attach9.xlsx

Cover

UNCLASSIFIED

DISTRIBUTION STATEMENT A: Approved for Public Release; distribution unlimited.

Distribution A only applies when form is not filled-in. Once completed reference the PEO CS & CSS Security Classification Guide for proper distribution statement/markings.

Other requests for this document shall be referred to the attention of the PEO CS & CSS Security Manager at: Gregg S. Schamel, gregory.s.schamel.civ@army.mil.

UNCLASSIFIED

Instructions

1. Technical Data and Computer Software (to include firmware) to be furnished with Restrictions: For technical data (other than computer software documentation) pertaining to items, components, or processes, identify both the deliverable technical data and each such item, component, or process. For computer software or computer software documentation identify the computer software or documentation.

2. Item Description: The contractor shall enter a description of the technical data or computer software which conveys the usage, function, and location of the item.

3. Technical Data or Computer Software: The contractor shall identify if the item is technical data or computer software. If computer software, the offeror must identify if it is object code, executable software, firmware, or source code, etc. If more than one then enter each on separate item ID's and on separate rows.

4. Drawing Number: The contractor shall enter the drawing number for the technical data. For example: “12345678”.

5. BOM Level: The contractor shall identify the level of the Indentured BOM corresponding to the technical data and computer software.

6. CDRL Number: The contractor shall identify the CDRL numbers that the technical data or computer softwrare is being delivered under. For example: "CDRL_A024" .

7. Commercial item: The contractor shall identify if the item meets the commercial definition of FAR 2.101 (Yes/No).

8. Basis for Assertion: The contractor shall state the basis for their assertion.

9. Asserted Rights Category: The contractor shall identify the category of the rights asserted.

10. Associated Background Patents: The contractor shall identify all associated Background Patents. All Background Patents shall be identified per H.3.1.1. The specific patent and application numbers are required.

11. ID'd Source for Commercial Item: The contractor shall enter the source(s) of item.

12. Name of Person Asserting Restrictions: The contractor shall enter “none” when all technical data or computer software will be submitted without restrictions.

Contractors are instructed to add additional lines as necessary to provide all rights and applicable components.

*If the assertion is applicable to items, components, or processes developed at private expense, identify both the data and each such item, component, or process.

**Generally, the development of an item, component, or process at private expense, either exclusively or partially, is the only basis for asserting restrictions on the Government's rights to use, release, or disclose technical data or computer software pertaining to such items, components, or processes. Indicate whether development was exclusively or partially at private expense. If development was not at private expense, enter the specific reason for asserting that the Government's rights should be restricted.

***Enter asserted rights category (e.g., government purpose license rights from a prior contract, rights in SBIR data generated under another contract, limited, restricted or government purpose rights under this or a prior contract, or specifically negotiated licenses).

****Corporation, individual, or other person, as appropriate.

UNCLASSIFIED//FOR OFFICIAL USE ONLY

Attachment 055- Technical Data, Computer Software and Patent License Identification and Assertions

W56HZV-18-R-0174

Assertions of Restrictions

Printed Name:

Title:

Signature:

Technical data and computer software including firmware to be furnished Technical data and computer software including firmware with the level of data rights to which the Government is entitled per DFARS 252.227-7013, 252.227-7014, 252.227-7015, or 227.7202-3(b)

The offeror asserts for itself, or the persons identified below, that the Government's rights to use, release, or disclose the following technical data or computer software including firmware should be restricted:

UNCLASSIFIED

&"-,Bold"&K000000Solicitation Number W56HZV-21-R-0149

&"-,Italic"&12Use or disclosure of data contained within this worksheet is subject to the restrictions on the cover page. Page &P of &N