DD Form 1423 CDRLs.pdf

CONTRACT DATA REQUIREMENTS LIST

(2 Data Items)

Form Approved OMB No. 0704-0188

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 the 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 DC, Headquarters Services, 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. B. EXHIBIT C. CATEGORY:

0001 A

TDP X TM OTHER

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

B111 UPS PROJECT PR 1300844788 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A001 Operating, Support, Health, and Safety (OSH&S) Hazard Analysis Report

ACTIVITY HAZARD ANALYSIS

4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACTING REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-SAFT-81841 SOW PARA 3.2 NUWCDIVPT CODE 1021 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

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 SUBSEQUENT

SUBMISSION

a. ADDRESSEE Final

A N/A SEE BLK 16 Drafts Reg Repro

16. REMARKS:

Code 1021 1

Block C: Activity Hazard Analysis (AHA) - Identify and evaluate potential hazards and provide the proposed methods and techniques for the safe completion of each phase of the work. Define activity being performed, sequence of work, hazard anticipated, control measures, and competent person in charge.

Block 10 and 13: Frequency will be once for each phase/activity of the work if the Analysis is APPROVED. Otherwise, a resubmission will be required within 7 days of the DISAPPROVAL

Block 12: Provide AHA within 14 calendar days of contract award

15. TOTAL 1

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A002 Test/Inspection Report

FIELD TESTS OF UPS

4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACTING REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-NDTI-80809B SOW PARA 3.2.2 NUWCDIVNPT CODE 1021 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ONCE SEE BLK 16 b. COPIES

8. APP CODE

A

11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Final

D N/A SEE BLK 16 Drafts Reg Repro

16. REMARKS:

Blocks 12 and 13: Provide written report within 7 days after tests are performed.

15. TOTAL 1

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

DD Form 1423-2, AUG 96 1059/183

Previous editions may be used Page of Pages

Form Approved OMB No. 0704-0188

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 the 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 DC, Headquarters Services, 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. B. EXHIBIT C. CATEGORY:

0001 A

TDP X TM OTHER

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

B111 UPS PROJECT PR 1300844788 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A003 Drawings, Installation Control, for Electronic Equipment AS BUILT DRAWINGS

4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACTING REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

MIL-D-23140D SOW PARA 3.3 NUWCDIVPT CODE 1021 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ONCE SEE BLK 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE Final

A N/A SEE BLK 16 Drafts Reg Repro

16. REMARKS:

Blocks 12 and 13: Required at final closeout of project Code 1021 1

15. TOTAL 1

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A004

TECHNICAL REPORT – STUDY/SERVICES UPS TECHNICAL SPECIFICATIONS

4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACTING REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MISC-80508B SOW PARA 3.1.1 NUWCDIVNPT CODE 1021 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT SEE BLK 16 SEE BLK 16 b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Final

A D N/A SEE BLK 16 Drafts Reg Repro

16. REMARKS:

Block 10 and 13: Frequency will be once if APPROVED. Otherwise a resubmission will be required within 7 days of DISAPPROVAL.

Block 12: Submit Technical Specifications within 14 days after contract award

Code 1021 1

15. TOTAL 1

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

DD Form 1423-2, AUG 96 1059/183

Form Approved OMB No. 0704-0188

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 the 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 DC, Headquarters Services, 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. B. EXHIBIT C. CATEGORY:

0001 A

TDP X TM OTHER

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

B111 UPS PROJECT PR 1300844788 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A005 Drawings, Installation Control, for Electronic Equipment ELECTRICAL CONDUIT SPECIFICATIONS

4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACTING REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

MIL-D-23140D SOW PARA 3.1.2 NUWCDIVPT CODE 1021 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

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 SUBSEQUENT

SUBMISSION

a. ADDRESSEE Final

A N/A 30 DAYS Drafts Reg Repro

16. REMARKS:

Block 10 and 13: Frequency will be once if APPROVED. Otherwise, a resubmission will be required within 7 days of DISAPPROVAL.

Block 12: Submit Technical Specifications within 14 days after contract award

Code 1021 1

15. TOTAL 1

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACTING REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Final

Drafts Reg Repro

16. REMARKS:

INTENTIONALLY LEFT BLANK

15. TOTAL

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

DD Form 1423-2, AUG 96 1059/183

DD FORM 1423

CONTRACT

DATA

REQUIREMENTS

BLOCK 16

ADDENDUM

BLOCK 9: The following information is provided in amplification of the Block 9 Distribution Statement shown on each DD FORM 1423.

Distribution Statement paragraphs are in addition to CLASSIFICATION markings of the data.

CDRL A001 – A005

Distribution Statement D. Distribution authorized to the Department of Defense and U.S. DoD contractors only (Critical Technology). Date of Determination Shall Be The Date Media Is Created. Other requests shall be referred to NUWCDIVNPT Code 102.

The following 'EXPORT CONTROL WARNING NOTICE' must be used in conjunction with DISTRIBUTION STATEMENTS identified the CDRL:

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. Violations of these export laws are subject to severe criminal penalties.

Disseminate in accordance with provisions of DoD Directive 5230.25.

Form 1423-2, AUG 96 (EG) PREVIOUS EDITION MAY BE USED Page 4 of 4