CDRLs_&_DIDs.pdf

For the best experience, open this PDF portfolio in

Acrobat X or Adobe Reader X, or later.

Get Adobe Reader Now!

http://www.adobe.com/go/reader

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

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 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 X

D. SYSTEM / ITEM

F110 / Servo Valve

E. CONTRACT / PR NO.

FD20301900741

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Commercial Asset Visibility AF (CAV AF) End Item Reporting

3. SUBTITLE

CAV AF

4. AUTHORITY

DI-MGMT-81634C

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS/SOW

6. REQUIRING OFFICE

421 SCMS/GUMC

7. DD 250 REQ

NO

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

See Block 16

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST

SUBMISSION

13. DATE OF SUBSEQUENT

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Zilar, Dale NNAME: 27 APR 2017DATE:

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 848 SCMG/SRM 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 will be provided by 848 SCMG/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:

OC-ALC 0 1 0

0 1 015. TOTAL

G. PREPARED BY

Zilar, Dale N

424 SCMS / GUBAB

405-736-7976

H. DATE

26 NOV 2018

I. APPROVED BY

//DIGITALLY SIGNED//

ROSS.TAMARA.K.1239570808

421 SCMS / GUME 405-734-8696 / 884-8696

J. DATE

21 NOV 2018

Page 1 of 6DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 15 Feb 2019

PREVIOUS EDITION MAY BE USED.

A002

Contract Depot Maintenance (CDM) Production Report

CDM Prod

DI-PSSS-81995

PWS

MTHLY

SEE BLOCK 16

Zilar, Dale NNAME: 20 NOV 2018DATE:

Manual Report:

Ref Block 11, 12, and 13:

Contractor shall report by contract delivery order on all applicable categories, totals and on-hand balances, IAW DI- PSSS-81995, providing TABLE I for EACH repair location, including subcontractor facilities, for the contracts maintenance occurrence actions during the reporting period.

Contractor shall report on production, providing TABLE I for EACH repair location, including subcontractor facilities, for which the contractor produced assets during the reporting period.

Reports will continue to be forwarded unless terminated by the 421 SCMS/GUMC Production Management Specialist (PMS). The report following the final reporting period on contract will be annotated "Final Report".

Complete address for distribution:

3001 Staff Drive, Annex 4, Suite 2AC4 108B Tinker AFB, OK 73145-3033

Commercial phone number: (405) 734-8696 Email preferred: Tamara.Ross@us.af.mil

CONTRACTOR FORMAT ACCEPTABLE UNLESS OTHERWISE DEFINED BY APPLICABLE DATA ITEM

DESCRIPTION (DID).

DID Requirements are NOT tailored.

Delivery CANNOT be deferred.

The contractor's CAV AF reporting shall reflect their inventory property control management system data records which shall represent timely and accurate accountability of AF inventory assets at the physical location(s) of the contractor's repair facility (including subcontractor facilities); shop floor, bond room and/or receiving/shipping docks, etc. for each repair, The report shall be provided within 5 business days of the previous month's last calendar date.

3001 Staff Drive, Annex 4, Suite 2AC4 108B Tinker AFB, OK 73145-3033 Attention: Ta'mara K. Ross

0 1 0

Page 2 of 6DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 15 Feb 2019

A003

Deficiency Report (DR)

DR

DI-PSSS-81535A

LT

ASREQ

As Required

Zilar, Dale NNAME: 27 JUN 2016DATE:

Block 11, 12, 13: As defined by T.O. 00-35D-54, submit a report whenever a material or quality deficiency occurs using SF 368 or equivalent.

Changes to office symbols shall be made by letter through the PCO/ACO without revision to this CDRL.

421 SCMS/GUMC 0 1 0

A004

Government Property Inventory Report

DI-MGMT-80441C

PWS/SOW

ANNLY

Zilar, Dale NNAME: 22 MAY 2018DATE:

DI-MGMT-80441C, Government Property Inventory Report, prescribes the format, content, and preparation instructions for the data product required to meet this requirement.

Contractor shall provide in Microsoft Excel (.xls or .xlsx compatible) format. The contractor shall conduct an annual 100% physical inventory over the course of a year's time of each NIIN as not to impede maintenance operations. Upon completion of each NIINs 100% physical inventory, the contractor shall provide the AF government an inventory listing of the result of all AF Government Furnished Property (GFP) in the contractor's possession, by contract, and by National Stock Number (NSN). The Contractor shall submit a Table for each designated repair facility / DoDAAC location for which the contractor has received inventory during the reporting period, including Subcontractor facilities. The report should include all AF Government Furnished Property in possession of the Contractor.

