View OPNAV docs at: http://doni.daps.dla.mil/OPNAV.aspx View AFI 10-3501 at: http://www.epublishing.af.mil/

2.3.1. Monthly Status Report. Contractor shall provide the Government a written monthly progress report containing Contractor progress, status, and maintenance updates by the tenth of the following month. The report shall address at a minimum, the general requirements description, progress during the past month, maintenance issues, actions to be taken to resolve the issues, and future plans. The report may be submitted electronically if readable by MS Word, latest version.

2.3.2. Inventory Report. Submit inventory report of all 103 RQS waterborne equipment, accessories, and its operational readiness.

http://doni.daps.dla.mil/OPNAV.aspx http://www.epublishing.af.mil/

2.3.3. Maintenance Report. As required, prepare oral/written reports/recommendations to correct deficiencies in all aspects of waterborne equipment maintenance.

2.3.4 Equipment Mishap Report. When requested, advise/assist in Air Force and Navy investigations and analysis of equipment incidents, and failures. As required, provide inputs in written form. As required, develop briefings and information papers related to maintenance and operational problems for dissemination to GAWS personnel.

2.3.5 AFTO Form 17, Marine Masters Operation and Maintenance Log. The Contractor shall maintain AFTO

Form 17 for all watercraft. When requested or required, provide copies of the log to appropriate agencies as required by local, national, or international law.

2.3.6 Training Policy. When requested, assist the GAWS RQS Training and Standards/Evaluations Sections in the development and drafting of waterborne training policies, directives, and regulations for review and approval by the 103RQS/Standards and Evaluations.

2.3.7 Cost Breakdown Report. The contractor will provide, as requested, a report detailing expenditures.

3.0 Additional Requirements and Notes:

3.1. Contractor shall possess advanced technical knowledge necessary to solve the complex problems of the performance objectives.

3.1.1 Military or civilian electronics background is highly desirable.

3.1.2 Contractor shall have working knowledge of the following computer software:

• Microsoft Word

• Excel

• Unit Level Logistics System-Ground (ULLS-G) program

• Fed Log

3.2 TRAVEL. Travel outside the local area may be required to support the requirements of this contract. All travel must be directed and approved in advance by the COR. Travel shall be reimbursed in accordance with the, Joint Travel Regulation (JTR), Allowable Travel Cost. Contractor personnel are not authorized to travel on Government invitational travel orders.

3.2.1 The Contractor shall fund all travel and expenses for technical training of on-site Contractors related to the operation, repair, and servicing of existing water craft and equipment in inventory at time of contract acceptance or options exercised. The Contractor shall also fund all expenses for routine technical training of other company personnel on any equipment and water craft currently in or added to inventory during the period of the contract.

3.2.2 The 103 RQS will arrange funding for all travel and expenses for technical training of on-site Contractors for new and/or unusual equipment and watercraft added to inventory GAWS-wide, if required. To qualify for 103rd funding, the technical training must be for a new technology/ability.

Local travel to attend meetings within the local city or base of assignment commuting vicinity shall be considered a cost of doing business and shall not be separately reimbursed. The Contractor will fund all travel and expenses for employee proficiency requirements.

3.2.3 The 103 RQS will fund all travel and expenses for technical training courses related to the operation, maintenance, repair, and servicing of locally purchased unit specific watercraft and equipment.

3.2.4 The 103 RQS will fund all travel and expenses for maintenance or servicing of equipment and water craft the on-site Contractor is required to perform at an off-site or commercial facility when on-site Government provided facilities are inadequate to accomplish the work. Determination of adequate facilities for servicing and maintenance tasks rests with the Contracting Officer Representative (COR)

3.3 Contractor will be provided with adequate office space located at the 103rd Rescue Squadron including a complete workstation and chair, expendable supplies, computer hardware and software (and support), internet/intranet/Local Area Network (LAN) (and support) , tools for day to day operation, telephone and fax, copy machine and printer, mail service and postage. All government furnished supplies and services shall be for official use only.

3.4 Contractor will be required to operate the following vehicles in order to perform the tasks listed on this statement of work:

• Fork Lift up to 10k

• Up to 10 PAX Van

• Up to F-650 or Dual Wheel Pick-up or equivalent

• Up to Full Size SUV

• Up to Triple Axle Trailer Towing

4.0 Security Requirements:

4.1 A CAC is required for Base access and the LAN:

A National Agency Check with Inquiries (NACI) is required and a favorable completion of FBI fingerprint History Check must be completed.

