EXHIBIT A - CONTRACT DATA REQUIREMENT LIST - CXU-3 Signal Cartridge 13SEP2021.pdf

PDF 971 KB Posted Sep 30, 2021

Attached to: CXU-3 A/B Signal Cartridge
Solicitation number: W52P1J21R0052
Issued by: Department of the Army Materiel Command Joint Munitions Command

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File	Type	Posted
B08 - W52P1J21R0052-0001.pdf	PDF	Oct 29, 2021
W52P1J21R0052-0002.pdf	PDF	Oct 29, 2021
ATTACHMENT 0001 - Price Matrix.xlsx	XLSX spreadsheet	Sep 30, 2021
ATTACHMENT 0006 - OPSEC Plan Sample.pdf	PDF	Sep 30, 2021
ATTACHMENT 0009- Scheduled Government Furnished Property.pdf	PDF	Sep 30, 2021
ATTACHMENT 0004 - CDRL Distribution - List of Addresses.pdf	PDF	Sep 30, 2021
ATTACHMENT 0005 - Quality Assurance Provisions QAP CXU-3 AB Signal Cartridge Rev D.pdf	PDF	Sep 30, 2021
ATTACHMENT 0010 - ASSIST Instructions.pdf	PDF	Sep 30, 2021
ATTACHMENT 0002 - Instructions for Form DD1423.pdf	PDF	Sep 30, 2021
ATTACHMENT 0007 - Hazardous Material Sheet.pdf	PDF	Sep 30, 2021
ATTACHMENT 0003 -Guidance of Documentation of CDRLS.pdf	PDF	Sep 30, 2021
W52P1J21R0052.pdf	PDF	Sep 30, 2021
ATTACHMENT 0008 - Security Statement of Work.pdf	PDF	Sep 30, 2021
ATTACHMENT 0011 - Past Performance Questionnaire (PPQ).pdf	PDF	Sep 30, 2021

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CONTRACT DATA REQUIREMENTS LIST Form Approved

(1 Data Item) 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:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A001 QUALITY PROGRAM PLAN (QPP)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-QCIC-81722 SECTION E (SEE BLK 16) AMJM-QAP

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 14. DISTRIBUTION

LT ONE/R (SEE 16)

12. DATE OF FIRST SUBMISSION

120 DACA (SEE 16)

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ (SEE 16) Reg Repro

AMJM-QAP 0 1 0

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

DCMA-MCWB (QAR) 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 7 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 16 Pages

QCIC

25 MAR 2020

(SEE 16)

16. REMARKS

BLK 5: THE QUALITY PROGRAM PLAN (QPP) SHALL DOCUMENT THE

CONTRACTOR'S IMPLEMENTATION OF A QUALITY SYSTEM IN

ACCORDANCE WITH THE QUALITY ASSURANCE PROVISION (QAP).

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED

TO THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS

ONLY: EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS SHALL

BE REFERRED TO PMA-201, NAS PATUXENT RIVER, MARYLAND

BLK 10, 12: THE QPP SHALL BE SUBMITTED NO LATER THAN 120

CALENDAR DAYS AFTER CONTRACT AWARD. THE GOVERNMENT

REQUIRES 30 DAYS FOR REVIEW. DISPOSITION OF THE QPP WILL BE

PROVIDED THROUGH THE PROCURING CONTRACTING OFFICER (PCO).

IF FURTHER REVISIONS ARE NECESSARY, THE CONTRACTOR SHALL

HAVE 15 DAYS TO PROVIDE REVISIONS AND THE GOVERNMENT

SHALL REVIEW AND PROVIDE DISPOSITION WITHIN 15 DAYS OF

RECEIPT. THE QPP SHALL BE APPROVED PRIOR TO FAT, IF FAT IS

REQUIRED, OR PRIOR TO INITIATION OF PRODUCTION.

BLK 13: SUBMIT UPDATES/REVISIONS FOR REVIEW AND APPROVAL

PRIOR TO IMPLEMENTATION.

