CDRL_Portfolio.pdf

CUI

CONTRACT DATA REQUIREMENTS LIST

(CDRL)

GENERAL INSTRUCTIONS

CONTRACT NUMBER:

FD2060-25-30324

PREPARED BY:

COMBAT READINESS DIRECTORATE

HUMAN SYSTEMS DIVISION

AFLCMC/ROU, Operations and Support

236 Milledgeville Street, Suite F30

Robins AFB GA 31098

CDRL MODIFICATION MATRIX.

This matrix identifies the CDRL changes as implemented by contract modification.

PROPOSAL NO.

CDRL REV

NO.

DATE CDRL/PAGES REVISED

Initial Basic 28 May 2026 All

Administrative

Updates A 17 Jun 2026 All

TABLE OF CONTENTS

1.0 APPLICABLE DOCUMENTS

2.0 REFERENCE DOCUMENTS

3.0 DATA DELIVERIES

3.1 DELIVERY DATES

3.2 TAILORED DATA ITEMS

3.3 APPROVAL OF DATA

3.4 RE-SUBMITTAL OF DATA

3.5 FINAL SUBMITTAL OF DATA

3.6 DD FORM 250 REQUIREMENTS

3.7 CLASSIFIED DATA

4.0 ELECTRONIC DATA TRANSMISSION

4.1 SUBMISSION

4.2 DELIVERY NON-COMPLIANCE

4.3 FINANCIAL INFORMATION FORMAT

5.0 LETTERS OF TRANSMITTAL (LT)

6.0 MODIFICATION OF DATA REQUIREMENTS

7.0 COMMON ABBREVIATIONS

8.0 MARKING TECHNICAL DOCUMENTATION

8.1 DISTRIBUTION MARKING SYSTEM

8.2 MARKING TECHNICAL DATA

8.3 DISTRIBUTION STATEMENTS

8.4 CONTROLLING OFFICE

8.5 EXPORT-CONTROLLED WARNING STATEMENT

8.6 CONTROLLED UNCLASSIFIED INFORMATION (CUI)

8.7 MARKING NON-TECHNICAL DOCUMENTATION

8.8 MARKING EXAMPLES

8.9 INTELLECTUAL PROPERTY/MARKING

9.0 MAILING LISTS

10.0 CDRL TABLE OF CONTENTS

1.0 APPLICABLE DOCUMENTS

Data Item Descriptions (DIDs)/DD Form 1664s, are identified in Block 4 of the individual Contract Data Requirements List (CDRL)/DD Form 1423-1. All DIDs are available to the contractor at the following website: http://quicksearch.dla.mil/.

2.0 REFERENCE DOCUMENTS

DAFI 61-201 Management of Scientific and Technical Information (STINFO)

DFARS 227.71 Rights in Technical Data

DFARS 227.72 Rights in Computer Software & Computer Software Documentation

DoD 5010.12-M Procedures for the Acquisition and Management of Technical Data

DoDD 5230.09 Clearance of DoD Information for Public Release

DoDD 5230.25 Withholding of Unclassified Technical Data from Public Disclosure

DoDD 5400.07 DoD Freedom of Information Act (FOIA) Program

DoDI 2040.02 International Transfer of Technology, Articles, and Services

DoDI 5200.48 Controlled Unclassified Information (CUI)

DoDI 5230.24 Distribution Statements on DoD Technical Information

DoDM 5200.01v1 DoD Information Security Program: Overview, Classification, and Declassification

DoDM 5200.01v2 DoD Information Security Program: Marking of Information

DoDM 5200.01v3 DoD Information Security Program: Protection of Classified Information

EIA 649-1 Configuration Management Requirements for Defense Contracts

3.0 DATA DELIVERIES

The CDRL establishes the data to be delivered by the contractor. The CDRL also identifies the submittal, inspection, approval, acceptance, and distribution requirements of all the CDRL data items contained herein.

