21-R-1000 DRAFT RFP - TASK ORDER 0001.pdf

ORDER FOR SUPPLIES OR SERVICES

1. CONTRACT/PURCH ORDER/AGREEMENT NO.

FA945121R1000

2. DELIVERY ORDER/ CALL NO.

TASK ORDER 0001

3. DATE OF ORDER/CALL

(YYYYMMMDD)

4. REQUISITION/PURCH REQUEST NO.

SEE SCHEDULE

5. PRIORITY

6. ISSUED BY AFRL/RDKB

CODE FA9451 7. ADMINISTERED BY (If Other than 6) CODE 8. DELIVERY FOB

AF RESEARCH LABORATORY (DET 8)

3550 ABERDEEN AVE SE

KIRTLAND AFB, NM 87117-5776

HARSH HARIYANI 505-846-6877

HARSH.HARIYANI@US.AF.MIL

X DESTINATION

OTHER

(See Schedule if other)

SCD: PAS: (NONE)

9. CONTRACTOR CODE FACILITY 10. DELIVER TO FOB POINT BY (Date) 11. X IFBUSINESS IS

(YYYYMMMDD) SEE SCHEDULE

SMALL

NAME

AND

12. DISCOUNT ITEMS

SMALL DISAD-

VANTAGED

ADDRESS N

WOMEN-

OWNED

13. MAIL INVOICES TO ADDRESS IN BLOCK

SEE BLOCK 15 (PAYMENT OFFICE)

14. SHIP TO CODE 15. PAYMENT WILL BE MADE BY CODE

SEE SCHEDULE MARK ALL

PACKAGES AND

PAPERS WITH

IDENTIFICATION

NUMBERS IN

BLOCKS 1 AND 2.

EFT:T

16.

DELIVERY/

X

This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract.

TYPE CALL

OF

PURCHASE

Reference your furnish the following on items specified herein.

ORDER ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME.

NAME OF CONTRACTOR SIGNATURE

TYPED NAME AND TITLE DATE SIGNED(YYYYMMMDD)

If this box is marked, supplier must sign Acceptance and return the following number of copies:

17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE

18. ITEM NO. 19. SCHEDULE OF SUPPLIES/SERVICES 20. QUANTITY

ORDERED/

ACCEPTED*

21.

UNIT

22. UNIT PRICE 23. AMOUNT

*If quantity accepted by the Government is same as quantity ordered, indicate by X. If different, enter actual quantity accepted below quantity ordered and encircle.

24. UNITED STATES OF AMERICA

25. TOTAL

$0.00

29.

DIFFERENCES

BY:

CONTRACTING/ORDERING OFFICER

26. QUANTITY IN COLUMN 20 HAS BEEN 27. SHIP NO. 28. D.O. VOUCHER NO. 30. INITIALS

INSPECTED RECEIVED ACCEPTED, AND CONFORMS TO THE

CONTRACT EXCEPT AS NOTED

PARTIAL 32. PAID BY 33. AMOUNT VERIFIED CORRECT FOR

_______ _________________________________________________ FINAL

DATE SIGNATURE AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32. PAYMENT 34. CHECK NUMBER

36. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT. COMPLETE

_______ _________________________________________________ PARTIAL 35. BILL OF LADING

DATE SIGNATURE AND TITLE OF CERTIFYING OFFICER FINAL

37. RECEIVED

AT

38. RECEIVED BY (Print) 39. DATE RECEIVED

(YYYYMMMDD)

40. TOTAL CON-

TAINERS

41. S/R ACCOUNT NO. 42. S/R VOUCHER NO.

DD FORM 1155, JAN 1998 (EG) ConWrite Version 7.4.0.0 PREVIOUS EDITION MAY BE USED Created 17 Jun 2021 7:28 AM

DRAFT TASK

ORDER 0001

LIST OF ATTACHMENTS

FA9451-21-F-1001

1. PURPOSE: The purpose of this task order is to place an order under the Basic contract FA9451-21-D- 1000, Advanced Space Technology Research & Optimization (ASTRO), for the tasks identified under the Statement of Work (SOW) entitled, "Air Force Maui Optical and Supercomputing (AMOS) Operations)", dated DD MONTH YYYY.