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

EMAIL OR DOD-SAFE (https://safe.apps.mil/).

PAWS, TPO

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A002 STATISTICAL PROCESS CONTROL (SPC) PLAN

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MGMT-81987A SECTION E AMJM-QAP

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 14. DISTRIBUTION

LT ONE/R (SEE 16)

12. DATE OF FIRST SUBMISSION

120 DACA (SEE 16)

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ (SEE 16) Reg Repro

AMJM-QAP 0 1 0

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

DCMA-MCWB (QAR) 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 7 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 2 of 16 Pages

MGMT

25 MAR 2020

(SEE 16)

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION

AUTHORIZED TO THE DEPARTMENT OF DEFENSE AND U.S. DOD

CONTRACTORS ONLY: EXPORT CONTROLLED: 03 DEC 2020. OTHER

REQUESTS SHALL BE REFERRED TO PMA-201, NAS PATUXENT

RIVER, MARYLAND

BLK 10, 12: THE GENERAL PLAN SHALL BE SUBMITTED NO LATER

THAN 120 CALENDAR DAYS AFTER CONTRACT AWARD. THE FINAL

DETAILED PLAN SHALL BE SUBMITTED 30 DAYS AFTER FAT

APPROVAL, IF FAT IS REQUIRED, OR 30 DAYS AFTER INITIATION OF

PRODUCTION. THE GOVERNMENT REQUIRES 30 DAYS FOR REVIEW.

DISPOSITION OF THE GENERAL AND DETAILED SECTIONS WILL BE

PROVIDED THROUGH THE PROCURING CONTRACTING OFFICER (PCO).

IF FURTHER REVISIONS ARE NECESSARY, THE CONTRACTOR SHALL

HAVE 15 DAYS TO PROVIDE REVISIONS AND THE GOVERNMENT

SHALL REVIEW AND PROVIDE DISPOSITION WITHIN 15 DAYS OF

RECEIPT.

BLK 13: SUBMIT UPDATES/REVISIONS FOR REVIEW AND APPROVAL

PRIOR TO IMPLEMENTATION.

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

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 i t 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:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A003 INSPECTION AND TEST PLAN

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-QCIC-81110- NOTICE 2 SECTION E (SEE BLK 16) AMJM-QAP

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 14. DISTRIBUTION

LT ONE/R (SEE 16)

12. DATE OF FIRST SUBMISSION

120 DACA(SEE 16)

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ (SEE 16) Reg Repro

AMJM-QAP 0 1 0

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

DCMA-MCWB (QAR) 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 7 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 3 of 16 Pages

QCIC

25 MAR 2020

(SEE 16)

16. REMARKS

BLK 5: THE INSPECTION AND TEST PLAN (ITP) SHALL BE IN

ACCORDANCE WITH THE QUALITY ASSURANCE PROVISION (QAP).

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED

TO THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS

ONLY: EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS

SHALL BE REFERRED TO PMA-201, NAS PATUXENT RIVER,

MARYLAND

BLK 10, 12: THE ITP SHALL BE SUBMITTED NO LATER THAN 120

CALENDAR DAYS AFTER CONTRACT AWARD. THE GOVERNMENT

REQUIRES 30 DAYS FOR REVIEW. DISPOSITION OF THE ITP WILL BE

PROVIDED THROUGH THE PROCURING CONTRACTING OFFICER (PCO).

IF FURTHER REVISIONS ARE NECESSARY, THE CONTRACTOR SHALL

HAVE 15 DAYS TO PROVIDE REVISIONS AND THE GOVERNMENT

SHALL REVIEW AND PROVIDE DISPOSITION WITHIN 15 DAYS. THE ITP

SHALL BE APPROVED PRIOR TO FAT, IF FAT IS REQUIRED, OR PRIOR

TO INITIATION OF PRODUCTION.

