Attachment 004 - Assertion of Restrictions.xlsx

Cover

DISTRIBUTION STATEMENT A: Approved for Public Release; distribution unlimited. PEO GCS OPSEC# OPSEC-2026-232

Instructions

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

2. Item Description: The contractor shall enter a description of the technical data or computer software which specifically describes the technical data or computer software and conveys the usage, function, and location of the associated item, component, or process. If computer software, the offeror shall identify if it is object code, executable software, firmware, or source code, etc. If more than one item of data, then enter each on separate item ID's and on separate rows.

3. Technical Data or Computer Software: The contractor shall identify if the data is technical data or computer software.

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 or computer software.

6. CDRL Number: The contractor shall identify the CDRL number(s) that the technical data or computer software is being delivered under. For example: "CDRL_A024" .

7. The contractor shall indicate if this technical data or computer software pertains to a commercial product per the definition of commercial product in FAR 2.101? (Y/N)

8. The contractor shall indicate if this technical data or computer software pertains to a Commercially available off-the-shelf (COTS) item per the definition of commercial in FAR 2.101? (Y/N)

9. The contractor shall indicate the Option under Section 11 of the PPA to which this technical data or computer software relates?

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

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

12. Associated Background Patents: The contractor shall identify all associated Background Patents. Background Patent is defined as any U.S. patent, or U.S. patent application, or PCT patent application, which covers an invention or discovery which is not a subject invention (as defined in FAR 52.227-11) and which is owned or controlled by the contractor at any time through the completion of this contract or to which the offeror has an interest through inventorship. The specific patent and application numbers and full titles are required to be provided.

13. Identification of the Source for Commercial Item and Commercial License: The contractor shall enter the source(s) of item and source of the commercial computer software license.

14. Name of Person Asserting Restrictions: The contractor shall enter the Corporation, individual, or other person, as appropriate.

*For technical data (other than computer software documentation) pertaining to items, components, or processes developed at private expense, identify both the deliverable technical data and each such item, component, or process. For computer software or computer software documentation identify the software or documentation.

**Generally, development at private expense, either exclusively or partially, is the only basis for asserting restrictions. For technical data, other than computer software documentation, development refers to development of the item, component, or process to which the data pertain. The Government's rights in computer software documentation generally may not be restricted. For computer software, development refers to the software. Indicate whether development was accomplished exclusively or partially at private expense. If development was not accomplished at private expense, or for computer software documentation, enter the specific basis for asserting restrictions.

***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 specially negotiated licenses).

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

*****Enter “none” when all data or software will be submitted without restrictions.

Assertions of Restrictions

Date:

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 the OTA

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: