Att 6 - LT-CRDS CDRL Portfolio.pdf

PDF 2 MB Posted

Attached to
Long-Term Capabilities Requirements Document Development Support (LT-CRDS) Federal contract opportunity
Solicitation number
HT001124R0064
Issued by
Defense Health Agency

About this file

This is a Contract Data Requirements List (CDRL) for the solicitation Long-Term Capabilities Requirements Document Development Support (LT-CRDS). The CDRL outlines 11 data items required from the contractor, including status reports, processes documentation for joint capability requirements development and management, requirements documentation development and evaluation, quality guidelines, monthly progress reports and transition plans. Delivery of the data items will be to the Defense Health Agency Contracting Officer. Submission frequency varies from annual to monthly, with initial submissions due 30 days after award and subsequent submissions due within 5 business days of changes. Distribution of the data items will be for administrative or operational use.

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Other files for this federal contract opportunity

Other files attached to Long-Term Capabilities Requirements Document Development Support (LT-CRDS), newest first.
File Type Posted
HT001124R0064-0002.pdf PDF
HT001124R0064-0001 LT-CRDS Amend 0001.pdf PDF
Att 18 - LT-CRDS RFP Q and A Sheet Final.pdf PDF
Att 14 - 7.2 FRCS Responsibility Matrix.pdf PDF
Att 11 - 7.1.2_DHA Mandatory Training List 2023.pdf PDF
Att 9 - 7.1.1_DHA CAC Request Process.pdf PDF
Att 7 - LT-CRDS QASP Draft.doc DOC document
Att 4 - LT-CRDS Sample Consent Letter.docx DOCX document
Att 3 - LT-CRDS Past Performance Questionnaire.docx DOCX document
Att 1 - LT-CRDS PWS.pdf PDF
Att 17 - WD 2015-4281 Rev 27.pdf PDF
Att 15 - 7.2 Risk Assessment Framework.pdf PDF
Att 10 - 7.1.1_DMDC TASS Application.xlsx XLSX spreadsheet
Att 5 - LT-CRDS OCI Contract List.xlsx XLSX spreadsheet
Att 16 - 7.2 DHA_Form_49_DHA KTR.pdf PDF
Att 13 - 7.2 Cybersecurity Regulations.pdf PDF
Att 8 - LT-CRDS DD Form 254.pdf PDF
Att 2 - LT-CRDS Pricing Sheet.xlsx XLSX spreadsheet
Att 8 - LT-CRDS DD Form 254 scanned pdf.pdf PDF
HT001124R0064 LT-CRDS RFP.pdf PDF
Att 12 - 7.1.3 DHA New Employee Handbook.pdf PDF
Show all 21

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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: CDRL 5 title: Perform and Document Capabilities Based Assessments sub: Capability Requirements auth: TBD ref: PWS 5.3.2.3 req_ofc:

dd250: LTR appcode: A dist: B freq: Annual asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: DHA CO draft1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: BLK 8: The government will have 5 business days to approve the report. If report is returned to contractor for rework, the contractor will have 3 business days to make changes.

BLK 9: DISTR B. "Administrative or Operational Use" BLK 11: Reporting will be completed within 30 days of award.

BLK 13: Submitted within 5 business days when changes are made to the plan.

BLK 14: Electronic submission via email.

group:

total_price:

prep_name:

line_item: PWS 5.3.2.3 exhibit: A xtdp: Off xtm: Off othercat: X system: Capability Requirements Documents ctr_no: HT001124R0064 contr: TBD remarksb:

Page2:

Reset:

2023-11-24T13:12:29-0500

DEABREU.NEIL.A.1019048256

prep_date: 22 Nov 2023 app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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: CDRL 6 title: Develop and Document Requirements sub: Capability Requirements auth: TBD ref: PWS 5.3.2.3 req_ofc:

dd250: LTR appcode: A dist: B freq: Annual asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: DHA CO draft1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: BLK 8: The government will have 5 business days to approve the report. If report is returned to contractor for rework, the contractor will have 3 business days to make changes.

BLK 9: DISTR B. "Administrative or Operational Use" BLK 11: Reporting will be completed within 30 days of award.

BLK 13: Submitted within 5 business days when changes are made to the plan.

BLK 14: Electronic submission via email.

group:

total_price:

prep_name:

line_item: PWS 5.3.2.3 exhibit: A xtdp: Off xtm: Off othercat: X system: Capability Requirements Documents ctr_no: HT001124R0064 contr: TBD remarksb:

Page2:

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2023-11-24T13:12:29-0500

DEABREU.NEIL.A.1019048256

prep_date: 22 Nov 2023 app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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: CDRL 7 title: QA Guidelines and Criteria sub: Capability Requirements auth: TBD ref: PWS 5.3.2.3 req_ofc:

dd250: LTR appcode: A dist: B freq: Annual asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: DHA CO draft1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: BLK 8: The government will have 5 business days to approve the report. If report is returned to contractor for rework, the contractor will have 3 business days to make changes.

BLK 9: DISTR B. "Administrative or Operational Use" BLK 11: Reporting will be completed within 30 days of award.

BLK 13: Submitted within 5 business days when changes are made to the plan.

BLK 14: Electronic submission via email.

group:

total_price:

prep_name:

line_item: PWS 5.3.2.3 exhibit: A xtdp: Off xtm: Off othercat: X system: Capability Requirements Documents ctr_no: HT001124R0064 contr: TBD remarksb:

Page2:

Reset:

2023-11-24T13:12:29-0500

DEABREU.NEIL.A.1019048256

prep_date: 22 Nov 2023 app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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: CDRL 8 title: Documentation for Program Management Office sub: Capability Requirements auth: TBD ref: PWS 5.3.3.3 req_ofc:

dd250: LTR appcode: A dist: B freq: Annual asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: DHA CO draft1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: BLK 8: The government will have 5 business days to approve the report. If report is returned to contractor for rework, the contractor will have 3 business days to make changes.

