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CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

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 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

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

Engineering Services / CSAG 6652

E. CONTRACT / PR NO.

FD20302102347

F. CONTRACTOR

1. DATA ITEM NO.

A045

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Final Qualification Report, CSAG 6652

4. AUTHORITY

DI-MISC-80508B

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Paragraph 3.2.1

6. REQUIRING OFFICE

423 SCMS/GUEA

7. DD 250 REQ

DD

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

See Block 16

10. FREQUENCY

1 XTIME

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Zilar, Dale NNAME: 02 NOV 2021DATE:

Blk 9, Distribution Statement D: Distribution authorized to the Department of Defense and US DOD Contractors only, critical technology (27 August 2020). Other requests shall be referred to 848 SCMG/EN, Tinker Air Force Base, Oklahoma.

Control Warning Notice: Warning - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, USC, Sec 2751 Et Seq) or the Export Administration Act of 1979, Title 50, USC, App 240 I Et Seq, as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DOD Directive 5230.25.

DESTRUCTION NOTICE : For classified documents, follow the procedures IAW DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, and DoDM 5200.01 Vol 3, DoD Information Security Program: Protection of Classified Information, Enclosure 3, paragraph 17.

For unclassified, destroy by any method that will prevent disclosure of contents or reconstruction of the document IAW DoDI 5230.24 Enclosure 3, Paragraph 17.

Blks 11, 12, & 13: IAW the PWS, EA, Table 4-1.

Blk 14a: Shipping Address:

3001 Staff Dr. Ste. 1AB1 100B Tinker AFB, OK 73145 Attn: Jeffrey Ryan Hill

Contractor's format is acceptable.

See PWS, EA for more details.

COORDINATORS:

423 SCMS/GUEA 0 1 0

See Block 16 0 0 0

0 1 015. TOTAL

G. PREPARED BY

Zilar, Dale N

424 SCMS / GUBAB

405-736-7976

H. DATE

03 NOV 2021

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Briggs, Ebony N

423 SCMS / GUMB 405-582-6866 / 852-6866

J. DATE

02-NOV-21

Page 1 of 3DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 03 Dec 2021

PREVIOUS EDITION MAY BE USED.

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM X OTHER

D. SYSTEM / ITEM

Engineering Services / CSAG 6652

E. CONTRACT / PR NO.

FD20302102347

F. CONTRACTOR

1. DATA ITEM NO.

A078

2. TITLE OF DATA ITEM

Technical Manual (TM) Contractor Furnished Aeronautical Equipment of Contractor Furnished Equipment (CFAE/CFE) Notice

3. SUBTITLE

Technical Manual, CSAG 6652

4. AUTHORITY

DI-TMSS-80067C

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Paragraph 3.1.2

6. REQUIRING OFFICE

423 SCMS/GUEA

7. DD 250 REQ

DD

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

1 XTIME

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Zilar, Dale NNAME: 02 NOV 2021DATE:

Blk 9, Distribution Statement D: Distribution authorized to the Department of Defense and US DOD Contractors only, critical technology (27 August 2020). Other requests shall be referred to 848 SCMG/EN, Tinker Air Force Base, Oklahoma.

Control Warning Notice: Warning - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, USC, Sec 2751 Et Seq) or the Export Administration Act of 1979, Title 50, USC, App 240 I Et Seq, as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DOD Directive 5230.25.

DESTRUCTION NOTICE : For classified documents, follow the procedures IAW DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, and DoDM 5200.01 Vol 3, DoD Information Security Program: Protection of Classified Information, Enclosure 3, paragraph 17.

For unclassified, destroy by any method that will prevent disclosure of contents or reconstruction of the document IAW DoDI 5230.24 Enclosure 3, Paragraph 17.

Blks 11, 12, & 13: IAW the PWS, EA, Table 4-1.

Blk 14a: Shipping Address:

3001 Staff Dr. Ste. 1AB1 100B Tinker AFB, OK 73145 Attn: Jeffrey Ryan Hill

Redline copies of the TO shall be in a Microsoft Word or PDF format and delivered electronically. Software updates shall be delivered IAW the format shown in PWS Attachment II. Contractor format is acceptable for the updated parts kit list.

Delivery CANNOT Be Deferred.

Contractor's format is acceptable.

See PWS, EA for more details.

COORDINATORS:

423 SCMS/GUEAB 0 1 0

See Block 16 0 0 0

0 1 015. TOTAL

G. PREPARED BY

Zilar, Dale N

424 SCMS / GUBAB

405-736-7976

H. DATE

03 NOV 2021

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Briggs, Ebony N

423 SCMS / GUMB 405-582-6866 / 852-6866

J. DATE

02-NOV-21

Page 2 of 3DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 03 Dec 2021

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

Engineering Services / CSAG 6652

E. CONTRACT / PR NO.

FD20302102347

F. CONTRACTOR

1. DATA ITEM NO.

A083

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Qualification Test Plan

4. AUTHORITY

DI-NDTI-80603A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Paragraph 3.1.1

6. REQUIRING OFFICE

423 SCMS/GUEA

7. DD 250 REQ

N/A

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

1 XTIME

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Zilar, Dale NNAME: 02 NOV 2021DATE:

Blk 9, Distribution Statement D: Distribution authorized to the Department of Defense and US DOD Contractors only, critical technology (27 August 2020). Other requests shall be referred to 848 SCMG/EN, Tinker Air Force Base, Oklahoma.

Control Warning Notice: Warning - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, USC, Sec 2751 Et Seq) or the Export Administration Act of 1979, Title 50, USC, App 240 I Et Seq, as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DOD Directive 5230.25.

DESTRUCTION NOTICE : For classified documents, follow the procedures IAW DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, and DoDM 5200.01 Vol 3, DoD Information Security Program: Protection of Classified Information, Enclosure 3, paragraph 17.

For unclassified, destroy by any method that will prevent disclosure of contents or reconstruction of the document IAW DoDI 5230.24 Enclosure 3, Paragraph 17.

Blks 11, 12, & 13: IAW the PWS, EA, Table 4-1.

Blk 14a: Shipping Address:

3001 Staff Dr. Ste. 1AB1 100B Tinker AFB, OK 73145 Attn: Jeffrey Ryan Hill

Contractor's format is acceptable.

See PWS, EA for more details.

COORDINATORS:

423 SCMS/GUEA 0 1 0

See Block 16 0 0 0

0 1 015. TOTAL

G. PREPARED BY

Zilar, Dale N

424 SCMS / GUBAB

405-736-7976

H. DATE

03 NOV 2021

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Briggs, Ebony N

423 SCMS / GUMB 405-582-6866 / 852-6866

J. DATE

02-NOV-21

Page 3 of 3DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 03 Dec 2021

File details come from the government source that posted it. Updated .