Page 3 of 6DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 15 Feb 2019

The contractor's CAV AF reporting shall reflect their inventory property control management system data records which shall represent timely and accurate accountability of AF inventory assets at the physical location(s) of the contractor's repair facility (including subcontractor facilities); shop floor, bond room and/or receiving/shipping docks, etc. for each repair facility location, including sub-contractor locations.

Report shall contain the following columns/data fields:

A: Contract Number B: CAGE Code C: Item Name/Description D: Manufacturer Name E: Manufacturer Part Number (if applicable) F: Material Control Number (if applicable) G: Serial Number (if applicable) H: National Stock Number (NSN) I: Quantity J: Unit of Measure K: Unit Acquisition Cost L: Location M: Sub Location N: Unique Item Identifier O: Type of Government Property - i.e., Government Furnished Property (GFP) or Contractor Acquired Property (CAP) P: Classification of Government Property- (i.e,, Equipment (EQP), Material (MAT), Special Test Equipment (STE), or Special Tooling (ST) Q: Posting Reference R: Date of Transaction S: Date Placed in Service T: Date of Last Physical Inventory U: Condition Code

Block 10. This report will be provided annually. Reporting Period is one year.

Block 11. The data is representative of the Contractor's Internal Property Control System and shall be current as of the last day of the annual reporting period (If period of performance begins on 13 September 17, first annual reporting period ends 12 September 18). If requested outside of an annual cadence, the data shall be current as of the date requested.

Blocks 12 and 13. The report shall be delivered within seven (7) calendar days of the end of the first reporting period and annually thereafter, or within seven (7) calendar days of government request.

Page 4 of 6DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 15 Feb 2019

A005

Report of Shipping (Item) and Packaging Discrepancy

SDR

DI-MGMT-80503

PWS

LT

D

ASREQ

Zilar, Dale NNAME: 01 OCT 2018DATE:

Changes to the office symbols shall be made by letter through the PCO/ACO without revision to this CDRL.

Contractor will use WEBSDR to submit an electronic SF-364 (Standard Form) IAW TO 00-35D-54 upon discovery of discrepancies for items of supply received for: overage, wrong item, duplication of shipment, misdirected shipment, nonreceipt, damage, and/or improperly packaged shipment. If the contractor submits a SF-364, Block 12 of the SF 364 must contain the following information for the missing items:

1.) NSN

2.) Part Number 3.) Nomenclature 4.) Quantity missing 5.) Price for part replacement to include all administrative and labor costs.

Additionally, all tags that accompanied the component, (i.e. shipping labels, repairable tags, and condition tags will be scanned and attached to the SDR/ROD request.

DCMA/QAR and/or Plant Clearance Officer must validate the discrepancy upon unpacking of the component. SDR/ROD must be submitted to the PCO/PMS within 48 hours of inventory receipt/induction.

BLOCK 9: Distribution Statement D: Distribution authorized to the Department of Defense and US DOD Contractors only, Critical Technology. Other requests shall be referred to 421 SCMS/GUEA.

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, Title 50, USC, App 240 I Et Seq, as amended. 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 Documents: destroyed by any method that will prevent disclosure of contents or reconstruction of the document.

Destruction Notice for Classified Documents: Follow the procedures in DOD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, or DOD 5220.0 I M, Information Security Program , Vol 3, Protection of Classified Information.

BLOCK 11: Within 5 working days of discovery of discrepancy.

BLOCK 14: E-mail copies to addressees per attached Distribution Matrix. Report of Discrepancy shall be submitted to the material originator.

Note: It is permissible to submit paper SF 364s until access to WEBSDR is attained.

FOB DESTINATION

Page 5 of 6DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 15 Feb 2019

Page 6 of 6DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 15 Feb 2019

DATA ITEM DESCRIPTION

Title: GOVERNMENT PROPERTY INVENTORY REPORT

Number: DI-MGMT-80441C Approval Date: 20171101 AMSC Number: 9865 Limitation:

DTIC Applicable: No GIDEP Applicable: No Preparing Activity: MDA Project Number: MGMT-2017-059 Applicable Forms: None

Use/Relationship: This report enables the contractor to periodically provide to the DoD Service/Agency an inventory listing of Government Property (i.e., both Government Furnished Property (GFP) and Contractor Acquired Property (CAP)) in the contractor’s possession (to include subcontractors) by contract.

This DID is applicable to all contracts where Government Property will be furnished by the Government (i.e., GFP) or acquired, fabricated, or otherwise provided by a contractor (i.e., CAP) in performance of a contract.