2. TASK ORDER TOTAL: The total value of the task order is $0.00.

3. AMOUNT OBLIGATED: The total amount obligated is $0.00.

4. PART I - THE SCHEDULE, SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

Qty Unit Price ITEM SUPPLIES OR SERVICES Purch Unit Total Item Amount

0001 1 $0.00 Lot $0.00 Noun: PHASE-IN

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The contractor shall furnish the necessary labor and associated labor costs reasonably required to accomplish the phase-in effort pursuant to Section J attachment 1, Task Order Statement of Work (SOW) entitled, " Air Force Maui Optical and Supercomputing (AMOS) Operations) " and clause B060 in Section B entitled "Transition/Phase-In and Phase-out Periods."

Qty Unit Price ITEM SUPPLIES OR SERVICES Purch Unit Total Item Amount

LABOR RDT&E - AWARD FEE

0002 1 $0.00 Lot $0.00 Noun: AWARD FEE - RDT&E

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The total award fee amount is to be determined but shall not exceed 10% of the estimated cost of performance (excluding baselined ODC). The award fee shall be administered and evaluated in accordance with the Basic contract Section J attachment 7, Award Fee Plan.

Contractor shall be reimbursed for performance of this contract in accordance with the contract clauses and the following additional terms:

(a) The total estimated cost of performance (excluding baselined ODC) is ____

(b) The base fee is ____

(c) The maximum award fee is ____

(d) The award fee earned for performance from inception of contract through the evaluation period ending _____ (insert end of evaluation period) has been determined to be _____ (insert award fee earned).

Qty Unit Price ITEM SUPPLIES OR SERVICES Purch Unit Total Item Amount

LABOR O&M - AWARD FEE

0003 1 $0.00 Lot $0.00 Noun: AWARD FEE - RDT&E

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The total award fee amount is to be determined but shall not exceed 10% of the estimated cost of performance (excluding baselined ODC). The award fee shall be administered and evaluated in accordance with the Basic contract Section J attachment 7, Award Fee Plan.

Contractor shall be reimbursed for performance of this contract in accordance with the contract clauses and the following additional terms:

(a) The total estimated cost of performance (excluding baselined ODC) is ____

(b) The base fee is ____

(c) The maximum award fee is ____

(d) The award fee earned for performance from inception of contract through the

Qty Unit Price ITEM SUPPLIES OR SERVICES Purch Unit Total Item Amount

LABOR PROCUREMENT - AWARD FEE

0004 1 $0.00 Lot $0.00 Noun: AWARD FEE - PROCUREMENT

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The total award fee amount is to be determined but shall not exceed 10% of the estimated cost of performance (excluding baselined ODC). The award fee shall be administered and evaluated in accordance with the Basic contract Section J attachment 7, Award Fee Plan.

Contractor shall be reimbursed for performance of this contract in accordance with the contract clauses and the following additional terms:

(a) The total estimated cost of performance (excluding baselined ODC) is ____

(b) The base fee is ____

(c) The maximum award fee is ____

(d) The award fee earned for performance from inception of contract through the

LABOR RDT&E

0005 1 $0.00 Lot $0.00 Noun: LABOR RDT&E

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The contractor shall furnish the necessary labor and associated labor costs reasonably required to accomplish Task Orders issued pursuant to Section J attachment 1, Task Order Statement of Work (SOW) entitled, " Air Force Maui Optical and Supercomputing (AMOS) Operations)" This CLIN allows for the obligation of any/all RDT&E funds applicable to the effort.

Qty Unit Price ITEM SUPPLIES OR SERVICES Purch Unit Total Item Amount

LABOR O&M

0006 1 $0.00 Lot $0.00 Noun: LABOR O&M

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The contractor shall furnish the necessary labor and associated labor costs reasonably required to accomplish Task Orders issued pursuant to Section J attachment 1, Task Order Statement of Work (SOW) entitled, " Air Force Maui Optical and Supercomputing (AMOS) Operations)" This CLIN allows for the obligation of any/all O&M funds applicable to the effort.

LABOR PROCUREMENT

0007 1 $0.00 Lot $0.00 Noun: LABOR PROCUREMENT

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The contractor shall furnish the necessary labor and associated labor costs reasonably required to accomplish Task Orders issued pursuant to Section J attachment 1, Task Order Statement of Work (SOW) entitled, " Air Force Maui Optical and Supercomputing (AMOS) Operations)" This CLIN allows for the obligation of any/all Procurement funds applicable to the effort.

