Atch 2 FINAL REPAS CDRLs.pdf

CONTRACT DAT A REQUIREMENTS LIST Form Approved (1 Data Item) OMS No. 0704-0188

The public reporting _burden for _this_ collection of information is estimated to average _110 hours per_ respoi:ise. including the time for reviewing instructions, searching existing data sources, gathering and mamta1n1ng the _data_needed, and completing and rev1ew1ng the collection of information. Send comments regarding this burden estimate or any o'.her aspect of this collection of information, mclud1ng suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications D1rect'?rate (0704-01 �8)._ Respondents �hould be aware tha_t _notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collect1on of 1nformat1on 1f 1t does not display a currently valid 0MB 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. 8. EXHIBIT C. CATEGORY:

N/A REF: DOD 5010.12-M

0001 A TDP TM OTHER --

0. SYSTEM/ITEM

I

E. CONTRACT/PR NO. F.CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A001 SCIENTIFIC AND TECHNICAL REPORTS Final Report

4. AUTHORITY (Data Acquisition Document No.J

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MISC-80711A/T AF SOW, PARA 8.0 AFRL/RQTE

7. OD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION xx REQUIRED ONE/R See Block 16 b. COPIES

8. APP CODE * 11.AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

SUBMISSION

A End of Tech Effort See Block 16

16. REMARKS

Blk 4:Tailored to allow for attached ANSI based AFRL

Format Guidelines including Standard Form 298. Also to include, if the Final Report contains data that is being delivered with less than unlimited , the data with less-than-unlimited rights shall be delivered in an appropriately marked appendix to the Final

Report.Block 10, is

DFARS 252.235-7011,

approved report

Center (DTIC). II to clarified so that, 11 Pursuant to the Government will forward the the Defense Technical Information

BLOCK 9: Distribution Statement(s) will be identified in each Task Order (TO}. Other requests for this document shall be referred to AFRL/RQT.

WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, u.s.c. I sec 2778 et seq.) or the Export Administration

Act of 1979, as amended, Title 50, u.s.c. App 2401 et seq. Violations of these export laws are subject to severe criminal Disseminate in accordance with provisions of DoD Directive 5230.25.

Electronic submittals shall be encrypted or protected.

Block 11: End of Technical Effort.

Block 12: 30 days from Block 11.

Approval/Disapproval by letter from the Air Force

Program Manager within 30 days after iD a.J:-1.J:JLVVCI. requires ... (continued on next

G. PREPARED BY H. DATE I. APPROVED BY

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED.

Draft Reg Repro

AFRL/RQON 1 1 0

AFRL/RQT-PM 1 1 0

15.TOTAL 2 2 0

J.DATE

Page 1-A of 19 Pages

I

I

I i l

I

I I

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

REPAS BAA

FA8650-20-S-6004

Attachment 2

CONTRACT DATA REQUIREMENTS LIST

( 1 Data Item)

A. CONTRACT LINE ITEM NO.

0001 I

B. EXHIBIT

I

C. CATEGORY:

N/A REF: DOD 5010.12-M

A TDP -- TM - - OTHER --- -- - -------- ----

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO.

I

F. CONTRACTOR

FA8650-20-S-6004

16. REMARKS (Continued) correction/resubmission within 30 days after receipt of Air Force comments.

Block 13: End of Contract, 90 days from Block 11.

Blocks 12 & 13: Contractor shall deliver the Final Report within 30 calendar days after completion of the technical effort. The AFRL Program Manager will take no more than 30 calendar days to review, edit, and return to the contractor. Upon receipt of the combined Technical and STINFO comments, the contractor shall take no more than 30 calendar days to incorporate all required changes and deliver the final technical report in camera ready and in an editable text format (MS Word) on CD-ROM electronic copy. CD-ROM shall be labeled IAW ANSI based AFRL Format Guidelines.

Block 14: Draft submittal shall consist of 1 editable (MS Word or PDF) file on CD-ROM. The final submittal shall consist of all editable text documents and all multimedia source files in current AF Standard Desktop format (MS Office or PDF compatible) Acceptance shall be in accordance with the ANSI based AFRL Format guidelines.

