Exhibit_A-E_06June2025.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

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 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

A/B/C/D/E

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

UH-1N HELICOPTER

E. CONTRACT / PR NO.

FD20602600008

F. CONTRACTOR

1. DATA ITEM NO.

A/B/C/D/E 001

2. TITLE OF DATA ITEM

Government Property (GP) Inventory Report

3. SUBTITLE

Government Property Inventory Report

4. AUTHORITY

DI-MGMT-80441D

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 3.4

6. REQUIRING OFFICE

411 SCMS/GULA

7. DD 250 REQ

LT

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

A

10. FREQUENCY

ANNLY

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Collins, Corey LNAME: 05 JUN 2025DATE:

CLIN Exhibit Data Item No Performance Period 0003 A A001 Base Year Period 1003 B B001 Ordering Period 1 2003 C C001 Ordering Period 2 3003 D D001 Ordering Period 3 4003 E E001 Ordering Period 4

BLK 4: The 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. See Data Item Description at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: Enter the applicable code as listed in DOD 5010.12-M, Chapter 3. (Enter LT for Letter of Transmittal if not separately priced or DD if separately priced). WAWF E-DD FORM 250 shall be required for separately priced data.

EDD FORM 250 shall be submitted to FA8524 Program Manager (PM/ and Supply Planner (SP) EMAIL ADDRESS) for acceptance.

BLK 8: Approval (written) is not required. However, the data item will be reviewed and accepted/rejected, based on its conforming to the requirements of the DID, and within the review time specified in Block 16, items 10-13.

BLK 9: "A" Approved for Public Release; distribution is unlimited.

BLKS 10-13: The annual physical inventory report shall be provided within seven (7) calendar days of the end of each option/ordering period for the contract. The data is representative of the Contractor's Internal Property Control System and shall be current as of the last day of the option/ordering reporting period. If requested outside of an annual cadence, the data shall be current as of the date requested.

BLK 14: EMAIL electronic Annual Physical Inventory Report to the Supply Planner (SP) and Program Manager (PM).

Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in Microsoft Office Excel format for all reports.

COORDINATORS:

Email:

411 SCMS Supply Planner SP Provided on Contract Award

0 1 0

Email:

411 SCMS/GULBA Program Manager (PM) PM email provided on Contract Award

0 1 0

0 2 015. TOTAL

G. PREPARED BY

Collins, Corey L

411 SCMS / GULBB

478-472-9645

H. DATE

06 JUN 2025

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Palumbo, Lindsay J

411 SCMS / GULBA 478-327-2774 / 497-2774

J. DATE

06-JUN-25

Page 1 of 9DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 10 Jun 2025

PREVIOUS EDITION MAY BE USED.

0003/1003/2003/3003/4003

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A/B/C/D/E

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

UH-1N HELICOPTER

E. CONTRACT / PR NO.

FD20602600008

F. CONTRACTOR

1. DATA ITEM NO.

A/B/C/D/E 002

2. TITLE OF DATA ITEM

Item Unique Identification (IUID) Marking Plan

3. SUBTITLE

Item Unique Identification

4. AUTHORITY

DI-MGMT-81803A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.4.4.2.3

6. REQUIRING OFFICE

411 SCMS/GULAB

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

QRTLY

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Collins, Corey LNAME: 05 JUN 2025DATE:

CLIN Exhibit Data Item No Performance Period 0003 A A002 Base Year Period 1003 B B002 Ordering Period 1 2003 C C002 Ordering Period 2 3003 D D002 Ordering Period 3 4003 E E002 Ordering Period 4

BLK 9: "C" Distribution authorized to U.S. Government Agencies and their contractors (Administrative or Operational Use, 28 April 16) Other requests shall be referred to the contract management team, AFSCC/PZAAA 460 Richard Ray BLvd, Suite 221, Robins AFB, GA 31098

BLKS 10-13: The contractor shall submit a complete IUID Marking Plan within 30 calendar days after contract award.

The Government will review and determine acceptance or rejection and notify contractor within 10 calendar days of receipt. If rejected, the contractor shall have 10 calendar days to correct any error and return a corrected IUID Marking Plan to the Government for review.

