Exhibit A.pdf

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KING NUTRONICS M/N 3689A
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N6426721R0113
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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: https://assist.dla.mil -- Downloaded: 2019-07-16T12:34Z Check the source to verify that this is the current version before use.

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: https://assist.dla.mil -- Downloaded: 2019-07-16T12:34Z

Source: http://assist.dla.mil -- Downloaded: 2021-02-17T15:28Z

Source: http://assist.dla.mil -- Downloaded: 2021-02-17T15:28Z

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.

Source: https://assist.dla.mil -- Downloaded: 2019-07-16T12:28Z

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

Precision Pressure Standard System N64267-19-D-XXXX King Nutronics

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

GROUP

A001 CALIBRATION CERTIFICATE Calibration Certificate

II

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

DI-QCIC-80798C

(See Block 16)

SOW Paragraph: 5.2

NSWC, Corona Division

TOTAL

PRICE

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

SUBMISSION

14. DISTRIBUTION

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

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

a. ADDRESSEE Final

N/A N/A (See Block 16) Draft Reg. Repro

16. REMARKS Daniel M Martinez (MS35) 1

Block 4/5: DI-QCIC-80798C and SOW specification paragraph 5.2 shall be used as guidance and are provided for reference. Data points from the actual calibration must be included with this report. Information items in DI- QCIC-80798C that are not relevant to the procurement do not need to be included in format.

Block 10: Frequency of Calibration Certificate (CDRL A001 subtitle) shall be generated for each unit calibrated.

Block 12: Date of first submission shall be in accordance with (IAW) first unit calibrated.

Block 13: Date of subsequent submissions shall be IAW each unit returned to the Government after subsequent calibration is performed.

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.

NSWC Corona Division With each calibration performed 1

15. TOTAL 2

G. PREPARED BY

H. DATE I. APPROVED BY J. DATE

D. M. Martinez NSWC, Corona (MS35) 16 FEB 2021 K. Bergland NSWC, Corona (MS35) 02/23/2021

DD FORM 1423 (CDRL) Supplemental

BLOCK 14 ENTRY COMPLETE ADDRESS

Daniel M Martinez, NSWC, Corona MS35, daniel.m.martinez@navy.mil NSWC Corona Division MS Department (Attn: Daniel M Martinez, MS35, Building 521) PO Box 5000 Corona CA 92878-5000

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.

TBD E TDP________ TM __ ____ OTHER CQIC

Precision Pressure Standard System N64267-19-D-XXXX King Nutronics

A002 Inspection and Test Plan Instrument Calibration Procedure

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

DI-QCIC-81110

SOW Paragraph 5.3

NSWC, Corona Division TOTAL PRICE

XX C

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

b. COPIES

A

N/A (See Block 16)

Draft Reg. Rep ro

16. REMARKS Daniel M Martinez /MS35 1 1 0

Block 4/5: DI-QCIC-81110 and SOW Paragraph 5.3 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) 90 calendar days prior to initial operating capability (IOC) of 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 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 MEASUREMENT SCIENCE

DIRECTORATE, NAVAL SURFACE WARFARE CENTER, CORONA

DIVISION, P.O. BOX 5000, CORONA.

Block 10/12/13: Submissions shall be provided with each Precision Pressure Standard 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.

Copies with each unit delivered

0 1 0

15. TOTAL 1 2 0

D. M. Martinez NSWC, Corona

(MS35)

16 FEB 2021 K. Bergland NSWC, Corona (MS35) 02/23/2021

DD Form 1423-1 JUN 90 Previous editions are obsolete. Page 1 of 2 Pages 1077/183

BLOCK 14 ENTRY COMPLETE ADDRESS

Daniel M Martinez, NSWC, Corona MS35, daniel.m.martinez@navy.mil NSWC Corona Division MS Department (Attn: Daniel M Martinez, MS35, Building 521)

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

TBD A TDP________ TM _______ OTHER IPSC

Precision Pressure Standard System N64267-19-D-XXXX TBD

A003 Software Version Description (SVD) Software/Firmware Version Description

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

DI-IPSC-81442A

SOW Paragraph: 5.4

NSWC, Corona Division TOTAL

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

N/A N/A (See Block 16) Draft Re g.

Repro

16. REMARKS Daniel M Martinez (MS35) 1 0

Block 4/5: For the description of software and firmware versions provided with each Precision Pressure Standard System DI-IPSC-81442A and SOW paragraph 5.4 shall be used as guidance and are provided for reference.

