Exhibit A.pdf

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page of Pages

(1 Data Item)

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

TDP ________ TM _______ OTHER

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

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423-1 (BACK), FEB 2001

DATA ITEM DESCRIPTION

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

SUPPLEMENTAL DATA

Approval Date: 20211203 Limitation: No GIDEP Applicable: No

Number: DI-TMSS-80527D AMSC Number: 10283 DTIC 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 that 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-80527C, dated 12 Aug 2011.

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 presented in the contractor's format. Supplemental data shall be presented in the format specified by the acquiring 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- 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.

9. Quick Reference Guides (QRGs). QRGs shall meet the requirements of MIL-PRF-32614.

End of DI-TMSS-80527D

Source: http://assist.dla.mil -- Downloaded: 2022-03-08T19:03Z Check the source to verify that this is the current version before use.

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

TDP ________ TM _______ OTHER

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

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data

DATA ITEM DESCRIPTION

Title: CALIBRATION CERTIFICATE/REPORT

Number: DI-QCIC-80798C Approved Date: 20170123 AMSC Number: F9766 Limitation: N/A DTIC Applicable: No GIDEP Applicable: No Preparing Activity: 36 Project Number: QCIC-2017-003 Applicable Forms: N/A Use/Relationship: The Calibration Certificate/Report documents calibration certificates or reports accompanying the calibrations performed on Department of Defense (DoD) test, measurement, and diagnostic equipment.

a. This Data Item Description (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.

b. This DID is applicable to contracts requiring calibration of test equipment prior to delivery.

This DID is consistent with ISO/IEC 17025, General requirements for the competence of testing and calibration laboratories, requirements for calibration reports or certificates.

(Copies of this document are available online at http://www.iso.org.)

c. This DID supersedes DI-QCIC-80798B.

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 contract.

2. Format. Contractor format is acceptable.

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

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

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 calibration certificate or test report (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 calibration certificate or test report;

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

e. Identification of the method used;

f. A description of, the condition of, and the 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;

DISTRIBUTION STATEMENT A. Approved for public release. Distribution is unlimited.

Source: http://assist.dla.mil -- Downloaded: 2022-03-08T18:53Z

DI-QCIC-80798C

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 calibration certificate or test report;

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-80798C.

Source: http://assist.dla.mil -- Downloaded: 2022-03-08T18:53Z

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

TDP ________ TM _______ OTHER

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

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data

Source: http://assist.dla.mil -- Downloaded: 2022-03-08T19:56Z

Source: http://assist.dla.mil -- Downloaded: 2022-03-08T19:56Z

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

TDP ________ TM _______ OTHER

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

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data

Source: http://assist.dla.mil -- Downloaded: 2022-03-08T20:02Z

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

TDP ________ TM _______ OTHER

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

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data

Data Item Description

Title: Software/Firmware Change Request Approval Date: 20100420 Number: DI-MISC-81807 Limitation: N/A AMSC Number: N9130 GIDEP Applicable: N/A DTIC Applicable: N/A Office of Primary Responsibility: SH/PMS-408 Applicable Forms: N/A

Use/relationship: The Software/ Firmware Change Request will be used to alert or inform the government about changes to software and firmware and also to provide detailed information to the government about the changes and the estimated cost of the software/firmware changes.

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

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 contract.

2. Format. The Software/Firmware Change Request shall be presented in the Contractor’s format.

3. Content. The Software/Firmware Change Request shall contain all the information identified in Figures 1-7.

4. End of DI-MISC-81807.

Page 1 of 8 Pages

Source: http://assist.dla.mil -- Downloaded: 2022-03-08T20:10Z

DI-MISC-81807

SOFTWARE CHANGE REQUEST (SCR), PAGE 1

2. DATE

3. JUSTIFICATION CODE

1. ORIGINATOR NAME AND ADDRESS (include e-mail address and telephone number)

Name:

Organization:

Street 1:

Street 2:

City, State, Zip Code:

Telephone Number: ( ) ext:: E-mail address:

4. TYPE OF SCR

Class I Class II

5. PRIORITY

Emergency Urgent Routine

6. SCR DESIGNATION 7. BASELINE AFFECTED

a. CI/CSCI AFFECTED

b. CAGE CODE

c. SYSTEM DESIGNATION

FUNCTIONAL ALLOCATED PRODUCT

d. SCR No.

e. REVISION

f. TYPE Preliminary Final

8. OTHER SYS/CONFIG ITEMS AFFECTED

YES NO

9. IN PRODUCTIO N

YES NO

10. DOCUMENTS AFFECTED

CAGE CODE SPEC/DOC NO. REVISION SCN/NOR/ECN/ECO NO.

11. TITLE OF CHANGE

12. CONTRACT NO. & LINE ITEM

13. CONFIGURATION ITEM NOMENCLATURE

14. PROCURING CONTRACTING OFFICER

15. LOWEST ASSEMBLY AFFECTED

a. NOMENCLATURE

b. PART NO.