BLK 13: SUBMIT UPDATES/REVISIONS FOR REVIEW AND APPROVAL

PRIOR TO IMPLEMENTATION.

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A004 MEASUREMENT SYSTEM EVALUATION (MSE) –

MEASUREMENT AND INSPECTION EQUIPMENT

SYSTEM DESIGN DOCUMENTATION FOR

ACCEPTANCE OF PRODUCT

ACCEPTANCE INSPECTION EQUIPMENT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-QCIC-81960- NOTICE 1 SECTION E (MSE CLAUSE) NSWC (MS-21)

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 14. DISTRIBUTION

LT ONE/R (SEE 16)

12. DATE OF FIRST SUBMISSION

120 DACA (SEE 16)

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ (SEE 16) Reg Repro

16. REMARKS

NSWC (MS-21) 0 1 0

AMJM-QAP 0 1 0

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

DCMA-MCWB (QAR) 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 8 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 4 of 16 Pages

QCIC

25 MAR 2020

(SEE 16)

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO

THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY:

EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS SHALL BE

REFERRED TO PMA-201, NAS PATUXENT RIVER, MARYLAND

BLK 10, 12: THE CONTRACTOR SHALL SUBMIT A COMPLETED

ACCEPTANCE INSPECTION EQUIPMENT (AIE) PACKAGE NO LATER

THAN 120 CALENDAR DAYS AFTER CONTRACT AWARD. THE

GOVERNMENT WILL PROVIDE DISPOSITION WITHIN 45 DAYS AFTER

FINAL AIE PACKAGE RECEIPT.

BLK 13: IF FURTHER REVISIONS ARE NECESSARY, THE CONTRACTOR

SHALL HAVE 30 DAYS TO GENERATE REVISIONS AND THE

GOVERNMENT SHALL HAVE 30 DAYS TO REVIEW AND RESPOND.

THE APPROVED AIE SHALL BE AVAILABLE FOR FAT, IF FAT IS

REQUIRED, PRODUCTION, AND/OR ALL ACCEPTANCE OF PRODUCT

UNDER THE CONTRACT. IF CONTRACTOR REVISES A PREVIOUSLY

GOVERNMENT-ACCEPTED AIE FOR THIS CONTRACT, THE REVISED

AIE MUST BE SUBMITTED TO THE GOVERNMENT FOR REVIEW AND

APPROVAL. GOVERNMENT APPROVAL MUST BE GRANTED BEFORE

AIE IS USED FOR ACCEPTANCE OF PRODUCT. THE GOVERNMENT

WILL RESPOND WITHIN 30 DAYS AFTER RECEIPT OF AIE.

THE CONTRACTOR SHALL NOTIFY THE RESPONSIBLE GOVERNMENT

TECHNICAL AGENCY WITHIN A MINIMUM OF 30 DAYS PRIOR

TO ACCEPTANCE (PROVE OUT) TESTING.

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

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 i t 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:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A005 REQUEST FOR VARIANCE (RFV)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-SESS-80640E (SEE BLK 16) SECTION C NAWCWD (D434200)

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ ASREQ

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ Reg Repro

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 5 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 5 of 16 Pages

SESS

25 MAR 2020

(SEE 16)

16. REMARKS

BLK 4: DELETE PARAGRAPH 2B AND 2C AND INCLUDE ADEQUATE

DATA/ANALYSIS/TESTING TO SUPPORT THE REQUEST IN THE

CONTENT OF THE RFV. THE CONTRACTOR SHALL PREPARE AND

SUBMIT A RFV FOR EACH VARIANCE ON DD FORM 1694, LOCATED AT:

http://www.dtic.mil/whs/directives/forms/dd/ddforms1500-1999.htm

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO

THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY:

EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS SHALL BE

REFERRED TO PMA-201, NAS PATUXENT RIVER, MARYLAND

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

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 i t 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:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A006 ENGINEERING CHANGE PROPOSAL (ECP)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-SESS-80639E (SEE BLK 16) SECTION C NAWCWD (D434200)

