Sec_J _Atch_2_-_Draft_CDRLS_LOSC.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: A011 title: Quality Management Plan sub:

auth:

ref: PWS 2.6.1, 8.2 req_ofc: 30 SW/PMD dd250: No appcode: A dist: F freq: See Blk 16 asof: 30 Sep firstsub: See Blk 16 subsub: 10 DARP addressee1: 30 SW/PMD draft1: 0 reg1: 1 repro1: 0 addressee2: 30 CONS/LGCZ draft2: 0 reg2: 1 repro2: 0 addressee3:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: This CDRL will document how the contractor intends to implement their Quality Management System. CDRL shall provide enough detail to ensure contractor complies with ISO 9001-20008 or equivalent standards.

group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system:

ctr_no:

contr:

remarksb:

Page2:

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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 data_item: A012 title: Requisition Summary Report sub:

auth: DI-MGMT-80208 ref: PWS 2.3.10 req_ofc: 30 SW/PMD dd250: No appcode: N/A dist: F freq: QRTLY asof: 0 firstsub: End 1st qtr subsub: 10 DARP addressee1: 30 SW/PMD draft1: 1 reg1: 1 repro1: 0 addressee2: 30 CONS/LGCZ draft2: 1 reg2: 1 repro2: 0 addressee3:

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total_draft: 2 total_reg: 2 total_repro: 0 remarks: The report shall consist of all material, supplies, plant equipment, equipment, possessory tax, training, travel, and vehicles obtained in direct support of the contract (not what was obtained in an overhead pool). Costs should displayed for each item.

group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system:

ctr_no:

contr:

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 data_item: A013 title: Inventory of Cross Connection Control and Backflow Prevention Systems Report sub: Cross Connection Control Management Plan auth: DI-MGMT-80592A ref: PWS 4.13 req_ofc: 30 SW/PMD dd250: No appcode: N/A dist: F freq: See Blk 16 asof: 0 firstsub: 30 DAC subsub: 15 DARP addressee1: 30 SW/PMD draft1: 0 reg1: 1 repro1: 0 addressee2: 30 CES/CEV draft2: 0 reg2: 1 repro2: 0 addressee3: 30 CES/CEOIU draft3: 0 reg3: 1 repro3: 0 addressee4:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Blk 4: Tailor DID as follows

DID para 10.2: Replace the paragraph with " The plan shall include a spreadsheet with AF Form 848 inventory information on one sheet and AF Form 843 or 844 test results on another sheet"

Add DID para 10.3: The plan shall include the information as required in 30 CES OI 32-1066.

Blk 10: After the initial submittal, the reporting periods for the subsequent submissions ends 31 Dec, 31 Mar, 30 Jun, and 30 Sep. The quarterly report would be a compilation of the forms of all back flow preventer devices tested during that quarter. In addition to quarterly reports, an annual report is required and due within 15 days following hte end of the reproting year, 1 Mar to 28 Feb.

Blk 13: Due on the 15th of the month or the next workday if the 15th is a weekend or federal holiday.

Submit data in an electronic Microsoft file or other file, readable by addressee group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system:

ctr_no:

contr:

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 data_item: A014 title: Cathodic Protection Annual Performance Booklet sub:

auth:

ref: PWS 4.13 req_ofc: 30 SW/PMD dd250: No appcode: N/A dist: F freq: ANNLY asof: 31 Dec firstsub: 30 Jan subsub: 30 Jan addressee1: 30 SW/PMD draft1: 0 reg1: 1 repro1: 0 addressee2: 30 SW/SEA draft2: 0 reg2: 1 repro2: 0 addressee3: 30 CE/CEOES draft3: 0 reg3: 1 repro3: 0 addressee4:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Ensure CDRL is completed in accordance with AFI 32-1054 and UFC 03-570-06.

Blk 13: Due on the the 30th of the month or the next work day if the 30th is a weekend or federal holiday.

Ensure all is done in accordance with AFI 32-1054 and UFC 03-570-06.

Submit data in an electronic Microsoft file or other file, readable by the addressee group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system:

ctr_no:

contr:

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 data_item: A015 title: Environmental Protection Plan sub:

auth:

ref: PWS 2.7.1 req_ofc: 30 SW/PMD dd250: No appcode: N/A dist: F freq: ONE/R asof: N/A firstsub: 10 DAC subsub: 10 DAR addressee1: 30 SW/PMD draft1: 0 reg1: 1 repro1: 0 addressee2: 30 CES/CEVC draft2: 1 reg2: 1 repro2: 0 addressee3: 30 LCSS draft3: 0 reg3: 1 repro3: 0 addressee4: 30 CONS/LGCZ draft4: 0 reg4: 1 repro4: 0 addressee5:

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addressee36:

draft36:

reg36:

repro36:

addressee37:

draft37:

reg37:

repro37:

addressee38:

draft38:

reg38x:

repro38:

total_draft: 1 total_reg: 4 total_repro: 0 remarks: The Environmental Protection Plan shall address the Contractor's processes of how they are going to comply with all environmental requirements listed in the PWS.

Blk 8: The government has 15 days to review the preliminary draft Environmental Protection Plan. The contractor has 30 days, after receipt of Government comments, to address comments prior to final review and approval for submittal of the Environmental Protection Plan. Suggest follow format of LOSC Vandenberg AFB Environmental Compliance Requirements Attachment 1D, paragraph 1.03, Environmental Protection Plan.

BLK 12 & 13: Due on the next workday if the 10th day is a weekend or federal holiday.