16. DESCRIPTION OF CHANGE

17. NEED FOR CHANGE

18. PRODUCTION EFFECTIVITY BY SERIAL NUMBER

19. EFFECT ON PRODUCTION DELIVERY

SCHEDULE

20. RETROFIT

a. RECOMMENDED ITEM EFFECTIVITY

b. ESTIMATED KIT DELIVERY SCHEDULE

c. PLATFORMS AFFECTED

21. ESTIMATED COST or (SAVINGS) UNDER CONTRACT

No Additional Cost/Savings – In Scope of the Contract

22. SUBMITTING ACTIVITY AUTHORIZING SIGNATURE

22a. TITLE

23. APPROVAL/DISAPPROVAL

a. LCCB CHAIRMAN

DATE :

RECOMMEND APPROVAL

RECOMMNED DISAPPROVAL

b. CCB CHAIRMAN

DATE :

APPROVED

DISAPPROVED

Figure 1 Page 2 of 8 Pages

SOFTWARE CHANGE REQUEST (SCR), Figure 2

SCR NUMBER & REV:

EFFECT ON FUNCTIONAL/ALLOCATED CONFIGURATION IDENTIFICATION

24. OTHER SYSTEMS AFFECTED

25. OTHER CONTRACTORS/ACTIVITIES AFFECTED

26. CONFIGURATION ITEMS AFFECTED

27. EFFECTS ON PERFORMANCE ALLOCATIONS AND INTERFACES IN SYSTEM SPECIFICATION

28. EFFECTS ON EMPLOYMENT, INTEGRATED LOGISTICS SUPPORT, TRAINING, OPERATIONAL, EFFECTIVENESS, OR SOFTWARE

29. EFFECTS ON CONFIGURATION ITEM SPECIFICATIONS

30. DEVELOPMENTAL REQUIREMENTS AND STATUS

31. TRADE-OFFS AND ALTERNATIVE SOLUTIONS

32. DATE BY WHICH CONTRACTUAL AUTHORITY IS NEEDED

Figure 2 Page 3 of 8 Pages

SOFTWARE CHANGE REQUEST (SCR), Figure 3

SCR NUMBER & REV:

EFFECTS ON PRODUCT CONFIGURATION IDENTIFICATION, LOGISTICS, AND OPERATIONS

(X) FACTOR ENCL. PAR. (X) FACTOR ENCL. PAR.

33. EFFECT ON PRODUCT CONFIGURATION

IDENTIFICATION OR CONTRACT

35. EFFECT ON OPERATIONAL

EMPLOYMENT

a. PERFORMANCE a. SAFETY

b. WEIGHT-BALANCE STABILITY (Aircraft) N/A N/A b. SURVIVABILITY

c. WEIGHT-MOMENT (Other equipment) N/A N/A c. RELIABILITY

d. CDRL, TECHNICAL DATA d. MAINTAINABILITY

e. NOMENCLATURE e. SERVICE LIFE

f. OPERATING PROCEDURES

g. ELECTROMAGNETIC INTERFERENCE 34. EFFECT ON INTEGRATED LOGISTICS

SUPPORT (ILS) ELEMENTS

h. ACTIVATION SCHEDULE

a. ILS PLANS i. CRITICAL SINGLE POINT FAILURE ITEMS

b. MAINTENANCE CONCEPT, PLANS, PROCEDURES j. INTEROPERABILITY c LOGISTICS SUPPORT ANALYSIS

d. INTERIM SUPPORT PROGRAMS 36. OTHER CONSIDERATIONS

e. SPARES AND REPAIR PARTS N/A N/A a. INTERFACE

f. TECH MANUALS/PROGRAMMING TAPES b. OTHER AFFECTED EQUIPMENT/GFE/GFP N/A N/A

g. FACILITIES N/A N/A c. PHYSICAL CONSTRAINTS N/A N/A P h. SUPPORT EQUIPMENT N/A N/A d. COMPUTER PROGRAMS AND RESOURCES

i. OPERATOR TRAINING e. REWORK OF OTHER EQUIPMENT N/A N/A

j. OPERATING TRAINING EQUIPMENT f. SYSTEM TEST PROCEDURES

k. MAINTENANCE TRAINING g. WARRANTY/GUARANTEE

l. MAINTENANCE TRAINING EQUIPMENT h. PARTS CONTROL N/A N/A

m. CONTRACT MAINTENANCE i. ENVIRONMENTAL

n. PACKAGING , HANDLING, STORAGE, AND

TRANSPORTABILITY

N/A N/A j. FMS RELEASE

37. ALTERNATE SOLUTIONS

38. DEVELOPMENTAL STATUS

39. RECOMMENDATIONS FOR RETROFIT

40. WORK-HOURS PER UNIT TO INSTALL RETROFIT KITS

a. ORGANIZATION

b. INTERMEDIATE

c. DEPOT

d. OTHER

41. WORK-HOURS TO CONDUCT SYSTEM TESTS AFTER RETROFIT

42. THIS CHANGE MUST BE ACCOMPLISHED

BEFORE WITH AFTER THE FOLLOWING CHANGES:

43. IS CONTRACTOR FIELD

SERVICE ENGINEERING

REQUIRED?