OTHER DIRECT COSTS - RDT&E

0008 1 $0.00 Lot $0.00 Noun: OTHER DIRECT COSTS - RDT&E

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

Baselined Other Direct Costs (ODCs) in support of labor CLINs to include: travel, trainng, maintenance, supplies, hardware, materials, facilities, equipment, non-labor subcontract costs, and other direct costs not associated with labor. ODC amounts are TBD. This CLIN allows for the obligation of any/all RDT&E funds applicable to the ODCs. Fee will not be paid on ODCs.

Qty Unit Price ITEM SUPPLIES OR SERVICES Purch Unit Total Item Amount

OTHER DIRECT COSTS - O&M

0009 1 $0.00 Lot $0.00 Noun: OTHER DIRECT COSTS - O&M

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

Baselined Other Direct Costs (ODCs) in support of labor CLINs to include: travel, trainng, maintenance, supplies, hardware, materials, facilities, equipment, non-labor subcontract costs, and other direct costs not associated with labor. ODC amounts are TBD. This CLIN allows for the obligation of any/all O&M funds applicable to the ODCs. Fee will not be paid on ODCs.

OTHER DIRECT COSTS - PROCUREMENT

0010 1 $0.00 Lot $0.00 Noun: OTHER DIRECT COSTS - PROCUREMENT

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

Baselined Other Direct Costs (ODCs) in support of labor CLINs to include: travel, trainng, maintenance, supplies, hardware, materials, facilities, equipment, non-labor subcontract costs, and other direct costs not associated with labor. ODC amounts are TBD. This CLIN allows for the obligation of any/all Procurement funds applicable to the ODCs. Fee will not be paid on ODCs.

Qty Unit Price ITEM SUPPLIES OR SERVICES Purch Unit Total Item Amount

DATA AND REPORTS

0011 1 NSP

Lot NSP Noun: DATA AND REPORTS

ACRN: U

PSC: AC15

NSN: N - Not Applicable DD1423 is Exhibit: A Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The Contractor shall deliver data and reports as required in accordance with Exhibit A Contract Data Requirements List (CDRL). This CLIN is not separately priced (NSP).

All data shall be delivered in accordance with the delivery schedule shown on the Contract Data Requirements List (CDRLs), or as incorporated by reference.

All reports and correspondence submitted under this contract shall include the contract number and project number, if applicable, and be forwarded prepaid. A copy of the letters of transmittal shall be delivered to the Contracting Officer and Administrating Contracting Officer.

0012 1 NSP

Lot NSP Noun: HARDWARE DELIVERABLE(S)

ACRN: U

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The contractor shall deliver hardware as required by Section J attachment 1, Task Order Statement of Work (SOW) entitled, " Air Force Maui Optical and Supercomputing (AMOS) Operations)". This CLIN is not separately priced (NSP).

Qty Unit Price ITEM SUPPLIES OR SERVICES Purch Unit Total Item Amount

0013 1 NSP

Lot NSP Noun: SOFTWARE DELIVERABLE(S)

ACRN: U

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The contractor shall deliver software as required by Section J attachment 1, Task Order Statement of Work (SOW) entitled, " Air Force Maui Optical and Supercomputing (AMOS) Operations)". This CLIN is not separately priced (NSP).

0014 1 $0.00 Lot $0.00 Noun: PHASE-OUT

PSC: AC15

NSN: N - Not Applicable Contract type: R - COST PLUS AWARD FEE Inspection: DESTINATION Acceptance: DESTINATION

FOB: DESTINATION

Descriptive Data:

The contractor shall furnish the necessary labor and associated labor costs reasonably required to accomplish the phase-in effort pursuant to Section J attachment 1, Task Order Statement of Work (SOW) entitled, " Air Force Maui Optical and Supercomputing (AMOS) Operations) " and clause B060 in Section B entitled "Transition/Phase-In and Phase-out Periods."

5. PART I - THE SCHEDULE, SECTION F - DELIVERIES OR PERFORMANCE

SHIP MARK TRANS

ITEM SUPPLIES SCHEDULE DATA QTY TO FOR PRI DATE

0001 1 FA9451 ASREQ

Noun: PHASE-IN

ACRN: 9

Descriptive Data:

The Phase-In Period of Performance ends on DD MONTH YYYY

0002 1 FA9451 ASREQ

Noun: AWARD FEE - RDT&E

ACRN: 9

Descriptive Data:

The Technical Period of Performance (TPOP) ends on DD MONTH YYYY.

