EXHIBIT B _10709378-00625-CDRL DI-MISC-80678 Non-Level 1 REV 06-19-2018.pdf
Data Item Description Jun 19, 2018 PDF 254 KB Posted
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CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
OMB No. 0704-0188 Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302.
Please DO NOT RETURN your form to either of these address. 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 MISC
D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR
1. DATA ITEM NO. 2. TITLE OF DATA ITEM
CERTIFICATION/DATA REPORT
3. SUBTITLE
CHEMICAL AND MECHANICAL
(PHYSICAL) PROPERTIES
4. AUTHORITY (Data Acquisition Document No.)
DI-MISC-80678
5. CONTRACT REFERENCE
PER CONTRACT
6. REQUIRING OFFICE
PURCHASING ACTIVITY
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
D*
10. FREQUENCY
ONE TIME
12. DATE OF FIRST
SUBMISSION
SEE BLOCK 16
14. DISTRIBUTION
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
A. ADDRESSEE Final
N/A Draft Reg Repr
16. REMARKS
Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.
Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 3/18/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.
Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:
Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).
Upon submission in iRAPT send email notifications to:
BREM.PSNS.WAWFQA.FCT@navy.mil . Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.
N4523A 0 1 0
TOTAL 0 1 0
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
/s/ Linda Cline 3/18/2021 /s/ James McCready 3/18/2021
DD Form 1423-1, FEB 2001 Previous edition may be used. Page 1 of 1 Pages
For Document no: 10709378
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
0004AA B
B001 mailto:BREM.PSNS.WAWFQA.FCT@navy.mil
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