13_CDRLs_FD2020_22_50040_AND_50041_Oct_22_Corrected.pdf
PDF 526 KB Posted
- Attached to
- KC-135 & C-17 Fire Cartridges Federal contract opportunity
- Solicitation number
- FA8213-23-R-5004
About this file
This document contains four Contract Data Requirements Lists (CDRLs) for a federal contract to produce KC-135 & C-17 Fire Cartridges. The CDRLs require the following deliverables: an Ammunition Data Card for each lot submitted prior to delivery; Engineering Change Proposals and Notices of Revision submitted as required for approval within 30 days; a Request for Variance submitted as required for approval within 30 days; an Acceptance Test Plan submitted at least 90 days prior to testing for approval within 30 days. Additional required deliverables include: a Failure Summary and Analysis Report submitted within timeframes specified for each failure; and a Test/Inspection Report submitted within 30 days of completing each Lot Acceptance Test. Deliverables are to be submitted to the Department of the Air Force Materiel Command Lifecycle Management Center Hill Air Force Base electronically through the Wide Area Workflow system under Distribution Statement B terms. This represents the key requirements for the referenced federal contract.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| FA8213-23-R-5004_0002.pdf | ||
| FA8213-23-R-5004_0001.pdf | ||
| 16_CDRLs_FD2020_22_50044.pdf | ||
| 12_ItemDescription_Combined_FD2020_22_50044_and_50072.pdf | ||
| FA8213-23-R-5004.pdf | ||
| 08_SPI_Combined.pdf | ||
| 05_ADC_SOW_Jan2018.pdf | ||
| 03_AirSpec_FD20202350072.pdf | ||
| 15_CDRLS_FD2020_23_50072.pdf | ||
| 04_REPSHIP.pdf | ||
| 09_QALI_KC_135_FireCart_MJ92_MJ15.pdf | ||
| 02_AirSpec_FD20202250044.pdf | ||
| 14_CDRLs_for_FAT_FD2020_22_50040_22_50041_Oct_ 2022_Corrected.pdf | ||
| 07_SOW_February2022.pdf | ||
| 11_ItemDescriptions_FD2020-22-50040and50041.pdf | ||
| 10_Rework_and_Repair_ES7034.pdf | ||
| 06_CADPAD_Item_Marking_Instruction_Ver1_5_20190501.pdf | ||
| 01-AirSpec_FD20202250040and50041.pdf |
Show all 18
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Text version
CONTRACT DATA REQUIREMENTS LIST
(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:
TDP TM OTHER MISC
D. SYSTEM/ITEM
1377012340912ES*
E. CONTRACT/PR NO.
FD2020-22-50040/22-50041
F. CONTRACTOR
1. DATA ITEM NO.
A001
2. TITLE OF DATA ITEM
Ammunition Data Card (ADC)
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-MISC-80043B
5. CONTRACT REFERENCE
Airmunitions Specification
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
SD
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK 16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Follow format and preparation requirements listed in paragraph 2 of the Data Item Description.
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. The electronic receiving report shall also be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at: https://wawf.eb.mil.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHJ.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979((Title 50, U.S.C, App. 2401 et seq.) as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with the provisions of DoD Directive 5230.25.
BLK 10,12,13: Submit after successful Lot Acceptance Test and prior to delivery of each production lot.
BLK 14: A sample ADC or "draft" will be generated and submitted for each part number/NSN produced under this contract using the Worldwide Ammunition-data Repository Program (WARP) system to ensure general format and content is acceptable. For the final submittals, two hard copies of ADCs shall be generated from the WARP. One copy shall accompany items shipped; second copy submitted with the electronic receiving report via WAWF to AFLCMC/EBHJ. The ADC shall be uploaded in WAWF under DoDAAC, FA8213.
*1377016765427ES,1377012258235ES,1377016767654ES.
FOB DESTINATION
EBH 21-222-001
Terry McCurdy, AFLCMC/EBHEC, 586-0535
WAWF 0 1 0
DoDAAC, FA8213
Included with item(s) shipped
Sample ADC via
WARP sys only 0 1 0
15. TOTAL 0 2 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2021/08/10
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2021/08/10
18. ESTIMATED
TOTAL PRICE
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages
17. PRICE GROUP
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:
TDP TM OTHER SESS
D. SYSTEM/ITEM
1377012340912ES*
E. CONTRACT/PR NO.
FD2020-22-50040/22-50041
F. CONTRACTOR
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM
Engineering Change Proposal (ECP)
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-80639E
5. CONTRACT REFERENCE
Airmunitions Specification
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
ASREQ
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: : Follow format requirements listed under paragraph 2 of Data Item Description. Data deliverable contents of Engineering Change Proposal shall contain all information required by DD Form 1692.