Blk 14a: Submit plan affecting 30 LCSS facilities to 30 LCSS group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system:

ctr_no:

contr:

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 data_item: A016 title: Solid Waste Report sub:

auth:

ref: PWS 2.7.2 req_ofc: 30 SW/PMD dd250: No appcode: N/A dist: F freq: MTHLY asof: 0 firstsub: 35 DAC subsub: 5 DARP addressee1: 30 SW/PMD draft1: 0 reg1: 1 repro1: 0 addressee2: 30 CES/CEVC draft2: 0 reg2: 1 repro2: 0 addressee3:

draft3:

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addressee31:

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addressee32:

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addressee37:

draft37:

reg37:

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addressee38:

draft38:

reg38x:

repro38:

total_draft: 0 total_reg: 2 total_repro: 0 remarks: Solid Waste Report shall be in accordance with AFI 32-7042, 30SW Solid Waste Management Plan.

Blk 12: Due on the next workday of the 5th day is a weekend or federal holiday.

Submit data in an electronic Microsoft file or other file, readable by addressee group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system:

ctr_no:

contr:

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 data_item: A017 title: Hazardous Materials Management Plan sub: Hazardous Material Business Plan Disclaimer auth:

ref: PWS 2.7.3 req_ofc: 30 SW/PMD dd250: No appcode: A dist: F freq: ONE/R asof: N/A firstsub: 30 DAC subsub: 30 DAR addressee1: 30 SW/PMD draft1: 0 reg1: 1 repro1: 0 addressee2: 30 CES/CEVC draft2: 1 reg2: 1 repro2: 0 addressee3: 30 CES/CEF draft3: 0 reg3: 1 repro3: 0 addressee4:

draft4:

reg4:

repro4:

addressee5:

draft5:

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draft21:

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draft24:

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draft25:

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draft26:

reg26:

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addressee27:

draft27:

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draft28:

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addressee32:

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total_draft: 1 total_reg: 3 total_repro: 0 remarks: Blk 3: A hazardous Material Business Plan or Hazardous Material Disclaimer. Reference the 30 SW Plan, 32-7086, Hazardous Materials Management Plan, for correct format and criteria.

Blk 8: The government has 30 days to review the preliminary draft Hazardous Material Business Plan or Hazardous Material Disclaimer. The contractor has 30 days, after receipt of government comments, to address comments prior to final review and approval for submittal of the Hazardous Material Business Plan or Hazardous Material Disclaimer.

Blk 12 & 13: Due on the next workday if the 30th day is a weekend or federal holiday.

group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system:

ctr_no:

contr:

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 data_item: A018 title: Environmental Cleanup Plan sub: Lead Based Paint Abatement Plan auth:

ref: PWS 2.7.6 req_ofc: 30 SW/PMD dd250: No appcode: A dist: F freq: As Required asof: N/A firstsub: See Blk 16 subsub: ASREQ addressee1: 30 SW/PMD draft1: 0 reg1: 1 repro1: 0 addressee2: 30 CES/CEVC draft2: 1 reg2: 1 repro2: 0 addressee3: 30 LCSS draft3: 0 reg3: 1 repro3: 0 addressee4:

draft4:

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total_draft: 1 total_reg: 3 total_repro: 0 remarks:

Blk 3: The contents of the Lead Based Paint Abatement Plan are identified in attachment 1D, Lead Based Paint (LBP) Management Requirements Document.

Blk 8: The government has 15 days to review the preliminary draft Lead Based Paint Abatement plan. A Contractor lead based paint abatement plan is required prior to any lead abatement activities with approval by 30 CES/CEVC and potential 10 day demolition notification to the local Santa Barbara Air Pollution Control District for related demolition activities. The government has 15 days to review and approve the Santa Barbara Air Pollution Control District demolition notification prior to submittal to the district. The contractor has 30 days, after receipt of government comments, to address comments prior to final review and approval for submittal of the final lead based paint abatement plan.

Blk 10: Due when the lead abatement activity is required. It is estimated there will be a need for six lead based paint abatement plans per year.

Blk 12 & 13: Due 30 days prior to start of lead abatement activities or on the previous workday of the 30th day is a weekend or federal holiday.

Blk 14a: Submit any plan for 30 LCSS facilities to 30 LCSS.

group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: ENVR system:

ctr_no:

contr:

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 data_item: A019 title: Contract Work Breakdown Structure sub:

auth: DI-MGMT-81334C ref: PWS 2.3.5 req_ofc: 30 SW/PMD dd250: No appcode: A dist: F freq: ANNLY asof: N/A firstsub: 5 DAC subsub: 10 DAR addressee1: 30 SW/PMD draft1: 0 reg1: 1 repro1: 0 addressee2: 30 CES/CERF draft2: 0 reg2: 1 repro2: 0 addressee3: 30 CPTS/FMA draft3: 0 reg3: 1 repro3: 0 addressee4: 30 CONS/LGCZ draft4: 0 reg4: 1 repro4: 0 addressee5:

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reg38x:

repro38:

total_draft: 0 total_reg: 4 total_repro: 0 remarks: Blk 8: The government has 30 days to review initial draft, and 15 days for revisions. The contractor has 10 days, after receipt of government comments, to prepare and deliver the final data. Criteria for approval shall be correct content and format.

Blk 12: Due 20 days before contract start, (20 days before phase in ends), or the next workday if the 20th day is a weekend or federal holiday.

Blk 13: Due on the next workday if the 10th day is a weekend or federal holiday.

group:

total_price:

prep_name:

line_item:

exhibit:

xtdp: Off xtm: Off othercat: MGMT system:

ctr_no:

contr:

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

Item 14.; Desired medium for delivery of th