Contract Data Requirements List CDRL_Redacted.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved

OMB No. 0704-0188 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 Service, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

TBD

B. EXHIBIT

A

C. CATEGORY

TDP________ TM___________ OTHER MISC

D. SYSTEM/ITEM

Closure Protective Covers

E. CONTRACT / PR NO.

TBD/TBD

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM:

Certificate of Compliance (CoC)

3. SUBTITLE

17. PRICE GROUP

4. AUTHORITY (Date Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

SOW 4.1

6. REQUIRING OFFICE

NUWCDIVNPT CODE 45

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMNT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

LT SEE BLK 16 SEE BLK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE Draft Final

N/A SEE BLK 16 N/A SEE BLK 16 Reg Repro

16. REMARKS NUWC TPM 0 1 0

Block 4: Contractor format is acceptable.

Block 9: See Distribution Statement Addendum.

Block 10, 12: The Contractor shall document compliance with the

JCM-14865 REV M drawing package by delivering a Certificate of

Compliance (CoC) for the Closure Protective Covers (CPCs). The

CoC submittal shall contain all material validations, certifications, and test documentation including but not limited to the following:

• JCM-14308 Adhesive, Epoxy, Filled o Certificate of Conformance per Note 7 IAW Note 4

• JCM-14865 Closure Protective Cover MK 19 Mod 0 o Certificates of Conformance and test data from

Note 10 and Note 27.

• JCM 14866 Hemispherical Shell Assembly o Results from Notes 5 and 6.

• JCM-14870 Screw, Cap, Socket Head o ASTM-B-633 Type II Class 3 conformance o IAW Note 8; Yield Strength Test to 170 KSI

• JCM-14874 Hose, Assembly o Certificate of Conformance and test results from

Note 3 Hydrostatic Test

• JCM-14878 Strap, Assembly o Certificate of Conformance and test results from

Note 5

• JCM-16592 Liner, Foam o Material Safety Data Sheet IAW Note 4 o Material Certificate for Polyurethane foam 8-12

Durometer

• 1553AS1492 Primer and Paint o Material Certifications for the epoxy and paint.

• JCM-14876 Cap, Dust o Material Certifications for what CRES used

• JCM-14877 Cap, Pressure o Material Certification for what CRES used

• JCM-16400 Gasket o Material Certification IAW Note 3

• JCM-16401 Pad o Material Certification IAW Note 3

• JCM-14872 Adapter, Bulkhead o Material Certification for what CRES used

• JCM-14873 Nipple, Valved o Material Certification for what CRES used

• JCM-14875 Fitting, Nipple o Material Certification for what CRES used

• JCM-16410 Bracket o Material Certification for ASTM A240 CL304

The Government estimates two deliveries, one (1) for the initial delivery of the CPC and one (1) for the completed CPCs.

NUWC COR 0 1 0

15. TOTAL

0 2 0

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 1 of _2 Pages

DD FORM 1423

CONTRACT DATA REQUIREMENTS LIST

BLOCK 16 ADDENDUM

BLOCK 16 DISTRIBUTION STATEMENT ADDENDUM

Block 9: The following information is amplification of the Block 9 Distribution Statement Selected:

Distribution Statement paragraph is in addition to CLASSIFICATION markings of the data.

Distribution Statement D: Applies to CDRL item No. A001. Distribution authorized to the DoD and U.S. DoD

Contractors only; CRITICAL TECHNOLOGY (date data generated). Other requests for this document shall be referred to NUWC Division, Newport (Code 45).

The following “EXPORT CONTROL WARNING NOTICE” must be used in conjunction with

DISTRIBUTION STATEMENT identified in the above CDRL items.

Warning - This document contains technical data whose export is restricted by the Arms Export Control Act

(Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections

4801-4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.