Attachment 2 Exhibit A Contract Data Requirements List.pdf

Exhibit A General Instruction Template

Enterprise IT & Cyber Infrastructure Division (HNI), Hanscom AFB MA 01731-2100

Version 2.0, March 2024

Exhibit A General Instructions

Contract Data Requirements List (CDRL)

For

Theater Deployable Communications (TDC)

Contractor Logistic Support (CLS)

Air Force Materiel Command (AFMC)

Air Force Life Cycle Management Center (AFLCMC)

Enterprise IT & Cyber Infrastructure Division (AFLCMC/HNI)

Connect Branch (AFLCMC/HNIB)

Contract Number

Delivery/Task Order

Date

THIS PAGE INTENTIONALLY LEFT BLANK

Table of Contents TABLE OF CONTENTS ............................................................................................................................................................ I

1.0 GENERAL INSTRUCTIONS

1.1 CDRL SUBMISSIONS

1.2 LETTER OF TRANSMITTAL

1.3 RESTRICTIONS

1.4 CORRECTIVE ACTION REQUESTS AND RESCINDING DELIVERIES

1.5 EXTENSION REQUESTS FROM CONTRACTOR

1.6 FORMAT

1.7 FILENAME REQUIREMENTS

1.8 DUPLICATIONS

1.9 ORDER OF PRECEDENCE

1.10 CONTRACTUAL RESPONSE TIMEFRAMES

2.0 TRANSMITTALS

2.1 PRIMARY METHOD OF TRANSMITTAL

2.2 ALTERNATE METHOD OF TRANSMITTAL

2.2.1. CUI DELIVERABLES

2.3 CLASSIFIED DELIVERIES

3.0 DD FORM 1423 BLOCK INFORMATION

3.1 BLOCKS A-J

3.2 BLOCKS 1-18

ATTACHMENT 1 - LETTER OF TRANSMITTAL TEMPLATE

ATTACHMENT 2 - CONTRACT DATA REQUIREMENTS LIST TABLE OF CONTENTS

Exhibit A Revision History

Date Mod No. Description

1.0 GENERAL INSTRUCTIONS

The Contract Data Requirements List (CDRL) contains a complete list of data deliverables for related Contract

Line Item Numbers. The general instructions provided herein are in accordance with DoD 5010.12-M, Procedures for the Acquisition and Management of Technical Data, dated May 1993. In compliance with the

Reduction of Paper Act, electronic delivery of data is required whenever possible. Unless otherwise stated in

Block 16 of DD Form 1423, all dates are business days. Business days are defined as Federal Government workdays and do not include weekends (Saturdays/Sundays) or United States Federal Holidays

(www.opm.gov). The date that the full delivery (Letter of Transmittal and all portions of the data delivery) is received will be identified and recorded as the received date.

* These standard submission requirements and instructions may be tailored by Data Management to meet your specific contractual requirements.

Below are the positions, names and email addresses for the points of contact identified within this document at this time. Contact information will be updated by the Program Management Office (PMO) as necessary.

Procurement Contracting

Officer (PCO) Filomena Gomez filomena.gomez@us.af.mil

Contract Specialist/Buyer Adam Walker adam.walker.26@us.af.mil

Program Manager (PM) Erika Leach C Lt Col USAF erika.leach.1@us.af.mil

Project Lead (PL) Steven Riley steven.riley.2.ctr@us.af.mil

Data Manager (DM) Robin Tisbert AFLCMC.HNI.Data.Manager@us.af.mil

1.1 CDRL Submissions

All CDRL Submissions shall be identified in a Letter of Transmittal sent to the AFLCMC/HNI DM

Common Mailbox, with copy to the Program Management Office (PM and PL), the PCO and the

Contract Specialist/Buyer (reference paragraph 1.2 and ATTACHMENT 1 - Letter of Transmittal

Template) with the following:

a. Contractor’s name and company

b. Contractor’s Letter of Transmittal number (numbered sequentially)

c. Contract number and delivery order number

d. CDRL Number, CDRL Name/ title of deliverable, and deliverable filename

e. Indication of first submittal, draft or final submission

f. Revision identification (R1, R2, etc.) and disapproving PCO letter number if applicable

g. Submission date

h. Distribution list

i. Attachment of adjudicated Government comments if applicable

1.2 Letter of Transmittal

A template for the Letter of Transmittal is provided as ATTACHMENT 1 - Letter of Transmittal Template.

