Attachment 5 CDRLs A001-A005 Redacted.pdf
PDF 192 KB Posted
- Attached to
- Reidville Hydraulics and Manufacturing, Inc. Thin Line Towed Array Federal contract opportunity
- Solicitation number
- N66604-21-Q-0068
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| Attachment 2 Provision 52.204-24 and Clause 52.204-25.pdf | ||
| Attachment 3 Vendor Information Request.docx | DOCX document | |
| Attachment 1 Combined Synopsis Solicitation.docx | DOCX document | |
| Attachment 4 Receipt Inspection Report.docx | DOCX document |
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Text version
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
Form Approved OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Service, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704- 0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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
A
C. CATEGORY
TDP_________ TM___________ OTHER MISC
D. SYSTEM/ITEM
15 - 9070 MOTOR PARTS REIDVILLE
E. CONTRACT / PR NO.
N66604-21-SIMACQ-NPT-15-0015
F. CONTRACTOR
REIDVILLE HYDRAULICS & MFG, INC.
1. DATA ITEM NO.
A001
2. TITLE OF DATA ITEM
CERTIFICATE OF COMPLIANCE
3. SUBTITLE
CERTIFICATE OF COMPLIANCE (COC)
17. PRICE
GROUP
4. AUTHORITY (Date Acquisition Document No.)
DI-MISC-81356A
5. CONTRACT REFERENCE
RIR_QAP_W03565
6. REQUIRING OFFICE
NPT-15-NUWC 18. ESTIMATED
TOTAL PRICE
7. DD 250 REQ 9. DIST STATEMNT
REQUIRED
10. FREQUENCY
OTIME
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION
LT
D
b. COPIES
8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE
Draft Final
N/A N/A N/A Reg Repro
16. REMARKS NPT-15-NUWC 0 1 0
Block 9: Distribution Statement D: Distribution authorized to the Department of Defense and U.S.
DoD contractors only; Critical Technology. Other requests for this document shall be referred to Naval Undersea Ware Center, Keyport Division.
Block 12: Submit certification of compliance data sheet upon completion of each delivered batch.
15. TOTAL ______> 0 1 0
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 1 of 5 Pages
Form Approved OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Service, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704- 0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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
A
C. CATEGORY
TDP_________ TM___________ OTHER MISC
D. SYSTEM/ITEM
15 - 9070 MOTOR PARTS REIDVILLE
E. CONTRACT / PR NO.
N66604-21-SIMACQ-NPT-15-0015
F. CONTRACTOR
REIDVILLE HYDRAULICS & MFG, INC.
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM
CERTIFICATE OF COMPLIANCE
3. SUBTITLE
MERCURY FREE CERTIFICATION
17. PRICE
GROUP
4. AUTHORITY (Date Acquisition Document No.)
DI-MISC-81356A
5. CONTRACT REFERENCE
RIR_QAP_W03565
6. REQUIRING OFFICE
NPT-15-NUWC 18. ESTIMATED
TOTAL PRICE
7. DD 250 REQ 9. DIST STATEMNT
REQUIRED
10. FREQUENCY
OTIME
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION
LT
D
b. COPIES
8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE
Draft Final
N/A N/A N/A Reg Repro
16. REMARKS NPT-15-NUWC 0 1 0
Block 9: Distribution Statement D: Distribution authorized to the Department of Defense and U.S.
DoD contractors only; Critical Technology. Other requests for this document shall be referred to Naval Undersea Ware Center, Keyport Division.
Block 12: Mercury Free Certification data sheet upon completion of each delivered batch.
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 2 of 5 Pages
Form Approved OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Service, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704- 0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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
A
C. CATEGORY
TDP_________ TM___________ OTHER MISC
D. SYSTEM/ITEM
15 - 9070 MOTOR PARTS REIDVILLE
E. CONTRACT / PR NO.
N66604-21-SIMACQ-NPT-15-0015
F. CONTRACTOR
REIDVILLE HYDRAULICS & MFG, INC.
1. DATA ITEM NO.
A003
2. TITLE OF DATA ITEM
TECHNICAL REPORT - STUDY/SERVICES
3. SUBTITLE
CERTIFICATE OF ANALYSIS
17. PRICE
GROUP
4. AUTHORITY (Date Acquisition Document No.)
DI-MISC-80508B
5. CONTRACT REFERENCE
RIR_QAP_W03565
6. REQUIRING OFFICE
NPT-15-NUWC 18. ESTIMATED
TOTAL PRICE
7. DD 250 REQ 9. DIST STATEMNT
REQUIRED
10. FREQUENCY
OTIME
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION
LT
D
b. COPIES
8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE
Draft Final
N/A N/A N/A Reg Repro
16. REMARKS NPT-15-NUWC 0 1 0
Block 9: Distribution Statement D: Distribution authorized to the Department of Defense and U.S.
