CDRL - JBD Components.docx

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Attached to
JBD Panel Repair Federal contract opportunity
Solicitation number
N6852022R0019
Issued by
Department of the Navy Naval Air Systems Command

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Statement of Work (SOW) Contract Data Requirements List (DD 1423s)

Abrasive Blast and Painting of Jet Blast Deflector Panels

FRCSW, North Island

09 March 2022

CONTRACT DATA REQUIREMENTS LIST

Form Approved

(1 Data Item)

OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget. Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract|PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.
B. EXHIBIT
C. CATEGORY:
A
TDP
TM
X
OTHER

X

D. SYSTEM|ITEM
E. CONTRACT/PR NO.
F. CONTRACTOR
Abrasive Blast Painting of JBD Panels
TBD
TBD
1. DATA ITEM NO.
2. TITLE OF DATA ITEM
3. SUBTITLE

17. PRICE GROUP

A001
Contract Field Service Report
(No Subtitle Was Used)
4. AUTHORITY (Data Acquisition Document No.)
5. CONTRACT REFERENCE
6. REQUIRING OFFICE

18. ESTIMATED TOTAL PRICE

DI-MGMT-81238
SOW paragraphs 5.1, 5.1.2
FRCSW
7. DD 250 REQ
9. DIST STATEMENT REQUIRED
10. FREQUENCY
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION
DD
A
1TIME
See block 16

b. COPIES

8. APP CODE
See block 16
11. ASN/A OF DATE
13. DATE OF SUBSEQUENT SUBMISSION
a. ADDRESSEE
DRAFT
FINAL

N/A

N/A
N/A
Reg
Repro
16. REMARKS
See Block 16

Block 4: Electronic format requested. Contractor Format Acceptable.

Block 7: DD: No source inspection, final inspection at destination.

Block 9: Distribution Statement: Approved for public release; distribution is unlimited.

Block 10: Frequency: One time submission

Block 12: Seven (7) days after service completion.

Block 14: Deliveries shall be provided in PDF and a MS Word editable file format and delivered by electronic email to the Technical Point of Contact (TPOC). If electronic mail is not available, the contractor shall ensure the delivery of a hard copy to the TPOC via overnight mail.

All technical data shall be written in the English language and be grammatically correct. All technical data shall identify the manufacturer’s name, model number, serial number, and contact number.

15. Total

G. PREPARED BY
H. DATE
I. APPROVED BY
J. DATE
Heidi Murillo
3/9/2022
William K. Fields
3/9/2022
DD FORM 1423-1, JUN 90 (EG)
Previous editions are obsolete
Page
1
of
2
Pages

CONTRACT DATA REQUIREMENTS LIST

Form Approved

(1 Data Item)

OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget. Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract|PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.
B. EXHIBIT
C. CATEGORY:
A
TDP
TM
X
OTHER

X

D. SYSTEM|ITEM
E. CONTRACT/PR NO.
F. CONTRACTOR
Abrasive Blast Painting of JBD Panels
TBD
TBD
1. DATA ITEM NO.
2. TITLE OF DATA ITEM
3. SUBTITLE

17. PRICE GROUP

A002
Quality Conformance Inspection and Test Procedures
(No Subtitle Was Used)
4. AUTHORITY (Data Acquisition Document No.)
5. CONTRACT REFERENCE
6. REQUIRING OFFICE

18. ESTIMATED TOTAL PRICE

DI-RELI-80322
SOW paragraph 6.2.3
FRCSW
7. DD 250 REQ
9. DIST STATEMENT REQUIRED
10. FREQUENCY
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION
DD
A
1TIME
See block 16

b. COPIES

8. APP CODE
See block 16
11. ASN/A OF DATE
13. DATE OF SUBSEQUENT SUBMISSION
a. ADDRESSEE
DRAFT
FINAL

N/A

N/A
N/A
Reg
Repro
16. REMARKS
(See Block 16)

Block 4: Electronic format requested. Contractor Format Acceptable.

Block 7: DD: No source inspection, final inspection at destination.

Block 9: Distribution Statement: Approved for public release; distribution is unlimited.

Block 10: 1TIME: One time submission

Block 12: At the end of the service.

Block 14: A hard copy shall be provided to the TPOC to be reviewed and signed. An electronic copy shall be provided in PDF or MS Word editable file format and delivered by electronic email to the TPOC. If electronic mail is not available, the Contractor shall ensure the delivery of a hard copy to the TPOC via overnight mail.

All technical data shall be written in the English language and be grammatically correct. All technical data shall identify the manufacturer’s name, model number, serial number, and contact number.

15. Total

G. PREPARED BY
H. DATE
I. APPROVED BY
J. DATE
Heidi Murillo
3/9/2022
William K. Fields
3/9/2022
DD FORM 1423-1, JUN 90 (EG)
Previous editions are obsolete
Page
2
of
2
Pages

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