The Letter of Transmittal shall be uniquely, incrementally and consistently numbered, with the numbering convention to be created and provided by the Data Manager. The primary format of the Letter of

Transmittal shall be as a Word document (.docx).

http://www.opm.gov/ mailto:filomena.gomez@us.af.mil mailto:adam.walker.26@us.af.mil erika.leach.1@us.af.mil mailto:steven.riley.2.ctr@us.af.mil mailto:AFLCMC.HNI.Data.Manager@us.af.mil

The purpose and intent of the Letter of Transmittal is for the formal notification of CDRL submission

ONLY and shall not contain any information or content contractually required to be submitted as a CDRL deliverable. The Letter of Transmittal shall not be used as a substitute for a formal deliverable document.

The PCO and Contract Specialist/Buyer do NOT receive the entire delivery, ONLY the Letter of

Transmittal, which shall be provided in a separate email from the complete data delivery.

1.3 Restrictions

a. Deliverables shall not contain any proprietary markings.

b. One (1) CDRL per transmittal letter. Multiple submissions of the same CDRL are allowable, but may not exceed five (5) per transmittal letter.

1.4 Corrective Action Requests and Rescinding Deliveries

Corrective action requests made by the Data Manager or the PMO do not require the total recension of a submission. When it is necessary to rescind a delivery, rescind requests shall be made formally within two

(2) business days of original delivery. The request shall be in the form of a Letter of Transmittal sent via email from the Contractor’s Contracting Officer to the Government PCO, the Contract Specialist/Buyer and the AFLCMC/HNI DM Common Mailbox. Rescind requests shall not be made informally. If not completed within this timeframe, the original delivery will be processed according to contractual requirements.

1.5 Extension Requests from Contractor

If the contractor cannot meet the required CDRL due date, an Extension Request is required. The request shall be in the form of a Letter of Transmittal sent via email from the Contractor’s Contracting Office to the Government PCO, the Contract Specialist/Buyer and AFLCMC/HNI DM Common Mailbox. The extension request Letter of Transmittal shall be received prior to the late due date.

1.6 Format

All documents shall be delivered with no digital rights management (free from password protection unless otherwise specified in Block 16 of the DD Form 1423 or the SOW/PWS) and shall be compatible with

Microsoft Office TM 2016. All electronic format submittals shall be word-searchable and editable (not scanned), except for signed documents. All technical data shall be submitted digitally, and documents shall be delivered virus-free. To protect the Air Force networks, malicious file types are blocked by the email infrastructure. In the case of blocked files, an alternate file format may be requested. If the substitute format fails, utilize one of the alternate methods of delivery (reference paragraphs 2.2 and 2.3).

1.7 Filename Requirements

Filename limitations are imposed for data deliveries. Ensure the delivery will be accepted by following the nomenclature criteria for all files:

▪ No special characters except underscore (_) or dash (-)

▪ 35 character limitation

▪ No spaces

▪ Utilize R1, R2, etc. to indicate resubmittals (when applicable)

▪ Filenames shall be representative of file contents, using the following naming conventions:

• Letters of Transmittal: Program Acronym Name LoT#-CDRL #-CDRL Name Date

• CDRL Deliverable: Program Acronym Name_CDRL#_CDRL Name_Date

1.8 Duplications

The Contractor shall make every effort to avoid duplicating data previously procured by the Government, except to provide required copies to additional recipients under the contract. Recommendations are encouraged for deletions, additions, substitutions, consolidations, and use of existing contractor or subcontractor formats of data when such actions will aid the procuring agency in obtaining minimum essential data in a timely and cost effective manner.

