CDRLS_SOL_N0010421RK132_Cover.pdf

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Attached to: NSN 6T-5340-01-227-2349 Cover, Storage and Shipping Assembly
Solicitation number: N0010421RK132
Issued by: Department of the Navy Naval Supply Systems Command

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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 220 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

6T-5340-01-227-2349

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.) 5.CONTRACT REFERENCE

6.REQUIRING OFFICE 18.ESTIMATED

TOTAL PRICE

DI-NDTI-80603A ALL DRAWINGS NSWC PCD (Code A12)

7.DD250 REQ

9.DIST STATEMENT

REQUIRED

10.FREQUENCY

ONE TIME

12.DATE OF FIRST

SUBMISSION

14.DISTRIBUTION

60 DAC

a. ADDRESSEE

b. COPIES

8.APP CODE

11.AS OF

DATE

13.DATE OF SUBSEQUENT

Draft

Final

Reg Repro

16.REMARKS SEE BLOCK 16

THE PLAN IS TO SPECIFY PROCESS CONTROL INSTRUCTIONS AND INSPECTION

PROCEDURES NEEDED TO ENSURE PRODUCT CONFORMANCE TO DRAWINGS,

SPECIFICATIONS, AND CONTRACT REQUIREMENTS IAW CDRL ITEM (FORM 1423-1)

FOR ISO 9001, ANSI / ASQC Q9001, OR MIL-Q-9858 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 ADDRESS

DEPARTMENT OF THE NAVY

WSS MANSKE

NAVAL SUPPLY SYSTEMS COMMAND WEAPON SYSTEMS SUPPORT

5450 CARLISLE PIKE, SUITE 410-WS D13

MECHANICSBURG, PA 17050-2411

isabel.m.manske@navy.mil

DEPARTMENT OF THE NAVY

NALC RZOMP

NAVAL SUPPLY SYSTEMS COMMAND AMMUNITION LOGISTICS CENTER

5450 CARLISLE PIKE, SUITE 407N-WS A3

MECHANICSBURG, PA 17050-2411

richard.rzomp@navy.mul

COMMANDING OFFICER

NAVAL SURFACE WARFARE CENTER

PANAMA CIT DIVISION

CODE A12

110 VERNON AVE

PANANA CITY, FL 32407-7001

anne.brown@navy.mil; robert.bethea@navy.mil

15.TOTAL

G. PREPARED BY:

RICHARD RZOMP

H. DATE

12/23/2020

I. APPROVED BY:

JEREMY HILLIKER

J. DATE

12/23/2020

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 8 Pages

A.CONTRACT LINE ITEM NO.

0001AA

D. SYSTEM/ITEM

A002

2.TITLE OF DATA ITEM

Test/Inspection Report

3.SUBTITLE

Pre-Production & Production Test

DI-NDTI-80809B ALL DRAWINGS NSWC PCD (Code A12)

REQUIRED

10.FREQUENCY

PER LOT

SEE BLOCK 16

a. ADDRESSEE

b. COPIES

8.APP CODE

16.REMARKS SEE BLOCK 16

THE REPORT IS TO VERIFY 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

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 ADDRESS

DEPARTMENT OF THE NAVY

WSS MANSKE

NAVAL SUPPLY SYSTEMS COMMAND WEAPON SYSTEMS SUPPORT

5450 CARLISLE PIKE, SUITE 410-WS D13

MECHANICSBURG, PA 17050-2411

isabel.m.manske@navy.mil

DEPARTMENT OF THE NAVY

NALC RZOMP

NAVAL SUPPLY SYSTEMS COMMAND AMMUNITION LOGISTIC CENTER

5450 CARLISLE PIKE, SUITE 407N-WS A3

richard.rzomp@navy.mil

PANAMA CITY DIVISION

CODE A12

110 VERNON AVE

PANAMA CITY, FL 32407-7001

RICHARD RZOMP

H. DATE

12/23/2020

I. APPROVED BY:

JEREMY HILLIKER

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 2 of 8 Pages

A.CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

A003

2.TITLE OF DATA ITEM

Failure Analysis/Corrective Action Report

DI-SESS-81315B Section E NSWC PCD (Code A12)

REQUIRED

10.FREQUENCY

SEE BLOCK 16

12.DATE OF FIRST

a. ADDRESSEE

SEE BLOCK 16 Reg Repro

16.REMARKS SEE BLOCK 16

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

Blk 8: ISEA (NSWC PCD) will review and approve within 30 calendar days of receipt. If disapproved, contractor has 14 calendar days to revise and resubmit.

