ATCH_6_Contract_Data_Requiremets_List.pdf

UNCLASSIFIED

CONTRACT DATA REQUIREMENTS LIST Form Approved

(1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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:

000X,100X,200X,300X,400X A/B/C/D/E TDP TM x OTHER MGM

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

C130-J FD20602600033 ROCKWELL COLLINS

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A/B/C/D/E 001 Government Property (GP) Inventory Report Government Property Inventory Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MGMT-80441D PWS Para 4.4 411 SCMS / GULAB

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ANNUAL

SEE BLK 16

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRA

FT

FINAL

A A SEE BLK 16 SEE BLK 16 Reg Repr o

16. REMARKS

CLIN Exhibit Data Item No. Performance Period 000X A A001 Basic Year Pd 100X B B001 Ordering/Option Period 1 200X C C001 Ordering/Option Period 2 300X D D001 Ordering/Option Period 3 400X E E001 Ordering/Option Period 4

Program Manager/ PM provided on contract award

BLK 4: The data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract. See Data Item Description at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: Enter the applicable code as listed in DOD 5010.12-M, Chapter 3. (Enter LT for Letter of Transmittal if not separately priced or DD if separately priced). WAWF E-DD FORM 250 shall be required for separately priced data. EDD FORM 250 shall be submitted to FA8524 Program Manager (PM/ and Supply Planner (SP) EMAIL ADDRESS) for acceptance.

BLK 8: Approval (written) is not required. However, the data item will be reviewed and accepted/rejected, based on its conforming to the requirements of the DID, and within the review time specified in Block 16, items 10-13.

BLK 9: "A" Approved for Public Release; distribution is unlimited.

BLKS 10-13: The annual physical inventory report shall be provided within seven (7) calendar days of the end of each option/ordering period for the contract. The data is representative of the Contractor's Internal Property Control System and shall be current as of the last day of the option/ordering reporting period. If requested outside of an annual cadence, the data shall be current as of the date requested.

BLK 14: EMAIL electronic Annual Physical Inventory Report to the Supply Planner: Courtney Jones (E-mail: courtney.jones.25@us.af.mil ) Program Manager: Kiem Tarpley (E-mail: kiem.tarpley@us.af.mil) Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in Microsoft Office Excel format for all reports.

SP email provided on Contract Award 1

15. Total 2

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

COURTNEY JONES 30 Oct 2025

DD FORM 1423, Feb 2024 UNCLASSIFIED Previous editions may be used

Page 1 of 7 Pages

31 Oct 2025 http://quicksearch.dla.mil/ mailto:courtney.jones.25@us.af.mil

(1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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:

000X,100X,200X,300X,400X A/B/C/D/E TDP TM x OTHER MGM

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

C130-J FD20602600033 ROCKWELL COLLINS

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A/B/C/D/E 002 Commercial Asset Availability (CAV) Reporting CAV AF

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MGMT-81838 PWS Para 4.2.3 411 SCMS / GULAB

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT SEE BLK 16

SEE BLK 16

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRA

FT

FINAL

N/A A SEE BLK 16 SEE BLK 16 Reg Repr o

16. REMARKS

CLIN Exhibit Data Item No. Performance Period 000X A A002 Basic Year Pd 100X B B002 Ordering/Option Period 1 200X C C002 Ordering/Option Period 2 300X D D002 Ordering/Option Period 3 400X E E002 Ordering/Option Period 4

Program Manager/ PM email provided on Contract Award

BLK 1. The contractor shall report End Item transactional data through electronic submission in CAV AF using the CAV AF web site or CICA XML IAW the referenced DID IAW and/or CAV AF CFM Reporting Requirements. This information will be accessed by the program office SP and by 420 SCMS/GUNAB-Robins in order to ascertain production status.

BLK 2. Transactions and data will be submitted by the contractor daily IAW CAV AF User Guide, Version

8.0.1 or higher.

The Contractor shall obtain a valid DOD PKI certificate to log into CAV AF. Each user shall be required to have an: Identity Certificate only; an encryption certificate is not required.

BLK 3. Training will be provided by 420 SCMS/GUNAB-Robins, (478) 327-6603 or 6602 if required and a request must be initiated by the CAV Reporter

BLK 4. This DD Form 1423-1 applies to Contractor Furnished Materiel (CFM) type contracts.