1.9 Order of Precedence

The following order of precedence (highest priority identified first) applies to data requirements when there is a discrepancy between the three sources:

a. Statement of Work (SOW)/Performance Work Statement (PWS)

b. CDRLs

c. Data Item Description (DID)

1.10 Contractual Response Timeframes

Response times are contractual commitments.

a. Required Government Review/Response - Unless otherwise specified in Block 16 of the DD Form

1423 or the SOW/PWS, if response is to be provided, the Government will respond no later than twenty (20) business days after receipt of the delivery. Status inquires for late responses shall be delivered formally via Letter of Transmittal.

b. Contractor Resubmittal - Resubmittals in response to Government disapprovals shall be made by the contractor no later than ten (10) business days after receipt of Government comments unless otherwise specified in the disapproval letter or contracting documentation (i.e., SOW/PWS, DD

1423 Blk 16).

c. Review/Resubmittal Cycles - The review/resubmit cycle shall continue as stated above until the delivery is approved.

d. Non Required Government Review/Response – In cases where Government response is not contractually required, the Government retains the right to review and provide comments as necessary. Such a response may require resubmittal by the Contractor as directed by the

Government.

2.0 TRANSMITTALS

2.1 Primary Method of Transmittal

In all cases, a softcopy of the Letter of Transmittal ONLY (reference paragraph 1.2) shall be delivered via email to the PCO and Contract Specialist/Buyer. For every submission, the Letter of Transmittal along with the actual CDRL deliverable shall be electronically submitted in a single email via EMAIL to the Data

Manager (AFLCMC/HNI DM Common Mailbox). Exceptions:

a. The Alternate Method of Delivery is necessary (reference paragraph 2.2.)

b. As directed by the Government in Block 16 of the DD Form 1423 or the SOW/PWS

c. The delivery is over 8 MB in total size

d. The delivery contains CUI (Controlled Unclassified Information) (reference paragraph 2.2.1)

e. The delivery contains classified materials (reference paragraph 2.3)

2.2 Alternate Method of Transmittal

All files larger than 8 MB shall be delivered via the DoD SAFE site (https://safe.apps.mil/). DoD SAFE is also the alternate option for files requiring encryption. Encrypted files shall not be submitted directly to the

AFLCMC/HNI DM Common Mailbox.

NOTE: If the DoD SAFE site is not available, direction for submittal will be identified by the

Program Manager (PM).

In all cases of Alternate Delivery, a softcopy of the Letter of Transmittal ONLY shall still be delivered via

EMAIL to the PCO, cc’d to the Contract Specialist/Buyer and delivered via EMAIL to the Data Manager

(AFLCMC/HNI DM Common Mailbox).

The DoD SAFE pick up notice SHALL NOT be considered a substitute for the Transmittal

Letter requirement.

When uploading to DoD SAFE, the following shall be included in the “Description of File(s)” field:

a. Contract number and delivery order number

b. Program Name or acronym (if applicable)

c. CDRL number and title of deliverable

d. Date

e. Contractor’s Letter of Transmittal number (sequential numbering)

f. List of filenames that have been uploaded to DoD SAFE

When uploading to DoD SAFE, the following shall be included in the “Recipient Information” field:

▪ AFLCMC/HNI DM Common Mailbox

▪ Selected members of PMO review teams

2.2.1. CUI Deliverables:

Please review your files carefully to ensure they meet the criteria for CUI/encryption requirements. CUI requires proper identification and portion marking as necessary.

2.3 Classified Deliveries

Classified data submissions shall have the classified data integrated into the body of the document (i.e., classified annexes or attachments are not acceptable). Classified data, COMSEC or CCI data shall be handled and delivered and packaged in accordance with the current versions of the DoD 5220.22, National

Industrial Security Program – Operating Manual and NSA 90-1, NSA Industrial COMSEC Manual.

2.3.1 Delivery Option 1: Delivery via SIPRNet email

Use only the SIPRNet email address provided in Block 16 of the DD Form 1423. If no SIPRNet email address is provided, contact the assigned PM.