3.1 Delivery Dates/Time

Delivery Dates and Time

If a CDRL delivery date falls on a Saturday, Sunday, or Federal holiday, the delivery shall be made on the preceding business day to be considered an on-time delivery.

Specifically:

For deliveries due on a Saturday or Sunday, the required delivery date shall be the preceding Friday.

For deliveries due on a Federal holiday, the required delivery date shall be the business day preceding the holiday. If the day prior to the holiday falls on a Sunday, the required delivery date shall be the Friday immediately preceding the Sunday.

All CDRL deliveries must be received no later than 1700 hours (5:00 PM) local Robins Air Force Base, Georgia time on the designated delivery date. Unless otherwise specified in Block 16 of the applicable CDRL, all references to "days" shall mean calendar days.

Early CDRL delivery is permitted. The Contractor shall immediately notify the Government in writing of any anticipated or actual late CDRL deliveries, including the reason for the delay and a proposed recovery schedule.

3.2 Tailored Data Items

Tailoring instructions are as described in Block 16 of each affected CDRL. If the data preparation instructions contained in Block 16 of the CDRL are different than the instructions contained in the DID, the CDRL shall govern.

3.3 Approval of Data

An "A" designator in Block 8 of the CDRL indicates the Government will formally reply to each data submittal with an approval, approval with comments, or disapproval. The Government will respond by issuing a Procuring Contracting Officer (PCO) letter or e-mail to the contractor within 45 calendar days, unless otherwise specified on the CDRL, Block 16. This does not apply to Engineering Change Proposals (ECPs) and Contract Change Proposals (CCPs).

For those CDRLs with an "N/A" in Block 8, Government approval of the content is not required; however, compliance with data item format and content requirements as specified in the DID, and as tailored in Block 16 of the CDRL, is mandatory. However, the Government may not provide a formal response back to the contractor. The Government has the right to reject/disapprove any data submittal(s) not in compliance with contract requirements.

3.4 Re-submittal of Data

If re-submittal of a CDRL is required, it shall be resubmitted within 30 calendar days after PCO notification, unless otherwise specified. Should the contractor disagree with the re-submittal requirements, they shall submit their comments to the PCO within 30 calendar days of notification. Each page of a re-submittal shall have changes indicated by a vertical line down the outer right margin designating those areas that have been revised.

The document revision shall be indicated on the title page of the data item, each page, and a summary of document changes section contained within the document.

3.5 Final Submittal of Data

For the final delivery of each data item in the contract/delivery order, the contractor shall clearly state in the Letter of Transmittal (LT), as defined in paragraph 5.0, when it is the last submittal being made, and that all contractual requirements concerning that data item have been fulfilled.

3.6 DD Form 250 Requirements

Block 7 of the CDRL directs the inspection and acceptance of the submittal. Individual DD Form 250s are required only if indicated in Block 7. All other submittals shall be accompanied by a Letter of Transmittal (LT).

3.7 Classified Data

Classified data shall be submitted in accordance with the requirements established by the DD Form 254, Contract Security Classification Specification. The contractor shall contact the PCO for the mailing address(es) if not specified in Block 14 or 16 of the DD Form 1423-1.

4.0 ELECTRONIC DATA TRANSMISSION

4.1 Submission

The contractor shall submit all data deliverables in accordance with the specific submittal instructions indicated in Block 16 of each CDRL. The versions of the software used shall remain compatible with current program office software. Any submittals by other means shall require program office approval prior to delivery of data. Data to be submitted by electronic data transmission (EDT) shall be identified in “Block 14.b Repro” of the CDRL.

The Contractor shall electronically deliver all contractual data using the Government-controlled method of delivery, Multi-user ECP Automated Review System (MEARS), https://mears1.redstone.army.mil/mears/Default.aspx. The Contractor shall work with the Government to ensure that an adequate number of Contractor personnel obtain and possess Public Key Infrastructure (PKI) certification from an accepted Government source. The Contractor shall be receptive to the training offered by the Government on the MEARS system.