4.2 Contractor shall work with the contracting office for processing into the Contractor Verification System

(CVS).

5.0 Miscellaneous:

5.1 Performance of Services During Crisis Declared by the National Command Authority or Overseas Combatant Commander is not applicable.

5.2 The contractor is cautioned that if off-duty active military personnel are hired under this contract, they may be subject to permanent change of station, change in duty hours, or deployment.

Military Reservists and National Guard members may be subject to recall to active duty. The absence of such employees shall not constitute an excuse for nonperformance under this contract.

5.3 Hours of Operation: The contractor shall perform the services required under this contract within core operating hours which are 0700-1630, Monday thru Friday.

5.4 Contractor Manpower Reporting (CMR): The contractor shall report ALL contractor labor hours (including subcontractor labor hours) required for performance of services provided under this contract for collection site. The contractor is required to completely fill in all required data fields using the following web ad-dress: http://www.ecmra.mil/.

Reporting inputs will be for the labor executed during the period of performance during each Government fiscal year (FY), which runs October 1 through September 30. While inputs may be reported any time during the FY, all data shall be reported no later than October 31 of each calendar year. Contractors may direct questions to the help desk at http://www.ecmra.mil/.

Unit Identification Code (UIC) for the Requiring Activity: FA6326 Issuing Office DoDAAC: W912PQ http://www.ecmra.mil/

QUALITY ASSURANCE PLAN – COR INFORMATION

In your role as Contracting Officer Representative (COR) you assume some Quality Assurance duties.

You will monitor contractor performance, complete and sign the Quality Assurance Worksheet provided below at least monthly, but you can submit the worksheet more frequently if needed. This worksheet allows you to document compliance with the contract and fill a regulatory requirement to ensure adequate oversight is being performed.

Annotate the number of hours worked and overtime (if applicable) worked, travel and reimbursable costs incurred. Hours worked in excess of the normal work schedule require prior approval by the Contracting Officer. Please annotate only the actual hours worked and approved; do not include holiday, vacation or sick hours. Only the actual time the contract employee was on the job should be submitted as billed hours.

Quality Assurance Plan Worksheets are to be sent directly to the Schedule Holder and Administering Contracting Office, not later than the 5th day of the month following the service (every month).

The quality rating may change from “Green” to “Red” without notice, however we encourage the COR to utilize the “Yellow” quality rating to alert the contracting office and the Schedule Holder of quality issues that have the potential for a “Red” quality rating if corrective action is not taken.

Any time the rating is less than “Green” the COR shall clearly document the worksheet to indicate what did or did not occur per the PWS requirement. When an observation indicates other than a “Green” rating, the COR will require the Contractor to initial the observation. Initialing the observation does not constitute concurrence with the observation; it only acknowledges that they have been made aware of the defective performance. Notify the Contracting Officer if there is a deficiency. If the Contractor’s response to an identified quality deficiency is unsatisfactory, the Contracting Officer along with the COR will contact the Schedule Holder to implement a plan of action to remedy the identified deficiency.

COR CHANGES: If your supervisor decides to re-assign these COR oversight duties to another Government employee, you must notify the Contracting Officer or Administrative Contract Office immediately, in writing, with their name, position, email and telephone number. Email notification is acceptable. Each COR conducting oversight duties must provide the Contracting Office a copy of the certificates from the required courses below BEFORE services start on the contract or before they can be assigned as the COR.

CONTRACT EMPLOYEE CHANGES: Ensure that all replacement contract employees, to include short-term temporary replacements, are reported to the Contracting Officer listed on the contract.

COR REQUIRED COURSES: The COR must be nominated by their supervisor, appointed in writing by the Contracting Officer and formally trained, which requires the following courses:

1.) DAU CLC106, COR With a Mission Focus – REQUIRED EVERY 3 YEARS 2.) DAU CLC 107, OPSEC Contract Requirements - REQUIRED ONE TIME 3.) DAU CLC 013, Services Acquisition - REQUIRED EVERY 3 YEARS 4.) DAU CLM 003, Overview of Acquisition Ethics - REQUIRED ANNUALLY 5.) Combating Trafficking in Persons - REQUIRED ANNUALLY

a. Air Guard Personnel complete course Human Relations ZZ133080 in ADLS.

b. Army Guard personnel go to http://ctip.defense.gov/ and complete J3TA-US030 course.