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ ASREQ

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ Reg Repro

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 5 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 6 of 16 Pages

SESS

25 MAR 2020

(SEE 16)

16. REMARKS

BLK 4: DELETE PARAGRAPH 2B AND 2C. SUBMIT TEXT FILES IN

GOVERNMENT COMPATIBLE MICROSOFT WORD AND VIEW FILES IN

GOVERNMENT COMPATIBLE ADOBE ACROBAT. FOR DRAWINGS,

SUBMIT PDF VIEW FILES IN GOVERNMENT COMPATIBLE ADOBE

ACROBAT. THE CONTRACTOR SHALL PREPARE AND SUBMIT AN

ECP ON DD FORM 1692, LOCATED AT: http://www.dtic.mil/whs/directives/ forms/dd/ddforms1500-1999.htm

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED

TO THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS

ONLY: EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS SHALL

BE REFERRED TO PMA-201, NAS PATUXENT RIVER, MARYLAND

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A007 NOTICE OF REVISION (NOR)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-SESS-80642E (SEE BLK 16) SECTION C NAWCWD (D43200)

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ ASREQ

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ Reg Repro

NAWCWD (D434200) 0 1 0

16. REMARKS

BLK 4: DELETE PARAGRAPH 2B AND 2C. SUBMIT IN CONJUNCTION

WITH CDRL A006 (ECP). FOR EACH DRAWING, ASSOCIATED LIST, OR

OTHER REFERENCED DOCUMENT WHICH REQUIRES REVISION, THE

CONTRACTOR SHALL PREPARE AND SUBMIT NOR ON DD FORM

1695, LOCATED AT: http://www.dtic.mil/whs/directives/forms/dd/ ddforms1500-1999.htm

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 5 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 7 of 16 Pages

SESS

25 MAR 2020

(SEE 16)

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED

TO THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS

ONLY: EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS

SHALL BE REFERRED TO PMA-201, NAS PATUXENT RIVER,

MARYLAND

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A008 TEST/INSPECTION REPORT FIRST ARTICLE TEST REPORT (FATR)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-NDTI-80809B NOTICE 2 SECTION E AMJM-QAP

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 14. DISTRIBUTION

LT ONE/R (SEE 16)

12. DATE OF FIRST SUBMISSION

270 DACA (SEE 16)

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ (SEE 16) Reg Repro

16. REMARKS

AMJM-QAP 0 1 0

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

DCMA-MCWB (QAR) 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 7 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 8 of 16 Pages

NDTI

25 MAR 2020

(SEE 16)

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED

TO THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS

ONLY: EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS SHALL

BE REFERRED TO PMA-201, NAS PATUXENT RIVER, MARYLAND

BLK 10, 12: THE FIRST ARTICLE TEST (FAT) REPORT SHALL BE

SUBMITTED WITH QAR FINDINGS ON DD FORM 1222. FAT REPORT

SHALL BE SUBMITTED 270 DAYS AFTER CONTRACT AWARD. THE

GOVERNMENT REQUIRES 30 DAYS FOR REVIEW. DISPOSITION OF THE

FAT REPORT WILL BE PROVIDED THROUGH THE PCO. FAT MUST BE

APPROVED PRIOR TO PRODUCTION.

BLK 13: IF FURTHER REVISIONS ARE NECESSARY, THE CONTRACTOR

SHALL HAVE 15 DAYS TO GENERATE REVISIONS AND THE

GOVERNMENT SHALL HAVE 15 DAYS TO REVIEW AND RESPOND.

