Exhibit_A.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters 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 C. CATEGORY:

TBD A TDP________ TM _______ OTHER QCIC

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

Portable Vibration Calibrator N64267-20-D-XXXX TBA

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A001 CALIBRATION CERTIFICATE Calibration Report

II

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-QCIC-80798B

(See Block 16)

SOW Paragraph: 5.1.2 (See Block 16)

NAVAIRLKE 41L400B TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

LT (See Block 16) (See Block 16) (See Block 16) A b. COPIES

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

SUBMISSION

a. ADDRESSEE Final

A N/A N/A Draft Reg. Repro

16. REMARKS Patrick Brannick 1 1 0

Block 4/5: DI-QCIC-80798B and SOW paragraph 5.1.2 shall be used as guidance and are provided for reference. This is a sample of format only, no actual data for workload calibrations. Information items in DI-QCIC-80798B that are not relevant to the procured unit do not need to be included in format.

Block 8: Calibration Report (CDRL A001 subtitle) requires government approval.

The contractor shall provide a preliminary draft of the Calibration Report of data to the Government for review, comment, and approval of the format no later than (NLT) 60 calendar days prior to initial operating capability (IOC) for each system.

Government will provide the contractor with approval/disapproval of format including comments within 15 days of receipt of preliminary draft. Contractor shall provide a government approved final version with incorporated comments NLT 30 days prior to IOC for each system.

Block 10: Frequency of Calibration Report shall be generated for each system installed.

Block 12: Date of first submission shall be no later than (NLT) 60 calendar days prior to initial operating capability (IOC) of the first system procured.

Block 13: Date of subsequent submissions: N/A

Block 14: Submission in contractor format is acceptable. Electronic format is preferred if in a widely available commercial document format such as MS-Excel or MS Word. Electronic submission of data is also accepted on CD-ROM. Quantity and copies shall be provided in accordance with (IAW) CDRL distribution (Block 14). Addressee's POC information provided on CDRL supplemental page 2.

Block 16: This CDRL refers only to the format of the Calibration Report printed by the calibration standards, it is not intended that the contractor run actual US Navy workload for calibration.

NAVAIRLKE 41L4

Heather M. Loprano 1 1 0

NAVAIRLKE 41L4

Corry Barnhouse 6.7.6.3S 1 1 0

NAWCAD 6.7.6.3S

Clifton Hanson, NSWC Corona

1 1 0

With each system installed 0 1 0

15. TOTAL 4 5 0

G. PREPARED BY

H. DATE I. APPROVED BY J. DATE

H. Loprano, NAVAIRLKE 4.1.12.4 04/02/2020 K. Bergland, NSWCCOR, MS35 06/17/2020 DD Form 1423-1 JUN 90 Previous editions are obsolete. Page 1 of 2 Pages

DD FORM 1423 (CDRL) Supplemental

BLOCK 14 ENTRY COMPLETE ADDRESS

Patrick Brannick, patrick.brannick@navy.mil

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Heather M. Loprano, heather.loprano@navy.mil NAVAIR Metrology and Calibration

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Corry Barnhouse, corry.barnhouse@navy.mil

NAVAIR METCAL 6.7.6.3S

Bldg 1403 22113 Fortin Circle, Unit 7 Patuxent River, MD 20670

Clifton Hanson, clifton.hanson.ctr@navy.mil NSWC Corona Building 521 Floor 1 Corona, CA 92878

DATA ITEM DESCRIPTION

Title: CALIBRATION CERTIFICATE

Number: DI-QCIC-80798B Approval Date: 20050328 AMSC Number: F7554 Limitation:

DTIC Applicable: GIDEP Applicable:

Preparing Activity: AFMETCAL DET 1/MLE Applicable Forms: None Use, Relationships:

This Data Item Description (DID) contains the format and content requirements for calibration reports or certificates accompanying calibrations performed on DoD test, measurement, and diagnostic equipment.

This DID is applicable to contracts requiring calibration of test equipment prior to delivery. This DID is consistent with ISO 17025 requirements for calibration reports or certificate.

This DID supersedes DI-QCIC-80798A.

