Exhibit A - W15QKN-21-R-0106.pdf

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DD FORM 1423-1, FEB 2001 PREVIOUS EDITIONS MAY BE USED Page____of____

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

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 9. DIST STATEMENT REQ’D 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13.13. DATE OF SUBSEQUENT SUBMISSION

Draft Final

Reg Repro

16. REMARKS

15. TOTAL

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

1 DATA ITEM NO: A012

2 TITLE OF DATA ITEM: Acceptance Description Sheets (ADS)

3 SUBTITLE:

5 CONTRACT REFERENCE: SOW Paragraph 3.6

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: Block 16

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: Block 16 a ADDRESSEERow1: FCDD-ACE-QPB

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a ADDRESSEERow2: FCDD-ACE-QMB

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a ADDRESSEERow3: ACC-NJ-MC

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a ADDRESSEERow4: DCMA-QAR

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Reg15 TOTAL: 4

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H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 10: Submit with every Lot.

Blocks 12 & 13: Submission shall commence with the first deliverable lot and continue with each subsequent lot.

Must be IAW MIL STDs 1171A and 1168C.

Block 14: Propellant data sheet or Energetic description sheet shall be uploaded/input into the Worldwide Ammunition Repository Program (WARP) Description Sheets and Loading Authorizations module located on the Munitions History Program web site at https://mhpwarp.redstone.army.mil

Notification of upload shall be provided to the Government within five (5) calendar days. Contractor shall provide a Letter of Transmittal using electronic mail as notification that the Propellant Data Sheet or Energetic Description Sheet has been entered into the system.

The government will entertain requests for use of energetic or propellant materials manufactured more than five (5) years ago; however, such requests shall be submitted to the Contracting Officer, on a Request for Variation (RFV) in accordance with provisions of the contract.

2021-12-02T21:18:49-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:17:09-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-MGMT-81978

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.

1 DATA ITEM NO: A013

2 TITLE OF DATA ITEM: Ammunition Data Card

3 SUBTITLE:

5 CONTRACT REFERENCE: SOW Paragraph 3.7

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: Block 16

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

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a ADDRESSEERow2: FCDD-ACE-QMB

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a ADDRESSEERow3: ACC-NJ-MC

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a ADDRESSEERow4: DCMA-QAR

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Draft15 TOTAL:

Reg15 TOTAL: 4

Repro15 TOTAL:

H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 4: Tailored: Ammunition Data Cards (ADC's) must be prepared electronic submission must be accomplished by accessing the Worldwide Ammunition Data Card Repository Program (WARP) which is located on the Munitions History Program web site at https://mhp.redstone.army.mil/. ADC's must include procurement acquisition numbers for each applicable RFV, RFD, NOR and ECP with a brief description for each listed on the card. Every avenue shall be pursued to ensure an accurate ADC is produced with all appropriate documentation included.

The Contractor shall also upload all approved FAT/LAT testing reports (FAT/LAT data) in to the LATR module also located in the Munitions History Program web site at https://mhp.redstone.army.mil/ ADC's must include procurement acquisition numbers for each applicable RFV, RFD, NOR and ECP with a brief description for each listed on the card. Every avenue shall be pursued to ensure an accurate ADC is produced with all appropriate documentation included.

Block10: Submission must commence with the first deliverable lot and continue with each subsequent lot.

Block 12: Submit Draft ADC IAW MIL-STD-1168 to FCDD-ACE-QPB thirty (30) days prior to FAT or first production lot if FAT is not applicable, for approval.

BLK 14: Hard copies of each ADC shall be generated from WARP and accompany each lot and shall be signed and dated by the representative of the Government agency responsible for acceptance (GARA) Usually the DCMA QAR. Local DMCA shall send two (2) hard copies with shipments.

2021-12-02T21:19:13-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:18:03-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-MISC-80043B

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.

