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DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. 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:

TDP ________ TM _______ OTHER

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page of Pages

16. REMARKS (Continued)

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

xTDP: Off xTM: Off

OTHER:

DSYSTEMITEM:

E_CONTRACTPR_NO:

FCONTRACTOR:

16_REMARKS_Continued: s. Original drawings are not required. If applicable, reproducible stable base copies of unidimensional drawings and master pattern drawings are required. See Block 14.

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1_DATA_ITEM_NO: A001

2_TITLE_OF_DATA_ITEM: Commercial Asset Visibility Air Force (CAV) Reporting

3_SUBTITLE: CFM End Item Reporting

4_AUTHORITY_Data_Acquisit: DI-MGMT-81838

5_CONTRACT_REFERENCE: PWS 1.3.1

6_REQUIRING_OFFICE: 414TH SCMS/GUMCA

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: N/A

10_FREQUENCY: SEE BLK 16

11_AS_OF_DATE: SEE BLK 16

12_DATE_OF_FIRST_SUBMISSI: SEE BLK 16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLK 16

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16_REMARKS: NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

1. Block 4: All reporting shall be submitted in the English Language.

2. Block 5: Contract Reference: PWS 1.3.1 and CAV AF Reporting Requirements Document.

3. Blocks 7, 8, 14:

a. The contractor shall report End Item transactional data through electronic submission in CAV AF using the CAV AF website or CICA XML.

b. A Letter of Transmittal shall be submitted in the month the delivery order is completed, covering all reports transmitted for that order. Submit the Letter to the following email address:

414SCMS.GUMC.Repaircontracts@us.af.mil

4. Blocks 10, 11, 12, 13:

a. Date of first submission shall be within 24 hours following a supply or maintenance transaction, after the contract award date.

b. Contractor reporting requirements to CAV AF shall be submitted daily and/or within 24 hours of a supply or maintenance action occurrence IAW the CAV AF Reporting Requirements Document.

c. Data shall be current within 24 hours of the last End Item maintenance occurrence.

17_PRICE_GROUP: NSP

ESTIMATED_TOTAL_PRICE: 0.00

G_PREPARED_BY:

H_DATE: 2/23/2023

1_APPROVED_BY:

J_DATE: 3/2/2023

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

xTDP: Off

OTHER:

DSYSTEMITEM: ICBM GROUND

E_CONTRACTPR_NO: FD20202300386

FCONTRACTOR:

of_pages: 1

Reset:

2023-02-23T12:01:13-0700

PARLET.AMANDA.J.1162008516

2023-03-02T15:07:21-0700

ELLINGTON.ERIC.A.1028455433

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No.

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

xTDP: Off xTM: Off

OTHER:

DSYSTEMITEM:

E_CONTRACTPR_NO:

FCONTRACTOR:

16_REMARKS_Continued: s. Original drawings are not required. If applicable, reproducible stable base copies of unidimensional drawings and master pattern drawings are required. See Block 14.

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Reset:

xtm: Off

1_DATA_ITEM_NO: A002

2_TITLE_OF_DATA_ITEM: Contract Depot Maintenance (CDM) Monthly Production Report

3_SUBTITLE: CDM Production Monthly Status Report

4_AUTHORITY_Data_Acquisit: DI-PSSS-81995A

5_CONTRACT_REFERENCE: PWS 1.3.1

6_REQUIRING_OFFICE: 414 SCMS/GUMCA

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D

10_FREQUENCY: MTHLY

11_AS_OF_DATE: SEE BLK 16

12_DATE_OF_FIRST_SUBMISSI: SEE BLK 16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLK 16

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16_REMARKS: NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

1. Block 4:

a. All reporting shall be submitted in the English Language.

b. The Contractor's CAV AF Reporting shall reflect their inventory property control management system data records which shall represent timely and accurate accountability of AF inventory assets at the physical location(s) of the contractor's repair facility (including subcontractor facilities); shop floor, bond room and/or receiving/shipping docks, etc. for each repair.

c. The Contractor shall report by contract delivery order on all applicable categories, totals and on-hand balances, providing TABLE I (DI-PSSS-81995) for EACH repair location, including subcontractor facilities, for the contracts maintenance occurrence actions during the reporting period.

d. The Contractor shall report on production, providing TABLE I (DI-PSSS-81995) for EACH repair location, including subcontractor facilities, for which the contractor produced assets during the reporting period.

