C-12_CLS_-_CDRLS.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: A001 title: STATUS REPORT sub: AIRCRAFT STATUS REPORT - DAILY auth: DI-MGMT-80368A (See Block 16) ref: PWS PARA 1.2.1 req_ofc: AFLCMC/WLVSC dd250: NO appcode: A dist: C freq: DAILY asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: AFLCMC/WLVSC draft1:

reg1: 1 repro1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: Block 4: Contractor format acceptable.

The Contractor shall provide the following information as a minimum:

a. Aircraft tail number

b. Location

c. Current status per AFI 21-101

d. Discrepancy description

e. Parts status (if required)

f. Estimated time to completion

g. Projected personnel movements (travel)

h. Projected site audits/visits

Block 8: The Program Management Office (PMO) will approve the 1st article.

Block 11: Date of assuming full performance.

Block 12: 1st Regular work day after assuming full performance not later than 10:00 a.m. CST.

Block 13: Regular work day not later than 10:00 a.m. CST.

Block 14: Place on Web-based Information System (WIS) and send an email notification to the (PMO).

group:

total_price:

prep_name:

line_item: X001 exhibit: A xtdp: Off xtm: Off othercat: MGMT system: USAF C-12 ctr_no:

contr:

remarksb:

Page2:

Reset:

2015-08-05T06:50:44-0500

BROWN.LORI.S.1169923503

prep_date: 5 AUG 15 app_by:

2015-08-05T10:03:10-0500

COOPER.ZACHARY.J.1230922787

app_date: 5 Aug 15

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: A001A title: STATUS REPORT sub: AIRCRAFT STATUS REPORT - MONTHLY auth: DI-MGMT-80368A (See Block 16) ref: PWS PARA 1.2.1, 1.2.3 req_ofc: AFLCMC/WLVSC dd250: NO appcode: A dist: C freq: MONTHLY asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: AFLCMC/WLVSC draft1:

reg1: 1 repro1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: Block 4: Contractor format is acceptable.

The Contractor shall provide the following information as a minimum:

a. Aircraft build number/tail number

b. Flight hours per aircraft (broken out by using command) for month and year

c. Aircraft mission capable rate

d. Total airframe time

e. Total engine time

f. Aircraft landings

g. Open Discrepancies

The report shall include the monthly aircraft status report submitted by the site.

Block 8: The Program Management Office (PMO) will approve the 1st article.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 15 December 2014. Other requests for this document shall be referred to AFLCMC/WLVSC.

Block 11: Date of assuming full performance.

Block 12: End the month plus 10 calendar days.

Block 13: End of month plus 10 calendar days.

Block 14: Place on Web-based Information System (WIS) and send an email notification to the (PMO).

group:

total_price:

prep_name:

line_item: X001 exhibit: A xtdp: Off xtm: Off othercat: MGMT system: USAF C-12 ctr_no:

contr:

remarksb:

Page2:

Reset:

2015-08-05T06:51:22-0500

BROWN.LORI.S.1169923503

prep_date: 5 AUG 15 app_by:

2015-08-05T10:03:52-0500

COOPER.ZACHARY.J.1230922787

app_date: 5 Aug 15

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: A002 title: CONFIGURATION STATUS ACCOUNTING INFORMATION sub: AIRCRAFT/ENGINE CONFIGURATION REPORT auth: DI-CMAN-81253A (See Block 16) ref: PWS PARA 1.2.6 req_ofc: AFLCMC/WLVSC dd250: NO appcode: A dist: C freq: QUARTERLY asof: Block 16 firstsub: Block 16 subsub: Block 16 addressee1: AFLCMC/WLVSC draft1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: Block 4: Contractor format is acceptable.

The Contractor shall provide the following information as a minimum:

Aircraft

a. Aircraft model/build number/tail number

b. Type service action

c. Service action tracking number

d. Date accomplished

Engine

a. Engine model/serial number

b. Type of service action

c. Service action tracking number

d. Date/engine time when accomplished

Block 8: The Program Management Office (PMO) will approve the 1st article.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 15 December 2014. Other requests for this document shall be referred to AFLCMC/WLVSC.

Block 11: Date of assuming full performance.

Block 12: Submit the first deliverable within 10 calendar days after the first completed quarter of the contract.

Block 13: Subsequent deliverables shall be submitted within 10 calendar days of the completion of each quarter.

Block 14: Place on Web-based Information System (WIS) and send an email notification to the (PMO).

group:

total_price:

prep_name:

line_item: X001 exhibit: A xtdp: Off xtm: Off othercat: MGMT system: USAF C-12 ctr_no:

contr:

remarksb:

Page2:

Reset:

2015-08-05T06:51:45-0500

BROWN.LORI.S.1169923503

prep_date: 5 AUG 15 app_by:

2015-08-05T10:08:18-0500

COOPER.ZACHARY.J.1230922787

app_date: 5 Aug 15

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: A003 title: STATUS REPORT sub: MISHAP/INCIDENT REPORTING auth: DI-MGMT-80368A ref: PWS 1.2.7 req_ofc: AFLCMC/WLVS dd250:

appcode:

dist: D freq: AS REQ asof: AS REQ firstsub: AS REQ subsub: AS REQ addressee1: AFLCMC/WLVSB draft1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: BLK 4: Contractor format acceptable.

