1005-01 (004-B50) - Calibration - A001-Certificate.doc

DOC document 145 KB Posted

Attached to
Calibration Federal contract opportunity
Solicitation number
N0017822Q6619
Issued by
Department of the Navy Naval Sea Systems Command

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SF18.pdf PDF
1005-01 (004-B50) - Calibration - DID DI-QCIC-80789C.pdf PDF

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CONTRACT DATA REQUIREMENTS LIST (CDRL)

(1 Data Item) Form Approved

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.
B. EXHIBIT
C. CATEGORY:
A

ASK \* MERGEFORMAT

TDP
TM
OTHER X - QCIC
D. SYSTEM/ITEM
E. CONTRACT/PR NO.
F. CONTRACTOR
ONSITE CALIBRATION SUPPORT
TEKTRONIX
1. DATA ITEM NO.
2. TITLE OF DATA ITEM
3. SUBTITLE

17. PRICE GROUP

A001
CALIBRATION CERTIFICATE
CERTIFICATES OF CALIBRATION

FORMTEXT

4. AUTHORITY (Data Acquisition Document No.)
5. CONTRACT REFERENCE
6. REQUIRING OFFICE

18. ESTIMATED

TOTAL PRICE

DI-QCIC-80798B (SEE BLK 16)
SOW PARA 3.0
NSWC DAHLGREN, B54
7. DD 250 REQ
9. DIST STATEMENT
10. FREQUENCY
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION
N/A
REQUIRED
ASREQ
SEE BLK 16
a. ADDRESSEE
b. COPIES
8. APP CODE
D (SEE BLK 16)
11. AS OF DATE
13. DATE IF SUBSEQUENT SUBM.
Draft
Final

N/A

N/A
SEE BLK 16
Reg
Repro
16. REMARKS
TPOC
1
1

BLK 4: CONTRACTOR FORMAT ACCEPTABLE. USE THE DID AS A GUIDELINE FOR THE INFORMATION DESIRED.

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY ADMINSTRATIVE OR OPERATIONAL USE, JUNE 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO NAVAL SURFACE WARFARE CENTER, DAHLGREN DIVISION, CODE H11, 18372 FRONTAGE ROAD, BUILDING 1460 DAHLGREN, VIRGINIA 22448-5161.

BLKS 12,13: SUBMISSION IS DUE 10 CALENDAR DAYS AFTER THE COMPLETION OF EACH CALIBRATION.

BLK 14: ELECTRONIC MEDIA: REPORTS SHALL BE SUBMITTED IN MS OFFICE 2010 APPLICATIONS (OR EARLIER) OR ADOBE PORTABLE DOCUMENT FORMAT (PDF) ATTACHED TO EMAIL NOTIFICATION TO THE TPOC IDENTIFIED IN THE SOW.

SEE BLK 16
15. TOTAL ▬▬▬▬►
1
1
0
G. PREPARED BY
H. DATE
I. APPROVED BY
J. DATE

DD FORM 1423-1, FEB 2001

PREVIOUS EDITION MAY BE USED

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