Exhibit A.pdf
PDF 77 KB Posted
- Attached to
- Cannon Containers for the Watervliet Arsenal
- Solicitation number
- W911PT27QA008
About this file
This is a Contract Data Requirement List (DD Form 1423) that specifies data deliverables required under a Department of the Army contract administered by Watervliet Arsenal (TAWV-CQD-E). The form documents three data items that the contractor must submit.
Data Item A001 requires submission of a Test/Inspection Report documenting inspection records for a first article sample using WVA Form 702-61-R-E, with one final copy due with the first article submission. The contractor must delete paragraph 10.2 of Data Item Description DI-NDTI-80809B and submit the form along with DD Form 1222; computerized versions may be used with prior procuring office approval. Data Item A002 requires a Certificate of Conformance (COC) with a General Application submission, referencing specific material, fabrication methods, or heat treat process characteristics per QAP-APPX-WVA paragraph 4.6, with one final copy due with the first shipment and each subsequent shipment. Data Item A003 requires submission of inspection records for all production components using the same authority (DI-NDTI-80809B), with paragraphs 10.2 through 10.2.8 deleted, one final copy due with the first shipment and each subsequent shipment per QAP-APPX-WVA paragraphs 4.2 and 4.5. All three data items carry a Distribution Statement B (Test and Evaluation) classification. The form was prepared by J Cannon on March 3, 2025, and approved by William Potter, TAWV-CQD-E on the same date. Completed forms must be submitted to the Government Issuing Contracting Officer for the applicable contract/purchase request number.
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| File | Type | Posted |
|---|---|---|
| Solicitation - W911PT27QA008.pdf |
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CONTRACT DATA REQUIREMENT LIST – DD Form 1423 Form Approval OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 440 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 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.: 0001
B. EXHIBIT A
C. CATEGORY
D. SYSTEM/ITEM
E. CONTRACT/PR NO.:
F. CONTRACTOR
1. DATA ITEM NO: A001
2. TITLE OF DATA ITEM: Test/Inspection Report
3. SUBTITLE: Inspection Records – First Article Sample WVA FORM 702-61-R-E, 16 March 2016 702-CQD-E 61 8 Jan 2025(CN 3)
4. AUTHORITY: DI-NDTI-80809B
5. CONTRACT REFERENCE: First Article Clause
6. REQUIRING OFFICE: TAWV-CQD-C CQD-E
7. DD250 REQUIRED: *See Block 16
8. APP CODE:
9. DISTRIBUTION STATEMENT REQUIRED: B Test and Evaluation
10. FREQUENCY: ONE/P
11. AS OF DATE:
12. DATE OF FIRST SUBMISSION: With First Article
13. DATE OF SUBSEQUENT SUBMISSIONS: With First Article
14. DISTRIBUTION:
A. ADDRESSEES: As specified in contract or purchase order
B. COPIES:
DRAFT: 0
FINAL: 1
15. TOTAL: 1
16. REMARKS: Delete paragraph 10.2 of referenced DID (Block 4). Submit WVA Form 702-61-R-E showing results of inspections. Also submit DD Form 1222. Computerized versions of these forms may be used with prior approval of the procuring office. See QAP-APPX-WVA paragraph 10 for requirements. * Inspection/acceptance requirements specified in the contract. Data Item Description (DID) referenced in block 4 can be accessed at:
http//assist.daps.mil.
17. PRICE GROUP:
18. ESTIMATED TOTAL PRICE:
G. PREPARED BY: J Cannon H. DATE: 3 Mar 2025 I. APPROVED BY: William Potter, TAWV-CQD-E J. DATE: 3 March 2025
Public reporting burden for this collection of information is estimated to average 440 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 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.: 0001 & 0002
B. EXHIBIT A
C. CATEGORY
D. SYSTEM/ITEM
E. CONTRACT/PR NO.:
F. CONTRACTOR
1. DATA ITEM NO: A002
2. TITLE OF DATA ITEM: Certification/Data Report
3. SUBTITLE: Certificate of Conformance (COC), General Application (CN 5)
4. AUTHORITY: DI-MISC-80678
5. CONTRACT REFERENCE: QAP-APPX-WVA and specific drawing requirement
6. REQUIRING OFFICE: TAWV-CQD-E
7. DD250 REQUIRED: No
8. APP CODE:
9. DISTRIBUTION STATEMENT REQUIRED: B Test and Evaluation
10. FREQUENCY: With Each Submission
11. AS OF DATE:
12. DATE OF FIRST SUBMISSION: With First Shipment
13. DATE OF SUBSEQUENT SUBMISSIONS: With Each Shipment
14. DISTRIBUTION:
A. ADDRESSEES: DEPARTMENT OF THE ARMY, Attn: TAWV-CQD-E Bldg. 35-E, Watervliet Arsenal, 1 Buffington Street, Watervliet NY 12189-4000
B. COPIES:
DRAFT: 0
FINAL: 1
15. TOTAL: 1
16. REMARKS: Delete paragraph 10.3, 10.4 of referenced DID (Block 4). See QAP-APPX-WVA paragraph 4.6 for the general requirement. The COC will also contain specific reference to any appropriate material, fabrication method or heat treat process characteristic. Data Item Description (DID) referenced in block 4 can be accessed at:
http//assist.daps.mil.
17. PRICE GROUP:
18. ESTIMATED TOTAL PRICE:
G. PREPARED BY: J Cannon H. DATE: 3 Mar 2025
J. DATE: 3 March 3, 2025
Public reporting burden for this collection of information is estimated to average 440 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 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.: 0001 & 0002
B. EXHIBIT A
C. CATEGORY
D. SYSTEM/ITEM
E. CONTRACT/PR NO.:
F. CONTRACTOR
1. DATA ITEM NO: A003
2. TITLE OF DATA ITEM: Test/Inspection Report
3. SUBTITLE: Inspection Records, Production Components (CN12)
4. AUTHORITY: DI-NDTI-80809B
5. CONTRACT REFERENCE: QAP-APPX-WVA
6. REQUIRING OFFICE: TAWV-CQD-E
7. DD250 REQUIRED: No
8. APP CODE:
9. DISTRIBUTION STATEMENT REQUIRED: B Test and Evaluation
10. FREQUENCY: With Each Submission
11. AS OF DATE:
12. DATE OF FIRST SUBMISSION: With First Shipment
13. DATE OF SUBSEQUENT SUBMISSIONS: With Each Shipment
14. DISTRIBUTION:
A. ADDRESSEES: DEPARTMENT OF THE ARMY, Attn: TAWV-CQD-E Bldg. 35-E, Watervliet Arsenal, 1 Buffington Street, Watervliet NY 12189-4000
B. COPIES:
DRAFT: 0
FINAL: 1
15. TOTAL: 1
16. REMARKS: Delete paragraph 10.2 through 10.2.8 of referenced DID (Block 4).
Submit all records for production components. See QAP-APPX-WVA paragraph 4.2 and 4.5 for the requirement.
Data Item Description (DID) referenced in block 4 can be accessed at: http//assist.daps.mil.
17. PRICE GROUP:
18. ESTIMATED TOTAL PRICE:
G. PREPARED BY: J. Cannon H. DATE: March 3, 2025
J. DATE: March 3, 2025
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