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A009 TEST/INSPECTION REPORT LOT ACCEPTANCE TEST REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-NDTI-80809B NOTICE 2 (SEE BLK 16) SECTION E DCMA-MCWB (QAR)

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ (SEE 16) ASREQ (SEE 16)

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ (SEE 16) Reg Repro

DCMA-MCWB (QAR) 0 1 0

WARP 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 4 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 9 of 16 Pages

NDTI

25 MAR 2020

(SEE 16)

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED

TO THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS

ONLY: EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS SHALL

BE REFERRED TO PMA-201, NAS PATUXENT RIVER, MARYLAND

BLK 4: LOT ACCEPTANCE TEST (LAT) REPORTS SHALL CONTAIN ALL

INSPECTION RECORDS OF CLASSIFIED CHARACTERISTIC SAMPLES

AND ANY OTHER TESTS REQUIRED FOR EACH LOT PER THE

CONTRACT.

BLK 10, 12, 13: SUBMISSION OF LAT REPORTS AND PRODUCTION

ACCEPTANCE TEST REPORTS SHALL BE NO LATER THAN 30 DAYS

AFTER LAT. THE QAR WILL PROVIDE DISPOSITION OF

LOT/PRODUCTION ACCEPTANCE TEST REPORTS.

BLK 14: LAT REPORTS SHALL BE SUBMITTED BY ACCESSING THE

WORLDWIDE AMMUNITION DATA CARD REPOSITORY PROGRAM

(WARP) WHICH IS LOCATED ON THE MUNITIONS HISTORY PROGRAM

(MHP) WEBSITE AT: https://mph.redstone.army.mil/. SUBMIT

ELECTRONICALLY UNLESS OTHERWISE SPECIFIED.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A010 AMMUNITION DATA CARD

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MISC-80043B NOTICE 2 SECTION C, MIL-STD-1168 AMJM-QAP

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

NO ASREQ (SEE 16) ASREQ (SEE 16)

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

N/A N/A ASREQ (SEE 16) Reg Repro

DCMA-MCWB (QAR) 0 1 0

WARP 0 1 0

LOT SHIPMENT* 0 2 0

MAIL TO DEST** 0 2 0

(SEE BLK 16)

15. TOTAL 0 6 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 10 of 16 Pages

MISC

25 MAR 2020

(SEE 16)

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO

THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY:

EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS SHALL BE

REFERRED TO PMA-201, NAS PATUXENT RIVER, MARYLAND

BLK 10, 12, 13: AMMUNITION DATA CARDS (ADC) SHALL BE PREPARED

IAW MIL-STD-1168, SECTION C, AND BY ACCESSING THE WORLDWIDE

AMMUNITION DATA REPOSITORY PROGRAM (WARP), WHICH IS

LOCATED AT https://mhp.redstone.army.mil.

BLK 14: SUBMIT VIA THE INTERNET OR MAIL A CD ROM (PC FORMAT)

IN ACCORDANCE WITH ATTACHMENT 0004.

* HARD COPY ADC PROVIDED WITH LOT SHIPMENTS SHALL BE

GENERATED FROM THE WARP PROGRAM AND SIGNED AND DATED

BY THE GOVERNMENT AGENCY RESPONSIBLE FOR ACCEPTANCE

(GARA).

**WHEN BALLISTIC TESTS ARE REQUIRED, ONE HARD COPY

GENERATED FROM THE WARP PROGRAM SIGNED AND DATED BY THE

GARA SHALL BE SENT TO THE PROVING GROUND WITH SAMPLE

SHIPMENT, PLUS AN ADDITIONAL SIGNED HARD COPY PROVIDED TO

THE PROVING GROUND BY MAIL.

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 i t 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:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A011 FAILURE ANALYSIS AND CORRECTIVE ACTION

REPORT (FACAR)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-SESS-80255B Attachment 0008 - QAP 1371AS100 AMJM-QAP

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ (SEE 16) ASREQ (SEE 16)

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ (SEE 16) Reg Repro

AMJM-QAP 0 1 0

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

DCMA-MCWB (QAR) 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 7 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 11 of 16 Pages

SESS

25 MAR 2020

(SEE 16)

16. REMARKS

BLK 5: THE FAILURE ANALYSIS AND CORRECTIVE ACTION REPORT

(FACAR) SHALL BE IN ACCORDANCE WITH THE QUALITY ASSURANCE

PROVISION (QAP).

