TMQ53CDRLsFinal15Sep14.pdf

CONTRACT DATA REQUIREMENTS LIST (CDRL)

EXHIBIT A (CDRLS A001 – A018)

SOLICITATION NUMBER: FA8217-14-R-5009

FOR

AN/TMQ-53 TACTICAL METEOROLOGICAL OBSERVING

SYSTEM (TMOS)

CONTRACTOR LOGISTICS SUPPORT (CLS)

DATE: 5 SEP 2014

PREPARING ORGANIZATION:

AFLCMC/HBZBG

Terrestrial Weather Section

6039 Wardleigh Road, Bldg 1206

Hill AFB, UT 84056

DISTRIBUTION STATEMENT A. Approved for public release; distribution is unlimited

CDRL PREPARATION INSTRUCTIONS

1. Document of Data Requirements. Except for data requirements in the DOD Federal

Acquisition Regulation Supplement (DFARS) clauses, DD Form 1423 or the automated DD Form 1423A must be used as the sole contractual list of data to be delivered under the contract.

2. Instructions for Completing Items A through J:

A. CONTRACT LINE ITEM NO. Enter the contract line item number (CLIN) that is associated with the CDRL.

B. EXH/ATCH NO. Enter the exhibit or attachment number for the Contract Data

Requirements List (CDRL).

C. CATEGORY: TDP, __TM__OTHER__. Check the appropriate category for Technical Data Package (TDP), Technical Manual, or Other Types of data which comprise a TDP, as defined in attachment 1. Acquisition of TMs is covered by AFR 8-2, Air Force Technical Order System. Other data may be further categorized, such as provisioning, configuration management, etc. If the CDRL does not contain a specific category of data requirements, simply enter “Miscellaneous”.

D. SYSTEM/ITEM. Identify the system, item, or project by designator or name.

E. CONTRACT/PR NO. If known, enter the actual contract number: if not, enter the number of the PR or other appropriate designator.

F. CONTRACTOR. Enter the contractor’s name or acronym (inserted at award).

G and H. PREPARED BY, DATE: Enter the name, title, and office symbol of the DMO responsible for preparation of the contract data requirements list. Normally, these items are completed only on the first page of each exhibit or attachment.

I and J. APPROVED BY, DATE: Enter the name, title, and office symbol of the program manager or the designee responsible for approving the CDRL. Normally these items will be filled in only on the first page of each exhibit or attachment.

3. Instructions for Completing Items 1 through 16:

1. DATA ITEM NO. Enter the CDRL sequence number (i.e. for exhibits, enter the Exhibit Line Item Number (ELIN); for attachments, enter the data item sequence number). Reference DFARS 4.7106.) NOTE: When the CDRL contains less than 1,000 data line items, the last three digits of the exhibit line may be numbered numerically.

2. TITLE OF DATA ITEM. Enter the exact title as it appears in item 1 of the DD Form 1664.

3. SUBTITLE. If the title requires further identification, enter a subtitle. (If necessary, use item 16 for further identification of the data item).

CDRL PREPARATION INSTRUCTIONS (continued)

4. AUTHORITY (Data Acquisition Document Number). Enter the number as it appears in item 2 of the DD FORM 1664. Add/T if the DID has been tailored.

5. CONTRACT REFERENCE. Enter document and paragraph numbers that identify the task or requirement from which the data flows (contract clause, statement of work paragraph, Integrated Master Plan paragraph, etc.) to help identify the data item authorized by item 4 (see item 4 above).

6. REQUIRING OFFICE. Enter the activity responsible for advising on the technical adequacy of the data. This may be the first addressee in item 14. When data require approval (see item 8 below), this activity is responsible for determining if the data submitted should be approved as submitted, or revised to meet contract requirements.

7. DD FORM 250 REQ:

a. DD Form 250 will only be required for data listed on the CDRL, which requires government inspection and acceptance. These are:

(1) Final Air Force technical Orders.

(2) Engineering drawings, which are delivered to an Air Logistics Center Engineering Data Service Center.

(3) Data which will be used by Air Force personnel for operation, installation, or maintenance, even though equipment and/or software will not be transferred to AFLC (AFR 800-4).

b. Designate the location (contractor’s facility, or destination) for performance of government inspection and acceptance, by entering the applicable code for inspection and acceptance, as shown below:

CODE INSPECTION ACCEPTANCE

SS Source (DD Form 250) Source (DD Form 250) DD Destination (DD Form 250) Destination (DD Form 250) SD* Source (DD Form 250) Destination (DD Form 250) DS Destination (DD Form 250) Source (DD Form 250) LT Letter of Transmittal only NO No inspection or acceptance required XX Inspection and acceptance requirements specified elsewhere in the contract

S indicates the contractor's facility.

D normally indicates the primary distribution point.