Requirements:

1. Format. Contractor format is acceptable.

2. Content. The calibration certificate or report shall include:

a. title (e.g., calibration report or calibration certificate);

b. the name and address of the laboratory, and the location where the calibrations were carried out, if different from the address of the laboratory;

c. unique identification of the test report or calibration certificate (such as the serial number), and on each page an identification in order to ensure that the page is recognized as a part of the test report or calibration certificate, and a clear identification of the end of the test report or calibration certificate;

d. the name and address of the client or customer;

e. identification of the method used;

f. a description of, the condition of, and unambiguous identification of the item(s) tested or calibrated;

g. the date of receipt of the test or calibration item(s) where this is critical to the validity and application of the results, and the date(s) of performance of the test or calibration;

Downloaded from http://www.everyspec.com

DI-QCIC-80798B

h. reference to the sampling plan and procedures used by the laboratory or other bodies where these are relevant to the validity or application of the results;

i. the test or calibration results with, where appropriate, the units of measurement;

j. the name(s), function(s) and signature(s) or equivalent identification of person(s) authorizing the test report or calibration certificate;

k. where relevant, a statement to the effect that the results relate only to the items tested or calibrated;

l. the conditions (e.g. environmental) under which the calibrations were made that have an influence on the measurement results;

m. the uncertainty of measurement or a statement of compliance with an identified metrological specification or clauses thereof;

n. evidence that the measurements are traceable.

End of DI-QCIC-80798B

Downloaded from http://www.everyspec.com

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters 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 C. CATEGORY:

TBD E TDP________ TM __ ____ OTHER QCIC

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

Portable Vibration Calibrator N64267-20-D-XXXX TBA

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A002 Inspection and Test Plan Instrument Calibration Procedure

II

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-QCIC-81110

(See Block 16)

SOW Paragraph 5.1.3 (See Block 16)

NAVAIRLKE 41L4 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

XX C

(See Block 16)

(See Block 16) (See Block 16) (See Block 16)

b. COPIES

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

SUBMISSION

a. ADDRESSEE Final

C (See Block 16)

(See Block 16) (See Block 16)

Draft Reg. Rep ro

16. REMARKS Patrick Brannick 1 1 0

Block 4/5: DI-QCIC-81110 and SOW Paragraph 5.1.3 shall be used as guidance and are provided for reference.

Block 8: Instrument Calibration Procedure (CDRL A002 subtitle) for each system requires government approval. Contractor shall provide a preliminary draft to the government for review, comment, and approval no later than (NLT) 60 calendar days prior to initial operating capability (IOC) of first system delivery. Government will provide the contractor with approval/disapproval of content and/or format including comments within 15 days of receipt of preliminary draft. Contractor shall provide a government approved final version with incorporated comments NLT 30 days prior to IOC of each system.

Block 9: DISTRIBUTION STATEMENT C. DISTRIBUTION AUTHORIZED TO

U. S. GOVERNMENT AGENCIES AND THEIR CONTRACTORS TO PROTECT

PUBLICATIONS REQUIRED FOR OFFICIAL USE OR FOR ADMINISTRATIVE

OR OPERATIONAL PURPOSES ONLY. OTHER REQUESTS FOR THIS

DOCUMENT SHALL BE REFERRED TO NAWCAD METROLOGY AND

CALIBRATION OFFICE, ATTN: CALIBRATION STANDARDS MANAGER,

NAWCAD, NAS PATUXENT RIVER, BLDG 1403, 22113 FORTIN CIRCLE,

UNIT 7, PATUXENT RIVER, MD 20670-1118.

Block 10/11/12/13: Submissions shall be provided with each new or upgraded system delivered as specified in the delivery schedule of the contract.

Block 14: Submission in contractor format is acceptable. Electronic format is desired and acceptable if in MS-Excel or MS Word. Electronic submission of data shall also be on CD-ROM. Quantity and copies shall be provided IAW CDRL distribution (Block 14). Addressee's POC information provided on CDRL supplemental page 2.

NAVAIRLKE 41L4

Heather M. Loprano 1 1 0

NAVAIRLKE 41L4

Corry Barnhouse 6.7.6.3S 1 1 0

NAWCAD 6.7.6.3S

With each new/upgraded system delivered.

0 1 0

Clifton Hanson, NSWC Corona

H. Loprano, NAVAIRLKE 41L4 04/02/2020 K. Bergland, NSWCCOR, MS35 06/17/2020

1077/183

BLOCK 14 ENTRY COMPLETE ADDRESS

Patrick Brannick, patrick.brannick@navy.mil

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Heather M. Loprano, heather.loprano@navy.mil NAVAIR Metrology and Calibration

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Corry Barnhouse, corry.barnhouse@navy.mil

NAVAIR METCAL 6.7.6.3S

Bldg 1403 22113 Fortin Circle, Unit 7 Patuxent River, MD 20670

Clifton Hanson, clifton.hanson.ctr@navy.mil NSWC Corona

Source: http://assist.dla.mil -- Downloaded: 2019-06-10T17:16Z Check the source to verify that this is the current version before use.

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters 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 C. CATEGORY:

TBD A TDP________ TM __ ____ OTHER ILSS

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

Portable Vibration Calibrator N64267-20-D -XXXX TBA

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A003 Proposed Spare Parts List Repairable Parts List

II

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-ILSS-80134A

(See Block 16)

SOW Paragraph 5.1.4

NAVAIRLKE 41L4 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

XX C

b. COPIES

8. APP CODE 11. AS OF DATE

13. DATE OF SUBSEQUENT

a. ADDRESSEE Final

A

16. REMARKS Patrick Brannick

Block 4/5: DI-ILSS-80134A and SOW Paragraph 5.1.4 shall be used as guidance and are provided for reference. Information items in DI-ILSS-80134A that are not relevant to the procured unit do not need to be included in format.