Submissions of large data files may be made via a DoD approved site such as Secure Access File Exchange (SAFE) (https://safe.apps.mil/) or CD/DVD mailed to the Government Program Office.

An alternate method of delivery when MEARS is down for maintenance will be the DISA application, known as DOD SAFE, https://safe.apps.mil/. It will be available to all DOD Common Access Card (CAC) holders or Contractor personnel who possess Public Key Infrastructure (PKI) certification from an accepted Government source.

4.2 Delivery Non-Compliance

The contractor shall inform the program office if any of their data deliverables cannot comply with the required electronic formats. In such cases the contractor shall recommend, for program office approval, an alternative delivery format(s).

4.3 Financial Information Format

Financial information provided in excel spreadsheets should be able to be manipulated.

5.0 LETTERS OF TRANSMITTAL (LT)

All data deliveries shall include a LT. The LT may be in the form of a letter or e-mail from the designated contractor representative. As a minimum, the LT shall contain:

Contractor’s POC Contractor’s address Date Contract number and program name Letter control number Document control number Document revision level Document date CDRL sequence number DID Number Data Title/Subtitle Reason/Frequency of submittal (monthly, draft, final, update, etc.)

List of Distribution addressees as identified in Block 14 of the CDRL

If a paper copy of the LT is prepared, a complete list of addressees shall be placed at the end of the LT, annotating the recipients (as identified on the DD Form 1423-1, Block

14) including the transmittal-letter-only recipients.

If submittal is made via e-mail, the list of addressees in the “TO” line shall include the complete list of addressees and shall be considered sufficient.

6.0 MODIFICATION OF DATA REQUIREMENTS

During the performance of this contract, the PCO may unilaterally increase or decrease the number of addressees and/or number of copies the technical office requires; or may make other administrative or clarification changes to the CDRL.

The PCO may unilaterally make other administrative and/or clarification changes to the CDRLs. The contract price will constitute full satisfaction of any entitlement of equitable adjustment under the “Changes” clause provided the Contractor agrees to accept such change at no change in contract price. Unilateral action shall be by the issuance of a PCO's letter, which will reference this paragraph as its authority. The Contractor shall notify the PCO of the estimated cost if the changes impact the contract price.

7.0 COMMON ABBREVIATIONS

Block 7: SS Inspection at Source / Acceptance at Source

DD Inspection at Destination / Acceptance at Destination

SD Inspection at Source / Acceptance at Destination

LT Letter of Transmittal

Block 8: A Approval

N/A Approval Not Required

16 See Block 16 for further instructions

Blocks 10, 12 & 13: ANNLY Annually

ASGEN As Generated

ASREQ As Required

BI-MO Bi-Monthly

BI-WE Bi-Weekly

BLK 16 See Block 16

DAILY Daily

DFDEL Deferred Delivery

EOC End of Contract

EOM End of Month

EOQ End of Quarter

MTHLY Monthly

ONE/P One-time Preliminary draft

ONE/R One-time with Revisions

OTIME One Time

QRTLY Quarterly

R/ASR Revisions as Required

SEMIA Every 6 Months

WEKLY Weekly

XDACM X Days after Contract Modification

XDADO X Days after Delivery Order

XDARC X Days after Receipt of Comments

XDARP X Days after Reporting Period

XDATC X Days after Test Completion

XDPTT X Days prior to Test

XTIMES X Times

8.0 MARKING TECHNICAL DOCUMENTATION

8.1 Distribution Marking System

In accordance with Section 1.30 of Title 10, “United States Code” a DoD distribution marking system for technical data has been established by DoD Instruction 5230.24, “Distribution Statements on Technical Documents” and DAFI 61-201, Management of Scientific and Technical Information. The intent of the system is to stem the flow of military-related technical data to our adversaries, without inhibiting technological growth or blocking the exchange of technical data that is vital to progress and innovation. The contractor shall mark all distribution statements and export-control statements, supplemental to any security markings, on all technical data to denote the extent of its availability for secondary distribution, release, and disclosure without need for additional approvals and authorizations from the controlling DoD office.