The Task Order Period of Performance (POP) ends on DD MONTH YYYY.

SHIP MARK TRANS

ITEM SUPPLIES SCHEDULE DATA QTY TO FOR PRI DATE

0003 1 FA9451 ASREQ

Noun: AWARD FEE - RDT&E

ACRN: 9

Descriptive Data:

0004 1 FA9451 ASREQ

Noun: AWARD FEE - PROCUREMENT

ACRN: 9

Descriptive Data:

0005 1 FA9451

Noun: LABOR RDT&E

ACRN: 9

Descriptive Data:

0006 1 FA9451

Noun: LABOR O&M

ACRN: 9

Descriptive Data:

0007 1 FA9451

Noun: LABOR PROCUREMENT

ACRN: 9

Descriptive Data:

0008 1 FA9451 ASREQ

Noun: OTHER DIRECT COSTS - RDT&E

ACRN: 9

Descriptive Data:

0009 1 FA9451 ASREQ

Noun: OTHER DIRECT COSTS - O&M

ACRN: 9

Descriptive Data:

0010 1 FA9451 ASREQ

Noun: OTHER DIRECT COSTS - PROCUREMENT

ACRN: 9

Descriptive Data:

0011 1 FA9451 ASREQ

Noun: DATA AND REPORTS

ACRN: U

Descriptive Data:

0012 1 FA9451 ASREQ

Noun: HARDWARE DELIVERABLE(S)

ACRN: U

Descriptive Data:

0013 1 FA9451 ASREQ

Noun: SOFTWARE DELIVERABLE(S)

ACRN: U

Descriptive Data:

0014 1 FA9451 ASREQ

Noun: PHASE-OUT Descriptive Data:

The Phase-Out Period of Performance ends on DD MONTH YYYY

6. PART I - THE SCHEDULE, SECTION G - CONTRACT ADMINISTRATION DATA:

TBD

7. PART I - THE SCHEDULE, SECTION G - CONTRACT ADMINISTRATION DATA:

DFARS PGI 204.7108 PAYMENT INSTRUCTIONS

OTHER (PGI 204-7.108(d)(12)

This Base contract and subsequent Task Orders are cost-type contracts funded by multiple funding types and/or customers, spanning several years. Funding for the CLINs contained in this contract are received from various funding sources and applied to specific tasking as defined in the funding modifications.

Based on the type of work contracted for on behalf of DoD/Air Force customers, payment by CLIN/SLIN/ACRN is significantly important and using any of the payment methods specified in the table identified in PGI 204.7108(b)(2) would result in the funding resources of one customer being paid for work received by another customer.

The contractor completes the effort in a fluid environment; therefore, in order to accurately track and account for funding expenditures in accordance with the specific tasking associated with each funding line, payment instruction (d)(12) "Other" applies as expenditures must reflect the actual work performed, in alignment with the type of funding to avoid violations to the Anti-Deficiency Act.

Payment shall be made in accordance with the Contracting Officer/DCMA approved billing whereby the contractor shall include identification of the CLIN, SLIN, and ACRN on each invoice. This will allow for appropriate contractor invoicing based on the unique customer requirement funding and COntracting Officer's instructions. This approach also allows for proper matching of the charge to the activity that have received the service/product with the application of the payment to the corresponding entity.

8. PART I - THE SCHEDULE, SECTION G - CONTRACT ADMINISTRATION DATA: The funding obligated to Task Order is as follows:

To Be Decided.

///last item///

SCHEDULE

DOCUMENT PGS DATE TITLE

EXHIBIT A 39 16 JUN 2021 CONTRACT DATA REQUIREMENTS LISTS

ATTACHMENT 1 8 15 JUN 2021 TASK ORDER 0001 STATEMENT OF WORK (SOW)

ATTACHMENT 2 4 16 JUN 2021 SOW SUPPLEMENTAL REQUIREMENTS

ATTACHMENT 3 1 16 JUN 2021 DD 254 - DOD CONTRACT SECURITY

CLASSIFICATION SPECIFICATION

ATTACHMENT 4 1 16 JUN 2021 DATA RIGHTS ASSERTIONS

ADVANCED SPACE TECHNOLOGY RESEARCH & OPTIMIZATION

(ASTRO)