Information items in DI-IPSC-81442A that are not relevant to the procured unit do not need to be included in format.

Block 10: Frequency of Software/Firmware Version Description (CDRL A003 subtitle) shall be as generated for each Precision Pressure Standard System.

Block 12: Date of first submission shall be in accordance with (IAW) first Precision Pressure Calibrator delivered.

Block 13: Date of subsequent submissions shall be IAW each Precision Pressure Standard System returned to the Government after warranty repair is performed. The Software/Firmware version shall be the same on all Precision Pressure Calibrators 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

With each system delivered 1

15. TOTAL 2 0

D. M. Martinez NSWC, Corona (MS35) 16 FEB 2021 K. Bergland NSWC, Corona (MS35) 02/23/2021

BLOCK 14 ENTRY COMPLETE ADDRESS

Daniel M Martinez, NSWC, Corona MS35, daniel.m.martinez@navy.mil NSWC Corona Division MS Department (Attn: Daniel M Martinez, MS35, Building 521)

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.

TBD A TDP________ TM __ ____ OTHER MISC

Precision Pressure Standard System

N64267-19-D-XXXX TBD

A004 Software/Firmware Change Request Software/Firmware Change Request

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

DI-MISC-81807

SOW Paragraph 5.4.1

NSWC, Corona Division TOTAL PRICE

$ 3,420.00

N/A

Draft Reg

Rep ro

16. REMARKS Daniel M Martinez (MS35) 1 1 0 Block 4/5: DI-MISC-81807 shall be used as guidance and is provided for reference.

SOW Paragraph 5.4.1 is mandatory to this requirement.

Block 8: Prior notification and Government approval of all Software/Firmware Change Request(s) (CDRL A004 subtitle) for the Precision Pressure Standard System is required by the Government. Contractor shall provide a Software/Firmware Change Request to the Government for review, comment, and approval no later than (NLT) 15 calendar days prior to installation of software and/or firmware revisions to any Precision Pressure Standard System. Government comments with or without approval will be provided to the contractor within 15 days of receipt of Software/Firmware Change Request providing information explained in

DI-MISC-81807.

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 MEASUREMENT SCIENCE

DIRECTORATE, NAVAL SURFACE WARFARE CENTER, CORONA

DIVISION, P.O. BOX 5000, CORONA.

Block 10/12/13: Submission(s) of Software/Firmware Change Request(s) apply to both new and warranty repaired Precision Pressure Standard System and shall be provided to the Government prior to each software/firmware change and initial operating capability (IOC) of the Precision Pressure Standard System. Transmission of the Software/Firmware Change Request(s) data shall follow the requirements specified in SOW paragraph 5.4.1

Block 14: Submission in Contractor format is acceptable. Quantity and copies shall be provided IAW CDRL distribution (Block 14). Addressee's POC information provided on CDRL supplemental page 2.

15. TOTAL 1 1

D. M. Martinez NSWC, Corona (MS35) 16/FEB/2021 K. Bergland NSWC, Corona (MS35) 02/23/2021

BLOCK 14 ENTRY COMPLETE ADDRESS

Daniel M Martinez, NSWC, Corona MS35, daniel.m.martinez@navy.mil NSWC Corona Division MS Department (Attn: Daniel M Martinez, MS35, Building 521)

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

TBD A TDP________ TM _______ OTHER PSSS

A005 PROPOSED SPARE PARTS LIST Reparable Parts List

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

DI-PSSS-80134B (See Block 16)

SOW Paragraph: 5.5

NSWC, Corona Division

TOTAL

C

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

N/A N/A (See Block 16) Draft Reg. Repro

16. REMARKS Daniel M Martinez (MS35) 1 1

Block 4/5: DI-PSSS-80134B and SOW specification paragraph 5.5 shall be used as guidance and are provided for reference.

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 MEASUREMENT SCIENCE

DIRECTORATE, NAVAL SURFACE WARFARE CENTER, CORONA

DIVISION, P.O. BOX 5000, CORONA.

Block 10/12/13: Final Repairable Parts List(s) shall be delivered with each new Precision Pressure Standard System.