Distribution statements are annotated in Block 9 of each CDRL and defined in paragraph

8.3. If the contractor feels that a different statement is required, they must notify the contracting officer with the recommended statement, prior to CDRL submittal. The Government will review the request and determine which statement is the most appropriate and provide the contractor with an acceptance of the change or reason for not accepting the contractor’s request for change.

8.2 Marking Technical Data

The contractor shall mark all requested technical information, regardless of its medium, with a distribution statement. This includes technical reports, blueprints, drawings, technical orders, technical manuals, plans, instructions, computer software, viewgraphs, film, technical papers, photographs, etc. If the document contains export-controlled technical data, it also must be marked with an export control warning statement.

Distribution statements can be applied to technical data that contain or reveal proprietary information used.

Technical data categorized as cryptographic/communications security, communications/electronic intelligence, and similar categories as may be designated by the Director, National Security Agency, whose distribution is limited through alternate methods, are exempt from these marking provisions.

Certain types of technical data preclude placing the entire notice on the document. To accommodate this problem, each distribution statement contains an authorized abbreviation form. Abbreviated distribution statements are to be used only when space precludes placing the entire notice on the document. The use and wording of these statements are described in the following paragraphs.

The contractor shall mark Controlled Unclassified Information (CUI) in accordance with DoDI 5200.48, paragraph 3.4.

8.3 Distribution Statements

A DoD distribution marking system for technical data is prescribed in DoD Instruction (DoDI) 5230.24, “Distribution Statements on DoD Technical Information.” The intent of the system is to identify the audience approved for secondary distribution of the data in order to stem the flow of military-related technical data to our adversaries, without inhibiting technological growth or appropriate exchange of technical data that is vital to progress and innovation. These markings are in addition to any security classification or other control markings.

The contractor shall mark all technical information, regardless of its medium, with the appropriate distribution statement as prescribed by the controlling DoD office.

Distribution statements are also applied to technical data that contain proprietary information. Per DAFI 61-201, paragraph 3.4.4.1, “Distribution statements are displayed conspicuously on all technical documents regardless of medium or format.

For standard written or printed material, the Distribution Statement is shown on all pages to the maximum extent practical and at a minimum on the front cover, title page, and SF 298, where applicable. If the technical information is digitally prepared or in any other medium that does not have a cover or title page, the applicable Distribution Statement is affixed to all physical and digital items by other means in a conspicuous position for ready recognition.” Drawings must display the distribution statement on the first sheet at a minimum.

Technical data categorized as cryptographic/communications security, communications/electronic intelligence, and similar categories as may be designated by the Director, National Security Agency, whose distribution is limited through alternate methods, are exempt from these marking provisions.

Certain types of technical data preclude placing the entire notice on the document.

Abbreviated distribution statements must be approved by the program office and are to be used only when space precludes placing the entire statement on the document.

The distribution statement is identified in Block 9 of each CDRL. If the contractor feels that a different statement or defense category is required, the contractor must notify the PCO with the recommended statement. The Government will review the request, determine which statement is the most appropriate, and provide the contractor with either an acceptance or rejection of the requested change.

Wording for the distribution statements is shown below. The acceptable defense categories for the distribution statements must be chosen from those listed in DoDI

5230.24. The following address will be used on all documentation for the “controlling DoD office” for this program:

DISTRIBUTION STATEMENT D: Distribution authorized to the Department of Defense and U.S. DoD contractors only [category] [date of determination]. Other requests for this document must be referred to [controlling DoD office].

