DRAFT CASEVAC CDRLs Exhibit A_2.docx

DOCX document 625 KB Posted May 7, 2020

Attached to: SOF TACTICAL COMBAT CASUALTY CARE (TCCC) CASUALTY EVACUATION SET
Solicitation number: 47QFSA20N0009
Issued by: General Services Administration Federal Acquisition Service Assisted Acquisition Services Region 4

About this file

Written by GovTribe AI · Dec 31, 2023

This document contains a draft Contract Data Requirements List (CDRL) for a federal contract to procure Tactical Combat Casualty Care (TCCC) Casualty Evacuation (CASEVAC) Sets.

The CDRL outlines twelve required data items to be delivered over the course of the contract, including safety studies reports, commercial drawings and associated lists, training materials such as student guides and videos, status reports, engineering change proposals, and item identification marking. Delivery dates and distribution statements are provided for each data item.

The CASEVAC Sets are organized into sets, kits and modules grouped according to functionality for extraction, mobility, transportation and sustainment of casualties from the point of injury to definitive care. The contract will also include new equipment training and continued product improvements. Evaluation criteria for the future solicitation process are still in development.

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Other files

File	Type	Posted
Final QandA to Draft Documents.xlsx	XLSX spreadsheet	Nov 19, 2020
Draft General Instructions to Offerors ITO s.docx	DOCX document	Oct 23, 2020
Draft Evaluation Factors for Award ID04200024 Oct 2020.docx	DOCX document	Oct 23, 2020
PPQ_20200709.docx	DOCX document	Jul 9, 2020
Industry Day_Slides QA.PPTX	PPTX presentation	Jun 30, 2020
Evaluation Factors for Award.docx	DOCX document	Jun 22, 2020
LOM Rev 01 Appendix A BetaSam June 22 2020.xlsx	XLSX spreadsheet	Jun 22, 2020
General Instructions to Offerors.docx	DOCX document	Jun 22, 2020
Draft SOW_TCCC CASEVAC Sets May 7 2020_.docx	DOCX document	May 7, 2020
General Info for Beta.Sam Synopsis.docx	DOCX document	May 7, 2020
Industry Request Beta.Sam.Gov Brand Name_.docx	DOCX document	May 7, 2020
Draft Brand Name J_A BetaSam_Redacted May 7 2020.pdf	PDF	May 7, 2020

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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 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 (0701-0188), 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 Safety .

D. SYSTEM/ITEM

SOF COMBAT CASUALTY CARE

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Safety Studies Report

3. SUBTITLE

Material Safety Data Sheets (MSDS)

4. AUTHORITY (Data Acquisition Document No.)

DI-SAFT-81065

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

USSOCOM

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

See block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

See Block 16

13. DATE OF SUBSEQUENT SUBMISSION

See block 16

a.	ADDRESSEE
	b.	COPIES

Draft Final

Reg

Repr

16. REMARKS

In lieu of format required by the DID, the Contractor shall provide a summary listing of all items containing hazardous materials or requiring special handling instructions. This summary shall have all related Material Safety Data Sheets included as an appendix and will be provided in digital format. In addition, the MSDS shall be delivered with each item containing hazardous material or requiring special handling instructions. The MSDS will provide workers and emergency personnel with procedures for handling or working with that substance in a safe manner, and includes information such as physical data (melting point, boiling point, flash point, etc.), toxicity, health effects, first aid, reactivity, storage, disposal, protective equipment, and spill handling procedures.

Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government Agencies and direst supporting contractors. Other requests for this document shall be referred to Program Manager – Special Operations Forces Survival, Support & Equipment Systems (PM‐SOF SSES).

Block 12/13: First submission within 30 days of contract award, subsequent deliveries with each procurement order

Block 14.a: Electronic submissions may be addressed to jeffrey.w.luciano.civ@mail.mil.

15. TOTAL

See

BLK

16b See

BLK

16b See

BLK

16b

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 1 Pages

(1 Data Item)

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER Configuration Management .

