CDRL A003 STI Insp Report_Service-OWTS Tank Repair.pdf

PDF 162 KB Posted

Attached to
Service-Oily Water Treatment System (OWTS) Federal contract opportunity
Solicitation number
N4523A21Q5731
Issued by
Department of the Navy Naval Supply Systems Command

About this file

This Contract Data Requirements List (CDRL) outlines reporting requirements for a certified inspector's report on an Oily Water Treatment System (OWTS) tank repair. The contractor must provide a report including actual material values and certifications traceable to unique markings. The report is due with corresponding material shipment and acceptance will not occur prior. Distribution of the report is restricted to the Department of Defense and contractors for administration and operations. The related solicitation from the Naval Supply Systems Command seeks service for an OWTS under solicitation N4523A21Q5731.

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Text version

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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:

TBD A TDP TM OTHER

MISC

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

OWTS # 4 1203-3052 TBD

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

GROUP

A003 CERTIFICATION/DATA REPORT

Certified STI Inspector’s Report

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

TOTAL PRICE

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 4 0

Block 3: The contractor shall provide a Certified STI Inspector’s Report.

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 8/10/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document No.: 1203-3052

15. Total 0

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

/s/ Chris Cooper 8/10/2021 /s/ Mike Baker 8/10/2021

DD FORM 1423-1, JUN 90 (EG)

Page 1 of 1 Pages

SEE BLOCK 16
N4523A

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