1 DATA ITEM NO: A014

2 TITLE OF DATA ITEM: Quality Program Plan (QPP)

3 SUBTITLE:

5 CONTRACT REFERENCE: SOW Paragraph 3.8.1

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

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a ADDRESSEERow2: FCDD-ACE-QMB

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a ADDRESSEERow3: ACC-NJ-MC

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Draft15 TOTAL:

Reg15 TOTAL: 4

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H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block12: Contractor shall submit a Quality Program Plan to meet government standard stated in ISO 9001 Quality management systems sixty (60) calendar days prior to production. The Contractor shall notify Contracting Officer of any changes within seven (7) calendar days of changes to the Manufacturing Plan.

Block 14: Submit electronically. Distribution list will be provided at post award.

2021-12-02T21:20:00-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:19:03-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-QCIC-81722

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.

1 DATA ITEM NO: A015

2 TITLE OF DATA ITEM: Technical Report - Study/Services

3 SUBTITLE: Material Certification

5 CONTRACT REFERENCE: SOW Paragraph 3.8.2

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

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H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 12: The Contractor shall provide a material certification with every shipment including FAT and LAT.

Block 14: Submit electronically. Distribution list will be provided at post award.

2021-12-02T21:20:30-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:27:19-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-MISC-80508

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.

1 DATA ITEM NO: A016

2 TITLE OF DATA ITEM: Management Plan

3 SUBTITLE: Process Capability, Control & Improvement (PCCI)

5 CONTRACT REFERENCE: SOW Paragraph 3.8.3

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: Block 16

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: Block 16 a ADDRESSEERow1: FCDD-ACE-QPB

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Draft15 TOTAL:

Reg15 TOTAL: 4

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H DATE: 18 November 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 12: The contractor shall establish and submit a Process Control Plan (PCP) and submit to government for review and acceptance thirty (30) calendar days prior FAT.

In the event of finding a noncompliance, a corrective action will be submitted to the Government.

Block 14: Submit electronically. Distribution list will be provided at post award.

2021-12-02T21:21:03-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:28:09-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-MGMT-80004A

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.

1 DATA ITEM NO: A017

2 TITLE OF DATA ITEM: Contractor's Progress and Status Report

3 SUBTITLE: Program Schedule

5 CONTRACT REFERENCE: SOW Paragraph 3.9.1

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: Monthly

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2: FCDD-ACE-QMB

DraftRow2:

RegRow2: 1

ReproRow2:

a ADDRESSEERow3: ACC-NJ-MC

DraftRow3:

RegRow3: 1

ReproRow3:

a ADDRESSEERow4: DCMA-QAR

DraftRow4:

RegRow4: 1

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

ReproRow6:

a ADDRESSEERow7:

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a ADDRESSEERow8:

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a ADDRESSEERow9:

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a ADDRESSEERow10:

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a ADDRESSEERow11:

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a ADDRESSEERow12:

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a ADDRESSEERow14:

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a ADDRESSEERow15:

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a ADDRESSEERow16:

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a ADDRESSEERow17:

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a ADDRESSEERow18:

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a ADDRESSEERow19:

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RegRow19:

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a ADDRESSEERow20:

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a ADDRESSEERow21:

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a ADDRESSEERow22:

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a ADDRESSEERow23:

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a ADDRESSEERow24:

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a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 4

Repro15 TOTAL:

H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block12: The Contractor shall provide the baseline schedule NLT Thirty (30) Calendar days after contact award for review at the post award kick-off meeting and provide an updated version thereafter on a monthly basis to the Government.

The contractor shall maintain an accurate schedule of events and recommend program schedules, including review and evaluation techniques, which provide for the earliest delivery schedule while at the same time satisfying requirements.

Block 14: Submit electronically. Distribution list will be provided at post award.

2021-12-02T21:21:43-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:30:22-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-MGMT-81928

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.

