A003 Test - Inspection Report.pdf

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Attached to
REQUEST FOR PROPOSALS – Test, Evaluation, Repair, Modification & Upgrade of Electronic Warfare Systems
Solicitation number
N0016426RWS78
Issued by

About this file

This is a DD Form 1423-1, Contract Data Requirements List (CDRL), which is a federal contracting form used to specify data deliverables required from contractors. The form is a template showing one data item requirement for contract N0016426RWS78 between the Navy and an unnamed contractor for WXS Off-Site Depot Repair services under contract line item 7000. The required data item is a Test/Inspection Report (Data Item Number A003) under the NDTI category, referencing authority DND1-MOD96 NOT 3, SOW paragraph 3.3.4. The report must be submitted as requested (ASREQ) in accordance with Block 16 requirements, with distribution to two addressees: Robert Knelly (AL-01) and David Ashbrook (AL-02), each receiving one copy. The document includes detailed remarks requiring that any changes to the CDRL be approved by the Government Technical POC or COR and noting that technical documents must be marked with Distribution Statement D, authorized to the Department of Defense and U.S. DoD Contractors only, with specific export control restrictions per the Arms Export Control Act and export control regulations.

The form includes distribution instructions specifying that non-confidential or unclassified deliverables be provided via encrypted email to the listed recipients, or if email encryption is unavailable, posted to the DoD SAFE website, with confidential or classified materials sent via secured mail (USPS or FEDEX) on a Compact Disc to the Naval Surface Warfare Center, Crane Division, located at Building 3330C, Code WXS, 300 Highway 361, Crane, Indiana 47522-5001. The form was prepared and approved on March 3, 2026, by government personnel and does not specify contractor pricing for the data deliverable.

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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 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

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

Page of Pages

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)

DD FORM 1423-1, FEB 2001 Page of Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423-1 (BACK), FEB 2001

data_item: A003
title: TEST/INSPECTION REPORT
sub:
auth: DI-NDTI-80809B NOT 3
ref: SOW 3.3.3, 3.3.4
req_ofc: NSWC CRANE DIVISION
dd250: LT
appcode: A
dist: D
freq: ASREQ
asof: N/A
firstsub: SEE BLK 16
subsub: SEE BLK 16
addressee1: AL--01
draft1:
reg1: 1
repro1:
addressee2: AL-02
draft2:
reg2: 1
repro2:
addressee3: (SEE BLK 16)
draft3:
reg3:
repro3:
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total_draft: 0
total_reg: 2
total_repro: 0
remarks: BLOCKS 7/8: If any changes need to be made to the CDRL, the Government Technical

POC or COR will provide comments to the Contractor. If the CDRL is acceptable and no changes are needed the Government Technical POC or COR will provide approval/acceptance.

BLOCK 9: The technical documents shall be marked as follows: "DISTRIBUTION STATEMENT D: Distribution authorized to the Department of Defense and U.S. DoD Contractors only, Export Controlled, 12/26/2018. Other requests for this document shall be referred to Naval Surface Warfare Center, Crane Division; Airborne Electronic Attack Systems Division; Building 3330C, Code WXS; 300 Highway 361; Crane, IN 47522-5001.

WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801-4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02."

Blocks 10, 12 & 13: As required based on No Fault Found (NFF) or return to RFI via repair, modification or upgrade. To be provided with the returned unit(s).

CONTINUED ON NEXT PAGE

group:
total_price:
prep_name:
line_item: 7000
exhibit: C
xtdp: Off
xtm: Off
othercat: NDTI
system: WXS OFF-SITE DEPOT REPAIR
ctr_no: N0016426RWS78
contr:
remarksb: Block 14: Data deliverables that are not confidential or classified shall be provided via encrypted email to the below recipients or, if not capable of encrypting email, it can be posted to the DoD SAFE website (https://safe.apps.mil/) for the below recipients:

AL-01: RTA (Robert Knelly, robert.g.knelly.civ@us.navy.mil) AL-02: COR (David Ashbrook, david.l.ashbrook.civ@us.navy.mil)

Data deliverables determined to be confidential or classified in nature shall be sent (UPS or FEDEX) on a Compact Disc - Recordable (USPS or FEDEX) to the following address, with email notification of shipment to AL-01 and AL-02:

Outer label:

COMMANDER

NAVSURFWARCENDIV CRANE

ATTN: SECURITY MANAGER, CODE 105

BLDG 300

300 HIGHWAY 361

CRANE, IN 47522-5001

Inner label:

COMMANDER

NAVSURFWARCENDIV CRANE

ATTN: Robert Knelly, 812-854-5496

BLDG 3330C, CODE WXS

300 HWY 361

CRANE, IN 47522-5001

Page2: 2
Reset:
2025-06-17T09:53:45-0400
MCATEE.STEVEN.ANTHONY.1230274050
prep_date: 03/03/2026
app_by:
2025-06-17T12:41:25-0400
GAINEY.JONATHAN.MARK.1282865641
app_date: 03/03/2026
Page: 1
of_pages: 2
app: Adobe Professional 8.0

File details come from the government source that posted it. Updated .