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

With each system delivered 1

15. TOTAL 1 2

BLOCK 14 ENTRY COMPLETE ADDRESS

Daniel M Martinez, NSWC, Corona MS35, daniel.m.martinez@navy.mil NSWC Corona Division MS Department (Attn: Daniel M Martinez, MS35, Building 521)

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

TBD T TDP________ TM TMSS OTHER _________

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

Operator/Service Manual

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

DI-TMSS-80527C

SOW Paragraph, 5.1

NSWC, Corona Division TOTAL

N/A (See Block 16)

Dra ft

Reg. Repro

16. REMARKS Daniel M Martinez (MS35) 1 1 0 Block 4/5: DI-TMSS-80527C shall be used as guidance and is provided for reference. SOW paragraph 5.1 is mandatory to this requirement and is provided for guidance.

Block 8: Operator/Service Manual (CDRL T001 subtitle) 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 acceptance testing. 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 days prior to Initial Operating Capability (IOC) of the first system. IOC shall be defined as the Estimated Day of Delivery (EDD) provided by the contractor and included in the base delivery order award.

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 MEASUREMENT SCIENCE

DIRECTORATE, NAVAL SURFACE WARFARE CENTER, CORONA

DIVISION, P.O. BOX 5000, CORONA.

Block 10/12/13: Submissions of Operator/Service Manual(s) shall be provided with each Precision Pressure Standard System delivered.

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. Quantity and copies shall be provided IAW CDRL distribution (Block 14a). Addressee's POC information provided on CDRL supplemental page 2.

With each system delivered 1 0

15. TOTAL 1 2 0

BLOCK 14 ENTRY COMPLETE ADDRESS

Daniel M Martinez, NSWC, Corona MS35, daniel.m.martinez@navy.mil NSWC Corona Division MS Department (Attn: Daniel M Martinez, MS35, Building 521)

Source: https://assist.dla.mil -- Downloaded: 2019-07-16T12:42Z

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: https://assist.dla.mil -- Downloaded: 2019-07-16T12:45Z

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

8. OTHER SYS/CONFIG ITEMS AFFECTED

YES NO

9. IN PRODUCTIO N

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?

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

T

(4) Update TDP b.

S

(1) Software Engineering Environment Upgrade

P

(2) Software Test Environment Upgrade

E Q

M c.

(1) Operator

(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

23. APPROVAL/DISAPPROVAL

Figure 1 Page 2 of 8 Pages

SOFTWARE CHANGE REQUEST (SCR), Figure 2

SCR NUMBER & REV:

SOFTWARE CHANGE REQUEST (SCR), Figure 3

SCR NUMBER & REV:

SCR NUMBER and REV:

SOFTWARE CHANGE REQUEST (SCR), Figure 6

SCR NUMBER and REV:

SCR NUMBER and REV:

Title: PROPOSED SPARE PARTS LIST Number: DI-PSSS-80134B Approval Date: 20171107 AMSC Number: F9866 Limitation: N/A DTIC Applicable: No GIDEP Applicable: No Preparing Activity: 11 (AFLCMC/WIN) Project Number: PSSS-2017-030 Applicable Forms: N/A Use/Relationship: The Proposed Spare Parts List identifies the contractor’s recommended spare parts required to maintain a system under a given set of circumstances and duration and will be used to determine spare parts stocking levels.

a. This Data Item Description (DID) contains the format, content, and intended use information for the data deliverable resulting from the work task described in the contract.

b. This DID supersedes DI-ILSS-80134A.

Requirements:

1. Reference documents. None.

2. Format. Contractor’s format shall be acceptable.

3. Content. The Proposed Spare Parts List shall contain the contractor’s recommended quantities of every type of spare part required for the system, to include all consumable and expendable items. This list shall explain any assumptions, formulas, or models used by the contractor in the creation of the list and shall include the following:

a. Complete item name.

b. Prime manufacturer’s or vendor’s part number.

c. Commercial and Government Entity (CAGE) Code

d. National Stock Number (NSN).

e. Quantity per end item.

f. Unit of issue (e.g., each, feet, lot).

g. Estimated unit price.

h. Recommended quantity to sustain operation for the time period and under the conditions stated in the contract.

i. Alpha numeric numbering of items on list.

j. Shelf life (if not indefinite).

k. Mean-Time-Between Failure (MTBF) of each item.

l. Production lead time for each item

m. Explanatory narrative which describes the recommended quantity to take into account multiple end items at a single location.

4. End of DI-PSSS-80134B.

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

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