1 DATA ITEM NO: A018

2 TITLE OF DATA ITEM: Conference Agenda

3 SUBTITLE:

5 CONTRACT REFERENCE: SOW Paragraph 3.9.3

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2: FCDD-ACE-QMB

DraftRow2:

RegRow2: 1

ReproRow2:

a ADDRESSEERow3: ACC-NJ-MC

DraftRow3:

RegRow3: 1

ReproRow3:

a ADDRESSEERow4: DCMA-QAR

DraftRow4:

RegRow4: 1

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

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RegRow6:

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a ADDRESSEERow7:

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a ADDRESSEERow8:

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a ADDRESSEERow9:

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a ADDRESSEERow10:

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a ADDRESSEERow11:

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a ADDRESSEERow12:

DraftRow12:

RegRow12:

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a ADDRESSEERow13:

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RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

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RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

ReproRow19:

a ADDRESSEERow20:

DraftRow20:

RegRow20:

ReproRow20:

a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

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a ADDRESSEERow23:

DraftRow23:

RegRow23:

ReproRow23:

a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 4

Repro15 TOTAL:

H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 12: The Contractor shall submit an agenda for all meetings three (3) calendar days prior to government review. Contractor shall participate in bi-weekly teleconferences with the government.

Block 14: Submit electronically. Distribution list will be provided at post award.

2021-12-02T21:22:33-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:33:31-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-ADMN-81249C

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.

1 DATA ITEM NO: A019

2 TITLE OF DATA ITEM: Report, Record of Meeting/Minutes

3 SUBTITLE: Meetings

5 CONTRACT REFERENCE: SOW Paragraph 3.9.3

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2: FCDD-ACE-QMB

DraftRow2:

RegRow2: 1

ReproRow2:

a ADDRESSEERow3: ACC-NJ-MC

DraftRow3:

RegRow3: 1

ReproRow3:

a ADDRESSEERow4: DCMA-QAR

DraftRow4:

RegRow4: 1

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

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a ADDRESSEERow7:

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a ADDRESSEERow8:

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a ADDRESSEERow9:

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a ADDRESSEERow10:

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a ADDRESSEERow11:

DraftRow11:

RegRow11:

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a ADDRESSEERow12:

DraftRow12:

RegRow12:

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a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

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a ADDRESSEERow16:

DraftRow16:

RegRow16:

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a ADDRESSEERow17:

DraftRow17:

RegRow17:

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a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

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a ADDRESSEERow20:

DraftRow20:

RegRow20:

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a ADDRESSEERow21:

DraftRow21:

RegRow21:

ReproRow21:

a ADDRESSEERow22:

DraftRow22:

RegRow22:

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a ADDRESSEERow23:

DraftRow23:

RegRow23:

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a ADDRESSEERow24:

DraftRow24:

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a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 4

Repro15 TOTAL:

H DATE: 3 December 21

J DATE: 3 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 12: The Contractor shall submit meeting minutes no later than seven (7) calendar days following the meeting. The Contractor shall submit tracking sheet no later than seven (7) calendar days following the bi-weekly meeting.

Block 14: Submit electronically. Distribution list will be provided at post award.

2021-12-03T08:15:46-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-03T08:12:40-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-ADMN-81505

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.

1 DATA ITEM NO: A020

2 TITLE OF DATA ITEM: Contractor's Progress, Status and Management Report

3 SUBTITLE: Monthly Report

5 CONTRACT REFERENCE: SOW Paragraph 3.9.4

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2: FCDD-ACE-QMB

DraftRow2:

RegRow2: 1

ReproRow2:

a ADDRESSEERow3: ACC-NJ-MC

DraftRow3:

RegRow3: 1

ReproRow3:

a ADDRESSEERow4: DCMA-QAR

DraftRow4:

RegRow4: 1

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

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a ADDRESSEERow7:

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a ADDRESSEERow8:

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a ADDRESSEERow9:

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a ADDRESSEERow10:

DraftRow10:

RegRow10:

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a ADDRESSEERow11:

DraftRow11:

RegRow11:

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a ADDRESSEERow12:

DraftRow12:

RegRow12:

ReproRow12:

a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

ReproRow15:

a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

DraftRow17:

RegRow17:

ReproRow17:

a ADDRESSEERow18:

DraftRow18:

RegRow18:

ReproRow18:

a ADDRESSEERow19:

DraftRow19:

RegRow19:

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a ADDRESSEERow20:

DraftRow20:

RegRow20:

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a ADDRESSEERow21:

DraftRow21:

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a ADDRESSEERow22:

DraftRow22:

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a ADDRESSEERow23:

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a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 4

Repro15 TOTAL:

H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 12: The Contractor shall submit monthly reports inclusive of progress, status management of the program.