BLK 7: The Letter of Transmittal shall be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data. The Letter of Transmittal shall be used only for this data item; do not combine other data item submittals with this requirement.
BLK 8: Within 30 days of receipt, the Government Engineer thru the Government Contracting Officer will respond with notification of approval/disapproval. If disapproved, Government Engineer response thru the Government Contracting Officer will include instruction for remediation. Notification of approval of the proposed engineering change shall be by signed contract modification.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHJ.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979(Title 50, U.S.C, App 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with the provisions of DoD Directive 5230.25.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
BLK 14: Submit reports electronically via e-mail in Microsoft Office or PDF format to the following e-mail recipients listed below. Refer to contract for e-mail address of the Government Contracting Officer (AFLCMC/EBHKB).
robert.morgan.27@us.af.mil (AFLCMC/EBHEC)
EBH 21-222-001
Terry McCurdy, AFLCMC/EBHEC, 586-0535
AFLCMC/EBHJ 1 1 0
AFLCMC/EBHEC 1 1 0
AFLCMC/EBHKB 1 1 0
DCMA/QAR 1 1 0
DCMA/ACO 1 1 0
15. TOTAL 5 5 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2021/08/10
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2021/08/10
18. ESTIMATED
TOTAL PRICE
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:
TDP TM OTHER SESS
D. SYSTEM/ITEM
1377012340912ES*
E. CONTRACT/PR NO.
FD2020-22-50040/22-50041
F. CONTRACTOR
1. DATA ITEM NO.
A003
2. TITLE OF DATA ITEM
Notice of Revision (NOR)
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-80642E
5. CONTRACT REFERENCE
Airmunitions Specification
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
ASREQ
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Follow format requirements listed under paragraph 2 of Data Item Description. Data deliverable contents of Notice of Revision shall contain all information required by DD Form 1695.
BLK 8: Within 30 days of receipt, the Government Engineer thru the Government Contracting Officer will respond with notification of approval/disapproval. If disapproved, Government Engineer response thru the Government Contracting Officer will include instruction for remediation. Notification of approval of the proposed notice of revision shall be by signed contract modification (AFLCMC/EBHKB).
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHJ.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979(Title 50, U.S.C, App 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.
BLK 14: Submit reports electronically via email in Microsoft Office or PDF format to the e-mail recipients listed below. Refer to contract for email address of the Government Contracting Officer
(AFLCMC/EBHKB).
robert.morgan.27@us.af.mil (AFLCMC/EBHEC)
*1377016765427ES,1377012258235ES,1377016767654ES.
FOB DESTINATION
EBH 21-222-001
Terry McCurdy, AFLCMC/EBHEC, 586-0535
AFLCMC/EBHJ 1 1 0
AFLCMC/EBHEC 1 1 0
AFLCMC/EBHKB 1 1 0
DCMA/QAR 1 1 0
DCMA/ACO 1 1 0
15. TOTAL 5 5 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2021/08/10
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2021/08/10
18. ESTIMATED
TOTAL PRICE
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:
TDP TM OTHER SESS
D. SYSTEM/ITEM
1377012340912ES*
E. CONTRACT/PR NO.
FD2020-22-50040/22-50041
F. CONTRACTOR
1. DATA ITEM NO.
A004
2. TITLE OF DATA ITEM
Request for Variance (RFV)
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-80640E
5. CONTRACT REFERENCE
Airmunitions Specification
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
ASREQ
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Follow format requirements listed under paragraph 2 of Data Item Description. Data deliverable contents of Request for Variance shall contain all information required by DD Form 1694.
BLK 7: Government engineer will perform review of the RFV.
Notification of approval shall be signed contract modification
(AFLCMC/EBHKB).
BLK 8: Within 30 days of receipt, the Government Engineer thru the Government Contracting Officer will respond with notification of approval/disapproval. If disapproved, Government Engineer response thru the Government Contracting Officer will include instruction for remediation.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHJ.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C, App 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
BLK 14: Submit reports electronically via e-mail in Microsoft Office or PDF format to the following e-mail recipients listed below. Refer to contract for e-mail address of the Government Contracting Officer
(AFLCMC/EBHKB).
robert.morgan.27@us.af.mil (AFLCMC/EBHEC)
*1377016465427ES,1377012258235ES,1377016467654ES.