BLK 7, 14: Forward one electronic copy in PDF format to the following email address:

Program Manager: Rebekah Banks(E-mail: rebekah.banks@us.af.mil) Engineer: Coby Giddens(E-mail: coby.giddens.1@us.af.mil)

COORDINATORS:

Email:

411 SCMS/GULAB Program Manager (PM)/COR Provided on Contract Award

1 1 0

Email:

AFLCMC/WIUEC Engineer Coby Giddens at coby.giddens.1@us.af.mil

1 1 0

Email:

AFSC/PZAAA Contracting Officer (PCO) Provided on Contract Award

0 1 0

Email: DCMA/ACO 0 1 0

2 4 015. TOTAL

G. PREPARED BY

Collins, Corey L

411 SCMS / GULBB

478-472-9645

H. DATE

06 JUN 2025

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Palumbo, Lindsay J

411 SCMS / GULBA 478-327-2774 / 497-2774

J. DATE

06-JUN-25

Page 2 of 9DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 10 Jun 2025

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A/B/C/D/E

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

UH-1N HELICOPTER

E. CONTRACT / PR NO.

FD20602600008

F. CONTRACTOR

1. DATA ITEM NO.

A/B/C/D/E 003

2. TITLE OF DATA ITEM

Item Unique Identification (IUID) Marking Activity, Validation, and Verification Report

3. SUBTITLE

IUID Marking Activity and Verification Report

4. AUTHORITY

DI-MGMT-81804A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.4.4.2.4

6. REQUIRING OFFICE

DI-MGMT-81804A

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

QRTLY

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Collins, Corey LNAME: 05 JUN 2025DATE:

CLIN Exhibit Data Item No Performance Period 0003 A A003 Base Year Period 1003 B B003 Ordering Period 1 2003 C C003 Ordering Period 2 3003 D D003 Ordering Period 3 4003 E E003 Ordering Period 4

BLK 4: : IUID Marking Activity and Verification Report can be combined with the monthly status report.

BLK 7: Applicable code as listed in DOD 5010.12-M, Chapter 3. (LT for Letter of Transmittal if not separately priced or DD if separately priced) WAWF E-DD FORM 250 shall be required for separately priced data. E-DD FORM 250 shall be submitted to FA8524 (PM EMAIL ADDRESS) for acceptance.

BLK 8: Approval (written) is not required. However, the data item will be reviewed and accepted/rejected based on its conforming to the requirements of the DID, and within the review time specified in Block 16, items 10-12.

BLK 9: "C" Distribution authorized to U.S. Government Agencies and their contractors (Administrative or Operational Use,28 April 16) Other requests shall be referred to the contract management team, AFSCC/PZAAA 460 Richard Ray BLVD, Suite 221, Robins AFB, GA 31098

BLKS 10-13: Contractor shall submit an IUID Marking Activity and Verification Report to the Engineer AFLCMC/WIUEE, every three months (quarterly). Written Government acceptance/comments/rejection will be within 10 working days after receipt of Plan from the Contractor. Contractor final submission shall be submitted within 10 working days of receiving Government comments. Acceptance by the Government is required prior to formal distribution

Procuring Contract Officer (PCO) Leigh Ann Taylor (E-mail leigh.taylor.3@us.af.mil) Program Manager (PM) Rebekah Banks (E-mail rebekah.banks@us.af.mil) Engineer Andrew Bailey (E-mail andrew.bailey.28@us.af.mil)

COORDINATORS:

Email:

411 SCMS/GULAB Program Manager (PM)/COR Provided on Contract Award

1 1 0

Email:

AFLCMC/WIUEE Engineer

1 1 0

Email:

AFSC/PZAAA Contracting Officer (PCO) Provided on Contract Award

1 1 0

Email:

DCMA/ACO

0 1 0

3 4 015. TOTAL

G. PREPARED BY

Collins, Corey L

411 SCMS / GULBB

478-472-9645

H. DATE

06 JUN 2025

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Palumbo, Lindsay J

411 SCMS / GULBA 478-327-2774 / 497-2774

J. DATE

06-JUN-25

Page 3 of 9DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 10 Jun 2025

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A/B/C/D/E

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

UH-1N HELICOPTER

E. CONTRACT / PR NO.

FD20602600008

F. CONTRACTOR

1. DATA ITEM NO.

A/B/C/D/E 004

2. TITLE OF DATA ITEM

Commercial Asset Visibility (CAV) Reporting

3. SUBTITLE

CAV AF

4. AUTHORITY

DI-MGMT-81838

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.6

6. REQUIRING OFFICE

411 SCMS/GULA

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

A

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Collins, Corey LNAME: 05 JUN 2025DATE:

CLIN Exhibit Data Item No Performance Period 0003 A A004 Base Year Period 1003 B B004 Ordering Period 1 2003 C C004 Ordering Period 2 3003 D D004 Ordering Period 3 4003 E E004 Ordering Period 4

BLK 1. The contractor shall report End Item transactional data through electronic submission in CAV AF using the CAV AF web site or CICA XML IAW the referenced DID IAW and/or CAV AF CFM Reporting Requirements. This information will be accessed by the program office SP and by 420 SCMS/GUNAB-Robins in order to ascertain production status.

