_Exhibit B - ENGINEERING DOCUMENTATION - NSP (B001 - B015) - FINAL - 24 June 2021.pdf

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

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ 9. DIST

STATEMENT

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B001 Engineering Change Proposal TBD

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-80639E SOW 4.4.1.3 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

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BLK 4: An Engineering Change Proposal (ECP) provides the documentation in which the engineering change is described. The ECP shall identify the specification, description, test, and training documentation affected by the proposed change.

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e. SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 30 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 12: Submit draft NLT 45 days following direction by Contracting Officer (KO) or Contracting Officers Representative (COR)

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

A

ASREQ SEE BLK 16DD

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

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ 9. DIST

STATEMENT

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B002 Notice of Revision (NOR)

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-80642E SOW 4.4.1.4 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

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COR

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BLK 4: The NOR shall describe the proposed changes to a technical document being requested by an Engineering Change Proposal (ECP) After ECP approval, the NOR is forwarded to the custodian for each specification, drawing, associated list, or other applicable document(s) to they can make the required documentation changes.

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e. SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 30 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 10: Deliver with each software version revision (software unit/module/CSCI) BLK 12: Contractor shall submit a draft within 30 days of request by by Contracting Officer (KO) or Contracting Officers Representative (COR) and with all draft ECPs

BLK 13: Updated submissions due NLT 15 days following the receipt of Government comments.

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B003 Requirements for Design Change Notification Requirements for Design Change Notification

DI-SESS-81758A SOW 4.4.1.5 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

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BLK 4: Contractor shall provide Design Change Notice IAW SOW Appendix 4. Only PLISNs affected by design change shall be resubmitted.

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e. SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 30 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 10: Contractor shall submit draft DCN 15 Calendar days after each approved ECP change that impacts provisioning.

BLK 12 & BLK 13: After initial and subsequent approved ECP or a new design change or part number change that impacts provisioning documentation per Appendix 4, a draft DCN shall be initiated within 15 calendar days for Government review.

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B004 Request for Waiver Request for Waiver

DI-SESS-81732 SOW 4.4.1.6 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

BLK 4: Prepare in accordance with DI-SESS-81732, DD 1694, and content described within the order. Contractor shall submit in MS Office (version to be specified in order)

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (ex: SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 30 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government's comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 12: Submit as needed

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B005 Request for Deviation Request for Deviation

DI-CMAN-81590 SOW 4.4.1.7 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

BLK 4: Prepare in accordance with DI-CMAN-81590, DD 1694, and content described within the order. Contractor shall submit in MS Office (version to be specified in order)

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (ex: SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 30 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government's comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 12: Submit as needed

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

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.) 6. REQUIRING OFFICE

7. DD 250 REQ 9. DIST

STATEMENT

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B006 Tracking Report for Equipment Modification Tracking Report for Equipment Modification-Modification

Work Order

DI-CMAN-81018

5. CONTRACT REFERENCE

SOW 4.4.1.8 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

BLK 4: Prepare in accordance with DI-CMAN-81018 and content described within the order.

Contractor shall submit in MS Office (version to be specified in order)

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (ex: SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 30 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 15 business days after receipt of the final submission that incorporates all of the Government's comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 12: Submit draft NLT 30 days following direction by Contracting Officer (KO) or Contracting Officers Representative (COR)

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

QRTLY SEE BLK 16DD

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

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ 9. DIST

STATEMENT

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B007 Configuration Audit Summary Report and Certification Configuration Audit Summary Report and Certification

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-81022E SOW 4.4.1.9 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

BLK 4: Prepare in contractor format with content described within the order. Contractor shall submit in MS Office (version to be specified in order)

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e. SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 60 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 12: Submit draft NLT 30 days following direction by Contracting Officer (KO) or Contracting Officers Representative (COR)

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B008 Technical Report - Study/Services National Security Agency (NSA) Certification

DI-MISC-80508B SOW 4.5.1 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

BLK 4: Prepare in contractor format with content described within the order and below. Contractor shall submit in MS Office (version to be specified in order)

a) The Contractor shall provide and maintain an Information Assurance Directorate Type 1 (as required and defined in CNSSI 4009) Product Certificate for national security cryptographic equipment from the National Security Agency for all hardware and software in accordance with NSA Information Assurance Security Requirements Document (IASRD)

b) Shall provide and maintain an Interim Authority to Operate or Authorization to Operate using unclassified and secret operational keys and data approved by a Designated Approval Authority (DAA) NLT 60 days after award of the order.

c) Shall provide the Operational Security Doctrine as referenced by the Product Certificate.

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e.

SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 60 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 60 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION STATEMENT TO

EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S. DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 10: Submit upon change in the NSA Certification or Authorization to Operate.

