CDRL.pdf

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of12 11

FD20301500776B-2 / Control Surface, Gui

A001

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Teardown Deficiency Report N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-ALSS-81534 PWS/SOW 424 SCMS/GUMAA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

NO

8. APP Code:

N/A A

11. As of Date: 13. Date of Subsequent Submission:

See Block 16

See Block 16

See Block 16

a. Addressee:

b. Copies:

Final

Draft Reg Repro See Block 16

G. Prepared By: H. Date I. Approved By: J. Date:

424 SCMS/GUMAA

3001 Staff Drive Tinker AFB, OK Attn: Tara Johnson

0 1 0

15. Total: 0 1 0

16. Remarks:

NAME: Zilar, Dale N DATE: 26 JUN 2014

Block 7: All Inspection and acceptance shall be at destination utilizing WAWF. A combination of an invoice and receiving report shall be submitted through WAWF in order to receive payment for data reports.

Blocks 10, 11, 12, and 13: To be negotiated on call by demand.

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

COORDINATORS:

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651

405-736-7856 / 886-7856

13 JAN 2015

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of22 11

A002

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Depot Manintenance Production Report N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-ALSS-80728A PWS/SOW 424 SCMS/GUMAA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

SD

8. APP Code:

N/A A

11. As of Date: 13. Date of Subsequent Submission:

See Block 16

See Block 16

MTHLY

a. Addressee:

b. Copies:

Final

Draft Reg Repro See Block 16

G. Prepared By: H. Date I. Approved By: J. Date:

424 SCMS/GUMAA

3001 Staff Drive Ste. 1AC4 96A Tinker AFB, OK 73145-3041 Attn: Tara Johnson

0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Zilar, Dale N DATE: 02 DEC 2014

MANUAL REPORT:

REF BLOCK 11, 12 AND 13

THE REPORT WILL BE PREPARED USING AFMC FORM 413, JUNE 95 EDITION, AS OF

THE LAST WORKING DAY OF EACH MONTH AND FORWARDED BY E-MAIL:

tara.johnson.6@us.af.mil, OR ORIGINAL MAIL SERVICE NLT THE FIFTH WORKING

DAY OF THE MONTH TO THE APPROPRIATE PMS. THE INITIAL REPORT WILL BE

PREPARED FOR THE MONTH DURING WHICH THE CONTRACTS ASSETS ARE

RECEIVED. REPORTS WILL CONTINUE TO BE FORWARDED UNLESS TERMINATED BY

THE 424 SCMS/GUMAA, PRODUCTION MANAGEMENT SPECIALIST (PMS). THE LAST

REPORT WILL BE ANNOTATED "FINAL MANUAL REPORT".

REF BLOCK 14A: COMPLETE ADDRESS FOR DISTRIBUTION:

424 SCMS/GUMAA

3001 STAFF DRIVE, Ste. 1AC4 96A

TINKER AFB, OK 73145

405-736-7856

E-MAIL PREFERRED: tara.johnson.6@us.af.mil

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

COORDINATORS:

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of32 11

A003

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Commercial Asset Visibility AF (CAV AF) End Item Reporting CAV AF

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-MGMT-81634B PWS/SOW 424 SCMS/GUMAA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

DD

8. APP Code:

N/A N/A

11. As of Date: 13. Date of Subsequent Submission:

See Block 16

See Block 16

See Block 16

a. Addressee:

b. Copies:

Final

Draft Reg Repro See Block 16

OC-ALC 0 1 0

15. Total: 0 1 0

16. Remarks:

NAME: Zilar, Dale N DATE: 27 OCT 2014

1. The contractor shall report End Item transactional data through electronic submission in CAV AF using the CAV AF web site or CICA XML IAW the referenced DID IAW and/or CAV AF CFM SOW. This information will be accessed by the program office PMS and by 420 SCMS/GUNA in order to ascertain production status.

2. Transactions and data will be submitted by the contractor daily IAW CAV AF User Guide, Version 8.0.1 or higher. The Contractor shall obtain a valid DoD PKI certificate to log into CAV AF.

Each user shall be required to have an Identity Certificate only; an encryption certificate is not required.

