Attach 1 Exhibit A - CDRL A0001FY26 and A0002FY26.pdf
PDF 82 KB Posted
- Attached to
- Coolant Machine Maintenance Service
- Solicitation number
- N4215826900F0023
About this file
This is a DD Form 1423-1, Contract Data Requirements List, specifying one data item requirement for an Industrial Fluid Equipment (IPE) Coolant contract with the Naval Supply Systems Command (NNSY) C900F.
The contractor must submit a Certification Data Report in the form of a Clean-Out Data Sheet on a weekly frequency, with the first submission due per Block 16 and subsequent submissions as specified in Block 16. The data item is referenced to PWS Paragraph 6.3.8.3 under contract authority DI-MISC-82386. The Clean-Out Data Sheet must be submitted within ten calendar days after each event for all continual maintenance of machine coolant on equipment listed in Appendix A of the PWS. Submissions shall be made to all Points of Contact via email in a downloadable Microsoft Office acceptable format that is write-protected or PDF format. The required data sheet must include identification of personnel performing work, DoD Asset Number, date service was accomplished, whether tramp oil was removed and quantity, initial and final refractometer readings, whether water or concentrate was added to achieve desired coolant concentration, number of mechanical and total man-hours, and service representative signature. The contractor must ensure monitoring results are attached to each machine for inspection purposes. Distribution is authorized to the Department of Defense and U.S. DoD contractors only (Critical Technology), with other requests referred to the Point of Contact at Naval Shipyard, Portsmouth, Virginia. The form was prepared by Marc E Lauture on 04/08/2026.
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Text version
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 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 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
| 1_DATA_ITEM_NO: A001 |
| 2_TITLE_OF_DATA_ITEM: Certification Data Report |
| 3_SUBTITLE: Clean-Out Data Sheet |
| 4_AUTHORITY_Data_Acquisit: DI-MISC-82386 |
| 5_CONTRACT_REFERENCE: PWS Paragraph 6.3.8.3 |
| 6_REQUIRING_OFFICE: NNSY C900F |
| 7_DID_250_REQ: LT |
| 8_APP_CODE: N/A |
| DIST_STATEMENT: D (See Block 16) |
| 10_FREQUENCY: Weekly |
| 11_AS_OF_DATE: See Block 16 |
| 12_DATE_OF_FIRST_SUBMISSI: See Block 16 |
| 13_DATE_OF_SUBSEQUENT_SUB: N/A |
| addressee1: NNSY C900F |
| draft1: 0 |
| reg1: 1 |
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| 16_REMARKS: Block 4: The submission of this data sheet is acceptable in the contractor's format. Additional format instructions and guidance can be obtained referencing DI-MISC-81423A(Facilities Maintenance Report). Tailoring Guidance as Follows: |
Clean-Out Data Sheet shall contain a minimum of the following:
• Identification of Personnel Performing Work
• DoD Asset Number
• Date service was accomplished
• Whether tramp oil was removed and approximate quantity
• Initial refractometer reading
• Whether water or concentrate was added in order to achieve desired coolant concentration
• Final refractometer reading
• Number of Mechanical Man-Hours
• Number of Total Man-Hours
• Service representative signature who performed work
Note: Contractor shall ensure the monitoring results listed in the data sheet are attached to each machine for inspection purposes.
Block 9: Distribution Statement D. Distribution authorized to the Department of Defense and U.S DoD contractors only. (Critical Technology) (August 15 2026)Other requests shall be referred to POC at Naval Shipyard, Portsmouth, VA.
Block 11: Contract Award Date.
Block 12: The contractor shall submit a clean-out data sheet within 10 calendar days after each event for all continual maintenance of machine coolant on any equipment listed in Appendix A of the PWS.
Block 14: Data submission shall be submitted to all POCs via Email in a downloadable Microsoft Office acceptable format that will be write-protected or PDF format. The contractor shall call the appropriate government organizational entities to ensure receipt of the report.
Technical POC: To be determined at award
| 17_PRICE_GROUP: |
| ESTIMATED_TOTAL_PRICE: |
| G_PREPARED_BY: Marc E Lauture |
| H_DATE: 04/08/2026 |
| 1_APPROVED_BY: |
| J_DATE: |
| Page: 1 |
| reg38t: 1 |
| A_CONTRACT_LINE_ITEM_NO: 0001 |
| B_EXHIBIT: A |
| TDP: |
| TM: |
| OTHER: MISC |
| DSYSTEMITEM: Industrial Plant Equipment (IPE) Coolant |
| E_CONTRACTPR_NO: N4215826RX60271 |
| FCONTRACTOR: TBD |
| of_pages: 1 |
| Reset: |
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