Block 14: Submit electronically. Distribution list will be provided at post award.

2021-12-02T21:25:00-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:36:58-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-MGMT-81928

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.

1 DATA ITEM NO: A021

2 TITLE OF DATA ITEM: Accident/Incident Report

3 SUBTITLE: Accident/Incident Report

5 CONTRACT REFERENCE: SOW Paragraph 3.9.5

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: Block 16

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2: FCDD-ACE-QMB

DraftRow2:

RegRow2: 1

ReproRow2:

a ADDRESSEERow3: ACC-NJ-MC

DraftRow3:

RegRow3: 1

ReproRow3:

a ADDRESSEERow4: DCMA-QAR

DraftRow4:

RegRow4: 1

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

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a ADDRESSEERow7:

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a ADDRESSEERow8:

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a ADDRESSEERow9:

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a ADDRESSEERow10:

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a ADDRESSEERow11:

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a ADDRESSEERow12:

DraftRow12:

RegRow12:

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a ADDRESSEERow13:

DraftRow13:

RegRow13:

ReproRow13:

a ADDRESSEERow14:

DraftRow14:

RegRow14:

ReproRow14:

a ADDRESSEERow15:

DraftRow15:

RegRow15:

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a ADDRESSEERow16:

DraftRow16:

RegRow16:

ReproRow16:

a ADDRESSEERow17:

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RegRow17:

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a ADDRESSEERow18:

DraftRow18:

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a ADDRESSEERow19:

DraftRow19:

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a ADDRESSEERow20:

DraftRow20:

RegRow20:

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a ADDRESSEERow21:

DraftRow21:

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a ADDRESSEERow22:

DraftRow22:

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a ADDRESSEERow23:

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a ADDRESSEERow24:

DraftRow24:

RegRow24:

ReproRow24:

a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 4

Repro15 TOTAL:

H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 12: The Contractor shall notify PCO any accident/incident, identifying a potential hazard requiring corrective action.

The Contractor shall report any fatalities or one or more disabling injuries, damage to Government property exceeding $10,000, affecting program planning or production schedules, degrading the safety of equipment under contract, such that a personnel injury or property damage.

Block 14:Submit electronically. Distribution list will be provided at post award.

2021-12-02T21:25:15-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:39:12-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-SAFT-81563

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.

1 DATA ITEM NO: A0022

2 TITLE OF DATA ITEM: Operations Security (OPSEC) Plan

3 SUBTITLE: OPSEC Program

5 CONTRACT REFERENCE: SOW Paragraph 3.10.4

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: Block 16

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2: FCDD-ACE-QMB

DraftRow2:

RegRow2: 1

ReproRow2:

a ADDRESSEERow3: ACC-NJ-MC

DraftRow3:

RegRow3: 1

ReproRow3:

a ADDRESSEERow4: DCMA-QAR

DraftRow4:

RegRow4: 1

ReproRow4:

a ADDRESSEERow5:

DraftRow5:

RegRow5:

ReproRow5:

a ADDRESSEERow6:

DraftRow6:

RegRow6:

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a ADDRESSEERow7:

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a ADDRESSEERow8:

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a ADDRESSEERow11:

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a ADDRESSEERow12:

DraftRow12:

RegRow12:

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a ADDRESSEERow13:

DraftRow13:

RegRow13:

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a ADDRESSEERow14:

DraftRow14:

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a ADDRESSEERow15:

DraftRow15:

RegRow15:

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a ADDRESSEERow16:

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a ADDRESSEERow17:

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a ADDRESSEERow18:

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a ADDRESSEERow19:

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a ADDRESSEERow20:

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a ADDRESSEERow21:

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a ADDRESSEERow22:

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a ADDRESSEERow26:

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Draft15 TOTAL:

Reg15 TOTAL: 4

Repro15 TOTAL:

H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 12: The Contractor shall develop an OPSEC Standard Operating Procedure (SOP) ninety (90) calendar days of contract award. The report will be reviewed and approved by the Government OPSEC officer.

Block 14:Submit electronically. Distribution list will be provided at post award.

