CDRLs.pdf

PDF 160 KB Posted Oct 1, 2020

Attached to: F15 Canopy Remover Federal contract opportunity
Solicitation number: FA8213-20-R-3030
Issued by: Department of the Air Force Materiel Command Lifecycle Management Center Hill Air Force Base

About this file

Written by GovTribe AI · Dec 29, 2023

This document is a Contract Data Requirements List (CDRL) specifying technical data items required under a federal contract for F-15 aircraft canopy removal systems and components. The CDRL identifies seven data items required to be delivered with item quantities, delivery dates, distribution statements, and formats. Required data includes ammunition data cards, engineering change proposals, request for variances, acceptance test plans, lead-free control plans, failure analysis reports, and lot acceptance test reports. Delivery is to occur electronically through the Wide Area Workflow system or via email in Microsoft Office or PDF format. Distribution is limited to U.S. government agencies and the requiring activity is the Air Force Lifecycle Management Center. The CDRL covers contract line items for F-15 canopy remover cartridges and related components with quantities ranging from 4 to 167 units and delivery required by December 31, 2021 to Hill Air Force Base in Utah.

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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

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 and Communications 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

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

MISC

1377-00-238-0553* FD2020-17-50009

A001 Ammunition Data Card (ADC)

DI-MISC-80043B Airmunitions Specification AFLCMC/EBHJ

A B

ASREQ

N/A

BLK 16

ASREQ

WAWF 0 1 0

DoDAAC, FA8213 Included with 0 1 0 item(s) shipped Sample ADC via 0 1 0 WARP system only

0 3 0

BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. The electronic receiving report shall also be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement.

Electronic receiving report required via internet Wide Area Work Flow (WAWF) at: https://wawf.eb.mil.

BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.

Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests shall be referred to AFLCMC/EBHJ.

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 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 DoD Directives 5230.25.

DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

BLK 10,12,13: Submit after successful Lot Acceptance Test and prior to delivery of each production lot.

BLK 14: A sample ADC or "draft" will be generated and submitted for each part number/NSN produced under this contract using the Worldwide Ammunition-data Repository Program (WARP) system to ensure general format and content is acceptable prior to final ADC submittals. Sufficient hard copies of final version ADCs shall be generated for each individual production lot from the Worldwide Ammunition-data Repository Program (WARP) such that at least one hard copy per production lot shall be provided with each individual CLIN shipment/destination. An electronic copy for each production lot shall be submitted/uploaded with the electronic receiving report through WAWF to AFLCMC/EBHJ using DoDAAC FA8213.

*See Page 2 BLOCK 16. REMARKS (Continued):

FOB DESTINATION

EBE 16-250-001

Robert W. Morgan, Jr., AFLCMC/EBHEC, 777-5126

6 SEP 2016 6 SEP 2016

1 2

MORGAN.ROBERT.W

ESLEY.JR.1158190040

Digitally signed by

MORGAN.ROBERT.WESLEY.JR.1158190040

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=MORGAN.ROBERT.WESLEY.JR.1158190040 Date: 2016.09.06 10:36:54 -06'00'

HARGROVE.ERIC.

V.1167016843

Digitally signed by

HARGROVE.ERIC.V.1167016843

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=HARGROVE.ERIC.V.1167016843 Date: 2016.09.06 11:06:02 -06'00'

(1 Data Item)

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

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

MISC

1377-00-238-0553* FD2020-17-50009

1377-00-245-7970, 1377-00-349-3938. 1377-00-361-6048, 1377-00-412-3205, 1377-01-015-6422, 1377-01-046-7782, 1377-01-046-7783, 1377-01-047-3523, 1377-01-047-7458, 1377-01-137-6037, 1377-01-137-6038, 1377-01-138-1551, 1377-01-138-1552, 1377-01-202-9195, 1377-01-260-6410, 1377-01-269-8060, 1377-01-346-2215, 1377-01-346-2216, 1377-01-346-2217, 1377-01-346-2218, 1377-01-346-2222, 1377-01-346-2223, 1377-01-348-6479, 1377-01-348-6480, 1377-01-348-6481, 1377-01-352-4161, 1377-01-352-4162, 1377-01-352-4163, 1377-01-352-4195, 1377-01-394-1227 1377-01-463-2595, 1377-01-463-3341, 1377-01-515-3484, 1377-01-515-3485, 1377-01-515-3486, 1377-01-515-3487, 1377-01-515-3489, 1377-01-515-5927, 1377-01-519-3361, 1377-01-519-3362, 1377-01-519-3366, 1377-01-519-3369, 1377-01-519-3370, 1377-01-519-3848,1377-01-519-4086, 1377-01-519-4091, 1377-01-519-4094, 1377-01-553-6533, 1377-01-648-8443, 1377-01-650-6329.

