CDRLs_A001-A008-FATRs.pdf

PDF 2 MB Posted Sep 25, 2019

Attached to: Power Supply, Etc. Federal contract opportunity
Solicitation number: FA8206-19-Q-1700
Issued by: Department of the Air Force Materiel Command Lifecycle Management Center Hill Air Force Base

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All CDRLs including First Article Test Reports

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File	Type	Posted
FAT_015432621.pdf	PDF	Sep 25, 2019
FA820619Q1700.pdf	PDF	Sep 25, 2019
FAT_015616085.pdf	PDF	Sep 25, 2019
FAT_015639175.pdf	PDF	Sep 25, 2019
Performance_Work_Statement.docx	DOCX document	Sep 25, 2019
SPI_2621.pdf	PDF	Sep 25, 2019
SPI_9175.pdf	PDF	Sep 25, 2019
FAT_015380122.pdf	PDF	Sep 25, 2019
SPI_6085.pdf	PDF	Sep 25, 2019
Statement_of_Work_for_Packaing_and_Preservation.pdf	PDF	Sep 25, 2019

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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

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: B002 title: TEST/INSPECTION REPORT sub: FIRST ARTICLE auth: DI-NDTI-80809B ref:

req_ofc: 414 SCMS/GUEA dd250: DD appcode: A dist: SEE BLK 16 freq: ONE/R asof: N/A firstsub: SEE BLK 16 subsub: N/A addressee1: 809 MXSS/MXDEB draft1:

reg1: 1 repro1:

addressee2: SEE BLK 16 draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

reg4:

repro4:

addressee5: 414 SCMS/GUEA draft5:

reg5: 1 repro5:

addressee6: 6031 Gum Lane draft6:

reg6:

repro6:

addressee7: Bldg 1227 draft7:

reg7:

repro7:

addressee8: Hill AFB, UT 84056 draft8:

reg8:

repro8:

addressee9: ATTN: Bryan Neilson draft9:

reg9:

repro9:

addressee10:

draft10:

reg10:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: BLOCK 4: Paragraph 10.2 of DI-NDTIO-80809B clarified as follows:

a. All dimensions and tolerances specified on the manufacturing data shall be listed in one column, with the actual corresponding reading obtained from the inspection of the part listed in another column.

b. Materials used in the manufacture of the "First Article" shall be identified and certified along with a copy of material purchase requirements as conforming to applicable data requirements.

c. Material processing including finish requirements (plating, heat treatment, welding, anodizing, painting, etc.) utilized in the manufacture of "First Article" item shall be identified and certified as conforming to applicable requirements. A copy of the purchase order certifying the process accomplished at other that contractor facility shall be included.

BLOCK 9: Data shall be marked with the following on the cover page:

DISTRIBUTION STATEMENT D: Distribution authorized to DOD and U.S. DOD contractors only for Intercontinental Ballistic Missiles (ICBM) administrative or operational use determined as of April 13, 2018. Other requests shall be referred to AFNWC/NIBF, Hill AFB, UT 84056-5816.

WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2773 et seq.) or the Export Administration Act of 1979, as amended, Title 50, USE., App. 2401 et seq. Violations of these export control laws is subject to severe criminal penalties. Dissemination of this document is controlled under DOD directive 5230.25.

DESTRUCTION NOTICE: For classified documents, follow procedures in DOD 5220.22-M, National Industry Security Manual, Chapter 5, Section 7, Para. 5-704, or DOD 5200.I-R, Information Security Program Regulation, Chapter 6, Para C6.7. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

NSN: 6130015616085AH

group:

total_price:

prep_name:

line_item:

exhibit: A xtdp: Off xtm: Off othercat: x system: Power Supply - BA23097 ctr_no: FD20201901700 contr:

remarksb:

BLOCKS 10: Report shall be submitted concurrently with the "First Article" item either in the shipping container or separately if the report will not fit unfolded within the container. When shipped in the "First Article" container, report shall be enclosed in a paper or plastic envelope.

