The file's text, extracted by GovTribe without its formatting.
C O N T R A C T D A T A R E Q U I R E M E N T S L I S T (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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 1 |
| TDP _____ TM _____ OTHER SESS |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F215-1
CAMP PENDLETON
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| D001 |
| BASELINE DESCRIPTION DOCUMENT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-SESS-81121A |
| SOW PARA: 3.1.1.5.2 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS.
1. BLK 8: THE GOVERNMENT WILL HAVE 7 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
2. BLK 9: THE FOLLOWING STATEMENT SHALL BE INCLUDED ON THE DELIVERABLE:
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW CONCURRENT WITH PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. THE FINAL SUBMISSION SHALL BE DUE 21 BUSINESS DAYS AFTER READY FOR TRAINING (RFT), WITH ALL COMMENTS CORRECTED RESULTING FROM THE PCA.
5. BLK 14: DIGITAL MEDIA SHALL BE IN MICROSOFT OFFICE 2016 OR LATER AND DELIVERED VIA EMAIL, IF LESS THAN 6MB, OTHERWISE SHIP ON CD-ROM. THE CONTRACT SCHEDULE IN SECTION F LISTS E-MAIL AND REGULAR MAIL ADDRESSES.
DELIVERY TO THE NAWCTSD PCO AND IPTL SHALL BE LETTER NOTIFICATION ONLY.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 1 |
| TDP _____ TM _____ OTHER SESS |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F227-5
FUTENMA
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| D002 |
| BASELINE DESCRIPTION DOCUMENT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-SESS-81121A |
| SOW PARA: 3.1.1.5.2 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS.
1. BLK 8: THE GOVERNMENT WILL HAVE 7 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW CONCURRENT WITH PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. THE FINAL SUBMISSION SHALL BE DUE 21 BUSINESS DAYS AFTER READY FOR TRAINING (RFT), WITH ALL COMMENTS CORRECTED RESULTING FROM THE PCA.
5. BLK 14: DIGITAL MEDIA SHALL BE IN MICROSOFT OFFICE 2016 OR LATER AND DELIVERED VIA EMAIL, IF LESS THAN 6MB, OTHERWISE SHIP ON CD-ROM. THE CONTRACT SCHEDULE IN SECTION F LISTS E-MAIL AND REGULAR MAIL ADDRESSES.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 2 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 1 |
| TDP _____ TM _____ OTHER SESS |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F227-3
JBMcGUIRE
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| D003 |
| BASELINE DESCRIPTION DOCUMENT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-SESS-81121A |
| SOW PARA: 3.1.1.5.2 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS.
1. BLK 8: THE GOVERNMENT WILL HAVE 7 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW CONCURRENT WITH PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. THE FINAL SUBMISSION SHALL BE DUE 21 BUSINESS DAYS AFTER READY FOR TRAINING (RFT), WITH ALL COMMENTS CORRECTED RESULTING FROM THE PCA.
5. BLK 14: DIGITAL MEDIA SHALL BE IN MICROSOFT OFFICE 2016 OR LATER AND DELIVERED VIA EMAIL, IF LESS THAN 6MB, OTHERWISE SHIP ON CD-ROM. THE CONTRACT SCHEDULE IN SECTION F LISTS E-MAIL AND REGULAR MAIL ADDRESSES.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 3 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 1 |
| TDP _____ TM _____ OTHER SESS |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F227-4
BELLE CHASSE
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| D004 |
| BASELINE DESCRIPTION DOCUMENT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-SESS-81121A |
| SOW PARA: 3.1.1.5.2 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS.
1. BLK 8: THE GOVERNMENT WILL HAVE 7 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW CONCURRENT WITH PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. THE FINAL SUBMISSION SHALL BE DUE 21 BUSINESS DAYS AFTER READY FOR TRAINING (RFT), WITH ALL COMMENTS CORRECTED RESULTING FROM THE PCA.
5. BLK 14: DIGITAL MEDIA SHALL BE IN MICROSOFT OFFICE 2016 OR LATER AND DELIVERED VIA EMAIL, IF LESS THAN 6MB, OTHERWISE SHIP ON CD-ROM. THE CONTRACT SCHEDULE IN SECTION F LISTS E-MAIL AND REGULAR MAIL ADDRESSES.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 4 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 1 |
| TDP _____ TM _____ OTHER SESS |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F197-1
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| D005 |
| BASELINE DESCRIPTION DOCUMENT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-SESS-81121A |
| SOW PARA: 3.1.1.5.2 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS.
1. BLK 8: THE GOVERNMENT WILL HAVE 7 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW CONCURRENT WITH PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. THE FINAL SUBMISSION SHALL BE DUE 21 BUSINESS DAYS AFTER READY FOR TRAINING (RFT), WITH ALL COMMENTS CORRECTED RESULTING FROM THE PCA.