8.4 Controlling Office

The following address will be used on all documentation for the “controlling office” for this program:

AFLCMC/ROU

Human Systems Division (Program Name) 236 Milledgeville Street, Suite F30 Robins AFB GA 31098

8.5 Export-Controlled Warning Statement

Authority to withhold and control the export of certain technical data with military or space application is determined in accordance with Title 10, United States Code section 130, “Authority to withhold from public disclosure certain technical data,” and implemented by DoDD 5230.25, if such data may not be exported lawfully outside the United States without an approval, authorization, or license under the Export Control Reform Act of 2018 or the Arms Export Control Act (AECA) (both cited in the Export Control Warning). Such withholding and export control applies to Defense items listed in the United States Munitions List (USML), which is part of the International Traffic in Arms

Regulations (ITAR) (22 CFR 120-130); and Export Administration Regulations (EAR) (15

CFR 730-774).

If a technical document, whether printed or electronic/digital, contains export-controlled technical data, it shall be marked with the export control warning statement prescribed in DoDI 5230.24 and shown below. When it is not feasible to use the entire statement, the abbreviated warning may be used, and a copy of the full warning added to the “Notice to Accompany the Dissemination of Export-Controlled Technical Data,” which is Enclosure 5 of DoDD 5230.25. For assistance in determining what is export controlled, consult the controlling DoD office. The Export Control Warning may be used in conjunction with distribution statements B, C, D, E, and F. Distribution statement A, which denotes public release, cannot be used in conjunction with the export-control warning notice.

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.

8.6 Controlled Unclassified Information (CUI)

Unclassified documentation that is associated with a law, regulation, or government-wide policy, and identified as needing safeguarding, is considered CUI and must be marked according to DoDI 5200.48, Controlled Unclassified Information (CUI).

8.7 Marking Non-Technical Documentation

Non-technical documentation that is associated with a law, regulation, or government-wide policy, and identified as needing safeguarding, is considered CUI and must be marked according to DoDI 5200.48, Controlled Unclassified Information (CUI).

8.8 Marking Examples

The marking examples below are for reference. Specific information within the distribution statements and the CUI Designation Indicator will depend upon each individual case.

Marking example for non-technical CUI:

Controlled by: USAF/AFMC Controlled by: AFLCMC/XXXX CUI Category: General Proprietary Business Information Distribution/Dissemination Control: IAW DoDI 5200.48 Limited Dissemination Controls are mandatory for non-technical CUI POC: Gov POC name and email

CUI Designation Indicator IAW DoDI 5200.48

CUI Mark Top of Page

Marking example for technical CUI:

Marking example for export-controlled technical CUI:

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.

CUI

Mark Bottom of Page

Complete DoDI 5230.24 Distribution Statement

DISTRIBUTION STATEMENT E. Secondary Distribution authorized to DoD components only; Controlled Technical Information; 27 August 2021. Other requests for this document must be referred to AFLCMC/XXXX, Gov address.

Controlled by AFLCMC/XXXX CUI Category: Controlled Technical Information Distribution/Dissemination Control: E POC: Gov POC name and email

CUI Designation Indicator IAW DoDI 5200.48

CUI

CUI Mark Top of Page

Mark Bottom of Page

Complete DoDI 5230.24 Distribution Statement

DISTRIBUTION STATEMENT E. Secondary Distribution authorized to DoD components only; Critical Technology, Export Controlled; 27 August 2021.

Other requests for this document must be referred to AFLCMC/XXXX, Gov address.

CUI Mark Top of Page

DoDI 5230.24 Export Control Warning

8.9 Intellectual Property/Marking

Any markings that are added to documents for review purposes must be removed prior to formal submittal. If a document still requires a marking not addressed in the contract, the contractor must provide a justification for the marking.

9.0 MAILING LISTS

The Government will provide the following information for each recipient identified in Block 14: office symbol, mailing address, point of contact e-mail and phone number.