*SD will be used for all engineering data that are to be delivered to an Engineering Data Service Center

8. APPROVAL CODE. Items of critical data requiring specific advance written approval prior to distribution of the final data item, such as test plans, are identified by an "A" placed in this item. Most of these data items require submission of a preliminary draft prior to publication of a final document. When block 8 is blank, approval is not required, although the Government has the inherent right to disapprove any data item.

9. DIST STATEMENT REQUIRED. References the distribution statement to be affixed to the deliverable in accordance with DODD 5230.24, Marking Technical Data Prepared By or For the Department of Defense.

10. FREQUENCY. The following are the codes used in this block:

CODE FREQUENCY

DAILY Daily WEKLY Weekly BI-WE Each 2 weeks MTHLY Monthly BI-MO Each 2 months QRTLY Quarterly ANNLY Annually SEMIA Each 6 months OTIME One time ONE/R One time and revisions R/ASR Revisions as required

* ASREQ As required DFDEL Deferred delivery ONE/P One time preliminary draft 2TIME Two separate submittals

* When ASREQ is used in Items 10, 11, 12, or 13, an explanation of the requirement will be entered in Item 16.

11. AS OF DATE (AOD). If the data will be submitted only once, enter the as of date (the cutoff date) as follows: year/month/day. If the data will be input on a recurring basis, which has been set by item 10, show the number of days between the cut-off date and the end of the input period. For instance, if the data are to be submitted 15 days before the end of the input period enter 15. If the data are to be submitted at the end of the input period enter 0. If necessary, use item 16 to explain further.

12. DATA OF FIRST SUBMISSION. Enter the date of submission as follows:

year/month/day. If the delivery of the data depends on the initiation of a specific event or milestone, identify this event or milestone. If you do not know the contract start date, enter the number of days the data is due after the contract start for example, 30 DAC (Days after Contract). If this data is not known nor needs more clarification, explain in item 16. If the data are subject to deferred delivery enter “DFDEL”. If an acronym is created to identify an event or milestone, define the acronym in item 16. NOTE: Do not insert classified dates.

13. DATE OF SUBSEQUENT SUBMISSION. If the data item will be submitted more than once, enter the dates of subsequent submission. If a draft was required, enter the date the final document is to be submitted.

14. DISTRIBUTION. Identify each addressee and give the number of copies (regular and reproducible) to be received by each one (for example, TIC-320/0). If appropriate, use office symbols, contractor initials, or DID Handbook E-4 code numbers and command initials:

in this case, attach a list explaining these codes. If reproducible copies are required, give the type of reproduction request here or in item 16 (offset, mat, vellum, negative, floppy disk, magnetic tape, etc.). If the data are not actually to be delivered to the Government or to associated contractors, enter the appropriate instruction.

15. TOTAL. Enter the total number of copies (regular or reproducible) for one delivery;

this number should be the sum of all the copies specified in item 14. If distribution fluctuates, use a not to exceed number.

16. REMARKS: Use this space to explain the following:

a. Tailored features of the DID.

b. Items 1 through 15

c. Any re-submittal schedule or special conditions involved in updating data submitted for government approval.

CDRL GENERAL INSTRUCTIONS

1. The Data Items on the DD Forms 1423 are cross-referenced thereon in Block 5, to the associated Integrated Master Plan (IMP) tasks under which the basic information is generated.

These data items shall be prepared in accordance with the applicable Data Item Descriptions (DIDs) set forth in DOD 5010.12-L, AMSDL, as tailored, or one-time DIDs.

a) Standard DIDs. These are identified in DOD 5010.12-M, and the “Assist Quick CDRL Search” Website: http://assist.daps.dla.mil/quicksearch/.

b) Tailored DIDs. These are standard DIDs which have specific modifications or tailoring applied to them. These are identified with the suffix “/T” at the end of the DID number in Block 4 (e.g. DI-MISC-80711/T).

c) One-Time DIDs. These are DIDs approved for one-time acquisition use which is associated with a unique data requirement applicable to a single contract (e.g., OT-97-xxxxx).

d) Marking of Data. DODD 5230.24, March 1987.

2. Block 10 of DD Form 1664 (DID) together with any tailoring of the DIDs contains instructions which shall be followed by the contractor in the preparation of data for delivery under this contract.

3. Data submitted in this contract shall be accompanied by a Letter of Transmittal (L\T) and be identified with the following elements:

a) Contractor

b) Contractor’s Transmittal Letter Number, including a running serial number and date

c) Contract Number

d) CDRL Data Item (Sequence) Number

e) DID number and Title

f) Revision Identification, if any

g) Block 14 (or modified) distribution list

4. Data shall be submitted for receipt by the customer in accordance with the delivery schedule specified on the individual DD Form 1423, except those due dates falling on non-working days (Saturdays, Sundays, and recognized national {legal} holidays) shall be construed to mean the next regular working day. All due dates (e.g. 30 DAC) are calendar days unless specified differently otherwise.