Block 8: Repairable Parts List (CDRL A003 subtitle) requires government approval for each system required by the government. Contractor shall provide a preliminary draft to the Government for review, comment, and approval no later than (NLT) 60 calendar days prior to initial operating capability (IOC) for each system. Government will provide the contractor with approval/disapproval of content and/or format including comments within 15 days of receipt of preliminary draft. Contractor shall provide a government approved final version with incorporated comments NLT 30 days prior to IOC for each system.

Block 9: DISTRIBUTION STATEMENT C. DISTRIBUTION AUTHORIZED TO

U. S. GOVERNMENT AGENCIES AND THEIR CONTRACTORS TO PROTECT

PUBLICATIONS REQUIRED FOR OFFICIAL USE OR FOR ADMINISTRATIVE

OR OPERATIONAL PURPOSES ONLY. OTHER REQUESTS FOR THIS

DOCUMENT SHALL BE REFERRED TO NAWCAD METROLOGY AND

CALIBRATION OFFICE, ATTN: CALIBRATION STANDARDS MANAGER,

NAWCAD, NAS PATUXENT RIVER, BLDG1403, 22113 FORTIN CIRCLE,

UNIT 7, PATUXENT RIVER, MD 20670-1118

Block 10/11/12/13: Final Repairable Parts List(s) submissions shall be provided with each new system delivered.

Block 14: Submission in contractor format is acceptable. Electronic format is preferred if in a widely available commercial document format such as MS-Excel or MS Word. Electronic submission of data is also accepted on CD-ROM. Quantity and copies shall be provided IAW CDRL distribution (Block 14). Addressee's POC information provided on CDRL supplemental page 2.

NAVAIRLKE 41L4 0 0 0

NAVAIRLKE 41L4

Corry Barnhouse 6.7.6.3S 1 1 0

NAWCAD 6.7.6.3S

Clifton Hanson, NSWC Corona

15. TOTAL 4 4 0

H. Loprano, NAVAIRLKE 41L4 04/02/2020

K. Bergland, NSWCCOR, MS35 06/17/2020

BLOCK 14 ENTRY COMPLETE ADDRESS

Patrick Brannick, patrick.brannick@navy.mil

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Heather M. Loprano, heather.loprano@navy.mil NAVAIR Metrology and Calibration

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Corry Barnhouse, corry.barnhouse@navy.mil

NAVAIR METCAL 6.7.6.3S

Bldg 1403 22113 Fortin Circle, Unit 7 Patuxent River, MD 20670

Clifton Hanson, clifton.hanson.ctr@navy.mil NSWC Corona

Page 2 of 2 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 this burden estimate or any other aspect of this collection of 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 C. CATEGORY:

TBD E TDP________ TM _______ OTHER SESS

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

Portable Vibration Calibrator N64267-20-D-XXXX TBA

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

E001 Subsystem Design Analysis Report Configuration Management/Design Analysis Report

II

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-SESS-80567B

(See Block 16)

SOW Paragraph: 5.1.5 (See Block 16)

NAVAIRLKE 41L4 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

LT (See Block 16) (See Block 16) A (See Block 16) b. COPIES

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

SUBMISSION

a. ADDRESSEE Final

A N/A (See Block 16)

Draft Reg. Rep ro

16. REMARKS Pat Brannick 41L400B 1 1 0

Block 4/5: DI-SESS-80567B and SOW paragraph 5.1.5 shall be used as guidance and are provided for reference.

Block 8: Configuration Management/Design Analysis Report (CDRL E001 subtitle) requires government approval. Contractor shall provide a preliminary draft to the government for review, comment, and approval no later than (NLT) 30 calendar days after contract award. Government will provide the contractor with comments NLT 15 calendar days of receipt of preliminary draft. If no comments are received within 15 calendar days, the preliminary draft is automatically rejected. Contractor shall provide a government approved final version with incorporated comments NLT 30 days prior to initial operating capability (IOC) of system procured on first delivery order to addressees in accordance with (IAW) CDRL distribution (Block 14a).

Block 10/13: The contractor shall provide the US government the release and/or version number of each item of hardware, software and firmware item included in each calibration standard ordered and/or delivered.

Block 12: Date of first submission of the government approved final version number of each item of hardware, software and firmware item shall be provided NLT 30 days prior to initial operating capability (IOC) of each system’s first delivery order.