2. Block 7, 14: Submit the CDM Production Monthly Status Reports to the following email address:

414SCMS.GUMC.Repaircontracts@us.af.mil

17_PRICE_GROUP: NSP

ESTIMATED_TOTAL_PRICE: 0.00

G_PREPARED_BY:

H_DATE: 2/23/2023

1_APPROVED_BY:

J_DATE: 3/2/2023

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

xTDP: Off xTM: Off

OTHER:

DSYSTEMITEM: ICBM GROUND

E_CONTRACTPR_NO: FD20202300386

FCONTRACTOR:

16_REMARKS_Continued: 3. Block 9:

DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DoD contractors only for Administrative or Operational Use and Export Control (date of determination)*.

Other requests shall be referred to MM III Systems Directorate, Hill AFB, UT 84056-5816.

WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

*NOTE: Date of determination is the date the distribution statement is added to the document.

4. Blocks 10, 11, 12, 13:

a. The reports shall be provided monthly within 10 (ten) business days of the previous month's last calendar date.

b. Reports shall continue to be submitted by the contractor unless the requirement is terminated by the assigned Contracting Officer at the request of the Program Manager (PM) and the Production Management Specialist (PMS),

c. The Final Report submitted following the final reporting period on the contract shall be annotated "Final Report"

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2023-02-23T12:03:32-0700

PARLET.AMANDA.J.1162008516

2023-03-02T15:08:52-0700

ELLINGTON.ERIC.A.1028455433

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

Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130

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.

TDP TM OTHER

15.TOTAL

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

DD FORM 1423-1 (BACK), FEB 2001

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package; TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref.

DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15. Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13;

Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DRAFT

SAMPLE

PREVIOUS EDITION MAY BE USED.

DD FORM 1423-1, FEB 2001

Pages

PREVIOUS EDITION MAY BE USED.

DD FORM 1423-1, FEB 2001

Pages

DRAFT

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

DD FORM 1423-1 (BACK), FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130

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.

C. CATEGORY:

14. DISTRIBUTION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft

Final

Reg

Repro

15.TOTAL

G. PREPARED BY

I. APPROVED BY

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

C. CATEGORY:

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data

Package; TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref.

DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in

Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15. Examples are: Tailoring of documents cited in

Item 4; Clarification of submittal dates in Items 12 and 13;

Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

9.0.0.2.20120627.2.874785

DD Form 1423-1, "CONTRACT DATA REQUIREMENTS LIST (1 Data Item) "

Click this button to save this form.:

Click this button to print this form.:

Click this Reset button to erase data from all fields.:

Enter total page numbers.:

A. CONTRACT LINE ITEM NUMBER:

EXHIB:

Select for "TDP.": 0

Select for "TM.": 0

Enter specification for "Other.": X

SYS: FRICTION LINING; NSN 3950-01-462-6005

PR: PR FD20202300386

CONF:

TextField2: A003

TextField2:

QUALITY DEFICIENCY REPORT (QDR)

TextField2: DI-QCIC-80736

TextField2: PWS PARA. 1.3.2

TextField2: 414 SCMS

TextField2: LT

TextField2: A

TextField2: D

TextField2: SEE BLK 16

TextField2: SEE BLK 16

TextField2: SEE BLK 16

TextField2: SEE BLK 16

TextField2: Changes to office symbols and/or e-mail addresses, when necessary, shall be made by letter through the CO without further revision to this CDRL.

BLOCKS 10, 11, 12, & 13:

If applicable, Contractor shall submit Quality Deficiency Report (QDR) after the receipt of deficient Government Furnished Material (GFM). Contractor shall deliver QDR within 5 business days from receiving deficient GFM.

