BAA-AFRL-RQKM-2016-0010-Atch4.pdf

PDF 524 KB Posted Mar 31, 2016

Attached to: Technical Operations V (TOPS V) Federal contract opportunity
Solicitation number: BAA-AFRL-RQKM-2016-0010
Issued by: Department of the Air Force Materiel Command Research Laboratory

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File	Type	Posted
BAA-AFRL-RQKM-2016-0010-Amd2.pdf	PDF	May 5, 2016
BAA-AFRL-RQKM-2016-0010-Atch5-Rev.pdf	PDF	Apr 1, 2016
BAA-AFRL-RQKM-2016-0010.pdf	PDF	Mar 31, 2016
BAA-AFRL-RQKM-2016-0010-Atch3.pdf	PDF	Mar 31, 2016
BAA-AFRL-RQKM-2016-0010-Atch2.pdf	PDF	Mar 31, 2016
BAA-AFRL-RQKM-2016-0010-Atch1.pdf	PDF	Mar 31, 2016
BAA-AFRL-RQKM-2016-0010-Atch6.pdf	PDF	Mar 31, 2016
BAA-AFRL-RQKM-2016-0010-Atch5.pdf	PDF	Mar 31, 2016

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CONTRACT DAT A REQUIREMENTS LIST Form Approved ( 1 Data Item) 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 and Communications 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: N/A REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A001 SCIENTIFIC AND TECHNICAL REPORTS Final Report

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-M ISC-80711 A!T ID/IQ AFRL/RXOP

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

REQUIRED ONE/R See Block 16* b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

A B End ofTech Effort

SUBMISSION Draft See Block 16* Reg Repro

16. REMARKS AFRL/RXOP 1 1 0

Blk 4:Tailored to allow for attached ANSI based AFRL AFRL/RXOT-TMP 1 1 0

Format Guidelines including Standard Form 298. Also to include, if the Final Report contains data that is being delivered with less than unlimited rights, the data with less-than-unlimited rights shall be delivered in an appropriately marked appendix to the Final Report.

BLOCK 9: B: Distribution authorized to us Government agencies only. Other requests for this document shall be ref erred to AFRL/RXOP

WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U,S.C. t sec 2751 et seq.) or the Export Administration Act of 1979, as amended, Title 50, u.s.c. App 2501 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Electronic submittals shall be encrypted or password protected.

Block 11: End of Technical Effort.

Block 12: 30 days from Block 11.

Approval/Disapproval by letter from the Air Force Program Manager within 30 days after receipt.

Disapproval requires correction/resubmission within 30 days after receipt of Air Force comments.

Block 13: End of Contract, 90 days from Block 11.

Blocks 12 & 13: Contractor shall deliver the Final Report ... (continued on next page) 2 2 0 15.TOTAL

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806 DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page~ of 14 Pages

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

CONTRACT DATA REQUIREMENTS LIST

( 1 Data Item)

A. CONTRACT LINE ITEM NO.

0001 I

B. EXHIBIT I c. CATEGORY: N/A REF: DOD 5010.12-M

B TOP __ TM __ OTHER ------------------

E. CONTRACT/PR NO. IF. CONTRACTOR

FA8650-15-D-

D.SYSTEM/ITEM

16. REMARKS (Continued) within 30 calendar days after completion of the technical effort. The AFRL Program Manager will take no more than 30 calendar days to review, edit, and return to the contractor. Upon receipt of the combined Technical and STINFO comments, the contractor shall take no more than 30 calendar days to incorporate all required changes and deliver the final technical report in an editable text format (MS Word)or editable PDF on CD-ROM electronic copy. CD-ROM shall be labeled IAW ANSI based AFRL Format Guidelines.

Block 14: Draft submittal shall consist of 1 editable (MS Word or PDF) file on CD-ROM. The final submittal shall consist of all editable text documents and all multimedia source files in current AF Standard Desktop format (MS Off ice or PDF compatible) Acceptance shall be in accordance with the ANSI based AFRL Format guidelines and the AFRL Quality Technical Report (TR) Checklist (attached) . The checklist must be signed and submitted with the Final Report.