BLOCK 12: 120 Days Post Contract..

BLOCK 14: Complete mailing address is:

809 MXSS/MXDEB (DODAAC: FB 2029)

Bldg 849, ATTN: Non-Accountable Bay Mark For: First Article Do Not Post Hill AFB, UT 84056-5713

FOB DESTINATION

INSPECTION SOURCE/ACCEPTANCE/DESTINATION

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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: B004 title: TEST/INSPECTION REPORT sub: FIRST ARTICLE auth: DI-NDTI-80809B ref:

req_ofc: 414 SCMS/GUEA dd250: DD appcode: A dist: SEE BLK 16 freq: ONE/R asof: N/A firstsub: SEE BLK 16 subsub: N/A addressee1: 809 MXSS/MXDEB draft1:

reg1: 1 repro1:

addressee2: SEE BLK 16 draft2:

reg2:

repro2:

addressee3:

draft3:

reg3:

repro3:

addressee4:

draft4:

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addressee5: 414 SCMS/GUEA draft5:

reg5: 1 repro5:

addressee6: 6031 Gum Lane draft6:

reg6:

repro6:

addressee7: Bldg 1227 draft7:

reg7:

repro7:

addressee8: Hill AFB, UT 84056 draft8:

reg8:

repro8:

addressee9: ATTN: Bryan Neilson draft9:

reg9:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: BLOCK 4: Paragraph 10.2 of DI-NDTIO-80809B clarified as follows:

b. Materials used in the manufacture of the "First Article" shall be identified and certified along with a copy of material purchase requirements as conforming to applicable data requirements.

BLOCK 9: Data shall be marked with the following on the cover page:

NSN: 1440015639175AH

group:

total_price:

prep_name:

line_item:

exhibit: A xtdp: Off xtm: Off othercat: x system: Actuator Lock Bar - BA22888A ctr_no: FD20201901700 contr:

remarksb:

BLOCK 12: 120 Days Post Contract..

BLOCK 14: Complete mailing address is:

809 MXSS/MXDEB (DODAAC: FB 2029)

Bldg 849, ATTN: Non-Accountable Bay Mark For: First Article Do Not Post Hill AFB, UT 84056-5713

FOB DESTINATION

INSPECTION SOURCE/ACCEPTANCE/DESTINATION

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CONTRACT DATA REQUIREMENTS LIST (CDRL)

A001 TDP TM _____ OTHER MGMT

ICBM FLIGHT FD2020-19-01700 CARLETON CONTROLS CORPORATION

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A001 COMMERCIAL ASSET VISIBILITY AIR FORCE (CAV)

REPORTING CFM END ITEM REPORTING NSP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

$0.00

DI-MGMT-81838/T SEE BLK 16 FOR REFERENCE 414 SCMS/GUMBD

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED SEE BLK 16 SEE BLK 16

N/A

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

N/A SEE BLK 16 SEE BLK 16 Reg Repro

16. REMARKS ORG1 (SEE BLOCK 16) 0 1 0

NOTE: CHANGES TO OFFICE SYMBOLS AND/OR E-MAIL ADDRESSES, WHEN NECESSARY SHALL

BE MADE BY LETTER THROUGH THE GOVERNMENT CO/ACO WITHOUT FURTHER REVISION TO

THIS CDRL.

1. BLOCK 5: CONTRACT REFERENCE: PWS PARAGRAPH AND CAV AF REPORTING

REQUIREMENTS DOCUMENT

2. BLOCK 4: ALL REPORTING SHALL BE SUBMITTED IN THE ENGLISH LANGUAGE.

3. BLOCKS 10, 11, 12, 13:

A. DATE OF FIRST SUBMISSION SHALL BE WITHIN 24 HOURS FOLLOWING A SUPPLY OR

MAINTENANCE TRANSACTION, AFTER THE CONTRACT AWARD DATE.