DD FORM 1423-1, FEB 2001 Page� of 19 Pages

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) 0MB 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 i�structions, 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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TDP - -- TM -- OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO. F. CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A002 FUNDS AND MAN-HOUR EXPENDITURE REPORT

4. AUTHORITY (Data Acquisition Document No.}

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-FNCL-80331 A/T AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED MTHLY **

b. COPIES

8. APP CODE 11. AS OF DATE

13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A B * SUBMISSION Draft **

Reg Repro

16. REMARKS DCMA/ACO 0 1 0

Tailored to allow contractor's format. AFRL/RQF 0 1 0

AFRL/RQKPB 0 1 0

* At the close of the contractor's monthly AFRL/RQT-PM 0 1 0 accounting period.

** 25 days after Block 11 time.

BLOCK 9: B: Distribution authorized to us Government agencies only.

Submit electronically. Electronic submittals shall be encrypted or password protected.

15.TOTAL 0 4 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Anthony M. Cerminaro

22;.JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 2 of 19 Pages

I

I i I I

I

I

I I

I I

I

I I

I

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

( 1 Data Item) 0MB 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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TDP

TM

OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO. F. CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A003 SCIENTIFIC AND TECHNICAL REPORTS SPEND PLAN

4. AUTHORITY /Data Acquisition Document No.J

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MISC-80711A/T AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED MTHLY **

b. COPIES

8. APP CODE 11. AS OF DATE

13. DA TE OF SUBSEQUENT a. ADDRESSEE Final

NIA

B

SUBMISSION Draft

Reg Repro

16. REMARKS DCMA/ACO 0 1 0

Tailored to require the reporting of current work AFRL/RQF 0 1 0 accomplished and billed against work scheduled to be AFRL/RQKPB 0 1 0 accomplished for the cumulative total work effort in AFRL/RQT-PM 0 1 0 dollars as defined herein. The report will show a graphical/tabular depiction by month comparing BCWS, ACWP, and the contractor's billed amount. Block 10 is clarified so that distribution to DTIC shall only be through Air Force distribution channels.

Budget Cost of Work Scheduled (BCWS) means the estimated cost of all work scheduled to be accomplished for total work effort.

Actual Cost of Work Performed (ACWP) means the actual costs of work accomplished as of the reporting cut-off date.

Billed means the amount of funds that have been billed to the Government by the contractor.

* At the end of the contractor's monthly accounting period.

** 25 days after Block 11 time.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15. TOTAL � 0 4 0

G. PREPARED BY H.DATE I. APPROVED BY J.DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 3 of 19 Pages

17. PRICE GROUP

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 ma1nta1ning the _data. needed, and completing and rev1ew1ng the collect1011 of 1nformat1on. Send comments regarding this burden estimate or any other aspect of this collection of 1nformat1on, 1nclud1ng suggestions for reducing the burden, to the Department of Defense, Executive Services and Communications 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 1nformat1on if 1t does not display a currently valid 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TOP - -- TM -- OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO. F. CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A004 CONTRACT FUNDS STATUS REPORT (CFSR)

4. AUTHORITY /Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MGMT-81468/T AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED QRTLY **

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final B SUBMISSION Draft N/A * ***

Reg Repro

16. REMARKS DCMA/ACO 0 1 0

Tailored so that the report contains forecasts by AFRL/RQF 0 1 0 month for the next six months, by quarter for the AFRL/RQKPB 0 1 0 remaining fiscal year, and by year for the remaining AFRL/RQT-PM 0 1 0 fiscal years. CFSR data shall be reconciled to the

Governments fiscal year end at 30 September if the contractor's fiscal year end does not coincide with the Government's fiscal year end.

* The last day of the contractor's monthly accounting period nearest the end of the governments fiscal year quarter.

** The initial submission shall be within

25 calendar days after the close of the contractor's monthly accounting period nearest the end of the first government fiscal year quarter after contract award.

*** Subsequent submissions shall be 25 calendar days after Block 11 time.

BLOCK 9: B: Distribution authorized to us Government agencies only.

Submit electronically. Electronic submittals shall be encrypted or password protected.

15.TOTAL � 0 � 4 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 4 of 19 Pages

I

I i

I

I

I I

I

I

I

I

17. PRICE GROUP

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 and Communications 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 0MB 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:

NIA REF: DOD 5010.12-M

0001 A TOP

TM

OTHER

D. SYSTEM/ITEM IE. CONTRACT/PR NO. F.CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A005 STATUS REPORT

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

D1-MGMT-80368AfT AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED QRTLY ***

b. COPIES

8. APP CODE * 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A ** SUBMISSION Draft *** Reg Repro

16. REMARKS DCMAIACO 0 1 0

Tailored to allow contractor's format and. to AFRL/RQKPB 0 1 0 delete para 3. 2. 3. AFRL/RQT-PM 0 1 0

* Distribution Statements will be identified in each

Task Order (TO).