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 ADDRESS

DEPARTMENT OF THE NAVY

WSS MANSKE

NAVAL SUPPLY SYSTEMS COMMAND WEAPON SYSTEMS SUPPORT

5450 CARLISLE PIKE, SUITE 410-WS D13

isabel.m.manske@navy.mil

DEPARTMENT OF THE NAVY

NALC RZOMP

NAVAL SUPPLY SYSTEMS COMMAND AMMUNITION LOGISTICS CENTER

5450 CARLISLE PIKE, SUITE 407N-WS A3

richard.rzomp@navy.mil

PANAMA CITY DIVISION

CODE A12

110 VERNON AVE

RICHARD RZOMP

H. DATE

12/23/2020

I. APPROVED BY:

JEREMY HILLIKER

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 3 of 8 Pages

A.CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

A004

2.TITLE OF DATA ITEM

Ammo Data Card (ADC)

DI-MISC-80043B Section C NSWC PCD (Code A12)

REQUIRED

10.FREQUENCY

PER LOT

a. ADDRESSEE

PER LOT Reg Repro

16.REMARKS SEE BLOCK 16

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-495 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-495 SUBMISSIONS SHALL ALSO INCLUDE HARDCOPY PRINTOUT OF

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

BLK 14: DISTRIBUTION ADDRESS

DEPARTMENT OF THE NAVY

NALC LUCAS

NAVAL SUPPLY SYSTEMS COMMAND AMMUNITION LOGISTICS CENTER

5450 CARLISLE PIKE, SUITE 407N-WS A7

ANNA.LUCAS@NAVY.MIL

RICHARD RZOMP

H. DATE

12/23/2020

I. APPROVED BY:

JEREMY HILLIKER

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 4 of 8 Pages

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

A005

2.TITLE OF DATA ITEM

Contractor’s Progress, Status and Management Report

DI-MGMT-80227 SEE BLOCK 16 NSWC PCD

REQUIRED

10.FREQUENCY

MTHLY

SEE BLOCK 16

a. ADDRESSEE

SEE BLOCK 16

Draf t

16.REMARKS SEE BLOCK 16

BLK 12, 13: The report shall be submitted via mail or email on or before the 5th day of each month after contract award.

BLK 14: Distribution address

DCMA Administrative Contracting Officer (Block 6 of Standard Form 26)

DEPARTMENT OF THE NAVY

WSS MANSKE

NAVAL SUPPLY SYSTEMS COMMAND WEAPON SYSTEMS SUPPORT

5450 CARLISLE PIKE, SUITE 410-WS D13

MECHANICSBURG, PA 17050-2411

Isabel.m.manske@navy.mil

COMMANDING OFFICER

NAVAL SURFACE WARFARE CENTER –

PANAMA CITY DIVISION

CODE A12

110 VERNON AVE

PANAMA CITY, FL 32407-7001

anne.brown@navy.mil; robert.bethea@navy.mil

DEPARTMENT OF THE NAVY

NALC RZOMP

NAVAL SUPPLY SYSTEMS COMMAND AMMUNITION LOGISTICS CENTER

5450 CARLISLE PIKE, SUITE 407N-WS A3

MECHANICSBURG, PA 17050-2411

richard.rzomp@navy.mil

15.TOTAL

G. PREPARED BY:

RICHARD RZOMP

H. DATE

12/23/2020

I. APPROVED BY:

JEREMY HILLIKER

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 5 of 8 Pages

A. CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

A006

2.TITLE OF DATA ITEM

QUALITY ASSURANCE INSPECTION PLAN

DI-MGMT-80227 SEE BLOCK 16 NSWC PCD

REQUIRED

10.FREQUENCY

SEE BLOCK 16

a. ADDRESSEE

SEE BLOCK 16

Draf t

16.REMARKS SEE BLOCK 16

Submitted for approval no later than 60 days after first article approval, or 90 days prior to delivery of first production lot if first articles are waived.

BLK 14: DISTRIBUTION ADDRESS

NAVAL SURFACE WARFARE CENTER –

PANAMA CITY DIVISION

CODE A12

110 VERNON AVE

PANAMA CITY, FL 32407-7001

anne.brown@navy.mil; robert.bethea@navy.mil

DEPARTMENT OF THE NAVY

WSS MANSKE

NAVAL SUPPLY SYSTEMS COMMAND WEAPON SYSTEMS SUPPORT

5450 CARLISLE PIKE, SUITE 410-WS D13

MECHANICSBURG, PA 17050-2411

Isabel.m.manske@navy.mil

DCMA Administrative Contracting Officer (Block 6 of Standard Form 26)

DEPARTMENT OF THE NAVY

NALC RZOMP

NAVAL SUPPLY SYSTEMS COMMAND AMMUNITION LOGISTICS CENTER

5450 CARLISLE PIKE, SUITE 407N-WS A3

MECHANICSBURG, PA 17050-2411

richard.rzomp@navy.mil

15.TOTAL

G. PREPARED BY:

Richard Rzomp

H. DATE

12/23/2020

I. APPROVED BY:

JEREMY HILLIKER

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 6 of 8 Pages

Form Approved

OMB No. 0704-0188 The public reporting burden for this collection of information is estimated to average 220 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.