2.3.2 Delivery Option 2: Classified Delivery via CD/DVD

CDs and DVDs shall be marked appropriately with the following information:

a. Contract number and delivery order number

b. Creation Date https://safe.apps.mil/

c. CDRL number and title of deliverable

d. STINFO statement, including destruction notice (reference paragraph 3.2, block 9)

e. Classification level (Top Secret, Secret, Confidential)

f. Statutory markings (CUI markings as necessary)

g. Contractor’s Letter of Transmittal number (sequential numbering)

2.3.2.1 Inside Wrap (highest classification/dissemination control on top and bottom of both sides of envelope):

AFLCMC/HNI

Attn: (DM name)

15 Eglin Street, Bldg. 1607

2.3.2.2 Outside Wrap (NO classification markings):

AFLCMC/HNI

Attn: AFLCMC/HNI Security Manager

15 Eglin Street, Bldg. 1607

When sending CDs/DVDs, a hard copy of the Letter of Transmittal shall be included. In all cases, a softcopy of the Letter of Transmittal ONLY shall be delivered via NIPRNet unclassified email to the PCO and cc’d to the Contract Specialist/Buyer and the Data Manager (AFLCMC/HNI DM Common Mailbox) to serve as notice of delivery. The Letter of Transmittal shall include the FedEx tracking number. The contractor shall deliver two (2) copies of the CDs/DVDs unless otherwise specified in the DD Form 1423 or the SOW/PWS.

3.0 DD FORM 1423 BLOCK INFORMATION

3.1 Blocks A-J

Block A - Contract Line Item Number

Block B - Exhibit

Block C - Category

Block D - System/Item

Block E - Contract/PR Number

Block F - Contractor

Block G - Prepared By

Block H – Prepared Date

Block I - Approved by

Block J – Approval Date

3.2 Blocks 1-18

Block 1 – Data Item Number

Block 2 - Title of Data Item

Block 3 - Subtitle

Block 4 - Authority (Data Acquisition Document Number)

Block 5 - Contract Reference

Block 6 - Requiring Office

Block 7 - DD 250 Requirement

a. Final Air Force Technical Orders (TOs): Engineering Drawings delivered to an Air Logistics

Engineering Data Service Center

b. Data to be used by Air Force personnel for operation, installation, or maintenance, even though equipment and/or software will not be transferred to AFLC (AFR 800-4).

Acceptance

In sp ec ti o n

S

(at source)

D

(at destination)

S

(at source)

SS

(Inspection at source, acceptance at source)

SD

(Inspection at source, acceptance at destination)

D

(at destination)

DS

(Inspection at destination, acceptance at source)

DD

(Inspection at destination, acceptance at destination)

LT

(Letter of Transmittal Required)

NO

(No inspection or acceptance required; not authorized for TDPs or TMs)

XX

(Inspection & acceptance specified elsewhere in the contract)

Table 1

Block 8 - Approval Code - Written approval is identified by an “A” in this field; if approval of the data item is not required, field will show “N/A”

Block 9 - Distribution Statement Required

Distro Definition

A Approved for public release; distribution unlimited

B Distribution authorized to US Government agencies only

C Distribution authorized to US Government agencies and their contractors

D Distribution for Department of Defense (DoD) and US DoD contractors only

E Distribution authorized to DoD components only

F Further dissemination only as directed by the Controlling or Originating DoD office

Table 2

Block 10 – Frequency

Code Frequency

ANNLY Annually

ASGEN As generated (requires further explanation in block 16)

ASREQ As required (requires further explanation in block 16)

BI-MO Every 2 months

BI-WE Every 2 weeks

DAILY Daily

DFDEL Deferred delivery

MTHLY Monthly

ONE/P One Preliminary

ONE/R One time with revisions

QRTLY Quarterly

R/ASR Revision as required (requires further explanation in block 16)

SEMIA Every 6 months

WEKLY Weekly

XTIME Number of times to be submitted (a number must be inserted in place of the "X”)

Table 3

Block 11 - As of Date

Block 12 - Date of First Submission

Code Frequency

ASGEN As generated (provide specific instructions for these requirements in block 16)

ASREQ As required (provide specific instructions for these requirements in block 16)

XXDAC Days after contract start (a number must be inserted in place of the "X)

DFDEL Deferred delivery (provide specific instructions for these requirements in block 16)

