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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: A007 title: Quality Program Plan (QPP) sub: Contractor's Progress, Status and Management Report auth: DI-QCIC-81722 ref: PWS Paragraph 4.10 req_ofc: 78 ABW/SEG dd250: LT appcode: A dist: D freq: One/P asof: See Blk 16 firstsub: See Blk 16 subsub: See Blk 16 addressee1: Martens, Tyler draft1:

reg1: 1 repro1:

addressee2: Smith, Harry draft2:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Changes to office symbols and/or e-mail addresses, when necessary, shall be made by letter through the PCO/ACO without further revision to this CDRL.

Block 10-13. Contractor shall submit the QPP 15 days after contract award. Written Government acceptance/comments/rejection will be within 5 working days after receipt of Plan from the Contractor.

Block 14. EMAIL electronic QPP to the following list: Program Manager (PM), Engineer and Equipment Specialist (ES). Points of contact will be provided to the Contractor at contract award and below. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

ENG: Hardaway, Christopher 409 SCMS/GUEA, christopher.hardaway@us.af.mil ES: Smith, Harry, 409 SCMS/GUMBB, harry.smith.12@us.af.mil PM: Martens, Tyler, 409 SCMS/GUMBC, tyler.martens.2@us.af.mil

COORDINATOR: Ruth H. Kirkland, DMO A007 2-4-25 RHK Concur group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: X system: Radio Control Set ctr_no: FD2060-25-00378 contr: Rockwell Collins, Inc.

remarksb:

Page2: 2

Reset:

2025-02-04T22:19:02-0500

MARTENS.TYLER.KEITH.1458516991

prep_date: 5 Feb 25 app_by:

2025-02-05T06:32:11-0500

MILLER.LARRY.THOMAS.1018594761

app_date: 5 Feb 25

Page: 1 of_pages: 2 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: Item Unique Identification (IUID) Marking Activity, Validation and Verification Report sub:

auth: DI-MGMT-81804A ref: PWS Paragraph 3.7.1 req_ofc: PZAAB dd250: LT appcode: A dist: D freq: Annually asof: See Blk 16 firstsub: See Blk 16 subsub: See Blk 16 addressee1: Martens, Tyler draft1:

reg1: 1 repro1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Changes to office symbols and/or e-mail addresses, when necessary, shall be made by letter through the PCO/ACO without further revision to this CDRL.

Block 10-13. Contractor shall submit an IUID Marking Activity and Verification Report after all assets have been repaired and returned to the Government. Written Government acceptance/comments/rejection will be within 5 working days after receipt of Plan from the Contractor.

Block 14. EMAIL electronic IUID Marking Activity and Verification Report to the following list: Program Manager (PM), Engineer and Equipment Specialist (ES). Points of contact will be provided to the Contractor at contract award and below. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

ENG: Hardaway, Christopher 409 SCMS/GUEA, christopher.hardaway@us.af.mil ES: Smith, Harry, 409 SCMS/GUMBB, harry.smith.12@us.af.mil PM: Martens, Tyler, 409 SCMS/GUMBC, tyler.martens.2@us.af.mil

A002 2-4-25 RHK Concur group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: X system: Radio Control Set ctr_no: FD2060-25-00378 contr: Rockwell Collins, Inc.

remarksb:

Page2:

Reset:

2025-02-04T22:17:48-0500

MARTENS.TYLER.KEITH.1458516991

prep_date: 5 Feb 25 app_by:

2025-02-05T06:28:49-0500

MILLER.LARRY.THOMAS.1018594761

app_date: 5 Feb 25

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: Commercial Asset Visibility Air Force sub: CAV-AF auth: DI-MGMT-81838 ref: PWS Paragraph 3.3.8 req_ofc: FA8538 dd250: LT appcode: N/A dist: N/A freq: See Blk 16 asof: See Blk 16 firstsub: See Blk 16 subsub: See Blk 16 addressee1: Martens, Tyler draft1:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: Changes to office symbol and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

1. Block 4: All reporting shall be submitted in the English language.

2. Block 5: Contract Reference: PWS and CAVAF Reporting Requirements Document.

3. Blocks 7, 8, 14:

a. The contractor shall report End Item transactional data through electronic submission in CAVAF using CAVAF website or CICA XML.

b. A Letter of Transmittal shall be submitted in the month the delivery order is completed, covering all reports transmitted for that order. Submit the Letter to the following email address:

SP: Lester, Vincent, 409 SCMS/GUMBA, vincent.lester@us.af.mil PM: Martens, Tyler, 409 SCMS/GUMBC, tyler.martens.2@us.af.mil

4. Blocks 10, 11, 12, 13:

a. Date of first submission shall be within 24 hours following a supply or maintenance transaction, after the contract award date.

b. Contractor reporting requirement to CAVAF shall be submitted daily and/or within 24 hours of supply or maintenance action occurrence IAW the CAVAF Reporting Requirements Document.

c. Data shall be current within 24 hours of the last End Item maintenance occurrence.

