CONTRACT DATA REQUIREMENTS_CDRLS 22-00396.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

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 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

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Commercial Asset Visibility; Air Force (CAVAF) Government Furnished Material Report

3. SUBTITLE

CAVAF

4. AUTHORITY

DI- MGMT-81634C

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS PAR: 4.5.1.1

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 03 OCT 2023DATE:

Contractor shall complete CAVAF reporting within 2 calendar days of repair occurrences with less than four errors and zero omissions per month. The contractor shall provide data related to the tasks and efforts conducted for each repairable unit. The contractor shall conduct production reporting on a daily or as transactions occur basis. The contractor shall obtain a valid DoD PKI certificate to log into CAVAF. Each user shall be required to have a "medium assurance certificate." Each contractor employee accessing CAVAF will need an External Certificate Authority (ECA) Medium Token Assurance (Federal Information Processing Standards (FIPS) 140 Level 2. Registration Authority)

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

See Block 16 0 1 0

0 1 015. TOTAL

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

Page 1 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

PREVIOUS EDITION MAY BE USED.

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Status Reports

3. SUBTITLE

Program Status

4. AUTHORITY

DI-MGMT-80368A/T

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS 4.2.3.3

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

MTHLY

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

MTHLY

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 03 OCT 2023DATE:

Block 11: Date of first submission shall be within 30 days of contract award. Status reports shall be delivered electronically via Email to Program Manager Trinity Choo at trinity.choo@us.af.mil

Block 12: Date of first submission shall be within 30 days of contract award. Status reports shall be delivered electronically via Email to Program Manager Trinity Choo at trinity.choo@us.af.mil

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

Program Manager 0 1 0

0 1 015. TOTAL

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

Page 2 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

IUID Marking Plan

3. SUBTITLE

IUID Marking Plan

4. AUTHORITY

DI-MGMT-81803

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Par. 4.7.2

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 04 OCT 2023DATE:

Contractor shall complete CAVAF reporting within 2 calendar days of repair occurrences with less than four errors and zero omissions per month. The contractor shall provide data related to the tasks and efforts conducted for each repairable unit. The contractor shall conduct production reporting on a daily or as transactions occur basis. The contractor shall obtain a valid DoD PKI certificate to log into CAVAF. Each user shall be required to have a "medium assurance certificate." Each contractor employee accessing CAVAF will need an External Certificate Authority (ECA) Medium Token Assurance (Federal Information Processing Standards (FIPS) 140 Level 2. Registration Authority)

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

See Block 16 0 1 0

0 1 015. TOTAL

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

Page 3 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

IUID Marking Activity, Validation and Verification Report

3. SUBTITLE

IUID Validation and Verification Report

4. AUTHORITY

DI-MGMT-81804A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS PARA 4.7.3

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

BLK 16

12. DATE OF FIRST

SUBMISSION

BLK 16

13. DATE OF SUBSEQUENT

SUBMISSION

BLK 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 12 OCT 2023DATE:

The contractor shall provide an IUID Marking Activity and Verification Report. A key attribute for the report is the Verification column which indicates pass/fail for each item's Data Matrix symbol Quality.

Block 4: Contractor format is acceptable. 100% of the units shall be inspected, evaluated and added to the activity and verification report.

Block 7: Contractor shall submit each report with a letter of transmittal. The last report shall summarize all reports and shall be submitted on DD Form 250 for payment.

Block 9: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use 03May2013). Other requests for this document shall be referred to Program Manager at trinity.choo@us.af.mil 409

SCMS/GUMC

Blocks 10-13: The first report shall be submitted within 10 days after the first full three months after contract award.

Reporting shall continue on a quarterly basis to be received no later than the 10th day of the quarter following the end of the report period. Quarterly reports shall be submitted via email.

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

See Block 16 0 1 0

0 1 015. TOTAL

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

Page 4 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

GOVERNMENT INDUSTRY DATA EXCHANGE

PROGRAM (GIDEP) ALERT/SAFE-ALERT REPORT

3. SUBTITLE

ALERT/SAFE-ALERT REPORT

4. AUTHORITY

DI-QCIC-80125B

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS PARA. 4.9.1

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 12 OCT 2023DATE:

The Contractor shall review each Alert/Safe-Alert report received from GIDEP to determine if the item or process for which the Alert/Safe-Alert report is issued is applicable to the contract/order and take appropriate action.

Changes to the office symbols shall be made by letter through the PCO/ACO without revision to this CDRL.

Block 4: The contractor shall participate and comply with the GIDEP requirements as defined below.

Block 9: Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, administrative or operational use, 5 July 2011. Other requests shall be referred to 409 SCMS/GUEA.

Blocks 10, 11, 12 & 13:

Annual Report: The report for the previous year will be prepared using DD Form 2166 and is due not later than 31 January of each new calendar year. The contractor shall participate in the GIDEP Failure Experience Data Interchange (FEDI) in accordance with MIL-STD-1556B.

Incident Report: For Alert/Safe Alerts (DI-QCIC-80125B) reports will be submitted in accordance with MIL-STD1556B upon discovery of defective parts or material by the contractor.

Block 14: E-mail copies to addressees per attached distribution matrix.

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

See Block 16 0 1 0

0 1 015. TOTAL

G. PREPARED BY H. DATE 3 I. APPROVED BY J. DATE

Page 5 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

GOVERNMENT INDUSTRY DATA EXCHANGE

PROGRAM (GIDEP) ALERT/SAFE-ALERT

RESPONSE

3. SUBTITLE

ALERT/SAFE-ALERT RESPONSE

4. AUTHORITY

DI-QCIC-80126B

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS PARA 4.9.1

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 12 OCT 2023DATE:

Upon the determination that an Alert/Safe-Alert report is applicable, the Contractor shall inform the impacted organizations and subcontractors in accordance with the CDRLs. The Contractor shall maintain a record of the status and disposition of all Alert/Safe-Alert reports in accordance with the CDRLs.