3. Training is provided by 848 SCMS/SRM (405) 736-7171.

4. This DD Form 1423-1 applies to Contractor Furnished Materiel (CFM) type contracts.

Block 10:

a. Contractor reporting requirements to CAV AF shall be accomplished daily and/or within 24 hrs of a supply or maintenance action occurrence IAW Contractor Users Guide.

b. The method of communication from the contractor to the Air Logistics Complex (ALC) will be mechanized using the CAV AF Online web site IAW CAV AF Contractor Users Guide.

Block 11: Data shall be current within 24 hours of last End Item maintenance occurrence.

Block 12: Date of first submission shall be within 24 hours following a supply or maintenance transaction after the contract award date and government training as specified in IAW CAV AF Users Guide.

Block 13: Same as remarks regarding Block 10 above.

COORDINATORS:

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of42 11

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

G. Prepared By: H. Date I. Approved By: J. Date:

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of52 11

A004

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Conference Agenda Meeting Agenda

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-ADMIN-81249A PWS 424 SCMS/GUEA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

DD

8. APP Code:

N/A D

11. As of Date: 13. Date of Subsequent Submission:

See Block 16

See Block 16

1 XTIME

a. Addressee:

b. Copies:

Final

Draft Reg Repro See Block 16

G. Prepared By: H. Date I. Approved By: J. Date:

424 SCMS/GUEA

3001 Staff Drive Tinker AFB, OK 73145

0 1 0

15. Total: 0 1 0

16. Remarks:

NAME: Zilar, Dale N DATE: 05 JAN 2015

Block 11, 12 & 13: Due one week prior to meetings.

Contractors's format is acceptable.

See PWS for more details.

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

COORDINATORS:

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of62 11

A005

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Conference Minutes Meeting minutes

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-ADMIN-81250A PWS 424 SCMS/GUEA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

DD

8. APP Code:

N/A D

11. As of Date: 13. Date of Subsequent Submission:

See Block 16

See Block 16

1 XTIME

a. Addressee:

b. Copies:

Final

Draft Reg Repro See Block 16

G. Prepared By: H. Date I. Approved By: J. Date:

424 SCMS/GUEA

3001 Staff Drive Tinker AFB, OK 73145

0 1 0

15. Total: 0 1 0

16. Remarks:

NAME: Zilar, Dale N DATE: 24 OCT 2014

Block 11, 12 &13: Due one week after meetings.

Contractors's format is acceptable.

See PWS for more details.

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

COORDINATORS:

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of72 11

A006

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Presentation Material N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-ADMIN-81373 N/A 424 SCMS/GUMAA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

N/A

8. APP Code:

N/A N/A

11. As of Date: 13. Date of Subsequent Submission:

N/A

N/A

MTHLY

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

424 SCMS/GUMAA

3001 Staff Drive Tinker AFB, OK Attn: Tara Johnson

0 1 0

15. Total: 0 1 0

16. Remarks:

NAME: Zilar, Dale N DATE: 19 AUG 2014

Blk 4: Contractor format is acceptable. The contract number, CDRL number, document name, date of submission and document number shall appear on the first page of deliverable.

Control Warning Notice: Warning-This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, USC, Sec 2751 Et Seq) or the Export Administration Act of 1979, as amended, Title 50, USC, App 240 I Et Seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DOD Directive 5230.25.

Destruction Notice for Unclassified/Limited documents: destroy by any method that will prevent disclosure of contents or reconstruction of the document.

REPORT SHALL BE SUBMITTED FOR THE MONTH INITIAL DELIVERY ORDER OR

ASSETS ARE RECEIVED AFTER CONTRACT AWARD. ALL REPORTS SHALL BE MAILED

SO AS TO ARRIVE AT 424 SCMS/GUME NO LATER THEN THE TENTH (10TH) CALENDAR

DAY OF THE MONTH FOLLOWING THE REPORTING PERIOD.

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

COORDINATORS:

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of82 11

A007

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Engineering Change Proposal (ECP) N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-CMAN-80639C PWS 424 SCMS/GUMAA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

DD

8. APP Code:

A C

11. As of Date: 13. Date of Subsequent Submission:

N/A

N/A

ASREQ

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

424 SCMS/GUMAA

3001 Staff Drive Tinker AFB, OK Attn: Tara Johnson

0 1 0

15. Total: 0 1 0

16. Remarks:

NAME: Zilar, Dale N DATE: 05 JAN 2015

BLK 8: The Government will have 10 days after receipt for approval or disapproval. The contractor shall have 5 days after receipt of the Government comments to resubmit.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests for this document shall be referred to 424 SCMS/GUMAA.

