Attachment_10c_-_Task_Order_02-CAF_Development_and_Integration_Contract_Data_Requirements_List.pdf

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DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page of Pages

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423-1 (BACK), FEB 2001

data_item: A029 title: Technical Report – Study/Services sub: Trouble Shooting Aids and Guides auth: DI-MISC-80508B ref: PWS (TBD) req_ofc: AFLCMC/HBAW-OL dd250: LT appcode: N/A dist: C freq: ASREQ asof: N/A firstsub: ASREQ subsub: ASREQ addressee1: AFLCMC/HBAW-OL draft1: 0 reg1: 1 repro1: 0 addressee2: ACC/A5W draft2: 0 reg2: 1 repro2: 0 addressee3: -----------------------------draft3:

reg3:

repro3:

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draft4:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: Block 4: Contractor format acceptable.

Block 12: Trouble Shooting Aids and Guides will be provided as required.

Block 13: Trouble Shooting Aids and Guides updates will be provided as required.

group:

total_price:

prep_name:

line_item: X008 exhibit: A xtdp: Off xtm: Off othercat: Engineering system: TADS - CAF Development & Integration ctr_no: TBD (Task Order 02) contr: TBD remarksb:

Page2:

Reset:

prep_date:

app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any

TO # - NAME

SECURITY CLASSIFICATION Unclassified

COST DATA SUMMARY REPORT Form Approved

The public reporting burden for this collection of information is estimated to average 8 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, 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.

1. MAJOR PROGRAM a. NAME:

b. PHASE/MILESTONE 2. PRIME MISSION PRODUCT 3. REPORTING ORGANIZATION TYPE 4. NAME/ADDRESS (Include ZIP Code) 5. APPROVED PLAN NUMBER

Pre-A B C-FRP PRIME / ASSOCIATE CONTRACTOR DIRECT-REPORTING SUBCONTRACTOR GOVERNMENT a. PERFORMING ORGANIZATION b. DIVISION

A C-LRIP O&S

6. CUSTOMER (Direct-reporting subcontractor use only) 7. CONTRACT TYPE 8. CONTRACT PRICE 9. CONTRACT CEILING 10. TYPE ACTION

a. CONTRACT NO.: c. SOLICITATION NO.: e. TASK ORDER/DELIVERY ORDER/LOT NO.:

b. LATEST MODIFICATION: d. NAME:

11. PERIOD OF PERFORMANCE 12. APPROPRIATION 13. REPORT CYCLE 14. SUBMISSION NUMBER 15. RESUBMISSION NUMBER 16. REPORT AS OF (YYYYMMDD)

a. START DATE (YYYYMMDD): RDT&E INITIAL

b. END DATE (YYYYMMDD): PROCUREMENT INTERIM

O&M FINAL

17. NAME (Last, First, Middle Initial) 18. DEPARTMENT 19. TELEPHONE NUMBER (Include Area Code) 20. EMAIL ADDRESS 21. DATE PREPARED (YYYYMMDD)

WBS

ELEMENT

CODE WBS REPORTING ELEMENTS NUMBER OF

UNITS

TO DATE COSTS INCURRED TO DATE (thousands of U.S. Dollars) NUMBER OF

UNITS AT

COMPLETION COSTS INCURRED AT COMPLETION (thousands of U.S. Dollars)

