CDRLS N0010426RK070.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. 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

4T-6135-01-339-8064 CWRG

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

ALL DRAWINGS

6. REQUIREING OFFICE

KEYPORT

18. ESTIMATED TOTAL

PRICE

7. DD 250 REQ

SD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE TIME

12. DATE OF FIRST SUBMISSION

60 DADC

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. ADP CODE

A

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

Reg Repro

16.REMARKS

THE PLAN IS TO SPECIFY PROCESS CONTROL INSTRUCTIONS AND INSPECTION

PROCEDURES NEEDED TO ENSURE PRODUCT CONFORMANCE TO DRAWINGS,

SPECIFICATIONS, AND CONTRACT REQUIREMENTS IAW ANSI/ASQC Q9000-2000 OR

EQUIVALENT. THE PLAN IS TO INCLUDE FIRST ARTICLE AND PRODUCTION LOT

QUALITY CONFORMANCE INSPECTION PROCEDURES IAW DI-NDTI-80603A ALONG

WITH ALL APPLICABLE DATA ENTRY SHEETS TO BE USED TO DOCUMENT PROCESS

INSPECTIONS.

BLK 14: Distribution List

1. Contract Administration Office (CAO)

2. NAVSUP WSS Contracting Officer N772

3. NAVSUP ALC, Code A115

4. NUWC-Newport Code 8554

See section H for distribution POC’s and their emails.

SEE BLOCK 14 0 1 0

15. TOTAL 0 1 0

G. PREPARED BY

Richard Rzomp

H. DATE

3/12/2025

I. APPROVED BY

John Knecht

J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 6 Pages

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

A002

Test/Inspection Report

3. SUBTITLE

Pre-Production & Production Test

DI-NDTI-80809B

ALL DRAWINGS

KEYPORT

PER LOT

SEE BLOCK 16

Reg Repro

16.REMARKS

THE REPORT IS TO VERIFY FAT AND PRODUCTION LOT CONFORMANCE TO THE APPLICABLE

DRAWINGS, SPECIFICATIONS, AND CONTRACT REQUIREMENTS. THE REPORT

CONSISTS OF THE PLAN (A001) CONTAINING ALL REQUIRED INSPECTION

RESULTS DOCUMENTED ON THE PLAN’S DATA ENTRY SHEETS. IN ADDITION, THE

REPORT IS TO INCLUDE MATERIAL CERTIFICATIONS AND ALL OTHER PERTINENT

OBJECTIVE QUALITY EVIDENCE. DCMC REVIEWIS REQUIRED PRIOR TO SUBMITTAL

TO NUWC DIVISION KEYPORT. THE REPORT MUST BE APPROVED BY NAVSEA

KEYPORT BEFORE FINAL ACCEPTANCE OF THIS LOT IN WAWF.

BLK 12: DATE OF PRE-PRODUCTION TEST REPORT SUBMISSION – NLT 15 DAYS

AFTER FIRST ARTICLE TEST COMPLETION.

BLK 13: DATE OF SUBSEQUENT SUBMISSION – NLT 15 DAYS AFTER LOT

ACCEPTANCE TESTING OF SECOND LOT AND BEYOND.

BLK 14: Distribution List

1. Contract Administration Office (CAO)

2. NAVSUP WSS Contracting Officer N772

3. NAVSUP ALC, Code A115

Richard Rzomp

H. DATE

3/12/2025

I. APPROVED BY

John Knecht

J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 2 of 6 Pages

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

A003

Failure Analysis/Corrective Action Report

DI-SESS-80255B

Section E

NUWC KEYPORT

LT

Reg Repro

16.REMARKS

BLK 5: INCLUDE AND TAKE ACTION ON SECTION I IF FAT IS REQUIRED.

BLK 10: FREQUENCY - IS DETERMINED BY NUMBER OF FAT/LAT FAILURES.

BLK 12: DATE OF FIRST SUBMISSION – NLT AN INTERIM REPORT IS DUE NLT

10 DAYS AFTER NOTIFICATION OF LOT FAILURE. A FINAL REPORT IS DUE 30

DAYS AFTER NOTIFICATION OF LOT FAILURE.

BLK 13: DATE OF SUBSEQUENT SUBMISSION – NLT 10 DAYS AFTER FAT

COMPLETION OF SECOND FAILED LOT AND BEYOND.

BLK 14: Distribution List

1. Contract Administration Office (CAO)

2. NAVSUP WSS Contracting Officer N772

3. NAVSUP ALC, Code A115

4. NUWC-Newport Code 8554

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 3 of 6 Pages

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302.