EOC End of contract

EOM End of month

EOQ End of quarter

XDACM Days after contract modification (a number must be inserted in place of the "X”)

XDARP Days after reporting period (a number must be inserted in place of the "X”)

XDARC Days after receipt of comments (a number must be inserted in place of the "X”)

XDATC Days after test completion (a number must be inserted in place of the "X”)

XDPTT Days before to test (a number must be inserted in place of the "X”)

XDADO Days after delivery order (a number must be inserted in place of the "X”)

Table 4

Block 13 - Date of Subsequent Submission used when data needs to be submitted more than once. (Not to be confused with “Resubmit” when there are issues with a previous submission)

Block 14 - Distribution - Includes the addressees and corresponding number of draft copies and final copies to be provided to each addressee

Block 15 - The total number of draft/final copies to be delivered

Block 16 - Additional or clarifying remarks such as DID tailoring, distribution requirements and addresses, and additional submission instructions

A-1

ATTACHMENT 1 - Letter of Transmittal Template

COMPANY LETTERHEAD

Date of Letter Program Name or Acronym-00x

(PROVIDED BY DM)

TRANSMITTED BY ELECTRONIC MAIL

C3I Infrastructure Division Contracting Office (HNIK)

Attn: Name of Procurement Contracting Officer

3 Eglin St, Bldg. 1612

Hanscom AFB, MA 01731-2110

Subject: Transmittal of CDRL Number CDRL Name (include document filename)

Reference: 1. Contract Number XXXX, Task/Delivery Order XXXX

Dear PCO Name:

(Vendor Name) is pleased to provide the subject document(s) (document filename) in accordance with the requirements of the referenced Contract/Delivery Order.

The subject CDRL has been submitted via Electronic Mail Message. (or approved alternate delivery method, i.e.

DoD SAFE)

Technical inquiries regarding this submittal should be directed to name of Contractor’s PM and matters of contractual nature to name of Contractor’s PCO at telephone and/or e-mail address.

Sincerely, Vendor Signature Block

Attachment(s):

1. CDRL Number CDRL Name (include document filename)

(Additional items as needed) cc:

Contract Specialist/Buyer’s Name ((PCO and Contract Specialist receive Letter of Transmittal Only)

Program Management Office

AFLCMC/HNI Data Manager Mailbox (aflcmc.hni.data.manager@us.af.mil) mailto:aflcmc.hni.data.manager@us.af.mil

A-2

ATTACHMENT 2 - Contract Data Requirements List Table of Contents

CDRL # DID # Title Subtitle

A001 DI-ADMN-81249B Conference Agenda Agendas and Presentation

Materials

A002 DI-ADMN-81505 Report, Record of Meeting/Minutes Meeting Minutes

A003 DI-MGMT-80368A Status Report Monthly Status Report (MSR)

A004 DI-MGMT-81419 Personnel Report Contractor Roster

A005 DI-CMAN-80858B

Contractor’s Configuration Management

Plan Configuration Management Plan

A006 DI-SESS-81759 Logistics Product Data Summaries Incident Report/Log

A007 DI-PACK-80120C Preservation and Packing Data Shipping Log

A008 DI-MGMT-80995A Maintenance Service Report Material Support Requests

A009 DI-MGMT-80269

Status of Government Furnished

Equipment (GFE) Report GFE Report

A010 DI-MGMT-8004A Management Plan Transition Plan

A011 DI-MISC-80711A Scientific & Technical Reports Trend Analysis

A012 DI-ADMN-81306

Program Protection Implementation Plan

(PPIP)

PPIP

A013 DI-MGMT-81453A Data Accession List (DAL) DAL

A014 DI-MISC-80711A Scientific & Technical Reports DLA Disposition Services

Report

A015 DI-MISC-81107A Inventory Utilization Data Report GFE Physical Inventory

A016 DI-SAFT-81563A Accident/Incident Report Mishap Report

A-3

ATTACHMENT 3 - DD 1423 Forms

CONTRACT DATA REQUIREMENTS LIST (CDRL)

(1 Data Item) 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:

CLIN, 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER ADMN

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A001 Conference Agenda Agendas and Presentation Materials

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

DI-ADMN-81249B/T PWS Para 3.4.1 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

N/A N/A See Blk 16 Reg Repro

16. REMARKS

AFLCMC/HNI 1

All submissions shall be marked IAW with contractual data rights clauses

All submissions shall be in electronic, editable format in accordance with the

Exhibit A General Instructions submission requirements.