2021-12-02T21:25:29-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:40:43-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-MGMT-80934C

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.

1 DATA ITEM NO: A023

2 TITLE OF DATA ITEM: Critical Characteristics Control Plan (CCCP)

3 SUBTITLE: Critical Characteristics

5 CONTRACT REFERENCE: SOW Paragraph 3.3.5

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2: FCDD-ACE-QMB

DraftRow2:

RegRow2: 1

ReproRow2:

a ADDRESSEERow3: ACC-NJ-MC

DraftRow3:

RegRow3: 1

ReproRow3:

a ADDRESSEERow4: DCMA-QAR

DraftRow4:

RegRow4: 1

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a ADDRESSEERow5:

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a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 4

Repro15 TOTAL:

H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 12: Submission for Government approval due NLT sixty (60) calendar days prior to FAT.

Block 13: If changes occur after initial approval, submit revisions for approval within ten (10) calendar days of revisions to the Process Capability,Control, and Improvement Plan.

Block 14: Submit electronically. Distribution list will be provided at post award.

2021-12-02T21:27:36-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:42:27-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-MGMT-81986

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.

1 DATA ITEM NO: A024

2 TITLE OF DATA ITEM: Critical Safety Item, Characteristic and Critical Defect Report

3 SUBTITLE: Critical Characteristics

5 CONTRACT REFERENCE: SOW Paragraph 3.3.5

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2: FCDD-ACE-QMB

DraftRow2:

RegRow2: 1

ReproRow2:

a ADDRESSEERow3: ACC-NJ-MC

DraftRow3:

RegRow3: 1

ReproRow3:

a ADDRESSEERow4: DCMA-QAR

DraftRow4:

RegRow4: 1

ReproRow4:

a ADDRESSEERow5:

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a ADDRESSEERow22:

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a ADDRESSEERow24:

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a ADDRESSEERow25:

DraftRow25:

RegRow25:

ReproRow25:

a ADDRESSEERow26:

DraftRow26:

RegRow26:

ReproRow26:

Draft15 TOTAL:

Reg15 TOTAL: 4

Repro15 TOTAL:

H DATE: 2 December 21

J DATE: 2 December 21

A CONTRACT LINE ITEM NO:

B EXHIBIT:

TDP:

TM:

OTHER:

D SYSTEMITEM: M88 Practice Mine Canister

E CONTRACTPR NO:

F CONTRACTOR:

Pg:

Remarks: Block 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors (date of determination). Other requests for this document shall be referred to (Project Manager Close Combat Systems (PM CCS) Picatinny Arsenal, NJ 07806).

Block 12: The Contractor shall submit a Safety Critical Items/Characteristics Report within sixty (60) calendar days prior to FAT.

2021-12-02T21:27:51-0500

MENDOZA.THOMAS.IAN.1555215629

2021-12-02T19:45:28-0500

BENTLEY.LESLIE.DORTHEA.1057840389

8 APP CODE:

4 AUTHORITY Data Acquisition Document No: DI-SAFT-80970A

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.

1 DATA ITEM NO: A025

2 TITLE OF DATA ITEM: Critical Plan of Action (CPOA)

3 SUBTITLE: Critical Characteristics

5 CONTRACT REFERENCE: SOW Paragraph 3.3.5

6 REQUIRING OFFICE: FCDD-ACM-FM

7 DD 250 REQ: LT

9 DIST STATEMENT REQD:

C

10 FREQUENCY: As Required

12 DATE OF FIRST SUBMISSION: Block 16

11 AS OF DATE: As Required

13 DATE OF SUBSEQUENT SUBMISSION: As Required a ADDRESSEERow1: FCDD-ACE-QPB

DraftRow1:

RegRow1: 1

ReproRow1:

a ADDRESSEERow2: FCDD-ACE-QMB

DraftRow2:

RegRow2: 1

ReproRow2:

a ADDRESSEERow3: ACC-NJ-MC

DraftRow3:

RegRow3: 1

ReproRow3:

a ADDRESSEERow4: DCMA-QAR

DraftRow4:

RegRow4: 1

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a ADDRESSEERow5:

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