CDRL.pdf
PDF 873 KB Posted
- Attached to
- F15 Ejection Selectors
- Solicitation number
- FA8213-26-R-3032
About this file
This document is a Contract Data Requirements List (CDRL) containing 11 data items (A001-A011 and B001-B002) for contract FD2020-26-50210 related to ammunition manufacturing and testing for system 1377-01-479-9295ES (ALT 1377-01-437-4075ES). The requiring office is AFLCMC/EBHJ at Hill Air Force Base, Utah. All data items carry Distribution Statement B (authorized to U.S. Government agencies and export-controlled recipients) with export restrictions under the Arms Export Control Act and Export Control Reform Act of 2018.
The CDRL specifies submission of 13 distinct deliverables spanning design, quality control, configuration management, and government property reporting. Key items include: Ammunition Data Cards (A001) prepared in the Worldwide Ammunition Data Repository Program (WARP) per MIL-STD-1168, submitted after successful Lot Acceptance Testing; Engineering Change Proposals (A002), Notices of Revision (A003), and Requests for Variance (A004) submitted via DD Forms 1692, 1695, and 1694 respectively with 10-90 calendar day review cycles; Lot Acceptance Test Plans (A005) and Reports (A006) with 30-90 calendar day advance notice requirements; Failure Summary & Analysis Reports (A007) submitted within 15 calendar days of failure identification; Contractor Possessed Munitions reports (A008) and GFM/End Items inventory reports (A009) in XML or CSV format; Obsolescence Alert Notices (A010) and DMSMS Health Assessment Reports (A011) submitted within 90-180 calendar days; and First Article Test procedures and reports (B001-B002) submitted within 30 calendar days of testing completion. All submissions route through Wide Area Workflow (WAWF) under DoDAAC FA8213 to designated AFLCMC/EBHJ personnel, with estimated total prices marked as not separately priced (NSP).
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Other files
| File | Type | Posted |
|---|---|---|
| FA821326R3032.pdf | ||
| ItemMarkingInstruction.pdf | ||
| ES7034.pdf | ||
| SPI_Combined.pdf | ||
| PackagingSOW.pdf | ||
| Statement_of_Objectives_SOO.pdf | ||
| ItemDescriptionCombined.pdf | ||
| SectionMCADPAD_26May2026.pdf | ||
| REPSHIP.pdf | ||
| JFQR.pdf | ||
| SectionLCADPAD_26May2026.pdf | ||
| SOWAppendix.docx | DOCX document | |
| ADC_SOW_Jan_2018.docx | DOCX document |
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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 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:
TDP TM OTHER MISC
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A001
2. TITLE OF DATA ITEM
Ammunition Data Card (ADC)
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-MISC-80043B
5. CONTRACT REFERENCE
SOW para 4.3.6.9.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
SD
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK 16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Ammunition Data Cards (ADC) shall be prepared in the World- Wide Ammunition Data Repository Program (WARP) in accordance with the requirements of MIL-STD-1168 and the on-line WARP User’s Manual.
Manufacturer’s Identification Symbols used in lot numbering must be registered per MIL-HDBK-1461 ‘Ammunition Manufacturers and Their Symbols’.
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. The electronic receiving report shall also be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at: https://wawf.eb.mil.
BLK 8: A sample ADC or "draft" will be generated and submitted for each part number/NSN produced under this contract using the Worldwide Ammunition-data Repository Program (WARP) system to ensure general format and content is acceptable prior to final ADC submittals.
Government (AFLCMC/EBHJC) will respond with notice of approval/acceptance.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies CTI & Export Controlled [date of determination].
Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801-4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.
Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 11 & 12: Submit after successful Lot Acceptance Test and prior to delivery of each production lot.
Continuation on page 002...