BLOCK 14:

Document submission shall be delivered in Adobe Acrobat PDF format when possible. All submittals shall be delivered electronically via DoD Safe (https://safe.apps.mil/). Recipients shall include:

Eric Ellington; eric.ellington.2@us.af.mil Gerritt Hansen; gerritt.hansen@us.af.mil

BLOCK 9:

Data shall be marked with the following on the cover page:

DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DoD contractors only for Administrative or Operational Use and Export Control (date of determination)*.

Other requests shall be referred to MM III Systems Directorate, Hill AFB, UT 84056-5816.

WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

*NOTE: Date of determination is the date the distribution statement is added to the document.

TextField2: SEE BLK 16

TextField2: NSP

TextField2: Michael Gonzales, Engineer, 414 SCMS

TextField2: 2 March 2023

TextField2: Eric Ellington, LMS, 414SCMS

TextField2: 2 March 2023

Total draft copies is automatically calculated.:

Total final regular copies is automatically calculated.: 1

Total final regular copies is automatically calculated.: 1

Total final reproducible copies is automatically calculated.:

DecimalField1: 0.00

G. PREPARED BY (Signature):

I. APPROVED BY (Signature):

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No.

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

xTDP: Off xTM: Off

OTHER:

DSYSTEMITEM:

E_CONTRACTPR_NO:

FCONTRACTOR:

16_REMARKS_Continued: s. Original drawings are not required. If applicable, reproducible stable base copies of unidimensional drawings and master pattern drawings are required. See Block 14.

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xtm: Off

1_DATA_ITEM_NO: A004

2_TITLE_OF_DATA_ITEM: Government Property Inventory Report

3_SUBTITLE: Annual Government Property Physical Inventory Report

4_AUTHORITY_Data_Acquisit: DI-MGMT-80441D

5_CONTRACT_REFERENCE: PWS 1.3.1

6_REQUIRING_OFFICE: 414TH SCMS/GUMCA

7_DID_250_REQ: LT

8_APP_CODE: N/A

DIST_STATEMENT: D

10_FREQUENCY: ANNLY

11_AS_OF_DATE: SEE BLK 16

12_DATE_OF_FIRST_SUBMISSI: SEE BLK 16

13_DATE_OF_SUBSEQUENT_SUB: SEE BLK 16

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16_REMARKS: NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

1. Block 4:

a. All reports shall be submitted in the English Language.

2. Block 7, 14: Submit the Annual Government Property Physical Inventory Report to the following email address:

414SCMS.GUMC.Repaircontracts@us.af.mil

3. Block 9:

DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DoD contractors only for Administrative or Operational Use and Export Control (date of determination)*. Other requests shall be referred to MM III Systems Directorate, Hill AFB, UT 84056-5816.

WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App. 2401 et seq.), as amended.

Violations of these export laws are subject to severe criminal penalties.

Disseminate in accordance with provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

*NOTE: Date of determination is the date the distribution statement is added to the document.

17_PRICE_GROUP: NSP

ESTIMATED_TOTAL_PRICE: 0.00

G_PREPARED_BY:

H_DATE: 2/23/2023

1_APPROVED_BY:

J_DATE: 3/2/2023

Page: 1 reg38t: 1

A_CONTRACT_LINE_ITEM_NO:

B_EXHIBIT:

xTDP: Off xTM: Off

OTHER:

DSYSTEMITEM: ICBM GROUND

E_CONTRACTPR_NO: FD20202300386

FCONTRACTOR:

16_REMARKS_Continued:

4. Blocks 10, 11, 12, 13:

a. This report shall be provided annually. Reporting Period is one year from Basic Contract award date and annually thereafter.

b. The data is representative of the Contractor's Internal Property Control System and shall be current as of the last day of the annual reporting period. If requested outside of an annual cadence, the data shall be current as of the date requested.

c. The report shall be delivered within seven (7) calendar days of the end of the first reporting period and annually thereafter, or within seven (7) calendar days of government request.

