CDRL A001-A005 (signed).pdf

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Attached to
Cable Pulleys Federal contract opportunity
Solicitation number
N6660423Q0343
Issued by
Department of the Navy Naval Sea Systems Command

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II.G-1. Attachment 1 VIR_W04260 #21.pdf PDF
II.G. N6660423Q0343P00001.pdf PDF
II.G-2. Attachment 2 RIR_QAP_W04260_R3 #21.pdf PDF

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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

276 CDU Cable Pulley & Driver

E. CONTRACT / PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

CERTIFICATE OF COMPLIANCE (COC)

17. PRICE

GROUP 1

4. AUTHORITY (Date Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

RIR_QAP_W04260_R3

6. REQUIRING OFFICE

NPT-15-NUWC 18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMNT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

LT

SEE BLOCK 16

1 TIME SEE BLOCK 16 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 REQUEST FOR THIS DOCUMENT SHALL BE REFERRED

TO NAVAL UNDERSEA WAREFARE CENTER, NEWPORT DIVISION

Block 12: Submit certification of compliance data sheet upon completion of each delivered batch.

15. TOTAL

______> 0 1 0

G. PREPARED BY:

HODGE, RONALD F.

H. DATE

02/21/2023

I. APPROVED BY

J. DATE

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 1 of 5 Pages

2/22/23LAFLEUR.VERONICA.

AIMEE M.1008802714

Digitally signed by

LAFLEUR.VERONICA.AIMEE M.1008802714

Date: 2023.02.22 06:50:36 -05'00'

N6660423P0343/1301065668

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

276 CDU Cable Pulley & Driver

E. CONTRACT / PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

MERCURY FREE CERTIFICATION

17. PRICE

GROUP 1

4. AUTHORITY (Date Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

RIR_QAP_W04260_R3

6. REQUIRING OFFICE

NPT-15-NUWC 18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMNT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

LT

SEE BLOCK 16

1 TIME SEE BLOCK 16 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 REQUEST FOR THIS DOCUMENT SHALL BE REFERRED

TO NAVAL UNDERSEA WAREFARE CENTER, NEWPORT DIVISION

Block 12: Submit certification of compliance data sheet upon completion of each delivered batch.

15. TOTAL

______> 0 1 0

G. PREPARED BY:

HODGE, RONALD F.

H. DATE

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 2 of 5 Pages

AIMEE M.1008802714

Digitally signed by

LAFLEUR.VERONICA.AIMEE M.1008802714

Date: 2023.02.22 06:51:26 -05'00'

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

276 CDU Cable Pulley & Driver

E. CONTRACT / PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

CERTIFICATE OF ANALYSIS

17. PRICE

GROUP 1

4. AUTHORITY (Date Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

RIR_QAP_W04260_R3

6. REQUIRING OFFICE

NPT-15-NUWC 18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMNT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

LT

SEE BLOCK 16

1 TIME SEE BLOCK 16 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 REQUEST FOR THIS DOCUMENT SHALL BE REFERRED

TO NAVAL UNDERSEA WAREFARE CENTER, NEWPORT DIVISION

Block 12: Submit certification of compliance data sheet upon completion of each delivered batch.

15. TOTAL

______> 0 1 0

G. PREPARED BY:

HODGE, RONALD F.

H. DATE

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 3 of 5 Pages

AIMEE M.1008802714

Digitally signed by LAFLEUR.VERONICA.AIMEE M.1008802714 Date: 2023.02.22 06:51:56 -05'00'

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

276 CDU Cable Pulley & Driver

E. CONTRACT / PR NO.

N6660423P0343/1301065668

F. CONTRACTOR

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

DOMESTICALLY SOURCED MATERIAL

17. PRICE

GROUP 1

4. AUTHORITY (Date Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

RIR_QAP_W04260_R3

6. REQUIRING OFFICE

NPT-15-NUWC 18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMNT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

LT

SEE BLOCK 16

1 TIME SEE BLOCK 16 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 REQUEST FOR THIS DOCUMENT SHALL BE REFERRED

TO NAVAL UNDERSEA WAREFARE CENTER, NEWPORT DIVISION

Block 12: Submit certification of compliance data sheet upon completion of each delivered batch.

15. TOTAL

______> 0 1 0

G. PREPARED BY:

HODGE, RONALD F.

H. DATE

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 4 of 5 Pages

AIMEE M.1008802714

Digitally signed by

LAFLEUR.VERONICA.AIMEE M.1008802714

Date: 2023.02.22 06:52:23 -05'00'

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

276 CDU Cable Pulley & Driver

E. CONTRACT / PR NO.

N6660423P0343/1301065668

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

PROCESS CERTIFICATION

17. PRICE

GROUP 1

4. AUTHORITY (Date Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

RIR_QAP_W04260_R3

6. REQUIRING OFFICE

NPT-15-NUWC 18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMNT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

LT

SEE BLOCK 16

1 TIME SEE BLOCK 16 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 REQUEST FOR THIS DOCUMENT SHALL BE REFERRED

TO NAVAL UNDERSEA WAREFARE CENTER, NEWPORT DIVISION

Block 12: Submit certification of compliance data sheet upon completion of each delivered batch.

15. TOTAL

______> 0 1 0

G. PREPARED BY:

HODGE, RONALD F.

H. DATE

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 5 of 5 Pages

2/22/23LAFLEUR.VERONICA.A

IMEE M.1008802714

Digitally signed by

LAFLEUR.VERONICA.AIMEE M.1008802714

Date: 2023.02.22 06:52:40 -05'00'

File details come from the government source that posted it. Updated .