B. CONTRACTOR REPORTING REQUIREMENTS TO CAV AF SHALL BE SUBMITTED DAILY AND/OR

WITHIN 24 HOURS OF A SUPPLY OR MAINTENANCE ACTION OCCURRENCE IAW THE CAV AF

REPORTING REQUIREMENTS DOCUMENT.

C. DATA SHALL BE CURRENT WITHIN 24 HOURS OF THE LAST END ITEM MAINTENANCE

OCCURRENCE.

4. BLOCKS 7, 8, 14:

A. THE CONTRACTOR SHALL REPORT END ITEM TRANSACTIONAL DATA THROUGH ELECTRONIC

SUBMISSION IN CAV AF USING THE CAV AF WEBSITE OR CICA XML.

B. A LETTER OF TRANSMITTAL SHALL BE SUBMITTED IN THE MONTH THE DELIVERY ORDER IS

COMPLETED, COVERING ALL REPORTS TRANSMITTED FOR THAT ORDER. SUBMIT THE LETTER

TO THE FOLLOWING EMAIL ADDRESS:

KATHRYN.DENNING@US.AF.MIL

RAYMOND.SANCHEZ@US.AF.MIL

15. TOTAL ▬▬▬▬► 0 1 0

16 Sep 2019

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages

2019-09-19T08:22:03-0600

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NEILSON.BRYAN.A.1547868788

A002 TDP TM _____ OTHER PSSS

A002 CONTRACT DEPOT MAINTENANCE (CDM) PRODUCTION

REPORT CDM PRODUCTION MONTHLY STATUS REPORT NSP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-PSSS-81995/T PWS 414 SCMS/GUMBD

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED MTHLY SEE BLK 16

THIS CDRL.

1. BLOCK 4:

A. ALL REPORTING SHALL BE SUBMITTED IN THE ENGLISH LANGUAGE.

B. 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.

C. THE CONTRACTOR SHALL REPORT BY CONTRACT DELIVERY ORDER ON ALL APPLICABLE

CATEGORIES, TOTALS AND ON-HAND BALANCES, PROVIDING TABLE I (DI-PSSS-81995) FOR

EACH REPAIR LOCATION, INCLUDING SUBCONTRACTOR FACILITIES, FOR THE CONTRACTS

MAINTENANCE OCCURRENCE ACTIONS DURING THE REPORTING PERIOD.

2. BLOCKS 10, 11, 12, 13:

A. THE REPORTS SHALL BE PROVIDED MONTHLY WITHIN 5 (FIVE) BUSINESS DAYS OF THE

PREVIOUS MONTH'S LAST CALENDAR DATE.

B. REPORTS SHALL CONTINUE TO BE SUBMITTED BY THE CONTRACTOR UNLESS THE

REQUIREMENT IS TERMINATED BY THE (REQUIRING OFFICE), PROGRAM MANAGER (PM) OR THE

PRODUCTION MANAGEMENT SPECIALIST (PMS),

C. THE FINAL REPORT SUBMITTED FOLLOWING THE FINAL REPORTING PERIOD ON THE

CONTRACT SHALL BE ANNOTATED "FINAL REPORT"

3. BLOCK 9:

A. DISTRIBUTATION STATEMENT "D": DISTRIBUTION AUTHORIZED TO THE DEPARTMENT OF

DEFENSE AND U.S. DOD CONTRACTORS ONLY (ADMINISTRATIVE OR OPERATIONAL USE).

(FEBRUARY 2019). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO (414

SCMS/GUMCB)

B. EXPORT CONTROL WARNING: ALL TECHNICAL DOCUMENTS/DATA (PRINTED,

DIGITAL/ELECTRONIC) THAT ARE DETERMINED TO CONTAIN EXPORT-CONTROLLED TECHNICAL

DATA, SHALL BE MARKED WITH THE FOLLOWING STATEMENT:

EXPORT CONTROL WARNING: THIS DOCUMENT CONTAINS TECHNICAL DATA WHOSE EXPORT IS

RESTRICTED BY THE ARMS EXPORT CONTROL ACT (TITLE 22, U.S.C., SEC 2751, ET SEQ.) OR THE EXPORT ADMINISTRATION ACT OF 1979 (TITLE 50, U.S.C., APP. 2401 ET SEQ.), AS AMENDED.