BLK 12: Submit draft NLT 30 days following direction by Contracting Officer (KO) or Contracting Officers Representative (COR)

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B009 Spectrum Certification Spectral Characteristics Data Spectrum Certification Spectral Characteristics Data

DI-EMCS-81827 SOW 4.5.2 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

BLK 4: Prepare in contractor format with content described within the order and below. Contractor shall submit in MS Office (version to be specified in order)

a) The contractor shall supply the technical information from DD Form 1494 sections “Transmitter Equipment Characteristics”, “Receiver Equipment Characteristics”, and “Antenna Equipment Characteristics” in accordance with the National Telecommunication and Information Administration (NTIA) Manual of Regulations and Procedures for Federal Radio Frequency Management. (i.e. Chapter 5 “Spectrum Standards” and DoDI 4650.01 “Policy and Procedure for Management and use of the Electromagnetic Spectrum”).

b) Shall supply measured technical data for the submission of the Spectrum Supportability Risk Assessment (SSRA) in accordance with DoD Directive 4650.1 in time to support BLK 12 requirements.

c) Shall provide copies of all submitted DD Form 1494 (Spectrum Certifications), including approved, denied and in-process submissions, as well as submitted modifications (i.e., "Note to Holders" (NTHs)).

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e.

SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 60 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 60 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION STATEMENT TO

EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S. DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 10: Submit upon change to any technical information that results in a change to the DD Form 1494 BLK 12: Submit draft NLT 30 days following direction by Contracting Officer (KO) or Contracting Officers Representative (COR) BLK 13: Updated submissions due NLT 14 days following the receipt of Government comments, or or seven (7) Days after change in technical data contained within the DD Form 1494..

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

5. CONTRACT REFERENCE

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B010 Assessment of Manufacturing Risk and Readiness Manufacturing Maturation Plan

DI-SESS-81974 SOW 4.3.5.1 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

BLK 4: The contractor shall submit the Manufacturing Maturation Plan IAW DI-SESS-81974 when any of the nine MRL Threads identified in the MRL Deskbook are assessed to be less than

MRL 9.

Prepare in contractor format with content described within the order. Contractor shall submit in MS Office (version to be specified in order).

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e. SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 60 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 12: Submit draft NLT 45 days after request by the Contracting Officer (KO) or Contracting Officers Representative (COR).

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16.

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B011 Test Procedure Contractor First Article Test (FAT) Procedures

DI-NDTI-80603A; SOW 4.4.4.1.1 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

REMARKS

BLK 4: Prepare in contractor format with content described within the order. Contractor shall submit in MS Office (version to be specified in order). Other references are DI-NDTI-81942 and

DI-QCIC-80553A

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e. SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 60 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 12: Submit draft NLT 30 days following direction by Contracting Officer (KO) or Contracting Officers Representative (COR)

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B012 Acceptance Test Report Contractor First Article Test (FAT) Report

DI-QCIC-81891 SOW 4.4.4.1.2 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

BLK 4: Prepare in contractor format with content described within the order. Contractor shall submit in MS Office (version to be specified in order)

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e. SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 60 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 12: Submit draft NLT 30 days following direction by Contracting Officer (KO) or Contracting Officers Representative (COR)

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT

Draft

Final Reg Repro

16. REMARKS

15. TOTAL ---------

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

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page of Pages

2002 B

Combat Net Radio (CNR) W15P7T-21-R-0009 TBD

B013 Test Procedure Production Acceptance Test Procedures

DI-NDTI-80603A SOW 4.4.4.2 PdM Waveforms (WF) PM

SEE BLK 16

N/A SEE BLK 16

ACC KO

COR

PdMWF POC 1

1 0

3 3 0

BLK 4: Prepare in contractor format with content described within the order. Contractor shall submit in MS Office (version to be specified in order)

BLK 7: Unclassified submissions shall be via email, or web-based electronic file delivery system (i.e. SharePoint). Classified submissions shall be via approved classified methods.

BLK 8: The Government requires 60 business days to review all draft submissions and provide comments addressing the technical content and format. Government approval will be provided within 30 business days after receipt of the final submission that incorporates all of the Government’s comments.

BLK 9: THE CONTRACTOR SHALL APPLY THE FOLLOWING DISTRIBUTION

STATEMENT TO EACH DELIVERABLE:

DISTRIBUTION STATEMENT: Distribution authorized to the Department of Defense and U.S.

DoD contractors only for critical technology effective 19 August 2014. Other requests shall be referred to Program Executive Office Command Control Communications-Tactical, Project Manager Tactical Radios.

WARNING -This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Control Reform Act of 2018 (Title 50, U.S.C., Chapter 58, Sec. 4801-4852). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Controlled by: PM TR CUI Category(ies): Controlled Technical Information (CTI), Export Control (EXPT) Limited Dissemination Control: Federal Employees and Contractors Only (FEDCON) POC: Glen R. Gearhart (443) 395-2923

BLK 12: Submit draft NLT 30 days following direction by Contracting Officer (KO) or Contracting Officers Representative (COR)

BLK 13: Updated submissions due NLT 30 days following the receipt of Government comments.

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

10. FREQUENCY 12. DATE OF 1ST SUBMISSION 14. DISTRIBUTION

a…