Exhibit A - Contract Data Requirements List - DD1423.pdf

For the best experience, open this PDF portfolio in

Acrobat X or Adobe Reader X, or later.

Get Adobe Reader Now!

http://www.adobe.com/go/reader

DD FORM 1423-1, FEB 2001 PREVIOUS EDITIONS MAY BE USED Page____of____

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP _______ TM _______ OTHER ____________________________

D. SYSTEM/ITEM E. CONTRACT/PR NO. 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 9. DIST STATEMENT REQ’D 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13.13. DATE OF SUBSEQUENT SUBMISSION

Draft Final

Reg Repro

16. REMARKS

15. TOTAL

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

1 DATA ITEM NO: A017

2 TITLE OF DATA ITEM: Contractor Progress, Status & Management Report

3 SUBTITLE: Reporting: Contractor's Progress, Status & Management Report

5 CONTRACT REFERENCE: SOW Paragraph 19.3

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/20022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 12 Contractor Progress, Status & Management Report shall be submitted after completion of each order

2022-02-08T20:11:42-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T07:12:19-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: N/A

4 AUTHORITY Data Acquisition Document No: DI-MGMT-81928

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.

1 DATA ITEM NO: A001

2 TITLE OF DATA ITEM: Critical Defect Control

3 SUBTITLE:

5 CONTRACT REFERENCE: SOW Paragraph 3.4.5

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/072022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 12: as per task order

The contractor shall establish and maintain critical defect controls for all critical safety characteristics in accordance with Paragraphs 3.4.3 and 3.4.4.

2022-02-08T19:50:12-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T06:48:41-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: A

4 AUTHORITY Data Acquisition Document No: DI-SAFT-80970A

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.

1 DATA ITEM NO: A002

2 TITLE OF DATA ITEM: Ammunition Data Card

3 SUBTITLE: Ammunition Lot Number and Data Card

5 CONTRACT REFERENCE: SOW Paragraph 3.4.6

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: Block 16

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 4: Ammunition Data Card (ADC) must be prepared electronic submission must be accomplished by accessing the Worldwide Ammunition Data Card Repository (WARP) which is located on the Munitions History Program web site at https://mhp.redstone.army.mil/ ADC must include procurement acquisition numbers for each applicable RFV, NOR, and ECP in the "REMARKS SECTION" with a brief description for each listed on the card. Every avenue shall be pursued to ensure an accurate ADC is produced with all appropriate documentation included.

Block 10: Submission must commence with the first deliverable lot and continue with each subsequent lot.

Block 12: Submit Draft ADC thirty (30) calender days prior to FAT or first production lot if FAT is not applicable, for approval.

Block 13: Hard copies of each ADC shall be generated from WARP and accompany each lot and shall be signed and dated by the representative of the Government agency responsible for acceptance (GARA) usually the DCMA QAS. Local DCMA shall send two (2) hard copies with shipments.

2022-02-08T19:51:38-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T06:49:57-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: A

4 AUTHORITY Data Acquisition Document No: DI-MISC-80043B

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.

1 DATA ITEM NO: A018

2 TITLE OF DATA ITEM: Test/Inspection Report

3 SUBTITLE: Reporting: Inspection and Test Reports

5 CONTRACT REFERENCE: SOW Paragraph 19.4

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: XX

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 15

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks:

Block 12: submit to Contracting Officer NLT 15 days after testing event

2022-02-08T20:13:22-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T07:13:38-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: A

4 AUTHORITY Data Acquisition Document No: DI-NDTI-80809B

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.

1 DATA ITEM NO: A003

2 TITLE OF DATA ITEM: MEASUREMENT SYSTEM EVALUATION (MSE)

3 SUBTITLE:

5 CONTRACT REFERENCE: SOW Paragraph 3.4.7

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: XX

9 DIST STATEMENT REQD:

D

10 FREQUENCY: Block 16

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 12: The Contractor shall submit a completed MSE package no later than 120 calendar days prior to First Article Testing (if FAT is required), production, and/or all acceptance of product under the contract. The Government will furnish disposition within calendar days of final AIE package receipt.