5. BLK 14: DIGITAL MEDIA SHALL BE IN MICROSOFT OFFICE 2016 OR LATER AND DELIVERED VIA EMAIL, IF LESS THAN 6MB, OTHERWISE SHIP ON CD-ROM. THE CONTRACT SCHEDULE IN SECTION F LISTS E-MAIL AND REGULAR MAIL ADDRESSES.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 5 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 1 |
| TDP _____ TM _____ OTHER SESS |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F227-2
NEW RIVER
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| D006 |
| BASELINE DESCRIPTION DOCUMENT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-SESS-81121A |
| SOW PARA: 3.1.1.5.2 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS.
1. BLK 8: THE GOVERNMENT WILL HAVE 7 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW CONCURRENT WITH PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. THE FINAL SUBMISSION SHALL BE DUE 21 BUSINESS DAYS AFTER READY FOR TRAINING (RFT), WITH ALL COMMENTS CORRECTED RESULTING FROM THE PCA.
5. BLK 14: DIGITAL MEDIA SHALL BE IN MICROSOFT OFFICE 2016 OR LATER AND DELIVERED VIA EMAIL, IF LESS THAN 6MB, OTHERWISE SHIP ON CD-ROM. THE CONTRACT SCHEDULE IN SECTION F LISTS E-MAIL AND REGULAR MAIL ADDRESSES.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 6 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 1 |
| TDP _____ TM _____ OTHER SESS |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII UH-1Y FTD, DEVICE 2F206-1
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| D007 |
| BASELINE DESCRIPTION DOCUMENT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-SESS-81121A |
| SOW PARA: 3.1.1.5.2 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS.
1. BLK 8: THE GOVERNMENT WILL HAVE 7 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW CONCURRENT WITH PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. THE FINAL SUBMISSION SHALL BE DUE 21 BUSINESS DAYS AFTER READY FOR TRAINING (RFT), WITH ALL COMMENTS CORRECTED RESULTING FROM THE PCA.
5. BLK 14: DIGITAL MEDIA SHALL BE IN MICROSOFT OFFICE 2016 OR LATER AND DELIVERED VIA EMAIL, IF LESS THAN 6MB, OTHERWISE SHIP ON CD-ROM. THE CONTRACT SCHEDULE IN SECTION F LISTS E-MAIL AND REGULAR MAIL ADDRESSES.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 7 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 1 |
| TDP _____ TM _____ OTHER SESS |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII UH-1Y FTD, DEVICE 2F226-3
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| D008 |
| BASELINE DESCRIPTION DOCUMENT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-SESS-81121A |
| SOW PARA: 3.1.1.5.2 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS.
1. BLK 8: THE GOVERNMENT WILL HAVE 7 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW CONCURRENT WITH PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. THE FINAL SUBMISSION SHALL BE DUE 21 BUSINESS DAYS AFTER READY FOR TRAINING (RFT), WITH ALL COMMENTS CORRECTED RESULTING FROM THE PCA.
5. BLK 14: DIGITAL MEDIA SHALL BE IN MICROSOFT OFFICE 2016 OR LATER AND DELIVERED VIA EMAIL, IF LESS THAN 6MB, OTHERWISE SHIP ON CD-ROM. THE CONTRACT SCHEDULE IN SECTION F LISTS E-MAIL AND REGULAR MAIL ADDRESSES.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 8 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 1 |
| TDP _____ TM _____ OTHER SESS |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII UH-1Y FTD, DEVICE 2F196B-2
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| D009 |
| BASELINE DESCRIPTION DOCUMENT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-SESS-81121A |
| SOW PARA: 3.1.1.5.2 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS.
1. BLK 8: THE GOVERNMENT WILL HAVE 7 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW CONCURRENT WITH PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. THE FINAL SUBMISSION SHALL BE DUE 21 BUSINESS DAYS AFTER READY FOR TRAINING (RFT), WITH ALL COMMENTS CORRECTED RESULTING FROM THE PCA.
5. BLK 14: DIGITAL MEDIA SHALL BE IN MICROSOFT OFFICE 2016 OR LATER AND DELIVERED VIA EMAIL, IF LESS THAN 6MB, OTHERWISE SHIP ON CD-ROM. THE CONTRACT SCHEDULE IN SECTION F LISTS E-MAIL AND REGULAR MAIL ADDRESSES.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 9 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 2 |
| TDP _____ TM _____ OTHER MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F197-1
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| K001 |
| TRAINING DEVICE INVENTORY CHECKLIST/RECORD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-81191B |
| SOW PARA: 3.2.9.5 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS
1. BLK 8: THE GOVERNMENT WILL HAVE 15 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW 15 BUSINESS DAYS PRIOR TO PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. BLK 13: A FINAL COPY SUBMISSION SHALL BE DUE AT ILSV, WITH ALL COMMENTS RESULTING FROM PCA INCORPORATED.