NONRECURRING RECURRING TOTAL NONRECURRING RECURRING TOTAL

A B C D E F G H I J

1.0 Information Systems (IS)/Defense Business Systems (DBS) Investment

1.1 IS/DBS Development/Customization/Configuration (PMP)

1.1.1 Custom Application 1…n (Specify)

1.1.2 Enterprise Service Element 1…n (Specify)

1.1.3 Enterprise/Management Information System 1…n (Specify)

1.1.4 External System Interface Development 1…n (Specify)

1.1.5 System Level Hardware

1.1.6 System Level Software

1.2 System Level Integration

1.3 System Engineering

1.3.1 Software Systems Engineering

1.3.2 Integrated Logistics Support (ILS) Systems Engineering

1.3.3 Cybersecurity Systems Engineering

1.3.4 Core Systems Engineering

1.3.5 Other Systems Engineering 1…n (Specify)

1.4 Program Management

1.5 Change Management

1.6 Data Management

1.7 System Test and Evaluation

1.8 Training

1.9 Data

1.10 Peculiar Support Equipment

1.11 Common Support Equipment

1.12 Operational/Site Activation

1.12.1 Initial Hardware Procurement

1.12.2 Initial Software License Procurement

1.12.3 Initial Software Release (Pre-IOC) Modification/Enhancement

1.12.4 Site Activation

1.12.4.1 Data Migration

1.12.4.2 User Training

1.12.4.3 User Documentation

1.12.4.4 Management/Engineering Support

1.12.4.5 Site Installation, Test, and Checkout

1.12.4.6 Other 1…n (Specify)

1.12.5 Interim Operations and Support (Pre-IOC)

1.13 Industrial Facilities

1.14 Initial Spares and Repair Parts

2.0 Information Systems (IS)/Defense Business Systems (DBS) Sustainment

2.1 Program Management

2.2 Systems/Sustainment Engineering

2.3 Change Management

2.4 Help Desk

2.5 Data Cleansing/Data Maintenance

2.6 System/Database Administration

2.7 IT Infrastructure/Network Maintenance Support

2.8 Operational Hardware Refresh/Upgrade

2.9 Operational Software License Refresh/Update

2.10 Cybersecurity Maintenance Management

2.11 Follow-on User Training

2.12 System Independent Verification and Validation

2.13 Continuing System Improvement

2.13.1 Operational Hardware Modification

2.13.2 Software Release Modification/Enhancement 1…n (Specify)

2.13.2.1 Modifications/Enhancements

2.13.2.2 Routine Fixes and Deficiency Correction

2.13.2.3 Installation/Test

2.13.2.4 IAVAs

2.14 AW/Safety/Networthiness Certification

2.15 Facilities

22. REMARKS

DD FORM 1921, MAY 2011 PREVIOUS EDITION IS OBSOLETE. SECURITY CLASSIFICATION Unclassified

DD Form 2794, Pg 0 (METADATA)

COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN *Input Form Approved OMB Number*

The public reporting burden for this collection of information is estimated to average 8 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THE ABOVE ORGANIZATION.

1a. PROGRAM NAME

Numerical Weather Modeling (NWM)

1b. PHASE/MILESTONE (check all that apply)

Pre-A

A

B

C-LRIP

X C-FRP

X O&S

1c. PRIME MISSION PRODUCT

1d. ACQUISITION CATEGORY (ACAT)

Pre-ACAT

ACAT I (MDAP)

ACAT IA (MAIS)

ACAT II

X ACAT III

Other (ACAT IV, Special Interest, etc.)

2. COMMODITY TYPE

Information Systems (IS)/Defense Business Systems (DBS)

3. PLAN ITERATION TYPE

X INITIAL

REVISION/ADMIN

4. CURRENT SUBMISSION DATE (YYYYMMDD)

5. LAST APPROVED PLAN DATE (YYYYMMDD)

6a. GOVERNMENT CO-PLAN POINT OF CONTACT (POC) NAME (Last, First, M.)

Mungal, Karen, L.

6b. ADDRESS (Include ZIP Code)

75 Vandengerg Drive, Bldg. 1630, Hanscom AFB, MA 01731-2103

6c. TELEPHONE NUMBER (Include Area Code)

(781) 225-5036

6d. FAX NUMBER (Include Area Code)

6e. E-MAIL ADDRESS karen.mungal.1@us.af.mil

7. PLAN TYPE

PROGRAM

X CONTRACT (PRIME)

CONTRACT (SUB)

8. CO-PLAN GOVERNMENT PREPARING ORGANIZATION

AFLCMC/HBAF

9a. CONTRACTOR NAME/ADDRESS

i. REPORTING ORGANIZATION NAME

ii. DIVISION NAME

iii. LOCATION

iv. CONTRACTOR BUSINESS DATA REPORT (CBDR 1921-3) REQUIREMENT:

CBDR REQUIRED FOR THIS ORGANIZATION

9b. CONTRACT NUMBER (List all that apply, separated by commas)

9c. APPROPRIATION (check all that apply)

X RDT&E

X PROCUREMENT

X O&M

FMS

WCF

OTHER

10a. APPROVED CO-PLAN NUMBER

10b. APPROVED CO-PLAN REVISION NUMBER

10c.APPROVED CO-PLAN REQUIREMENTS

AT COMPLETION COSTS FOR STANDARD FUNCTIONAL CATEGORIES (FlexFile or Legacy)

AT COMPLETION COSTS FOR RECURRING/NONRECURRING (FlexFile only)

ADDITIONAL DATA FIELDS INCLUDED (FlexFile only; see Remarks for details)

DD FORM 2794 (Page 0), METADATA, MARCH 2018 PREVIOUS EDITION IS OBSOLETE mailto:karen.mungal.1@us.af.mil

DD Form 2794, Pg 1 (REPORTING)

COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN

11. WORK BREAKDOWN STRUCTURE (WBS) 12. COST 13. IPMR 14. TECHNICAL DATA

a. PROGRAM/ CONTRACT/ SUBCONTRACT CODE b. WBS CODE c. WBS LEVEL d. WBS ELEMENT NAME a. FLEXFILE ACTUALS TO DATE (ATD) b. LEGACY 1921 c. LEGACY 1921-1 d. LEGACY 1921-2 e. LEGACY 1921-5 f. AT COMPLETION COSTS a. FORMAT 1 REPORTING ELEMENTS a. QUANTITY b. SOFTWARE c.

TECHNICAL DATA

d.