FOB DESTINATION
EBH 21-222-001
Terry McCurdy, AFLCMC/EBHEC, 586-0535
AFLCMC/EBHJ 1 1 0
AFLCMC/EBHEC 1 1 0
DCMA/QAR 1 1 0
DCMA/ACO 1 1 0
15. TOTAL 4 4 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2021/08/10
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2021/08/10
18. ESTIMATED
TOTAL PRICE
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:
TDP TM OTHER QCIC
D. SYSTEM/ITEM
1377012340912ES*
E. CONTRACT/PR NO.
FD2020-22-50040/22-50041
F. CONTRACTOR
1. DATA ITEM NO.
A005
2. TITLE OF DATA ITEM
Acceptance Test Plan
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-QCIC-80553A
5. CONTRACT REFERENCE
Airmunitions Specification
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
BLK16
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
BLK16
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor format required.
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at:
https://wawf.eb.mil. The electronic receiving report shall be used only for this data item, do not combine other data item submittals with this requirement.
BLK 8: Comments/approval/disapproval will be submitted within 30 working days of receipt by AFLCMC/EBHJ.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHJ.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C. Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C, App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with the provisions of DoD Directives 5230.25.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
BLK 10,11, 12, 13: The contractor shall provide a Acceptance Test Plan after contract award and at least 90 days prior to Lot Acceptance Testing allowing for 30 day approval time. No changes to previously approved government Acceptance Test Plans shall be made without prior notification of AFLCMC/EBHJ. Engineering approval in accordance with Airmunitions Specification.
BLK 14: Report shall be in Microsoft Office or PDF format. Submit through WAWF, DoDAAC, FA8213.
*1377016765427ES, 1377012258235ES, 1377016767654ES.
FOB DESTINATION
EBH 21-221-002
Terry McCurdy, AFLCMC/EBHEC, 586-0535
WAWF 0 1 0
DoDAAC, FA8213
15. TOTAL 0 1 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2021/08/10
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2021/08/10
18. ESTIMATED
TOTAL PRICE
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:
TDP TM OTHER NDTI
D. SYSTEM/ITEM
1377012340912ES*
E. CONTRACT/PR NO.
FD2020-22-50040/22-50041
F. CONTRACTOR
1. DATA ITEM NO.
A006
2. TITLE OF DATA ITEM
Test/Inspection Report
3. SUBTITLE
Lot Acceptance Test
4. AUTHORITY (Data Acquisition Document No.)
DI-NDTI-80809B
5. CONTRACT REFERENCE
Airmunitions Specification
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK 16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor format is acceptable.
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at:
https://wawf.eb.mil. The electronic receiving report shall be used only for that data item; do not combine other data item submittals with this requirement.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies only (Administrative/Operational Use) (Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHJ.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C, App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
BLK 10,12,13: Submit within 30 calendar days after completion of each Lot Acceptance Test.
BLK 14: Report shall be in Microsoft Office software or PDF format.
Submit through WAWF, DoDAAC, FA8213.
EBH 21-222-001
Terry McCurdy, AFLCMC/EBHEC, 586-0535
WAWF 1 0 1
DoDAAC, FA8213
IHDV, NSWC 0 1 0
(ref BLK 16)
15. TOTAL 1 1 1
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2021/08/10
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2021/08/10
18. ESTIMATED
TOTAL PRICE
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:
TDP TM OTHER SESS
D. SYSTEM/ITEM
1377012340912ES*
E. CONTRACT/PR NO.
FD2020-22-50040/22-50041
F. CONTRACTOR
1. DATA ITEM NO.
A007
2. TITLE OF DATA ITEM
Failure Summary and Analysis Report
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-80255B
5. CONTRACT REFERENCE
Airmunitions Specification
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK 16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor's format required for both the Preliminary and Final report.
BLK 7: The Letter of Transmittal shall be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data. The Letter of Transmittal shall be used only for this data item; do not combine other data item submittals with this requirement.
BLK 8: Comments/approval/disapproval will be submitted within 30 calendar days after receipt by AFLCMC/EBHJ.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHJ.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec.
2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C, App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.
BLK 10, 12, 13: Submit within 7 calendar days of each failure.
Final with 15 calendar days after receipt of AFLCMC/EBHJ comments.
BLK 14: Report shall be in Microsoft Office or PDF format. Submit via e-mail to cognizant Hill AFB Contracting Officer.
*1377016765427ES,1377012258235ES,1377016767654ES.
FOB DESTINATION
EBH 21-222-001
Terry McCurdy, AFLCMC/EBHEC, 586-0535
Contr. Officer 0 1 0
Hill AFB, UT
15. TOTAL 0 1 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2021/08/10
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2021/08/10
18. ESTIMATED
TOTAL PRICE
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