COORDINATOR: Ruth H. Kirkland, DMO A001 2-4-25 RHK Concur group:

total_price:

prep_name:

line_item:

exhibit: A xtdp: Off xtm: Off othercat: X system: Radio Control Set ctr_no: FD2060-25-00378 contr: Rockwell Collins, Inc.

remarksb:

Page2: 2

Reset:

2025-02-04T22:17:22-0500

MARTENS.TYLER.KEITH.1458516991

prep_date: 5 Feb 25 app_by:

2025-02-05T06:29:13-0500

MILLER.LARRY.THOMAS.1018594761

app_date: 5 Feb 25

Page: 1 of_pages: 2 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: A003 title: Item Unique Identification (IUID) Marking Plan sub:

auth: DI-MGMT-81803A ref: PWS Paragraph 3.7.1 req_ofc: PZAAB dd250: LT appcode: A dist: D freq: One/P asof: See Blk 16 firstsub: See Blk 16 subsub: See Blk 16 addressee1: Martens, Tyler draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Changes to office symbols and/or e-mail addresses, when necessary, shall be made by letter through the PCO/ACO without further revision to this CDRL.

Block 11 and Block 12. Initial submission shall be required within 15 days of contract award.

Block 13. As required.

Block 14. EMAIL electronic IUID Marking Plan to the following list: Program Manager (PM), Engineer and Equipment Specialist (ES). Points of contact will be provided to the Contractor at contract award and below. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

ENG: Hardaway, Christopher 409 SCMS/GUEA, christopher.hardaway@us.af.mil ES: Smith, Harry, 409 SCMS/GUMBB, harry.smith.12@us.af.mil PM: Martens, Tyler, 409 SCMS/GUMBC, tyler.martens.2@us.af.mil

COORDINATOR: Ruth H. Kirkland, DMO A003 2-4-25 RHK Concur group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: X system: Radio Control Set ctr_no: FD2060-25-00378 contr: Rockwell Collins, Inc.

remarksb:

Page2: 1

Reset:

2025-02-04T22:17:58-0500

MARTENS.TYLER.KEITH.1458516991

prep_date: 5 Feb 25 app_by:

2025-02-05T06:29:58-0500

MILLER.LARRY.THOMAS.1018594761

app_date: 5 Feb 25

Page: 1 of_pages: 2 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: A004 title: Contract Depot Maintenance Production Report sub: CDM auth: DI-PSSS-81995A ref: PWS Paragraph 3.3.9 req_ofc: FA8538 dd250: LT appcode: N/A dist: D freq: Monthly asof: See Blk 16 firstsub: See Blk 16 subsub: See Blk 16 addressee1: Martens, Tyler draft1:

reg1: 1 repro1:

addressee2: Lester, Vincent draft2:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: Changes to office symbol and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

1. Block 4:

a. All reporting shall be submitted in the English language.

b. The contractor CAVAF Reporting shall reflect their inventory property control management system data records which shall represent timely and accurate accountability of AF inventory assets at the physical location(s) of the contractor's repair facility (including subcontractor facilities); shop floor, bond room and/or receiving/shipping docks, etc. for each repair.

c. The contractor shall report by contract delivery order on all applicable categories, totals and on-hand balances, providing TABLE I (DI-PSSS-81995A) for EACH repair location, including subcontractor facilities, for the contracts maintenance occurrence actions during the reporting period.

d. The contractor shall report on production, providing TABLE I (DI-PSSS-81995A) for EACH repair location, including subcontractor facilities, for which the contractor produced during the reporting period.

2. Block 7, 14: Submit the CDM Production Monthly Status Reports to the following email address:

SP: Lester, Vincent, 409 SCMS/GUMBA, vincent.lester@us.af.mil PM: Martens, Tyler, 409 SCMS/GUMBC, tyler.martens.2@us.af.mil

3. Block 9:

a. DISTRIBUTION STATEMENT "D": Distribution authorized to the Department of Defense and U.S. DoD contractors only (Reason for Use). (Date of Determination). Other requests for this document shall be referred to (DoD Controlling Office).

b. EXPORT CONTROL WARNING: All technical documents/data (printed, digital/electronic) that are determined to contain export-controlled technical data, shall be marked with the following statement: EXPORT CONTROL 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 (Title 50, U.S.C., App.

2401 et seq), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate IAW provisions of DoD Directive 5230.25.

c. DESTRUCTION NOTICE: For classified documents, follow the procedures, in DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, or DoD 5200.1-R, Information Security Program Chapter VI. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: X system: Radio Control Set ctr_no: FD2060-25-00378 contr: Rockwell Collins, Inc.

remarksb: 4. Blocks 10, 11, 12, 13:

a. The reports shall be provided monthly within ten (10) business days of the previous month's last calendar date.

b. Reports shall continue to be submitted by the contractor unless the requirement is terminated by the assigned Contracting Officer at the request of the Program Manager (PM) and the Supply Planner (SP).

c. The Final Report submitted following the final reporting period on the contract shall be annotated "Final Report".