6.) Complete Form OGE 450, Confidential Financial Disclosure Report – REQUIRED

ANNUALLY

http://ctip.defense.gov/

a. Go to: HTTPS://WWW.FDM.ARMY.MIL/ within 30 days of appointment and annually by February 15 of each year you are a COR. A copy of the OGE 450 shall NOT be provided to the Contracting Officer as it is a confidential form.

The COR Nomination Letter and Appointment Letter and proof of training certificates are required to be submitted to the contracting office BEFORE services start on the task order.

MONITOR TRAFFICKING IN PERSONS: The COR shall monitor the contractor’s performance for noncompliance with FAR 52.222-50, Combating Trafficking in Persons (CTIP). At a minimum, the COR shall:

1.) Read and understand the Combat Trafficking in Persons clause, FAR 52.222-50.

2.) Monitor the contractor’s performance for noncompliance with the Combat Trafficking in

Person clause through contractor inspection and reported information or complaints.

3.) Document any observed non-compliance.

4.) Bring any potential issue in this area to the immediate attention of the contracting officer before engaging the contractor in reference to these activities.

CONTRACTS OVER $150,000- VIRTUAL CONTRACTING ENTERPRISE (VCE) REGISTRY

REQUIRED:

1.0 Virtual Contracting Enterprise’s (VCE) Contracting Officer Representative (COR) Module. The COR, the COR Supervisor, the Contracting Officer (KO), and the Contract Administrator (CA) shall comply with the DoD requirements for participation in the VCE-COR Module. The VCE COR Module can be access at the following link https://arc.army.mil/COR.

1.1. The COR, the COR Supervisor, the KO, and the CA shall create an Army Knowledge Online (AKO) email address at www.us.army.mil. An AKO email address is required to access the VCE- COR Module.

1.2. A COR shall be nominated, appointed, and revoked if necessary in the VCE-COR Module.

1.3. A COR shall create a COR Profile and process a nomination package in the VCE-COR Module.

1.4. The COR shall upload and maintain the following documents listed below in the VCE-COR Module:

• Training certificates: See “COR Required Courses” above.

• COR Monthly Surveillance Reports (QAW) starting the first mo. of the task order.

THE QAW MUST BE UPLOADED BY THE 5TH DAY OF THE MONTH

FOLLOWING THE SERVICE (EVERY MONTH).

1.5. The COR Supervisor or Commander will review and approve the COR Nomination and Appointment Letters. Contact the contracting office for a sample COR Nomination Letter.

1.6. The KO will review the COR Nomination and appoint the COR.

The COR referred to in this QAP is Capt Bryan Walsh. Office phone number is 631-723-7415.

https://arc.army.mil/COR

Rating Description Green Yes performance and technical specifications are being met at AQL.

Yellow

Yes, performance and technical specifications are currently being met at the minimum AQL, but the following service / deliverable needs contractor attention.

The Customer must identify what component of the deliverable and/or service requires attention.

Red

No, performance and technical specifications are not being met at AQL and the following service / deliverable needs immediate contractor resolution.

The Customer must identify what component of the deliverable and/or service is below the minimum AQL.

QUALITY ASSURANCE WORKSHEET

Performance Rating

Deliverable/Service Quality Rating Causative Factors Effect on Mission

Action Required /

Date

Perform inventories of 103rd RQS diving equipment, watercraft, outboard motors, and associated maritime equipment

Green Comments Unnecessary for “Green” QA Rating.

Yellow

Red

Perform functional tests, and analyses of performance and malfunctions of electrical and mechanical assemblies.

Red

Performs routine and field sustainment maintenance.

Note: Attach Time Card Period of Performance: From _______________to____________

Number of Hours Actually Worked: ______ (Include only actual hours worked. Do not include non worked holidays, leave, etc. these are included in the rate the Government pays and are not paid as hours worked.) Overtime_____ (if applicable): ________ Reimbursable Expenses (include receipts): _______ Travel (include approval sheet): _______

Approved by: Date:__________________

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