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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

4T-1356-01-294-6889-TH01

A004

Ammo Data Card (ADC)

DI-MISC-80043B

13. DATE OF SUBSEQUENT SUBMISSION

Reg Repro

16.REMARKS

BLK 4: DATA CARD SHALL BE PREPARED IN ACCORDANCE WITH MIL-STD-1168,

AS CHANGED BY ADL EXCEPTIONS AND THE CONTRACT DOCUMENT LIST BY

ACCESSING THE WORLDWIDE AMMUNITION-DATA REPOSITORY (WARP) WHICH IS

LOCATED: https://mhpwarp.redstone.army.mil. AN ACCESS REQUEST FORM

MUST BE COMPLETED BEFORE WARP CAN BE ACCESSED. QUESTIONS SPECIFIC TO

WARP SHOULD BE ADDRESSED TO ONE OF THE RESPECTIVE POCs AS LISTED ON

THE WEBSITE.

BLK 10,12,13: DATA CARDS PROVIDED TO NAVSEA PMS-404 AND THOSE SENT

WITH SHIPMENTS SHALL BE HARDCOPY PRINTOUTS GENEREATED WITH THE WARP

PROGRAM AND SHALL BE SIGNED AND DATED BY THE GOVERNMENT INSPECTOR.

NAVSEA PMS-404 SUBMISSIONS SHALL ALSO INCLUDE HARDCOPY PRINTOUT OF

SAMPLES CARDS (SEE MIL-STD-1168, PARA 4.3.1.4)

BLK 14: Distribution List

1. Contract Administration Office (CAO)

2. NAVSUP WSS Contracting Officer N772

3. NAVSUP ALC, Code A115

See section H for distribution POC’s and their emails

SEE BLOCK 16 0 1 0

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 4 of 6 Pages

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

A005

Contractor’s Progress, Status and Management Report

DI-MGMT-81928

MNTHLY

Reg Repro

16. REMARKS

BLK 11, 12,14: THE DD-375 REPORT SHALL BE SUBMITTED VIA MAIL OR EMAIL ON OR BEFORE THE 5TH DAY OF EAC

MONTH AFTER CONTRACT AWARD.

BLK 14: Distribution List

1. Contract Administration Office (CAO)

2. NAVSUP WSS Contracting Officer N772

3. NAVSUP ALC, Code A115

4. NUWC-Newport Code 8554

15. TOTAL

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 5 of 6 Pages

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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

A006

Certificate of Compliance

3. SUBTITLE

Certificate of Compliance

DI-MISC-81356A

Reg Repro

16.REMARKS

BLK 5: ENSURE COMPLIANCE IAW DWG 5816814 REV G AND DWG 5816882 REV J. CERTIFICATES

OF COMPLIANCE (COC) ARE TO BE PROVIDED TO SHOW CONFORMANCE TO ALL

ASSOCIATED DRAWINGS, NOTICES OF REVISION, SPECIFICATIONS, AND

CONTRACT REQUIREMENTS AS PROVIDED IN TECHNICAL DATA PACKAGE.

BLK 9: DISTRIBUTION STATEMENT "D" - DISTRIBUTION AUTHORIZED TO

DOD AND U.S. DOD CONTRACTORS ONLY; CRITICAL TECHNOLOGY, EXPORT

CONTROLLED (8/25/2016). OTHER REQUESTS SHALL BE REFERRED TO

PEO-SUBS (PMS404).

"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. VIOLATORS OF THESE EXPORT LAWS

ARE SUBJECT TO SEVERE CRIMINAL PENALTIES. DISSEMINATE PER THE

PROVISIONS OF DOD DIRECTIVE 5230.25.

DESTRUCTION NOTICE - FOR UNCLASSIFIED, LIMITED DOCUMENTS,

DESTROY BY ANY METHOD THAT WILL PREVENT DISCLOSURE OF

CONTENTS OR RECONSTRUCTION OF THE DOCUMENT.

BLKS 10-13: COC SHALL BE SUBMITTED WITH EACH DELIVERY, INCLUDING

FIRST ARTICLE DELIVERY.

BLK 14: Distribution List

1. Contract Administration Office (CAO)

2. NAVSUP WSS Contracting Officer N772

3. NAVSUP ALC, Code A115

4. NUWC-Newport Code 8554

15. TOTAL

Richard Rzomp

H. DATE

3/12/2025

I. APPROVED BY

John Knecht

DD FORM 1423-1, FEB 2001

PREVIOUS EDITION MAY BE USED. Page 6 of 6 Pages

INSTRUCTION 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 Manuals

- 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 5010.12-1 (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 it Item 16

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

Item 16. Use of 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 contracted 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 requirement, 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 delivering such data item to the Government.

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 s 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 not 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