A004 2-4-25 RHK Concur

Page2: 2

Reset:

2025-02-04T22:18:28-0500

MARTENS.TYLER.KEITH.1458516991

prep_date: 5 Feb 25 app_by:

2025-02-05T06:30:24-0500

MILLER.LARRY.THOMAS.1018594761

app_date: 5 Feb 25

Page: 1 of_pages: 2 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: A005 title: Counterfeit Prevention Plan sub: CPP auth: DI-MISC-81832 ref: PWS Paragraph 3.8 req_ofc: FA8538 dd250: LT appcode: A dist: D freq: One/P asof: See Blk 16 firstsub: See Blk 16 subsub: See Blk 16 addressee1: Martens, Tyler draft1:

reg1: 1 repro1:

addressee2: Smith, Harry P.

draft2:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Changes to office symbols and/or e-mail addresses, when necessary, shall be made by letter through the PCO/ACO without further revision to this CDRL.

Block 10-13. Contractor shall submit the CPP fifteen (15) days after contract award. Written Government acceptance/comments/rejection will be within 5 working days after receipt of Plan from the Contractor.

Block 14. EMAIL electronic CPP to the following list: Program Manager (PM), Engineer and Equipment Specialist (ES). Points of contact will be provided to the Contractor at contract award and below. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

ENG: Hardaway, Christopher 409 SCMS/GUEA, christopher.hardaway@us.af.mil ES: Smith, Harry, 409 SCMS/GUMBB, harry.smith.12@us.af.mil PM: Martens, Tyler, 409 SCMS/GUMBC, tyler.martens.2@us.af.mil

A005 2-4-25 RHK Concur group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: X system: Radio Control Set ctr_no: FD2060-25-00378 contr: Rockwell Collins, Inc.

remarksb:

Page2: 2

Reset:

2025-02-04T22:18:43-0500

MARTENS.TYLER.KEITH.1458516991

prep_date: 5 Feb 25 app_by:

2025-02-05T06:31:07-0500

MILLER.LARRY.THOMAS.1018594761

app_date: 5 Feb 25

Page: 1 of_pages: 2 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: A006 title: Government Property (GP) Inventory Report sub:

auth: DI-MGMT-80441D ref: PWS Paragraph 3.5 req_ofc: FA8538 dd250: LT appcode: A dist: D freq: One/P asof: See Blk 16 firstsub: See Blk 16 subsub: See Blk 16 addressee1: Martens, Tyler draft1:

reg1: 1 repro1:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

Block 11 and Block 12: Initial submission shall be required within 30 days of contract award.

Block 13. As required.

Submit the Government Property Inventory Report to the following email address:

SP: Lester, Vincent, 409 SCMS/GUMBA, vincent.lester@us.af.mil PM: Martens, Tyler, 409 SCMS/GUMBC, tyler.martens.2@us.af.mil

A006 2-4-25 RHK Concur group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: X system: Radio Control Set ctr_no: FD2060-25-00378 contr: Rockwell Collins, Inc.

remarksb:

Page2:

Reset:

2025-02-04T22:18:53-0500

MARTENS.TYLER.KEITH.1458516991

prep_date: 5 Feb 25 app_by:

2025-02-05T06:31:35-0500

MILLER.LARRY.THOMAS.1018594761

app_date: 5 Feb 25

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: A008 title: Accident/Incident Report sub: Mishap Notification and Reporting auth: DI-SAFT-81563 ref: PWS Paragraph 4.5.1 req_ofc: 78 ABW/SEG dd250: LT appcode: A dist: B freq: As required asof: See Blk 16 firstsub: As required subsub:

addressee1: 78 ABW/SEG draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Block 4: Report all mishaps, damage to DoD property and employees injury, to the Installation Safety Office telephonic-ally within eight (8) hours where the dollar value exceeds $600,000.00, and within two (2) workdays for any damage to government property less than $600,000.00. An Accident/Incident Report must be submitted within 48 hours of the mishap.

Block 9: Submit to U.S. Government ONLY.

Block 11. Submit written report within 72 hours of mishap.

PM: Martens, Tyler, 409 SCMS/GUMBC, tyler.martens.2@us.af.mil PCO: Johnson, Stacylee, AFSC/PZAAB, stacylee.johnson.1@us.af.mil

COORDINATOR: Ruth H. Kirkland, DMO A008 2-4-25 RHK Concur group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: X system: Radio Control Set ctr_no: FD2060-25-00378 contr: Rockwell Collins, Inc.

remarksb:

Page2: 2

Reset:

2025-02-04T22:19:10-0500

MARTENS.TYLER.KEITH.1458516991

prep_date: 5 Feb 25 app_by:

2025-02-05T06:32:41-0500

MILLER.LARRY.THOMAS.1018594761

app_date: 5 Feb 25

Page: 1 of_pages: 2 app: Adobe Professional 8.0