C12 - CDRLs.pdf

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 4 Pages

1161/183

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 Services, 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 C. CATEGORY:

A TDP TM OTHER MGMT

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

SDV MK8 300 Bar Din Hose Assemblies 1301049421 TBD

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

A001 QUALITY MANAGEMENT SYSTEM (QMS)

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

DI-MGMT-82184 SOW para. 3.0 NSWC PCD Code E12 18 ESTIMATED

TOTAL PRICE

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

LT REQUIRED ONE/P SEE BLK 16 b. COPIES

8. APP CODE

D

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft Final

N/A SEE BLK 16 N/A SEE BLK 16 Reg Repro

16. REMARKS NSWC PCD Code E10 0 1 0

Blk 4: The DID is cited for guidance as to content only. Contractor format is acceptable.

Blk 8, 10, 12, 13: Submittal due 3 calendar days after award of contract.

Blk 9: Technical Documents generated under this contract shall carry the Distribution Limitation Statement in the Statement of Work. Word- processing/electronic files shall have the statement included in the file such that the first page of any resultant hard copy shall display the statement.

Blks 14: MEDIA Requirements: Microsoft Office 2016 compatible files via e-mail. E-mail addresses will be provided at award.

LT ONLY

NSWC PCD Code 024

15. TOTAL 2 2 0

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

NSWC PCD Code E12

See Section G.

Jason Zimmerman, NSWC PCD Code 02T

See Section I.

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 2 of 4 Pages

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 Services, 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

A TDP TM OTHER MISC

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

SDV MK8 300 Bar Din Hose Assemblies 1301049421 TBD

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

A002 Certification Data Report Certificate of Conformance

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

DI-MISC-82386 SOW para. 3.0 NSWC PCD Code E12 18 ESTIMATED

TOTAL PRICE

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

LT REQUIRED ONE/P ASREQ b. COPIES

N/A SEE BLK 16 N/A ASREQ Reg Repro

16. REMARKS NSWC PCD Code E10 0 1 0

Blk 4: The DID is cited for guidance as to content only. Contractor format is acceptable.

Blk 8, 10, 12, 13: Submittal due upon delivery of manufactured items.

Blk 9: Technical Documents generated under this contract shall carry the Distribution Limitation Statement in the Statement of Work. Word- processing/electronic files shall have the statement included in the file such that the first page of any resultant hard copy shall display the statement.

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 3 of 4 Pages

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 Services, 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

A TDP TM OTHER MISC

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

SDV MK8 300 Bar Din Hose Assemblies 1301049421 TBD

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

A003 Certification Data Report Cleanliness Documentation

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

DI-MISC-82386 SOW Para. 3.0 NSWC PCD Code E12 18 ESTIMATED

TOTAL PRICE

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

LT REQUIRED ONE/P ASREQ b. COPIES

N/A SEE BLK 16 N/A ASREQ Reg Repro

16. REMARKS NSWC PCD Code E10 0 1 0

Blk 4: The DID is cited for guidance as to content only. Contractor format is acceptable.

Blk 8, 10, 12, 13: Submittal due upon delivery of manufactured items.

Blk 9: Technical Documents generated under this contract shall carry the Distribution Limitation Statement in the Statement of Work. Word- processing/electronic files shall have the statement included in the file such that the first page of any resultant hard copy shall display the statement.