Blk 4: The Data Item Description is tailored as follows:

Delete paragraphs 3d, 3e, 3g, 3h, 3i

Blks 10, 12 & 13:

Submit NLT ten (10) business days before all meetings requiring presentation materials including but not limited to the following:

Kick Off Meeting Program Management Reviews (PMRs)

Blk 14: All submissions shall be delivered via email to the Data

Management Common Mailbox: (aflcmc.hni.data.manager@us.af.mil) with copy to the Program Management Office

*AFLCMC/HNIK shall receive the letter of transmittal only.

AFLCMC/HNIK*

*see Blk 16

15. TOTAL ▬▬▬▬► 1

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

Robin Tisbert Data Manager, AFLCMC/HNIB //SIGNED// Lt Col Erika Leach USAF

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM ADMN

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A002 Report, Record of Meeting/Minutes Meeting Minutes

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

DI-ADMN-81505/T PWS Para 3.4.1, 3.4.2 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

All submissions shall be in electronic, editable format in accordance with the Exhibit A

General Instructions submission requirements.

Delete paragraph: 10.4

Initial submission is due NLT five (5) business days after Kick Off Meeting. Subsequent submissions are due NLT five (5) business days after meeting event.

Blk 14: All submissions shall be delivered via email to the Data Management Common

Mailbox: (aflcmc.hni.data.manager@us.af.mil) with copy to the Program Management

Office

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 2 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER MGMT

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A003 Status Report MSR

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

DI-MGMT-80368A/T PWS Para 3.3, 3.4, 3.7, 3.7.2.3 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk16 See Blk16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

N/A N/A See Blk16 Reg Repro

A copy of the MSR Template for reporting will be provided in softcopy as

Government Furnished Information (GFI).

Blk4: Data Item Description is tailored as follows:

Delete: 3.2.3 Itemized man-hours and costs. Itemized man-hour and cost expenditure incurred for the reporting period by category and task.

Blk 10, 12 &13: Submit no later than the fifth (5th) business day of each month.

Report should be current as of the last business day of the previous month.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 3 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER MISC

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A004 Personnel Report Contractor Roster

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

DI-MISC-81419/T PWS Para 3.2.3 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk16 See Blk16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

N/A N/A See Blk16 Reg Repro

Delete 10.2.1, 10.2.2, 10.2.4

Submit initial report NLT twenty (20) business days after contract award. Report updates shall be submitted NLT five (5) business days after each addition, change in status, or departure from the project.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 4 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER CMAN

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A005 Contractor’s Configuration Management Plan CM Plan

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

DI-CMAN-80858B PWS Para 3.6 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED 1TIME See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

Submission shall be due NLT thirty (30) business days after contract award.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 5 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER SESS

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A006 Logistics Product Data Summaries Incident Report/Log

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

DI-SESS-81759/T PWS Para 3.5, 3.7.4, 3.7.7 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

Delete paragraphs: 3, 3.1, 3.2, 3.3, 3.4, 3.5, 3.6, 3.7, 3.8

Use the latest version of the Government Furnished Spreadsheet provided as GFI

Blk 10, 12, &13:

Initial submission is due NLT twenty (20) business days after contract award.

Subsequent submissions are due weekly, NLT close of business on Friday.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 6 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER PACK

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A007 Preservation and Packing Data Shipping Log

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

DI-PACK-80120C/T PWS Para 3.4.2, 3.7.3 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

Delete 1 and 2.1

Blk 10, 12 & 13:

Submissions are due NLT the third (3rd) day of each month. Report should be current as of the last business day of the previous month.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 7 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER MGMT

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A008 Maintenance Service Report Material Support Requests

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

DI-MGMT-80995A/T PWS Para 3.3.1 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

Delete Paragraphs 3.1.c, 3.1.h, 3.1.i, 3.1.j, 3.1.k and 3.6

Submissions are due NLT close of business on Friday.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 8 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER MGMT

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A009 Status of Government Furnished Equipment (GFE) Report GFE Report

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

DI-MGMT-80269/T PWS Para 3.7, 3.8, 5, 6.2, 6.3, 6.5 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

Use the latest version of the Government Furnished Spreadsheet provided as GFI.

