CDRL A001.pdf

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

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17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

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 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.

A001

B. EXHIBIT

A

C. CATEGORY: X - SAFT TDP TM OTHER

D. SYSTEM/ITEM

MK44 System Safety Objective

E. CONTRACT/PR NO.

N0017820Q6956

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Safety Assessment Report (SAR)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-SAFT-80102C

5. CONTRACT REFERENCE

SOW 3.2.1

6. REQUIRING OFFICE

NSWCDD/E30

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D(SEE BLK 16)

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft Final

Reg Repro

16. REMARKS

BLK 8: The Government will have 14 calendar days of receipt of draft to review and comment. The Contractor has 30 calendar days to incorporate comments. If the Government does not submit revision requests within 14 calendar days, submittal is approved.

BLK 9: Distribution Statement D: Distribution authorized to Department of Defense and U.S. DoD contractors only for administrative and operational use [July 2020]. Other requests for this document shall be referred to Command, Naval Surface Warfare Center, Dahlgren Division (NSWCDD), 4045 Higley Road, Dahlgren, VA 22448-5110.

BLK 10, 12, 13: Initial and subsequent reports shall be required upon completion of the Gun Control Unit analysis.

BLK 14: Electronic Media: Submission may be sent via electronic mail (email) to the Technical Points of Contact (TPOC) identified in the Statement of Work. In addition, all final deliverables shall be provided on CD-ROM media to NCWCDD.

TPOC 1 1

SEE BLK 16

15. TOTAL 1 1 0

G. PREPARED BY

MELTON.ZACHARY.DAVID.1 Digitally signed by

MELTON.ZACHAR

388251758 Date: 2020.06.30 1

H. DATE

Y.DAVID.1388251758

4:32:46 -04'00'

I. APPROVED BY

WHITE.JEFFREY.STEPHE Digitally signed

WHITE.JEFFRE

N.1501664690 Date: 2020.06.30

J. DATE

by

Y.STEPHEN.1501664690

14:43:04 -04'00'