Submit quarterly except when Final Report is due to be submitted, then omit this report.

** At the close of the contractor's quarterly accounting period.

*** 25 days after Block 11 time.

Submit electronically. Electronic submittals shall be encrypted or password protected.

15.TOTAL 0 3 0

G. PREPARED BY H. DATE I. APPROVED BY J.DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 5 of 19 Pages

17. PRICE GROUP

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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TDP

TM

OTHER

D.SYSTEM/ITEM

I

E. CONTRACT/PR NO. F.CONTRACTOR

1. DATA ITEM NO. 3. SUBTITLE

A006

FA8650-20-S-6004

2. TITLE OF DATA ITEM

SCIENTIFIC AND TECHNICAL REPORTS Interim Report

4. AUTHORITY /Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MISC-80711Arr AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ASGEN *

b. COPIES

8. APP CODE 11. AS OF DA TE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

C SUBMISSION* N/A *

16. REMARKS

Tailored to allow contractor's format, and Block 10, is clarified so that, "Pursuant to DFARS

Government will forward the approved to the Defense Technical Information

* Submit as generated.

252.235-7011, the interim report

Center (DTIC). II

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: C: Distribution authorized to us Government agencies and their contractors.

G. PREPARED BY H.DATE I. APPROVED BY

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED.

Draft Reg Repro

AFRL/RQT-PM 0 1 0

15.TOTAL 0 1 0

J.DATE

Page 6 of 19 Pages

I

I

I

I

I

I

17. PRICE GROUP

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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TOP

TM

OTHER

D.SYSTEM/ITEM

I

E. CONTRACT/PR NO. F. CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A007

PRESENTATION MATERIAL

4. AUTHORITY /Data Acquisition Document No./

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

D1-ADMN-81373!T AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ASREQ ·*

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final C SUBMISSION Draft N/A * *

Reg Repro

16. REMARKS AFRL/RQT-PM 0 1 1

Tailored to require only computer generated file.

ASREQ means as required to document topics under discussion at briefings and reviews.

* Submit at each briefing or review as appropriate.

Submit reproducible on media compatible with

MS-Office for Windows.

BLOCK 9: C: Distribution authorized to us Government agencies and their contractors.

Submit electronically. Electronic submittals shall be encrypted or password protected.

15.TOTAL .

0 1 1

G. PREPARED BY H.DATE I. APPROVED BY J.DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 7 of 19 Pages

17. PRICE GROUP

CONTRACT DATA REQUIREMENTS UST Form Approved

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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TOP - -- TM -- OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO. F. CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A008 TEST PROCEDURE

4. AUTHORITY (Data Acquisition Document No.I 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

O1-N DTl-80603A/T AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DA TE OF FIRST SUBMISSION 14. DISTRIBUTION

REQUIRED ASREQ LT *

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final B SUBMISSION Draft A N/A **

Reg Repro

16. REMARKS AFRL/RQT-PM 1 1 0

Tailored to allow contractor's format and to be submitted as Microsoft Word document.

ASREQ means as required to document plans for testing procedures throughout the technical effort.

* 60 days prior to each test.

Approval/disapproval by letter from the Air Force

Program Manager within 30 days after receipt.

** Disapproval requires correction/resubmission within 15 days after receipt of Air Force comments.

NOTE: Testing shall not begin until after contractor receipt of Air Force approval to proceed with testing.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15.TOTAL .

1 1 0

G. PREPARED BY H.DATE I. APPROVED BY J.DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 8 of 19 Pages

I

I

I I I

I I

I

I I I

I

I

I

I

I

17. PRICE GROUP

CONTRACT DAT A REQUIREMENTS LIST Form Approved

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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TDP

TM

OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO. F.CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A009 TEST PLAN

4. AUTHORITY (Data Acquisition Document No.}

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-NDTl-80566Afr AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DA TE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ASREQ *

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

A B

NIA

SUBMISSIO�* Draft

Reg Repro

16. REMARKS AFRL/RQT-PM 1 1 0

Tailored to allow AFRL/RQT Test Planning Best Practice and to be submitted as Microsoft Word document.