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO

THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY:

EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS SHALL BE

REFERRED TO PMA-201, NAS PATUXENT RIVER, MARYLAND

BLK 10, 12, 13: CONTRACTOR SHALL NOTIFY NAWCWD (QA),

NAWCWD (685200D), AMSJM-QAP, AND THE PCO VIA EMAIL WITHIN 24

HOURS AFTER THE OCCURRENCE OF A FAILURE DURING

ACCEPTANCE TESTING; INCLUDING, BUT NOT LIMITED TO, ANY

FAILURES DURING FAT/LAT AND ANY DESTRUCTIVE OR

NONDESTRUCTIVE TEST FAILURES. FORMAL SUBMITTAL SHALL BE

NO LATER THAN 10 DAYS AFTER REPORTED FAILURE. FINAL REPORT

SHALL BE SUBMITTED NO LATER THAN 30 DAYS AFTER

DETERMINING/CONDUCTING ROOT CAUSE FAILURE ANALYSIS.

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP ___________ TM ___________ OTHER _____MGMT___________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A012 OPERATIONS SECURITY (OPSEC) PLAN

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MGMT-80934C NOTICE 1 SECTION H AMJM-QAP

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ONE/R ASREQ (SEE 16)

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

A N/A ASREQ (SEE 16) Reg Repro

AMJM-OPP 0 1 0

0 1 0 AMJM-QAP

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

DCMA-MCWB (QAR) 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 7 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 12 of 16 Pages

25 MAR 2020

(SEE 16)

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED

TO THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS

ONLY: EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS

SHALL BE REFERRED TO PMA-201, NAS PATUXENT RIVER,

MARYLAND

BLK 10: GOVERNMENT REQUIRES 10 CALENDAR DAYS REQUIRED

FOR REVIEW AND APPROVAL. IF REVISIONS ARE REQUIRED,

RESUBMIT 10 CALENDAR DAYS AFTER RECEIPT OF

GOVERNMENT COMMENTS.

BLK 12: CONTRACTOR SHALL SUBMIT OPSEC PLAN 30 CALENDAR

DAYS AFTER THE CONTRACTING OFFICER PROVIDES

THE LIST OF KNOWN CRITICAL INFORMATION (CI)/THREAT

INFORMATION.

BLK 13: ANNUAL SELF-ASSESSMENT AND CHECKLIST ARE DUE ON

THE ANNIVERSARY OF THE CONTRACT AWARD DATE.

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

EMAIL OR DOD-SAFE (https://safe.apps.mil/) IN ADDITION TO usarmy.ria.jmc.mbx.opsec-fd@mail.mil.

https://safe.apps.mil/

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TDP ___________ TM ___________ OTHER ________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

CARTRIDGE, SIGNAL, PRACTICE

BOMB, CXU-3A/B

U12A02EBHI / R12A02ECHI

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A013 PRODUCTION PROGRESS REPORTS

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MGMT-81255- NOTICE 1 SECTION I CCRI-AR

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

NO MTHLY SEE 16

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Draft

Final

N/A N/A SEE 16 Reg Repro

AMJM-QAP 0 1 0

NAWCWD (D434200) 0 1 0

NAWCWD (QA) 0 1 0

AFLCMC/EBHCB 0 1 0

DCMA-MCWB (QAR) 0 1 0

CCRI-AR 0 1 0

SFAE-AA-JB 0 1 0

(SEE BLK 16)

15. TOTAL 0 7 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 13 of 16 Pages

MGMT

25 MAR 2020PAWS, TPO

(SEE 16)

16. REMARKS

BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED

TO THE DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS

ONLY: EXPORT CONTROLLED: 03 DEC 2020. OTHER REQUESTS

SHALL BE REFERRED TO PMA-201, NAS PATUXENT RIVER,

MARYLAND

BLK 12, 13: FIRST SUBMITTAL IS DUE 2 WORKING DAYS AFTER END

OF THE MONTH IN WHICH PRODUCTION BEGINS. SUBSEQUENT

SUBMISSIONS ARE DUE MONTHLY, 2 WORKING DAYS AFTER

REPORTING PERIOD WITH THE LAST SUBMITTAL DUE 2 WORKING

DAYS AFTER THE END OF THE MONTH PRODUCTION HAS

COMPLETED.

