Attachment 6 - Combined CDRLs.pdf

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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 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

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423-1 (BACK), FEB 2001

data_item: A005 title: Spare Parts Usage Report sub: Parts Report auth: DI-ILSS-80483(T) ref: PWS PARA 2.5.1 and 2.7.5 req_ofc: OO-ALC/OBCA dd250: L/T appcode: N/A dist: A freq: WEEKLY asof: Block 16 firstsub: Block 16 subsub: WEEKLY addressee1: OO-ALC/OBCA draft1:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: Provide Parts Report IAW PWS. Acceptable format is most recent version MS Word, MS Excel, Adobe pdf.

Delete DID requirements 10.2.2 - 10.2.4; 10.2.5.1 (b, c, d);10.2.5.3; 10.2.5.4.2 - 10.2.5.4.5; 10.2.5.5 - 10.2.5.8; 10.3 - 10.4

Block 9. Distribution Statement A: authorized for public release.

Block 10, 11, 12, and 13: weekly on Monday or first business day of the week.

Block 14:

John Conner

OO-ALC/OBCA

Contracting Officer Representative john.conner.10@us.af.mil Deliver electronic copy

Justin Palmatier

OO-ALC/OBCA

Contracting Officer Representative justin.palmatier.2@us.af.mil Deliver electronic copy group: NSP total_price:

prep_name: Justin L. Simmons line_item:

exhibit: A xtdp: Off xtm: Off othercat: ILSS system: Aerospace Ground Equipment (AGE) ctr_no:

contr:

remarksb:

Page2:

Reset:

2020-09-24T15:37:10-0600

SIMMONS.JUSTIN.LEE.1256189212

prep_date: 20200923 app_by: Justin Marshburn

2020-10-06T08:49:16-0600

MARSHBURN.JUSTIN.LEE.1257774836

app_date: 20201006

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A006 title: Test/Inspection Report sub: Equipment Abuse Report auth: DI-NDTI-80809B(T) ref: PWS PARA 2.7.6 req_ofc: OO-ALC/OBCA dd250: L/T appcode: N/A dist: A freq: ASREQ asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: OO-ALC/OBCA draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Provide Equipment Abuse Report IAW PWS. Acceptable format most recent version MS Word, Adobe pdf.

Delete DID requirements 10.2.3.2 (f, g, h); 10.2.3.3; 10.2.4 (a,b,c); 10.2.5;10.2.6.1 (d, e); 10.2.6.2 - 10.2.8

Block 9. Distribution Statement A: approved for public release.

Block 10, 11, 12, and 13: as occurs.

Block 14:

John Conner

OO-ALC/OBCA

Contracting Officer Representative john.conner.10@us.af.mil Deliver electronic copy

Justin Palmatier

OO-ALC/OBCA

Contracting Officer Representative justin.palmatier.2@us.af.mil Deliver electronic copy

Justin Simmons

OO-ALC/OBCA

AGE Program Manager justin.simmons.22@us.af.mil Deliver electronic copy group: NSP total_price:

prep_name: Justin L. Simmons line_item:

exhibit: A xtdp: Off xtm: Off othercat: NDTI system: Aerospace Ground Equipment (AGE) ctr_no:

contr:

remarksb:

Page2:

Reset:

2020-09-24T15:38:14-0600

SIMMONS.JUSTIN.LEE.1256189212

prep_date: 20200923 app_by: Justin Marshburn

2020-10-06T08:46:50-0600

MARSHBURN.JUSTIN.LEE.1257774836

app_date: 20201006

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A007 title: Technical Report–Study/Services sub: Maintenance Timeframe Report auth: DI-MISC-80508B(T) ref: PWS PARA 2.4.5.1 and 2.7.7 req_ofc: OO-ALC/OBCA dd250: L/T appcode: N/A dist: A freq: Monthly asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: OO-ALC/OBCA draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Maintenance Timeframe Report IAW PWS. Acceptable format is MS Word, MS Excel, Adobe pdf.

