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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

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

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: A001 title: Contract Status Report sub: Monthly Status Report with Roster auth: DI-MGMT-81991 ref: SOW 3.7.1 and 4.1 req_ofc: NSWCPD Code 105 dd250: LT appcode: N/A dist: SEE BLK 16 freq: MTHLY asof: SEE BLK 16 firstsub: SEE BLK 16 subsub: SEE BLK 16 addressee1: Tech POC draft1: 0 reg1: 1 repro1:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: BLK 4: Contractor shall provide a monthly report to include the most current roster and the personnel's most recent training certification dates. This report shall also verify that each personnel's medical and physical qualifications are current in accordance with the SOW.

Block 9: Distribution Statement B. Distribution authorized to U.S. Government agencies only for contractor performance evaluation, 6 August 2015. Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 South Broad Street, Building 4, Philadelphia, PA 19112.

Block 11, 12 and 13 Submit report same day as submission of each monthly i-RAPT invoice throughout the Period of Performance for this contract.

BLK 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

COR: as identified on the contract TPOC: as identified on the contract group:

total_price:

prep_name:

line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: MGMT system: Access Control Personnel Services ctr_no: TBD contr: TBD remarksb: Intentionally left blank

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2020-02-18T17:01:48-0500

MCCUNNEY.EDWARD.J.1229434833

prep_date: 2/18/20 app_by: Rayann Surel

2020-02-25T13:57:40-0500

SUREL.RAYANN.M.1250032958

app_date: 2/25/2020

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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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A002 title: CONTRACTOR PERSONNEL ROSTER sub: ON-SITE CONTRACTOR PERSONNEL and POST SCHEDULE auth: DI-MGMT-81834A ref: SOW 1.2.6 and 4.2 req_ofc: NSWCPD Code 105 dd250: LT appcode: N/A dist: SEE BLK 16 freq: WEEKLY asof: SEE BLK 16 firstsub: SEE BLK 16 subsub: SEE BLK 16 addressee1: TPOC draft1: 0 reg1: 1 repro1:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: BLK 4: Contractor shall provide the planned weekly schedule and roster for each week as well as the actual schedule and roster that took place the week prior. Report shall include personnel names, post locations, and times at those locations.

BLK 9: Distribution Statement B. Distribution authorized to U.S. Government agencies only for contractor performance evaluation, 6 August 2015. Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 South Broad Street, Building 4, Philadelphia, PA 19112.

BLKS 11, 12, & 13: First submission due No Later Than (NLT) 25 September 2020 or sooner. Subsequent submissions due on Monday of each week.

BLK 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

TPOC: as identified on the contract COR: as identified on the contract group:

total_price:

prep_name:

line_item: XXXX exhibit: A xtdp: Off xtm: Off othercat: MGMT system: Access Control Personnel Services ctr_no: TBD contr: TBD remarksb: Intentionally left blank

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MCCUNNEY.EDWARD.J.1229434833

prep_date: 2/18/20 app_by: Rayann Surel

2020-02-25T13:58:21-0500

SUREL.RAYANN.M.1250032958

app_date: 2/25/2020

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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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A003 title: Government Property Inventory Report sub: Government Furnished Property Inventory Baseline Report auth: DI-MGMT-80441C ref: SOW Paragraph 4.3 req_ofc: NSWCPD Code 105 dd250: LT appcode: N/A dist: B freq: See Blk 16 asof: See Blk 16 firstsub: See Blk 16 subsub: None addressee1: COR (email) draft1: 0 reg1: 1 repro1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Tailoring instructions for DI-MGMT-81441C:

(A) General. Delete any reference to Contractor Acquired Property. Abbreviations are not allowed. Acronyms may be used if a term is defined on first usage.

(B) Block 2.B. Change to read: "Manufacturer Commercial and Government Entity (CAGE) Code."

(C) Block 2.E. Delete.

(D) Block 2.H. Delete.

(E) Block 2.N. Delete.

(F) Block 2.O. Delete.

(G) Block 2.Q. Delete.

(H) Block 2.R. Delete.

(I) Block 2.S. Delete.

(J) Block 2.T. Delete.

(K) Block 2.V. Delete.

(L) Block 2.W. Change to read: "Condition of Property."

Block 9: Distribution Statement B. Distribution authorized to U.S. Government agencies only for contractor performance evaluation, 6 August 2015. Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 S. Broad Street, Building 4, Philadelphia, PA 19112.

Block 10: Submit information as GFM is received by Contractor.

Block 11: Date shall be as of the date of inspection of GFM; Contractor shall submit reports within 15 days of inspection; all GFM shall be inspected within 30 days of receipt.

Block 12: Within fifteen (15) days after inspection of GFM.

Block 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

Email address for COR submission shall be as follows: Brian.McGrath1@navy.mil group:

total_price:

prep_name: Brian McGrath line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: MGMT system: Access Control Personnel Services ctr_no: TBD contr: TBD remarksb:

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