ASREQ means as required to document plans for testing through out the technical effort.

* 60 days prior to each test.

Approval/disapproval by letter from the Air Force

Program Manager within 30 days after receipt.

** Disapproval requires correction/resubmission within 15 days after receipt of Air Force comments.

NOTE: Testing shall not begin until after contractor receipt of Air Force approval to proceed with testing.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15.TOTAL - 1 1 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 9 of 19 Pages

17. PRICE GROUP

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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TDP TM OTHER --- --

D.SYSTEM/ITEM I E. CONTRACT/PR NO. F. CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A010 TEST/ INSPECTION REPORTS

4. AUTHORITY /Data Acquisition Document No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-NDTl-808098/T AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ASREQ **

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

NIA

B

SUBMISSIO�* Draft

Reg Repro

16. REMARKS AFRL/RQT-PM 0 1 0

Tailored to allow contractor's format.

ASREQ means as required to document testing/inspection findings for the Task Order.

* Test completion.

** 30 days after Block 11.

BLOCK 9: B: Distribution authorized to us Government agencies only.

Submit electronically. Electronic submittals shall be encrypted or password protected.

15.TOTAL 0 1 0

G. PREPARED BY H.DATE I. APPROVED BY J.DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 10 of 19 Pages

I i

I

I

I

I

I I

I

I

I

I

17. PRICE GROUP

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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TDP

TM

OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO. F. CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A011 SYSTEM SAFETY HAZARD ANALYSIS REPORT

(SSHA)

4. AUTHORITY (Data Acquisition Document No.}

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-SAFT-80101 BIT AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED 1TIME b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final C SUBMISSION Draft N/A N/A N/A Reg Repro

16. REMARKS AFRL/RQON 0 1 0

Tailored to allow contractor's format and to require AFRL/RQT-PM 0 1 0 only the SSHA report.

* Submit at the Test Readiness Review.

BLOCK 9: C: Distribution authorized to us Government agencies and their contractors.

Submit electronically. Electronic submittals shall be encrypted or password protected.

15.TOTAL 0 2 0

G. PREPARED BY H. DATE I. APPROVED BY J.DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 11 of 19 Pages

17. PRICE GROUP

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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TDP - -- TM -- OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO. F.CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A012 OPERATING PROCEDURES FOR HAZARDOUS

MATERIALS

I

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-SAFT-80402ff AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST ST A TEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ASREQ *

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A C * SUBMISSION Draft *

Reg Repro

16. REMARKS AFRL/RQT-PM 0 1 0

Tailored to allow contractor's format.

ASREQ means as required to document the operating procedures for all hazardous materials under this

Task Order effort.

* Submit as generated.

BLOCK 9: C: Distribution authorized to us Government agencies and their contractors.

Submit electronically. Electronic submittals shall be encrypted or password protected.

15.TOTAL . 0 1 0

G. PREPARED BY H.DATE I. APPROVED BY J. DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 12 of 19 Pages

I

I i I I

I

I

I

I

I

I I

I

I

I

I

I

17. PRICE GROUP

( 1 Data Item} 0MB 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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TOP

TM

OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO .. F.CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A013 SOFTWARE USER MANUAL (SUM)

4. AUTHORITY /Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

D1-IPSC-81443A/T AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ASGEN b. COPIES

8. APP CODE 11. AS OF DATE

13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A C

SUBMISSION

* Draft Reg Repro

16. REMARKS AFRL/RQT-PM 0 1 0

Tailored to allow contractor's format.

* Submit as generated.

Submit reproducible medium compatible with MS-Office for Windows.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: C: Distribution authorized to us Government agencies and their contractors.

15.TOTAL 0 1 0

G. PREPARED BY H.DATE I. APPROVED BY J.DATE

Anthony M. Cerminaro

22-JAN-2020

I

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 13 of 19 Pages

I

I

I I

I

I

17. PRICE GROUP

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 and Communications 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 0MB 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:

NIA REF: DOD 5010.12-M

0001 A TDP

TM - -- OTHER

D.SYSTEM/ITEM IE. CONTRACT/PR NO. F. CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A014

DIGITAL IMAGING

I I

4. AUTHORITY (Data Acquisition Document No./

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

D1-MISC-81579!T AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST ST A TEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ASREQ *

COPIES b.