Block 13: If further revisions are necessary, the Contractor shall have 30 calendar days to generate them and the Government shall have 30 calendar days to review and respond to them. The approved AIE shall be available for First Article Testing (if First Article Testing 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. Approval must be granted before AIE is used for acceptance of product. The Government will respond within 30 calendar days. The Contractor shall notify the responsible Government technical agency a minimum of 30 calendar days prior to acceptance (prove out) testing.

An MSE Review Guide is available to assist Contractors on the ARDEC Public Website in the application of the MSE Clause. The MSE Review Guide's content, in its entirety, is provided solely for REFERENCE and GUIDANCE PURPOSES ONLY- it is not, nor is it intended to be, contractually binding. Accordingly, the information contained within the MSE Review Guide is expressly not, nor shall it be construed to be, incorporated either directly or by reference into the terms of the MSE clause itself nor into the terms and conditions of any underlying contract which contains the MSE clause.

2022-02-08T19:52:58-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T06:51:09-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: A

4 AUTHORITY Data Acquisition Document No: DI-QCIC-81960

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.

1 DATA ITEM NO: A019

2 TITLE OF DATA ITEM: Test Plans

3 SUBTITLE: Reporting: Test Plans

5 CONTRACT REFERENCE: SOW Paragraph 19.4.1

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: XX

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks:

Block 12: Test plans shall be submitted NLT 30 days prior to each test

2022-02-08T20:15:16-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T07:15:58-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: A

4 AUTHORITY Data Acquisition Document No: DI-NDTI-80566A

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.

1 DATA ITEM NO: 004

2 TITLE OF DATA ITEM: Accident/Incident Report

3 SUBTITLE: Safety Requirements

5 CONTRACT REFERENCE: SOW Paragraph 3.5.1

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: As Required

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks:

The Contractor shall report immediately any major accident/incident (including fire) to the Contracting Officer.

2022-02-08T19:55:06-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T06:52:24-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: N/A

4 AUTHORITY Data Acquisition Document No: DI-SAFT-81563

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.

1 DATA ITEM NO: A020

2 TITLE OF DATA ITEM: Reports & Meetings

3 SUBTITLE: Reporting: Reports and Meetings

5 CONTRACT REFERENCE: SOW Paragraph 19.5

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: As Required

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks:

Block 12: Presentation material shall be submitted. Further guidance will be given each order.

2022-02-08T20:16:29-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T07:16:49-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: N/A

4 AUTHORITY Data Acquisition Document No: DI-ADMN-81373

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.

1 DATA ITEM NO: A005

2 TITLE OF DATA ITEM: Safety Assessment Report (SAR)

3 SUBTITLE:

5 CONTRACT REFERENCE: SOW Paragraph 3.5.2

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: XX

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: See BLK 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNC-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE:

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 12: SAR shall be submitted NLT 90 days before any testing event.

The SAR shall contain results from the contractor's safety assessments, hazard analyses, and testing. A SAR shall be submitted for each unique configuration

2022-02-07T06:53:20-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: A

4 AUTHORITY Data Acquisition Document No: DI-SAFT-80102C

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.

1 DATA ITEM NO: A021

2 TITLE OF DATA ITEM: Product Engineering Design Data

3 SUBTITLE: Reports: Technical Data Packages

5 CONTRACT REFERENCE: SOW Paragraph 19.6

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks:

Block 12: submit to Contracting Officer 120 days prior to FAT.

2022-02-08T20:17:45-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T07:18:02-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: A

4 AUTHORITY Data Acquisition Document No: DI-SESS-81000F

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.

1 DATA ITEM NO: A006

2 TITLE OF DATA ITEM: Explosive Hazard Classification Report

3 SUBTITLE: Interim Hazard Classification

5 CONTRACT REFERENCE: SOW Paragraph 4.1.1

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ:

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: Block 16 a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 12: prior to initial shipment of energetic materials

Block 13: resubmit for any changes

The contractor is responsible for obtaining Hazard Classification from the Department of Transportation prior to any shipment of energetic materials.

