A003_1423_CAVAF.pdf

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. 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

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

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Essential Repair FD2020-21-00916

A003 Government Property Inventory Report Annual Government Property Physical Inventory Report

DI-MGMT-80441C/T SOOParagraph: 4.1 415 SCMS

LT

N/A D

ANNLY

SEE BLK 16

SEE BLK 16

SEE BLK 16

415 SCMS 1

6012 FIR AVE

Bldg. 1239 Hill AFB, UT 84056-5825

SEE BLK 16

0 1 0

NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

1. Block 4:

a. All reports shall be submitted in the English Language.

2. Blocks 10, 11, 12, 13:

a. This report will be provided annually. Reporting Period is one year.

b. The data is representative of the Contractor's Internal Property Control System and shall be current as the last day of the annual reporting period. If requested outside of an annual cadence, the data shall be current as of the date requested.

c. The report shall be delivered within seven (7) calendar days of the end of the first reporting period and annually thereafter, or within seven (7) calendar days of government request.

3. Block 9:

a. DISTRIBUTATION STATEMENT "D": Distribution authorized to the Department of Defense and U.S. DoD contractors only (Administrative or Operational Use). (March 2019). Other requests for this document shall be referred to 415 SCMS.

b. EXPORT CONTROL WARNING: All technical documents/data (printed, digital/electronic) that are determined to contain export-controlled technical data, shall be marked with the following statement:

NSP

0.00

9-Apr-19 17JUN21

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TUBBS.BRAD.H.12734

58103

Digitally signed by

TUBBS.BRAD.H.1273458103

Date: 2019.04.09 16:26:55 -06'00'

NIELSEN.BECKY.ADELE

.1297815160

Digitally signed by

NIELSEN.BECKY.ADELE.1297815160

Date: 2021.06.17 09:51:31 -06'00'

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

16. REMARKS (Continued)

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A MGMT

Essential Repair FD2020-21-00916

EXPORT CONTROL 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 IAW provisions of DoD Directive 5230.25.

c. DESTRUCTION NOTICE: For classified documents, follow the procedures, in DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, or DoD 5200.1-R, Information Security Program Chapter VI. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

4. Block 7, 14: Submit the Annual Government Property Physical Inventory Report to the following email address:

415SCMS.PMS.CONTRACT@US.AF.MIL

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