FA9451-21-R-1000

EXHIBIT A, CONTRACT DATA REQUIREMENTS LIST

ITEM TITLE SUBTITLE DID

A001 Technical and

Management Work Plan

DI-MGMT-81117A

A002 Status Report DI-MGMT-80368A

A003 Presentation Material DI-ADMN-81373

A004 Integrated Program Management Data and Analysis Report

Integrated Master Schedule (IMS)

DI-MGMT-81861B

Notice 1

A005 Report, Record of Meetings/Minutes

DI-ADMIN-81505

A006 Real-Property Facilities

As Built Drawings DI-MISC-81489B

A007 Hazardous Materials Management Plan

Hazardous Waste Plan

DI-MISC-81398C

A008 Contract Work Breakdown Structure

(CWBS)

DI-MGMT-81334D

A009 Contract Funds Status Report (CFSR)

DI-MGMT-81468A

A010 Performance and Cost Report

DI-FNCL-80912A

A011 Operation and Maintenance Instructions for R&D Equipment

Mission Equipment O&M Instructions

DI-MISC-81414A

A012 Management Plan Task Order Management Plan

DI-MGMT-80004A

A013 Management Plan Maintenance Management Plan

DI-MGMT-80004A

A014 Management Plan Operations Management Plan

DI-MGMT-80004A

A015 Management Plan Program Management Plan

DI-MGMT-80004A

A016 Accident/Incident Report

DI-SAFT-81563

A017 System Safety Program Plan

DI-SAFT-81626

A018 System Safety Hazard Analysis Report (SSHA)

DI-SAFT-80101C

A019 Safety Assessment Report

DI-SAFT-80102C

A020 Technical Report— Studies/Services

DI-MISC-80508B

A021 Supplier’s Configuration Management Plan

Configuration Management Plan

DI-SESS-80858D

A022 System/Subsystem Specification

DI-IPSC-81431A

A023 Test Plan DI-NDTI-80566A

A024 Test/Inspection Report

DI-NDTI-80809B

A025 Interface Control Document

DI-SESS-81248B

A026 Development Design Drawings/Models and Associated Lists

DI-SESS-81002F

A027 Conceptual Design Drawings/Models and Associated Lists

DI-SESS-81001E

A028 Scientific and Technical Report

Final Report DI-MISC-80711A

A029 Systems Engineering Management Plan

DI-SESS-81785A

A030 Software Development Plan

DI-IPSC-81427B

A031 Interface Requirements Specification

DI-IPSC-81434A

A032 Software Requirements Specification

DI-IPSC-81433A

A033 Software Design Description (SDD)

DI-IPSC-81435A

A034 Software Test Description

DI-IPSC-81439A

A035 Software Test Report DI-IPSC-81440A

A036 Software User Manual

DI-IPSC-81443A

EXHIBIT A

A. CONTRACT DATA REQUIREMENTS LIST (1 Data Item) Form Approval 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 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 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.: xxxx

B. EXHIBIT....................................: A

C. CATEGORY..............................:

D. SYSTEM/ITEM........: ASTRO

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A001

2. TITLE OF DATA ITEM............: Technical and Management Work Plan

3. SUBTITLE..................................:

4. AUTHORITY.............................: DI-MGMT-81117A

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: A

9. DIST. STATEMENT REQUIRED......: B

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

12. DATE OF FIRST SUBMISSION: 60DAC

13. DATE OF SUBSEQUENT SUBM.: See Blk 16

14. DISTRIBUTION A. ADDRESSEES

B. COPIES

DRAFT FINAL

AFRL/RDSM 1 1

AFRL/RDKB LT LT

ACO LT LT

15. TOTAL: 1 1

16. REMARKS

Blk 4: DI-MGMT-81117A is tailored as follows:

A. General: Contractor format is acceptable. Electronic media format. Submission via unencrypted or unsecure email is not permitted.

Blk 8: Approval by the Task Order Officer.

Blk 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S. Government agencies only, Administrative or Operational Use, (author fill in date of report, dd mmm yy). Other requests for this document shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, Kirtland AFB, NM 87117-5776.

Blk 10, 12, 13, 14: Based on instructions in each individual task order as tailored by the Task Order Officer. The government will review, edit and return the draft no later than 10 business days. Upon receipt of the reviewed and edited draft, the contractor shall take no more than 10 business days to incorporate all required changes and deliver a final version.