VIOLATIONS OF THESE EXPORT LAWS ARE SUBJECT TO SEVERE CRIMINAL PENALTIES.

DISSEMINATE IAW PROVISIONS OF DOD DIRECTIVE 5230.25.

C. 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 5200.1-R, INFORMATION SECURITY PROGRAM CHAPTER VI. FOR

UNCLASSIFIED, LIMITED DOCUMENTS, DESTROY BY ANY METHOD THAT WILL PREVENT

DISCLOSURE OF CONTENTS OR RECONSTRUCTION OF THE DOCUMENT.

4. BLOCK 7, 14: SUBMIT THE CDM PRODUCTION MONTHLY STATUS REPORTS TO THE

FOLLOWING EMAIL ADDRESS: KATHRYN.DENNING@US.AF.MIL

2019-09-19T08:15:36-0600

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NEILSON.BRYAN.A.1547868788

A003 TDP TM _____ OTHER MGMT

A003 GOVERNMENT PROPERTY INVENTORY REPORT ANNUAL GOVERNMENT PROPERTY PHYSICAL

INVENTORY REPORT NSP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MGMT-80441C/T PWS 414 SCMS/GUMBD

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED ANNLY SEE BLK 16

THIS CDRL.

1. BLOCK 4:

A. ALL REPORTS SHALL BE SUBMITTED IN THE ENGLISH LANGUAGE.

2. BLOCKS 10, 11, 12, 13:

A. THIS REPORT WILL BE PROVIDED ANNUALLY. REPORTING PERIOD IS ONE YEAR.

B. 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

REQUESTED OUTSIDE OF AN ANNUAL CADENCE, THE DATA SHALL BE CURRENT AS OF THE

DATE REQUESTED.

C. 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.

3. BLOCK 9:

A. DISTRIBUTATION STATEMENT "D": DISTRIBUTION AUTHORIZED TO THE DEPARTMENT OF

DEFENSE AND U.S. DOD CONTRACTORS ONLY (ADMINISTRATIVE OR OPERATIONAL USE).

(FEBRUARY 2019). OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO (414

SCMS/GUMCB).

B. EXPORT CONTROL WARNING: ALL TECHNICAL DOCUMENTS/DATA (PRINTED,

DIGITAL/ELECTRONIC) THAT ARE DETERMINED TO CONTAIN EXPORT-CONTROLLED TECHNICAL

DATA, SHALL BE MARKED WITH THE FOLLOWING STATEMENT:

EXPORT CONTROL WARNING: THIS DOCUMENT CONTAINS TECHNICAL DATA WHOSE EXPORT IS

RESTRICTED BY THE ARMS EXPORT CONTROL ACT (TITLE 22, U.S.C., SEC 2751, ET SEQ.) OR THE EXPORT ADMINISTRATION ACT OF 1979 (TITLE 50, U.S.C., APP. 2401 ET SEQ.), AS AMENDED.

VIOLATIONS OF THESE EXPORT LAWS ARE SUBJECT TO SEVERE CRIMINAL PENALTIES.

DISSEMINATE IAW PROVISIONS OF DOD DIRECTIVE 5230.25.

C. 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 5200.1-R, INFORMATION SECURITY PROGRAM CHAPTER VI. FOR

UNCLASSIFIED, LIMITED DOCUMENTS, DESTROY BY ANY METHOD THAT WILL PREVENT

DISCLOSURE OF CONTENTS OR RECONSTRUCTION OF THE DOCUMENT.

