CDRL A002.RS33.Service Report - Signed.pdf

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

CONTRACT DATA REQUIREMENTS LIST

(DiD 81928)

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. B. EXHIBIT C. CATEGORY: MGMT

A TDP TM OTHER

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

MCIWEST Building 1270 Emergency Gen. TBD

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

A002 Contractor’s Progress Report Service Report (SR)

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

DI-MGMT-81928 (See Blk 16) SOW Section(s) 5.2, 5.3, 7.1 NSWC Corona Division

7. DD 250 REQ

LT

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

See Blk 16

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

See Blk 16

13. DATE OF SUBSEQUENT

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Final

A C N/A

SUBMISSION

See Blk 16 Draft Reg Repro

16. REMARKS

Blk 8: Approval for technical content and format. Government has 5 working days to review. Contractor has 5 additional working days to resubmit, if necessary.

Blk 9: Affix the following distribution statement on all documents;

"DISTRIBUTION STATEMENT C: Distribution authorized to U. S. Government agencies and their contractors only (Administrative Use). (08 May 2013). Other requests for this document shall be referred to the Naval Surface Warfare Center, Corona Division, CA., Attn: Phil Pratt, RS33, P.O. Box 5000 Corona, CA 92878-5000." (or phillip.pratt@navy.mil)

Blk 10, 12, A Service Report shall be submitted within 5 business after the completion of any work.

Blk 14: Service Reports shall be submitted digitally via email using either Microsoft Word and/or Microsoft Excel as appropriate. Electronic copies are to be sent to below emails for Government representative QA acceptance.

clint.westridge@navy.mil phillip.pratt@navy.mil

RS33 1 2

15. TOTAL

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

y

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

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May 6, 2020 mailto:%20clint.westridge@navy.mil mailto:%20clint.westridge@navy.mil mailto:phillip.pratt@navy.mil