BLK 7: Enter the applicable code as listed in DOD 5010.12-M, Chapter 3. (Enter LT for Letter of Transmittal if not separately priced or DD if separately priced.) E-DD FORM 250 shall be submitted to DCMA for acceptance.

BLK 10:

a. Contractor reporting requirements to CAV AF shall be accomplished daily and/or within 24 hours of a supply or maintenance action occurrence IAW Contractor Users Guide.

b. The method of communication from the contractor to the funding base will be mechanized using the CAV AF Online web site IAW CAV AF Contractor Users Guide.

BLK 11: Data shall be current within 24 hours of last End Item maintenance occurrence.

BLK 12: Date of first submission shall be within 24 hours following a supply or maintenance transaction after the contract award date and government training as specified in IAW CAV AF Users Guide.

BLK 13: Same as remarks regarding Block 10 above.

Supply Planner

SP email provided on Contract Award 1

15. Total 2

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

COURTNEY JONES 30 Oct 2025

DD FORM 1423, Feb 2024 UNCLASSIFIED Previous editions may be used

Page 2 of 7 Pages

31 Oct 2025

(1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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:

000X,100X,200X,300X,400X A/B/C/D/E TDP TM x OTHER MGM

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

C130-J FD20602600033 ROCKWELL COLLINS

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A/B/C/D/E 003 Item Unique Identification (IUID) Marking Plan Item Unique Identification

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MGMT-81803A PWS Para 4.5.2 411 SCMS / GULAB

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT QUARTERLY

SEE BLK 16

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRA

FT

FINAL

SEE BLK 16 C SEE BLK 16 SEE BLK 16 Reg Repr o

16. REMARKS

CLIN Exhibit Data Item No. Performance Period 000X A A003 Basic Year Pd 100X B B003 Ordering/Option Period 1 200X C C003 Ordering/Option Period 2 300X D D003 Ordering/Option Period 3 400X E E003 Ordering/Option Period 4

Program Mgr PM email provided on Contract Award

1 1

BLK 9: "C" Distribution authorized to U.S. Government Agencies and their contractors (Administrative or Operational Use, 28 April 16) Other requests shall be referred to the contract management team, AFSCC/PZAAA 460 Richard Ray BLVD, Suite 221, Robins AFB, GA 31098

BLKS 10-13: The contractor shall submit a complete IUID Marking Plan within 30 calendar days after contract award. The Government will review and determine acceptance or rejection and notify contractor within 10 calendar days of receipt. If rejected, the contractor shall have 10 calendar days to correct any error and return a corrected IUID Marking Plan to the Government for review.

BLK 7, 14: Forward one electronic copy in PDF format to the following email address:

Program Manager: Kiem Tarpley (E-mail: kiem.tarpley@us.af.mil) Engineer: Mark Garner (E-mail: mark.garner@us.af.mil)

Contracting Officer/ PCO email provided on contract award

DCMA/ACO 1

Engineer:

Mark Garner @ mark.garner@us.af.mil

1 1

15. Total 2 4

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

COURTNEY JONES 30 Oct 2025

DD FORM 1423, Feb 2024 UNCLASSIFIED Previous editions may be used

Page 3 of 7 Pages mailto:mark.garner@us.af.mil

(1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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:

000X,100X,200X,300X,400X A/B/C/D/E TDP TM x OTHER MGM

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

C130-J FD20602600033 ROCKWELL COLLINS

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A/B/C/D/E 004 Item Unique Identification (IUID) Marking Activity, Validation and Verification Report

IUID Marking and Verification Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MGMT-81804A PWS Para 4.5.3 411 SCMS / GULAB

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT QUARTERLY

SEE BLK 16

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRA

FT

FINAL

SEE BLK 16 C SEE BLK 16 SEE BLK 16 Reg Repr o

16. REMARKS

CLIN Exhibit Data Item No. Performance Period 000X A A004 Basic Year Pd 100X B B004 Ordering/Option Period 1 200X C C004 Ordering/Option Period 2 300X D D004 Ordering/Option Period 3 400X E E004 Ordering/Option Period 4

EMAIL:

411 SCMS/ GULA

Program Manager

(PM)/COR

Provided on contract award

1 1

BLK 4: IUID Marking Activity and Verification Report can be combined with the monthly status report.

