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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 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

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

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: A001 title: TEST PROCEDURE sub: TEST AND INSPECTION REPORT auth: DI-NDTI-80603A ref: SOW Para. 5 req_ofc: NSWC CORONA DIVISION dd250: LT appcode: N/A dist: A freq: SEE BLK 16 asof: N/A firstsub: SEE BLK 16 subsub: SEE BLK 16 addressee1: Eric Schreiner, MS24 draft1: 1 reg1: 1 repro1:

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BLK 4/5: DI-NDTI-80603A and SOW specification paragraph 5.0 shall be used as guidance and are provided for reference. Information items in DI-NDTI-80603A that are not relevant to the procurement do not need to be included in format.

BLK 10, 12, 13: Frequency of TEST/INSPECTION REPORT (CDRL A001 subtitle) shall be generated 30 days prior to Acceptance Testing.

BLK 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.

group:

total_price:

prep_name:

line_item: A001 exhibit: E xtdp: Off xtm: Off othercat: NDTI system: FIBER OPTIC SPLITTERS ctr_no: N64267-22-R-0002 contr:

remarksb: Eric Schreiner, Code MS24 1999 Fourth Street Norco, CA 92860-5000 Phone: (951) 393-5032 Email: eric.schreinder@navy.mil

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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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A002 title: FIRST ARTICLE INSPECTION REPORT sub: FIRST ARTICLE INSPECTION REPORT auth: DI-NDTI-80809B ref: SOW Para. 5 req_ofc: NSWC CORONA DIVISION dd250: LT appcode: N/A dist: A freq: SEE BLK 16 asof: N/A firstsub: SEE BLK 16 subsub: SEE BLK 16 addressee1: Eric Schreiner, MS24 draft1: 1 reg1: 1 repro1:

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BLK 4/5: DI-NDTI-80809B and SOW specification paragraph 5.0 shall be used as guidance and are provided for reference. Information items in DI-NDTI-80809B that are not relevant to the procurement do not need to be included in format.

BLK 10, 12, 13: Frequency of First Article Inspection Report (CDRL A002 subtitle) shall be generated 30 days after First Article Inspection event.

BLK 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.

group:

total_price:

prep_name:

line_item: A002 exhibit: E xtdp: Off xtm: Off othercat: NDTI system: FIBER OPTIC SPLITTERS ctr_no: N64267-22-R-0002 contr:

remarksb: Eric Schreiner, Code MS24 1999 Fourth Street Norco, CA 92860-5000 Phone: (951) 393-5032 Email: eric.schreinder@navy.mil

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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 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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A003 title: TEST/INSPECTION REPORT sub: PROCUREMENT ACTIVITY QUALIFICATION TEST REPORT auth: DI-NDTI-80809B ref: SOW Para. 5 req_ofc: NSWC CORONA DIVISION dd250: LT appcode: N/A dist: A freq: SEE BLK 16 asof: N/A firstsub: SEE BLK 16 subsub: SEE BLK 16 addressee1: Eric Schreiner, MS24 draft1: 1 reg1: 1 repro1:

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BLK 4/5: DI-NDTI-80809B and SOW specification paragraph 5.0 shall be used as guidance and are provided for reference. Information items in DI-NDTI-80809B that are not relevant to the procurement do not need to be included in format.

BLK 10, 12, 13: Procurement Activity Qualification (PAQ) Test Report (CDRL A003 subtitle) shall be generated 30 days after Procurement Activitity Qualification (PAQ) event.

BLK 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.

group:

total_price:

prep_name:

line_item: A003 exhibit: E xtdp: Off xtm: Off othercat: NDTI system: FIBER OPTIC SPLITTERS ctr_no: N64267-22-R-0002 contr:

remarksb: Eric Schreiner, Code MS24 1999 Fourth Street Norco, CA 92860-5000 Phone: (951) 393-5032 Email: eric.schreiner@navy.mil

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DATA ITEM DESCRIPTION

Title: Test Procedure

Number: DI-NDTI-80603A Approval Date: 14 Nov 2006 AMSC Number: 7637 Limitation: N/A DTIC Applicable: N/A GIDEP Applicable: None Office of Primary Responsibility: NS/DA023 Applicable Forms: N/A

Use/relationship:

The test procedure identifies the step-by-step testing operations to be preformed on items under going developmental, qualification, or acceptance testing. It identifies items to be tested, the test equipment and support required, the test conditions to be imposed, the parameters to be measured, and the pass/fail criteria against which the test results will be measured. The document is a compilation of individual test procedures for related elements of a system, subsystem, or equipment.

This Data Item Description (DID) contains the format and content preparation instructions for each tech data product generated by the specific and discrete task requirement as delineated in the contract.

This DID is applicable to contracts requiring tests to be preformed for the purpose of developmental or environmental evaluation, acceptance testing, and item qualification testing.

This DID supersede DI-NDTI-80603.

Requirements:

1. Reference documents: None

2. Format: The test procedures shall be in contractor’s format on 8 ½ x 11 inch paper. It shall be bound in such a manner that pages may be removed or inserted without damage or mutilation.