Block 14: Submission in contractor format is acceptable. Electronic format is preferred if in a widely available commercial document format such as MS-Excel or MS Word. Electronic submission of data is also accepted on CD-ROM. Quantity and copies shall be provided IAW CDRL distribution (Block 14). Addressee's POC information provided on CDRL supplemental page 2.

Block 14: The US Government reserves all data rights included in DFARS SUBPART 227.71-Rights in Technical data, for the posting of Configuration Management/Design Analysis Report and related information in total or in part, to limited access websites for use by US Government personnel and US Government Support Contractors for the purposes of operation and/or maintenance of the Portable Vibration Calibrator .

Corry Barnhouse 6.7.6.3S 1 1 0 Heather Loprano 1 1 0 Clifton Hanson, NSWC Corona

Copies with ordered units 0 1 0

H. Loprano, NAVAIRLKE 4.1.12.4 04/02/2020

K. Bergland, NSWCCOR, MS35 06/30/2020

BLOCK 14 ENTRY COMPLETE ADDRESS

Patrick Brannick, patrick.brannick@navy.mil

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Heather M. Loprano, heather.loprano@navy.mil NAVAIR Metrology and Calibration

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Corry Barnhouse, corry.barnhouse@navy.mil

NAVAIR METCAL 6.7.6.3S

Bldg 1403 22113 Fortin Circle, Unit 7 Patuxent River, MD 20670

Clifton Hanson, clifton.hanson.ctr@navy.mil NSWC Corona

Title: SUBSYSTEM DESIGN ANALYSIS REPORT

Number: DI-SESS-80567B Approval Date: 20140610 AMSC Number: F9469 Limitation: N/A DTIC Applicable: Yes Defense Technical Information Center 8725 John J. Kingman Road Fort Belvoir, VA 22060-6218

GIDEP Applicable: No

Preparing Activity: 11 (AFLCMC/EZFA) Applicable Forms:

Use/Relationship: This report is used to evaluate the design approach for the configuration item or subsystem and to provide visibility to the government. The data may also be used to formulate additional technical direction to the design activity.

This report is normally prepared during the analysis effort for each configuration item or subsystem during system acquisition. It may also be applicable to other developmental efforts.

This is a REV B to previous DID Area GDRQ which has been replaced by SESS. This DID supersedes

DI-GDRQ-80567A.

Requirements:

1. Reference documents. The applicable issue of the documents cited herein, including their approval dates and dates of any applicable amendments, notices, and revisions shall be as specified in the solicitation or contract.

2. Format. This DID contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

2.1 The report shall be structured to cover each of the major subsections of the design analysis task separately. The analysis report shall correlate the design requirements with the system requirement and any specified requirement for the subsystem or configuration item. The report shall describe or reference all related data (sketches, preliminary drawings, schematics, functional diagrams) necessary for portrayal of the analysis or to aid in an understanding of the analysis.

2.2 The report shall conform to the specific requirements of ANSI/NISO Z39.18 as stated in the Contract Data Requirements List (CDRL) (DD Form 1423). Copies of ANSI/NISO Z39.18 are available online at www.niso.org.

3. Content. The report shall include the following:

3.1 Objective of the analysis;

3.2 Description of the items involved, including adequate drawings, schematics, and computer print-outs, to support the analysis;

3.3 Specification of design constraints and assumptions imposed on the analysis;

DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited.

Source: https://assist.dla.mil -- Downloaded: 2016-05-23T19:35Z http://www.niso.org/

DI-SESS-80567B

3.4 Discussion of the evaluation and analysis procedure, method, or technique used, and its probable accuracy, explained by sample calculations;

3.5 Identification of source material used in the analysis;

3.6 Results of the analysis, to include the following:

a. Predicted performance related to requirements;

b. Design impact and any constraints which influence other subsystems or configuration items;

c. Producibility considerations;

d. Problems encountered or revealed, and suggested solutions.

4. End of DI-SESS-80567B.

Source: https://assist.dla.mil -- Downloaded: 2016-05-23T19:35Z

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters 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 C. CATEGORY:

TBD E TDP________ TM _______ OTHER QCIC

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

Portable Vibration Calibrator N64267-20-D-XXXX TBA

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

E002 Inspection and Test Plan Level B Testing Requirements

II

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-SESS-81110

(See Block 16)

SOW Paragraph: 5.1.6 (See Block 16)

NAVAIRLKE 41L4 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

LT (See Block 16) (See Block 16) A (See Block 16) b. COPIES

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

SUBMISSION

a. ADDRESSEE Final

A N/A (See Block 16)

Draft Reg. Rep ro

16. REMARKS Pat Brannick 41L400B 1 1 0

Block 4/5: DI-QCIC-81110, SOW paragraph 5.1.6 and CSS paragraph 4.3.1.3 shall be used as guidance and are provided for reference.