MAINT. & REPAIR PARTS

i. QUANTITY DATA ii. GFE QUANTITY i. SRDR DEV. ii. SRDR MAINT. iii. SRDR ERP

1.0 1.0 Information Systems (IS)/Defense Business Systems (DBS) Investment X X X

1.1 1.1 IS/DBS Development/Customization/Configuration (PMP) X X X

1.1.1 1.1.1 Custom Application 1…n (Specify) X X X

1.1.2 1.1.2 Enterprise Service Element 1…n (Specify) X X X

1.1.3 1.1.3 Enterprise/Management Information System 1…n (Specify) X X X

1.1.4 1.1.4 External System Interface Development 1…n (Specify) X X X

1.1.5 1.1.5 System Level Hardware X X X

1.1.6 1.1.6 System Level Software X X X

1.2 1.2 System Level Integration X X X

1.3 1.3 System Engineering X X X

1.3.1 1.3.1 Software Systems Engineering X X X

1.3.2 1.3.2 Integrated Logistics Support (ILS) Systems Engineering X X X

1.3.3 1.3.3 Cybersecurity Systems Engineering X X X

1.3.4 1.3.4 Core Systems Engineering X X X

1.3.5 1.3.5 Other Systems Engineering 1…n (Specify) X X X

1.4 1.4 Program Management X X X

1.5 1.5 Change Management X X X

1.6 1.6 Data Management X X X

1.7 1.7 System Test and Evaluation X X X

1.8 1.8 Training X X X

1.9 1.9 Data X X X

1.10 1.10 Peculiar Support Equipment X X X

1.11 1.11 Common Support Equipment X X X

1.12 1.12 Operational/Site Activation X X X

1.12.1 1.12.1 Initial Hardware Procurement X X X

1.12.2 1.12.2 Initial Software License Procurement X X X

1.12.3 1.12.3 Initial Software Release (Pre-IOC) Modification/Enhancement X X X

1.12.4 1.12.4 Site Activation X X X

1.12.4.1 1.12.4.1 Data Migration N/A

1.12.4.2 1.12.4.2 User Training N/A

1.12.4.3 1.12.4.3 User Documentation N/A

1.12.4.4 1.12.4.4 Management/Engineering Support X X X

1.12.4.5 1.12.4.5 Site Installation, Test, and Checkout X X X

1.12.4.6 1.12.4.6 Other 1…n (Specify) X X X

1.12.5 1.12.5 Interim Operations and Support (Pre-IOC) X X X

1.13 1.13 Industrial Facilities X X X

1.14 1.14 Initial Spares and Repair Parts X X X

2.0 2.0 Information Systems (IS)/Defense Business Systems (DBS) Sustainment X X

2.1 2.1 Program Management X X X

2.2 2.2 Systems/Sustainment Engineering X X X

2.3 2.3 Change Management X X

2.4 2.4 Help Desk X X X

2.5 2.5 Data Cleansing/Data Maintenance X X

2.6 2.6 System/Database Administration X X X

2.7 2.7 IT Infrastructure/Network Maintenance Support X X

2.8 2.8 Operational Hardware Refresh/Upgrade X X

2.9 2.9 Operational Software License Refresh/Update X X

2.10 2.10 Cybersecurity Maintenance Management X X X

2.11 2.11 Follow-on User Training X X X

2.12 2.12 System Independent Verification and Validation X X

2.13 2.13 Continuing System Improvements X X X

2.13.1 2.13.1 Operational Hardware Modification X X

2.13.2 2.13.2 Software Release Modification/Enhancement 1…n (Specify) X X X

2.13.2.1 2.13.2.1 Modifications/Enhancements X X X

2.13.2.2 2.13.2.2 Routine Fixes and Deficiency Correction X X X

2.13.2.3 2.13.2.3 Installation/Test X X X

2.13.2.4 2.13.2.4 IAVAs X X X

2.14 2.14 AW/Safety/Networthiness Certification X X

2.15 2.15 Facilities X X X

Subtotal Cost X

Reporting Contractor G&A X

Reporting Contractor Undistributed Budget X

Reporting Contractor Management Reserve X

Reporting Contractor FCCM X

Total Cost X

Reporting Contractor Profit/Loss or Fee X

Total Price X

DD FORM 2794 (Page 1), REPORTING, MARCH 2018

DD Form 2794, Pg 2 (EVENTS)

COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN

15. CSTDR SUBMISSION EVENTS

(YYYYMMDD) (YYYYMMDD)

1 CWBS Dictionary Thirty (30) calendar days after contract award Initial

2 1921 Thirty (30) calendar days after contract award Initial

3 1921-1 Thirty (30) calendar days after contract award Initial

4 1921-5 Thirty (30) calendar days after contract award Initial

5 Mx SRDR Thirty (30) calendar days after contract award Initial

6 CWBS Dictionary End of Task Order 1…n (Specify as awarded) Final

7 1921 End of Task Order 1…n (Specify as awarded) Final

8 1921-1 End of Task Order 1…n (Specify as awarded) Final

9 1921-5 End of Task Order 1…n (Specify as awarded) Final

10 Mx SRDR End of Task Order 1…n (Specify as awarded) Final

11 CWBS Dictionary Annually (for multi-year Task Orders only) Interim

12 1921 Annually (for multi-year Task Orders only) Interim

13 1921-1 Annually (for multi-year Task Orders only) Interim

14 1921-5 Annually (for multi-year Task Orders only) Interim

15 Mx SRDR Annually (for multi-year Task Orders only) Interim

DD FORM 2794 (PAGE 2), SUBMISSION EVENTS, MARCH 2018

DD Form 2794, Pg 3 (REMARKS)

COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN

16. REMARKS

TOP LEVEL DESCRIPTION

1. NON-RECURRING/RECURRING DEFINITIONS:

Recurring cost results from repetitive activities that vary with the quantity being produced. Nonrecurring cost results from non-repetitive activities that do not vary with the quantity being produced.

