CDRL of CLIN ITEM 0001.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved

(1 Data Item) 0MB 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 SeNices Directorate (0704-0188). Respondents should be aware that not'Nithstanding 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 0MB 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. I B. EXHIBIT C. CATEGORY:

TOP TM OTHER

MISC

D. SYSTEMIITEM I E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITl.E

CERTIFICATE OF COMPLIANCE

4. AUTHORITY (Data Acquisition Document No.)

·· CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MISC-81356A PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9 DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14 DISTRIBUTION

REQUIRED

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE

D

11. ASOF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE OSAH FINAL

SUBMISSION

N/A N/A N/A

16. REMARKS

Block 9: Distribution Statement 0. Distribution authorized to DoD and DoO contractors only.

Administration and operations only, effective 1/30/2023. Other U.S. requests shall be referred lo COMNAVSEASYSCOM.

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

Docu men! No.:

G. PREPARED BY

Isl Wayne Booher

DD FORM 1 423-1, FEB 2001

Doc# 30308332

1/30/2023 I

H. DATE

Isl James Mccready 1

1. APPROVED BY

Reg Repr

N4523A 0 1 0

15 Total 0 1 0

J. DATE

1/30/2023

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