Delete DID Requirement 3 a, 3 b, 3 c (3).

Block 9: Distribution Statement A. Authorized for public release.

Block 11, 12, and 13: Monthly during first week of each month

Block 14:

John Conner

OO-ALC/OBCA

Contracting Officer Representative john.conner.10@us.af.mil Deliver electronic copy

Justin Palmatier

OO-ALC/OBCA

Contracting Officer Representative justin.palmatier.2@us.af.mil Deliver electronic copy

Justin Simmons

OO-ALC/OBCA

AGE Program Manager justin.simmons.22@us.af.mil Deliver electronic copy group: NSP total_price:

prep_name: Justin L. Simmons line_item:

exhibit:

xtdp: Off xtm: Off othercat: MISC system: Aerospace Ground Equipment (AGE) ctr_no:

contr:

remarksb:

Page2:

Reset:

2020-09-24T15:39:20-0600

SIMMONS.JUSTIN.LEE.1256189212

prep_date: 20200923 app_by: Justin Marshburn

2020-10-06T08:53:50-0600

MARSHBURN.JUSTIN.LEE.1257774836

app_date: 20201006

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A008 title: Test/Inspection Report sub: Quality Assessment Pass Rate Report auth: DI-NDTI-80809B(T) ref: PWS PARA 2.7.8 req_ofc: OO-ALC/OBCA dd250: L/T appcode: N/A dist: A freq: Monthly asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: OO-ALC/OBCA draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Provide Quality Assessment Pass Rate Report IAW PWS. Acceptable format is MS Word, MS Excel, Adobe pdf.

Delete DID requirements 10.2.3.2 (f, g, h); 10.2.3.3; 10.2.4 (a,b,c); 10.2.5; 10.2.6.1 (d, e); 10.2.6.2 - 10.2.8

Block 9: Distribution Statement A: authorized for public release.

Block 11, 12, and 13: Monthly within five business days following the end of each month.

Block 14:

John Conner

OO-ALC/OBCA

Contracting Officer Representative john.conner.10@us.af.mil Deliver electronic copy

Justin Palmatier

OO-ALC/OBCA

Contracting Officer Representative justin.palmatier.2@us.af.mil Deliver electronic copy

Justin Simmons

OO-ALC/OBCA

AGE Program Manager justin.simmons.22@us.af.mil Deliver electronic copy group: NSP total_price:

prep_name: Justin L. Simmons line_item:

exhibit: A xtdp: Off xtm: Off othercat: NDTI system: Aerospace Ground Equipment (AGE) ctr_no:

contr:

remarksb:

Page2:

Reset:

2020-09-24T15:40:29-0600

SIMMONS.JUSTIN.LEE.1256189212

prep_date: 20200923 app_by: Justin Marshburn

2020-10-06T08:48:15-0600

MARSHBURN.JUSTIN.LEE.1257774836

app_date: 20201006

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A009 title: Presentation Material sub: Program Management Review (PMR) Meeting Minutes auth: DI-ADMN-81373 ref: PWS Par 2.7.9 req_ofc: OO-ALC/OBCA dd250: L/T appcode: N/A dist: A freq: QTR asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: OO-ALC/OBCA draft1:

reg1: 3 repro1:

addressee2: OL:H/PZIMA draft2:

reg2: 1 repro2:

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total_draft: 0 total_reg: 4 total_repro: 0 remarks: Provide Program Management Review (PMR) Meeting Minutes IAW PWS. Acceptable formats are Microsoft Power Point (as used in PMR presentation), or Adobe Acrobat pdf.

Block 9: Distribution Statement A: authorized for public release.

Block 11, 12, and 13: Quarterly by the fifth business day following PMR or as requested by the contracting officer.

