EXHIBITS A-E- CDRLs.pdf
PDF 643 KB Posted
- Attached to
- AIR PURIFIER Federal contract opportunity
- Solicitation number
- SPMYM222Q1997
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| File | Type | Posted |
|---|---|---|
| SPECIFICATIONS.pdf | ||
| SPMYM2-22-Q-1997.pdf |
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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
OSHA CERTIFICATION
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/R
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 6/3/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.
Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite.
Upon submission in WAWF send email notifications to:
PSNS.WAWFQACertifications.FCM@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.
DOCUMENT # 2140-3070
N4523A 0 1 0
TOTAL 0 1 0
G. PREPARED BY H. DATE I. APPROVED BY J. DATE
/s/ TJ Delacy C/980M.1 6/3/2022 /s/ R. Balter C/980S.2 6/3/2022
DD Form 1423-1, FEB 2001 Previous edition may be used. Page 1 of 1 Pages
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
0002AA A
A001
CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) 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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget.
Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.
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 3. SUBTITLE 17. PRICE
GROUP
CERTIFICATION/DATA REPORT
POLYCHLORINATED BIPHENYL (PCB)
CERTIFICIATION
4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED
TOTAL PRICE
DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
DD ONE/R SEE BLOCK 16 b. COPIES
8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE DRAFT FINAL
N/A N/A N/A Reg Repr o
16. REMARKS N4523A 0 1 0
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 6/3/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.
Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.
Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite.
Upon submission in WAWF send email notifications to:
PSNS.WAWFQACertifications.FCM@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.
Document No.: 2140-3070
15. Total 0
/s/ TJ Delacy C/980M.1 6/3/2022 /s/ R. Balter C/980.3 6/3/2022
DD FORM 1423-1, JUN 90 (EG)
Page 1 of 2 Pages
0002AB B
B001
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
TDP TM OTHER NDTI
D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR
1. DATA ITEM NO. 2. TITLE OF DATA ITEM
TEST/INSPECTION REPORT
LOAD TEST
DI-NDTI-80809B
5. CONTRACT REFERENCE
PER CONTRACT
6. REQUIRING OFFICE
PURCHASING ACTIVITY
REQUIRED
SUBMISSION
SEE BLOCK 16*
14. DISTRIBUTION
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
N/A
Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 6/3/2022. Other U.S. requests shall be referred to COMNAVSEASYSCOM.
Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.
Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite.
Upon submission in WAWF send email notifications to:
PSNS.WAWFQACertifications.FCM@navy.mil. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding
/s/ TJ Delacy C/980M.1 6/3/2022 /s/ R. Balter C/980.3 6/3/2022
DD Form 1423-1, FEB 2001 Previous edition may be used. Page 1 of 2 Pages
Document # 2140-3070
17. PRICE
18.
ESTIMAT
ED
TOTAL
0002AC C
C001
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
TDP TM OTHER TMSS
COMMERCIAL OFF-THE-SHELF (COTS) MANUALS
AND ASSOCIATED SUPPLEMENTAL DATA
3. SUBTITLE
Operation & Maintenance Manuals
4. AUTHORITY (Data Acquisition Document No.)
DI-TMSS-80257C
5. CONTRACT REFERENCE
PER CONTRACT
6. REQUIRING OFFICE
PURCHASING ACTIVITY
REQUIRED
SUBMISSION
SEE BLOCK 16*
14. DISTRIBUTION
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
N/A referred to COMNAVSEASYSCOM.
Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite.
Upon submission in WAWF send email notifications to:
PSNS.WAWFQACertifications.FCM@navy.mil. Acceptance/Rejection of
N4523A 0 3 1
TOTAL 0 3 1
/s/ TJ Delacy C/980M.1 6/3/2022 /s/ R. Balter C/980S.2 6/3/2022
DD Form 1423-1, FEB 2001 Previous edition may be used. Page 1 of 1 Pages
DOCUMENT NO.: 2140-3070
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
0002AD D
D001
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
TDP TM OTHER NDTI
TEST/INSPECTION REPORT
TEST DATA RESULTS
DI-NDTI-80809B
5. CONTRACT REFERENCE
PER CONTRACT
6. REQUIRING OFFICE
PURCHASING ACTIVITY
REQUIRED
SUBMISSION
SEE BLOCK 16*
14. DISTRIBUTION
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
N/A referred to COMNAVSEASYSCOM.
Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.
Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite.
Upon submission in WAWF send email notifications to:
PSNS.WAWFQACertifications.FCM@navy.mil. Acceptance/Rejection of
/s/ TJ Delacy C/980M.1 6/3/2022 /s/ R. Balter C/980.3 6/3/2022
DD Form 1423-1, FEB 2001 Previous edition may be used. Page 1 of 2 Pages
DOC # 2140-3070
17. PRICE
18.
ESTIMAT
ED
TOTAL
0002AE E
E001
| 21403070 cdrl 1.pdf |
| 21403070 cdrl 2.pdf |
| SEE BLOCK 16 |
| N4523A |
| 21403070 cdrl 3.pdf |
| 21403070 cdrl 4.pdf |
| 21403070 cdrl 5.pdf |
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