CDRL-A001_REV Posting_Redacted.pdf

CONTRACT DATA REQUIREMENTS LIST (CDRL)

(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 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:

A TDP ____ TM _____ OTHER X-QCIC

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

M24623/8 QUALIFICATION

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

A001 QUALIFICATION TEST REPORT (QTR) N/A

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-QCIC-81890 SOW Para 4.1 NSWCDD

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

NO REQUIRED OTIME SEE BLK 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D (SEE BLK 16)

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

A N/A SEE BLK 16 Reg Repro

16. REMARKS TPOC 1 1 1

BLK 8: APPROVAL OF TECHNICAL DATA ONLY. GOVERNMENT HAS 10 DAYS FROM RECEIPT OF

DRAFT TO REVIEW AND COMMENT. THE CONTRACTOR HAS 5 DAYS TO SUBMIT REVISIONS.

BLOCK 9: DISTRIBUTION STATEMENT D. DISTRIBUTION AUTHORIZED TO DEPARTMENT OF

DEFENSE AND U.S. DOD CONTRACTORS ONLY (OPERATIONAL AND ADMINISTRATIVE USE ONLY)

(15 MAY 2022). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO (THE NAVAL

SURFACE WARFARE CENTER, DAHLGREN DIVISION (NSWCDD), A31, FIBER OPTICS SECTION).

BLKS 10,12: FIRST SUBMISSION DUE NO LATER THAN 30 BUSINESS DAYS AFTER COMPLETION

OF ALL TESTING.

BLK 14: ELECTRONIC MEDIA: REPORTS SHALL BE SUBMITTED IN MICROSOFT (MS) OFFICE

APPLICATION OR ADOBE PORTABLE DOCUMENT FORMAT (PDF) VIA EMAIL NOTIFICATION TO

BRANDON.J.NELSON31.CIV@US.NAVY.MIL AND CHRISTOPHER.A.GOOD8.CIV@US.NAVY.MIL

TPOC 2 1 1

SEE BLK 16

15. TOTAL 2 2

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

BRANDON NELSON, TPOC

LISA A. BLOM

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