Changes to the office symbols shall be made by letter through the PCO/ACO without revision to this CDRL.

Block 9: Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, administrative or operational use, 5 July 2011. Other requests shall be referred to 409 SCMS/GUEA.

Blocks 10, 11, 12 & 13: The purpose of this requirement is to provide the government with a response relation to a failure experience report.

Contractor format is acceptable.

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

See Block 16 0 1 0

0 1 015. TOTAL

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

Page 6 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

PARTS APPROVAL REQUEST

3. SUBTITLE

PARTS APPROVAL REQUEST

4. AUTHORITY

DI-MISC-80071E

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS PAR. 4.10

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 04 OCT 2023DATE:

The Parts Approval Request plan shall provide the Government with a mechanism for visibility, communications, and means to achieve a goal of reducing the total life cycle cost and obsolescence risk of the program. The Contractor will have configuration management responsibility while the USAF retains sole Operational, Safety, Suitability and Effectiveness (OSS&E) responsibility. The Contractor shall perform, with Government concurrence, Minor/Class II changes.

Blocks 10, 11, 12 & 13: Requests will be submitted on an as needed basis IAW the Performance Work Statement

(PWS).

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

15. TOTAL

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

Page 7 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

Engineering Change Proposal (ECP)

3. SUBTITLE

ECP

4. AUTHORITY

DI-SESS-80639D

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Par. 4.10.1

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 04 OCT 2023DATE:

The Contractor shall, with government concurrence, propose Major/ Class I changes. Contractor shall submit required Engineering Change Proposals.

BLK 8: The Government will have 10 days after receipt for approval or disapproval. The contractor shall have 5 days after receipt of the Government comments to resubmit.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors.

Other requests for this document shall be referred to 409 SCMS/GUEA.

BLK 14: Documents shall be provided to the following personnel via electronic media utilizing standard Microsoft Office applications.

409 SCMS/GUMC

PM: Trinity R. Choo Email: trinity.choo@us.af.mil ENG: William Johansen Email: william.johansen@us.af.mil

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

See Block 16 0 1 0

0 1 015. TOTAL

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

Page 8 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A009

2. TITLE OF DATA ITEM

Counterfeit Prevention Plan

3. SUBTITLE

CPP

4. AUTHORITY

DI-MISC-81832

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para. 4.8

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 04 OCT 2023DATE:

Contractors that supply electronic parts or systems that contain electronic parts shall establish policies and procedures to avoid, detect, mitigate and disposition counterfeit electronic parts to prevent such parts from entering the USAF/DoD supply chain.

The plan shall be delivered in electronic PDF format through the Wide Area Workflow (WAWF) system no later than 90 calendar days after contract award (FA8711).

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

15. TOTAL

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

Page 9 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A010

2. TITLE OF DATA ITEM

Technical Report

3. SUBTITLE

TP

4. AUTHORITY

DI-MISC-80508B/T

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.4.4.3

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

N/A

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 04 OCT 2023DATE:

The contractor shall provide a level of effort technical support by telephone and /or e-mail during the normal work week to resolve field and USAF test site problems. The contractor shall submit monthly technical status reports to 409

SCMS/GUEA.

Block 4: Contractor format is acceptable contingent upon approval by the Government.

Block 8: Government approval/disapproval will be provided within 10 working days of receipt of each submittal. If disapproved, the contractor shall resubmit within 10 working days of receipt of Government comments.

Block 9: Distribution authorized to the Department of Defense and U.S. DoD contractors only, administrative or operational use, 28 Jul 2016. Other requests shall be referred to the lead engineer, 409 SCMS Robins AFB, GA 31098- 1670, ATTN: William Johansen

Block 10, 12 & 13: The contractor shall submit the approved report within 30 working days following government review and comments.

Block 14b: Submission shall be made in .pdf or MS Word format to william.johansen@us.af.mil and trinity.choo@us.af.mil

Delivery shall be provided via CD/DVD ROM or on-line access when email submittal is not possible.

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023

See Block 16 0 1 0

0 1 015. TOTAL

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

Page 10 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

F-15/Air Data Test Set (ADTS

E. CONTRACT / PR NO.

FD20602200396

F. CONTRACTOR

1. DATA ITEM NO.

A011

2. TITLE OF DATA ITEM

Accident/Incident Report

3. SUBTITLE

Mishap Notification Reporting

4. AUTHORITY

DI-SAFT-81563

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 5.5.2

6. REQUIRING OFFICE

409 SCMS

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

11. AS OF DATE

Contract Award

12. DATE OF FIRST

SUBMISSION

As Required

13. DATE OF SUBSEQUENT

SUBMISSION

As Required

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Choo, Trinity RNAME: 04 OCT 2023DATE:

The Contractor shall report mishaps involving damage or injury to USAF interests by contacting the Contracting Officer Representative by telephone within two hours and the Contractor shall cooperate with USAF safety investigations.

The Contractor shall cooperate and assist Government personnel in the investigation of the mishap and submit an Accident/Incident Report within 24 hours.

COORDINATORS:

Johansen, William C 409 SCMS / GUEA 478-926-3935 / 468-3935 24 OCT 2023 trinity.choo@us.af.mil 0 1 0

0 1 015. TOTAL

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

Page 11 of 11DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 31 Jan 2024