BLK 14: SUBMIT IN ACCORDANCE WITH ATTACHMENT 0004 VIA

G. PREPARED BY

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page _14_ of _16_ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

D. SYSTEM/ITEM F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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.

Designed using Perform Pro, WHS/DIOR, Aug 96

MGMT

CTG, Signal, Practice Bomb, CXU-3A/B

E. CONTRACT/PR NO.

U12A02EBHI / R12A02ECHI

A014

DI-MGMT-81978 (Current Revision)

Acceptance Description Sheets Loading Authorizations and Description Sheets

Section: E AMJM-QA

ASREQ ASREQ

A N/A ASREQ

WARP

03/29/2021

0 1 0

BLK 12: Loading authorizations, Propellant description sheets and/or description sheets for chemicals and explosives shall be submitted for each lot or batch processed and shall be loaded into WARP at the time of acceptance.

BLK 14: Electronic submissions are made by accessing the Worldwide Ammunition Data Card Repository Program (WARP) housing the Description Sheets and Loading Authorizations modules which are located on the Munitions History Program (MHP) website at https://mhpwarp.redstone.army.mil/

This requirement is in addition to the distribution requirements called out in the specification and contract.

Advisory note: The first energetic description sheet submitted in the WARP system will undergo a Government review.

0 1 0

G. PREPARED BY

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page _15_of _16__Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

D. SYSTEM/ITEM F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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.

Designed using Perform Pro, WHS/DIOR, Aug 96

MISC

CTG, Signal, Practice Bomb, CXU-3A/B

E. CONTRACT/PR NO.

U12A02EBHI / R12A02ECHI

A015 Management Plan 2-D Bar Code Label Verification

DI-MGMT-80004 (Current Revision) Section: C & D AMJM-QA

N/A

ONE/R ASREQ

A N/A N/A

Mail to Dest

03/29/2021

0 2 0

2-D Bar Codes shall be prepared IAW MIL-STD-129 and MIL-PRF-61002.

BLKS 12 & 14: Prior to formal submission of product to the Government for acceptance, a first time sample of the supplier's 2-D Bar Coding Label, comprising of two (2) each of the exterior pack label and two (2) each of the pallet label, shall be submitted and approved. A material certification (CoC) shall also be submitted that identifies the label being used conforms to the specifications of MIL-PRF-61002. Only sections 3.2.k and 3.2.j of the DID DI-MGMT-80004 are applicable for these deliverables.

2-D Bar Code samples and label CoC shall be sent to:

HQ, US ARMY JMC, 2695 Rodman Avenue, Rock Island, IL 61299 ATTN: AMJM-QAP/O, "Enter PQM name"

Within fifteen calendar days, the supplier will be notified electronically of the approval, conditional approval, or disapproval of the submitted 2-D Bar Code Label.

0 2 0

A016

0 1 0

Page: 16 of 1

N/A N/A

ASREQ

N/A

MTHLY

DI-MGMT-80438B

GOVERNMENT FURNISHED MATERIAL (GFM) CONSUMPTION REPORT CONSUMPTION REPORT

TDP____________ TM____________ OTHER____________

/ R12A02ECHI

Form Approved OMB No. 0704-0188

0 0

CDRLs revised - R12A02ECHI

QA_CDRLS

GFM CDRL- Air Force

File details come from the government source that posted it. Updated Sep 30, 2021.