BLK 7: Applicable code as listed in DOD 5010.12-M, Chapter 3. (LT for Letter of Transmittal if not separately priced or DD if separately priced) WAWF E-DD FORM 250 shall be required for separately priced data. E-DD FORM 250 shall be submitted to FA8524 (PM EMAIL ADDRESS) for acceptance.

BLK 8: Approval (written) is not required. However, the data item will be reviewed and accepted/rejected based on its conforming to the requirements of the DID, and within the review time specified in Block 16, items 10-12.

BLK 9: "C" Distribution authorized to U.S. Government Agencies and their contractors (Administrative or Operational Use,28 April 16) Other requests shall be referred to the contract management team, AFSCC/PZAAA 460 Richard Ray BLVD, Suite 221, Robins AFB, GA 31098

BLKS 10-13: Contractor shall submit an IUID Marking Activity and Verification Report to the Engineer AFLCMC/WIUEE, every three months (quarterly). Written Government acceptance/comments/rejection will be within 10 working days after receipt of Plan from the Contractor. Contractor final submission shall be submitted within 10 working days of receiving Government comments. Acceptance by the Government is required prior to formal distribution

BLK 14: Forward one electronic copy in PDF format to the following email address:

Procuring Contract Officer (PCO) AFSC/PZAA: Teresa Smith (E-mail: teresa.smith.16@us.af.mil) Supply Planner: Courtney Jones (E-mail: courtney.jones.25@us.af.mil) Program Manager: Kiem Tarpley (E-mail: kiem.tarpley@us.af.mil ) Engineer: Mark Garner (E-mail: mark.garner@us.af.mil)

Email:

AFLCMC/WIUEE 1 1

235 Byron Street Suite 19A Robins AFB,GA 31098

EMAIL:

AFSC/PZAAA

Contracting Office (PCO) provided on contract award

DCMA/ACO 1

15. Total 2 4

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

COURTNEY JONES 30 Oct 2025

DD FORM 1423, Feb 2024 UNCLASSIFIED Previous editions may be used

Page 4 of 7 Pages mailto:kiem.tarpley@us.af.mil

(1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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:

000X,100X,200X,300X,400X A/B/C/D/E TDP TM x OTHER MGM

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

C130-J FD20602600033 ROCKWELL COLLINS

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A/B/C/D/E 005 Contract Depot Maintenance (CDM) Monthly Production Report

Production Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-PSSS-81995A PWS Para 4.7 411 SCMS / GULAB

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT SEE BLK 16

SEE BLK 16

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRA

FT

FINAL

SEE BLK 16 A SEE BLK 16 SEE BLK 16 Reg Repr o

16. REMARKS

CLIN Exhibit Data Item No. Performance Period 000X A A005 Basic Year Pd 100X B B005 Ordering/Option Period 1 200X C C005 Ordering/Option Period 2 300X D D005 Ordering/Option Period 3 400X E E005 Ordering/Option Period 4

Program Manager/ PM provided on contract award

BLK 4: The Data Item Description (DID) contains the format, content and preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

This report shall be provided in the format of Table 1. See DID for Table 1 and content requirement explanations at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: WAWF E-DD FORM 250 shall be required for separately priced data. E-DD FORM 250 shall be submitted to FA8524 (PMS EMAIL ADDRESS) for acceptance.

BLK 8: Approval (written) is not required. However, the data item will be reviewed and accepted/rejected, based on its conforming to the requirements of the DID, and within the review time specified in Block 16.

BLK 9: "A" Approved for Public Release; distribution is unlimited.

BLKS 10- 13: Report shall be submitted NLT the 10th calendar day after the end of the month being reported.

BLK 14: EMAIL electronic Contract Depot Maintenance Production Report to Supply Planner: Courtney Jones (E-mail: courtney.jones.25@us.af.mil ) Program Manager: Kiem Tarpley (E-mail: kiem.tarpley@us.af.mil ) Engineer: Mark Garner (E-mail: mark.garner@us.af.mil ) Point of Contact will be provide to the Contractor as contract Award. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

Supply Planner

SP email provided on Contract Award 1

15. Total 2

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

COURTNEY JONES 30 Oct 2025

DD FORM 1423, Feb 2024 UNCLASSIFIED Previous editions may be used

Page 5 of 7 Pages

31 Oct 2025 http://quicksearch.dla.mil/ mailto:courtney.jones.25@us.af.mil

(1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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:

