Exhibit A_CDRLS.pdf

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Submarine High Data Rate (SubHDR), Q-Band Traveling Wave Tubes (TWT)
Solicitation number
N66604-21-R-0236
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N6660421R02360001.pdf PDF
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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

Submarine HDR TWT SparesRepairs

E. CONTRACT / PR NO.

1300888609

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM:

CERTIFICATE OF COMPLIANCE

3. SUBTITLE

N/A

17. PRICE GROUP

4. AUTHORITY (Date Acquisition Document No.)

DI-MGMT-81991

5. CONTRACT REFERENCE

N/A

6. REQUIRING OFFICE

NUWCDIVNPT CODE 3411

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

9. DIST STATEMNT

REQUIRED

10. FREQUENCY

12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION *

See Block 16

LT D ASREQ* See Block 16 b. COPIES

8. APP CODE See Block 16 11. AS OF DATE 13. DATE OF SUBSEQNT

SUBMISSION

a. ADDRESSEE Draft Final

N/A O N/A Reg Repro

16. REMARKS COR 0 1 0

Block 9: See BLOCK 16 ADDENDUM 3432 DM 0 1 0

Block 10: Minimum of five (5) with maximum of fifteen (15) submissions are anticipated per year.

Block 12: Certificate of Compliance shall be delivered with each unit that is delivered.

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

COR: kristy.mosier@navy.mil 3432 DM: NUWC_NPT_3432DataMgt@navy.mil

15. TOTAL

______> 0 2 0

G. PREPARED BY:

Kristy Mosier

H. DATE

01/12/2021

I. APPROVED BY

J. DATE

Approved for

RFP 03/11/2021

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 1 of 3 Pages

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

Submarine HDR TWT SparesRepairs

E. CONTRACT / PR NO.

1300888609

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM:

CONTRACT STATUS REPORT

3. SUBTITLE

N/A

17. PRICE GROUP

4. AUTHORITY (Date Acquisition Document No.)

DI-MGMT-81991

5. CONTRACT REFERENCE

N/A

6. REQUIRING OFFICE

NUWCDIVNPT CODE 3411

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

9. DIST STATEMNT

REQUIRED

10. FREQUENCY

12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION *

See Block 16

LT D ASREQ* See Block 16 b. COPIES

8. APP CODE See Block 16 11. AS OF DATE 13. DATE OF SUBSEQNT

SUBMISSION

a. ADDRESSEE Draft Final

N/A O N/A Reg Repro

16. REMARKS COR 0 1 0

Block 9: See attached addendum. 3432 DM 0 1 0

Block 10/12: The contractor shall submit the report for the same timeframe as each invoice submitted in the Procurement Integrated Enterprise Environment (PIEE) module of wide area work flow (WAWF).

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

COR: kristy.mosier@navy.mil 3432 DM: NUWC_NPT_3432DataMgt@navy.mil

15. TOTAL

______> 0 2 0

G. PREPARED BY:

Kristy Mosier

H. DATE

01/12/2021

I. APPROVED BY

J. DATE

Approved for

RFP 03/11/2021

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 2 of 3 Pages

DD FORM 1423, CONTRACT DATA REQUIREMENTS LIST

BLOCK 16 ADDENDUM

PR 1300888609

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 and A002

Distribution Statement D. Distribution authorized to the Department of Defense and U.S. DoD contractors only (Critical Technology) (12 January 2021). Other requests shall be referred to NUWCDIVNPT Code 3411.

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

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page 3 of 3 Pages

2021-03-11T10:56:49-0500
CANUEL.CHARLENE.M.1454350100
2021-03-11T10:57:48-0500
CANUEL.CHARLENE.M.1454350100

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