YES NO

44. OUT-OF-SERVICE TIME

45. EFFECT OF THIS SCR AND PREVIOUSLY APPROVED SCRs

46. DATE CONTRACTUAL AUTHORITY NEEDED

FOR PRODUCTION:

FOR RETROFIT:

Figure 3 Page 4 of 8 Pages

Figure 4 Page 5 of 8 Pages

SOFTWARE CHANGE REQUEST (SCR), Figure 5 SCR NUMBER and REV:

48. ESTIMATED COSTS SAVINGS/SUMMARY, RELATED SCRs (Use parentheses for savings)

FACTOR

CAGE CODE

(a)

SCR NUMBER

(b)

COSTS/SAVINGS

UNDER CONTRACT

(c)

OTHER COSTS/

SAVINGS

(d)

a. PRODUCTION COST/SAVING (Subtotal of Costs/Savings Elements from block 51a applicable to aircraft, ship, tank, vehicle, missile, or its subsystem)

SUBTOTAL PRODUCTION COSTS/SAVINGS

b. RETROFIT COSTS (Applicable to aircraft, ship, tank, vehicle, missile, or its subsystem)

SUBTOTAL RETROFIT COSTS

c. INTEGRATED LOGISTICS SUPPORT COSTS/SAVING REVISED

REQUIREMENTS

(1) ITEM RETROFIT (If not covered under “b”) (Applicable to aircraft, ship tank, vehicle, missile, or its subsystem)

(2) ILS SUBTOTAL (Applicable to aircraft, ship, tank, vehicle, missile or its subsystem)

(3) OPERATOR TRAINER (Net total cost/saving from each SCR covering operator trainer)

(4) MAINTENANCE TRAINER (Net total cost/saving from each SCR covering maintenance trainer)

(5) OTHER TRAINING EQUIPMENT

(6) SUPPORT EQUIPMENT (Net total cost/saving from each SCR on support equipment)

(7) ILS PLANS

(8) MAINTENANCE CONCEPT, PLANS, SYSTEM DOCUMENTS

(9) INTERIM SUPPORT PLAN

RECURRING COSTS

NEW REQUIREMENTS

PROCURIN

G

ACTIVITY

CODE

NON-

RECURRING

COSTS UNIT QTY TOTAL

(10) PROVISIONING DOCUMENTATION

(11) OPER TRNR/TRNG DEVICES/EQUIP

(12) MANUALS/PROGRAMMING TAPES, SPARES,

REPAIR PARTS (For 11)

(13) MAINTENANCE TRNR/TRNG DEVICES/

EQUIPMENT

(14) MANUALS/PROGRAMMING TAPES, SPARES,

REPAIR PARTS (For 13)

(15) SUPPORT EQUIPMENT

(16) MANUALS/PROGRAMMING TAPES (For 15)

(17) PROVISIONING DOCUMENTATION (For 15)

(18) REPAIR PARTS (For 15) N/A N/A N/A N/A N/A N/A N/A

(19) SUBTOTAL ILS COSTS/SAVINGS (Sum of c. 1 through c. 18)

CAGE CODE SCR NUMBER

d. OTHER COSTS/SAVINGS (Total from block 48d of related SCRs)

TOTAL OTHER COSTS/SAVINGS

SUBTOTALS OF COLUMNS

SUBTOTAL UNDER CONTRACT

Figure 5 Pages 6 of 8 Pages

SOFTWARE CHANGE REQUEST (SCR), Figure 6

SCR NUMBER and REV:

49. TITLE OF CHANGE

50. DATE AUTHORIZATION TO PROCEED

RECEIVED BY CONTRACTOR (YYMMDD)

S START DELIVERY C COMPLETED DELIVERY PROGRESS POINT

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36

Figure 6 Page 7 of 8 Pages a.

C O

(1) Software Engineering

N F I

(2) Software Documentation

G U R

(3) Software Engineering Test

A T

(4) Update TDP b.

S

(1) Software Engineering Environment Upgrade

P

(2) Software Test Environment Upgrade

E Q

M c.

(1) Operator

A

(2) Maintenance

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2

26 27 28 29 30 31 32 33 34 35 36

SOFTWARE CHANGE REQUEST (SCR), Continuation Sheet, Figure 7

TITLE OF CHANGE

SCR NUMBER and REV:

PARAGRAPH# BLOCK/LINE NO. BLOCK TITLE AND SUPPLEMENTARY INFORMATION

Figure 7 Page 8 of 8 Pages

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP ________ TM _______ OTHER

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

TDP ________ TM _______ OTHER

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

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when…