20200519 CDRLS A001-A003-A004.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved

OMB No. 0704-0188

Public reporting burden for this collection of information is estimated 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 other aspect of this collection of 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 Harrisonget, 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

A

C. CATEGORY:

TDP TM OTHER MISC

D. SYSTEM/ITEM

HERMETIC SEALING CAN

E. CONTRACT/PR NO.

N00253-20-X-XXXX

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

CERTIFICATE OF CONFORMANCE

17.PRICE GROUP

4. AUTHORITY (Data Acquisition Doc. No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

SOW PARAGRAPH 2

6. REQUIRING OFFICE

NUWCDIVKPT

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMSSN

SEE BLOCK 16

14. DISTRIBUTION

SEE BLOCK 16

18. ESTIMATED

TOTAL PRICE

8. APP CODE SEE BLK 16 11. AS OF DATE 13.DATE OF SUBSEQ SUBMSSN b. COPIES

N/A N/A SEE BLOCK 16 a. ADDRESSEE Final

16. REMARKS Draft Reg Repro

TPOC 1

PCO 1

CS 1

15. TOTAL 3

G. PREPARED BY

Jose Cardoza

H. DATE

20 May 2020

I. APPROVED BY

Donald Joel Mapes, Certified Data Manager

J. DATE

21 May 2020

DD Form 1423-1, FEB 2001 Previous editions are obsolete. Page 1 of 1 Page

BLOCK 4: Contractor format is acceptable.

BLOCK 9: DISTRIBUTION STATEMENT D - Distribution authorized to the U.S. Department of Defense and U.S. DoD contractors only. Administrative (insert date). Other requests shall be referred to NUWC, Division Keyport, Attn: Contracting, 610 Dowell Street, Keyport, WA 98345-7610.

BLOCKS 10, 12 and 13: A certificate of conformance shall be delivered with each production delivery lot.

BLOCK 14: Distribution and submittal shall be by electronic media whenever possible to addressees specified in the CDRL Distribution List. Electronic deliverables shall be delivered in the following formats unless otherwise approved by the Government. The deliverables shall be in accordance with the latest Federal Government Microsoft Office approved version.

Text Document: Adobe PDF (.pdf, searchable) or Microsoft Word (.doc) Presentation: Adobe PDF (.pdf, searchable) or Microsoft PowerPoint (.ppt) Spreadsheet: Microsoft Excel (.xls)

If this CDRL deliverable contains classified information, distribution and submittal shall be in accordance with the contract DD Form 254.

Public reporting burden for this collection of information is estimated 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 other aspect of this collection of 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 Harrisonget, 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

B. EXHIBIT

A

E. CONTRACT/PR NO.

N00253-20-X-XXXX

A004

2. TITLE OF DATA ITEM

SCIENTIFIC AND TECHNICAL REPORTS

3. SUBTITLE

FIRST ARTICLE AND PRODUCTION

TEST REPORTS

17.PRICE GROUP

4. AUTHORITY (Data Acquisition Doc. No.)

DI-MISC-80711A

5. CONTRACT REFERENCE

SOW PARAGRAPH 10

12. DATE OF FIRST SUBMSSN

SEE BLOCK 16

14. DISTRIBUTION

SEE BLOCK 16

18. ESTIMATED

TOTAL PRICE

8. APP CODE SEE BLK 16 11. AS OF DATE 13.DATE OF SUBSEQ SUBMSSN b. COPIES

N/A N/A SEE BLOCK 16 a. ADDRESSEE Final

16. REMARKS Draft Reg Repro

TPOC 1

Donald Joel Mapes, Certified Data manager

DD Form 1423-1, FEB 2001 Previous editions are obsolete. Page 1 of 1 Pages

BLOCK 4: Contractor format acceptable.

BLOCK 9: DISTRIBUTION STATEMENT D - Distribution authorized to the U.S. Department of Defense and U.S. DoD contractors only. Critical Technology: (insert date). Other requests shall be referred to NUWC, Division Keyport, Attn: Contracting, 610 Dowell Street, Keyport, WA 98345-7610.