This DID contains the format and content preparation instructions for the data deliverable resulting from the work task described in the solicitation.

This DID supersedes DI-MGMT-80441B.

Requirements:

1. Format. The report shall be electronic .xls or .xlsx compatible.

2. Content. The report shall contain the following columns/data fields:

A. Contract Number B. Manufacturer CAGE Code (if known) C. Item Name D. Item Description E. Manufacturer Name F. Manufacturer Part Number G. Manufacturer Model Number H. Material Control Number (MCN) (if applicable) I. Serial Number J. National Stock Number (NSN) K. Quantity L. Unit of Measure M. Unit Acquisition Cost N. Location O. Sub Location (if applicable) P. Unique Item Identifier (as registered in the IUID Registry) Q. Type of Government Property (i.e., Government Furnished Property (GFP) or

Contractor Acquired Property (CAP) R. Classification of Government Property (i.e., Communication Security (COMSEC), Equipment (EQP), Material (MAT), Special Test Equipment (STE), or Special Tooling

(ST))

Source: https://assist.dla.mil -- Downloaded: 2018-05-22T20:41Z Check the source to verify that this is the current version before use.

DI-MGMT-80441C

S. Posting Reference T. Date of Transaction / Date of Acquisition U. Date Placed in Service V. Date of Last Physical Inventory W. Condition Code

END OF DI-MGMT-80441C

Source: https://assist.dla.mil -- Downloaded: 2018-05-22T20:41Z

AMSC Number: 9865 Limitation:

Requirements:

Source: https://assist.dla.mil -- Downloaded: 2016-03-18T19:05Z

Title: COMMERCIAL ASSET VISIBILITY AIR FORCE (CAV AF)/GOVERNMENT

FURNISHED MATERIAL REPORT

Number: DI- MGMT-81634C Approved Date: 20150911 AMSC Number: 9581 Limitation: N/A DTIC Applicable: No GIDEP Applicable: No Preparing Activity: 11 (AFMC/A4RM) Project Number: MGMT-2015-025 Applicable Forms: N/A Use/Relationship: CAV AF is a web based system used to permit the reporting of end item repair and Government Furnished Material (GFM) transactions incident to the execution of Contract Depot Maintenance (CDM) contracts for the purpose of providing visibility and oversight of these assets.

a. This Data Item Description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirements as delineated in the contract.

b. This DID may be used on any depot-level repair contract.

c. This DID supersedes DI-MGMT-81634B.

Requirements:

1. Reference documents. The applicable issue of the documents cited herein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

2. Format. Format. The CAV AF System transactions are processed via the World Wide Web, https://www.cavaf.com. Input formats are found in the CAV AF Users Guide. Repair contractors will be furnished with a copy of the CAV AF Users Guide.

3. Content. The contractor reporting shall contain the following transactions and report types as described in the CAV AF Users Guide:

a. End Items:

(1) Receipt

(2) Induction

(3) Awaiting Parts (AWP)

(4) Re-induction

(5) Survey/Scrap

(6) Completion

(7) Shipment

(8) Proof of Shipment

(9) Reversals

DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited.

Source: https://assist.dla.mil -- Downloaded: 2016-04-12T17:40Z https://www.cavaf.com/

DI-MGMT-81634C

(10) Assets Beyond Economic Repair (BER) and Maintenance Expenditure Limit (MEL)

(11) Bulk Process

(12) Borrow/Payback

b. Government Furnished Material (GFM):

(1) Requisitions:

(a) Create

(b) Modify

(c) Cancel

(d) Follow-up as appropriate

(2) Receive material:

(a) Modify/reverse material option

(3) Issue material:

(a) Reverse issue of material

(4) Transfer material.

(5) Turn-in material:

(a) Reverse material turn in

(6) Condemnation/Plant Clearance of material:

(a) Condemn an item

(b) Reverse Condemnation

(c) Plant Clearance

(d) Reverse Plant Clearance

(7) Shipping of material:

(a) Material Release Order (MRO)

(b) Redistribution Order (RDO)

(c) After Receipt of Order (ARO)

(d) Reverse Material Shipment

End of DI-MGMT-81634C

Source: https://assist.dla.mil -- Downloaded: 2016-04-12T17:40Z

Title: DEFICIENCY REPORT (DR)

Number: DI-PSSS-81535A Approved Date: 20160524 AMSC Number: F9660 Limitation: N/A DTIC Applicable: No GIDEP Applicable: No Preparing Activity: AF 11 (AFLCMC/EZSC) Project Number: PSSS-2016-013 Applicable Forms: N/A

Use/Relationship: The Deficiency Report (DR) provides complete and accurate deficiency identification on government furnished material (GFM) in repair contracts by contractors to the Government. This information is used by the Government to identify necessary corrective action in accordance with T.O. 00-35D-54, USAF Deficiency Reporting, Investigation, and Resolution.