D. SYSTEM/ITEM

SOF COMBAT CASUATLY CARE

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Training Materials

3. SUBTITLE

TCCC Training Guide - Student Guide

4. AUTHORITY (Data Acquisition Document No.)

DI-ILSS-80872

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

USSOCOM

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

AS REQ

12. DATE OF FIRST SUBMISSION

See block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

16. REMARKS

The Contractor shall provide a Student Training Guide to include safety, operation, and maintenance procedures for the CASEVAC Set. The content shall be suitable for application in a self-paced, self-directed format. The material shall contain sufficient instructions to guide students through all specified hands-on training without a need for instruction lectures and instructor interface. Existing manufacturer’s training and service manuals may be incorporated into the material insofar as they meet specified requirements. The Training Guide will be developed and approved by the Program office prior to delivery of the first New Equipment Training (NET) Course.

Block 12/13: First submission (draft) in digital format within 30 days of contract award. Student guides in hard copy will then be provided during each NET Training course.

Block 14.a: Electronic submissions may be addressed to jeffrey.w.luciano.civ@mail.mil

Total qty. not to exceed 10, 000

Government review and approval shall be within 30 days of contractor submission. Contractor revisions shall be within 2 weeks of Government review and approval. Final Government approval shall be within 20 days of delivery of final Training Materials.

NSRDEC

See

BLK

16b See

BLK

16b See

BLK

See

BLK

16b See

BLK

16b See

BLK

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP X TM OTHER .

D. SYSTEM/ITEM

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

Commercial Drawings/Models and Associated Lists

3. SUBTITLE

Product Baseline Drawings and Inventory Diagrams

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-81003F

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ REQREQ

12. DATE OF FIRST SUBMISSION

See BLK 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

AS REQD

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

16. REMARKS

This deliverable shall be reflective of the CASEVAC Set configuration delivered to the Government. The data rights associated with this CDRL are owned by the Government in their entirety and without restriction. Contractor drawing format shall apply in lieu of TDP Option Selection Worksheet. First submission of this CDRL shall reflect configuration of the First Article Test Set. The drawings or ‘tabletop’ will be used for inventory management to ensure kits are complete and available for reuse. Any changes made to the kit configuration after First Article Test Set delivery shall be submitted as updates to this CDRL. Any changes made after Production Sets are delivered shall follow the ECP Configuration Process and will require resubmission of this CDRL reflecting the approved changes and affected data.

Documentation shall be made available in digital format. The drawings will be provided during each delivery in hard copy and on CD-ROM with each respective Set, Kit, or Module. All computer media will be compatible with current Government software. All digital copies provided to the Government program office will be available for future editing.

Block 12/13: The base file will be provided by the government. Initial submission of final award configuration will be delivered in digital format within 30 days of award. Subsequent deliveries will occur with every Set, Kit, or Module delivery. Updates will be made and submitted in digital format for review within 10 days of ECP changes to configuration.

Block 14.a Electronic submissions may be addressed to jeffrey.w.luciano.civ@mail.mil

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER Training .

D. SYSTEM/ITEM

SOF Combat Casualty Care

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Training Material

3. SUBTITLE

Safety, Operation, and Maintenance Training for the CASEVAC SET

4. AUTHORITY (Data Acquisition Document No.)

DI-ILSS-80872

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

See block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

16. REMARKS

The Contractor shall provide a Training Video on CD or DVD ROM, in lieu of hardcopy text specified in the DID, to include safety, operation, and maintenance procedures for the CASEVAC Set. The content shall be suitable for application in a self-paced, self-directed format. The material shall contain sufficient instructions to guide students through all specified hands-on training without a need for instruction lectures and instructor interface. Existing manufacturer’s training and service manuals may be incorporated into the material insofar as they meet specified requirements.

Block 12/13: First submission within 30 days of award, subsequent deliveries with each procurement order in each Set, Kit or Module. Videos will also be distributed to the components thru SOFSA.

Total qty not to exceed 10, 000

Updates to equipment configurations via ECP or changes in training requirements and/or techniques will require revisions to the training video.

See

BLK

16b See

BLK

16b See

BLK

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 1 Pages

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER Configuration Management .