BLOCKS 10, 12 and 13: Test data shall be delivered with each shipment of material (first article and production units). See contract for delivery schedule.

BLOCK 14: Distribution and submittal shall be by electronic media whenever possible to addressees specified in the CDRL Distribution List. Electronic deliverables shall be delivered in the following formats unless otherwise approved by the Government. The deliverables shall be in accordance with the latest Federal Government Microsoft Office approved version.

Text Document: Adobe PDF (.pdf, searchable) or Microsoft Word (.doc) Presentation: Adobe PDF (.pdf, searchable) or Microsoft PowerPoint (.ppt) Spreadsheet: Microsoft Excel (.xls)

Public reporting burden for this collection of information is estimated 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 other aspect of this collection of 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 Harrisonget, 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

B. EXHIBIT

A

E. CONTRACT/PR NO.

N00253-20-X-XXXX

A003

2. TITLE OF DATA ITEM

SCIENTIFIC AND TECHNICAL REPORTS

3. SUBTITLE

MANUFACTURING MATERIALS

LIST

17.PRICE GROUP

4. AUTHORITY (Data Acquisition Doc. No.)

DI-MISC-80711A

5. CONTRACT REFERENCE

SOW PARAGRAPH 10

12. DATE OF FIRST SUBMSSN

SEE BLOCK 16

14. DISTRIBUTION

SEE BLOCK 16

18. ESTIMATED

TOTAL PRICE

8. APP CODE SEE BLK 16 11. AS OF DATE 13.DATE OF SUBSEQ SUBMSSN b. COPIES

N/A N/A SEE BLOCK 16 a. ADDRESSEE Final

16. REMARKS Draft Reg Repro

TPOC 1

Donald Joel Mapes, Certified Data Manager

BLOCK 4: Contractor format acceptable.

BLOCK 9: DISTRIBUTION STATEMENT D - Distribution authorized to the U.S. Department of Defense and U.S. DoD contractors only. Critical Technology: (insert date). Other requests shall be referred to NUWC, Division Keyport, Attn: Contracting, 610 Dowell Street, Keyport, WA 98345-7610.

BLOCKS 10, 12 and 13: A manufacturing materials list shall be delivered with each shipment of material (first article and production units). See contract for delivery schedule.

BLOCK 14: Distribution and submittal shall be by electronic media whenever possible to addressees specified in the CDRL Distribution List. Electronic deliverables shall be delivered in the following formats unless otherwise approved by the Government. The deliverables shall be in accordance with the latest Federal Government Microsoft Office approved version.

Text Document: Adobe PDF (.pdf, searchable) or Microsoft Word (.doc) Presentation: Adobe PDF (.pdf, searchable) or Microsoft PowerPoint (.ppt) Spreadsheet: Microsoft Excel (.xls)

5/21/2020

X Joel Mapes

Donald Joel Mapes

Certified Data Manager

Signed by: MAPES.DONALD.J.1392160201

DD Form 1423-1, FEB 2001 Previous editions are obsolete. Page 1 of 1 Pages

CDRL Distribution List. Provide documentation in accordance with Block 14 of the appropriate CDRL. The e-mail subject block shall contain the contract number, CDRL title and date.

Distribution mailing addressees and electronic mailing addresses are provided below.

Block 14 Entry Mailing Address Attention E-mail Address

TPOC Commander Naval Undersea Warfare Center Division Keyport 610 Dowell Street Keyport, WA 98345-7610

FirstName LastName, Title, Code

Jose Cardoza Jose.l.cardoza@navy.mil 360-315-0754

PCO Commander Naval Undersea Warfare Center Division Keyport 610 Dowell Street Keyport, WA 98345-7610

FirstName LastName, Contracting Officer, Code

Jason Gavinski jason.gavinski@navy.mil 360-615-0947

CS Commander Naval Undersea Warfare Center Division Keyport 610 Dowell Street Keyport, WA 98345-7610

FirstName LastName, Contract Specialist, Code

Elizabeth Ferguson elizabeth.ferguson@navy.mil 360-396-5024 mailto:Jose.l.cardoza@navy.mil mailto:jason.gavinski@navy.mil mailto:elizabeth.ferguson@navy.mil