2157-7900 - CERTIFIED MILL TEST REPORT (CMTR) CDRL DI-MISC-80678 REV 4-11-2022.doc
Data Item Description Apr 11, 2022 DOC document 91 KB Posted
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- SPMYM222Q2363
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| SHOP STORES - T9074-BD-GIB-010-0300 Appendix B.doc | DOC document | |
| SPMYM222Q2363.pdf |
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CONTRACT DATA REQUIREMENTS LIST
Form Approved
(1 Data Item)
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: |
0002AAA
TDP
TM
| OTHER MISC |
| X |
| D. SYSTEM|ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| A001 |
| CERTIFICATION/DATA REPORT |
Certified Mill Test Report (CMTR)
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED TOTAL PRICE
| DI-MISC-80678 |
| PER CONTRACT |
| PURCHASING ACTIVITY |
| 7. DD 250 REQ |
| 9. DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
DD
| ONE/R |
| SEE BLOCK 16 |
b. COPIES
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBMISSION |
| a. ADDRESSEE |
| DRAFT |
| FINAL |
N/A
| N/A |
| N/A |
| Reg |
| Repro |
| 16. REMARKS |
| N4523A |
| 0 |
| 1 |
| 0 |
Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings and include lot class and schedule, 10.5.
Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 7/18/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.
Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.
Document No.: 2157-7900
| 15. Total |
| 0 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| /s/ PARKER, BRIAN |
| 7/18/2022 |
| /s/ LEACH, WILLIE |
| 7/18/2022 |
DD FORM 1423-1, FEB 2001
| Page |
| 1 |
| of |
| 1 |
| Pages |
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