D. SYSTEM/ITEM

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

Provisioning Parts List (PPLs)

3. SUBTITLE

Spare equipment, parts and maintenance material

4. AUTHORITY (Data Acquisition Document No.)

DI-SSES-81715

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

Initial offer

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

16. REMARKS

The Contractor shall submit a complete list of all individually replaceable sub-components with the entire TCCC Set.

The list shall include, as a minimum, Contractor quantities for every type of spare part for the Set to include all consumable and expendable items, part number, OEM part number, NSN if assigned, nomenclature, quantity and price.

The list must be kept updated with pricing and ECP driven part changes.

The deliverable shall be submitted in electronic format in Government compatible software.

The data rights associated with this CDRL are owned by the Government in their entirety and without restriction.

Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government Agencies and direct supporting contractors. Other requests for this document shall be referred to Program Manager – Special Operations Forces Survival, Support & Equipment Systems (PM‐SOF SSES).

BLK 12: The Contractor shall submit a PPL concurrent with the awarded equipment configuration.

BLK 13: Subsequent submissions shall be delivered in electronic format within 10 days of ECP-driven configuration updates.

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 1 Pages

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER Configuration Management .

D. SYSTEM/ITEM

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Engineering Change Proposal (ECP)

3. SUBTITLE

ECP

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-80639E

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

AS REQ

12. DATE OF FIRST SUBMISSION

See block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

16. REMARKS

The Contractor shall submit a Class II ECP for each proposed change that will NOT affect form, fit, function, or safety. Class II ECPs shall be provided in Contractor format. They shall be provided for Government concurrence in classification only and will not require Government approval, but will be used for configuration tracking.

The Contractor shall provide Type I ECPs for Government review and approval. The Government will review the ECP for technical merit and impact. Final approval/disapproval of the Type I ECPs will be granted by the Government Contracting Officer in writing.

Block 12/13: BLK 12: Class I ECPs shall be submitted in time to allow 30 days for Government approval process.

See

16b See

BLK

16b See

See

BLK

16b See

BLK

16b See

BLK

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

ALL

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER Program Management .

D. SYSTEM/ITEM

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Monthly contract status report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

USSOCOM

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

MONTHLY

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

Blocks 10, 12, 13: Initial submission in digital format shall be made within 15 days of the end of the first full month of performance under this order. Subsequent submissions shall be made by the 15th day of each month thereafter.

The Report shall contain the following:

1.0		Summary: The summary shall include a brief statement of the overall project status, covering accomplished technical activities and development, objectives of efforts, summary results of efforts, identification of major problems/deficiencies with impact and recommended solutions.
2.0	Body of Report: The body shall contain the following:
a.	A statement as to whether the program is on task/schedule. If not, provide details of why and the planned effort to get on task/schedule.
b.	Effort expended on each task to date, a brief description of work performed during the reporting period.
c.	Key dates in any testing or development work with significant results.
d.	A narrative of outstanding problems existing as of the previous status report and their resolution status.
e.	New problem areas encountered or anticipated, their effect on the overall work effort/project and steps being taken to remedy problem situations.
f.	Significant results of conferences, trips or directives for the Contracting Officers Representative.
g.	Any other information which may cause significant changes in the program schedule.
3.0	Itemized man-hours and costs. Itemized man-hour and cost expenditure incurred for the reporting period by category and task, total contractual expenditures and funds remaining as of the reporting date.
4.0		Contract deliveries status. The status of each deliverable end items, including data deliverables, as required by the contract. Provide item and contract identification, shipping/transmittal data, acceptance status, and schedule due date information.
5.0	ECP Status. Include a summary of ECP’s, including identification of proposed ECP’s, Approved

ECP’s and implemented ECP’s.

Electronic submissions may be addressed to stephanie.t.elder.civ@mail.mil

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 1 Pages

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP X TM OTHER .