2 2

(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

SESS

1377-00-238-0553* FD2020-17-50009

A002 Engineering Change Proposal (ECP)

DI-SESS-80639D Airmunitions Specification AFLCMC/EBHJ

A B

ASREQ

N/A

ASREQ

AFLCMC/EBHJ 1 1 0

AFLCMC/EBHEC 2 2 0

AFLCMC/EBHKA 1 1 0

DCMA/QAR 1 1 0

DCMA/ACO 1 1 0

6 6 0

BLK 4: Data delivery description for content of engineering change proposal via applicable DD Form 1692 shall be in accordance with para. 3.3.1(1) of EIA-649-1and the principles of EIA-649-B. Other forms and submittal means are acceptable provided the data content requirements of EIA-649-1 are met.

BLK 7: The Letter of Transmittal shall be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data. The Letter of Transmittal shall be used only for this data item; do not combine other data item submittals with this requirement.

BLK 8: Within 30 days of receipt, the Government engineer thru the Government contracting officer will respond with notification of approval/disapproval. If disapproved, Government engineer response thru the Government contracting officer will include instruction for remediation. Notification of approval of the proposed engineering change shall be by signed contract modification.

BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.

Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests shall be referred to AFLCMC/EBHJ.

Violations of these export laws are subject to severe criminal penalties.

Dissemination of this document is controlled under DoD Directive 5230.25.

DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

BLK 14: Submit reports electronically via e-mail in Microsoft Office or PDF format to the following e-mail recipients listed below. Refer to contract for e-mail address of the government contracting officer (AFLCMC/EBHKA).

robert.morgan.27@us.af.mil (AFLCMC/EBHEC)

*See Page 2 BLOCK 16. REMARKS (Continued):

FOB DESTINATION

EBE 16-250-001

Robert W. Morgan, Jr., AFLCMC/EBHEC, 777-5126

6 SEP 2016 6 SEP 2016

1 2

MORGAN.ROBERT.WE

SLEY.JR.1158190040

Digitally signed by

MORGAN.ROBERT.WESLEY.JR.1158190040

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=MORGAN.ROBERT.WESLEY.JR.1158190040 Date: 2016.09.06 10:39:57 -06'00'

HARGROVE.ERIC.V.

1167016843

Digitally signed by HARGROVE.ERIC.V.1167016843 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2016.09.06 11:07:13 -06'00'

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

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

SESS

1377-00-238-0553* FD2020-17-50009

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

SESS

1377-00-238-0553* FD2020-17-50009

A003 Request for Variance (RFV)

DI-SESS-80640D Airmunitions Specification AFLCMC/EBHJ

A B

ASREQ

N/A

ASREQ

AFLCMC/EBHEC 1 1 0

AFLCMC/EBHJ 1 1 0

DCMA/QAR 1 1 0

DCMA/ACO 1 1 0

4 4 0

BLK 4: Data delivery description for content of Request for Variance via applicable DD Form 1694 shall be in accordance with para. 3.3.2(1)-(6) of EIA- 649-1 and the principles of EIA-649-B. Other forms and submittal means are acceptable provided the data content requirements of EIA-649-1 are met.

BLK 7: Government engineer will perform review of the RFV. Notification of approval shall be signed contract modification (AFLCMC/EBHKA).

BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.

Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests shall be referred to AFLCMC/EBHJ.

Violations of these export laws are subject to severe criminal penalties.

Dissemination of this document is controlled under DoD Directive 5230.25.

DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

robert.morgan.27@us.af.mil (AFLCMC/EBHEC)

*See Page 2 BLOCK 16. REMARKS (Continued):

FOB DESTINATION

EBE 16-250-001

Robert W. Morgan, Jr., AFLCMC/EBHEC, 777-5126

6 SEP 2016 6 SEP 2016

1 2

MORGAN.ROBERT.W

ESLEY.JR.1158190040

Digitally signed by

MORGAN.ROBERT.WESLEY.JR.1158190040

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=MORGAN.ROBERT.WESLEY.JR.1158190040 Date: 2016.09.06 10:44:19 -06'00'

HARGROVE.ERIC.V

.1167016843

Digitally signed by HARGROVE.ERIC.V.1167016843 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2016.09.06 11:07:53 -06'00'

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

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

SESS

1377-00-238-0553* FD2020-17-50009

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

QCIC

1377-00-238-0553* FD2020-17-50009

A004 Acceptance Test Plan

DI-QCIC-80553A Airmunitions Specification AFLCMC/EBHJ

A B

ASREQ

WAWF 0 1 0

DoDAAC FA8213

0 1 0

BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at: https://wawf.eb.mil. The electronic receiving report shall be used only for this data item, do not combine other data item submittals with this requirement.

BLK 8: Comments/approval/disapproval will be submitted within 30 working days of receipt by AFLCMC/EBHJ.

BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.

Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests shall be referred to AFLCMC/EBHJ.

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.

Violation of these export-control laws is subject to severe criminal penalties.

Dissemination of this document is controlled under DoD Directives 5230.25.

DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

BLK 10,11, 12, 13: The contractor shall provide a Acceptance Test Plan after contract award and at least 90 days prior to Lot Acceptance Testing allowing for 30 day approval time. No changes to previously approved government Acceptance Test Plans shall be made without prior notification of AFLCMC/EBHJ.

Engineering approval in accordance with Airmunitions Specification.

BLK 14: Report shall be in Microsoft Office software or PDF format.

Submit through WAWF, DoDAAC, FA8213.

*See Page 2 BLOCK 16. REMARKS (Continued):

FOB DESTINATION

EBE 16-250-001

Robert W. Morgan, Jr., AFLCMC/EBHEC, 777-5126

6 SEP 2016 6 SEP 2016

1 2

MORGAN.ROBERT.W

ESLEY.JR.1158190040

Digitally signed by

MORGAN.ROBERT.WESLEY.JR.1158190040

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=MORGAN.ROBERT.WESLEY.JR.1158190040 Date: 2016.09.06 10:46:34 -06'00'

HARGROVE.ERIC.V.

1167016843

Digitally signed by HARGROVE.ERIC.V.1167016843 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2016.09.06 11:09:42 -06'00'

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

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

QCIC

1377-00-238-0553* FD2020-17-50009

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

MGMT

1377-00-238-0553* FD2020-17-50009

A005 LEAD-FREE CONTROL PLAN (LFCP)

DI-MGMT-81772 Airmunitions Specification AFLCMC/EBHJ

N/A B

ASREQ

N/A

ASREQ

N/A

WAWF 1 1 0

DoDAAC, FA8213

AFLCMC/EBHJ 1 1 0

2 2 0

BLK 4: Contractor's format required. Follow content preparation instruction and requirements listed in the Data Item Description.

BLK 7: Receiving report shall be submitted electronically via the internet through Wide Area Work Flow (WAWF) at: https://wawf.eb.mil under DoDAAC FA 8213.

BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.

Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests shall be referred to AFLCMC/EBHJ.

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 in accordance with provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE--Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

BLK 14: Submit reports electronically in Microsoft Office software or PDF format to e-mail recipient listed below.

david.monk.1@us.af.mil (AFLCMC/EBHJ)

*See Page 2 BLOCK 16. REMARKS (Continued):

FOB DESTINATION

EBE 16-250-001

Robert W. Morgan, Jr., AFLCMC/EBHEC, 777-5126

6 SEP 2016 6 SEP 2016

1 2

MORGAN.ROBERT.WE

SLEY.JR.1158190040

Digitally signed by

MORGAN.ROBERT.WESLEY.JR.1158190040

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=MORGAN.ROBERT.WESLEY.JR.1158190040 Date: 2016.09.06 10:52:42 -06'00'

HARGROVE.ERIC.V.