5. BLK 14: DIGITAL MEDIA SUBMISSION SHALL BE DELIVERED ON CD ROM OR VIA E-MAIL IF IT IS LESS THAN 6MB IN MICROSOFT WORD COMPATIBLE WITH OFFICE 2016 FORMAT. EMAIL ADDRESSES ARE PROVIDED IN SECTION F OF THE CONTRACT.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 10 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 2 |
| TDP _____ TM _____ OTHER MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F227-3
JB McGUIRE
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| K002 |
| TRAINING DEVICE INVENTORY CHECKLIST/RECORD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-81191B |
| SOW PARA: 3.2.9.5 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS
1. BLK 8: THE GOVERNMENT WILL HAVE 15 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW 15 BUSINESS DAYS PRIOR TO PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. BLK 13: A FINAL COPY SUBMISSION SHALL BE DUE AT ILSV, WITH ALL COMMENTS RESULTING FROM PCA INCORPORATED.
5. BLK 14: DIGITAL MEDIA SUBMISSION SHALL BE DELIVERED ON CD ROM OR VIA E-MAIL IF IT IS LESS THAN 6MB IN MICROSOFT WORD COMPATIBLE WITH OFFICE 2016 FORMAT. EMAIL ADDRESSES ARE PROVIDED IN SECTION F OF THE CONTRACT.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 11 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 2 |
| TDP _____ TM _____ OTHER MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F227-4
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| K003 |
| TRAINING DEVICE INVENTORY CHECKLIST/RECORD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-81191B |
| SOW PARA: 3.2.9.5 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS
1. BLK 8: THE GOVERNMENT WILL HAVE 15 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW 15 BUSINESS DAYS PRIOR TO PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. BLK 13: A FINAL COPY SUBMISSION SHALL BE DUE AT ILSV, WITH ALL COMMENTS RESULTING FROM PCA INCORPORATED.
5. BLK 14: DIGITAL MEDIA SUBMISSION SHALL BE DELIVERED ON CD ROM OR VIA E-MAIL IF IT IS LESS THAN 6MB IN MICROSOFT WORD COMPATIBLE WITH OFFICE 2016 FORMAT. EMAIL ADDRESSES ARE PROVIDED IN SECTION F OF THE CONTRACT.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 12 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 2 |
| TDP _____ TM _____ OTHER MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F215-1
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| K004 |
| TRAINING DEVICE INVENTORY CHECKLIST/RECORD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-81191B |
| SOW PARA: 3.2.9.5 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS
1. BLK 8: THE GOVERNMENT WILL HAVE 15 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW 15 BUSINESS DAYS PRIOR TO PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. BLK 13: A FINAL COPY SUBMISSION SHALL BE DUE AT ILSV, WITH ALL COMMENTS RESULTING FROM PCA INCORPORATED.
5. BLK 14: DIGITAL MEDIA SUBMISSION SHALL BE DELIVERED ON CD ROM OR VIA E-MAIL IF IT IS LESS THAN 6MB IN MICROSOFT WORD COMPATIBLE WITH OFFICE 2016 FORMAT. EMAIL ADDRESSES ARE PROVIDED IN SECTION F OF THE CONTRACT.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 13 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 2 |
| TDP _____ TM _____ OTHER MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F227-5
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| K005 |
| TRAINING DEVICE INVENTORY CHECKLIST/RECORD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-81191B |
| SOW PARA: 3.2.9.5 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS
1. BLK 8: THE GOVERNMENT WILL HAVE 15 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW 15 BUSINESS DAYS PRIOR TO PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. BLK 13: A FINAL COPY SUBMISSION SHALL BE DUE AT ILSV, WITH ALL COMMENTS RESULTING FROM PCA INCORPORATED.
5. BLK 14: DIGITAL MEDIA SUBMISSION SHALL BE DELIVERED ON CD ROM OR VIA E-MAIL IF IT IS LESS THAN 6MB IN MICROSOFT WORD COMPATIBLE WITH OFFICE 2016 FORMAT. EMAIL ADDRESSES ARE PROVIDED IN SECTION F OF THE CONTRACT.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 14 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 2 |
| TDP _____ TM _____ OTHER MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII AH-1Z FTD, DEVICE 2F227-2
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| K006 |
| TRAINING DEVICE INVENTORY CHECKLIST/RECORD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-81191B |
| SOW PARA: 3.2.9.5 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS
1. BLK 8: THE GOVERNMENT WILL HAVE 15 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW 15 BUSINESS DAYS PRIOR TO PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. BLK 13: A FINAL COPY SUBMISSION SHALL BE DUE AT ILSV, WITH ALL COMMENTS RESULTING FROM PCA INCORPORATED.