DD FORM 1423-1, FEB 2001 Page~ of 14 Pages

CONTRACT DATA REQUIREMENTS LIST Form Approved

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

N/A REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A002 FUNDS AND MAN-HOUR EXPENDITURE REPORT

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-FNCL-80331 A/T ID/IQ AFRL/RXOP

7. DD 250 REG 9. DIST STATEMENT 10.FREOUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

REQUIRED MTHLY ** b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A B

SUBMISSION Draft

** Reg Re pro

16. REMARKS AFRL/RXF 0 1 0

Tailored to allow contractor's format. AFRL/RXOP 0 1 0

DCMA/ACO 0 1 0

Submit electronically. Electronic submittals shall be DET1 ,AFRL/PKMM 0 1 0 encrypted or password protected.

* At the close of the contractor's monthly accounting period.

** 25 days after Block 11 time.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15.TOTAL 0 4 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 2 of 14 Pages

17. PRICE GROUP

18. ESTIMATED

(1 Data Item) OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY: N/A REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A003 CONTRACT FUNDS STATUS REPORT (CFSR)

4. AUTHORITY !Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-MGMT-81468/T ID/IQ AFRL/RXOP

18. ESTIMATED

1 TOTAL PRICE

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

REQUIRED QRTLY ** b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A B

SUBMISSION Draft ** Reg Re pro

16. REMARKS AFRL/RXF 0 1 0

Tailored so that the report contains forecasts by AFRL/RXOP 0 1 0 month for the next six months, by quarter for the DCMA/ACO 0 1 0 remaining fiscal year, and by year for the remaining DET1 ,AFRL/PKMM 0 1 0 fiscal years. CFSR data shall be reconciled to the Governments fiscal year end at 30 September if the contractor's fiscal year end does not coincide with the Government's fiscal year end.

Submit electronically. Electronic submittals shall be encrypted or password protected.

* The last day of the contractor's monthly accounting period nearest the end of the governments fiscal year quarter.

** The initial submission shall be within 25 calendar days after the close of the contractor's monthly accounting period nearest the end of the first government fiscal year quarter after contract award. Subsequent submissions shall be 25 calendar days after Block 11 time.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15.TOTAL 0 4 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015 AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806 DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 3 of 14 Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY: N/A REF: DOD 5010.12-M

0001 B TDP --- TM -- OTHER

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

FA8650-15-D-

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

A004 STATUS REPORT

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-MGMT-80368Aff ID/IQ AFRL/RXOP

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

REQUIRED QRTLY ** b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A B

SUBMISSION Draft ** Reg Re pro

16. REMARKS AFRL/RXOP 0 1 0

Tailored to allow contractor's format and to DC MA/ A CO 0 1 0 delete para 3. 2. 3. DET1 ,AFRL/PKMM 0 1 0

Submit electronically, except when final report is due to be submitted, then omit this item. Electronic submittals shall be encrypted or password protected.

* At the close of the contractor's quarterly accounting period.

** 25 days after Block 11 time.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15.TOTAL 0 3 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 4 of 14 Pages

17. PRICE GROUP

{ 1 Data Item) OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY: N/A REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A005 PRESENTATION MATERIAL

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-ADMN-81373ff ID/IQ AFRL/RXOP

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

REQUIRED ASREQ * b. COPIES

8. APP CODE c 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A * SUBMISSION Draft

* Reg Repro

16. REMARKS AFRL/RXOP 0 1 1

Tailored to require view graphs and hardcopy or computer generated file.

Submit electronically.

ASREQ means as required to document topics under discussion at briefings and reviews.

* Submit at each briefing or review as appropriate.

Maximum # of view graphs shall not exceed the amount stated per deliver order.

Submit reproducible on media compatible with MS-Off ice for Windows.

Electronic submittals shall be encrypted or password protected.

BLOCK 9: C: Distribution authroized to us Government agencies and their contractrs.

15.TOTAL - 0 1 1

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015 AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 5 of 14 Pages

17. PRICE GROUP

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY: N/A REF: DOD 5010.12-M

0001 B TDP --- TM -- OTHER

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

FA8650-15-D-

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

A006 DATA ACCESSION LIST (DAL)

4. AUTHORITY (Data Acquisition Document No.J 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-MGMT-81453rr ID/IQ AFRL/RXOP

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

REQUIRED SEMIA. ** b. COPIES

8. APP CODE c 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A * SUBMISSION Draft

** Reg Re pro

16. REMARKS AFRL/RXOP 0 1 0

Tailored to allow contractor's format.

* At the end of each six month period.

** 30 days after Block 11 time.

Submit electronically. Electronic submittals shall be encrypted or password protected.

BLOCK 9: C: Distribution authroized to us Government agencies and their contractrs.

15.TOTAL - 0 1 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 6 of 14 Pages

17. PRICE GROUP

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 and Communications 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: NIA REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A007 STILL PHOTO COVERAGE

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-MISC-80169!T ID/IQ AFRL/RXOP

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

REQUIRED ASREQ * b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A D

SUBMISSION Draft

* Reg Re pro

16. REMARKS 88ABW/PA 0 1 0

Tailored to allow contractor format. AFRL/RXOP 0 1 1

ASREQ means as required to do the photo coverage under this effort.

* Submit when generated.

DO NOT SUBMIT CLASSIFIED PHOTOS OR

NEGATIVES TO 88ABW/PA, 255-6297.

Maximum # of photos shall not exceed 3000.

BLOCK 9: D· I Distribution authorized to DoD and us DoD contractors only.

15.TOTAL 0 2 1

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015 AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806 DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 7 of 14 Pages

I i

17. PRICE GROUP

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

N/A REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A008 CONFERENCE MINUTES

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-ADMN-81250A/T ID/IQ AFRL/RXOP

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

REQUIRED ASREQ * b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

NIA

SUBMISSION Draft

* Reg Re pro

16. REMARKS AFRL/RXOP 0 1 0

Tailored to allow contractor's format.

Submit electronically. Electronic submission must be encrypted or password protected.

ASREQ means as required to document each review or presentation.

* Submit within 30 days after each review or presentation.

BLOCK 9: D· I Distribution authorized to DoD and us DoD contractors only.

15.TOTAL . 0 1 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 8 of 14 Pages

I i i

17. PRICE GROUP

A- CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY: N/A REF: DOD 5010.12-M I

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A009 CONFERENCE AGENDA

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-ADMN-81249Aff ID/IQ AFRL/RXOP '

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

REQUIRED ASREQ * b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

A D

SUBMISSION Draft

* ** Reg Re pro

16. REMARKS AFRL/RXOP 1 1 0

Tailored to allow contractor's format.

Submit electronically. Electronic submission must be encrypted or password protected.

ASREQ means as required to document plans for each review/presentation.

* Submit 10 days prior to each review or presentation.

Approval/disapproval by letter from the Air Force Program Manager within 5 days after receipt.

** Disapproval requires correction/resubmission within 5 days after receipt of Air Force comments.

BLOCK 9: D; Distribution authorized to DoD and us DoD contractors only.

15.TOTAL . 1 1 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 9 of 14 Pages

17. PRICE GROUP

( 1 Data Item) OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

N/A REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A010 TECHNICAL REPORT-STUDY I SERVICES

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-M ISC-80508A/T ID/IQ AFRL/RXOP

, 18. ESTIMATED

• TOT AL PRICE

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

REQUIRED ONE/R ** b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

A D

SUBMISSION Draft

** *** Reg Re pro

16. REMARKS AFRL/RXOP 1 1 0

Tailored to allow contractor's format.

Submit electronically. Electronic submission must be encrypted or password protected.

* At the close of each delivery order under this ID/

IQ.

** 30 days after Block 11 time.

Approval/disapproval by letter from the Air Force Program Manager within 60 days after receipt.

Disapproval requires correction/resubmission within 30 days after receipt of Air Force comments.

BLOCK 9: D; Distribution authorized to DoD and US DoD contractors only.

