FY21_BRK_CDRLS.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

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 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 MISC

D. SYSTEM/ITEM

1377015715244ES*

E. CONTRACT/PR NO.

FD2020-21-50082/21-50083

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Ammunition Data Card (ADC)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80043B

5. CONTRACT REFERENCE

Airmunitions Specification

6. REQUIRING OFFICE

AFLCMC/EBHJ

7. DD 250 REQ

SD

9. DIST STATEMENT

REQUIRED

B

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

Draft

Final

Reg Repro

16. REMARKS

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 for this document 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 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.

*1377016525022ES.

FOB DESTINATION

EBH 20-177-002

Terry McCurdy, AFLCMC/EBHTC, 586-0535

WAWF 0 1 0

DoDAAC, FA8213

Included with item(s) shipped

Sample ADC via

WARP sys only

15. TOTAL 0 1 0

G. PREPARED BY

mccurdy.terry.d.1075978215

H. DATE

2020/06/25

I. APPROVED BY

blanch.teresa.m.1260787809

J. DATE

2020/06/26

18. ESTIMATED

TOTAL PRICE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 6 Pages

17. PRICE GROUP

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 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

TDP TM OTHER SESS

E. CONTRACT/PR NO.

A002

2. TITLE OF DATA ITEM

Engineering Change Proposal (ECP)

DI-SESS-80639E

6. REQUIRING OFFICE

AFLCMC/EBHJ

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

B

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

Reg Repro

16. REMARKS

BLK 4: Follow format requirements listed under paragraph 2 of Data

Item Description. Data deliverable contents of Engineering Change

Proposal shall contain all information required by DD Form 1692.

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.

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

DESTRUCTION NOTICE--Destroy by any method that will prevent

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/EBHKB).

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

Terry McCurdy, AFLCMC/EBHTC, 586-0535

AFLCMC/EBHJ 1 1 0

AFLCMC/EBHTC 1 1 0

AFLCMC/EBHKB 1 1 0

DCMA/QAR 1 1 0

DCMA/ACO 1 1 0

15. TOTAL 5 5 0

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 2 of 6 Pages

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 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

E. CONTRACT/PR NO.

A003

2. TITLE OF DATA ITEM

Notice of Revision (NOR)

DI-SESS-80642E

6. REQUIRING OFFICE

AFLCMC/EBHJ

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

B

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

Reg Repro

16. REMARKS

BLK 4: : Follow format requirements listed under paragraph 2 of

Data Item Description. Data deliverable contents of Notice of

Revision shall contain all information required by DD Form 1695.

submittal of data. The Letter of Transmittal shall be used only for

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.

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

Terry McCurdy, AFLCMC/EBHTC, 586-0535

AFLCMC/EBHJ 1 1 0

AFLCMC/EBHEC 1 1 0

AFLCMC/EBHKB 1 1 0

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 3 of 6 Pages

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 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

E. CONTRACT/PR NO.

A004

2. TITLE OF DATA ITEM

Request for Variance (RFV)

DI-SESS-80640E

6. REQUIRING OFFICE

AFLCMC/EBHJ

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

B

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

Reg Repro

16. REMARKS

BLK 4: Follow format requirements listed under paragraph 2 of Data

Item Description. Data deliverable contents of Request for Variance shall contain all information required by DD Form 1694.

submittal of data. The Letter of Transmittal shall be used only for

BLK 8: Government Engineer will perform review of the RFV. 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 shall be signed contract modification (AFLCMC/EBHKB).

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 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

Terry McCurdy, AFLCMC/EBHTC, 586-0535

AFLCMC/EBHJ 1 1 0

AFLCMC/EBHTC 1 1 0

AFLCMC/EBHKB 1 1 0

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 4 of 6 Pages

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 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

TDP TM OTHER NDTI

E. CONTRACT/PR NO.

A005

2. TITLE OF DATA ITEM

Test/Inspection Report

3. SUBTITLE

Lot Acceptance Test

DI-NDTI-80809B

6. REQUIRING OFFICE

AFLCMC/EBHJ

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

B

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

Reg Repro

16. REMARKS

BLK 4: Contractor's 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 this data item; do not combine other data item submittals with this requirement.

Government agencies only (Administrative/Operational Use) (Date of

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

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

BLK 14: Test plan shall be in Microsoft Office software or PDF format. Submit through WAWF, DoDAAC, FA8213.

Terry McCurdy, AFLCMC/EBHTC, 586-0535

WAWF 0 1 0

DoDAAC, FA8213

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 5 of 6 Pages

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 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

E. CONTRACT/PR NO.

A006

2. TITLE OF DATA ITEM

Failure Summary & Analysis Report

DI-SESS-80255B

6. REQUIRING OFFICE

AFLCMC/EBHJ

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

B

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

Reg Repro

16. REMARKS

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

Final report.

submittal of data. The Letter of Transmittal shall be used only for requirement

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

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

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

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

Terry McCurdy, AFLCMC/EBHTC, 586-0535

Contr. Officer 0 1 0

Hill AFB, UT

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 6 of 6 Pages