Report shall contain:

a. Date, time and exact location of accident/incident

b. Brief narrative of accident/incident

c. Cause of accident/incident, if known

d. Estimated cost of accident/incident (material and labor to repair/replace)

e. Nomenclature of equipment and personnel involved in accident/incident

f. Corrective actions (taken or proposed)

g. Other pertinent information

BLK 12: Contractor shall deliver an interim status report 3 calendar days after each occurrence.

BLK 13: Contractor shall deliver a final report 20 calendar days after each occurrence.

group:

total_price:

prep_name:

line_item: X001 exhibit:

xtdp: Off xtm: Off othercat: MGMT system: USAF C-12 ctr_no:

contr:

remarksb:

Page2:

Reset:

2015-08-05T06:52:06-0500

BROWN.LORI.S.1169923503

prep_date: 5 AUG 15 app_by:

2015-08-05T10:09:03-0500

COOPER.ZACHARY.J.1230922787

app_date: 5 Aug 15

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: A004 title: STATUS REPORT sub: TECHNICAL DATA SERVICES auth: DI-MGMT-80368A ref: PWS 1.3.8 req_ofc: AFLCMC/WLVS dd250:

appcode:

dist: D freq: AS REQ asof: AS REQ firstsub: AS REQ subsub: AS REQ addressee1: AFLCMC/WLVSB draft1:

reg1: 1 repro1:

addressee2: AFLCMC/WLVSC draft2:

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

BLK 14:

a. Contractor shall deliver all updates for all manuals list in the PWS, Appendix D, Para. C, Industry Publications on DVD or provide access to a website with the ability to download/view data.

b. Contractor shall deliver a copy of all service actions.

group:

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app_date: 5 Aug 15

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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: A005 title: TECHNICAL REPORT-STUDY/SERVICES sub: DIMINISHING MANUFACTURING SOURCES AND MATERIAL SHORTAGES (DMSMS) auth: DI-MISC-80508B ref: PWS PARA 1.4.1 req_ofc: AFLCMC/WLVSC dd250: NO appcode: A dist: C freq: QUARTERLY asof: N/A firstsub: Block 16 subsub: Block 16 addressee1: AFLCMC/WLVSC draft1:

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

Block 8: The Program Management Office (PMO) will approve the 1st article.

Block 12: End of quarter plus 10 calendar days.

Block 13: End of quarter plus 10 calendar days.

Block 14: Place on Web-based Information System (WIS) and send an email notification to the (PMO).

group:

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app_date: 5 Aug 15

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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: A006 title: INVENTORY CHECKLIST/RECORD (ICL/R) sub: AIRCRAFT LOOSE EQUIPMENT INVENTORY auth: DI-MISC-81191A ref: PWS 1.4.7, APPENDIX G req_ofc: AFLCMC/WLVS dd250: N/A appcode: N/A dist: D freq: N/A asof: N/A firstsub: SEE BLK 16 subsub: SEE BLK 16 addressee1: AFLCMC/WLVSB draft1:

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

BLK 12/BLK 13:

a. Submit verified document No Later Than 5 calendar days after initial receipt of aircraft or any time an aircraft is permanently relocated to a site.

group:

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app_date: 5 Aug 15

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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: A007 title: CONSUMABLE PARTS BONDROOM/INVENTORY AND PARTS USAGE REPORT sub: USAGE REPORT auth: DI-ILSS-80834 ref: PWS PARA 1.4.11 req_ofc: AFLCMC/WLVSC dd250: NO appcode: A dist: C freq: Block 16 asof: N/A firstsub: Block 16 subsub: Block 16 addressee1: AFLCMC/WLVSC draft1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: Block 4: Contractor format acceptable.

Block 8: The Program Management Office (PMO) will approve the 1st article.

Block 10: The Contractor shall provide the usage report annually Block 12: End of first performance period.

Block 13: End of performance period plus 10 calendar days.

Block 14: Place on Web-based Information System (WIS) and send an email notification to the (PMO).

group:

total_price:

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contr:

remarksb:

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app_date: 5 Aug 15

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: A008 title: STATUS REPORT sub: AIRCRAFT/ENGINE MAINTENANCE FORECAST auth: DI-MGMT-80368A ref: PWS PARA 1.5.2, 1.6 req_ofc: AFLCMC/WLVSC dd250: NO appcode: A dist: C freq: Block 16 asof: N/A firstsub: Block 16 subsub: Block 16 addressee1: AFLCMC/WLVSC draft1:

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total_draft: 0 total_reg: 1 total_repro: 0 remarks: Block 4: Contractor format acceptable.

The following information shall be provided:

Aircraft S/N Engine S/N Prop S/N Projected scheduled maintenance due within 90 days Engine Time Remaining until Hot Section Inspection (HSI) Hot Section Inspection Projected Due Date Engine Time Remaining Until Overhaul Engine Overhaul Projected Due Date

Block 8: The Program Management Office (PMO) will approve the 1st article.

Block 10: The Contractor shall provide the maintenance forecast quarterly.

Block 12: Submit the first deliverable within 15 days after the first completed quarter of the contract.

Block 13: Subsequent deliverables shall be submitted within 15 days of the completion of each quarter.

Block 14: Place on Web-based Information System (WIS) and send an email notification to the (PMO).

group:

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contr:

remarksb:

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prep_date: 5 AUG 15 app_by:

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COOPER.ZACHARY.J.1230922787

app_date: 5 Aug 15

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 1. See DoD FAR Supplement