CONTRACT DATA REQUIREMENTS LISTS.pdf

PDF 829 KB Posted Feb 14, 2022

Attached to: HOSE ASSEMBLY Federal contract opportunity
Solicitation number: SPMYM2-22-Q-0930
Issued by: Defense Logistics Agency Land and Maritime

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MATERIAL SPECIFICATION SHEETS.pdf	PDF	Feb 14, 2022
SOLICITATION SPMYM2-22-Q-0930.pdf	PDF	Feb 14, 2022

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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 the 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.

Please DO NOT RETURN your form to either of these 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 MISC

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

UNITED STATES COAST GUARD

CERTIFICATION

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

14. DISTRIBUTION7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16* b. COPIES

A. ADDRESSEE Final8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A Draft Reg Repr o

N4523A 0 1 0

16. REMARKS

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 2/8/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

PSNS.WAWFQACertifications.FCM@navy.mil. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document no: 2014-9975

TOTAL 0 1 0

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

/s/ Grace Booker 2/8/2022 /s/Malvin Doinog 2/8/2022

DD Form 1423-1, JUN 90 Page 1 of 2 Page(s)

S/N 0102-LF-010-5600

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

0002AA A

A001

Form Approved OMB No. 0704-0188

Please DO NOT RETURN your form to either of these 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 MISC

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

NATIONAL ASSOCIATION FOR HOSE

ACCESSORIES DISTRIBUTION (NAHAD)

CERTIFICATION

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

14. DISTRIBUTION7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16* b. COPIES

A. ADDRESSEE Final8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A Draft Reg Repr o

N4523A 0 1 0

16. REMARKS

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

Document no: 2014-9975 TOTAL 0 1 0

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

/s/ Grace Booker 2/8/2022 /s/Malvin Doinog 2/8/2022

TOTAL PRICE

0002AB B

B001

Form Approved OMB No. 0704-0188

Please DO NOT RETURN your form to either of these 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 NDTI

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

HYDROSTATIC TEST REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

14. DISTRIBUTION7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16* b. COPIES

A. ADDRESSEE Final8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A Draft Reg Repr oATAT

N4523A 0 1 0

16. REMARKS

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

Document no: 2014-9975

TOTAL 0 1 0

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

/s/ Grace Booker 2/8/2022 /s/Malvin Doinog 2/8/2022

TOTAL PRICE

0002AC C

C001

Form Approved OMB No. 0704-0188

Please DO NOT RETURN your form to either of these 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 MISC

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

CONFORMANCE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

14. DISTRIBUTION7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16* b. COPIES

A. ADDRESSEE Final8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A Draft Reg Repr o

N4523A 0 1 0

16. REMARKS

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

Document no: 2014-9975

TOTAL 0 1 0

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

/s/ Grace Booker 2/8/2022 /s/Malvin Doinog 2/8/2022

DD Form 1423-1, FEB 2001 Page 1 of 2 Page(s)

TOTAL PRICE

0002AD D

D001

Form Approved OMB No. 0704-0188

Please DO NOT RETURN your form to either of these 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 MISC

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

UNITED STATES COAST GUARD

CERTIFICATION

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

14. DISTRIBUTION7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16* b. COPIES

A. ADDRESSEE Final8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A Draft Reg Repr o

N4523A 0 1 0

16. REMARKS

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

Document no: 2014-9976 TOTAL 0 1 0

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

/s/ Grace Booker 2/8/2022 /s/Malvin Doinog 2/8/2022

TOTAL PRICE

0004AA E

E001

Form Approved OMB No. 0704-0188

Please DO NOT RETURN your form to either of these 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 MISC

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

NATIONAL ASSOCIATION FOR HOSE

ACCESSORIES DISTRIBUTION (NAHAD)

CERTIFICATION

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

14. DISTRIBUTION7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16* b. COPIES

A. ADDRESSEE Final8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A Draft Reg Repr o

N4523A 0 1 0

16. REMARKS

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

Document no: 2014-9976 TOTAL 0 1 0

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

/s/ Grace Booker 2/8/2022 /s/Malvin Doinog 2/8/2022

TOTAL PRICE

0004AB F

F001

Form Approved OMB No. 0704-0188

Please DO NOT RETURN your form to either of these 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 NDTI

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

HYDROSTATIC TEST REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

14. DISTRIBUTION7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16* b. COPIES

A. ADDRESSEE Final8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A Draft Reg Repr oATAT

N4523A 0 1 0

16. REMARKS

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

Document no: 2014-9976

TOTAL 0 1 0

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

/s/ Grace Booker 2/8/2022 /s/Malvin Doinog 2/8/2022

TOTAL PRICE

0004AC G

G001

Form Approved OMB No. 0704-0188

Please DO NOT RETURN your form to either of these 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 MISC

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

CONFORMANCE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

14. DISTRIBUTION7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16* b. COPIES

A. ADDRESSEE Final8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A Draft Reg Repr o

N4523A 0 1 0

16. REMARKS

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

Document no: 2014-9976 TOTAL 0 1 0

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

/s/ Grace Booker 2/8/2022 /s/Malvin Doinog 2/8/2022

DD Form 1423-1, FEB 2001 Page 1 of 2 Page(s)

TOTAL PRICE

0004A H

H001

File details come from the government source that posted it. Updated Feb 14, 2022.