A04 CDRL A002 Service Report for the BC30_ GC60_X80_SR_bec.pdf
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CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
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
16. REMARKS
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
14. DISTRIBUTION
a. ADDRESSEE Draft
b. COPIES
Final
Reg Repro
15. TOTAL 0 0 0
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page of Pages Adobe Professional 8.0
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
| CONTRACT DATA REQUIREMENTS LIST |
| A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY: |
| D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR |
| G. PREPARED BY H. DATE I. APPROVED BY J. DATE |
DD FORM 1423-1 (BACK), FEB 2001
| Text9: N/A |
| Text10: Maintenance Service Report |
| Text11: A001 |
| Text12: DI-MGMT-80995 |
| Text13: SOW Section 2.1, 2.2 & 2.3 |
| Text14: NAVSEA 04ND |
| Text15: |
| Text16: |
| Text33: NO |
| Text34: N/A |
| Text35: C (See Block 16) |
| Text36: ASREQ (See Block 16) |
| Text37: N/A |
| Text38: ASREQ (See Block 16) |
| Text39: See Blk 16 |
| Text40: Block 9: Distribution Statement C: Distribution authorized to U.S. Government Agencies and their contractors; Administrative/Operational Use: Date of Designation. Other request for this document shall be referred to Naval Sea Systems Command (NAVSEA 04ND). |
Block 10, 12 and 13: Submissions shall be made after performing non-routine maintenance and emergency repairs on the BC30, GC60, and X80 Irradiators. Maintenance Service Report shall be provided no later than five (5) business days upon completion of service.
Block 14: Media Requirement: Final issue shall be submitted electronically in Adobe PDF format as attachments to:
Shiona.lonesky.civ@us.navy.mil matthew.a.spierenburg.civ@us.navy.mil
| 2022-11-07T08:25:49-0500 | |
| RIGGS.SHEILA.B.1229365530 |
| 2023-02-13T06:21:21-0500 | |
| CARIAS.BRENDA.E.1016619570 |
| Text43: 11/7/2022 |
| Text44: 11/7/2022 |
| Check Box4: Off |
| Check Box5: Off |
| Text3: MGMT |
| Text6: BC30, GC60, and X80 Irradiators |
| Text1: CLIN 0002 |
| Text2: A |
| Text7: TBD |
| Text8: Hopewell Design, Inc. |
| Text17: |
| 0: NSWCCD Code 631 |
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