Block 8: Level B testing requirements (CDRL E002 subtitle) requires government approval. Contractor shall provide a preliminary draft to the government for review, comment, and approval no later than (NLT) 30 calendar days after contract award.

Government will provide the contractor with comments NLT 15 calendar days of receipt of preliminary draft. If no comments are received within 15 calendar days, the preliminary draft is automatically rejected. Contractor shall provide a government approved final version with incorporated comments NLT 30 days prior to initial operating capability (IOC) of system procured on first delivery order to addressees in accordance with (IAW) CDRL distribution (Block 14a).

Block 10/11/12/13: Submissions shall be provided with each new or upgraded system delivered as specified in the delivery schedule of the contract.

Block 14: Submission in contractor format is acceptable. Electronic format is preferred if in a widely available commercial document format such as MS-Excel or MS Word. Electronic submission of data is also accepted on CD-ROM. Quantity and copies shall be provided IAW CDRL distribution (Block 14). Addressee's POC information provided on CDRL supplemental page 2.

Block 16: The US Government reserves all data rights included in DFARS SUBPART 227.71-Rights in Technical data, for the posting of Inspection and Test Plan and related information in total or in part, to limited access websites for use by US Government personnel and US Government Support Contractors for the purposes of operation and/or maintenance of the system.

Corry Barnhouse 6.7.6.3S 1 1 0 Heather Loprano 1 1 0 Clifton Hanson, NSWC Corona

Copies with ordered units 0 0 0

15. TOTAL 4 4 0

H. Loprano, NAVAIRLKE 4.1.12.4 05/22/2020

BLOCK 14 ENTRY COMPLETE ADDRESS

Patrick Brannick, patrick.brannick@navy.mil

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Heather M. Loprano, heather.loprano@navy.mil NAVAIR Metrology and Calibration

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Corry Barnhouse, corry.barnhouse@navy.mil

NAVAIR METCAL 6.7.6.3S

Bldg 1403 22113 Fortin Circle, Unit 7 Patuxent River, MD 20670

Clifton Hanson, clifton.hanson.ctr@navy.mil NSWC Corona

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters 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 C. CATEGORY:

TBD E TDP________ TM _______ OTHER NDTI

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

Portable Vibration Calibrator N64267-20-D-XXXX TBA

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

E003 Test/Inspection Report Level B Test Report

II

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-NDTI-80809

(See Block 16)

SOW Paragraph: 5.1.7 (See Block 16)

NAVAIRLKE 41L4 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

LT (See Block 16) (See Block 16) A (See Block 16) b. COPIES

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

SUBMISSION

a. ADDRESSEE Final

A N/A (See Block 16)

Draft Reg. Rep ro

16. REMARKS Pat Brannick 41L400B 1 1 0

Block 4/5: DI-NDTI-80809 and SOW paragraph 5.1.7 shall be used as guidance and are provided for reference.

Block 8: Level B Test Report (CDRL E003 subtitle) requires government approval.

Contractor shall provide a preliminary draft to the government for review, comment, and approval no later than (NLT) 30 calendar days after contract award. Government will provide the contractor with comments NLT 15 calendar days of receipt of preliminary draft. If no comments are received within 15 calendar days, the preliminary draft is automatically rejected. Contractor shall provide a government approved final version with incorporated comments NLT 30 days prior to initial operating capability (IOC) of system procured on first delivery order to addressees in accordance with (IAW) CDRL distribution (Block 14a).

Block 10/11/12/13: Submissions shall be provided with each new or upgraded system delivered as specified in the delivery schedule of the contract.

Block 14: Submission in contractor format is acceptable. Electronic format is preferred if in a widely available commercial document format such as MS-Excel or MS Word. Electronic submission of data is also accepted on CD-ROM. Quantity and copies shall be provided IAW CDRL distribution (Block 14). Addressee's POC information provided on CDRL supplemental page 2.

Block 16: The US Government reserves all data rights included in DFARS SUBPART 227.71-Rights in Technical data, for the posting of Test/Inspection Report and related information in total or in part, to limited access websites for use by US Government personnel and US Government Support Contractors for the purposes of operation and/or maintenance of the system.

Corry Barnhouse 6.7.6.3S 1 1 0 Heather Loprano 1 1 0 Clifton Hanson, NSWC Corona

Copies with ordered units 0 1 0

H. Loprano, NAVAIRLKE 4.1.12.4 05/22/2020

BLOCK 14 ENTRY COMPLETE ADDRESS

Patrick Brannick, patrick.brannick@navy.mil

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Heather M. Loprano, heather.loprano@navy.mil NAVAIR Metrology and Calibration

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Corry Barnhouse, corry.barnhouse@navy.mil

NAVAIR METCAL 6.7.6.3S

Bldg 1403 22113 Fortin Circle, Unit 7 Patuxent River, MD 20670

Clifton Hanson, clifton.hanson.ctr@navy.mil NSWC Corona

DATA ITEM DESCRIPTION I Form Approved OMB No.0704.0188

1.nTLE 2.IOENTIFICATIONNUMBER

TEST/ INSPECTION REPORT DI-NM’I-80809B

L OESCRIPTlOtVPURPOSE

3.1 The testl inspection report is used to document testl inspection results, findings, and analyses that will enable the government or contracting agency to evaluate compliance with system requirements, performance objectives, specifications, and test linspection plans.

