DRAFT CDRLs N6660424Q0707_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: MGMT

D. SYSTEM/ITEM

Flared Base Group (FBG) Switches and Filters Assembly RF Components

E. CONTRACT / PR NO.

N6660424Q0707

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A002

2. TITLE O ITEM:

Status Report

3. SUBTITLE

N/A

17. PRICE GROUP

4. AUTHORITY (Date Acqu Document No.)

DI-MGM 80368A

S lock 16*

5. CONTRACT REFERENCE

SOW Para# N/A

6. REQUIRING OFFICE

NUWCDIVNPT, Code 3425

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMNT

REQUIRED

FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION *

LT e Block 16* See Block 16* b. COPIES

8. APP COD . AS OF DATE 13. DATE OF SUBSEQNT

SUBMISSION

a. ADDRESSEE Draft Final

N/A See Block 1 See Bl 16* e Block 16* Reg Repro

16. REMARKS

Block 4: Waive DI-MGMT-80368A i 3.2.3.

PI 0 1 0

Block 9: See BLOCK 16 ADD DUM 3432 DM 0 1 0

Block 10: Two (2) submissions are anticipated

Block 11, 12 & 13: Contractor shall deliver q erly status rep n the first of every quarter until Government accepta ce of all cted materia

Block 14: Media Requirements: The report shall be delivered electro y in Microsoft 2016 format with email notification to all addressees.

15. TOTAL ______> 0 2 0

G. PREPARED BY:

H. DATE

27 June 2024

I. APPROVED BY J. DATE

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

DRAFT

(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

Flared Base Group (FBG) Switches and Filters Assembly RF Components

E. CONTRACT / PR NO.

N6660424Q0707

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A003

2. TITLE O ITEM:

rtificate of Compliance

3. SUBTITLE

N/A

17. PRICE GROUP

4. AUTHORITY (Date Acqu Document No.)

DI-MI 81356A

S lock 16*

5. CONTRACT REFERENCE

SOW Para# N/A

6. REQUIRING OFFICE

NUWCDIVNPT, Code 3423

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMNT

REQUIRED

FREQUENCY

12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION *

LT ee Block 1 See Block 16* b. COPIES

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

SUBMISSION

a. ADDRESSEE Draft Final

N/A Bl A See Block 16* Reg Repro

16. REMARKS PI 0 1 0

Block 4: Contractor shall deliver a ifi of Complianc ith each unit that is delivered. The Certificate omplain hall include mercury free statement.

3432 DM 0 1 0

Block 9: See BLOCK 16 ADDENDUM

Block 10: One (1) submission is anticipated. units may be docume on one submittal or provided individually.

Block 11, 12 & 13: Data submission upon delivery of material.

Block 14: Media Requirements: The report shall be delivered electro ally in Microsoft 2016 format with email notification to all addressees.

15. TOTAL ______> 0 2 0

G. PREPARED BY:

H. DATE

27 June 2024

I. APPROVED BY J. DATE

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

DD FORM 1423

BLOCK 16 ADDENDUM

PR TBD

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

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

CDRLs A001-A00

Distribution tement D: Distr ution authorized to Department of Defense and U.S. DoD contractors only Critical T nology (30 Septemb 2020). Other requests shall be referred to NUWCDIVNPT, Code 349.

The following XPORT C TROL W RNIN NOTICE" must be used in conjunction with DISTRIBUTION STATEMENTS ide in the CD .

WARNING -This document co ins tec ical data w se export is restricted by the Arms Export Control Act (Title 22, U.S.C. Sec. 2751, eq.) or the ort Ad nistration Act of 1979, as amended, Title 50, U.S.C., App.

2401 et seq. Violations of these export law are ject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25

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