1167016843

Digitally signed by

HARGROVE.ERIC.V.1167016843

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2016.09.06 11:10:11 -06'00'

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

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

MGMT

1377-00-238-0553* FD2020-17-50009

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

SESS

1377-00-238-0553* FD2020-17-50009

A006 Failure Analysis and Corrective Action Report

DI-SESS-81315B Airmunitions Specification AFLCMC/EBHJ

A B

ASREQ

N/A

BLK 16

ASREQ

Contracting Officer 0 1 0 Hill AFB, UT

0 1 0

BLK 4: Contractor's format required for both the Preliminary and Final report

BLK 8: Comments/approval/disapproval will be submitted within 30 calendar days after receipt by AFLCMC/EBHJ.

BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.

Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests shall be referred to AFLCMC/EBHJ.

Violation of these export-control laws is subject to severe criminal penalties.

Dissemination of this document is controlled under DoD Directives 5230.25.

DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

BLK 10, 12, 13: Submit within 7 calendar days of each failure. Final with 15 calendar days after receipt of AFLCMC/EBHJ comments.

BLK 14: Report shall be in Microsoft Office software or PDF format.

Submit via e-mail to cognizant Hill AFB Contracting Officer.

*See Page 2 BLOCK 16. REMARKS (Continued):

FOB DESTINATION

EBE 16-250-001

Robert W. Morgan, Jr., AFLCMC/EBHEC, 777-5126

6 SEP 2016 6 SEP 2016

1 2

MORGAN.ROBERT.W

ESLEY.JR.1158190040

Digitally signed by

MORGAN.ROBERT.WESLEY.JR.1158190040

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=MORGAN.ROBERT.WESLEY.JR.1158190040 Date: 2016.09.06 10:59:56 -06'00'

HARGROVE.ERIC.V.

1167016843

Digitally signed by HARGROVE.ERIC.V.1167016843 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2016.09.06 11:10:56 -06'00'

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

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

SESS

1377-00-238-0553* FD2020-17-50009

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

NDTI

1377-00-238-0553* FD2020-17-50009

A007 Test/Inspection Report Lot Acceptance Test

DI-NDTI-80809B Airmunitions Specification AFLCMC/EBHJ

N/A B

ASREQ

N/A

BLK 16

ASREQ

WAWF 0 1 0

DoDAAC, FA8213

0 1 0

BLK 4: Contractor format is acceptable.

BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at: https:// wawf.eb.mil. The electronic receiving report shall be used only for that data item; do not combine other data item submittals with this requirement.

BLK 9: DISTRIBUTION STATEMENT B. Distribution authorized to U.S.

Government agencies only, (Administrative/Operational Use) (Date of Contract Award). Other requests shall be referred to AFLCMC/EBHJ.

Violation of these export-control laws is subject to severe criminal penalties.

Disseminate in accordance with provisions of DoD Directives 5230.25.

DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

BLK 10,12,13: Submit within 30 calendar days after completion of each Lot Acceptance Test.

* See Page 2 BLOCK 16. REMARKS (Continued):

FOB DESTINATION

EBE 16-250-001

Robert W. Morgan, Jr., AFLCMC/EBHEC, 777-5126

6 SEP 2016 6 SEP 2016

1 2

MORGAN.ROBERT.WE

SLEY.JR.1158190040

Digitally signed by

MORGAN.ROBERT.WESLEY.JR.1158190040

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=MORGAN.ROBERT.WESLEY.JR.1158190040 Date: 2016.09.06 10:57:47 -06'00'

HARGROVE.ERIC.V.

1167016843

Digitally signed by

HARGROVE.ERIC.V.1167016843

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=HARGROVE.ERIC.V.1167016843 Date: 2016.09.06 11:11:30 -06'00'

BLK 14: Test plan shall be in Microsoft Office software or PDF format.

Submit through WAWF, DoDAAC, FA8213.

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

TDP ________ TM _______ OTHER

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

NDTI

1377-00-238-0553* FD2020-17-50009

(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 delivering such data item to the Government.

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

FD2020-17-50009

A1 17-50009 DI-MISC-80043B

A2 17-50009 DI-SESS-80639D ECP

A3 17-50009 DI-SESS-80640D RFV

A4 17-50009 DI-QCIC-80553A

A5 17-50009 DI-MGMT-81772 Lead Free Plan

A6 17-50009 DI-SESS-81315B

B1 17-50009 DI-NDTI-80809 FAT-CTR B Series

17-50009 Page 3 Instructions

B001 DI-NDTI-80603A FAT-CTR B Series

B002 DI-NDTI-81307A B Series

File details come from the government source that posted it. Updated Oct 2, 2020.