DoD contractors only; Critical Technology. Other requests for this document shall be referred to Naval Undersea Ware Center, Keyport Division.
Block 12: Certificate of Analysis data sheet upon completion of each delivered batch.
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 3 of 5 Pages
Form Approved OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Service, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704- 0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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
A
C. CATEGORY
TDP_________ TM___________ OTHER MISC
D. SYSTEM/ITEM
15 - 9070 MOTOR PARTS REIDVILLE
E. CONTRACT / PR NO.
N66604-21-SIMACQ-NPT-15-0015
F. CONTRACTOR
REIDVILLE HYDRAULICS & MFG, INC.
1. DATA ITEM NO.
A004
2. TITLE OF DATA ITEM
TECHNICAL REPORT - STUDY/SERVICES
3. SUBTITLE
PROCESS CERTIFICATION
17. PRICE
GROUP
4. AUTHORITY (Date Acquisition Document No.)
DI-MISC-80508B
5. CONTRACT REFERENCE
RIR_QAP_W03565
6. REQUIRING OFFICE
NPT-15-NUWC 18. ESTIMATED
TOTAL PRICE
7. DD 250 REQ 9. DIST STATEMNT
REQUIRED
10. FREQUENCY
OTIME
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION
LT
D
b. COPIES
8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE
Draft Final
N/A N/A N/A Reg Repro
16. REMARKS NPT-15-NUWC 0 1 0
Block 9: Distribution Statement D: Distribution authorized to the Department of Defense and U.S.
DoD contractors only; Critical Technology. Other requests for this document shall be referred to Naval Undersea Ware Center, Keyport Division.
Block 12: Process Certification data sheet upon completion of each delivered batch.
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 4 of 5 Pages
Form Approved OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Service, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704- 0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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
A
C. CATEGORY
TDP_________ TM___________ OTHER MISC
D. SYSTEM/ITEM
15 - 9070 MOTOR PARTS REIDVILLE
E. CONTRACT / PR NO.
N66604-21-SIMACQ-NPT-15-0015
F. CONTRACTOR
REIDVILLE HYDRAULICS & MFG, INC.
1. DATA ITEM NO.
A005
2. TITLE OF DATA ITEM
TECHNICAL REPORT - STUDY/SERVICES
3. SUBTITLE
TEST DATA
17. PRICE
GROUP
4. AUTHORITY (Date Acquisition Document No.)
DI-MISC-80508B
5. CONTRACT REFERENCE
RIR_QAP_W03565
6. REQUIRING OFFICE
NPT-15-NUWC 18. ESTIMATED
TOTAL PRICE
7. DD 250 REQ 9. DIST STATEMNT
REQUIRED
10. FREQUENCY
OTIME
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION
LT
D
b. COPIES
8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE
Draft Final
N/A N/A N/A Reg Repro
16. REMARKS NPT-15-NUWC 0 1 0
Block 9: Distribution Statement D: Distribution authorized to the Department of Defense and U.S.
DoD contractors only; Critical Technology. Other requests for this document shall be referred to Naval Undersea Ware Center, Keyport Division.
Block 12: Test data sheet upon completion of each delivered batch.
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 5 of 5 Pages
DD FORM 1423, CONTRACT DATA REQUIREMENTS LIST
BLOCK 16 ADDENDUM
PR 1300887599
BLOCK 9: The following information is provided in amplification of the Block 9 Distribution Statement shown on each DD FORM 1423.
Distribution Statement paragraphs are in addition to CLASSIFICATION markings of the data.
CDRLs A001 through A005
Distribution Statement D . Distribution authorized to U.S. Government Agencies and their contractors (Critical Technology) (4/26/2017). Other requests for this document shall be referred to insert (controlling DoD office – NUWCDIVNPT Code 1534
The following 'EXPORT CONTROL WARNING NOTICE' must be used in conjunction with DISTRIBUTION STATEMENTS identified in all CDRL Items:
WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C. Sec. 2751, et seq.) or the Export Administration Act of 1979, as amended, Title 50, U.S.C., App.
2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.
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