4. BLOCK 7, 14: SUBMIT THE ANNUAL GOVERNMENT PROPERTY PHYSICAL INVENTORY REPORT

TO THE FOLLOWING EMAIL ADDRESS:

KATHRYN.DENNING@US.AF.MIL

2019-09-19T08:27:51-0600

NELSON.RUSS.B.1287389414

2019-09-19T08:40:43-0600

NEILSON.BRYAN.A.1547868788

A004 TDP X TM _____ OTHER ________________________

D. SYSTEM/ITEM F. CONTRACTOR

ICBM

E. CONTRACT/PR NO.

FD2020-19-01700 CARLETON CONTROLS

A004 COUNTERFEIT PROTECTION PLAN FAST RISING B PLUG

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICEDI-MISC-81832 SEE BLK 16 FOR REFERENCE 414 SCMS/GUEA

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD REQUIRED SEE BLK 16 SEE BLK 16

A SEE BLK 16 SEE BLK 16 Reg Repro

ORG1 (SEE BLOCK 16) 0 1 0 16. REMARKS

THIS CDRL.

BLOCK 5: CONTRACT REFERENCE: PWS FOR FD2020-19-01700

BLOCK 8: LENGTH OF TIME FOR GOVERNMENT APPROVAL SHALL BE 90 CALENDAR DAYS.

LENGTH OF TIME FOR CONTRACTOR RESUBMITTAL SHALL BE 30 CALENDAR DAYS.

BLOCK 9: DATA SUBMITTAL SHALL BE MARKED WITH THE FOLLOWING ON THE COVER PAGE:

DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF DEFENSE AND

U.S. DOD CONTRACTORS ONLY FOR ADMINISTRATIVE AND OPERATIONAL USE DETERMINED

[DATE OF DOCUMENT]. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO ICBM

SYSTEMS DIRECTORATE, 6014 DOGWOOD AVE BLDG 1258, HILL AFB, UT 84056-5826.

WARNING: THIS DOCUMENT CONTAINS TECHNICAL DATA WHOSE EXPORT IS RESTRICTED BY

THE ARMS EXPORT CONTROL ACT (TITLE 22, U.S.C. 2751 ET SEQ.) OR THE EXPORT

ADMINISTRATIVE ACT OF 1979, AS AMENDED, TITLE 50, U.S.C., APP. 2401, ET SEQ. VIOLATION OF

THESE EXPORT-CONTROL LAWS IS SUBJECT TO SEVERE CRIMINAL PENALTIES.

DISSEMINATION OF THIS DOCUMENT IS CONTROLLED UNDER DODD 5230.25 AND AFI 61-204.

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 5200.1-R, INFORMATION SECURITY PROGRAM REGULATIONS, CHAPTER

VI. FOR UNCLASSIFIED, LIMITED DOCUMENTS, DESTROY BY ANY METHOD THAT WILL PREVENT

DISCLOSURE OF CONTENTS OR RECONSTRUCTION OF THE DOCUMENT.

BLOCKS 10, 12, AND 13: CONTRACTOR SHALL DELIVER THE COUNTERFEIT PREVENTION PLAN

WITHIN 30 DAYS OF CONTRACT AWARD. GOVERNMENT COMMENTS WILL BE PROVIDED TO THE

CONTRACTOR WITHIN 14 DAYS AFTER RECEIPT, WITH CONTRACTOR RE-SUBMITTAL WITHIN 15

DAYS AFTER RECEIPT OF COMMENTS.

ELECTRINIC SUBMISSIONS AUTHORIZED TO:

414SCMS FASTRISING.B-PLUG@US.AF.MIL

23 Sep 2019

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NELSON.RUSS.B.1287389414

TDP TM _____ OTHER _PSSS____________________

A005 REPAIRABLE ITEM INSPECTION REPORT PROGRAM MANAGEMENT REVIEWS NSP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-PSSS-80386A SEE BLK 16 FOR REFERENCE 414 SCMS/GUMBD

LT REQUIRED MTHLY SEE BLK 16

CHANGES TO OFFICE SYMBOLS, WHEN NECESSARY, SHALL BE MADE BY THE

CO/ACO WITHOUT REVISIONS TO THE CDRL.