Office/Symbol Addresses Email/Phone

AFLCMC/ROU

For data deliveries

MEARS https://mears1.redstone.

army.mil/mears/default.a spx

10.0 CDRL TABLE OF CONTENTS

Controlled by AFLCMC/XXXX CUI Category: Controlled Technical Information Distribution/Dissemination Control: E POC: Gov POC name and email

CUI Designation Indicator IAW DoDI 5200.48

CUI Mark Bottom of Page

6/17/2026 7:07:54 PM EDT CDRL Table of Contents

CONTRACT #: FD2060-25-30324

F4FDAL5192A001

CONTRACTOR: W.S. DARLEY & CO

SET NAME: JSMLT (Option 1) SYSTEM ITEM: Joint Service Mask Leakage Tester Repair

PROGRAM: Human Systems

DATA ITEM REQUIRING OFFICE AUTHORITY/TITLE/SUBTITLE SOW PARAGRAPH

B001 AFLCMC/ROU DI-MGMT-80441D 3.2, 3.6

Government Property (GP) Inventory Report

B002 AFLCMC/ROU DI-QCIC-80278C 4.3.1

Calibration and Measurements Requirements Summary

(CRMS)

B003 AFLCMC/ROU DI-MGMT-81803A 4.7.1.1

Item Unique Identification (IUID) Marking Plan

B004 AFLCMC/ROU DI-MGMT-81804A 4.7.1

Item Unique Identification (IUID) Marking Activity, Validation and Verification Report

B005 AFLCMC/ROU DI-NDTI-80809B 4.7.3.2

Test/Inspection Report

Individual Test Report

B006 AFLCMC/ROU DI-QCIC-80553A 4.7.3.2

Acceptance Test Plan

B007 AFLCMC/ROU DI-NDTI-80603A 4.7.3.3

Test Procedure

B008 AFLCMC/ROU DI-NDTI-80809B 4.7.3.3

Test/Inspection Report

Test Procedure Qualification

B009 AFLCMC/ROU DI-MGMT-81634C 4.7.5.2

Commercial Asset Visibility Air Force (CAVAF) Government Furnished Material Report

B00A AFLCMC/ROU DI-MGMT-81838 4.7.5.3

Commercial Asset Visibility (CAV) Reporting

B00B AFLCMC/ROU DI-PSSS-81995A 4.7.5.2

Contract Depot Maintenance (CDM) Monthly Production Report

CDM Production Monthly Status Report

B00C AFLCMC/ROU DI-MGMT-82128A 3.2

Contract Government Furnished Material (GFM) Monthly Requisition and Inventory Report

B00D AFLCMC/ROU DI-MISC-81832 4.7.6.1

6/17/2026 7:07:54 PM EDT CDRL Table of Contents

Counterfeit Prevention Plan

B00E AFLCMC/ROU DI-MISC-80711A 4.10

Scientific and Technical Reports

B00F AFLCMC/ROU DI-SESS-80639E 4.10.1.2, 4.10.1.2.1, 4.10.1.2.2

Engineering Change Proposal (ECP)

B00G AFLCMC/ROU DI-SESS-80642E 4.10.1.2

Notice of Revision (NOR)

B00H AFLCMC/ROU DI-MISC-81618 4.10.2.2

Service Bulletins

B00J AFLCMC/ROU DI-PSSS-81656B 4.10.3

Bill of Materials (BOM) for Logistics and Supply Chain Risk

B00K AFLCMC/ROU DI-MGMT-8004A 5.2.1

Management Plan

Mission-Essential Services Plan

B00L AFLCMC/ROU DI-IPSC-81442A 4.8.2

Software Version Description

SVD

B00M AFLCMC/ROU DI-MISC-81454D 4.8.2

Computer Program Identification Number (CPIN) Catalog Information

B00N AFLCMC/ROU DI-IPSC-80590B 4.8.2

Computer Program End Item Documentation

(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

B

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B001

2. TITLE OF DATA ITEM

Government Property (GP) Inventory Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80441D

5. CONTRACT REFERENCE

3.2, 3.6

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

BLK 16

Draft

Final

Reg Repro

16. REMARKS

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 12:

First submission due 60 days after contract award, if applicable.