TDP TM OTHER CONFIG MGMT

D. SYSTEM/ITEM

A007

2.TITLE OF DATA ITEM

Engineering Change Proposal (ECP)

6.REQUIRING OFFICE

DI-SESS-80639D SEE BLOCK 16 NSWC PCD

7.DD250 REQ

9.DIST STATEMENT

REQUIRED

10.FREQUENCY

AS REQ

SEE BLOCK 16

AS REQ

a. ADDRESSEE

b. COPIES

8.APP CODE

11.AS OF DATE

AS REQ

When Revised

16.REMARKS SEE BLOCK 16

Blk 4: Use of format of DD Form 1692 (Page 1 only – Short Form) is recommended.

Form may be downloaded at https://www.pica.army.mil/prod_techdata/cmdocs-links.htm.

Blk 12: ECPs shall be submitted thru QAR to all addresses. Material Review Board Authority withheld.

NAVAL SURFACE WARFARE CENTER

PANAMA CITY DIVISION

CODE A12

110 VERNON AVENUE

WSS MANSKE

NAVAL SUPPLY SYSTEMS COMMAND WEAPON SYSTEMS SUPPORT

5450 CARLISLE PIKE, SUITE 410-WS D13

MECHANICSBURG, PA 17050-2411

Isabel.m.manske@navy.mil

DCMA Administrative Contracting Officer (Block 6 of Standard Form 26)

DEPARTMENT OF THE NAVY

NALC RZOMP

NAVAL SUPPLY SYSTEMS COMMAND AMMUNITION LOGISTICS CENTER

5450 CARLISLE PIKE, SUITE 407N-WS A3

MECHANICSBURG, PA 17050-2411

richard.rzomp@navy.mil

15.TOTAL

G. PREPARED BY:

RICHARD RZOMP

H. DATE

12/23/2020

I. APPROVED BY:

JEREMY HILLIKER

J. DATE

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 7 of 8 Pages

Form Approved

A. CONTRACT LINE ITEM NO.

TBD

B. EXHIBIT

AS REQ

C.CATEGORY:

TDP TM OTHER CONFIG MGMT

D. SYSTEM/ITEM

A008

2.TITLE OF DATA ITEM

Request for Variance (RFV)

6.REQUIRING OFFICE

DI-SESS-80640D SEE BLOCK 16 NSWC PCD

7.DD250 REQ

9.DIST STATEMENT

REQUIRED

10.FREQUENCY

AS REQ

SEE BLOCK 16

AS REQ

a. ADDRESSEE

b. COPIES

8.APP CODE

11.AS OF DATE

AS REQ

When Revised

16.REMARKS SEE BLOCK 16

Blk 4: Use of format of DD Form 1694 is recommended. Form may be downloaded at http://www.dtic.mil/whs/directives/infomgt/forms.

Blk 12: RFVs shall be submitted thru QAR to all addresses. Material Review Board Authority withheld.

NAVAL SURFACE WARFARE CENTER

PANAMA CITY DIVISION

CODE A12

110 VERNON AVENUE

WSS MANSKE

NAVAL SUPPLY SYSTEMS COMMAND WEAPON SYSTEMS SUPPORT

5450 CARLISLE PIKE, SUITE 410-WS D13

MECHANICSBURG, PA 17050-2411

isabel.m.manske@navy.mil

DCMA Administrative Contracting Officer (Block 6 of Standard Form 26)

DEPARTMENT OF THE NAVY

NALC RZOMP

NAVAL SUPPLY SYSTEMS COMMAND AMMUNITION LOGISTICS CENTER

5450 CARLISLE PIKE, SUITE 407N-WS A3

MECHANICSBURG, PA 17050-2411

richard.rzomp@navy.mil

15.TOTAL

G. PREPARED BY:

RICHARD RZOMP

H. DATE

12/23/2020

I. APPROVED BY:

JEREMY HILLIKER

J. DATE

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 8 of 8 Pages

Distribution of Contract Documents

(See key below) A B C D

(X) (X) (X) (X) richard.rzomp@navy.mil

(X) (X) (X) (X) chris.capasso@navy.mil

(X) (X) (X) (X) philip.lindley@navy.mil ( ) ( ) (X) (X) anne.brown@navy.mil ( ) ( ) (X) (X) robert.bethea@navy.mil ( ) ( ) (X) (X) john.d.knecht@navy.mil ( ) ( ) (X) (X) casey.jarrell@navy.mil ( ) ( ) (X) (X) robert.zwiren@navy.mil

( ) ( ) (X) (X) DCMA

Key:

A- Solicitation/Amendments B- Preliminary Notice of Award Sheet C- Contract D- Contract Amendments

File details come from the government source that posted it. Updated Sep 16, 2021.