CDRL Status Report_FD2030-22-31003 signed.pdf

CONTRACT DATA REQUIREMENTS LIST

Form Approved

CMB 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 this burden estimate or any other aspect of this collection of 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 222202-2302, 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 A

C. Category

D. System/Item.

F100-PW-220/229 Balance Segment Assembly

E. Contract/PR NO.

FD2030-22-31003

F. Contractor

1. Data Item No.

2. Title of Data Item:

Status Report for Contractor Receipt/Shipment of FMS R/R

3. Subtitle:

4. Authority (Data Acquisition Document No.)

DI-MISC-80915

5. Contract Reference

6. Requiring Office

AFLCMC/LPSIB

7. DD 250 Req

N/A

1. Dist Statement Required

N/A

10. Frequency

Monthly

12. Date of First Submission

See Block 16

14. Distribution

8. APP Code

N/A

11. As of Date

See Block 16

13. Date of Subsequent Submission

See Block 16

a. Addressee b. Copies

D r a f t

Final

Reg Repro

16. REMARKS

BLOCK 4: DID IS TAILORED AS FOLLOWS:

THIS CDRL WILL SERVER FOR BASIC YEAR AND ALL OPTION YEARS

THE CONTRACTOR SHALL PREPARE AND FURNISH A MONTHLY CUMULATIVE

STATUS REPORT FOR ALL ITEMS THAT HAVE BEEN RECEIVED FOR REPAIR. THE

REPORT SHALL BE PREPARED AS OF THE LAST WORKING DAY OF EACH MONTH

AND FORWARDED BY E-MAIL OR FAXED NO LATER THAN THE 5TH WORKING DAY

OF THE FOLLOWING MONTH. THE INITIAL REPORT WILL BE PREPARED FOR THE

MONTH DURING WHICH THE CONTRACT ASSETS ARE RECEIVED. REPORTS WILL

CONTINUE TO BE FORWARDED UNTIL ALL END ITEMS ARE REPAIRED. THE LAST

REPORT WILL BE ANNOTATED “FINAL REPORT”. NEGATIVE REPORTS ARE

REQUIRED.

CONTRACTOR’S FORMAT IS ACCEPTABLE.

NOTE: THIS REPORT SHOULD REFLECT THE APPLICABLE COUNTRY, ITEM PART

NUMBER, NATIONAL STOCK NUMBER, SERIAL NUMBER, NOMENCLATURE, DATE

RECEIVED, DOCUMENT NUMBER, DATE INPUT INTO WORK, EXHIBIT LINE ITEM

NUMBER, FORECAST COMPLETION DATE AND SHIP DATE OF SERVICEABLE ASSET.

REPORT IS TO BE FURNISHED IN EITHER NATIONAL STOCK NUMBER OR PART

NUMBER SEQUENCE. SCRAPPED ITEMS REQUIRE REASON FOR SCRAP AND T.O.

REFERENCE.

AFLCMC/LPSIB

3001 Staff Dr., Ste. 2AE1107B

Tinker AFB, OK. 73145-3031

Atueayu.Wilson.2@us.af.mil

405-582-5308

AFLCMC/LPSIB 1

DCMA/ACO 1

15. TOTAL 2 2 1

G. PREPARED BY H. DATE

16 March 22

I. APPROVED BY

J. DATE

16 March 22

DD Form 1423-1, JUN 90 Previous editions are obsolete Page 1 of 1 Pages mailto:Atueayu.Wilson.2@us.af.mil