BLK 9: DISTR B. "Administrative or Operational Use" BLK 11: Reporting will be completed within 30 days of award.

BLK 13: Submitted within 5 business days when changes are made to the plan.

BLK 14: Electronic submission via email.

group:

total_price:

prep_name:

line_item: PWS 5.3.3.3 exhibit: A xtdp: Off xtm: Off othercat: X system: Capability Requirements Documents ctr_no: HT001124R0064 contr: TBD remarksb:

Page2:

Reset:

2023-11-24T13:12:29-0500

DEABREU.NEIL.A.1019048256

prep_date: 22 Nov 2023 app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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: CDRL 9 title: Project Management Methodologies sub: Capability Requirements auth: TBD ref: PWS 5.4.1.1 req_ofc:

dd250: LTR appcode: A dist: B freq: Annual asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: DHA CO draft1:

reg1: 1 repro1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: BLK 8: The government will have 5 business days to approve the report. If report is returned to contractor for rework, the contractor will have 3 business days to make changes.

BLK 9: DISTR B. "Administrative or Operational Use" BLK 11: Reporting will be completed within 30 days of award.

BLK 13: Submitted within 5 business days when changes are made to the plan.

BLK 14: Electronic submission via email.

group:

total_price:

prep_name:

line_item: PWS 5.4.1.1 exhibit: A xtdp: Off xtm: Off othercat: X system: Capability Requirements Documents ctr_no: HT001124R0064 contr: TBD remarksb:

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DEABREU.NEIL.A.1019048256

prep_date: 22 Nov 2023 app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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: A001 title: Status Report sub: Quality Program Plan auth: DI-QCIC-81722 ref: PWS 1.10 req_ofc: DHA COD dd250: LTR appcode: A dist: B freq: Annual asof: blk 16 firstsub: blk 16 subsub: blk 16 addressee1: DHA CO draft1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: BLK 8: The government will have 5 business days to approve the report. If report is returned to contractor for rework, the contractor will have 3 business days to make changes.

BLK 9: DISTR B. "Administrative or Operational Use" BLK 11: Reporting will be completed within 30 days of award.

BLK 13: Submitted within 5 business days when changes are made to the plan.

BLK 14: Electronic submission via email.

group:

total_price:

prep_name:

line_item: 000X exhibit: A xtdp: Off xtm: Off othercat: x system: DHA Requirement ctr_no:

contr:

remarksb: None

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2016-05-18T15:00:56-0400

MORVATZ.RICHARD.N.1080770282

prep_date: 28 Feb 2017 app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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: CDRL 10 title: Monthly Progress Reports sub: Capability Requirements auth: TBD ref: PWS 5.5.2 req_ofc:

dd250: LTR appcode: A dist: B freq: Annual asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: DHA CO draft1:

reg1: 1 repro1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: BLK 8: The government will have 5 business days to approve the report. If report is returned to contractor for rework, the contractor will have 3 business days to make changes.

BLK 9: DISTR B. "Administrative or Operational Use" BLK 11: Reporting will be completed within 30 days of award.

BLK 13: Submitted within 5 business days when changes are made to the plan.

BLK 14: Electronic submission via email.

group:

total_price:

prep_name:

line_item: PWS 5.5.2 exhibit: A xtdp: Off xtm: Off othercat: X system: Capability Requirements Documents ctr_no: HT001124R0064 contr: TBD remarksb:

Page2:

Reset:

2023-11-24T13:12:29-0500

DEABREU.NEIL.A.1019048256

prep_date: 22 Nov 2023 app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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: CDRL 11 title: Transition-in sub: Capability Requirements auth: TBD ref: PWS 1.6.1.1 req_ofc:

dd250: LTR appcode: A dist: B freq: Annual asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: DHA CO draft1:

reg1: 1 repro1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: BLK 8: The government will have 5 business days to approve the report. If report is returned to contractor for rework, the contractor will have 3 business days to make changes.

BLK 9: DISTR B. "Administrative or Operational Use" BLK 11: Reporting will be completed within 30 days of award.

BLK 13: Submitted within 5 business days when changes are made to the plan.

BLK 14: Electronic submission via email.

group:

total_price:

prep_name:

line_item: PWS 1.6.1.1 exhibit: A xtdp: Off xtm: Off othercat: X system: Capability Requirements Documents ctr_no: HT001124R0064 contr: TBD remarksb:

Page2:

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DEABREU.NEIL.A.1019048256

prep_date: 30 Nov 2023 app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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: CDRL 12 title: Transition-out sub: Capability Requirements auth: TBD ref: PWS 1.6.1.2 req_ofc:

dd250: LTR appcode: A dist: B freq: Annual asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: DHA CO draft1:

reg1: 1 repro1:

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draft2:

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repro38:

total_draft: 0 total_reg: 1 total_repro: 0 remarks: BLK 8: The government will have 5 business days to approve the report. If report is returned to contractor for rework, the contractor will have 3 business days to make changes.

BLK 9: DISTR B. "Administrative or Operational Use" BLK 11: Reporting will be completed within 30 days of award.

BLK 13: Submitted within 5 business days when changes are made to the plan.

BLK 14: Electronic submission via email.

group:

total_price:

prep_name:

line_item: PWS 1.6.1.2 exhibit: A xtdp: Off xtm: Off othercat: X system: Capability Requirements Documents ctr_no: HT001124R0064 contr: TBD remarksb:

Page2:

Reset:

2023-11-24T13:12:29-0500

DEABREU.NEIL.A.1019048256

prep_date: 30 Nov 2023 app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 delive

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