BLOCK 12, 13: BEGINNING AT THE END OF THE FIRST MONTH OF CONTRACT PERFORMANCE

AND AT THE END OF EVERY MONTH THEREAFTER. SUBMISSIONS WILL BE DELIVERED NO

LATER THAN 10 DAYS

BEFORE EACH REVIEW.

ELECTRONIC SUBMISSIONS AUTHORIZED TO ORG1:

2019-09-23T09:48:50-0600

NEILSON.BRYAN.A.1547868788

2019-09-23T09:56:35-0600

NELSON.RUSS.B.1287389414

A006 TDP X TM _____ OTHER ________________________

A006 REQUEST FOR VARIANCE FAST RISING B PLUG

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-80640 REV. D SEE BLK 16 FOR REFERENCE 414 SCMS/GUEA

LT REQUIRED SEE BLK 16 SEE BLK 16

A SEE BLK 16 SEE BLK 16 Reg Repro

NOTE: CHANGES TO OFFICE SYMBOLS AND OR EMAIL ADDRESSES, WHEN NECESSARY SHALL

THIS CDRL.

BLOCK 5: CONTRACT REFERENCE: PWS FOR FD2020-19-01700

BLOCKS 10, 11, 12, AND 13: CONTRACTOR SHALL DELIVER A REQUEST FOR VARIATION WITHIN

10 DAYS AFTER DISCOVERY OF THE RECOGNIZED VARIATION.

2019-09-23T11:01:59-0600

NEILSON.BRYAN.A.1547868788

2019-09-23T11:06:46-0600

NELSON.RUSS.B.1287389414

TDP TM _____ OTHER _QCIC____________________

A007 QUALITY DEFICIENCY REPORT QUALITY DEFICIENCY REPORT NSP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-QCIC-80736 SEE BLK 16 FOR REFERENCE 414 SCMS/GUMBD

LT REQUIRED AS REQ. SEE BLK 16

BLOCKS 10, 11, 12, AND 13: CONTRACTOR SHALL DELIVER A REQUEST FOR VARIATION WITHIN

10 DAYS AFTER DISCOVERY OF THE RECOGNIZED VARIATION.

BLOCK 10, 12, 13: AS NEEDED FOR PQDR AND ENGINEERING INVESTIGATION REPORTING.

SUBMIT

NO LATER THAN 5 DAYS AFTER EVENT.

2019-09-23T09:52:04-0600

NEILSON.BRYAN.A.1547868788

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NELSON.RUSS.B.1287389414

TDP TM _____ OTHER _MGMT____________________

A008 REPORT OF SHIPPING (ITEM) AND PACKAGING

DISCREPENCY SHIPPING AND PACKAGING DISCREPENCY NSP

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-MGMT-80503 SEE BLK 16 FOR REFERENCE 414 SCMS/GUMBD

LT REQUIRED AS REQ. SEE BLK 16

CHANGES TO OFFICE SYMBOLS, WHEN NECESSARY, SHALL BE MADE BY THE

CO/ACO WITHOUT REVISIONS TO THE CDRL.

BLOCK 4:

PARA. 10.1 TO INCLUDE: CONTRACTOR FORMAT CAN BE USED WHEN APPROVED, WILL

REQUIRE THE SAME

INFORMATION AS IDENTIFIED ON THE SF 364.

PARA. 10.2.21 CHANGE, "PROVIDE PHOTOS WHERE IT WOULD ASSIST THE SHIPPING ACTIVITY

DETERMINING THE CAUSE OF THE DISCREPANCY OR DEFICIENCY." TO "PROVIDE PHOTOS

WHERE IT WOULD

ASSIST IN THE DESCRIPTION OF DISCREPANCY OR DEFICIENCY (PACKAGING DAMAGE, ASSET

DAMAGE,

MISSING COMPONENTS, ETC.) FOR THE SHIPPING ACTIVITY TO DETERMINE CAUSE AND

RESPONSIBILITY."