BLK 14: Documents shall be provided to the following personnel via electronic media utilizing standard Microsoft Office applications.

424 SCMS/GUMAA

3001 Staff Drive Tinker AFB, OK Attn: Tara Johnson Email: Tara.Johnson.6@us.af.mil

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

COORDINATORS:

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of92 11

A008

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Scientific and Technical Reports N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-MISC-80711A N/A 424 SCMS/GUMAA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

N/A

8. APP Code:

N/A N/A

11. As of Date: 13. Date of Subsequent Submission:

N/A

N/A

ASREQ

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

424 SCMS/GUMAA

3001 Staff Drive Tinker AFB, OK Attn: Tara Johnson

0 1 0

15. Total: 0 1 0

16. Remarks:

NAME: Zilar, Dale N DATE: 05 JAN 2015

Block 10: 30 day after receipt of order.

Block 11 & 12: Submitted to government upon completion of contract.

Contractor format is acceptable. Reports shall be provided in Microsoft Office compatible format via electronic media or email.

Electronic versions shall be submitted via email to the following:

Tara.Johnson.6@us.af.mil

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

COORDINATORS:

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of102 11

A009

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Counterfeit Prevention Plan N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-MISC-81832 N/A 424 SCMS/GUEA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

NO

8. APP Code:

N/A D

11. As of Date: 13. Date of Subsequent Submission:

See Block 16

See Block 16

See Block 16

a. Addressee:

b. Copies:

Final

Draft Reg Repro See Block 16

G. Prepared By: H. Date I. Approved By: J. Date:

424 SCMS/GUEA

3001 Staff Drive Tinker AFB, OK 73145-3041

0 0 1

15. Total: 0 0 1

16. Remarks:

NAME: Zilar, Dale N DATE: 01 AUG 2014

The plan shall be delivered in electronic PDF format through the Wide Area Workflow (WAWF) system no later than 90 calendar days after contract award (FA8711).

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

COORDINATORS:

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of112 11

A010

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. Contract Line Item No.: B. Exhibit: C. Category:

TDP TM OTHER X

D. System/Item: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Source Data For Forecasting Diminishing Manufacturing Sources And Material Shortages (DMSMS)

N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-SESS-81656A N/A 424 SCMS/GUMAA

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

XX

8. APP Code:

A C

11. As of Date: 13. Date of Subsequent Submission:

SEE BLOCK 16

SEE BLOCK 16

QRTLY

a. Addressee:

b. Copies:

Final

Draft Reg Repro

SEE BLOCK 16

G. Prepared By: H. Date I. Approved By: J. Date:

424 SCMS/GUMAA

3001 Staff Drive Tinker AFB, OK Attn: Tara Johnson

0 1 0

15. Total: 0 1 0

16. Remarks:

NAME: Zilar, Dale N DATE: 05 JAN 2015

BLOCK 7: ALL INSPECTION AND ACCEPTANCE SHALL BE AT DESTINATION

UTILIZING WAWF. A COMBINATION OF AN INVOICE AND RECEIVING REPORT SHALL

BE SUBMITTED THROUGH WAWF IN ORDER TO RECEIVE PAYMENT FOR DATA

REPORTS.

Blocks 11-3: The first report shall be submitted within 5 calendar days of the contractor's discovery that one or more of the components or materials intended to be incorporated directly into an end item specified to be delivered under the delivery order or contract is a DMS component, the contractor shall notify the contracting officer in writing.

BLOCK 14A: ALL DIGITAL SUBMISSIONS SHALL BE MADE VIA ELECTRONIC MAIL

TO:

424 SCMS/GUMAA

3001 Staff Drive Tinker AFB, OK Attn: Tara Johnson

Email: Tara.Johnson.6@us.af.mil

CONTRACTOR FORMAT IS ACCEPTABLE.

DID REQUIREMENTS ARE NOT TAILORED.

DELIVERY CANNOT BE DEFERRED.

Zilar, Dale N

424 SCMS / GUBAA

405-736-7976

13 JAN 2015 //DIGITALLY SIGNED//

COORDINATORS:

424 SCMS / GUMA

JOHNSON.TARA.H.1270012651