5. Content (Tailored). The following data fields are not required:

B. Agency or Service Asset Identification Number (GFP Only) C. Contractor Asset Identification Number F. Manufacturer Model Number J. Unit of Measure K. Unit Acquisition Cost L. Unique Item Identifier (if registered in the Item Unique Identification (IUID) Registry; GFP only)

NOTE: An Inventory report shall be provided.

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2023-02-23T12:07:05-0700

PARLET.AMANDA.J.1162008516

2023-03-02T15:13:04-0700

ELLINGTON.ERIC.A.1028455433

Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130

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.

15.TOTAL

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

DD FORM 1423-1 (BACK), FEB 2001

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package; TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref.

DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15. Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13;

Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DRAFT

SAMPLE

PREVIOUS EDITION MAY BE USED.

DD FORM 1423-1, FEB 2001

Pages

PREVIOUS EDITION MAY BE USED.

DD FORM 1423-1, FEB 2001

Pages

DRAFT

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

DD FORM 1423-1 (BACK), FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130

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.

C. CATEGORY:

14. DISTRIBUTION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft

Final

Reg

Repro

15.TOTAL

G. PREPARED BY

I. APPROVED BY

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

C. CATEGORY:

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data

Package; TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref.

DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in

Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15. Examples are: Tailoring of documents cited in

Item 4; Clarification of submittal dates in Items 12 and 13;

Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

9.0.0.2.20120627.2.874785

DD Form 1423-1, "CONTRACT DATA REQUIREMENTS LIST (1 Data Item) "

Click this button to save this form.:

Click this button to print this form.:

Click this Reset button to erase data from all fields.:

Enter total page numbers.:

A. CONTRACT LINE ITEM NUMBER:

EXHIB:

Select for "TDP.": 0

Select for "TM.": 0

Enter specification for "Other.": X

SYS: FRICTION LINING; NSN 3950-01-462-6005

PR: PR FD20202300386

CONF:

TextField2: A005

TextField2:

REPAIRABLE ITEM INSPECTION REPORT

TextField2: DI-PSSS-80386A

TextField2: PWS PARA. 1.3.3

TextField2: 414 SCMS

TextField2: LT

TextField2: A

TextField2: D

TextField2: SEE BLK 16

TextField2: SEE BLK 16

TextField2: SEE BLK 16

TextField2: SEE BLK 16

TextField2: Changes to office symbols and/or e-mail addresses, when necessary, shall be made by letter through the CO without further revision to this CDRL.

BLOCKS 10, 11, 12, & 13:

Contractor shall deliver a Repairable Item Inspection Report within 5 business days of shipping repaired assets back to the government. The report shall contain the inspection information for each asset in the shipment.

BLOCK 14:

Document submission shall be delivered in Adobe Acrobat PDF format when possible. All submittals shall be delivered electronically via DoD Safe (https://safe.apps.mil/). Recipients shall include:

Eric Ellington; eric.ellington.2@us.af.mil Gerritt Hansen; gerritt.hansen@us.af.mil

BLOCK 9:

Data shall be marked with the following on the cover page:

DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DoD contractors only for Administrative or Operational Use and Export Control (date of determination)*.

Other requests shall be referred to MM III Systems Directorate, Hill AFB, UT 84056-5816.

WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

*NOTE: Date of determination is the date the distribution statement is added to the document.

TextField2: SEE BLK 16

TextField2: NSP

TextField2: Michael Gonzales, Engineer, 414 SCMS

TextField2: 2 March 2023

TextField2: Eric Ellington, LMS, 414SCMS

TextField2: 2 March 2023

Total draft copies is automatically calculated.:

Total final regular copies is automatically calculated.: 1

Total final regular copies is automatically calculated.: 1

Total final reproducible copies is automatically calculated.:

DecimalField1: 0.00

G. PREPARED BY (Signature):

I. APPROVED BY (Signature):