Exhibit A - Contract Data Requirements List.pdf

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Attached to
Fish Barrier Controls Replacement, Romeoville, IL (USACE-CHICAGO DISTRICT)
Solicitation number
W912P6-20-R-0009
Issued by

About this file

This document provides a solicitation notice for a federal contract opportunity with the U.S. Army Corps of Engineers Engineering District Chicago. The contractor shall furnish and install a complete pulse generating control system for Barrier IIA and the optional Barrier IIB at the Chicago Sanitary and Ship Canal aquatic nuisance species dispersal barrier facility in Romeoville, Illinois. The control systems will include IGBT assembly control, high voltage power supply control, high voltage polarity/position switch control, power monitoring system control, cooling control system, backup generator monitoring and control, database control, and any supportive systems. The contractor must also install a remote control system to integrate the existing backup generators at Barriers IIA and IIB with the control system at the Permanent Barrier I Facility. Competition is unrestricted with a 10% price evaluation preference for HUBZone small businesses. The North American Industry Classification code is 334513. The solicitation is available as downloadable PDF files from the provided Internet site. Proposals are due by the date specified in the solicitation document.

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DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 32 Pages Adobe Professional 8.0

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

Technical Data Package 1

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.15.1

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Technical Data Package 1 as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document. Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

15. TOTAL 1 1 0

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

A

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 2 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

Technical Data Package 2

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.15.2 and 3.3.22

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Technical Data Package 2 as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document. Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 60 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

15. TOTAL 1 1 0

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 3 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT C. CATEGORY:

TDP TM OTHER DRPR

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

INSTALLATION CONTROL DRAWINGS

3. SUBTITLE

Installation plans for the PGS

4. AUTHORITY (Data Acquisition Document No.)

DI-DRPR-81242

5. CONTRACT REFERENCE

PWS at 3.3.15.3(a) and (i)

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Installation plans for the PGS as specified in the contract and in accordance with DID DI-DRPR-81242. Tailoring instructions for DI-DRPR-81242 are as follows:

- Paragraph 7.1: Delete "resulting from the work task described by 3.3 of MIL-D-023140";

- Paragraph 10.2: Delete in its entirety.

- Paragraph 10.3: Delete "Specific content requirements shall be as specified in 3.3.6 through 3.3.15 of MIL-D-23140."

Format requirements specified in the Contract supersede any conflicting format requirements in DID DI-DRPR-81242.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 60 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (24 July 2017). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit data on DVDs or an external hard drive via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. Compatibility requirements for external hard drives and the name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: The drawings shall be delivered in a format that complies with the requirements of the contract.

COR 1 1

15. TOTAL 1 1 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 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT C. CATEGORY:

TDP TM OTHER DRPR

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

INSTALLATION CONTROL DRAWINGS

3. SUBTITLE

Control System Drawings

4. AUTHORITY (Data Acquisition Document No.)

DI-DRPR-81242

5. CONTRACT REFERENCE

PWS at 3.3.15.3(b)

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Control System Drawings as specified in the contract and in accordance with DID DI-DRPR-81242. Tailoring instructions for DI-DRPR-81242 are as follows:

- Paragraph 7.1: Delete "resulting from the work task described by 3.3 of MIL-D-023140";

- Paragraph 10.2: Delete in its entirety.

- Paragraph 10.3: Delete "Specific content requirements shall be as specified in 3.3.6 through 3.3.15 of MIL-D-23140."

Format requirements specified in the Contract supersede any conflicting format requirements in DID DI-DRPR-81242.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (24 July 2017). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit data on DVDs or an external hard drive via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. Compatibility requirements for external hard drives and the name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

COR 1 1

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

A. CONTRACT LINE ITEM NO.

0001AA

B. EXHIBIT C. CATEGORY: DRPR

TDP TM OTHER

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

16. REMARKS (Continued)

Submissions Format and Instructions:

The Contractor shall prepare the Control System Drawings in the format depicted in Example B at Sheet E-601(One-Line Network & Peripheral Diagram). The drawings shall be delivered in a format compatible with Microstation CADD, or allowing for conversion to a Microstation CADD .dgn format, and shall also be provided in a .pdf format. The Contractor shall deliver two electronic copies on DVDs or external hard drives and one hard copy in 11"x17" size. Also, all drawings shall use the standard USACE border, a current copy of which may be obtained from the Contracting Officer.

DD FORM 1423-1, FEB 2001 Page 5 of 32 Pages Reset

A004

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 6 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

PGS Equipment Specifications

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.15.3 (c)

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the PGS Equipment Specifications as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document. Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 60 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 7 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

PGS Control Software

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.15.3 (d)

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the PGS Control Software as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document. Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 8 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

Major System Control Components

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.15.3 (e)

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Major System Control Components as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document.

Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 9 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

Minor System Control Components

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.15.3 (f)

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Minor System Control Components as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document.

Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 10 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER DRPR

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A009

2. TITLE OF DATA ITEM

INSTALLATION CONTROL DRAWINGS

3. SUBTITLE

HMI and Local Process Panel Control and Display Screen Layouts

4. AUTHORITY (Data Acquisition Document No.)

DI-DRPR-81242

5. CONTRACT REFERENCE

PWS at 3.3.15.3(g)

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the HMI and Local Process Panel Control and Display Screen Layouts as specified in the contract and in accordance with DID DI-DRPR-81242. Tailoring instructions for DI-DRPR-81242 are as follows:

- Paragraph 7.1: Delete "resulting from the work task described by 3.3 of MIL-D-023140";

- Paragraph 10.2: Delete in its entirety.

- Paragraph 10.3: Delete "Specific content requirements shall be as specified in 3.3.6 through 3.3.15 of MIL-D-23140."

Format requirements specified in the Contract supersede any conflicting format requirements in DID DI-DRPR-81242.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (24 July 2017). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit data on DVDs or an external hard drive via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. Compatibility requirements for external hard drives and the name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

COR 1 1

A. CONTRACT LINE ITEM NO.

0001AA

B. EXHIBIT C. CATEGORY: DRPR

TDP TM OTHER

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

16. REMARKS (Continued)

Submissions Format and Instructions:

The drawings shall be delivered in a format compatible with Microstation CADD, or allowing for conversion to a Microstation CADD .dgn format, and shall also be provided in a .pdf format. The Contractor shall deliver two electronic copies on DVDs and one hard copy in 11"x17" size. Also, all drawings shall use the standard USACE border, a current copy of which may be obtained from the Contracting Officer.

DD FORM 1423-1, FEB 2001 Page 11 of 32 Pages Reset

A009

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 12 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AA

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A010

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

CSCI Structure Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.12.1 and 3.3.15.3(h)

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the CSCI Structure Report as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document. Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 13 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AB

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A011

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

Electrical Analysis Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.19

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Electrical Analysis Report as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document. Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 14 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AB

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A012

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

Contractor’s Field Test Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.24.2

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Contractor’s Field Test Report as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document. Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 15 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AB

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A013

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

Performance Verification Test (PVT) and Endurance Testing Procedures

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.25.2

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Performance Verification Test (PVT) and Endurance Testing Procedures as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document. Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 40 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and Instructions: All submissions shall be submitted in electronic format (PDF, Word, Excel).

COR 1 1

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 16 of 32 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

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.

0001AB

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER MISC

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

W912P6-20-C-xxxx

F. CONTRACTOR

ENTER CONTRACTOR

1. DATA ITEM NO.

A014

2. TITLE OF DATA ITEM

Technical Report–Study/Services

3. SUBTITLE

Performance Verification Test (PVT) and Endurance Test Results

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS at 3.3.27.2

6. REQUIRING OFFICE

USACE-LRC COR

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

NA

13. DATE OF SUBSEQUENT

SUBMISSION

See BLK 16 Draft

Final

Reg Repro

16. REMARKS

The Contractor shall prepare and deliver the Performance Verification Test (PVT) and Endurance Test Results as specified in the contract and in accordance with DID DI-MISC-80508B. Tailoring instructions for DID DI-MISC-80508B are as follows: Delete Paragraph 3(c) and 3(d), and follow the Performance Work Statement requirements for the content of the document. Format requirements specified in the Performance Work Statement supersede any conflicting format requirements in DID DI-MISC-80508B.

BLK 8: Government approval/disapproval will be within 30 working days after receipt, unless otherwise specified by the Contract. If disapproved, the contractor shall resubmit within 30 calendar days, unless otherwise specified by the Contract.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use) (28 Sept 2016). Other requests for this document shall be referred to:

Contracting Officer U.S. Army Corps of Engineers, Chicago District 231 S. LaSalle St., Suite 1500 Chicago, IL 60604

BLK 12, Date of First Submission: As Required in the Contract.

BLK 10 and 13: Subsequent submittals shall be provided as required by the Contract.

BLK 14: Unless other format requirements are specified in the Contract, the Contractor shall submit the data on DVDs via Federal Express, to the following office: Contracting Officer Representative, Chicago District, U.S. Army Corps of Engineers, 231 S. LaSalle St., Suite 1500, Chicago, IL 60604. The name of the assigned Contracting Officer Representative will be provided by the Contracting Officer.

Submissions Format and…

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