BLK 2. Transactions and data will be submitted by the contractor daily IAW CAV AF User Guide, Version 8.0.1 or higher.

The Contractor shall obtain a valid DOD PKI certificate to log into CAV AF. Each user shall be required to have an:

Identity Certificate only; an encryption certificate is not required.

BLK 3. Training will be provided by 420 SCMS/GUNAB-Robins, (478) 327-6603 or 6602 if required and a request must be initiated by the CAV Reporter

BLK 4. This DD Form 1423-1 applies to Contractor Furnished Materiel (CFM) type contracts.

BLK 7: Enter the applicable code as listed in DOD 5010.12-M, Chapter 3. (Enter LT for Letter of Transmittal if not separately priced or DD if separately priced.) E-DD FORM 250 shall be submitted to DCMA for acceptance.

BLK 10:

a. Contractor reporting requirements to CAV AF shall be accomplished daily and/or within 24 hours of a supply or maintenance action occurrence IAW Contractor Users Guide.

b. The method of communication from the contractor to the funding base will be mechanized using the CAV AF Online web site IAW CAV AF Contractor Users Guide.

BLK 11: Data shall be current within 24 hours of last End Item maintenance occurrence.

BLK 12: Date of first submission shall be within 24 hours following a supply or maintenance transaction after the contract award date and government training as specified in IAW CAV AF Users Guide.

BLK 13: Same as remarks regarding Block 10 above.

COORDINATORS:

Email:

411 SCMS Supply Planner SP Provided on Contract Award

0 1 0

Email:

411 SCMS/GULAB Program Manager (PM)/COR Provided on Contract Award

0 1 0

0 2 015. TOTAL

Page 4 of 9DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 10 Jun 2025

G. PREPARED BY

Collins, Corey L

411 SCMS / GULBB

478-472-9645

H. DATE

06 JUN 2025

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Palumbo, Lindsay J

411 SCMS / GULBA 478-327-2774 / 497-2774

J. DATE

06-JUN-25

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A/B/C/D/E

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

UH-1N HELICOPTER

E. CONTRACT / PR NO.

FD20602600008

F. CONTRACTOR

1. DATA ITEM NO.

A/B/C/D/E 005

2. TITLE OF DATA ITEM

Contract Depot Maintenance (CDM) Monthly Production Report

3. SUBTITLE

Production Report

4. AUTHORITY

DI-PSSS-81995A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.7

6. REQUIRING OFFICE

411 SCMS/GULAA

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

A

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Collins, Corey LNAME: 05 JUN 2025DATE:

CLIN Exhibit Data Item No Performance Period 0003 A A005 Base Year Period 1003 B B005 Ordering Period 1 2003 C C005 Ordering Period 2 3003 D D005 Ordering Period 3 4003 E E005 Ordering Period 4

BLK 4: The Data Item Description (DID) contains the format, content and preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract. This report shall be provided in the format of Table 1. See DID for Table 1 and content requirement explanations at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: WAWF E-DD FORM 250 shall be required for separately priced data. E-DD FORM 250 shall be submitted to FA8524 (PMS EMAIL ADDRESS) for acceptance.

BLK 8: Approval (written) is not required. However, the data item will be reviewed and accepted/rejected, based on its conforming to the requirements of the DID, and within the review time specified in Block 16.

BLK 9: "A" Approved for Public Release; distribution is unlimited.

BLKS 10- 13: Report shall be submitted NLT the 10th calendar day after the end of the month being reported.

BLK 14: EMAIL electronic Contract Depot Maintenance Production Report to the Production Management Specialist (PMS) and Program Manager (PM). Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

COORDINATORS:

Email:

411 SCMS/GULAB Program Manager (PM)/COR Provided on Contract Award

0 1 0

Email:

411 SMS/PMS

WORKFLOW@411SCMS@4

11SCMS.PMS@US.AF.MIL

If PMS email not provided

0 1 0

0 2 015. TOTAL

G. PREPARED BY

Collins, Corey L

411 SCMS / GULBB

478-472-9645

H. DATE

06 JUN 2025

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Palumbo, Lindsay J

411 SCMS / GULBA 478-327-2774 / 497-2774

J. DATE

06-JUN-25

Page 5 of 9DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 10 Jun 2025

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A/B/C/D/E

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

UH-1N HELICOPTER

E. CONTRACT / PR NO.

FD20602600008

F. CONTRACTOR

1. DATA ITEM NO.

A/B/C/D/E 006

2. TITLE OF DATA ITEM

First Article Test/Inspection Procedures and Report

(FAT/IPP)