DESTRUCTION NOTICE—CUI documents may be destroyed by means approved for destroying classified information or by any other means making it unreadable, indecipherable, and unrecoverable.

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Billy Paney, Jr., DO-II, DAF I. APPROVED BY: Devin K.H. Leong, Maj, USAF

H. DATE: J. DATE:

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

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 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....................................: A

C. CATEGORY..............................: Other; IDIQ Contract

D. SYSTEM/ITEM........: ASTRO

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A002

2. TITLE OF DATA ITEM............: Status Report

3. SUBTITLE..................................:

4. AUTHORITY.............................: DI-MGMT-80368A

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: N/A

9. DIST. STATEMENT REQUIRED......: D

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

12. DATE OF FIRST SUBMISSION: See Blk 16

AFRL/RDSM 1

AFRL/RDKB 1

ACO LT

15. TOTAL: 2

Submission via unencrypted or unsecure email is not permitted.

Blk 9: DISTRIBUTION STATEMENT D. Distribution authorized to Department of Defense and U.S. DoD contractors only, Critical Technology, Export Controlled, (author fill in date of report, dd mmm yy). Other requests for this document shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, Kirtland AFB, NM 87117-5776.

EXPORT CONTROL WARNING: All technical data shall be marked as follows: “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, 11, 12, 13: Task Order Status Reports: The contractor shall submit status of task order activities documented in a monthly status report submitted five business days after each full month of performance for each task order.

DESTRUCTION NOTICE—CUI documents may be destroyed by means approved for destroying classified information or by any other means making it unreadable,

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Billy Paney, Jr., DO-II, DAF I. APPROVED BY: Devin K.H. Leong, Maj, USAF

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

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 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....................................: A

C. CATEGORY..............................: Other; IDIQ Contract

D. SYSTEM/ITEM........: ASTRO

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A003

2. TITLE OF DATA ITEM............: Presentation Materials

3. SUBTITLE..................................:

4. AUTHORITY.............................: DI-ADMIN-81373

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: N/A

9. DIST. STATEMENT REQUIRED......: D

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

AFRL/RDKB LT

15. TOTAL: 1

Blk 4: DI-ADMN-81373 is tailored as follows:

A. General: Contractor format is acceptable. Submission via unencrypted or unsecure email is not permitted.

Blk 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only, Critical Technology and Export Controlled, (author fill in date of report, dd mmm yy). Other requests shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, Kirtland

AFB, NM 87117-5776.

EXPORT CONTROL WARNING: All technical data shall be marked as follows: “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, 11, 12, 13, 14: Draft presentation material shall be delivered 3 business days before the scheduled event. Final presentation material (for gov’t records) will be delivered 3 business days after the event, unless otherwise stated.

Blk 14: The contractor shall submit presentation materials concurrent with the presentation in the format requested by the task order officer.

DESTRUCTION NOTICE—CUI documents may be destroyed by means approved for destroying classified information or by any other means making it unreadable,

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Billy Paney, Jr., DO-II, DAF I. APPROVED BY: Devin K.H. Leong, Maj, USAF

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

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 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....................................: A

C. CATEGORY..............................: Other

D. SYSTEM/ITEM........:

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A004

2. TITLE OF DATA ITEM............: Integrated Program Management Data and Analysis Report

3. SUBTITLE..................................: Integrated Master Schedule (IMS)

4. AUTHORITY.............................: DI-MGMT-81861B Notice 1

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: No

9. DIST. STATEMENT REQUIRED......: D

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

DRAFT FINAL

AFRL/RDSM 1

Blk 9: DISTRIBUTION STATEMENT D. Distribution authorized to Department of Defense and U.S. DoD contractors only, Critical Technology, Export Controlled, (author fill in date of report, dd mmm yy). Other requests for this document shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, Kirtland AFB, NM 87117-5776.

EXPORT CONTROL WARNING: All technical data shall be marked as follows: “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 10-13: Reports submitted within 10 working days after completion of the first full month following task order award. Final submittal is due one month after technical performance period ends.

Note: All formats shall be submitted electronically encrypted in accordance with DI-MGMT-81861A.