BLOCK 10:

REPORT WILL BE REQUIRED WHEN PACKAGING AND/OR ASSET DISCREPANCY OR DEFICIENCY

(PACKAGING

DAMAGE, ASSET DAMAGE, MISSING COMPONENTS, ETC.) ARE IDENTIFIED DURING ASSET

SHIPMENT

RECEIVING INSPECTION.

BLOCKS 11, 12 AND 13: SUBMIT REPORTS NO LATER THAN 10 CALENDAR

DAYS AFTER EACH DEFICIENCY IS ADDRESSED..

2019-09-23T09:52:46-0600

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NELSON.RUSS.B.1287389414

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: B003 title: TEST/INSPECTION REPORT sub: FIRST ARTICLE auth: DI-NDTI-80809B ref:

req_ofc: 414 SCMS/GUEA dd250: DD appcode: A dist: SEE BLK 16 freq: ONE/R asof: N/A firstsub: SEE BLK 16 subsub: N/A addressee1: 809 MXSS/MXDEB draft1:

reg1: 1 repro1:

addressee2: SEE BLK 16 draft2:

reg2:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: BLOCK 4: Paragraph 10.2 of DI-NDTIO-80809B clarified as follows:

b. Materials used in the manufacture of the "First Article" shall be identified and certified along with a copy of material purchase requirements as conforming to applicable data requirements.

BLOCK 9: Data shall be marked with the following on the cover page:

NSN: 1440015380122AH

group:

total_price:

prep_name:

line_item:

exhibit: A xtdp: Off xtm: Off othercat: x system: Linear Actuator - BA22766 ctr_no: FD20201901700 contr:

remarksb:

BLOCK 12: 120 Days Post Contract..

BLOCK 14: Complete mailing address is:

809 MXSS/MXDEB (DODAAC: FB 2029)

Bldg 849, ATTN: Non-Accountable Bay Mark For: First Article Do Not Post Hill AFB, UT 84056-5713

FOB DESTINATION

INSPECTION SOURCE/ACCEPTANCE/DESTINATION

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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: B001 title: TEST/INSPECTION REPORT sub: FIRST ARTICLE auth: DI-NDTI-80809B ref:

req_ofc: 414 SCMS/GUEA dd250: DD appcode: A dist: SEE BLK 16 freq: ONE/R asof: N/A firstsub: SEE BLK 16 subsub: N/A addressee1: 809 MXSS/MXDEB draft1:

reg1: 1 repro1:

addressee2: SEE BLK 16 draft2:

reg2:

repro2:

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addressee5: 414 SCMS/GUEA draft5:

reg5: 1 repro5:

addressee6: 6031 Gum Lane draft6:

reg6:

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addressee7: Bldg 1227 draft7:

reg7:

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addressee8: Hill AFB, UT 84056 draft8:

reg8:

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total_draft: 0 total_reg: 2 total_repro: 0 remarks: BLOCK 4: Paragraph 10.2 of DI-NDTIO-80809B clarified as follows:

b. Materials used in the manufacture of the "First Article" shall be identified and certified along with a copy of material purchase requirements as conforming to applicable data requirements.

BLOCK 9: Data shall be marked with the following on the cover page:

NSN: 6110015432621AH

group:

total_price:

prep_name:

line_item:

exhibit: A xtdp: Off xtm: Off othercat: x system: Motor Drive - BA22930 ctr_no: FD20201901700 contr:

remarksb:

BLOCK 12: 120 Days Post Contract..

BLOCK 14: Complete mailing address is:

809 MXSS/MXDEB (DODAAC: FB 2029)

Bldg 849, ATTN: Non-Accountable Bay Mark For: First Article Do Not Post Hill AFB, UT 84056-5713

FOB DESTINATION

INSPECTION SOURCE/ACCEPTANCE/DESTINATION

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