5. BLK 14: DIGITAL MEDIA SUBMISSION SHALL BE DELIVERED ON CD ROM OR VIA E-MAIL IF IT IS LESS THAN 6MB IN MICROSOFT WORD COMPATIBLE WITH OFFICE 2016 FORMAT. EMAIL ADDRESSES ARE PROVIDED IN SECTION F OF THE CONTRACT.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 15 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 2 |
| TDP _____ TM _____ OTHER MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII UH-1Y FTD, DEVICE 2F226-3
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| K007 |
| TRAINING DEVICE INVENTORY CHECKLIST/RECORD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-81191B |
| SOW PARA: 3.2.9.5 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS
1. BLK 8: THE GOVERNMENT WILL HAVE 15 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW 15 BUSINESS DAYS PRIOR TO PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. BLK 13: A FINAL COPY SUBMISSION SHALL BE DUE AT ILSV, WITH ALL COMMENTS RESULTING FROM PCA INCORPORATED.
5. BLK 14: DIGITAL MEDIA SUBMISSION SHALL BE DELIVERED ON CD ROM OR VIA E-MAIL IF IT IS LESS THAN 6MB IN MICROSOFT WORD COMPATIBLE WITH OFFICE 2016 FORMAT. EMAIL ADDRESSES ARE PROVIDED IN SECTION F OF THE CONTRACT.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 16 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 2 |
| TDP _____ TM _____ OTHER MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII UH-1Y FTD, DEVICE 2F196B-2
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| K008 |
| TRAINING DEVICE INVENTORY CHECKLIST/RECORD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-81191B |
| SOW PARA: 3.2.9.5 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS
1. BLK 8: THE GOVERNMENT WILL HAVE 15 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW 15 BUSINESS DAYS PRIOR TO PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. BLK 13: A FINAL COPY SUBMISSION SHALL BE DUE AT ILSV, WITH ALL COMMENTS RESULTING FROM PCA INCORPORATED.
5. BLK 14: DIGITAL MEDIA SUBMISSION SHALL BE DELIVERED ON CD ROM OR VIA E-MAIL IF IT IS LESS THAN 6MB IN MICROSOFT WORD COMPATIBLE WITH OFFICE 2016 FORMAT. EMAIL ADDRESSES ARE PROVIDED IN SECTION F OF THE CONTRACT.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 17 of 54 Pages
Form Approved
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 BLK E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D LOT 2 |
| TDP _____ TM _____ OTHER MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
LOT VIII UH-1Y FTD, DEVICE 2F206-1
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| K009 |
| TRAINING DEVICE INVENTORY CHECKLIST/RECORD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-81191B |
| SOW PARA: 3.2.9.5 |
| PMA-276 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| XX |
| REQUIRED |
| 2 TIMES |
| SEE BLK 16 |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT SUBM. |
| a. ADDRESSEE |
| b. COPIES |
Final
A
16. REMARKS
1. BLK 8: THE GOVERNMENT WILL HAVE 15 BUSINESS DAYS FOR REVIEW AND ACCEPT, ACCEPT WITH COMMENTS, OR REJECT EACH SUBMISSION.
DISTRIBUTION STATEMENT D- DISTRIBUTION AUTHORIZED TO DOD AND U.S. DOD CONTRACTORS ONLY. ADMINISTRATIVE OR OPERATIONAL USE 01 JANUARY 2021. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO PEO (CS)/PMA-205, 47123 BUSE ROAD, RADM WILLIAM A. MOFFETT BUILDING, PATUXENT RIVER, MARYLAND 20670-1547.
3. BLK 12: FIRST SUBMISSION SHALL BE A DRAFT COPY DELIVERED FOR REVIEW 15 BUSINESS DAYS PRIOR TO PHYSICAL CONFIGURATION AUDIT (PCA) OF DEVICE.
4. BLK 13: A FINAL COPY SUBMISSION SHALL BE DUE AT ILSV, WITH ALL COMMENTS RESULTING FROM PCA INCORPORATED.
5. BLK 14: DIGITAL MEDIA SUBMISSION SHALL BE DELIVERED ON CD ROM OR VIA E-MAIL IF IT IS LESS THAN 6MB IN MICROSOFT WORD COMPATIBLE WITH OFFICE 2016 FORMAT. EMAIL ADDRESSES ARE PROVIDED IN SECTION F OF THE CONTRACT.
| NAWCTSD PCO |
| SEE BLK16 |
| SEE BLK16 |
| 0 |
| NAWCTSD IPTL3 |
| SEE BLK16 |
| SEE BLK16 |
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| S. NESS, NAWCTSD ILSM |
| 15 MARCH 2022 |
| S. COLN, PMA205, DAPMTS |
| 15 MARCH 2022 |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 18 of 54 Pages
Form Approved
The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching…
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