3. SUBTITLE

FA Report

4. AUTHORITY

DI-NDTI-82326

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.10

6. REQUIRING OFFICE

411 SCMC/GULB

7. DD 250 REQ

DD

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Collins, Corey LNAME: 05 JUN 2025DATE:

CLIN Exhibit Data Item No Performance Period 0003 A A006 Base Year Period 1003 B B006 Ordering Period 1 2003 C C006 Ordering Period 2 3003 D D006 Ordering Period 3 4003 E E006 Ordering Period 4

BLK 10: The contractor shall submit the approved Test Report one time.

BLK 11: Once functional testing has been completed on the newly built First Articles (FA).

BLK 12: Contractor will deliver a First Article (FA) Test Report in accordance with the approved FA Test Plan (A004) prepared by the Contractor within 30 calendar days after functional testing is completed. WIUED Engineering will have 20 calendar days to review the FA Test Report and provide a disposition for either acceptance or rejection.

BLK 14: EMAIL one (1) electronic copy of the First Article Test Report to the following list: Program Manager (PM), Engineer and Equipment Specialist (ES). Points of contact will be provided to the Contractor at contract award and below. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

COORDINATORS:

Email:

411 SCMS/GULAB Program Manager Rebekah Banks, rebekah.banks@us.af.mil

0 1 0

Email:

AFLCMC/WIUED Engineer Traci Polk, traci.polk@us.af.mil

0 1 0

Email:

WIUED Engineer Coby Giddens, coby.giddens.1@us.af.mil

0 1 0

0 3 015. TOTAL

G. PREPARED BY

Collins, Corey L

411 SCMS / GULBB

478-472-9645

H. DATE

06 JUN 2025

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Palumbo, Lindsay J

411 SCMS / GULBA 478-327-2774 / 497-2774

J. DATE

06-JUN-25

Page 6 of 9DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 10 Jun 2025

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A/B/C/D/E

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

UH-1N HELICOPTER

E. CONTRACT / PR NO.

FD20602600008

F. CONTRACTOR

1. DATA ITEM NO.

A/B/C/D/E 007

2. TITLE OF DATA ITEM

First Article Test/Inspections Procedures and Plan (FAT/IPP)

3. SUBTITLE

FA Plan

4. AUTHORITY

DI-NDTI-82327

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.10.1

6. REQUIRING OFFICE

411 SCMS/GULB

7. DD 250 REQ

DD

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Collins, Corey LNAME: 05 JUN 2025DATE:

CLIN Exhibit Data Item No Performance Period 0003 A A007 Base Year Period 1003 B B007 Ordering Period 1 2003 C C007 Ordering Period 2 3003 D D007 Ordering Period 3 4003 E E007 Ordering Period 4

BLKS 10-13: Contractor shall submit the Test Plan to support the first article testing requirement performed by the Contractor within 30 calendar days after contract award.

Written Government acceptance/comments/rejection will be within 20 working days after receipt of Plan from the Contractor. If rejected, the Contractor will have 20 workings days to revise and return to the Government. Contractor final submission shall be submitted within 20 working days of receiving Government comments. Acceptance by the Government is required prior to formal distribution.

BLK 14. EMAIL one (1) electronic Test Plan to the following list: Program Manager (PM) and Engineer. Points of contact will be provided to the Contractor at contract award and below. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

COORDINATORS:

Email:

411 SCMS/GULAB Program Manager Rebekah Banks, rebekah.banks@us.af.mil

0 1 0

Email:

AFLCMC/WIUED Engineer Traci Polk, traci.polk@us.af.mil

0 1 0

Email:

WIUED Engineer Coby Giddens coby.giddens.1@us.af.mil

0 1 0

0 3 015. TOTAL

G. PREPARED BY

Collins, Corey L

411 SCMS / GULBB

478-472-9645

H. DATE

06 JUN 2025

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Palumbo, Lindsay J

411 SCMS / GULBA 478-327-2774 / 497-2774

J. DATE

06-JUN-25

Page 7 of 9DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 10 Jun 2025

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A/B/C/D/E

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

UH-1N HELICOPTER

E. CONTRACT / PR NO.

FD20602600008

F. CONTRACTOR

1. DATA ITEM NO.

A/B/C/D/E 008

2. TITLE OF DATA ITEM

Government Industry Data Exchange Program (GIDEP) Alert/Safe Alert Report

3. SUBTITLE

GIDEP Report

4. AUTHORITY

DI-QCIC-80125B

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.11

6. REQUIRING OFFICE

411 SCMS/GULAB

7. DD 250 REQ

LT

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

See Block 16

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Collins, Corey LNAME: 05 JUN 2025DATE:

