2640767_ATTACH.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) 0MB No. 0704-0 188

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 ot this collection of information, incIudin suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1218 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 t does not display a currently valid 0MB control number. Please DO NOT RE1'URN your form to the above address, 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

A

C. CATEGORY:

TDP TM OTHER

D. SYSTEM/ITEM (A1O-1S-018)

DOOR, AIRCRAFT

E. CONTRACT/PR NO.

FD2020-19-00250

F. CONTRACTOR

1. DATA ITEM NO.

AOO 1

2. TITLE OF DATA ITEM

Test/Inspection Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B/T

5. CONTRACT REFERENCE

CLIN for Data

6. REQUIRING OFFICE

416 SCMS/GUEAB

7. DD 250 REQ

i-sm

LLJ

9. DIST STATEMENT

REQUIRED

1.)

10. FREQUENCY

rsmn Kr?

SJ I IIVir?

12. DATE OF FIRST SUBMISSION

'kT/ A IN/t's.

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A

Draft Final

Reg Repm

16. REMARKS

NSN: 1560-01 -125-l440FJ

NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the CO/ACO without further revision to this CDRL.

1. BLK 4: Contractor's format is acceptable. Paragraph 10.2 of DI-NDTI-80809B is 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 utilized in the manufacture of "First Article" item shall be identified and certified along with a copy ofmaterial purchase requests as conforming to applicable data requirements.

c. Material processing, including finish requirements (plating, heat treatment, welding, inspecting, anodize, 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 than contractor facility shall be included.

d. Other requirements as called out on Engineering Data Requirements.

2. BLK 9: The Distribution Statement, Export Control Warning and Destruction Notice shall be placed on the first sheet of each document and be located in a conspicuous location.

a. DISTRIBUTION STATEMENT "B": Distribution authorized to U.S.

Government agencies only (Test & Evaluation) (23 Oct 2018). Other requests for this document shall be referred to (416 SCMS/GUEAB, Hill AFB, UT 84056-5826).

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:

SEE BLK 16 1

15.TOTAL 0 1 0

G. PREPARED BY

Nila Dagsen (Contractor Data na r)

H. DATE

23 Oct 2018

I.

Jaime Meredith (Engineer)

J.DATE

23 Oct 2018

17. PRICE GROUP

NSP

18. ESTIMATED

TOTAL PRICE

0.00

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 2 Pages

CONTRACT DATA REQUIREMENTS UST

(1 Data Item)

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

A TOP TM OTHER NDTI

D. SYSTEM/ITEM (A1O-18-018) E. CONTRACT/PR NO. F. CONTRACTOR

DOOR, AIRCRAFT FD2020-19-00250

16. REMARKS (Continued)

b. 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 JAW 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.

3. BLKs 10, 11, 12, 13, 14:

a. For Contractor Testing - submit JAW the current delivery schedule.

b. For Government Testing - Report to assist in "First Article" testing by the Air Force shall be submitted concurrently with the "First Article" item either in the packaging of the shipping container or separately if the report will not fit within the container packaging unfolded. When shipped in the "First Article" container, the report shall be enclosed in a paper or plastic envelop.

c. SHIP TO: FB2029 Non-Accountable Bay Transportation Officer Bldg. 849 West Hill AFB, UT 84056-5999

MARK FOR: 809 MXSS/MXDEB

7278 4th Street (Bldg. 100, Bay D) Hill AFB, UT 84056-5205

NOTE: If report is shipped separate from First Article item, send report to "MARK FOR" address listed above.

d. Contractor shall deliver a Test Report via e-mail to the following e-mail address: jaime.meredith@us.af.mil

DD FORM 1423-1, FEB 2001 Page 2 of 2 Pages