Prime Mission Equipment (PME) Recurring hardware costs include fabrication; procurement of raw materials, purchased parts and equipment, and major and minor subcontracts; touch labor; integration and assembly; installation and checkout; engineering support for unit fabrication and quality control/assurance/inspection and certain elements of systems engineering and program management.

Examples of software design and development activities include design and development of all software; delivered operational software and software developed to correct deficiencies and add capabilities; Initial integration of COTS and GOTS products into operational configuration; Support for HW-SW integration and test, system level testing; initial integration of COTS and GOTS products into operational configuration; and commercial software licenses for development facilities.

Nonrecurring PME activities include design and development effort such as preliminary, critical prototype and test article design activities, and software design and maintenance, regardless of whether the purpose is to correct deficiencies or add capabilities. In the development phases, hardware component costs are nonrecurring until such times as those components are no longer prototypical, i.e. ready to be delivered on a recurring basis as operational representative. Components, sub-assemblies, assemblies with 100% complete design are considered operational representative. Test articles built to an operational configuration are considered operational representative. The costs of operational representative items are recurring. Subcontractor, vendor, and supplier cost should be obtained and reported in recurring and nonrecurring categories, wherever reasonably possible. (If vendor amortizes their nonrecurring costs across a lot buy resulting in non-visibility of a recurring/nonrecurring split, annotate as such.)

Non-PME System Test and Evaluation (ST&E) activities are typically nonrecurring such as non-production-representative test articles built for the testing purposes only such as test stands, bench and coupon test articles; structural development, static, fatigue, software, and ballistics testing; stress analysis; flight or ground testing of system properties; redesign as a result of testing; and retesting efforts. System Engineering, Program Management, and Data activities occur throughout the system life cycle and are supportive in nature; as such, these costs take on the characteristics of the underlying activities being performed.

Nonrecurring cost categories include design and development of Support Equipment and Training devices; Support Equipment and Training activity such as initial equipment design and test efforts, test program sets, initial courseware development, and simulator development are nonrecurring. Training and Support Equipment efforts are recurring when they pertain to repetitive activities that vary with the quantity of training devices or support items being produced. Initial Spares and Repair Parts are recurring as they pertain to repetitively producing hardware. Industrial Facilities are nonrecurring as well as nonrecurring tooling activities such as special test equipment, special tooling, procurement of initial and rate tooling, tool replacement (with exact same tool), and tool modification (to accommodate product configuration changes). For situations not explicitly addressed above, categorize any cost as recurring if it represents repetitive effort that is sensetive to quantity.

2. COST ACCOUNTING STANDARDS (CAS) DISCLOSURE STATEMENT:

Describe significant accounting changes from previous accounting period in the Remarks section of the reports, if applicable.

3. FAC vs. EAC

The checkmarks for EACs in column 13f at the WBS level shall be reported as "Forecast at Completion" (FAC). The Forecast at Completion (FAC) required here is not subject to the standards established in ANSI/EIA-748 guideline #27 (Estimate at Complete); therefore, the FAC does not need to be, but may be, derived from Industry Earned Value Management (EVM) processes.

4. FINAL COST REPORT

Final Cost Report to be submitted when final end item has been delivered and accepted by the government (e.g., as evidenced by a completed DD 250) and 95% or more of total contract costs have been incurred.

5. IDIQ & BOA CONTRACTS

One report will be submitted for each task order or delivery order, regardless of value. This approach is required in order to capture the entire contract value. When additional delivery orders or task orders are added or defined, Program Office must request an updated plan.

DD FORM 2794 (PAGE 3), REMARKS, MARCH 2018 PREVIOUS EDITION IS OBSOLETE

DD Form 2794, Pg 4 (SCOPE DEF)

COST, SOFTWARE, & TECHNICAL DATA REPORTING/EARNED VALUE MANAGEMENT CO-PLAN

INTRA-CONTRACT SCOPE REPORTING DEFINITION

17. ORDERS/LOTS

a. ID b. NAME c. PHASE/MILESTONE

18. END ITEMS

a. ID b. NAME

19. OPTIONAL REQUIREMENTS

a. ORDER/LOT ID b. END ITEM ID c. UNIT REPORTING (X if applicable) d. SEQUENCING (X if applicable)

DD FORM 2794 (Supplement), INTRA-CONTRACT SCOPE, MARCH 2018

DD Form 2794, Supp. (SRDR DEV)

CSDR PLAN SUPPLEMENT - SRDR DEVELOPMENT

20. RELEASES

a. ID b. NAME c. DATE

21. CSCI'S

a. ID b. NAME

22. PRODUCT SIZE REPORTING ELEMENTS

a. CODE b. NAME c. RELEASE ID d. CSCI ID

23. PRODUCT SIZE SUBMISSIONS c. RELEASE ID:

a. NUMBER b. NAME Included? Included? Included?

