12080155_CDRL.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) OMB No. 0704-0188

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.

Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

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:

TDP TM OTHER

MISC

D. SYSTEM|ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

CERTIFICATE OF COMPLIANCE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MISC-81356A PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 7/29/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document No.: 12080155

15. Total 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

/s/ Jessica Ray 7/29/2021 /s/ Frank Gilger 7/29/2021

DD FORM 1423-1, JUN 90 (EG)

Page 1 of 1 Pages

0002AA A

A001

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.

Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

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:

TDP TM OTHER

MISC

CERTIFICATION/DATA REPORT

PERIOD LOAD TEST

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-NDTI-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 7/29/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

0002AB B

B001

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.

Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

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:

TDP TM OTHER

QCIC

CALIBRATION CERTIFICATE/REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-QCIC-80798C PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

0002AC C

C001

DD FORM 1423-2, AUG 96 PREVIOUS EDITION MAY BE USED. Page _1_ of _1_ Pages

CONTRACT DATA REQUIREMENTS LIST

(2 Data Items) Form Approved OMB No. 0704-0188

The public reporting burden for this collect ion of information is est imated to average 220 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 o ther aspect o f th i s co l lec t ion o f in fo rmat ion , in c lud ing suggest ions fo r reducin g the burden, to the Department o f Defe nse, Execut ive Se rv ices Di rec tora te (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for fai ling to comply with a collect ion 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:

TDP TM _______ OTHER MISC

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

CERTIFICATION/DATA REPORT

3. SUBTITLE

DEFECT REMOVAL AUTHORIZATION

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80678

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16* 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A*

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A

Draft Final

Reg Repro

16. REMARKS

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 7.2, 10.4, 10.5 - Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 7/29/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 10 - Submit Defect Removal Authorization unless acceptable Defect Removal Criteria is provided.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Upon submission in WAWF send email notifications to:

ddpw_wawf_group.fct@navy.mil

N4523A 0 1 0

15. TOTAL 0 1 0

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

CERTIFICATION/DATA REPORT

3. SUBTITLE

DEFECT REMOVAL CRITERIA

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80678

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16 14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A

a. ADDRESSEE Final

Draft Reg Repro

16. REMARKS

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 7.2, 10.4, 10.5 - Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 7/29/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 10 - Submit Defect Removal Criteria unless Defect Removal Authorization is provided.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Upon submission in WAWF send email notifications to:

ddpw_wawf_group.fct@navy.mil

Document no.: 12080155

N4523A 0 1 0

15. TOTAL

0 1 0

G. PREPARED BY

/S/Jessica Ray

H. DATE

7/29/2021

I. APPROVED BY

/S/Frank Gilger

J. DATE

7/29/2021

17. PRICE GROUP

19. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

19. ESTIMATED

TOTAL PRICE

0002AD D

D001 mailto:ddpw_wawf_group.fct@navy.mil mailto:ddpw_wawf_group.fct@navy.mil

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.

Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

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:

TDP TM OTHER

NDTI

TEST/INSPECTION REPORT

STATIC LOAD TEST

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-NDTI-80809B PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr to COMNAVSEASYSCOM.

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

0002AE E

E001

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.

Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

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:

TDP TM OTHER

VISUAL INSPECTION

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-NDTI-80809B PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr to COMNAVSEASYSCOM.

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

0002AF F

F001

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.

Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

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:

TDP TM OTHER

MAGNETIC PARTICLE TEST REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-NDTI-80809B PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr to COMNAVSEASYSCOM.

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

0002AG G

G001

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.

Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

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:

TDP TM OTHER

LIQUID PENETRANT (PT) TEST

REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-NDTI-80809B PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr to COMNAVSEASYSCOM.

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

0002AH H

H001

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.

Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

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:

TDP TM OTHER

SESS

WARRANTY PERFORMANCE REPORT WARRANTY DOCUMENTATION

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-SESS-81639A PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4 - Tailored to allow vendor to provide only 3.1.1 (a, c, d, e), 3.1.2 (a, b, c, d, e, f, g, h, j, k, l, m).

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 7/29/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

J0002AJ

J001

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.

Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

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:

TDP TM OTHER

TMSS

EQUIPMENT TECHNICAL MANUAL (SANITIZED)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-TMSS-81675 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

K0002AK

K001