1.APPROVALDATE 5.OFFICEOFPRIMARYRESPONSIBILITY(OPB) Ea.DTICAPPLICABLE 6b.CWIEP AppliCable

(YVMMOD)

F/AFMC-DCJP

970124

,.APPLlCAT\0NflNTER7iElAT10NSH1P

7.1 This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement

I as delineated in the contract.

I

7.2 This DID is applicable to engineering (developmental ), preliminary qualification, qualification, and acceptance testing.

7.3 This DID supersedes DI-NDTI-80809A and DI-MISC-80653

1.APPROVALLIMITATION 9a.APPLICABLEFORMS 9b.AMSCNUMBER

F7231

10,PREPARATIONlNSTRUCnONS

10.1 Format. Contractor format is acceptable.

paragraph 10.2 and its subparagraphs in a manner understanding

10.2 CQnL!aL. The test/inspection report shall

applicable.

Organize the information required by that facilitates presentation and contain the following information, as

10. 2.1 Cove. and tile uaae. The following information shall appear on the outside front :over and title page:

a. Report date.

b. Report number (contractor or government)

Contractor’ s name, address, and commercia 1 and government entity code.

Contract number and contract line item number or sequence number (if applicable)

e. ‘fvpe of test/inspection (for example. first article acceptance test, aualitv con formanc-e-inspection, d-evelopmental test-, qualification test, f Identification of item tested/inspected.

9. Date or period of test/inspection.

h. Name and address of requiring government activity.

i. Security classification, downgrading and declassifying environmental Lest) .“ information, if applicable.

(Continued on page 2 )

1.DIS77UBUTIONSTATEMEW

DISTRIBUTION STATEMRNT A : APPROVED FOR PUBLIC RELBASE; DISTRIBUTION IS UNLIMITED.

ID Form 1664,APR 89 PreviOLIsedtliomwe obsdem. Page 1 of & Pages 39123

Source: http://assist.dla.mil -- Downloaded: 2020-05-22T12:59Z

DI-NDTI-80809B

Block 10, Preparation Instructions (continued)

10.2.2 ~. The table of contents shall identify the following:

a. The title and starting page of each major section, paragraph, and apPendix of the report.

b. The page, identifying number, and title of each illustration (for example; figure, table, photograph, chart, and drawing)

10 .2.3 -ductim. The introduction shall include the following information:

10.2 .3.1 obyectlve W. The specific test/ inspection objective (s) as specified in the contract tasking document.

10. 2.3.2 L.temls) tes~. Complete identification of the item(s) testedl inspected including the following:

a. Nomenclature.

b. National stock number.

Model number, part number t and serial number :: Type of item (for example, prototype, production item, laboratory model )

e. Serial or lot number.

f. Applicable engineering changes

9. Production item specification, if applicable.

h. Date of manufacture.

10.2 .3.3 Complete inspection requirements correlated to contractual following:

Required testl inspection parameters :: Performance requirements, acceptance or environmental criteria.

10.2.4 ~. Complete test/inspection report following:

identification of the testl requirements including the compliance limits, and summary including the

a. A brief discussion of the significant test/inspection results, ObSerVati Qns, conclusions, and recommendations covered in greater detail elsewhere in the report.

b. Proposed corrective actions and schedules for failures or problems encountered.

c. Identification of deviations, departures, or limitations encountered, referenced to the contract requirements.

d. Tables, graphs, illustrations, or charts as appropriate to simplify the summary data.

10.2.5 ~. Complete identification of all documents referenced in the test finspection report including the following, as applicable:

a. Prior testf inspection reports on the same item.

b. Test /inspection plans and procedure documents

c. Prior certifications of compliance.

d. Contractor’ s file designation where test/ inspection records are maintained.

e. Input parameters used.

The applicable issue of the documents cited therein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

Page 2 of 4 Pages Source: http://assist.dla.mil -- Downloaded: 2020-05-22T12:59Z

10.2.6 ~. The body of the testlinspection report shall be as follows :

10 .2.6.1 KzZL_ + de.tlflca~.

Complete identification of each item of test equipment used in the testlinspection including the following:

a.

b.

c.

d.

e.

f.

9.

10. 2.6.2

Nomenclature.

Model number.

Serial number.