000X,100X,200X,300X,400X A/B/C/D/E TDP TM x OTHER MGM

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

C130-J FD20602600033 ROCKWELL COLLINS

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A/B/C/D/E 006 Government Industry Exchange Program (GIDEP) Alert-Safe Alert Report

GIDEP Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-QCIC-80125B PWS Para 4.9.2 411 SCMS / GULAB

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT SEE BLK 16

SEE BLK 16

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRA

FT

FINAL

A SEE BLK

SEE BLK 16 SEE BLK 16 Reg Repr o

16. REMARKS

CLIN Exhibit Data Item No. Performance Period 000X A A006 Basic Year Pd 100X B B006 Ordering/Option Period 1 200X C C006 Ordering/Option Period 2 300X D D006 Ordering/Option Period 3 400X E E006 Ordering/Option Period 4

Program Manager/ PM provided on contract award

BLK 4: The data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract. The Alert/Safe Alert Report can be tailored to contractor format but shall contain all data specified on DD Form 1938 electronic template in accordance with instructions cited on back side of the form and or the guidance of S0300-BT-PRO-010, Chapter 7. See Data Item Description at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: Enter the applicable code as listed in DOD 5010.12-M, Chapter 3. (Enter LT for Letter of Transmittal if not separately priced or DD if separately priced) WAWF E-DD FORM 250 shall be required for separately priced data. EDD FORM 250 shall be submitted to FA8524 Program Manager for acceptance.

BLK 9: "A" Approved for Public Release; distribution is unlimited.

BLKS 10-13: Report shall be submitted to arrive NLT 10th calendar day after the end of the month to notify the Government of non-conforming items, supplies, and services or safety problems which have adversely impacted or have the potential to adversely impact the program during the duration of the contract.

BLK 14: EMAIL electronic GIDEP Report to Program: Kiem Tarpley (E-mail:

kiem.tarpley@us.af.mil) and Engineer: Mark Garner (E-mail: mark.garner@us.af.mil). Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

GIDEP

P.O. BOX 8000

Corona, CA 92878-8000 1

15. Total 2

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

COURTNEY JONES 30 Oct 2025

DD FORM 1423, Feb 2024 UNCLASSIFIED Previous editions may be used

Page 6 of 7 Pages

31 Oct 2025 http://quicksearch.dla.mil/

(1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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:

000X,100X,200X,300X,400X A/B/C/D/E TDP TM x OTHER MGM

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

C130-J FD20602600033 ROCKWELL COLLINS

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A/B/C/D/E 007 Accident/Incident Report Accident/Incident Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-SAFT-81563 PWS Para 5.5.2 ABW/SE

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

N/A AS REQUIRED

AS REQUIRED

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRA

FT

FINAL

N/A B AS REQUIRED AS REQUIRED Reg Repr o

16. REMARKS

CLIN Exhibit Data Item No. Performance Period 000X A A007 Basic Year Pd 100X B B007 Ordering/Option Period 1 200X C C007 Ordering/Option Period 2 300X D D007 Ordering/Option Period 3 400X E E007 Ordering/Option Period 4

ABW/SE MISHAP

REPORTING

78abw.se.mishap@us.af.

mil

BLK 10: IAW AFI 91-204, if damage occurs BLK 11: Once assets have been received after contract award BLK 12: 24 hours after accident/incident BLK 13: As needed, IAW AFI 91-207

Supply Planner: Courtney Jones (E-mail: courtney.jones.25@us.af.mil ) Program Manager: Kiem Tarpley (E-mail: kiem.tarpley@us.af.mil ) Engineer: Mark Garner (E-mail: mark.garner@us.af.mil ) Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in Microsoft Office Excel format for all reports.

CONTRACT OFFICER

REPRESENTITIVE

(COR) @

kiem.tarpley@us.af.mil

1 1

PROCUREMENT

CONTRACT OFFICE @

teresa.smith.16@us.af.mil

15. Total 1 3

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

COURTNEY JONES 30 Oct 2025

DD FORM 1423, Feb 2024 UNCLASSIFIED Previous editions may be used

Page 7 of 7 Pages

31 Oct 2025 mailto:78abw.se.mishap@us.af.mil mailto:78abw.se.mishap@us.af.mil mailto:courtney.jones.25@us.af.mil mailto:kiem.tarpley@us.af.mil mailto:mark.garner@us.af.mil mailto:kiem.tarpley@us.af.mil