Exhibit A - Contract Data Requirements List.pdf
PDF 250 KB Posted
- Attached to
- Grade D Air Testing Federal contract opportunity
- Solicitation number
- N6852025R0049
About this file
The document is a Contract Data Requirements List (DD Form 1423-1) for Air Sampling and Testing Services for Supplied Air Breathing Units at FRCSW, North Island, dated 3 July 2025. The form specifies three primary data items to be submitted:
- Test/Inspection Report (A001): A one-time submission within seven days of fieldwork completion, to be delivered as a hard copy and electronic version to the Technical Point of Contact (TPOC). 2. Failure Analysis and Corrective Action Report (A002): Another one-time submission within seven days of completing fieldwork, requiring a hard copy and electronic version to the TPOC. 3. Contract Field Service Report (A003): To be submitted within seven days following field-testing completion, delivered electronically to the Contracting Officer's Representative (COR) and TPOC. All technical documentation must be in English, grammatically correct, and include manufacturer details such as name, model number, serial number, and contact information. The contract number and contractor are currently marked as "TBD" (To Be Determined).
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| N6852025R0049-Draft.pdf |
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DD FORM 1423-1, JUN 90 (EG) Previous editions are obsolete Page 1 of 3 Pages
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
Form Approved
OMB No. 0704-0188
Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget. Paperwork Reduction Project
(0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract PR No. listed in Block E.
A. CONTRACT LINE ITEM NO. B. EXHIBIT
A
C. CATEGORY:
TDP
TM
OTHER
X
D. SYSTEM|ITEM
Air Sampling and Testing Services
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A001
2. TITLE OF DATA ITEM
Test/Inspection Report
3. SUBTITLE
(No Subtitle Was Used)
4. AUTHORITY (Data Acquisition Document No.)
DI-NDTI-80809B
5. CONTRACT REFERENCE
SOW paragraphs 5.1, 6
6. REQUIRING OFFICE
FRCSW
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
DD A 1TIME
See block 16
See block 16 b. COPIES
8. APP CODE See block 16 11. ASN/A OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE DRAFT FINAL
N/A N/A N/A Reg Repr o
16. REMARKS
Block 9: Distribution Statement: Approved for public release; distribution is unlimited.
Block 10: Frequency: One-time submission (1TIME).
Block 12: Date of First Submission: Within seven (7) days of fieldwork completion.
Block 14: Distribution: A hard copy shall be submitted to the Technical Point of Contact
(TPOC) for review and signature. An electronic version shall also be provided via email to the TPOC in either PDF or Microsoft Word (editable) format. If email delivery is unavailable, the Contractor shall ensure a hard copy is sent to the TPOC via overnight mail.
All technical data shall be written in English, be grammatically correct, and clearly identify, where applicable, the manufacturer’s name, model number, serial number, and contact information.
TPOC (hard copy) 1
TPOC (elec. copy) 1
(See block 16)
15. Total
G. PREPARED BY
Helen Rains
H. DATE
0 6 / 3 0 / 2 0 2 5
I. APPROVED BY J. DATE
18. ESTIMATED
TOTAL PRICE
17. PRICE
GROUP
William Fields 7/2/2025
DD FORM 1423-1, JUN 90 (EG) Previous editions are obsolete Page 2 of 3 Pages
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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget. Paperwork Reduction Project
(0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract|PR No. listed in Block E.
A. CONTRACT LINE ITEM NO. B. EXHIBIT
A
OTHER X
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM
Failure Analysis and Corrective Action Report
3. SUBTITLE
DI-SESS-81927
SOW paragraphs 5.1, 5.2
6. REQUIRING OFFICE
FRCSW
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
DD A 1TIME
See Block 16
See block 16 b. COPIES
8. APP CODE See block 16 11. ASN/A OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE DRAFT FINAL
N/A N/A N/A Reg Repr o
Block 10: Frequency: One-time submission (1TIME).
Block 12: Date of First Submission: Submission required within seven (7) days of completing fieldwork.
Block 14: Distribution: A hard copy of the report shall be submitted to the Technical Point of
Contact (TPOC) for review and signature. An electronic version shall also be submitted via email to the TPOC in either PDF format or Microsoft Word (editable). In cases where email is unavailable, the Contractor shall provide the hard copy via overnight mail.
All technical documentation shall be written in English, be free of grammatical errors, and include the following identifiers where applicable: manufacturer name, model number, serial number, and contact information.
TPOC (hard copy) 1
Helen Rains
H. DATE
17. PRICE
D FORM 1423-1, JUN 90 (EG) Previous editions are obsolete Page 3 of 3 Pages
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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget. Paperwork Reduction Project
(0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract|PR No. listed in Block E.
A. CONTRACT LINE ITEM NO. B. EXHIBIT
A
OTHER X
E. CONTRACT/PR NO.
TBD
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A003
2. TITLE OF DATA ITEM
Contract Field Service Report
3. SUBTITLE
DI-MGMT-81238
SOW paragraphs 5.2, 6
6. REQUIRING OFFICE
FRCSW
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
DD A 1TIME
See Block 16
See block 16 b. COPIES
8. APP CODE See block 16 11. ASN/A OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE DRAFT FINAL
N/A N/A N/A Reg Repr o
Block 12: Date of First Submission: Submission required within seven (7) days following completion of field-testing.
Block 14: Distribution: Deliveries shall be provided in PDF and a MS Word editable file format and delivered by electronic email to the Contracting Officers Representative (COR) and Technical Point of Contact (TPOC). If electronic mail is not available, the contractor shall ensure the delivery of a hard copy to the TPOC via overnight mail.
All technical documentation shall be written in English, be grammatically correct, and include, where applicable, the following information: manufacturer name, model number, serial number, and contact details.
TPOC (hard copy) 1
Helen Rains
H. DATE
17. PRICE
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| Exhibit A - Contract Data Requirements List.pdf |
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