Block 14:

John Conner

OO-ALC/OBCA

Contracting Officer Representative john.conner.10@us.af.mil Deliver electronic copy

Justin Palmatier

OO-ALC/OBCA

Contracting Officer Representative justin.palmatier.2@us.af.mil Deliver electronic copy

Justin Simmons

OO-ALC/OBCA

AGE Program Manager justin.simmons.22@us.af.mil Deliver electronic copy

Brian Goodrich

OL:H/PZIMA

Administrative Contracting Officer brian.goodrich.1@us.af.mil Deliver electronic copy group: NSP total_price:

prep_name: Justin L. Simmons line_item:

exhibit: A xtdp: Off xtm: Off othercat: ADMN system: Aerospace Ground Equipment (AGE) ctr_no:

contr:

remarksb:

Page2:

Reset:

2020-09-24T15:42:30-0600

SIMMONS.JUSTIN.LEE.1256189212

prep_date: 20200923 app_by: Justin Marshburn

2020-10-06T08:51:47-0600

MARSHBURN.JUSTIN.LEE.1257774836

app_date: 20201006

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A010 title: Status of Government Furnished Equipment (GFE) Report sub: Government Furnished Equipment (GFE) Inventory Report auth: DI-MGMT-80269 ref: PWS PARA 2.7.10 req_ofc: OO-ALC/OBCA dd250: L/T appcode: N/A dist: A freq: ANNLY asof: Block 16 firstsub: Block 16 subsub: ANNLY addressee1: OO-ALC/OBCA draft1:

reg1: 3 repro1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Provide a Government Furnished Equipment (GFE) Inventory Report IAW PWS. Acceptable format most recent version MS Word, MS Excel, Adobe pdf.

Delete DID requirement 10.2.6

Block 9: Distribution Statement A: authorized for public release.

Block 11, 12, and 13: Annually during the first week of May.

Block 14:

John Conner

OO-ALC/OBCA

Contracting Officer Representative john.conner.10@us.af.mil Deliver electronic copy

Justin Palmatier

OO-ALC/OBCA

Contracting Officer Representative justin.palmatier.2@us.af.mil Deliver electronic copy

Justin Simmons

OO-ALC/OBCA

AGE Program Manager justin.simmons.22@us.af.mil Deliver electronic copy group: NSP total_price:

prep_name: Justin L. Simmons line_item:

exhibit: A xtdp: Off xtm: Off othercat: MGMT system: Aerospace Ground Equipment (AGE) ctr_no:

contr:

remarksb:

Page2:

Reset:

2020-09-24T15:43:26-0600

SIMMONS.JUSTIN.LEE.1256189212

prep_date: 20200923 app_by: Justin Marshburn

2020-10-06T08:50:16-0600

MARSHBURN.JUSTIN.LEE.1257774836

app_date: 20201006

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A011 title: Briefing Material sub: Refusal Report auth: DI-MGMT-81605 ref: PWS PARA 2.7.11 req_ofc: OO-ALC/OBCA dd250: L/T appcode: N/A dist: A freq: ASREQ asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: OO-ALC/OBCA draft1:

reg1: 3 repro1:

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addressee38:

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reg38x:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Provide AGE Refusal Report IAW PWS. Acceptable format is current version of MS Word, MS Excel, or Adobe pdf is acceptable.

Block 9: Distribution Statement A: authorized for public release.

Block 10, 11, 12, and 13: as occurs

Block 14:

John Conner

OO-ALC/OBCA

Contracting Officer Representative john.conner.10@us.af.mil Deliver electronic copy

Justin Palmatier

OO-ALC/OBCA

Contracting Officer Representative justin.palmatier.2@us.af.mil Deliver electronic copy

Justin Simmons

OO-ALC/OBCA

AGE Program Manager justin.simmons.22@us.af.mil Deliver electronic copy group: NSP total_price:

prep_name: Justin L. Simmons line_item:

exhibit: A xtdp: Off xtm: Off othercat: MGMT system: Aerospace Ground Equipment (AGE) ctr_no:

contr:

remarksb:

