CDRLs Exhibits A-H J K.pdf

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SHACKLE Federal contract opportunity
Solicitation number
SPMYM222Q2092
Issued by
Defense Logistics Agency Land and Maritime

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CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) 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

MISC X

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

CERTIFICATION/DATA REPORT

PROOF & WORKING LOAD LIMIT

TEST CERTIFICATE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar- Guarniz@navy.mil & BREM.PSNS.WAWFQA.FCT@navy.mil.

Document No.: 2116-1000

15. Total 0

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

/s/ Irvin Aguilar Guarniz 5/28/2022 /s/ Richard Hawkins 5/28/2022

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

0002AA A

SHACKLE

A001

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

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar-

Document No.: 2116-1001

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

0004AA B

B001

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

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar-

Document No.: 2116-1003

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

0007AA C

C001

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

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar-

Document No.: 2116-1004

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

0009AA D

D001

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

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar-

Document No.: 2116-1005

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

E

SHACKLE

E001

0011AA

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

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar-

Document No.: 2116-1006

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

SHACKLE

0013AA F

F001

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

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar-

Document No.: 2116-1008

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

0015AA G

G001

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

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar-

Document No.: 2116-1009

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

0017AA H

H001

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

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar-

Document No.: 2116-1010

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

0019AA J

J001

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

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

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

DD ONE/R SEE BLOCK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 5/28/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 – Draft Certification/Data Report documentation shall be sent to Irvin.Aguilar- Guarniz@navy.mil. Allow 14 days from submission of draft for government to review.

Subsequent drafts will be required based on comments from government review. Final report is due within 10 days after receipt of draft approval.

Block 16 - Send Draft and Final Certification/Data Report documentation to Irvin.Aguilar-

Document No.: 2116-1011

DD FORM 1423-1, FEB 2001 Page 1 of 1 Pages

0021AA K

K001

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