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DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page of Pages

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423-1 (BACK), FEB 2001

data_item: C001 title: Counterfeit Prevention Plan sub: CPP auth: DI- MISC-81832 ref: PWS 8.3 req_ofc: 415 SCMS/GUEA dd250: DD appcode: A dist: D freq: 1TIME asof: N/A firstsub: 30DAC subsub: N/A addressee1: FY2073 draft1:

reg1: 1 repro1:

addressee2: 415 SCMS/EN draft2:

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total_draft: 0 total_reg: 1 total_repro: 1 remarks: Changes to office symbols and/or e-mail addresses, when necessary, shall be made by letter through the CO/ACO without further revision to this CDRL.

Block 4: Plan shall include all items from section 3 of SAE AS5553.

Block 12: Contractor shall deliver the Counterfeit Prevention Plan within 30 days of contract award. Government comments provided to the contractor within 14 days after receipt, with contractor re-submittal due 7 days after receipt of comments.

Block 14: Document submission shall be made electronically using MS Office 2010 or newer format or Portable Document Format (PDF).

Address e-mail submissions to:

USAF AFMC 415 SCMS/EN, 415SCMS.en@us.af.mil, peter.pham.2@us.af.mil

DODAAC: FY2073

Address Line 1: FY2073 GLSC 415 SCMS Address Line 2: BLDG 1226 CP 801 586 0540 Address Line 3: 6041 Gum Lane Address Line 4: HILL AFB UT 84056 Block 9:

DISTRIBUTION STATEMENT D: Distribution authorized to the Department of Defense and U.S. DoD contractors only for administration and operational purposes, contains limited access information, 21 Nov 2008. Other requests for this document shall be referred to OO-ALC/ AFMC 415 SCMS/GUEA.

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

group: NSP total_price: 0.00 prep_name: Engineer 415 SCMS/GUEA line_item:

exhibit: C xtdp: Off xtm: Off othercat: MISC system: AN/TPT-T1(V) ctr_no: N/A contr:

remarksb:

Page2:

Reset:

2023-01-17T07:05:22-0700

PHAM.PETER.H.1230957769

prep_date: 01/17/2023 app_by: Jackson Andrasko 415 SCMS/GUEA

2022-05-11T09:05:19-0600

ANDRASKO.JACKSON.1258051030

app_date: 5/11/2022

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A001 title: First Article Qualification Test Plan sub: First Article Test Procedure auth: DI-NDTI-81307A ref: USAF AFMC 260 Block 9C req_ofc: 415 SCMS/GUEA dd250: DD appcode: A dist: D freq: ONE/R asof: NA firstsub: See 16 subsub: NA addressee1: 415 SCMS/GUEA draft1:

reg1:

repro1: 1 addressee2: FY2073 draft2:

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addressee3: 415 SCMS/EN draft3:

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total_draft: 0 total_reg: 1 total_repro: 2 remarks: Changes to names and office symbols, when necessary, shall be made by letter through the CO/ACO without revision to this CDRL.

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

DISTRIBUTION STATEMENT D: Distribution authorized to the Department of Defense and U.S. DoD contractors only for administration and operational purposes, contains limited access information, 7 May 2020. Other requests for this document shall be referred to OO-ALC/ AFMC 415 SCMS/GUEA.

WARNING: Export Controlled Destruction Notice: Destroy by any means that will prevent disclosure of the contents or reconstruction of the document.

Block 12: The Contractor shall deliver the First Article Test Plan a minimum of 30 days prior to first article test. The contractor shall make any re-submittal NLT 15 days after receipt of government comments.

Block 14a: Electronic submission is acceptable. Addresses are:

DODAAC: FY2073

peter.pham.2@us.af.mil 415SCMS.EN@us.af.mil

CUI

CONTROLLED UNCLASSIFIED INFORMATION (CUI) Requirements:

Mark the top and bottom of the first page with CUI.

Include the CUI block below the Destruction Notice.

CUI Block:

"Controlled By: 415 Supply Chain Management Squadron CUI Categories: CTI, CUI EXPT Distribution/Dissemination Control: Distribution Statement D POC: STINFO Manager: 415SCMS.en@us.af.mil" group: NSP total_price: 0.00 prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: NDTI system: AN/TPT-T1(V), UMTE ctr_no: FD20202300389 contr:

remarksb:

Page2:

Reset:

2023-02-06T14:51:44-0700

PHAM.PETER.H.1230957769

prep_date: 2/6/2023 app_by: Engineering Chief

2023-02-06T15:22:11-0700

ANDRASKO.JACKSON.1258051030

app_date: 2/6/2023

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A002 title: Test/Inspection Report sub: First Article Test Report auth: DI-NDTI-80809B ref: USAF AFMC 260 Block 9E req_ofc: 415 SCMS/GUEA dd250: DD appcode: A dist: D freq: ONE/R asof: NA firstsub: See 16 subsub: NA addressee1: 415 SCMS/GUEA draft1:

reg1:

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total_draft: 0 total_reg: 1 total_repro: 2 remarks: Changes to names and office symbols, when necessary, shall be made by letter through the CO/ACO without revision to this CDRL.

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

DISTRIBUTION STATEMENT D: Distribution authorized to the Department of Defense and U.S. DoD contractors only for administration and operational purposes, contains limited access information, 7 May 2020. Other requests for this document shall be referred to OO-ALC/ AFMC 415 SCMS/GUEA.

WARNING: Export Controlled Destruction Notice: Destroy by any means that will prevent disclosure of the contents or reconstruction of the document.

Block 12: The Contractor shall deliver the First Article Test Report NLT 15 days after first article test. The contractor shall make any re-submittal NLT 15 days after receipt of government comments..

Block 14a: Electronic submission is acceptable. Addresses are:

DODAAC: FY2073

peter.pham.2@us.af.mil 415SCMS.EN@us.af.mil

CUI

CONTROLLED UNCLASSIFIED INFORMATION (CUI) Requirements:

Mark the top and bottom of the first page with CUI.

Include the CUI block below the Destruction Notice.

CUI Block:

"Controlled By: 415 Supply Chain Management Squadron CUI Categories: CTI, CUI EXPT Distribution/Dissemination Control: Distribution Statement D POC: STINFO Manager: 415SCMS.en@us.af.mil" group: NSP total_price: 0.00 prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: NDTI system: AN/TPT-T1(V), UMTE ctr_no: FD20202300389 contr:

remarksb:

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Reset:

2023-02-06T14:53:20-0700

PHAM.PETER.H.1230957769

prep_date: 2/6/2023 app_by: Engineering Chief

2023-02-06T15:22:40-0700

ANDRASKO.JACKSON.1258051030

app_date: 2/6/2023

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app: Adobe Professional 8.0