CDRLS_A021-A030.pdf
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PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, FEB 2001 PagesPage of
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
0001 A MISC
CONSTRUCTION SERVICES TBD TBD
A021 Technical Report–Study/Services REPETITIVE ITEMS/MATERIALS SUBMITTAL
DI-MISC-80508B Section 00 73 02, Subsection 37 NSWC PHD CODE 1022
LT
N/A D
ASREQ
N/A
SEE BLK 16
SEE BLK 16
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12: First Submission for the Repetitive Items/Materials Submittal should be within 21 days of contract award.
BLK 13: When requested by the Government.
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO), miguel.alamo4.civ@us.navy.mil (BD33-COR), forrest.w.linder.civ@us.navy.mil (CODE 1022-RG)
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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
BD33-COR 1
CODE1022-RG 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:45:57 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:14:12 -07'00'
3/27/2023
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
0001 A MISC
CONSTRUCTION SERVICES TBD TBD
A022 Technical Report–Study/Services Modification Price Breakdown
DI-MISC-80508B Section 00 73 02, Subsection 39 NSWC PHD CODE 1022
LT
N/A D
ASREQ
N/A
SEE BLK 16
SEE BLK 16
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12 and 13: Submission for the Modification Price Breakdown should be furnished to the Government with each Modification Proposal.
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO), miguel.alamo4.civ@us.navy.mil (BD33-COR), forrest.w.linder.civ@us.navy.mil (CODE 1022-RG)
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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
BD33-COR 1
CODE1022-RG 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:46:17 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:15:39 -07'00'
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
0001 A MISC
CONSTRUCTION SERVICES TBD TBD
A023 Technical Report–Study/Services Schedule of Prices
DI-MISC-80508B Section 00 73 02, Subsection 42 NSWC PHD CODE 1022
LT
N/A D
Monthly
N/A
SEE BLK 16
SEE BLK16
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12: First Submission for the Schedule of Prices shall be within 20 days of task order issuance.
BLK 13: Submit subsequent Schedule of Prices every month for each task order issued.
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO), miguel.alamo4.civ@us.navy.mil (BD33-COR), forrest.w.linder.civ@us.navy.mil (CODE 1022-RG)
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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
BD33-COR 1
CODE1022-RG 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:46:38 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:17:07 -07'00'
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
0001 A MISC
CONSTRUCTION SERVICES TBD TBD
A024 Technical Report–Study/Services Record Documents
DI-MISC-80508B Section 00 73 02, Subsection 47 NSWC PHD CODE 1022
LT
N/A D
ASREQ
N/A
SEE BLK 16
N/A
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12 and 13: First Submission for the Record Documents should be delivered at final acceptance of the respective task order
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO), miguel.alamo4.civ@us.navy.mil (BD33-COR), forrest.w.linder.civ@us.navy.mil (CODE 1022-RG)
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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
BD33-COR 1
CODE1022-RG 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:46:56 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:21:16 -07'00'
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
0001 A MISC
CONSTRUCTION SERVICES TBD TBD
A025 Technical Report–Study/Services Operation and Maintenance Manual
DI-MISC-80508B Section 00 73 02, Subsection 48 NSWC PHD CODE 1022
LT
N/A D
ASREQ
N/A
SEE BLK 16
N/A
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12 and 13: Submission of the Operation and Maintenance Manual should be at final acceptance of the respective task order
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO), miguel.alamo4.civ@us.navy.mil (BD33-COR), forrest.w.linder.civ@us.navy.mil (CODE 1022-RG)
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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
BD33-COR 1
CODE1022-RG 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:47:32 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:23:08 -07'00'
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
0001 A MISC
CONSTRUCTION SERVICES TBD TBD
A026 Technical Report–Study/Services Certificate of Insurance
DI-MISC-80508B Section 00 73 03, Subsection 3 NSWC PHD CODE 1022
LT
N/A D
OTIME
N/A
SEE BLK 16
N/A
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12: First Submission for the Certificate of Insurance within fifteen (15) days after contract award.