Page2:

Reset:

2020-09-24T15:44:22-0600

SIMMONS.JUSTIN.LEE.1256189212

prep_date: 20200923 app_by: Justin Marshburn

2020-10-05T14:45:51-0600

MARSHBURN.JUSTIN.LEE.1257774836

app_date: 20201005

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A012 title: Status of Government Furnished Equipment (GFE) Report sub: Lost Tool Report auth: DI-MGMT-80269(T) ref: PWS PARA 2.7.12 and 4.3 req_ofc: OO-ALC/OBCA dd250: L/T appcode: N/A dist: A freq: ASREQ asof: N/A firstsub: Block 16 subsub: Block 16 addressee1: OO-ALC/OBCA draft1:

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addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 3 total_repro: 0 remarks: Provide Lost Tool Report IAW PWS. Acceptable format most recent version MS Word, MS Excel, Adobe pdf.

Delete DID requirement 10.2.6

Block 9. Distribution Statement A: authorized for public release.

Block 10, 12, and 13: as occurs

Block 14:

John Conner

OO-ALC/OBCA

Contracting Officer Representative john.conner.10@us.af.mil Deliver electronic copy

Justin Palmatier

OO-ALC/OBCA

Contracting Officer Representative justin.palmatier.2@us.af.mil Deliver electronic copy

Justin Simmons

OO-ALC/OBCA

AGE Program Manager justin.simmons.22@us.af.mil Deliver electronic copy group: NSP total_price:

prep_name: Justin L. Simmons line_item:

exhibit: A xtdp: Off xtm: Off othercat: MGMT system: Aerospace Ground Equipment (AGE) ctr_no:

contr:

remarksb:

Page2:

Reset:

2020-09-24T15:45:19-0600

SIMMONS.JUSTIN.LEE.1256189212

prep_date: 20200923 app_by: Justin Marshburn

2020-10-05T14:47:13-0600

MARSHBURN.JUSTIN.LEE.1257774836

app_date: 20201005

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A013 title: Status of Government Furnished Equipment (GFE) Report sub: Lost Badge Report auth: DI-MGMT-80269(T) ref: PWS PARA 2.7.13 and 9.4.3 req_ofc: OO-ALC/OBCA dd250: L/T appcode: N/A dist: D freq: ASREQ asof: N/A firstsub: Block 16 subsub: Block 16 addressee1: OO-ALC/OBCA draft1:

reg1: 3 repro1:

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repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 3 total_repro: 0 remarks: Provide Lost Badge Report IAW PWS. Acceptable format is MS Word, Adobe pdf.

Delete DID requirement 10.2.3; 10.2.6; 10.2.8; 10.2.9

Block 9. Distribution Statement D: DoD and DoD Contractors only

Block 10, 12, and 13: upon occurrence within one day of loss

Block 14:

John Conner

OO-ALC/OBCA

Contracting Officer Representative john.conner.10@us.af.mil Deliver electronic copy

Justin Palmatier

OO-ALC/OBCA

Contracting Officer Representative justin.palmatier.2@us.af.mil Deliver electronic copy

Justin Simmons

OO-ALC/OBCA

AGE Program Manager justin.simmons.22@us.af.mil Deliver electronic copy group: NSP total_price:

prep_name: Justin L. Simmons line_item:

exhibit: a xtdp: Off xtm: Off othercat: MGMT system: Aerospace Ground Equipment (AGE) ctr_no:

contr:

remarksb:

Page2:

Reset:

2020-09-24T15:46:12-0600

SIMMONS.JUSTIN.LEE.1256189212

prep_date: 20200923 app_by: Justin Marshburn

2020-10-05T14:48:49-0600

MARSHBURN.JUSTIN.LEE.1257774836

app_date: 20201005

Page:

of_pages:

app: Adobe Professional 8.0

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

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