Contr. Officer 1 1 0
AFLCMC/EBHJ 1 1 0
15. TOTAL 2 2 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 2 Pages
17. PRICE GROUP
A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:
TDP TM OTHER MISC
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
16. REMARKS (Continued) Page 002 (A001):
BLK 14: A sample ADC or "draft" will be generated and submitted for each part number/NSN produced under this contract using the Worldwide Ammunition-data Repository Program (WARP) system to ensure general format and content is acceptable prior to final ADC submittals. Sufficient hard copies of final version ADCs shall be generated for each individual production lot from the Worldwide Ammunition-data Repository Program (WARP) such that at least one hard copy per production lot shall be provided with each individual CLIN shipment/destination. An electronic copy for each production lot shall be submitted/uploaded with the electronic receiving report through WAWF to AFLCMC/EBHJC using DoDAAC FA8213.
FOB DESTINATION
EBH 26-061-003
Editha Miller, AFLCMC/EBHX, 775-4389
DD FORM 1423-1, FEB 2001 Page 2 of 2 Pages
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:
TDP TM OTHER SESS
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM
Engineering Change Proposal (ECP)
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-80639E
5. CONTRACT REFERENCE
SOW para 4.3.4.8.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Data delivery description for content of Engineering Change Proposal (ECP) via applicable DD Form 1692 shall be in accordance with EIA-649-1A and the principles of EIA-649C.
BLK 7: The Letter of Transmittal shall be annotated to reflect if additional submittals are to be furnished or if this is the final submittal. The Letter of Transmittal shall be used only for this data item; do not combine other data item submittals with this requirement.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies; CTI & Export Controlled [date of determination].
Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801- 4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.
Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 11 & 12: Contractor shall submit Engineering Change Proposal (ECP) via DD Form 1692 NLT 10 calendar days after identification/discovery of needed change proposal. Within 30 calendar days of receipt, Government Engineer (AFLCMC/EBHJ) through the Government Contracting Officer (AFLCMC/EBHKB) will respond with notice of receipt. Government Engineer will perform review of the ECP and will respond with approval/disapproval within 90 calendar days for routine, 30 calendar days for urgent, and within 48 hours for emergency changes. If disapproved, Government Engineer’s response through the Government Contracting Officer will include instruction for remediation. Notification of approval of the proposed engineering change shall be by signed contract modification (AFLCMC/EBHKB).
*ECP APPROVAL: AFLCMC/EBHJ Configuration Control Board (CCB) shall have the final approval for all ECPs.
BLK 14: Submit report(s) electronically via email in Microsoft Office or PDF format to the email recipients listed below. Refer to contract for email address of the Government Contracting Officer (AFLCMC/EBHKB). Submit through WAWF under DoDAAC FA8213.
robert.morgan.27@us.af.mil (AFLCMC/EBHX) alyson.weber.ctr@us.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
Editha Miller, AFLCMC/EBHX, 775-4389
AFLCMC/EBHJ 0 1 0
AFLCMC/EBHX 0 1 0
Cont. Officer 0 1 0
DCMA/QAR 0 1 0
DCMA/ACO 0 1 0
15. TOTAL 0 5 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages
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:
TDP TM OTHER SESS
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A003
2. TITLE OF DATA ITEM
Notice of Revision (NOR)
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-80642E
5. CONTRACT REFERENCE
SOW para 4.3.4.8.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
1TIME
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
N/A Draft
Final
Reg Repro
16. REMARKS
BLK 4: Data delivery description for content of Notice of Revision (NOR) via applicable DD Form 1695 shall be in accordance with EIA- 649-1A and the principles of EIA-649C. Must be submitted with the approval of an Engineering Change Proposal (ECP) request.
BLK 7: The Letter of Transmittal shall be annotated to reflect if additional submittals are to be furnished or if this is the final submittal. The Letter of Transmittal shall be used only for this data item; do not combine other data item submittals with this requirement.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies; CTI & Export Controlled [date of determination].
Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801- 4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.
Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 11 & 12: Contractor shall submit Notice of Revision (NOR) via DD Form 1695 within 30 calendar days following approval of an ECP.