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A C * SUBMISSIO� Draft

Reg Repro

16. REMARKS AFRL/RQT-PM 0 1 0 �

ASREQ means as required to document progress through out the effort via digital imaging.

* Submit as generated.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: C: Distribution authorized to us Government agencies and their contractors.

15. TOTAL 0 1 0

G. PREPARED BY H. DATE I. APPROVED BY J.DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 14 of 19 Pages

I

I

I I

I, I I

I I

I

I

17. PRICE GROUP

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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TDP

TM

OTHER

D.SYSTEM/ITEM

I

E. CONTRACT/PR NO. F.CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A015 OPERATIONS SECURITY (OPSEC) PLAN

4. AUTHORITY (Data Acquisition Document No.!

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MGMT-80934C/T AF SOW, PARA 7.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ONE/R **

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final B SUBMISSION Draft A *

R/ASR Reg Repro

16. REMARKS AFRL/RQT-PM 1 1 0

Tailored to allow contractor format.

* Task Order award date.

** 30 days after Block 11.

Approval/disapproval by letter from the Air Force

Program Manager within 30 days after receipt.

*Disapproval requires correction/resubmission within 15 days after receipt of Air Force comments.

R/ASR means revisions as required to keep the

OPSEC Plan up to date, make changes or corrections; submit revisions as generated.

Revisions are subject to the above stated approval/disapproval cycle.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15.TOTAL 1 1 0

G. PREPARED BY H.DATE I. APPROVED BY J. DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 15 of 19 Pages

17. PRICE GROUP

Form Approved

0MB No. 0704-0188 t-----------------------------�--------------1I

The public reporting burden for this collection of information is estimated to average 110 hours per response, ii1cluding 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 and Communications I 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 0MB 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.

D. SYSTEM/ITEM

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

A016

B. EXHIBIT

A

C. CATEGORY:

N/A REF: DOD 5010.12-M

TDP

I

E. CONTRACT/PR NO.

FA8650-20-S-6004

TM __ OTHER

F.CONTRACTOR

3. SUBTITLE

I I

117. PRICE GROUP

CONCEPTUAL DESIGN DRAWINGS /MODELS

.__ ______ L_ __________ --, ______________ 1.___ __ --,------------------1 1-------1

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

I

4. AUTHORITY (Data Acquisition Document No./

DI-SESS-81001 E/T AF SOW, PARA 8.0 AFRL/RQTE

1----------,---------.----j__-----.-----------+-----------------t

9. DIST ST A TEMENT 7. DD 250 REG 10. FREQUENCY 12. DATE OF FIRST SUBMISSION

LT

REQUIRED ASREQ *

8. APP CODE 11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

A N/A * * R/ASR

16. REMARKS

Tailored to allow for format as defined in the attached DD Form 2554-2.

ASREQ means as required to document conceptual designs drawings/models

* Submit as generated.

Approval/disapproval by letter from the Air Force

Program Manager within 30 days after receipt.

** Disapproval requires correction/resubmission within 30 days after receipt of Air Force comments.

R/ASR means revisions as required to maintain up to date and accurate drawings and lists. Revisions are subject to the approval cycle as stated.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: C: Distribution authorized to US Government agencies and their contractors.

G. PREPARED BY

Anthony M. Cerminaro

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001

H. DATE I. APPROVED BY

22-JAN-2020

PREVIOUS EDITION MAY BE USED.

1---------D_1s_T_R _1B_u .... T _1o_N _______

b. COPIES

14.

a. ADDRESSEE Draft

AFRL/RQT-PM

15. TOTAL

Final

Reg Repro

1 0

J. DATE

Page 16 of 19 Pages

18. ESTIMATED

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 and Communications 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 0MB 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: N/A REF: DOD 5010.12-M

0001 A TOP

TM

OTHER

D. SYSTEM/ITEM

I

E. CONTRACT/PR NO. F. CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A017

DEVELOPMENTAL DESIGN DRAWINGS/MODELS AND

ASSOCIATED LISTS

4. AUTHORITY (Data Acquisition Document No.) 1

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-SESS-81002F/T AF SOW, PARA 8.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ASGEN *

b. COPIES

8. APP CODE 11. AS OF DATE 13. DA TE OF SUBSEQUENT a. ADDRESSEE Final C SUBMISSION Draft A N/A ** R/ASR Reg Repro

16. REMARKS AFRL/RQT-PM 1 1 0

Tailored to allow the format as defined in the attached DD Form 2554-3.