3. Content: The test procedure shall contain the following:

3.1 Front matter.

3.1.1 Cover and title page. The following information shall be included on the cover and title page:

Downloaded from http://www.everyspec.com

DI-NDTI-80603A

a. Date of issue.

b. Revision date (if applicable)

c. Procedure document identification number

d. Contract number

e. Contractor’s name and address

f. Type of procedure. Including purpose(e.g., first article test, developmental

Evaluation, qualification, environmental(specify), acceptance, or other)

g. Identification of the system, subsystem, or equipment to be tested.

h. Security classification (if applicable)

3.1.2 Record of changes. A record of change pages shall be included to provide for tracking of changes to the test procedures.

3.1.3 Table of contents. A table of contents is required when more that one test procedure is included in the test procedures document. It shall identify the page location of each procedure number, procedure title, and related equipment nomenclature.

3.2 Body of document. For each test procedure, the following information is required.

3.2.1 Procedure number. Each procedure shall have a unique number assigned to it.

3.2.2 Title of procedure. The title should relate to the purpose of the test.

3.2.3 Introduction. The following shall be addressed in the introduction:

3.2.3.1 Purpose of test. (As specified in the contract tasking document).

3.2.3.2 System, subsystem, or equipment to be tested. The following identification shall be provided.

a. Nomenclature

b. Model or part number

c. Type of test item(prototype, production item, laboratory model, etc)

d. Applicable specification

3.2.3.3 Test requirements. Included the following, each related to the prescribing contract requirement paragraph(specification, standard, plan, or work statement)

a. Required tests, and parameters to be measured.

b. Performance requirements, acceptance of compliance limits, and

Environmental criteria.

3.2.3.4 Referenced documents. A list by title, number, date, and source of those documents cited in the test procedure.

3.2.4 Required test equipment. Includes the following for each piece of test equipment required to perform the procedure:

a. Nomenclature

b. Use of test equipment

c. Model number(if applicable)

d. Manufacturer(if mandatory)

e. Accuracy and calibration requirements

f. Range or spectrum of measurements required

3.2.5 Table of tests. This table lists each test performed under the procedure in the sequence it is to be performed., identified to the procedure paragraph and the related specification/contract requirement.

3.2.6 Step-by-step procedure. The following shall be included for each step of the test procedure:

a. Test set-up diagrams, including test equipment connections.

b. Input and output instrumentation points.

c. Test item operating limits and test conditions to be imposed.

d. Performance parameters to be measured.

e. Step-by-step operations to obtain the required data.

f. Caution and safety warnings as appropriate.

3.2.7 Data sheets. Data sheets shall be included with the procedure, or be separately attached at the end of all procedures. They shall provide for:

a. Identification of item tested, including model and serial numbers.

b. Recording of test measurements

c. Identification of required or objective performance values, with

Tolerances.

d. Identification of applicable procedure paragraphs.

e. Date of test.

f. Signature of technician or inspector performing the tests/\.

3.2.8 Support requirements. Any special support requirement would be included in this section, such as:

a. Use of special facilities or test ranges.

b. Personnel requirements (numbers, types, qualifications).

c. Unusual electrical, hydraulic, pneumatic, etc, requirements

d. Support equipment requirements.

4. END OF DI-NDTI-80603A

DATA ITEM DESCRIPTION I Form Approved OMB No.0704.0188

1.nTLE 2.IOENTIFICATIONNUMBER

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

L OESCRIPTlOtVPURPOSE

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

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

(YVMMOD)

F/AFMC-DCJP

970124

,.APPLlCAT\0NflNTER7iElAT10NSH1P

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

I as delineated in the contract.

I

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

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

1.APPROVALLIMITATION 9a.APPLICABLEFORMS 9b.AMSCNUMBER

F7231

10,PREPARATIONlNSTRUCnONS

10.1 Format. Contractor format is acceptable.

paragraph 10.2 and its subparagraphs in a manner understanding

10.2 CQnL!aL. The test/inspection report shall

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

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

a. Report date.

b. Report number (contractor or government)

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

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

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

9. Date or period of test/inspection.

h. Name and address of requiring government activity.

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

(Continued on page 2 )

1.DIS77UBUTIONSTATEMEW

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

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

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DI-NDTI-80809B

Block 10, Preparation Instructions (continued)

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

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

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

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

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

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

a. Nomenclature.

b. National stock number.

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

e. Serial or lot number.

f. Applicable engineering changes

9. Production item specification, if applicable.

h. Date of manufacture.

10.2 .3.3 Complete inspection requirements correlated to contractual

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

10.2.4 ~. Complete test/inspection report identification of the testl requirements including the compliance limits, and summary including the

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

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

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

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

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

a. Prior testf inspection reports on the same item.

b. Test /inspection plans and procedure documents

c. Prior certifications of compliance.

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

e. Input parameters used.

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

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

10 .2.6.1 KzZL_ + de.tlflca~.

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

a.

b.

c.

d.

e.

f.

9.

10. 2.6.2

Nomenclature.

Model number.

Serial number.

Manufacturer.

Calibration status.

Accuracy data.

Comments, if applicable.

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

a. Location or orientation of the item.

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

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

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

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

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

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

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

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

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

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

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

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

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

Calculation examples.

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

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

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

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

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

d. The need for item redesign or further development.

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

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

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

a b.

c.

d.

e.

f.

9.

h.

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

Redesign required.

Problem resolution.

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

Documentation changes required.

Testing/ inspection improvements

10.2.7 The following certifications shall be included, .as

applicable:

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

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

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

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

10.2.8 Appendices shall be used to append detailed

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

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