Within 30 calendar days of receipt, Government Engineer (AFLCMC/EBHJ) through the Government Contracting Officer (AFLCMC/EBHKB) will respond with notice of receipt. Government Engineer will perform review of the NOR and will respond with approval/disapproval within 90 calendar days for routine, 30 calendar days for urgent, and within 48 hours for emergency changes. If disapproved, Government Engineer’s response through the Government Contracting Officer will include instruction for remediation. Notification of approval of the notice of revision shall be by signed contract modification (AFLCMC/EBHKB).
BLK 14: Submit report electronically via email in Microsoft Office or PDF format to the email recipients listed below. Refer to contract for email address of the Government Contracting Officer (AFLCMC/EBHKB). Submit through WAWF under DoDAAC FA8213.
robert.morgan.27@us.af.mil (AFLCMC/EBHX) alyson.weber.ctr@us.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
Editha Miller, AFLCMC/EBHX, 775-4389
AFLCMC/EBHJ 0 1 0
AFLCMC/EBHX 0 1 0
Contr. Officer 0 1 0
DCMA/QAR 0 1 0
DCMA/ACO 0 1 0
15. TOTAL 0 5 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
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:
TDP TM OTHER SESS
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A004
2. TITLE OF DATA ITEM
Request for Variance (RFV)
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-80640E
5. CONTRACT REFERENCE
SOW para 4.3.4.8.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Data delivery description for content of Request for Variance (RFV) via applicable DD Form 1694 shall be in accordance with EIA- 649-1A and the principles of EIA-649C.
BLK 7: The Letter of Transmittal shall be annotated to reflect if additional submittals are to be furnished or if this is the final submittal. The Letter of Transmittal shall be used only for this data item; do not combine other data item submittals with this requirement.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies; CTI & Export Controlled [date of determination].
Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801- 4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.
Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 11 & 12: Contractor shall submit Request for Variance (RFV) via DD Form 1694 NLT 10 calendar days after identification/discovery of needed variance. Within 30 calendar days of receipt, Government Engineer (AFLCMC/EBHJ) through the Government Contracting Officer (AFLCMC/EBHKB) will respond with notice of receipt. Government Engineer will perform review of the RFV and will respond with approval/disapproval within 90 calendar days for routine, 30 calendar days for urgent, and within 48 hours for emergency changes. If disapproved, Government Engineer’s response through the Government Contracting Officer will include instruction for remediation.
Notification of approval of the request for variance shall be by signed contract modification (AFLCMC/EBHKB).
*RFV APPROVAL: AFLCMC/EBHJ Technical Engineering Review Board (TERB) Configuration Control Board (CCB) shall have the final approval for all RFVs.
BLK 14: Submit report(s) electronically via email in Microsoft Office or PDF format to the email recipients listed below. Refer to contract for email address of the Government Contracting Officer (AFLCMC/EBHKB). Submit through WAWF under DoDAAC FA8213.
robert.morgan.27@us.af.mil (AFLCMC/EBHX) alyson.weber.ctr@us.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
Editha Miller, AFLCMC/EBHX, 775-4389
AFLCMC/EBHJ 0 1 0
AFLCMC/EBHX 0 1 0
Contr. Officer 0 1 0
DCMA/QAR 0 1 0
DCMA/ACO 0 1 0
15. TOTAL 0 5 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
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:
TDP TM OTHER QCIC
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A005
2. TITLE OF DATA ITEM
Acceptance Test Plan
3. SUBTITLE
Lot Acceptance Test Plan (w/ updated Gross Leak Check)
4. AUTHORITY (Data Acquisition Document No.)
DI-QCIC-80553A
5. CONTRACT REFERENCE
SOW para 4.3.4.6.2.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: The Acceptance Test Plan shall be in contractor’s format.
Follow content preparation and requirements listed in the Data Item Description.
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at:
https://wawf.eb.mil. The electronic receiving report shall be used only for this data item, do not combine other data item submittals with this requirement.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies; CTI & Export Controlled [date of determination].
Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801- 4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.
Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 11 & 12: The contractor shall provide a Lot Acceptance Test Plan (with updated Gross Leak Check procedures) after contract award and at least 90 calendar days prior to Lot Acceptance Testing allowing for 30-calendar day approval time after submission. No changes to previously approved government Lot Acceptance Test Plan shall be made without prior notification of AFLCMC/EBHJ Engineering approval.
BLK 14: Test Plan shall be in Microsoft Office software or PDF format to the email recipient listed below. Submit through WAWF under DoDAAC FA8213. Refer to contract for email address of the Government Contracting Officer (AFLCMC/EBHKB).
alyson.weber.ctr@us.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
Editha Miller, AFLCMC/EBHX, 775-4389
Contr. Officer 0 1 0
DCMA/QAR 0 1 0
AFLCMC/EBHJ 0 1 0
15. TOTAL 0 3 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
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:
TDP TM OTHER NDTI
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A006
2. TITLE OF DATA ITEM
Test/Inspection Report
3. SUBTITLE
Lot Acceptance Test/Inspection Report
4. AUTHORITY (Data Acquisition Document No.)
DI-NDTI-80809B
5. CONTRACT REFERENCE
SOW para 4.1.2.1.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
SS
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor's format is acceptable. Follow content and requirements preparation instructions listed in the Data Item Description.
BLK 7: The Letter of Transmittal shall be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data. The Letter of Transmittal shall be used only for this data item; do not combine other data item submittals with this requirement.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies; CTI & Export Controlled [date of determination].
Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801- 4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.
Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 11 & 12: Submit within 30 calendar days after completion of each Lot Acceptance Test/Inspection.
BLK 14: Test/Inspection report shall be in Microsoft Office software or PDF format to the email recipient listed below. Submit through WAWF under DoDAAC FA8213. Refer to contract for email address of the Government Contracting Officer (AFLCMC/EBHKB).
alyson.weber.ctr@us.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
Editha Miller, AFLCMC/EBHX, 775-4389
DCMA/QAR 0 1 0
Contr. Officer 0 1 0
AFLCMC/EBHJ 0 1 0
15. TOTAL 0 3 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
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:
TDP TM OTHER SESS
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A007
2. TITLE OF DATA ITEM
Failure Summary & Analysis Report
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-80255B
5. CONTRACT REFERENCE
SOW para 4.1.2.2.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
BLK16
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
BLK16
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor's format required. Follow content and requirements preparation instructions listed in the Data Item Description (DID).
BLK 7: The Letter of Transmittal shall be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data. The Letter of Transmittal shall be used only for this data item; do not combine other data item submittals with this requirement.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies; CTI & Export Controlled [date of determination].
Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801- 4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.
Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 10, 11, 12, & 13: Contractor to notify AFLCMC/EBHJ Engineering of failure of lot acceptance testing or failure to complete lot acceptance testing within one (1) business day every time a failure is identified. Submit a report with proposed corrective actions/recommendations within 15 calendar days of each failure. If a revision is needed to the report after submission, submit a revision or final report within 30 calendar days after receipt of AFLCMC/EBHJ revised or final comments. Extensions can be requested and approved by the Government Contracting Officer (AFLCMC/EBHKB) via letter.
BLK 14: Submit reports electronically via email in Microsoft Office or PDF format to the following email recipient listed below. Refer to contract for email address of the Government Contracting Officer.
Sumit through WAWF under DoDAAC FA8213.