DESTRUCTION NOTICE—CUI documents may be destroyed by means approved for destroying classified information or by any other means making it unreadable,

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Billy Paney, Jr., DO-II, DAF I. APPROVED BY: Devin K.H. Leong, Maj, USAF

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

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 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.: 0004

B. EXHIBIT....................................: A

C. CATEGORY..............................:

D. SYSTEM/ITEM........: ASTRO

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A005

2. TITLE OF DATA ITEM............: Report, Record of Meetings/Minutes

3. SUBTITLE..................................:

4. AUTHORITY.............................: DI-ADMIN-81505

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: N/A

9. DIST. STATEMENT REQUIRED......: D

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

DRAFT FINAL

AFRL/RDSM 1

Blk 4: DI-ADMN-81505 is tailored as follows:

A. General: Contractor format is acceptable. Submission via unencrypted or unsecure email is not permitted.

Blk 9: DISTRIBUTION STATEMENT D. Distribution authorized to Department of Defense and U.S. DoD contractors only, Critical Technology, Export Controlled, (author fill in date of report, dd mmm yy). Other requests for this document shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, EXPORT CONTROL WARNING: All technical data shall be marked as follows: “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, 11, 12, 13, 14: The contractor shall deliver reports and records of meetings as generated in support of specified task order or standardized meeting requirements.

DESTRUCTION NOTICE—CUI documents may be destroyed by means approved for destroying classified information or by any other means making it unreadable,

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Billy Paney, Jr., DO-II, DAF I. APPROVED BY: PM; Devin K. H. Leong, Maj, USAF H. DATE: 09 June 2021 J. DATE: 09 June 2021

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

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 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.: 0004

B. EXHIBIT....................................: A

C. CATEGORY..............................:

D. SYSTEM/ITEM........: ASTRO

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A006

2. TITLE OF DATA ITEM............: Real-Property Facilities

3. SUBTITLE..................................: As Built Drawings

4. AUTHORITY.............................: DI-MISC-81489B

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: A

9. DIST. STATEMENT REQUIRED......: C

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

DRAFT FINAL

AFRL/RDSM 1 1

Blk 4: DI-MISC-81489B is tailored as follows:

A. General: Contractor format is acceptable. Submission via unencrypted or unsecure email is not permitted. Copies shall be maintained and stored electronically at the individual site.

Blk 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors, Administrative or Operational Use, (author fill in date of report, dd mmm yy). Other requests for this document shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, Kirtland AFB, NM 87117-5776.

Blk 10, 11, 12, 13, 14: The contractor shall deliver as built drawings in support of individual task orders, experiment support or infrastructure changes. The government will review, edit and return the draft no later than 10 business days. Upon receipt of the reviewed and edited draft, the contractor shall take no more than 5 business days to incorporate all required changes and deliver a final version.

DESTRUCTION NOTICE—CUI documents may be destroyed by means approved for destroying classified information or by any other means making it unreadable,

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Billy Paney, Jr., DO-II, DAF I. APPROVED BY: PM; Devin K. H. Leong, Maj, USAF

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

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 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.: 000x

B. EXHIBIT....................................: A

C. CATEGORY..............................:

D. SYSTEM/ITEM........: ASTRO

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A007

2. TITLE OF DATA ITEM............: Hazardous Materials Management Plan

3. SUBTITLE..................................: Hazardous Waste Plan

4. AUTHORITY.............................: DI-MISC-81398C

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: A

9. DIST. STATEMENT REQUIRED......: B

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

12. DATE OF FIRST SUBMISSION: 90 DAC

DRAFT FINAL

AFRL/RDSM 1 1

AFRL/RDKB LT LT

ACO LT LT

Blk 4: DI-MISC-81398C is tailored as follows:

A. General: Contractor format is acceptable. Submission via unencrypted or unsecure email is not permitted. Copies shall be maintained and stored electronically at the individual site.

Blk 9: DISTRIBUTION STATEMENT B: Distribution authorized to U.S. Government agencies, Administrative or Operational Use, (author fill in date of report, dd mmm yy). Other requests for this document shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, Kirtland AFB, NM 87117-5776.

Blk 10, 11, 12, 13: The government will review, edit and return the draft no later than 10 business days. Upon receipt of the reviewed and edited draft, the contractor shall take no more than 10 business days to incorporate all required changes and deliver a final version.

Blk 14: Copies will be provided to the site facilities officer and/or local civil engineering for review and comment.

