DRAFT CDRL A001 Test Report (Rev 8-26-21).docx
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CONTRACT DATA REQUIREMENTS LIST (CDRL)
(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 the 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 |
| C. CATEGORY: |
| 0001-0003 |
| A |
| TDP |
| TM _____ |
| OTHER NDTI |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| MK96 MOD 2, COLD GAS FES, BAG ASSEMBLY |
| 1300930901 |
| N/A |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| A001 |
| TEST/ INSPECTION REPORT |
| WRITTEN TEST REPORT- BAG ASEMBLY, COLD GAS |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-NDTI-80809B |
| SOW, SEE BLK 16 |
| NUWC DIVISION, KEYPORT |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| DD |
| REQUIRED |
| ASREQ |
| SEE BLK 16 |
| a. ADDRESSEE |
| b. COPIES |
| 8. APP CODE |
| D (SEE BLK 16) |
| 11. AS OF DATE |
| 13. DATE IF SUBSEQUENT SUBM. |
| Draft |
| Final |
A
| N/A |
| SEE BLK 16 |
| Reg |
| Repro |
| 16. REMARKS |
| TECHNICAL POC |
| 1 |
| 1 |
BLK 5: ALL WRITTEN TEST DATA REQUIREMENTS PER THE DRAWING AND SOW, TEST DATA SHEETS FOR DRAWING 8290040, NOTES 3, PRESSURE TEST, NOTE 4, LEAKAGE TEST, AND NOTE 19, PROOFING PRESSURE TEST, AND NOTE 6 OF DRAWING 8290021, STATIC TENSILE LOAD PROOF TEST. TEST REPORTS SHALL ACCOMPANY EACH DELIVERY OF MATERIAL ENSURING CONFORMANCE TESTING ACCOMPLISHED IAW WITH TECHNICAL REQUIREMENTS. A CERTIFICATE OF CONFORMANCE SHALL ALSO ACCOMPANY EACH DELIVERY OF MATERIAL.
BLK 9: DISTRIBUTION STATEMENT "D" - DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY; CRITICAL TECHNOLOGY, EXPORT CONTROLLED (4/29/2021). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO NUWC, DIVISION KEYPORT, CODE 323, WEAPONS LOGISTICS SUPPORT BRANCH, TRACI SEELEY.
DESTRUCTION NOTICE - FOR UNCLASSIFIED, LIMITED DOCUMENTS, DESTROY BY ANY METHOD THAT WILL PREVENT DISCLOSURE OF CONTENTS OR RECONSTRUCTION OF THE DOCUMENT.
BLK 10: NUWCDIVKPT WILL HAVE 45 DAYS TO ACCEPT/REJECT THE REPORT. IF THE REPOST IS REJECTED THE CONTRACTOR HAS 30 DAYS TO RESUBMIT.
BLK 12 & 13: TEST DATA SHALL BE DELIVERED WITH EACH SHIPMENT OF MATERIAL (FIRST ARTICLES AND PRODUCTION UNITS. SEE CONTRACT CLINS 0001-0003 FOR DELIVERY SCHEDULE.
BLK 14: DELIVERABLE FORMAT:
TEXT DOCUMENT: ADOBE PDF (PDF SEARCHABLE) OR MICROSOFT WORD (DOC).
PRESENTATION: ADOBE PDF (PDF SEARCHABLE) OR MICROSOFT POWERPOINT (PPT).
SPREADSHEET: MICROSOFT EXCEL (XLS).
DISTRIBUTION ADDRESSEES AND ELECTRONIC MAILING ADDRESSES ARE PROVIDED BELOW:
1) NUWC DIVISION KEYPORT, TRACI SEELEY, LOGISTICS TECH POC, TRACI.SEELEY@NAVY.MIL.
2) NUWC DIVISION KEYPORT, PCO (CONTRACTING OFFICER), MONIQUE KLOSE, MONIQUE.KLOSE@NAVY.MIL
3) NUWC DIVISION KEYPORT, CONTRACT SPECIALIST, JULIE THOMAS, JULIE.THOMAS@NAVY.MIL
4) NUWC DIVISION KEYPORT, TECH POC, MIKHAIL VAYNER ENGINEERING, MIKHAIL.VAYNER@NAVY.MIL, MAILING ADDRESS:
SEE CONTRACT, SECTION F
| PCO |
| 1 |
| 1 |
| CONTRACT SPECIALIST |
| 1 |
| 1 |
| ENGINEER |
| 1 |
| 1 |
| 15. TOTAL ▬▬▬▬► |
| 1 |
| 0 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| TRACI SEELEY |
| 10 AUG, 2021 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages
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