(Copies of this document are available online at http://www.tinker.af.mil/technicalorders/.)

a. This Data Item Description (DID) contains the format, content, and intended use information for the data deliverable resulting from the work task described in the solicitation.

b. This DID is applicable when contractors are responsible for maintaining custodial records for government property being repaired.

c. This DID interrelates with DI-MGMT-80258, Material Improvement Project (MIP) Report.

(Copies of this document are available online at http://quicksearch.dla.mil.)

d. This DID supersedes DI-ALSS-81535.

1. Reference documents. The applicable issue of the documents cited herein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

2. Format. The Contractor format is acceptable.

3. Content. The Deficiency Report content shall be as described in Table I.

Source: https://assist.dla.mil -- Downloaded: 2016-06-27T19:20Z http://www.tinker.af.mil/technicalorders/ http://quicksearch.dla.mil/

TABLE I. Deficiency report content.

1. From: Address of Originating Activity

2. To: Office of Primary Responsibility (OPR) for the equipment. Refer to D043 or D086 for guidance.

Subject First Part as applicable:

a. Category I Deficiency Report (CAT I DR)

b. Category II Deficiency Report (CAT II DR)

c. Report Control Number (RCN): An RCN consists of three parts. The first part will be the DoD Activity Address Code (DoDAAC).

The second part will be the last two digits of the calendar year.

The third part will be a 4-digit sequence number that is locally assigned.

3. Description of Deficiency:

Describe in detail what is wrong, the circumstances prior to the difficulty, probable cause, any action taken, and recommendations. Attach copy of supporting documents. Continue on separate sheet if necessary. Ensure that the description answers the questions listed in the instructions on the back of this form

4. Date of Deficiency: Year, month, day deficiency was discovered.

5. National Stock

Number (NSN) NSN and applicable Material Management Aggregation Code (MMAC) of item (see D043 and D086).

6. Nomenclature Noun of item for which report is submitted. Software DRs shall provide nomenclature of programmable hardware.

7. Operating Time at Failure

Hours, cycles, days, miles rounds or others

8. Deficient Item Part Number

Complete Manufacturer part number. If Computer Identification Number (CPIN) is associated with a computer program it shall also be provided.

9a. Manufacturer’s CAGE Code

Unique code assigned to suppliers of government or defense agencies.

9b. Manufacturer/Shipper/ City/State

Complete address of manufacturer or shipper.

10. Quantity Number received, inspected, deficient, and in stock.

11. Serial, lot or batch number Complete item serial number.

12a. Item new, repaired or overhauled

Use one to identify item as appropriate.

12b. Date Manufacturer, Repaired or Overhauled

Year/Month/Day

12c. Last Repair Facility CAGE/DoDAAC/Address

13a. Contract Number Obtain contract number from records service tag, manufacturer/container label, etc. Contract number is critical to processing reports.

13b. Requisition/Document Number

Obtain from tags/labels on item packaging.

13c. Purchase Order Number.

The Purchase Order Number associated with the defective part. This can usually be found on the attached shipping document.

14. Government Furnished Material (GFM)

Yes/No/Unknown

15a. Item Under Warranty Yes/No/Unknown 15b. Warranty Expiration

Date Provide if known.

16. End Item Enter the applicable Equipment Item Code (EIC), Work Unit Code (WUC), or Table of Authorized Material Control Number (TAMCN) for the deficient material.

17. Next Higher Assembly a. NSN – National Stock Number associated with the next higher assembly.

b. NOMENCLATURE – Item name of the next higher assembly.

c. PART NUMBER – Part number assigned to the next higher assembly.

d. SERIAL NUMBER – Serial number from the next higher assembly.

18. End Item a. NSN – National Stock Number associated with the end item.

b. NOMENCLATURE – Name of the end item.

c. TYPE/MODEL – Type or model assigned to the end item configuration.

d. SERIAL NUMBER – Serial number from the end item equipment or system.

19. Current Disposition of Deficient Item

Holding/Disposed or Destroyed/Repaired/Other

20. Location of Deficient Material

Enter the name and location or supply activity that is currently holding the exhibit/deficient material.

End of DI-PSSS-81535A.