CLIN Exhibit Data Item No Performance Period 0003 A A008 Base Year Period 1003 B B008 Ordering Period 1 2003 C C008 Ordering Period 2 3003 D D008 Ordering Period 3 4003 E E008 Ordering Period 4

BLK 4: The 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. The Alert/Safe Alert Report can be tailored to contractor format, but shall contain all data specified on DD Form 1938 electronic template in accordance with instructions cited on back side of the form and or the guidance of S0300-BT-PRO-010, Chapter 7. See Data Item Description at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: Enter the applicable code as listed in DOD 5010.12-M, Chapter 3. (Enter LT for Letter of Transmittal if not separately priced or DD if separately priced) WAWF E-DD FORM 250 shall be required for separately priced data.

EDD FORM 250 shall be submitted to FA8524 Program Manager for acceptance.

BLK 9: "A" Approved for Public Release; distribution is unlimited.

BLKS 10-13: Report shall be submitted to arrive NLT 10th calendar day after the end of the month to notify the Government of non-conforming items, supplies, and services or safety problems which have adversely impacted or have the potential to adversely impact the program during the duration of the contract.

BLK 14: EMAIL electronic GIDEP Report to Program Manager (PM) Rebekah Banks (E-mail rebekah.banks@us.af.mil)and Engineer Coby Giddens (E-mail coby.giddens.1@us.af.mil).

Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

COORDINATORS:

Email:

411 SCMS/GULAA Program Manager (PM) Provided on Contract Award

0 1 0

GIDEP

PO BOX 8000

Corona, CA 92878-8000

0 1 0

0 2 015. TOTAL

G. PREPARED BY

Collins, Corey L

411 SCMS / GULBB

478-472-9645

H. DATE

06 JUN 2025

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Palumbo, Lindsay J

411 SCMS / GULBA 478-327-2774 / 497-2774

J. DATE

06-JUN-25

Page 8 of 9DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 10 Jun 2025

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A/B/C/D/E

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

UH-1N HELICOPTER

E. CONTRACT / PR NO.

FD20602600008

F. CONTRACTOR

1. DATA ITEM NO.

A/B/C/D/E 009

2. TITLE OF DATA ITEM

Accident/Incident Report

3. SUBTITLE

Accident/Incident Report/Mishap Notification

4. AUTHORITY

DI-SAFT-81563

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 5.5.2

6. REQUIRING OFFICE

ABW/SE

7. DD 250 REQ

N/A

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

B

10. FREQUENCY

ASREQ

11. AS OF DATE

ASREQ

12. DATE OF FIRST

SUBMISSION

ASREQ

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Collins, Corey LNAME: 05 JUN 2025DATE:

CLIN Exhibit Data Item No Performance Period 0003 A A009 Base Year Period 1003 B B009 Ordering Period 1 2003 C C009 Ordering Period 2 3003 D D009 Ordering Period 3 4003 E E009 Ordering Period 4

NOTE: Changes to office symbols and/or e-mail addresses, when necessary, shall be made by letter through the Government CO/ACO without further revision to this CDRL.

BLK 10: IAW AFI 91-204, if damage occurs

BLK 11: Once assets have been received after contract award

BLK 12: 24 hours after accident/incident

BLK 13: As needed, IAW AFI 91-207

Program Manager: Rebekah Banks (E-mail rebekah.banks@us.af.mil) ENG: Coby Giddens (E-mail coby.giddens.1@us.af.mil)

COORDINATORS:

ABW/SE MISHAP

REPORTING

78abw.se.mishap@us.af.mil

0 1 0

CONTRACT OFFICER

REPRESETITIVE (COR)

@ rebekah.banks@us.af.mil

1 1 0

Procurement Contract Office @ leigh.taylor.3@us.af.mil

0 1 0

1 3 015. TOTAL

G. PREPARED BY

Collins, Corey L

411 SCMS / GULBB

478-472-9645

H. DATE

06 JUN 2025

I. APPROVED BY

//ELECTRONICALLY SIGNED//

Palumbo, Lindsay J

411 SCMS / GULBA 478-327-2774 / 497-2774

J. DATE

06-JUN-25

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