BLK 13:

Subsequent submissions due upon government request or 10 days after a modification to the report.

MEARS 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages

17. PRICE GROUP

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

B

C. CATEGORY:

TDP TM OTHER QCIC

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B002

2. TITLE OF DATA ITEM

Calibration and Measurements Requirements Summary

(CRMS)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-QCIC-80278C

5. CONTRACT REFERENCE

4.3.1

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

BLK16

12. DATE OF FIRST SUBMISSION

BLK16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

BLK16

Draft

Final

Reg Repro

16. REMARKS

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 12:

First submission due 120 days after contract award.

BLK 10 & BLK 13:

Subsequent submissions due every 90 days.

MEARS 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

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

B

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B003

2. TITLE OF DATA ITEM

Item Unique Identification (IUID) Marking Plan

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81803A

5. CONTRACT REFERENCE

4.7.1.1

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

Draft

Final

Reg Repro

16. REMARKS

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 12:

First submission due 120 days after contract award.

MEARS 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

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

B

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B004

2. TITLE OF DATA ITEM

Item Unique Identification (IUID) Marking Activity, Validation and Verification Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81804A

5. CONTRACT REFERENCE

4.7.1

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

Draft

Final

Reg Repro

16. REMARKS

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 16:

First submission due 120 days after contract award.

MEARS 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

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

B

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B005

2. TITLE OF DATA ITEM

Test/Inspection Report

3. SUBTITLE

Individual Test Report

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

4.7.3.2

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

QRTLY

12. DATE OF FIRST SUBMISSION

ASREQ

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

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 11 & BLK 13:

The Contractor shall submit a Developmental Test Report for Performance Validation documenting the results of all tests and demonstrations required by the Government approved Developmental Test Plan for Performance Validation NLT thirty (30) calendar days after the last planned test or demonstration event is satisfactorily complete. This report shall reflect how the prototype met, or failed to meet, thresholds and objectives laid out int the Statement of Objectives.

WAWF 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

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

B

C. CATEGORY:

TDP TM OTHER QCIC

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B006

2. TITLE OF DATA ITEM

Acceptance Test Plan

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-QCIC-80553A

5. CONTRACT REFERENCE

4.7.3.2

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

QRTLY

12. DATE OF FIRST SUBMISSION

BLK16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

Draft

Final

Reg Repro

16. REMARKS

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 12:

The Contractor shall submit Acceptance Test Plan 30 days prior to acceptance test procedures.

WAWF 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

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

B

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B007

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

4.7.3.3

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

BLK16

12. DATE OF FIRST SUBMISSION

BLK16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

BLK16

Draft

Final

Reg Repro

16. REMARKS

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 10, BLK 12, & BLK 13:

Contractor shall use approved Acceptance Test Procedures (ATPs) already in Contractor’s possession in the normal course for repair and manufacture. If ordered, the Contractor shall be required to generate or modify the ATP qualification, if applicable, shall consist of specific requirements which will be stipulated in the applicable Delivery Order.

Government will be allowed up to 30 days, after receipt from contractor, to provide Comment Resolution Matrix (CRM), which allows up to 21 days for formal review, and 9 days for consolidation. The contractor has up to 4 days after CRM receipt from government to provide government with CRM decision (i.e. provide accept/modify/reject response) and updated Test Procedures with accepted CRM comments implemented. The contractor has up to 4 days to conduct a meeting with the government for CRM modify/reject resolution. The contractor has up to 4 days to submit adjudicated Test Procedures (i.e. Test procedures modified to include CRM accepted comments and adjudicated modify/reject decision comments) to government for signature/approval. The government has up to 15 days, after receipt from contractor, to approve Test Procedures.

