14231CDRLTR.pdf
PDF 151 KB Posted
- Attached to
- dsm 157 Test Set Federal contract opportunity
- Solicitation number
- SPRHA4-21-Q-0998
- Issued by
- Defense Logistics Agency Aviation
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| File | Type | Posted |
|---|---|---|
| 3066664EDLREPORT.pdf | ||
| SPRHA421Q0998.pdf | ||
| SOW.pdf |
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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 MGMT
D. SYSTEM/ITEM
6150011987225
E. CONTRACT/PR NO.
FD2020-20-00998
F. CONTRACTOR
1. DATA ITEM NO.
A001
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
PS para 3.3.1 & 5.0
6. REQUIRING OFFICE
AFLCMC/EBHGA
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
D
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK16
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: 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 D: Distribution authorized to Department of Defense and U.S. DoD contractors only (Critical Technology)(Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHGA.
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 as well as the Worldwide Ammunition-Data Repository Program (WARP) system and addressee listed in block 14.
FOB DESTINATION
EBH 20-131-001
Terry McCurdy, AFLCMC/EBHEC, 586-0535
AFLCMC/EBHGA 0 1 0
6034 Dogwood Av
Bldg 1257
Hill AFB, UT
84056-5816
Attn:A. Matesen
WARP 0 1 0
DoDAAC, FA8213
WAWF 0 1 0
15. TOTAL 0 3 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2020/08/18
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2020/08/18
18. ESTIMATED
TOTAL PRICE
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages
17. PRICE GROUP
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 SESS
D. SYSTEM/ITEM
6150011987225
E. CONTRACT/PR NO.
FD2020-20-00998
F. CONTRACTOR
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM
Request for Variance (RFV)
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-80640E
5. CONTRACT REFERENCE
PS para 3.1
6. REQUIRING OFFICE
AFLCMC/EBHGA
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: 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: Government Engineer will perform review of the RFV. 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 shall be signed contract modification (AFLCMC/EBHKA).
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/EBHGA.
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/EBHKA).
robert.morgan.27@us.af.mil (AFLCMC/EBHEC)
FOB DESTINATION
EBH 20-130-001
Terry McCurdy, AFLCMC/EBHTC, 586-0535
AFLCMC/EBHGA 0 1 0
AFLCMC/EBHTC 1 1 0
AFLCMC/EBHKA 1 1 0
DCMA/QAR 1 1 0
DCMA/ACO 1 1 0
15. TOTAL 4 5 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2020/08/18
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2020/08/18
18. ESTIMATED
TOTAL PRICE
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages
17. PRICE GROUP
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