DD FORM 2794 (Supplement), SRDR DEVELOPMENT, MARCH 2018

DD Form 2794, Supp. (SRDR MX)

CSDR PLAN SUPPLEMENT - SRDR MAINTENANCE

24. RELEASES

a. ID b. NAME c. DATE

TBD TBD TBD

25. PRODUCT SIZE REPORTING ELEMENTS

a. CODE b. NAME c. RELEASE ID

26. PRODUCT SIZE SUBMISSIONS c. RELEASE ID:

a. NUMBER b. NAME Included? Included? Included?

DD FORM 2794 (Supplement), SRDR MAINTENANCE, MARCH 2018

DD Form 2794, Supp. (TECH RQTS)

TECHNICAL PARAMETER REQUIREMENTS

27. WBS ELEMENT CODE 28. WBS ELEMENT NAME 29. ITEM TYPE 30. TECHNICAL PARAMETER

a. PARAMETER NAME b. UNIT OF MEASURE c. UNIT OF MEASURE QUALIFIER d. REPEATABLE e. REMARKS

DD FORM 2794 (SUPPLEMENT),TECHNCIAL PARAMETER REQUIREMENTS, MARCH 2018

data_item: A030 title: Cost Data Summary Report sub: Cost Data Summary Report auth: DI-FNCL-81565C ref: PWS (TBD) req_ofc: AFLCMC/HBAF dd250: LT appcode: N/A dist: C freq: ASREQ asof: N/A firstsub: ASREQ subsub: ASREQ addressee1: AFLCMC/HBAF draft1: 0 reg1: 1 repro1: 0 addressee2: DCARC (see Block 16) draft2: 0 reg2: 1 repro2: 0 addressee3: -----------------------------draft3:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: Block 4: Format and content preparation instructions: The contractor shall organize and provide to the government in the required format (MS Excel format, titled "Cost Data Summary Report - 1921," is attached)

Block 10: Frequency shall be IAW the appropriate TADS DD Form 2794 CSDR plan. (attached)

Block 11: As of Contract Award.

Block 12: The contractor shall submit an initial DD Form 1921 to AFLCMC/HBAF per the appropriate TADS DD Form 2794 CSDR Plan thirty (30) calendar days after contract award. The Government will provide comments and approval/disapproval to Contractor within thirty (30) days. The contractor shall incorporate comments and resubmit thirty (30) days after receipt.

Block 13: Subsequent submissions to AFLCMC/HBAF and DCARC shall be IAW the appropriate DD Form 2794 CSDR Plan.

Block 14: The Cost Data Summary Report shall be submitted to DCARC electronically using the CSDR Submit-Review System. Data submitters must register through the DCARC website and possess a DoD-approved ECA digital certificate or a DoD-issued CAC to obtain a DCARC Portal account and be authorized to upload CSDR content. Users can obtain access by submitting user information about themselves and their organizations to the DCARC portal and requesting a CSDR submitter user role. After the registration information has been verified, the DCARC shall authorize the user account and requested role. All DCARC Portal accounts need to be renewed at least annually.

group:

total_price:

prep_name:

line_item: X008 exhibit: A xtdp: Off xtm: Off othercat: Financial system: TADS - CAF Development & Integration ctr_no: TBD (Task Order 02) contr: TBD remarksb:

Page2:

Reset:

prep_date:

app_by:

app_date:

Page:

of_pages:

app: Adobe Professional 8.0

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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any

WBS 1.0

SECURITY CLASSIFICATION Unclassified

FUNCTIONAL COST-HOUR REPORT Form Approved

The public reporting burden for this collection of information is estimated to average 16 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, 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.

1. MAJOR PROGRAM a. NAME:

b. PHASE/MILESTONE 2. PRIME MISSION PRODUCT 3. REPORTING ORGANIZATION TYPE 4. NAME/ADDRESS (Include Zip Code) 5. APPROVED PLAN NUMBER

Pre-A B C-FRP PRIME / ASSOCIATE CONTRACTOR DIRECT-REPORTING SUBCONTRACTOR GOVERNMENT a. PERFORMING ORGANIZATION b. DIVISION

A C-LRIP O&S

6. CUSTOMER (Direct-Reporting Subcontractor Use Only) 7. TYPE ACTION

a. CONTRACT NO.: c. SOLICITATION NO.: e. TASK ORDER/DELIVERY ORDER/LOT NO.:

b. LATEST MODIFICATION: d. NAME:

8. PERIOD OF PERFORMANCE 9. REPORT CYCLE 10. SUBMISSION NUMBER 11. RESUBMISSION NUMBER 12. REPORT AS OF (YYYYMMDD)

a. START DATE (YYYYMMDD): INITIAL

b. END DATE (YYYYMMDD): INTERIM

FINAL

13. NAME (Last, First, Middle Initial) 14. DEPARTMENT 15. TELEPHONE NO. (Include Area Code) 16. EMAIL ADDRESS 17. DATE PREPARED (YYYYMMDD)

18. WBS ELEMENT CODE 19. WBS REPORTING ELEMENT 20. NUMBER OF UNITS 21. APPROPRIATION

a. TO DATE b. AT COMPLETION RDT&E

PROCUREMENT

O&M

(thousands of U.S. Dollars or thousands of hours)