alyson.weber.ctr@uf.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
Editha Miller, AFLCMC/EBHX, 775-4389
DCMA/QAR 0 1 0
AFLCMC/EBHJ 0 1 0
Contr. Officer 0 1 0
15. TOTAL 0 3 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
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:
TDP TM OTHER MGMT
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A008
2. TITLE OF DATA ITEM
Report of Receipts, Inventory, Adjustments and Shipments of Government Property
3. SUBTITLE
Contractor Possessed Munitions (CPM) Report
4. AUTHORITY (Data Acquisition Document No.)
DI-MGMT-80442/T
5. CONTRACT REFERENCE
SOW para 4.3.4.9.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
ASREQ
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
ASREQ
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Data Item Description (DID) DI-MGMT-80442 will be used to report on-hand inventory only. Receipt and shipment transactions, and adjustments will not be reported. In reference to DID para 10.1, format as follows:
Column 1(NSN Rec'd): Report the on-hand NSN Column 2(Related NSN): Report Lot Number if applicable Column 3(Document Number): Report the Contract Number Column 4(Serial Number): Report Serial Number if applicable Column 5(Qty Received): Do Not Use Column 6(Date Received): Do Not Use Column 7(Balance On-Hand): Report the on-hand balance quantity Column 8(Condition Code): Report the condition code of the on-hand balance Column 9(NSN Shipped): Do Not Use Column 10(Qty Shipped): Do Not Use Column 11(Date Shipped): Do Not Use Column 12(Shipment Number): Do Not Use Column 13(Adjustment Qty): Do Not Use Column 14(Explanation): Do Not Use Column 15(Remarks): Report the DODAAC of the contractor facility where inventory is located.
DID para 10.2: Do not report assets shipped or received during reporting period. Only report the on-hand balances.
DID para 10.2.2.1: Stock numbered components removed from items that will not be re-installed and/or are designated as spares will be reported in the format outlined above for DID para 10.1.
DID para 10.2.2.2: Stock numbered components that will be re-installed to the parent assembly should not be reported.
DID para 10.2.3: Do not report adjustments following physical inventories. Only report the resulting on-hand balance.
DID para 10.2.4: No dates should be reported.
BLK 7: Electronic receiving report required via internet WAWF at:
https://wawf.eb.mil. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement.
Continuation on page 002...
Contr. Officer 0 1 0
DCMA ACO 0 1 0
AFLCMC/EBHJ 0 1 0
15. TOTAL 0 3 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:
TDP TM OTHER MGMT
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
16. REMARKS (Continued) Page 002 (A008):
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S. Government agencies; CTI & Export Controlled [date of determination]. Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801-4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 10, 11, 12, & 13: Submission requirements per SOW.
- Discrepancy reporting will be submitted within five (5) calendar days of identification.
BLK 14: Submittals shall be in .XML (preferred) or .CSV format in accordance with DID to the email recipient listed below. Refer to contract for the email address of the Government Contracting Officer (AFLCMC/EBHKB). Submit through WAWF under DoDAAC FA8213.
joshua.stifter.1.ctr@uf.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
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:
TDP TM OTHER MGMT
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A009
2. TITLE OF DATA ITEM
Report of Receipts, Inventory, Adjustments and Shipments of Government Property
3. SUBTITLE
GFM and End Items
4. AUTHORITY (Data Acquisition Document No.)
DI-MGMT-80442/T
5. CONTRACT REFERENCE
SOW para 4.3.6.12.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
BLK16
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
BLK16
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Data Item Description (DID) DI-MGMT-80442 will be used to report on-hand inventory only. Receipt and shipment transactions, and adjustments will not be reported. In reference to DID para 10.1, format as follows:
Column 1(NSN Rec'd): Report the on-hand NSN Column 2(Related NSN): Report Lot Number if applicable Column 3(Document Number): Report the Contract Number Column 4(Serial Number): Report Serial Number if applicable Column 5(Qty Received): Do Not Use Column 6(Date Received): Do Not Use Column 7(Balance On-Hand): Report the on-hand balance quantity Column 8(Condition Code): Report the condition code of the on-hand balance Column 9(NSN Shipped): Do Not Use Column 10(Qty Shipped): Do Not Use Column 11(Date Shipped): Do Not Use Column 12(Shipment Number): Do Not Use Column 13(Adjustment Qty): Do Not Use Column 14(Explanation): Do Not Use Column 15(Remarks): Report the DODAAC of the contractor facility where inventory is located.
DID para 10.2: Do not report assets shipped or received during reporting period. Only report the on-hand balances.