Blk 4: Tailor the Data Item Description as Follows:

Delete paragraphs 10.2.8, 10.2.9

10.2.2 remove Nomenclature change to description

10.2.3 remove NSN change to part number

Initial submission is due thirty (30) business days after receipt of Government furnished property (GFP). Subsequent submissions shall be every twelve (12) months.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 9 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER MGMT

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A010 Management Plan Transition Plan

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

DI-MGMT-8004A/T PWS Para 6.2, 6.4, 6.5 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

A N/A See Blk 16 Reg Repro

Blk 10, 12, and 13: First submission due at contract award. Any changes to the plan shall be submitted within three (3) business days

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 10 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER MISC

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A011 Scientific & Technical Reports Trend Analysis

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

DI-MISC-80711A/T PWS Para 3. AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

N/A See Blk 16 See Blk 16 Reg Repro

Delete paragraphs: 10.2, 10.3

Blks 10,11, 12 & 13: Reports shall be submitted as required

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 11 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER ADMN

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A012 Program Protection Implementation Plan PPIP

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

DI-ADMN-81306/T PWS Para 3.7.8.2 AFLCMC/HNI

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED ONE/R See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

Use the latest version of the ID-0171-HNI PPIP template provided as GFI.

Blk 4: Tailor the Data Item Description as follows:

Delete Paragraphs 7.1 and 7.2 and 10.1.d

Initial submissions is due NLT sixty (60) business days after contract award.

If issues are identified, the comments shall be incorporated into an updated version due NLT ten (10) business days after receipt of Government response.

Blk 14: All submissions shall be delivered via email to the

Data Management Common Mailbox: (aflcmc.hni.data.manager@us.af.mil) with copy to the Program Management Office

Robin TisbertData Manager, AFLCMC/HNIB //SIGNED// Lt Col Erika Leach USAF

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 12 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM

OTHER MGMT

GMT

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A013 Data Accession List

DAL

DI-MGMT-81453A

PWS Para 3.5

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16

See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

Blk 10, 12, and 13:

Submissions are due NLT the tenth (10th) business day of the month and shall be current as of the last business day of the previous month.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 13 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER MISC

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A014 Scientific and Technical Reports

DLA Disposition Services Report

DI-MISC-80711A/T

PWS Para 5

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

Delete paragraphs: 10.2, 10.3

Updated report shall be submitted NLT thirty (30) business days after any equipment change (assets/parts/materials).

If issues are identified, the comments shall be incorporated into an updated version due NLT ten (10) business days after receipt of Government response.

Blk 14: All submissions shall be delivered via email to the Data Management

Common Mailbox: (aflcmc.hni.data.manager@us.af.mil) with copy to the

Program Management Office

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 14 of 16 Pages

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:

CLIN 0002,1002,2002,3002,

4002,4012

A TDP TM OTHER SAFT

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

TDC Contractor Logistics Support

(CLS)

TBD TBD

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

A016 Accident/Incident Report Mishap Report

DI-SAFT-81563A/T

PWS Para 5.2

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED See Blk 16 See Blk 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

Paragraph 3.a. delete word "nomenclature"

Block 10, 12, & 13:

Report shall be submitted without delay in the event of any serious accident or incident O.E. (explosion, fire, flood, pressure rupture, major malfunction) which will adversely affect capability to meet contractual obligations. The report shall be generated by the fastest means, providing all pertinent information.

Blk 14: All submissions shall be delivered via email to the Data Management

Common Mailbox: (aflcmc.hni.data.manager@us.af.mil) with copy to the Program Management Office

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 16 of 16 Pages