A03_Attachment_0002_24-3-30_CDRL.pdf

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 8 Pages

C O N T R A C T D A T A R E Q U I R E M E N T S L I S T (1 Data Item)

Form Approved 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.

B. EXHIBIT

C. CATEGORY

D. SYSTEM/ITEM

2D Scanner

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

Installation and Preparation Documentation

3. SUBTITLE

Installation Documentation List

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD250 REQ

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a copy of this information in either electronic or paper format, a minimum of 60-calendar-days prior to delivery of equipment. The contractor shall provide a second copy of this information in electronic or paper format at the time of delivery of the equipment.

Acceptable electronic formats include acrobat files (.pdf), drawing exchange files (.dxf), and Microsoft Word (.doc).

A plainly visible cover sheet shall be provided with the Installation and Preparation Documentation package listing drawings and schematics required for installation.

PROVIDE COPIES, AS REQUESTED TO THE FOLLOWING:

Rock Island Arsenal

ATTN: TARA-LGC

Jeffery Merry Bldg 220B, Rm Plant Engineering Rock Island, IL 61299-6400

15. TOTAL

G. PREPARED BY

Tad Larson

H. DATE

24-April-2025

I. APPROVED BY

J. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 2 of 8 Pages

(1 Data Item)

Form Approved 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

2. TITLE OF DATA ITEM

Installation and Preparation Documentation

3. SUBTITLE

Tool List

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a copy of this information in either electronic or paper format, a minimum of 60-calendar-days prior to delivery of equipment. The contractor shall provide a second copy of this information in electronic or paper format at the time of delivery of the equipment.

Acceptable electronic formats include acrobat files (.pdf), drawing exchange files (.dxf), and Microsoft Word (.doc).

An itemized list of all fixtures, tools, and equipment, whether special or not, required to install, align, and maintain the equipment in this purchase description. NOTE: The contractor is responsible for providing special/custom tools and equipment necessary for installation, moving, and/or set-up as part of the equipment.

ATTN: TARA-LGC

Jeffery Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 3 of 8 Pages

Form Approved 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

2. TITLE OF DATA ITEM

Installation and Preparation Documentation

3. SUBTITLE

Footprint Drawing

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a copy of this information either in electronic or paper format, a minimum of 60-calendar-days prior to delivery of equipment. The contractor shall provide a second copy of this information in electronic or paper format at the time of delivery of the equipment.

Acceptable electronic formats include acrobat files (.pdf), drawing exchange files (.dxf), and initial graphic exchange specification (.igs).

A dimensioned drawing shall be provided to accurately depict the layout of system, showing contours. It shall be fully dimensioned and include net operating clearance for moving components which travel beyond the gross contour. The drawing shall distinguish between the base of the equipment at floor level and the gross contour where it may overhang the base.

Location of access doors for servicing of the equipment shall also be designated.

ATTN: TARA-LGC

Jeffery Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 4 of 8 Pages

Form Approved 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

2. TITLE OF DATA ITEM

Installation and Preparation Documentation

3. SUBTITLE

Electrical Schematic

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a copy of this information either in electronic or paper format, a minimum of 60-calendar-days prior to delivery of equipment. The contractor shall provide a second copy of this information in electronic or paper format at the time of delivery of the equipment.

Acceptable electronic formats include acrobat files (.pdf), drawing exchange files (.dxf), and initial graphic exchange specification (.igs).

The equipment includes this type of utility and a complete system schematic is required. The capacity required at the point of first connection must be clearly stated.

ATTN: TARA-LGC

Jeffery Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 5 of 8 Pages

Form Approved 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

2. TITLE OF DATA ITEM

Installation and Preparation Documentation

3. SUBTITLE

Equipment Identification

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide a copy of this information either in electronic or paper format, a minimum of 60-calendar-days prior to delivery of equipment.

This document shall consist of the make & model of the equipment with a complete list of standard features, optional features being installed in order to meet the specification, and a list of optional features available for field installation but not included. Each section shall be clearly identified.

Also included will be any technical data or brochures applicable to the equipment being provided.

ATTN: TARA-LGC

Jeffery Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 6 of 8 Pages

Form Approved 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

2. TITLE OF DATA ITEM

Maintenance Manual

3. SUBTITLE

Preventive Maintenance Procedure

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide (3) copies of this manual/information with delivery of the equipment. Of these, (2) will be paper, and (1) shall be electronic. Acceptable electronic formats include acrobat files (.pdf), drawing exchange files (.dxf), and initial graphic exchange specification (.igs).

This section of the documentation shall include: Daily Operator Checklist, Visual Inspections, and a Lubrication Schedule. Procedures and schedules for inspections, adjustments, cleaning, and component replacements.

ATTN: TARA-LGC

Jeffery Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 7 of 8 Pages

Form Approved 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

2. TITLE OF DATA ITEM

Operator Manual

3. SUBTITLE

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide (3) copies of this manual/information with delivery of the equipment. Of these, (2) will be paper, and (1) shall be electronic. Acceptable electronic formats include acrobat files (.pdf), drawing exchange files (.dxf), and initial graphic exchange specification (.igs).

This section of the documentation shall include: Procedures for safe operation of the equipment in all modes. It shall include information necessary for performing all the operations and utilizing all the functions listed in the purchase description.

ATTN: TARA-LGC

Jeffery Merry

Tad Larson

H. DATE

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 8 of 8 Pages

Form Approved 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

2. TITLE OF DATA ITEM

Pre-Shipment Testing Report

3. SUBTITLE

12. DATE OF FIRST SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLOCK 16

a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

The contractor shall provide (1) copies of this information in paper format no later than 10-calendar-days prior to delivery of the equipment.

ATTN: TARA-LGC

Jeffery Merry

Tad Larson

H. DATE