A. NONRECURRING B. RECURRING C. TOTAL D. NONRECURRING E. RECURRING F.TOTAL

ENGINEERING

(1) DIRECT ENGINEERING LABOR HOURS

(2) DIRECT ENGINEERING LABOR DOLLARS

(3) ENGINEERING OVERHEAD DOLLARS

(4) TOTAL ENGINEERING DOLLARS

MANUFACTURING OPERATIONS

(5) DIRECT TOOLING LABOR HOURS

(6) DIRECT TOOLING LABOR DOLLARS

(7) DIRECT TOOLING & EQUIPMENT DOLLARS

(8) DIRECT QUALITY CONTROL LABOR HOURS

(9) DIRECT QUALITY CONTROL LABOR DOLLARS

(10) DIRECT MANUFACTURING LABOR HOURS

(11) DIRECT MANUFACTURING LABOR DOLLARS

(12) MANUFACTURING OPERATIONS OVERHEAD DOLLARS (Including Tooling and Quality Control)

(13) TOTAL MANUFACTURING OPERATIONS DOLLARS (Sum of rows 6, 7, 9, 11, and 12)

MATERIALS

(14) RAW MATERIAL DOLLARS

(15) PURCHASED PARTS DOLLARS

(16) PURCHASED EQUIPMENT DOLLARS

(17) MATERIAL HANDLING OVERHEAD DOLLARS

(18) TOTAL DIRECT-REPORTING SUBCONTRACTOR DOLLARS

(19) TOTAL MATERIAL DOLLARS

OTHER COSTS

(20) OTHER COSTS NOT SHOWN ELSEWHERE (Specify in Remarks)

SUMMARY

(21) TOTAL COST (Direct and Overhead)

22. REMARKS

DD FORM 1921-1, MAY 2011 SECURITY CLASSIFICATION Unclassified

WBS 1.1

SECURITY CLASSIFICATION Unclassified

FUNCTIONAL COST-HOUR REPORT Form Approved

The public reporting burden for this collection of information is estimated to average 16 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, 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.

1. MAJOR PROGRAM a. NAME:

b. PHASE/MILESTONE 2. PRIME MISSION PRODUCT 3. REPORTING ORGANIZATION TYPE 4. NAME/ADDRESS (Include Zip Code) 5. APPROVED PLAN NUMBER

Pre-A B C-FRP PRIME / ASSOCIATE CONTRACTOR DIRECT-REPORTING SUBCONTRACTOR GOVERNMENT a. PERFORMING ORGANIZATION b. DIVISION

A C-LRIP O&S

6. CUSTOMER (Direct-Reporting Subcontractor Use Only) 7. TYPE ACTION

a. CONTRACT NO.: c. SOLICITATION NO.: e. TASK ORDER/DELIVERY ORDER/LOT NO.:

b. LATEST MODIFICATION: d. NAME:

8. PERIOD OF PERFORMANCE 9. REPORT CYCLE 10. SUBMISSION NUMBER 11. RESUBMISSION NUMBER 12. REPORT AS OF (YYYYMMDD)

a. START DATE (YYYYMMDD): INITIAL

b. END DATE (YYYYMMDD): INTERIM

FINAL

13. NAME (Last, First, Middle Initial) 14. DEPARTMENT 15. TELEPHONE NO. (Include Area Code) 16. EMAIL ADDRESS 17. DATE PREPARED (YYYYMMDD)

18. WBS ELEMENT CODE 19. WBS REPORTING ELEMENT 20. NUMBER OF UNITS 21. APPROPRIATION

a. TO DATE b. AT COMPLETION RDT&E

PROCUREMENT

O&M

A. NONRECURRING B. RECURRING C. TOTAL D. NONRECURRING E. RECURRING F.TOTAL

LABOR

TOTAL LABOR HOURS

TOTAL LABOR DOLLARS

MATERIALS

TOTAL MATERIAL DOLLARS

OTHER COSTS

OTHER COSTS NOT SHOWN ELSEWHERE (Specify in Remarks)

SUMMARY

TOTAL COST (Direct and Overhead)

22. REMARKS

DD FORM 1921-1, MAY 2011 SECURITY CLASSIFICATION Unclassified

WBS 1.1.1

SECURITY CLASSIFICATION Unclassified

FUNCTIONAL COST-HOUR REPORT Form Approved

The public reporting burden for this collection of information is estimated to average 16 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, 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.

1. MAJOR PROGRAM a. NAME:

b. PHASE/MILESTONE 2. PRIME MISSION PRODUCT 3. REPORTING ORGANIZATION TYPE 4. NAME/ADDRESS (Include Zip Code) 5. APPROVED PLAN NUMBER

Pre-A B C-FRP PRIME / ASSOCIATE CONTRACTOR DIRECT-REPORTING SUBCONTRACTOR GOVERNMENT a. PERFORMING ORGANIZATION b. DIVISION

A C-LRIP O&S

6. CUSTOMER (Direct-Reporting Subcontractor Use Only) 7. TYPE ACTION

a. CONTRACT NO.: c. SOLICITATION NO.: e. TASK ORDER/DELIVERY ORDER/LOT NO.:

b. LATEST MODIFICATION: d. NAME:

