CDRL_FATR.pdf

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 the Department of Defense, Executive Services (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 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

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

0001AC NDTI

AN/FPS-117 FD20202300264

A002 Test/Inspection Report First Article Test Report

DI-NDTI-80809B USAF AFMC 260 Block 9E 415 SCMS/GUEA

DD

A D

ONE/R

NA

See 16

NA

415 SCMS/GUEA 1

FY2073 1

415 SCMS/EN 1

0 1 2

Changes to names and office symbols, when necessary, shall be made by letter through the CO/ACO without revision to this CDRL.

Block 9: Data submittal shall be marked with the following on the cover page:

DISTRIBUTION STATEMENT D: Distribution authorized to the Department of Defense and U.S. DoD contractors only for administration and operational purposes, contains limited access information, 7 May 2020. Other requests for this document shall be referred to OO-ALC/ AFMC 415 SCMS/GUEA.

WARNING: Export Controlled Destruction Notice: Destroy by any means that will prevent disclosure of the contents or reconstruction of the document.

Block 12: The Contractor shall deliver the First Article Test Report NLT 15 days after first article test. The contractor shall make any re-submittal NLT 15 days after receipt of government comments..

Block 14a: Electronic submission is acceptable. Addresses are:

DODAAC: FY2073

Engineer@us.af.mil 415SCMS.EN@us.af.mil

CUI

CONTROLLED UNCLASSIFIED INFORMATION (CUI) Requirements:

Mark the top and bottom of the first page with CUI.

Include the CUI block below the Destruction Notice.

CUI Block:

"Controlled By: 415 Supply Chain Management Squadron CUI Categories: CTI, CUI EXPT Distribution/Dissemination Control: Distribution Statement D POC: STINFO Manager: 415SCMS.en@us.af.mil"

NSP

0.00

NGUYEN.THI.D.1515727392 Digitally signed by NGUYEN.THI.D.1515727392 Date: 2021.12.20 13:32:14 -07'00'

12/20/2021 KENT.BRYSON.C.13855179

Digitally signed by

KENT.BRYSON.C.1385517986

Date: 2021.12.21 10:35:16 -07'00'

12/21/2021

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