MEARS 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

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

B

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B008

2. TITLE OF DATA ITEM

Test/Inspection Report

3. SUBTITLE

Test Procedure Qualification

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

4.7.3.3

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

QRTLY

12. DATE OF FIRST SUBMISSION

ASREQ

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

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 11 & BLK 13:

The Contractor shall submit a Developmental Test Report for Performance Validation documenting the results of all tests and demonstrations required by the Government approved Developmental Test Plan for Performance Validation NLT thirty (30) calendar days after the last planned test or demonstration event is satisfactorily complete. This report shall reflect how the prototype met, or failed to meet, thresholds and objectives laid out int the Statement of Objectives.

WAWF 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

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

B

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B009

2. TITLE OF DATA ITEM

Commercial Asset Visibility Air Force (CAVAF) Government Furnished Material Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81634C

5. CONTRACT REFERENCE

4.7.5.2

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

BLK 16

Draft

Final

Reg Repro

16. REMARKS

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 12 & 13:

The contractor shall conduct production reporting as transactions occur and report problems. No more than two late or incorrect entries shall be allowed per delivery order. Any delayed entries shall not exceed three calendar days.

BLK 14:

The contractor shall report End Item transactional data through electronic submission in CAV AF using CAV AF web site (https://www.cavaf.com) or CICA XML IAW the referenced DID IAW and/or

CAV AF CFM PWS.

BLK 16 0 0 1

WAWF 0 0 1

15. TOTAL 0 0 2

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

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

B

C. CATEGORY:

TDP TM OTHER MGMT

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B00A

2. TITLE OF DATA ITEM

Commercial Asset Visibility (CAV) Reporting

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81838

5. CONTRACT REFERENCE

4.7.5.3

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

BLK16

12. DATE OF FIRST SUBMISSION

BLK16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

BLK16

11. AS OF DATE

BLK16

13. DATE OF SUBSEQUENT

SUBMISSION

BLK16

Draft

Final

Reg Repro

16. REMARKS

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 7, BLK 8, and BLK 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. The contractor shall submit a DD Form 250 (Material Inspection and Receiving Report) electronically via the Internet to iRAPT (WAWF) website address: https://wawf.eb.mil, using DODAAC FB2065. MARK FOR:

Address in block 14a.

c. A Letter of Transmittal shall be submitted in the month the delivery order is completed, covering all reports transmitted for that order.

BLK 10, BLK 11, BLK 12, & BLK 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.

BLK 16 0 0 1

WAWF 0 0 1

15. TOTAL 0 0 2

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

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

B

C. CATEGORY:

TDP TM OTHER PSSS

D. SYSTEM/ITEM

Joint Service Mask Leakage Tester Repair

E. CONTRACT/PR NO.

FD2060-25-30324 F4FDAL5192A001

F. CONTRACTOR

W.S. DARLEY & CO

1. DATA ITEM NO.

B00B

2. TITLE OF DATA ITEM

Contract Depot Maintenance (CDM) Monthly Production Report

3. SUBTITLE

CDM Production Monthly Status Report

4. AUTHORITY (Data Acquisition Document No.)

DI-PSSS-81995A

5. CONTRACT REFERENCE

4.7.5.2

6. REQUIRING OFFICE

AFLCMC/ROU

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

MTHLY

12. DATE OF FIRST SUBMISSION

BLK16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

BLK16

Draft

Final

Reg Repro

16. REMARKS

Applicable to the following Joint Service Mask Leakage Tester (JSMLT) Repair Equipment: NSN:6665-01-506-9002 and NSN:6665-01-665-5513

BLK 12 & BLK 13:

Submittal due on the 15th of each month after the first full month after contract award.

MEARS 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

Michelle L. Mullins //SIGNED//Configuration Management

H. DATE

2026/06/17

I. APPROVED BY

Eula F. Deriso //SIGNED//Logistics Mgmt. Spec.

J. DATE

2026/06/17

18. ESTIMATED

TOTAL PRICE

Form Approved OMB No. 0704-0188

T…