Hazard classification documents shall be forwarded to the - Combat Capabilities Development Command (DEVCOM), ATTN: RDAR-QES-C, Picatinny Arsenal, NJ 07806-5000.

If the contractor elects to use -DEVCOM for this support, the contractor will need to provide technical data to DEVCOM CCDC-AC 60 days prior to shipment of the energetic materials/items. The necessary data is explained in Army Technical Bulletin (TB) 700-2 (DI-SAFT-81299C).

2022-02-08T19:56:47-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T06:54:33-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-SAFT-81299C

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.

1 DATA ITEM NO: A007

2 TITLE OF DATA ITEM: Technical Report - Study/Services

3 SUBTITLE: U.S. Supplier: TDP Energetic Material

5 CONTRACT REFERENCE: SOW Paragraph 5.2.1

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE:

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: For energetic materials or energetic items made in the US, the contractor is responsible for obtaining hazard classification from the Department of Transportation prior to any shipment of energetic materials.

Hazard classification documents shall be submitted to the PCO.

2022-02-07T06:55:38-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: N/A

4 AUTHORITY Data Acquisition Document No: DI-MISC-80508B

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.

1 DATA ITEM NO: A008

2 TITLE OF DATA ITEM: Technical Report - Study/Services

3 SUBTITLE: Foreign Supplier: TDP Energetic Material

5 CONTRACT REFERENCE: SOW Paragraph 5.2.2

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: For energetic materials or energetic items from a foreign country, the foreign company shall provide specific hazard classification.

If available, the test data from running UN Test Series should be obtained. The information and test data shall be submitted to the PCO.

2022-02-08T19:58:02-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T06:56:40-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: N/A

4 AUTHORITY Data Acquisition Document No: DI-MISC-80508B

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.

1 DATA ITEM NO: A009

2 TITLE OF DATA ITEM: System Safety Hazard Analysis Report

3 SUBTITLE: SSHAR

5 CONTRACT REFERENCE: SOW Paragraph 6.1

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/22

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 12: submit no later than 60 days after task order award

Each task order shall identify whether this requirement applies.

2022-02-08T19:59:23-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T06:59:59-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: N/A

4 AUTHORITY Data Acquisition Document No: DI-SAFT-80101C

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.

1 DATA ITEM NO: A010

2 TITLE OF DATA ITEM: Hazardous Materials Management Program (HMMP) Plan

3 SUBTITLE: Hazardous Material Management Program

5 CONTRACT REFERENCE: SOW Paragraph 6.3.2

6 REQUIRING OFFICE: CCNJ-MC

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

D

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: CCNJ-MC

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2:

DraftRow2:

RegRow2:

ReproRow2:

a ADDRESSEERow3:

DraftRow3:

RegRow3:

ReproRow3:

a ADDRESSEERow4:

DraftRow4:

RegRow4:

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

DraftRow7:

RegRow7:

ReproRow7:

a ADDRESSEERow8:

DraftRow8:

RegRow8:

ReproRow8:

a ADDRESSEERow9:

DraftRow9:

RegRow9:

ReproRow9:

a ADDRESSEERow10:

DraftRow10:

RegRow10:

ReproRow10:

a ADDRESSEERow11:

DraftRow11:

RegRow11:

ReproRow11:

a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

ReproRow22:

a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 1

Repro15 TOTAL:

H DATE: 2/07/2022

J DATE: 2/8/22

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: Small Caliber Munition Systems NRE

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 12: submit HMMP Plan no later than 90 days after task order award

Each order shall identify whether these requirements apply. The full HMMP Plan shall be generated and will be reviewed and approved by the Contracting 0fficer.

2022-02-08T20:01:34-0500

MICHAELS-KURTZ.ROSE.M.1094965477

2022-02-07T07:01:12-0500

FAWNS.MICHAEL.WILLIAM.1030196410

8 APP CODE: A

4 AUTHORITY Data Acquisition Document No: DI-MGMT-81398C

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.

1 DATA ITEM…