Title: CONTRACT DEPOT MAINTENANCE (CDM) PRODUCTION REPORT

Number: DI-PSSS-81995 Approved Date: 20150904 AMSC Number: 9576 Limitation: N/A DTIC Applicable: No GIDEP Applicable: No Preparing Activity: 11 (AFMC/A4) Project Number: PSSS-2015-009 Applicable Forms: N/A Use/Relationship: The Contract Depot Maintenance (CDM) Production Report is a two-part report which provides the Government with monthly maintenance production figures, status and accountability of assets at the contractor facility, performance to schedule, anticipated production for the next month, and a summary of unresolved problems at the end of the report period.

a. This Data Item Description (DID) contains the format, content and preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

b. This DID may be used on any depot level maintenance contract.

1. Format. This report shall be provided in the format of Table I.

2. Content. The report shall consist of two parts and contain the following information:

a. Part I:

(1) As of date: The year, month and day applicable to the report. Data must be through the end of the month.

(2) Block 1, Issuing/Procuring Agency. Include address and Point of Contact.

(3) Block 2, Contractor and activity address code (AAC). The name of the business and the DoDAAC assigned to your business for shipment of material.

(4) Block 3, Contract number and Program or Weapon System supported.

(5) Block 4, Government item manager or technical Point of Contact.

(6) Block A, Item identification. The National Stock Number (NSN), A-1 is the Federal Supply Class (FSC) and A-2 is the National Item Identification Number (NIIN) of the item being reported.

(7) Block B, Delivery/Call Order number. When the awarded contract is a call/delivery order type, this is the applicable order number. When an item is awarded on more than one order, it is repeated for each order until completed. If the current report completes the call, the word “completed” will be added.

(8) Block C, The contract line item number (CLIN). The CLIN assigned to the NSN in the contract.

Source: https://assist.dla.mil -- Downloaded: 2016-04-12T17:42Z

(9) Block D, The document/voucher number the item was received under. The document number listed on the shipping documentation the item was received against.

(10) Block E, Quantity on contract or call. E-1 is the quantity of the end items to be repaired on each call/delivery order or contract quantity when orders do not apply. E-2 is the total quantity scheduled for repair cumulative to date.

(11) Block F, Reparables received. Number of reparable items received for repair. F-1 is the quantity of reparables received during the report month. F-2 is the quantity of reparables received cumulative from the start of the contract through report month.

(12) Block G, Reparables inducted into repair during report month.

(13) Block H, Reparables on hand. Number of reparables on hand waiting induction into repair.

(14) Block I, Quantity produced. The quantity produced during the month.

(15) Block J, Serviceables shipped. Serviceables shipped from repair facility. J-1 is the serviceables shipped through report month. J-2 is serviceables shipped cumulative from start of contract.

(16) Block K, Serviceables on hand. The quantity of serviceables on hand awaiting shipping action.

(17) Block L, Quantity condemned. The quantity condemned. L-1 is the quantity condemned during report month. L-2 is the quantity condemned cumulative from start of contract.

(18) Block M, Forecast to complete. The quantity of items scheduled to be produced next month.

(19) Block N, Report date. Enter date of report.

b. Part II, Production problems. Report shall be in narrative format and only required if:

(1) Previous reports production forecast was not shipped.

(2) Current forecast does not equal contract scheduled quantity.

(3) Contract anticipates a problem in the near future.

TABLE I. Contract Depot Maintenance (CDM) Production Report format.

CONTRACT DEPOT MAINTENANCE (CDM) PRODUCTION REPORT Month and As-Of Date

(YYYYMMDD)

Part I

1. ISSUED BY: 2. CONTRACTOR AND ACTIVITY ADDRESS CODE 3. CONTRACT NUMBER/PRGM/WS 4. GOVERNMENT ITEM MANAGER OR TECHNICAL POC

DURING REPORT PERIOD/TOTAL TO DATE

A.

ITEM

IDENTIFICATION

B.

DELIVERY/

CALL NUMBER

C.

CONTRACT

LINE ITEM

(CLIN)

D.

DOCUMENT/

VOUCHER

NUMBER

E.

QTY ON

CONTRACT

OR

DO/CALL

F.

REPARABLES

RECEIVED

G.

QTY

IND TO

WORK

H.

REPS ON

HAND

I.

PROD

J.

SERVICEABLES

SHIPPED

K.

SERV ON

HAND

L.

CONDEMNED

M.

FORECAST PROD

N.

REPORT DATE

FSC NIIN

1 2 1 2 3 1 2 1 2 1 2

Part II, Production Summary

End of DI-PSSS-81995.