CDRL.pdf

I CONTRACT DATA REQUIREMENTS LIST Form Approved

( 1 Data Item) 0MB 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 i07Q4.Q188). 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 f information if it does not display a currently valid 0MB control number. Please do not .return your form to the above organization. Send completed form to the �overnmont Issuing Contracting Officer for tho Contract/PR No. listed in Block E.

' . CONTRACT LINE ITEM NO.

A TOP

B. EXHIBIT C. CATEGORY:

--- TM -- OTHER NDTI

D.SYSTEM/ITEM

E. CONTRACT/PR NO. F. CONTRACTOR

I F-16 ADG FD2020 190 I 00 1-00

r om ,n••o 2. TITLE OF DATA ITEM 3. SUBTITLE

AOOI Test/Inspection Report NSN 30200 I 054 I 27 I YP

4. AUTHORITY (Data Acquisition Document No.J 6. REQUIRING OFFICE

I DI-NDTI-808098 ,

5. CONTRACT REFERENCE

CUN for Data 419 SCMSIGUEA

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

I REQUIRED See Blk 16 See Blk 16 DD b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

I D SUBMISSION

NIA NIA NIA

16. REMARKS

flock 9. Distribution B may be an option for situations where the deliverable includes fAroprietary data or sensitive information. This detennination must be agreed upon by the r ir Force prior to any draft or final submittal.

r1ock 9: Distribution Statement D Distribution authorized to U.S. Government Agencies, Administrative or Operational Use, � I January 201 9. Other requests for this document shall be referred to (insert selection from rollowing paragraph).

US Air Force: OO-ALC/419 SCMS/GUEA. Hill AFB. Utah 84056-5826.

k11 other entities: First Article Laboratory 00-ALC/809 MXSS/MXDTAA, Hill AFB, Utah 84056-5826

Blocks I 0. 1 2.

k. Submit the Test/Inspection Report after the completion or cancellation of the testing of [A.uxiliary Drive Gear Housing Assembly.

b. All dimensions and tolerances specified on the manufacturing data shall be /istcd in one column with the actual corresponding reading obtained from the mspection of the parts listed in another column.

b. Proof of conformance to materials, manufacturing processes, and testing in accordance lvith the drawing shall be provided. A copy of the purchase order certifying the process accomplished at other than contractor facility shall be included.

d. The test reports shall include a description of the test facilities & equipment used, a description of the testing completed. The test report should summarize all aspects of the �ffort and provide sufficient data such that the government can verify. Data provided shall be clearly organized according to the s/n of the Spur Gear Assembly.

e. Other requirements as called out with the Technical Data Package. See AFMC Form 260

Block I 4. Send one copy in electronic fonnat or paper copy to the appropriate entity listed.

I

G. PREPARED BY H. DATE I. APPROVED BY

USAF

Sec AFMC Fom1 260

15.TOTAL

�1 �

DD FORM 1423-1, FEB 2001

6/10120 19 Lance Moss

\J\." _---f O>- � PREVIOUS EDITl01'r°'MA Y BE USE D. Page

Draft Reg Repro

I I

I

I 2 0

J. DATE

611012019 of 2 Pages

Adobe Professional 7 .0

I

I

117. PRICE GROUP

I """-_N_s_r_"""'

I

18. ESTIMATED

TOTAL PRICE

I 0.00

L-----'

I

I

I I

I

I

I

I

I

I

I

I

I

I

I

I

I

I l

I

I

CONTRACT DATA REQUIREMENTS LIST

( 1 Data Item)

A. CONTRACT LINE ITEM NO. I B. EXHIBIT

I

C. CATEGORY:

A TDP __ TM __ OTHER _ NDTI ____________ _

D. SYSTEM/ITEM

F-16 ADG

16. REMARKS /Continued/

First Article Delivery Address:

OO-ALC/809 MXSS/MXDEB

Bldg 849 Attn: Non-Accountable Bay (Dear John Bay) Transportation Office Hill Air Force Base, UT 84056-5713 United States

I E. CONTRACT/PR NO.

I

F. CONTRACTOR

FD2020190l001-00

All documents shall be marked on the first page with the following information:

DISCLOSURE NOTICE: This information is furnished upon the condition that ii will not be released lo another nation without the specific authority of the Department of the Air Force of the United States, that it will be used for military purposes only, that individual or corporate rights originating in the information, whether patented or not. will be respected. that the recipient will report promptly to the United Stales. any known or suspected compromise, and that the information will be provided substantially the same degree of security afforded it by the Department of Defense of the United Slates. Also, regardless of any other markings on the document, it will not be downgraded or declassi lied without written approval of the originating United States agency.

DISTRIBUTION STATEMENT: Applicable distribution statement as described above.

WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C.. Sec 275 l el seq) or the Export Administration Act of I 979. as amended (Title 50, U.S.C .. App 240! et seq). Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

HANDLING AND DESTRUCTION NOTICE: Comply with distribution statement and destroy by any method that will prevent disclosure of contents or reconstruction of the document.

Each subsequent page shall be marked with the following or similar language: Subject to the restrictions staled on the first page of this document or file.

DD FORM 1423-1, FEB 2001 Page_2_ of __ 2_Pages