8. PERIOD OF PERFORMANCE 9. REPORT CYCLE 10. SUBMISSION NUMBER 11. RESUBMISSION NUMBER 12. REPORT AS OF (YYYYMMDD)

a. START DATE (YYYYMMDD): INITIAL

b. END DATE (YYYYMMDD): INTERIM

FINAL

13. NAME (Last, First, Middle Initial) 14. DEPARTMENT 15. TELEPHONE NO. (Include Area Code) 16. EMAIL ADDRESS 17. DATE PREPARED (YYYYMMDD)

18. WBS ELEMENT CODE 19. WBS REPORTING ELEMENT 20. NUMBER OF UNITS 21. APPROPRIATION

a. TO DATE b. AT COMPLETION RDT&E

PROCUREMENT

O&M

A. NONRECURRING B. RECURRING C. TOTAL D. NONRECURRING E. RECURRING F.TOTAL

LABOR

TOTAL LABOR HOURS

TOTAL LABOR DOLLARS

MATERIALS

TOTAL MATERIAL DOLLARS

OTHER COSTS

OTHER COSTS NOT SHOWN ELSEWHERE (Specify in Remarks)

SUMMARY

TOTAL COST (Direct and Overhead)

22. REMARKS

DD FORM 1921-1, MAY 2011 SECURITY CLASSIFICATION Unclassified

WBS 1.1.2

SECURITY CLASSIFICATION Unclassified

FUNCTIONAL COST-HOUR REPORT Form Approved

The public reporting burden for this collection of information is estimated to average 16 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, 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.

1. MAJOR PROGRAM a. NAME:

b. PHASE/MILESTONE 2. PRIME MISSION PRODUCT 3. REPORTING ORGANIZATION TYPE 4. NAME/ADDRESS (Include Zip Code) 5. APPROVED PLAN NUMBER

Pre-A B C-FRP PRIME / ASSOCIATE CONTRACTOR DIRECT-REPORTING SUBCONTRACTOR GOVERNMENT a. PERFORMING ORGANIZATION b. DIVISION

A C-LRIP O&S

6. CUSTOMER (Direct-Reporting Subcontractor Use Only) 7. TYPE ACTION

a. CONTRACT NO.: c. SOLICITATION NO.: e. TASK ORDER/DELIVERY ORDER/LOT NO.:

b. LATEST MODIFICATION: d. NAME:

8. PERIOD OF PERFORMANCE 9. REPORT CYCLE 10. SUBMISSION NUMBER 11. RESUBMISSION NUMBER 12. REPORT AS OF (YYYYMMDD)

a. START DATE (YYYYMMDD): INITIAL

b. END DATE (YYYYMMDD): INTERIM

FINAL

13. NAME (Last, First, Middle Initial) 14. DEPARTMENT 15. TELEPHONE NO. (Include Area Code) 16. EMAIL ADDRESS 17. DATE PREPARED (YYYYMMDD)

18. WBS ELEMENT CODE 19. WBS REPORTING ELEMENT 20. NUMBER OF UNITS 21. APPROPRIATION

a. TO DATE b. AT COMPLETION RDT&E

PROCUREMENT

O&M

A. NONRECURRING B. RECURRING C. TOTAL D. NONRECURRING E. RECURRING F.TOTAL

LABOR

TOTAL LABOR HOURS

TOTAL LABOR DOLLARS

MATERIALS

TOTAL MATERIAL DOLLARS

OTHER COSTS

OTHER COSTS NOT SHOWN ELSEWHERE (Specify in Remarks)

SUMMARY

TOTAL COST (Direct and Overhead)

22. REMARKS

DD FORM 1921-1, MAY 2011 SECURITY CLASSIFICATION Unclassified

WBS 1.1.3

SECURITY CLASSIFICATION Unclassified

FUNCTIONAL COST-HOUR REPORT Form Approved

The public reporting burden for this collection of information is estimated to average 16 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, 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.

1. MAJOR PROGRAM a. NAME:

b. PHASE/MILESTONE 2. PRIME MISSION PRODUCT 3. REPORTING ORGANIZATION TYPE 4. NAME/ADDRESS (Include Zip Code) 5. APPROVED PLAN NUMBER

Pre-A B C-FRP PRIME / ASSOCIATE CONTRACTOR DIRECT-REPORTING SUBCONTRACTOR GOVERNMENT a. PERFORMING ORGANIZATION b. DIVISION

A C-LRIP O&S

6. CUSTOMER (Direct-Reporting Subcontractor Use Only) 7. TYPE ACTION

a. CONTRACT NO.: c. SOLICITATION NO.: e. TASK ORDER/DELIVERY ORDER/LOT NO.:

b. LATEST MODIFICATION: d. NAME:

8. PERIOD OF PERFORMANCE 9. REPORT CYCLE 10. SUBMISSION NUMBER 11. RESUBMISSION NUMBER 12. REPORT AS OF (YYYYMMDD)

a. START DATE (YYYYMMDD): INITIAL

b. END DATE (YYYYMMDD): INTERIM

FINAL

13. NAME (Last, First, Middle Initial) 14. DEPARTMENT 15. TELEPHONE NO. (Include Area Code) 16. EMAIL ADDRESS 17. DATE PREPARED (YYYYMMDD)