D. SYSTEM/ITEM

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

Identification Marking of U.S. Military Property

3. SUBTITLE

IUID Marking

4. AUTHORITY (Data Acquisition Document No.)

MIL-STD-130/DFARS 252.211-7003

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

USSOCOM

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

Item Unique Identification marking requirements: End items for which the Government’s unit acquisition cost is $5,000 or more are to be marked and registered with the IUID registry in compliance with Defense Acquisition Regulation Supplement (DFARS) clause 252.211-7003 and IAW MIL-STD-130.

BLK 8: Approval (written) is not required. However, the data will be rejected and submitted for rework if it does not conform to the requirements herein. The Government will review and provide comment within 30 days of receipt, as required.

BLK 10/11/12: Due concurrent with delivery of applicable items.

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 1 Pages

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER Configuration Management .

D. SYSTEM/ITEM

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A009

2. TITLE OF DATA ITEM

Supplier’s Configuration Management Plan (SCMP)

3. SUBTITLE

SCMP

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-80858D

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

Contactor will develop and maintain a SCMP to control all aspects of the Configuration Management (CM) process. The SCMP will include event-based criteria for assumption of control of the CM process following acceptance by the Government of documents, designs, or requirements. The Contractor will designate a CM representative to serve as primary point of contact (POC) to the Government for all CM matters and be responsible for any sub-contractor CM efforts.

Contractor will notify the Government of any changes which affect the Contractor’s established CM process.

BLK 10/11/12: Initial submission (draft) in digital format within 60 days of award; final submission 14 days after receipt of Government comments. Subsequent submissions will be made if applicable (i.e. changes to approved SCMP).

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 1 Pages

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER Management .

D. SYSTEM/ITEM

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A010

2. TITLE OF DATA ITEM

Data Accession List (DAL)

3. SUBTITLE

DAL

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81453B

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

BLK 10/11/12: Initial submission (draft) in digital format within 30 days of award. Subsequent submissions shall be monthly as changes occur. If no changes occur during the month, the contractor shall provide a negative response to addressees via email.

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER Management .

D. SYSTEM/ITEM

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A011

2. TITLE OF DATA ITEM

Diminishing Manufacturing Sources and Material Shortages Management Plan

3. SUBTITLE

DMSMS

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81948

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

BLK 10/11/12/13: Initial submission (draft) in digital format within 60 days of award. Final submission due 14 days after receipt of government comments.

Subsequent submissions of Health Assessment Reports shall be submitted as an attachment to the Monthly Status Report (MSR), as applicable.

Block 14.a: Electronic submissions may be addressed to jeffrey.w.luciano.civ@mail.mil

Tailoring to Data Item Description DI-MGMT-81948:

Para 3: The Health Assessment Report shall contain, at a minimum:

· Traceability of issues impacting CASEVAC Set, Kit, or Module functionality to determine if a functional re-design will be cost effective.

· Out-year availability information for future supportability and planning purposes

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

Form Approved OMB No 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP TM OTHER Configuration Management .

D. SYSTEM/ITEM

E. CONTRACT/PR. NO.

F. CONTRACTOR

1. DATA ITEM NO.

A012

2. TITLE OF DATA ITEM

Request for Variance (RFV)

3. SUBTITLE

RFD

4. AUTHORITY (Data Acquisition Document No.)

MIL-HDBK-61

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 250 REQ

9. DIST STATEMENT REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16

a.	ADDRESSEE
	b.	COPIES

Final

Reg

Repr

At a minimum, the RFV shall contain the following information: (a) Date prepared; (b) Originator; (c) RFV Classification (critical, major, or minor); (d) Designation for variance (model/type, CAGE code, system designation, and variance number); (e) Class of variance; (f) Part Number affected; (g) Cost/Price data; (h) Effectivity; (i) Description of variance; (j) Need for variance; (k) Effect on delivery schedule; (l) Recommended corrective action; and (m) Alternatives evaluated

BLK 10/11/12/13: Initial submission (draft) in digital format within 60 days of award. Final submission due 14 days after receipt of government comments. Subsequent submissions as required.

G. PREPARED BY

H. DATE

I. APPROVED BY

J. DATE

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File details come from the government source that posted it. Updated May 7, 2020.