DID para 10.2.2.1: Stock numbered components removed from items that will not be re-installed and/or are designated as spares will be reported in the format outlined above for DID para 10.1.
DID para 10.2.2.2: Stock numbered components that will be re-installed to the parent assembly should not be reported.
DID para 10.2.3: Do not report adjustments following physical inventories. Only report the resulting on-hand balance.
DID para 10.2.4: No dates should be reported.
BLK 7: Electronic receiving report required via internet WAWF at:
https://wawf.eb.mil. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement.
Continuation on page 002...
Contr. Officer 0 1 0
DCMA ACO 0 1 0
AFLCMC/EBHJ 0 1 0
15. TOTAL 0 3 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:
TDP TM OTHER MGMT
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
16. REMARKS (Continued) Page 002 (A009):
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S. Government agencies; CTI & Export Controlled [date of determination]. Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801-4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 10, 11, 12, & 13: Submission requirements per SOW.
- Excess build quantities for attrition (assurance items) that are in serviceable (Condition Code-A*) or excess serviceable (Condition code F*) shall be reported within 10 calendar days of LAT on the Contractor Possessed Munitions Report (CPM).
- Condemned F condition Government Furnished Property (GFP) carcasses shall be reported on the CPM Report in WAWF, within five (5) calendar days of identification of discrepancy.
BLK 14: Submittals shall be in .XML (preferred) or .CSV format in accordance with DID. Refer to contract for email address of the Government Contracting Officer (AFLCMC/EBHKB). Submit through WAWF, DODAAC, FA8213.
joshua.stifter.1.ctr@uf.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
Kendra Reese, AFLCMC/EBHX, 586-0670
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:
TDP TM OTHER MGMT
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A010
2. TITLE OF DATA ITEM
Obsolescence Alert Notice
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-MGMT-81941/T
5. CONTRACT REFERENCE
SOW para 4.1.9.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
BLK16
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
BLK16
Draft
Final
Reg Repro
16. REMARKS
BLK 4: The Obsolescence Alert Notice shall be in contractor’s format.
Follow content and requirements preparation instructions as listed in the Data Item Description. Omit requirement in letter 2g (affected Dual Band Radar System).
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. The electronic receiving report shall also be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at: https://wawf.eb.mil.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies; CTI & Export Controlled [date of determination].
Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801-4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.
Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
BLK 10, 11, 12, & 13: Submissions shall be completed no later than 90 calendar days after obsolescence issue is identified. Submit periodic reviews of obsolescence every six months. The government will have 30 calendar days for approval after each submission.
BLK 14: Submit report(s) electronically in Microsoft Office software or PDF format to the email recipient listed below. Refer to contract for email address of the Government Contracting Officer (AFLCMC/EBHKB). Submit through WAWF under DoDAAC FA8213.
joshua.stifter.1.ctr@uf.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
Editha Miller, AFLCMC/EBHX, 775-4389
AFLCMC/EBHJ 0 1 0
Contr. Officer 0 1 0
15. TOTAL 0 2 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
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:
TDP TM OTHER MGMT
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
A011
2. TITLE OF DATA ITEM
Diminishing Manufacturing Sources and Material Shortages (DMSMS) Health Assessment Report
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-MGMT-82273
5. CONTRACT REFERENCE
SOW para 4.1.9.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
LT
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
SEMIA
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
BLK16
Draft
Final
Reg Repro
16. REMARKS
BLK 4: The DMSMS Health Assessment Report shall contain a health assessment of the systems or end item deliverables specified by the contract using the Data Elements in Table 1 of the Data item Description (DID). The information shall be included to the lowest indenture level (component level) for all items, including subcontractor items, which are not commercial items. Commercial items are defined in 48 CFR 2.101 – Definitions. Follow format and content preparation and requirements listed in the DID.