Manufacturer.

Calibration status.

Accuracy data.

Comments, if applicable.

Testlinmection kuhtv mstd.b&mn and set–w. Complete description of the physical set-up used in conducting the test/inspection to include the following:

a. Location or orientation of the item.

b. Location. orientation, or settinm of test equipment and instrumentation.

c. Location, orientation, or settings of sensors and probes

d. Location or orientation of interconnections, cables, and hoop-ups.

e. Electrical power, pneumatic, fluidic, and hydraulic requirements.

Drawings, illustrations, and photographs maY be used for clarification.

10 .2.6.3 wrocedur~. Complete description of the procedures used in conducting the test/inspection to include the following:

a. Item selection and inspection that verified suitability for test/ inspection.

b. Summarized sequence of testing/inspection steps, including a description of how the item was operated during the test/inspection, and any control conditions imposed.

10 .2.6.4 A copy of all testlinspection results and analysis to include the following:

10.2.6 .4.1 ~. The actual recorded data (for example, log book entries, oscillographs, instrument readings, plotter graphs) If the recorded data is extensive, provide it in an appendix.

10. 2.6.4.2 Test/ insQec!iion resu. Identification of all testlinspection results to include the following:

a. Matrices comparing results achieved against test/inspection objectives or requirements

b. A discussion of these matrices as to their significance, and how they compare to any prior testlinspections.

Calculation examples.

;; Discussion of anomalies, deviations, discrepancies, or failures, including their impact, causes, and proposed corrective actions The discussion shall address discrepancies between design requirements and the tested/inspected Configuration.

10. 2.6.5 Conclusicxls Test/ inspection conclusions distinguished between objective and subjective to include the following:

a. The effectiveness of the testlinspection procedures in measuring item performance.

Page 3 of 4 PagesSource: http://assist.dla.mil -- Downloaded: 2020-05-22T12:59Z

b. The success or failure of the item to meet required test/inspection objectives.

c. The need for repeat, additional, or alternative tests linspections.

d. The need for item redesign or further development.

e. The need for improved test/inspection procedures, techniques, or facilities.

f. The adequacy and completeness of the test/inspection requirements.

10.2 .6.6 Recommendations appropriate to the test/inspection results and conclusions including the following:

a b.

c.

d.

e.

f.

9.

h.

Acceptability of the item tested/inspected (pass or fail) Additional testing/inspection required. ,.

Redesign required.

Problem resolution.

Test/inspection procedure or facility improvements Disposition of items tested/inspected.

Documentation changes required.

Testing/ inspection improvements

10.2.7 The following certifications shall be included, .as

applicable:

10.2 .7.1 A statement that the testlinspection was performed in accordance with applicable testlinspection plans and procedures, and that the results are true and accurate. The authentication shall include the signature of the contractor personnel that performed the test(s) /inspection(s) , a contractor representative authorized to make such certification, and any government witnesses

10.2 .7.2 A statement identifying those requirements not tested/inspected or measured that were previously validated.

Include identification of the data and method employed for such validation (for example, prior test/inspection, analytical verification, equivalent item, and so on) The authentication shall include the signature of a contractor representative authorized to make such authentication and any government witness.

10.2 .7.3 A statement that the item tested/ inspected either passed or failed item acceptability requirements This authentication shall include the signature of a contractor representative authorized to make such authentication and any government witness

10.2.8 Appendices shall be used to append detailed

test/inspection daia, drawings, photographs , or other documentation too voluminous to include in the main body of the report This includes referenced documentation not previously provided by the government, and test/ inspection reports from any associated test/inspection activity that may have performed some of the testing/inspecting requirements.

Page 4 of 4 Pages Source: http://assist.dla.mil -- Downloaded: 2020-05-22T12:59Z

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters 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 C. CATEGORY:

TBD T TDP________ TM TMSS OTHER _________

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

Portable Vibration Calibrator N64267-20-D-XXXX TBA

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

T001 Commercial Off-The-Shelf (COTS) Manuals and Associated Supplemental Data

Operator/Service Manual

II

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-TMSS-80527C

(See Block 16)

SOW Paragraph 5.1.1

NAVAIRLKE 41L4 TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST

14. DISTRIBUTION

XX C

(See Block 16)

(See Block 16)

(See Block 16) (See Block 16)

b. COPIES

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

SUBMISSION

a. ADDRESSEE Final

A

N/A (See Block 16)

16. REMARKS Patrick Brannick 1 1 0

Block 4/5: DI-TMSS-80527C shall be used as guidance and is provided for reference. SOW paragraph 5.1.1 is mandatory to this requirement.

