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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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Text5: 1
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Text41: 0
Text18: 1
Text19: 1

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