DESTRUCTION NOTICE—CUI documents may be destroyed by means approved for destroying classified information or by any other means making it unreadable,

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Billy Paney, Jr., DO-II, DAF I. APPROVED BY: PM; Devin K. H. Leong, Maj, USAF

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

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 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.: 000x

B. EXHIBIT....................................: A

C. CATEGORY..............................:

D. SYSTEM/ITEM........: ASTRO

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A008

2. TITLE OF DATA ITEM............: Contract Work Breakdown Structure (CWBS)

3. SUBTITLE..................................:

4. AUTHORITY.............................: DI-MGMT-81334D

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: No

9. DIST. STATEMENT REQUIRED......: D

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

DRAFT FINAL

AFRL/RDSM 1

ACO 1

Blk 4: Extensions of the CWBS can be tailored to the specific program but will be consistent with MIL-HDBK-881 at the discretion of the Task Order Officer.

Blk 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only, Critical Technology and Export Controlled, (author fill in date of report, dd mmm yy). Other requests shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, Kirtland

EXPORT CONTROL WARNING: All technical data shall be marked as follows: “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 10-13: First report submitted within 17 working days after completion of the first full month following task order award.

If changes to the CWBS occur, the contractor must submit an updated CWBS Index and Dictionary with the next affected Integrated Program Management Report.

(CDRL A004).

All reports shall be submitted electronically in accordance with DI-MGMT-81334D. Contractor formats are acceptable and can be submitted via DoD encrypted email via Kirtland AFB local area network.

DESTRUCTION NOTICE—CUI documents may be destroyed by means approved for destroying classified information or by any other means making it unreadable,

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Billy Paney, Jr., DO-II, DAF I. APPROVED BY: PM; Devin K. H. Leong, Maj, USAF

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

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 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.: 000x

B. EXHIBIT....................................: A

C. CATEGORY..............................: Other: IDIQ Contract

D. SYSTEM/ITEM........: ASTRO

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A009

2. TITLE OF DATA ITEM............: Contract Funds Status Report (CFSR)

3. SUBTITLE..................................:

4. AUTHORITY.............................: DI-MGMT-81468A

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: N/A

9. DIST. STATEMENT REQUIRED......: D

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

DRAFT FINAL

AFRL/RDSM 1

AFRL/RDKB Lt ACO Lt

Blk 4: Tailoring

- Contractor Format is encouraged. All financial data should be presented in a format that facilitates interpretation.

Blk 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only, Critical Technology and Export Controlled, (author fill in date of report, dd mmm yy). Other requests shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, Kirtland

EXPORT CONTROL WARNING: All technical data shall be marked as follows: “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 10-13: First report submitted within 10 working days after completion of the first full month following task order award. Monthly thereafter for the duration of the contract. Last submission shall be at contract completion.

Note: E-mail transmittal is not permitted for CDRL submission.

DESTRUCTION NOTICE—CUI documents may be destroyed by means approved for destroying classified information or by any other means making it unreadable,

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Billy Paney, Jr., DO-II, DAF I. APPROVED BY: PM; Devin K. H. Leong, Maj, USAF

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

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 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.: 000x

B. EXHIBIT....................................: A

C. CATEGORY..............................: Other

D. SYSTEM/ITEM........: ASTRO

E. CONTRACT/PR NO.

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A010

2. TITLE OF DATA

Performance and Cost Report

3. SUBTITLE..................................:

4. AUTHORITY.............................: DI-FNCL-80912A

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: N/A

9. DIST. STATEMENT REQUIRED......: D

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: See Blk 16

DRAFT FINAL

AFRL/RDKB 1

ACO

LT

Blk 4: Tailored:

-FORMAT – The Performance and Cost Report format shall be contractor selected. All financial data should be presented in a format that facilitates interpretation.

When reporting at the CLIN level, roll up all of the labor CLINs as one item and all of the ODC CLINs as one item. No separate reporting at the funding type level is required (i.e. RDT&E, O&M, etc.). Copies will be provided in Excel and PDF format.

-CONTENT – The Performance and Cost Report shall contain the following:

Replacement for 3.1. Man-Hours – Total man-hours expended by WBS by CLIN for the month, cumulative total man-hours to date, and percentages of total man-hours spent to date. State whether or not remaining hours are sufficient to complete the WBS task.