18. WBS ELEMENT CODE 19. WBS REPORTING ELEMENT 20. NUMBER OF UNITS 21. APPROPRIATION

a. TO DATE b. AT COMPLETION RDT&E

PROCUREMENT

O&M

A. NONRECURRING B. RECURRING C. TOTAL D. NONRECURRING E. RECURRING F.TOTAL

LABOR

TOTAL LABOR HOURS

TOTAL LABOR DOLLARS

MATERIALS

TOTAL MATERIAL DOLLARS

OTHER COSTS

OTHER COSTS NOT SHOWN ELSEWHERE (Specify in Remarks)

SUMMARY

TOTAL COST (Direct and Overhead)

22. REMARKS

DD FORM 1921-1, MAY 2011 SECURITY CLASSIFICATION Unclassified

WBS 1.1.4

SECURITY CLASSIFICATION Unclassified

FUNCTIONAL COST-HOUR REPORT Form Approved

The public reporting burden for this collection of information is estimated to average 16 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, 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.

1. MAJOR PROGRAM a. NAME:

b. PHASE/MILESTONE 2. PRIME MISSION PRODUCT 3. REPORTING ORGANIZATION TYPE 4. NAME/ADDRESS (Include Zip Code) 5. APPROVED PLAN NUMBER

Pre-A B C-FRP PRIME / ASSOCIATE CONTRACTOR DIRECT-REPORTING SUBCONTRACTOR GOVERNMENT a. PERFORMING ORGANIZATION b. DIVISION

A C-LRIP O&S

6. CUSTOMER (Direct-Reporting Subcontractor Use Only) 7. TYPE ACTION

a. CONTRACT NO.: c. SOLICITATION NO.: e. TASK ORDER/DELIVERY ORDER/LOT NO.:

b. LATEST MODIFICATION: d. NAME:

8. PERIOD OF PERFORMANCE 9. REPORT CYCLE 10. SUBMISSION NUMBER 11. RESUBMISSION NUMBER 12. REPORT AS OF (YYYYMMDD)

a. START DATE (YYYYMMDD): INITIAL

b. END DATE (YYYYMMDD): INTERIM

FINAL

13. NAME (Last, First, Middle Initial) 14. DEPARTMENT 15. TELEPHONE NO. (Include Area Code) 16. EMAIL ADDRESS 17. DATE PREPARED (YYYYMMDD)

18. WBS ELEMENT CODE 19. WBS REPORTING ELEMENT 20. NUMBER OF UNITS 21. APPROPRIATION

a. TO DATE b. AT COMPLETION RDT&E

PROCUREMENT

O&M

A. NONRECURRING B. RECURRING C. TOTAL D. NONRECURRING E. RECURRING F.TOTAL

LABOR

TOTAL LABOR HOURS

TOTAL LABOR DOLLARS

MATERIALS

TOTAL MATERIAL DOLLARS

OTHER COSTS

OTHER COSTS NOT SHOWN ELSEWHERE (Specify in Remarks)

SUMMARY

TOTAL COST (Direct and Overhead)

22. REMARKS

DD FORM 1921-1, MAY 2011 SECURITY CLASSIFICATION Unclassified

WBS 1.1.5

SECURITY CLASSIFICATION Unclassified

FUNCTIONAL COST-HOUR REPORT Form Approved

The public reporting burden for this collection of information is estimated to average 16 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, 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 COMPLETED FORM TO THE ABOVE ORGANIZATION.

1. MAJOR PROGRAM a. NAME:

b. PHASE/MILESTONE 2. PRIME MISSION PRODUCT 3. REPORTING ORGANIZATION TYPE 4. NAME/ADDRESS (Include Zip Code) 5. APPROVED PLAN NUMBER

Pre-A B C-FRP PRIME / ASSOCIATE CONTRACTOR DIRECT-REPORTING SUBCONTRACTOR GOVERNMENT a. PERFORMING ORGANIZATION b. DIVISION

A C-LRIP O&S

6. CUSTOMER (Direct-Reporting Subcontractor Use Only) 7. TYPE ACTION

a. CONTRACT NO.: c. SOLICITATION NO.: e. TASK ORDER/DELIVERY ORDER/LOT NO.:

b. LATEST MODIFICATION: d. NAME:

8. PERIOD OF PERFORMANCE 9. REPORT CYCLE 10. SUBMISSION NUMBER 11. RESUBMISSION NUMBER 12. REPORT AS OF (YYYYMMDD)

a. START DATE (YYYYMMDD): INITIAL

b. END DATE (YYYYMMDD): INTERIM

FINAL

13. NAME (Last, First, Middle Initial) 14. DEPARTMENT 15. TELEPHONE NO. (Include Area Code) 16. EMAIL ADDRESS 17. DATE PREPARED (YYYYMMDD)

18. WBS ELEMENT CODE 19. WBS REPORTING ELEMENT 20. NUMBER OF UNITS 21. APPROPRIATION

a. TO DATE b. AT COMPLETION RDT&E

PROCUREMENT

O&M

A. NONRECURRING B. RECURRING C. TOTAL D.