**The contractor shall deliver DMSMS impact assessment reports in accordance with this DID, for all assemblies, line replaceable units, and weapon replaceable assemblies and their related software used on the end item deliverables. The report will detail the predicted impact of known DMSMS issues and projected DMSMS issues. It will use the most accurate forecasting data available to the contractor. The report will detail the date the assembly and its related higher assemblies will most likely become unsupportable considering inventories, usage, repair capability, funded upgrades, redesigns, and similar attributes or actions. The Contractor should provide sufficient reports to the government to enable government oversight if the contractor is tasked to manage DMSMS.
BLK 7: The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at: https://wawf.eb.mil.
BLK 8: Within 30 calendar days of receipt, Government Engineer (AFLCMC/EBHJ) through the Government Contracting Officer (AFLCMC/EBHKB) will respond with notice of approval/disapproval for technical content and completeness. Failure to comment/approve/disapprove within 30 calendar days does not constitute full/final acceptance by the Government. The Contractor will resubmit for approval or provide final copy of the plan within 30 calendar days of Government disposition.
BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.
Government agencies; CTI & Export Controlled [date of determination].
Other requests must be referred to AFLCMC/EBHJ, Hill AFB, UT 84056.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801-4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.
Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.
Continuation on page 002...
Contr. Officer 0 1 0
AFLCMC/EBHJ 0 1 0
15. TOTAL 0 2 0
G. PREPARED BY
MILLER.EDITHA.S.1040031797
H. DATE
2026/03/02
I. APPROVED BY
HARGROVE.ERIC.V.1167016843
J. DATE
2026/03/03
18. ESTIMATED
TOTAL PRICE
NSP
A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:
TDP TM OTHER MGMT
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
16. REMARKS (Continued) Page 002 (A011):
BLK 11, 12, & 13: Contractor shall submit report within 180 calendar days after award of contract and every 180 calendars thereafter until the completion of the contract. No changes to previously approved DMSMS Health Assessment Report shall be made without prior approval from AFLCMC/EBHJ.
BLK 14: The DMSMS Health Assessment Report shall be in an electronic Microsoft Excel (.xls or .xlsx) file.
Submit report via email to the to the email recipient listed below. Refer to contract for email address of the Government Contracting Officer (AFLCMC/EBHKB). Submit through WAWF under DoDAAC FA8213.
joshua.stifter.1.ctr@us.af.mil (AFLCMC/EBHJ)
FOB DESTINATION
EBH 26-061-003
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:
TDP TM OTHER NDTI
D. SYSTEM/ITEM
1377-01-479-9295ES ALT 1377-01-437-
4075ES*
E. CONTRACT/PR NO.
FD2020-26-50210
F. CONTRACTOR
1. DATA ITEM NO.
B001
2. TITLE OF DATA ITEM
First Article Test/Inspection Procedures and Report
(FAT/IPR)
3. SUBTITLE
FAT Procedure and Report
4. AUTHORITY (Data Acquisition Document No.)
DI-NDTI-82326
5. CONTRACT REFERENCE
SOW para 4.3.6.5.
6. REQUIRING OFFICE
AFLCMC/EBHJ
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
B
10. FREQUENCY
1TIME
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
BLK16
13. DATE OF SUBSEQUENT
SUBMISSION
N/A Draft
Final
Reg Repro
16. REMARKS
BLK 4: Follow format, requirements, and content preparation instructions per Data Item Description. Incorporate the following applicable requirements:
a. Dimension and tolerances specified on the manufacturing data shall be listed in one column with the actual corresponding reading obtained from inspection of the part, listed in another column.
b. Material utilized in the manufacture of "First Article" item shall be identified and certified as conforming to applicable data requirements.
c. Certification that identification markings, i.e. part number per MIL-STD-130N and Federal Supply manufacturer (FSCM) per H4-1 Cataloging Handbook (if applicable) have been complied with.
e. The test report will be certified by the responsible DCMA/QAR.
(Authorization for any deviations from the requirements specified by the manufacturing data must be obtained from the procuring agency prior to inclusion in the test report).
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number, and Nomenclature. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at https://wawf.eb.mil.
BLK…
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