Block 8: Operator/Service Manual(s) (CDRL T001 subtitle) requires government approval. Contractor shall provide an Illustrated Parts Breakdown (IPB) within the manual(s). Contractor shall provide a preliminary draft to the government for review, comment, and approval no later than (NLT) 60 calendar days prior to Initial Operational Capability (IOC). Government will provide the contractor with comments NLT 15 calendar days of receipt of preliminary draft. Contractor shall provide a government approved final version with incorporated comments NLT 30 calendar days prior to IOC of the first system(s) ordered to addressees in accordance with (IAW) CDRL T001 distribution (Block 14a). For commercial items, the Initial Operational Capability (IOC) is defined as the first delivery under a contract.

Block 9: DISTRIBUTION STATEMENT C. DISTRIBUTION AUTHORIZED TO

U. S. GOVERNMENT AGENCIES AND THEIR CONTRACTORS TO PROTECT

PUBLICATIONS REQUIRED FOR OFFICIAL USE OR FOR ADMINISTRATIVE

OR OPERATIONAL PURPOSES ONLY. OTHER REQUESTS FOR THIS

DOCUMENT SHALL BE REFERRED TO NAWCAD METROLOGY AND

CALIBRATION OFFICE, ATTN: CALIBRATION STANDARDS MANAGER,

NAWCAD, NAS PATUXENT RIVER, BLDG 1403, 22113 FORTIN CIRCLE,

UNIT 7, PATUXENT RIVER, MD 20670-1118

Block 12: First submission of the government approved final version of the Operator/Service Manual shall be provided to the government (NLT) 30 calendar days prior to (IOC) of the first system(s) ordered under a contract.

Block 10/13: Submissions of Operator/Service Manual(s) shall be provided with each new system provided.

Block 14: Submission in contractor format is acceptable. Electronic format is desired and acceptable if in MS-Excel or MS Word. Electronic submission of data shall also be on CD-ROM and/or DvD media. Qty. (1) Operator/Service Manual shall be shipped with each system installed. Quantity and copies shall be provided IAW CDRL distribution (Block 14a). Addressee's POC information provided on CDRL supplemental page 2.

NAVAIRLKE 41L4

NAVAIRLKE 41L4

Corry Barnhouse 6.7.6.3S 1 1 0

NAWCAD 6.7.6.3S

Clifton Hanson, NSWC Corona

With each unit shipped 0 1 0

H. Loprano, NAVAIRLKE 41L4 04/28/2020

BLOCK 14 ENTRY COMPLETE ADDRESS

Patrick Brannick, patrick.brannick@navy.mil

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Heather M. Loprano, heather.loprano@navy.mil NAVAIR Metrology and Calibration

NAWCAD 4.1.12.4

JB MDL

Highway 547, Building 120-3, Rm. 269 Lakehurst, NJ 08733

Corry Barnhouse, corry.barnhouse@navy.mil

NAVAIR METCAL 6.7.6.3S

Bldg 1403 22113 Fortin Circle, Unit 7 Patuxent River, MD 20670

Clifton Hanson, clifton.hanson.ctr@navy.mil NSWC Corona

Title: COMMERCIAL OFF-THE-SHELF (COTS) MANUALS AND ASSOCIATED

SUPPLEMENTAL DATA

Number: DI-TMSS-80527C Approval Date: 20110812 AMSC Number: 9207 Limitation: No DTIC Applicable: No GIDEP Applicable: No Office of Primary Responsibility: TM

Applicable Forms: None

Use/relationship: Commercial Off-the-Shelf Manuals may be used as is or with supplementation to support COTS equipment used by DOD. This DID is used to:

a. Acquire sample COTS manuals for evaluation.

b. Acquire COTS manuals which have been evaluated and found to be acceptable.

c. Acquire associated supplemental data, if required.

This DID contains format, content, and intended use information for the data deliverable(s) resulting from the work described in MIL-PRF-32216.

This DID supersedes DI-TMSS-80527B, dated 17 Oct 2006.

Requirements:

1. Content. The manual shall contain all technical information on the assembly, installation, operation, parts, and maintenance of commercial equipment.

2. Evaluation. The manual shall be evaluated using the criteria found in MIL-PRF-32216.

3. Supplementation. The manual may be supplemented with additional data to comply with contract. Supplemental data shall be prepared in accordance with MIL-PRF-32216.

4. Format. The basic manual shall be in the contractor's format. Supplemental data shall be in the format specified by the contracting activity.

5. Digital files. Interactive Electronic Technical Manuals (IETMs) or PDFs are preferred for electronic COTS manuals.

6. PDF Files. PDF files shall be searchable, capable of having links added, and have fonts embedded.

7. IETMs. IETMs shall meet the general style and format and user interface requirements in MIL-PRF-87268 or MIL-STD-40051-1 (Army only) or MIL-STD-3031 (Army only).

8. Paper manuals. If paper manuals are acquired, the data shall be clearly legible and on paper of sufficient quality for long term use.