Contract Data Requirements List - A012

UNCLASSIFIED

CONTRACT DATA REQUIREMENTS LIST

A. CONTRACT LINE ITEM NO.
TBD

C. CATEGORY:

B. EXHIBIT

A

TDP

OTHER SAFT

TM

D. SYSTEM/ITEM

E. CONTRACT/PR NO.
Vandenberg Building 9320 Hoist/Crane Replacement
TBD

F. CONTRACTOR

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

Environmental, Safety, and Occupational Health (ESOH) Plan

Site-Specific Safety

A012

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

DI-SAFT-82313

7. DD 250 REQ

LT

10. FREQUENCY

A

11. AS OF DATE

N/A

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

309 MXSG/MASO

12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

1/TIME

N/A

NSP

6. REQUIRING OFFICE

SOW Paragraph 3.17.2

9. DIST STATEMENT

REQUIRED

8. APP CODE

TBD

13. DATE OF SUBSEQUENT

SUBMISSION

0.00

b. COPIES

Block 16

a. ADDRESSEE

Draft

N/A

Final
Reg

Repro

16. REMARKS

(9) DISTRIBUTION STATEMENT A: Approved for public release. Distribution is unlimited.
(12) Due 15 calendar days prior to commencement of site work. (14) One (1) copy of each submittal shall be provided electronically to each addressee in block 16 in Microsoft Office compatible format.
Submit electronically in searchable PDF format per SOW 3.17.2. The Site-Specific Safety Plan shall include detailed procedures for LOTO, fall protection, electrical safety in compliance with AFMAN 91-203, and hot work.
No on-site work shall commence until written approval of this plan is granted. Addressees:
Alan Taylor 309 MMXG - EN
[email protected]
DSN: 586-9298

COMM: 801-586-9298

Mason Figueroa 309 MXSS/MXDVAAC
[email protected]
DSN: 777-2545

COMM: 801-777-2545

Shane Weston MXSG/MXDEQ
[email protected]
DSN: 586-8624

COMM: 801-586-8624

John Pedri 309 MXSG - COR
[email protected]
DSN: 775-6122

COMM: 801-775-6122

15.TOTAL

G. PREPARED BY

H. SIGNATURE

I. APPROVED BY

J. SIGNATURE

Paulette Johnson

DD FORM 1423, FEB 2024

UNCLASSIFIED

PREVIOUS EDITION MAY BE USED.

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoDM 5010.12 for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.
Item B. Self-explanatory.
Item C. Mark (X) appropriate category: TDP - Technical Data Package; TM Technical Manual; Other - other category of data, such as "Provisioning," "Configuration Management," etc.
Item D. Enter name of system/item being acquired that data will support (e.g., Mission Design Series (MDS) designator).
Item E. Self-explanatory (to be filled in after contract award). Item F. Self-explanatory (to be filled in after contract award). Item G. Name of preparer of CDRL.