* Submit as generated.

Approval/disapproval by letter from the Air Force

Program Manager within 30 days after receipt.

** Disapproval requires correction/resubmission within 30 days after receipt of Air Force comments.

R/ASR means revisions as required to maintain up to date and accurate drawings and lists

Revisions are subject to the approval cycle as stated.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: C: Distribution authorized to us Government agencies and their contractors.

15.TOTAL 1 1 0

G. PREPARED BY H.DATE I. APPROVED BY J. DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 17 of 19 Pages

17. PRICE GROUP

Form Approved

0MB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 11 0 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 and Communications

I Directorate (0704-0188). Respondents should be aware that notwithstanding any other prov·1sion 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 0MB 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.

D. SYSTEM/ITEM

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

B. EXHIBIT

A

C. CATEGORY:

N/A REF: DOD 5010.12-M

TDP

I

E. CONTRACT/PR NO.

FA8650-20-S-6004

TM __ OTHER

F. CONTRACTOR

3. SUBTITLE

A018 COMPUTER SOFTWARE PRODUCT

\ 11. PRICE GROUP

Source Code I l------1._-------r------'--------'----.-----------t �---t

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

18. ESTIMATED 4. AUTHORITY (Data Acquisition Document No.I

Dl-lPSC-81488/T csow AFRL/RQTE TOTAL PRICE

1--------,--------r----..l.------,------------+-----------------j 9. DIST STATEMENT

REQUIRED

7. DD 250 REQ

LT

8. APP CODE

NIA

C

16. REMARKS

10. FREQUENCY

ASGEN

12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

I

1------�--b. C-OP-IES---ll I 1-----------+--,,....,..,--=-,...,,.,,-::--:-c==------1 ______ ..

13. DATE OF SUBSEQUENT a. ADDRESSEE Final I

11. AS OF DATE

NIA

SUBMISSION., Draft

Reg Repro I

AFRL/RQT-PM 0 0

Tailored to allow contractor 1 s format.

* Submit with software for this technical effort.

Delivery of Software shall be inclusive of software source code and executable.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: C: Distribution authorized to US Government agencies and their contractors.

G. PREPARED BY

Anthony M. Cerminaro

AFRL/RQTE (937) 255-7622

H. DATE I. APPROVED BY

22-JAN-2020

1-------1-----+---+----I I

1----------+-----t---t----t i l-------+--+----+----11

15.TOTAL 0

J. DATE

I I

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 18 of 19 Pages

(1 Data Item) 0MB 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 and Communications 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 0MB 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:

N/A REF: DOD 5010.12-M

0001 A TOP

TM

OTHER

D. SYSTEM/ITEM I E. CONTRACT/PR NO. F.CONTRACTOR

FA8650-20-S-6004

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A019 PROGRAM PROTECTION IMPLEMENTATION PLAN

(PPIP)

4. AUTHORITY /Data Acquisition Document No.}

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-ADMN-81306/ T AF SOW, PARA 7.0 AFRL/RQTE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED ASREQ b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final B SUBMISSION Draft A N/A R/ASR Reg Repro

16. REMARKS AFRL/RQT-PM 1 1 0

Tailored as follows: Paragraph 7.1 is tailored to read requirements set forth in DoDI 5000.02. Omit from 7.2

DOD 5000.2-M. There will be an appendix to the PPIP titled Anti-Tamper Recommendation Report.

* 60 days after receipt of signed "Technology

Protection Plan" for each Task Order.

Approval/disapproval by letter from the Air Force

Program Manager within 30 days after receipt.

Disapproval requires correction/resubmission within 30 days after receipt of Air Force comments.

R/ASR means revisions as required to keep the

PPIP up to date, make changes or corrections; submit revisions as generated.

Revisions are subject to the above stated approval/disapproval cycle.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15.TOTAL � 1 1 0

G. PREPARED BY H.DATE I. APPROVED BY J.DATE

Anthony M. Cerminaro

22-JAN-2020

AFRL/RQTE (937) 255-7622

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 19 of 19 Pages

17. PRICE GROUP

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: TOP - 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 CORL.

Item H. Date CORL was prepared.

Item I. Signature of CORL approval authority.

Item J. Date CORL 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.

DD FORM 1423-1 (BACK), FEB 2001

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,…