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO)
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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:47:59 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:25:12 -07'00'
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
SEE BLK 16 A MISC
CONSTRUCTION SERVICES TBD TBD
A027 Technical Report–Study/Services Statement and Acknowledgement Standard Form (SF)
DI-MISC-80508B Section 00 73 03,Subsection 4 NSWC PHD CODE 1022
LT
N/A D
ASREQ
N/A
SEE BLK 16
N/A
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12 and 13: Submission for the SF 1413 should be prior to each subcontractors' construction start.
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO)
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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:49:56 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:28:57 -07'00'
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
0001 A MISC
CONSTRUCTION SERVICES TBD TBD
A028 Technical Report–Study/Services Key Personnel Substitutions Requests
DI-MISC-80508B Section 00 73 03, Subsection 15 NSWC PHD CODE 1022
LT
N/A D
ASREQ
N/A
SEE BLK 16
SEE BLK 16
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12 and 13: Submission for Key Personnel Substitutions Requests shall be 15 calendar days (45 calendar working days if security clearance is required to be obtained) in advance of the proposed substitutions
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO)
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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:49:16 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:31:40 -07'00'
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
0001 A MISC
CONSTRUCTION SERVICES TBD TBD
A029 Technical Report–Study/Services Evidence of Permits and Licenses
DI-MISC-80508B Section 00 73 03, Subsection 25 NSWC PHD CODE 1022
LT
N/A D
ASREQ
N/A
SEE BLK 16
SEE BLK 16
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12 and 13: Submission for Evidence of Permits and Licenses should be prior to construction start
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO), miguel.alamo4.civ@us.navy.mil (BD33-COR), 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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
BD33-COR 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:50:35 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:32:47 -07'00'
3/17/2023
(1 Data Item)
Form Approved OMB No. 0704-0188 OMB Approval Expires 20221130
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
8. APP CODE
9. DIST STATEMENT
REQUIRED
10. FREQUENCY
11. AS OF DATE
12. DATE OF FIRST SUBMISSION
13. DATE OF SUBSEQUENT
SUBMISSION
16. REMARKS
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
Draft Final
Reg Repro
15.TOTAL
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
1 1
0001 A MISC
CONSTRUCTION SERVICES TBD TBD
A030 Technical Report–Study/Services Strike Contingency Plan
DI-MISC-80508B Section 00 73 03, Subsection 33 NSWC PHD CODE 1022
LT
N/A D
OTIME
N/A
SEE BLK 16
N/A
BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only 18 JAN 2023. Other requests shall be referred to NSWC PHD.
BLK 12: Submission for Strike Contingency Plan should be within 15 working days after award.
BLK 14 &14a: Media Requirement. The report shall be delivered in Microsoft Office format (NMCI current deployed version) with E-mail notification to the following: ted.l.reed.civ@us.navy.mil (023- CS), siouzann.r.lende.civ@us.navy.mil (0231-KO), miguel.alamo4.civ@us.navy.mil (BD33-COR), 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, U.S.C., App. 2401 et seq.
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 in DoD 5220.22-M, Industrial Security Manual, Section 11 - 19 or DoD 5200.1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.
GOVERNMENT DOCUMENTATION SHALL BE DESTROYED UPON COMPLETION OF THE
CONTRACT OR PURCHASE ORDER, USE OF GOVERNMENT DOCUMENTATION FOR
COMMERCIAL PURPOSES IS FORBIDDEN.
CODE 023-CS 1
CODE 0231-KO 1
BD33-COR 1
N/A
Forrest Linder
LINDER.FORREST.WILLIAM.1545953788 Digitally signed by LINDER.FORREST.WILLIAM.1545953788 Date: 2023.03.24 12:51:04 -07'00'
3/24/2023 Wendy Doman
DOMAN.WENDY.JO.1070425692 Digitally signed by DOMAN.WENDY.JO.1070425692 Date: 2023.03.27 11:34:31 -07'00'
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File details come from the government source that posted it. Updated .