15.TOTAL - 1 1 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 10 of 14 Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY: N/A REF: DOD 5010:12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A011 COMPUTER SOFTWARE PRODUCT END ITEMS DATA BASE

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-MCCR-80700ff cs ow AFRL/RXOP

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

REQUIRED ASREQ * b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A B

SUBMISSION Draft

* Reg Re pro

16. REMARKS AFRL/RXOP 0 1 0

Tailored to allow contractor's format.

Submit electronically.

* Submit as required per the Air Force program manager.

Electronic submittals shall be encrypted or password protected.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15.TOTAL 0 1 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 11 of 14 Pages

17. PRICE GROUP

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY: N/A REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A012 MATHEMATICAL MODEL FINITE ELEMENT ANALYSIS

REPORT

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-GDRQ-81257Aff ID/IQ AFRL/RXOP

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

REQUIRED ASREQ ** b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

A D

SUBMISSION Draft ** *** Reg Re pro

16. REMARKS AFRL/RXOP 1 1 0

Tailored to allow contractor's format.

ASREQ means as required to document mathmatical model finite analyses results per the delivery order.

* At the close of each delivery order.

** 30 days after Block 11.

Approval/disapproval by letter from the Air Force Program Manager within 60 days after receipt.

Disapproval requires correction/resubmission within 30 days after receipt of Air Force comments.

BLOCK 9: D; Distribution authorized to DoD and us DoD contractors only.

15.TOTAL - 1 1 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 12 of 14 Pages

I I

17. PRICE GROUP

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 and Communications 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 organizatfon. 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: N/A REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A013 SCIENTIFIC AND TECHNICAL REPORTS Annual Report

4. AUTHORITY (Data Acquisition Document No.) 15. CONTRACT REFERENCE 6. REQUIRING OFFICE

Dl-M ISC-80711 A/T cs ow AFRL/RXOP

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

REQUIRED ANNLY 13MAC b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A B SUBMISSION Draft 12MAC * Reg Re pro

16. REMARKS AFRL/RXOP 0 1 0

Tailored to allow contractor's format, and Block 10, is clarified so that, "Pursuant to DFARS 252.235-7011, the Government will forward the approved interim report to the Defense Technical Information Center (DTIC). II

Submit electronically. See Section F for addresses.

* Submit every 12 months through out the technical effort.

BLOCK 9: B: Distribution authorized to us Government agencies only. Electronic submittals shall be encrypted or password protected.

15. TOTAL 0 1 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806 DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 13 of 14 Pages

17. PRICE GROUP

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY: N/A REF: DOD 5010.12-M

0001 B TOP --- TM -- OTHER

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

FA8650-15-D-

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

A014 COMPUTER SOFTWARE PRODUCT Source Code

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

Dl-IPSC-81488/T cs ow AFRL/RXOP

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

REQUIRED AS GEN * b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

N/A B SUBMISSION Draft N/A * Reg Re pro

16. REMARKS AFRL/RXOP 0 1 0

Tailored to allow contractor's format.

* Submit with software for this technical effort.

Delivery of Software shall be inclusive of software source code and executable.

Electronic submittals shall be encrypted or password protected.

BLOCK 9: B: Distribution authorized to us Government agencies only.

15.TOTAL 0 1 0

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

Mark N. Groff

26-MAY-2015 RAGLAND.KAREN.E.1230136412 26-MAY-2015

AFRL/RXOP (937) 255-9836 Data Manager AFRL/RQKC 0-9806

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

I i

17. PRICE GROUP

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: TOP - 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 CORL.

Item H. Date CORL was prepared.

Item I. Signature of CORL approval authority.

Item J. Date CORL 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.

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 Ill. 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 Ill are the administrative and other expenses related to reproducing and delivering such data item to the Government.

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.

Item 13. Specify when subsequent submittals are required, when Estimated Price - Group IV items should normally be shown applicable. on the DD Form 1423 at no cost.

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.

DD FORM 1423-1 (BACK), FEB 2001

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.

File details come from the government source that posted it. Updated Nov 14, 2017.