CDRLFATR.pdf

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page of Pages Adobe Professional 8.0

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

CONTRACT DATA REQUIREMENTS LIST

(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 C. CATEGORY:

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION Draft

Final

Reg Repro

16. REMARKS

15. TOTAL 0 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Block D: 6150-00-005-1715; PN:71D46266G1; Description: Cable Assembly, Spec, W6B A Block 4: Contractor format acceptable.

A Paragraph 10.2 of DI-NDTI-80809B clarified as follows:

A

a. All dimensions and tolerances specified on the manufacturing data shall be listed in one column, with the actual corresponding reading obtained from the inspection of the part listed in another column.

A

b. Materials used in the manufacture of the "First Article" shall be identified and certified along with a copy of material purchase requirements as conforming to applicable data requirements.

A

c. Material processing, including finish requirements (plating, heat treatment, welding, anodizing, painting, etc.) utilized in the manufacture of "First Article" item shall be identified and certified as conforming to applicable requirements. A copy of the purchase order certifying the process accomplished at other than contractor facility shall be included.

A Block 9: Data submittal shall be marked with the following on the cover page:

A DISTRIBUTION STATEMENT D: Distribution authorized to DOD and U.S. DOD contractors only for Intercontinental Ballistic Missiles (ICBM) administrative or operational use determined as of 2 DEC 2021. Other requests for this document shall be referred to MMIII Systems Directorate, Hill AFB, UT. 84056.

A WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751 et seq.) or the Export Administration Act of 1979, as amended, Title 50, USE., App. 2401 et seq.

Violations of these export control laws is subject to severe criminal penalties.

Dissemination of this document is controlled under DOD Directive 5230.25.

A DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

NSP

$0.00

See Blk 16 PR# FD20202200051

A001 Test/Inspection Report First Article Test Report

DI-NDTI-80809B/T 414 SCMS/GUEAA

SD

See Blk 16

See Blk 16 See Blk 16

A See Blk 16 See Blk 16

SEE BLOCK 16

809 MXSS/MXDEB 1

414th Engineer

02DEC21

414th Lead Engineer

02DEC21

1 2

DUFFY.ALEXAND

ER.J.1546754835

Digitally signed by

DUFFY.ALEXANDER.J.1546754835

Date: 2021.12.02 16:30:03 -07'00'

MURRISON.RAY.D.

JR.1513506828

Digitally signed by

MURRISON.RAY.D.JR.1513506828

Date: 2021.12.02 11:04:09 -07'00'

ResetDD FORM 1423-1, FEB 2001 Page of Pages

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP TM OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

16. REMARKS (Continued)

See Blk 16 PR# FD20202200051

Block 10: ONE/R, Report shall be submitted concurrently with the "First Article" item either in the shipping container or separately if the report will not fit within the container unfolded. When shipped in the "First Article" container, report shall be enclosed in a paper or plastic envelope.

Block 11, 12, and 13: Defined in Contract

Block 14: Complete mailing address is:

809 MXSS/MXDEB (DODAAC: FB2029)

Bldg 849, Attn: Non-Accountable Bay Mark For: First Article Do Not Post Hill AFB, UT 84056-5713

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