5. Existence of an “A” in Block 8 on the DD Form 1423 indicates written approval by the Procuring Contracting Officer (PCO) is required. Unless a different time period for approval is specified on the DD Form 1423, the Government will have 30 days from the date of receipt on the data for notifying the contractor of the approval/disapproval disposition of a data submission. In the event that a data submission is disapproved, the PCO will advise the contractor of the reasons for disapproval and a resubmission shall be accomplished within thirty (30) days unless specified differently otherwise. Approval indicates Government concurrence to proceed to the next event.

http://assist.daps.dla.mil/quicksearch/

CDRL GENERAL INSTRUCTIONS (continued)

In the absence of an “A” in Block 8, the Government has the inherent right to disapprove any data item. Approval does not ensure compliance with DID format and content requirements, since the Contractor is obligated to meet these requirements under the terms of the contract.

6. DD250s will be required upon completion of the last deliverable of each CDRL Exhibit.

7. Appropriate DODD5230.24 Distribution Statements identified in Block 9 on the DD Form 1423, and further defined in the CDRL “Remarks” Block, shall be placed on the document cover page.

8. The contractor shall apply export control warning statements IAW MIL-STD-1806 to CDRL items identified as “TDP” in item C of each DD Form 1423-1.

9. The contractor shall address all letters of transmittal to the Procuring Contracting Officer.

10. Increases or decreases to CDRL quantities shall be in accordance with the Special Provision titled “Modification of Data Requirements”.

11. Data should be delivered by electronic media whenever possible. All data, electronic or otherwise specified, must comply with the distribution statements indicated in Block 9 of the DD Form 1423.

12. Requirements for periodic revisions to data, where no changes have occurred since the last submission, shall be satisfied by a record transmittal letter/form from the Contractor stating that “no changes have occurred since the last submission”. In such cases, the Contractor shall identify the data in question, the reporting period, and the transmittal letter and number of the prior data transmittal. Government disposition will not be provided for record transmittals;

however, the Government reserves the right to non-concur with the reported negative status.

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

0006AA A

MGMT

AN/TMQ-53 TMOS FD2020-14-76004

A001 Program Management Plan

DI-MGMT-81797A See BLK 16 AFLCMC/HBZBG

LT

A C

See BLK 16

N/A

30 DAC

See BLK 16

AFLCMC/HBZBG 1 1 0

6039Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 1

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

HQ AFWA/A5/8 0 1 1

101 Nelson Drive Offutt AFB, NE 68113

1 3 2

Block 5:

PWS paragraphs: 3.1, 5.1, 5.1.1, 5.2, 5.3.4, 6.3.1, 6.4, 6.8

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838.

Blocks 10, 12, & 13:

Proposed Program Management Plan is due no later than thirty (30) calendar days after contract award and annually thereafter. Final Program Management Plan is due no later than seven (7) calendar days after receipt and incorporation of government comments.

All submissions are considered drafts until final government approval.

Block 14:

One (1) copy of the submittals (including all revisions) shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. The draft distribution list is for Inspection. Final distribution is for distribution of the accepted CDRL delivery. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.G.1

253441239

Digitally signed by MOORE.BARBARA.G.1253441239 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USAF, cn=MOORE.BARBARA.G.1253441239 Date: 2014.09.05 10:27:46 -06'00'

(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

0006AA A

MGMT

AN/TMQ-53 TMOS FD2020-14-76004

A002 Status Report Monthly Status Report

DI-MGMT-80368A See BLK 16 AFLCMC/HBZBG

LT

N/A C

MTHLY

45 DAC

See BLK 16

AFLCMC/HBZBG 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Rd Hill AFB,Utah 84056-5838

HQ AFWA/A5/8 0 1 0

101 Nelson Drive Offutt AFB, NE 68113

0 3 0

Block 5:

PWS paragraphs: 3.1, 3.2, 5.3.1, 5.4, 6.1, 6.1.2, 6.2.5, 6.3.2, 6.4, 6.5, 6.6, 6.8, 7.1.3, 7.2.1, 8.2

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838

Blocks 10, 11, 12, and 13:

First report due NLT forty-five (45) DAC award. Monthly Status Report due no later than the fifteen (15th) of each month for the previous month.

Block 14:

One (1) copy of the submittal shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.G

.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 10:41:14 -06'00'

(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

0006AA A

ADMN

AN/TMQ-53 TMOS FD2020-14-76004

A003 Conference Agenda

DI-ADMN-81249A/T PWS: 5.3, 5.3.1, 5.3.2, 5.3.4 AFLCMC/HBZBG

LT

A C

See BLK 16

N/A

See BLK 16

See BLK 16

AFLCMC/HBZBG 1 1 0

6039 Wardleigh Rd Hill AFB,Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFWA/A5/8 0 1 0

101 Nelson Drive Offutt AFB, NE 68113

1 3 0

Block 4:

Tailoring to DI-ADMN-81249A as follows: Delete paragraph 10.2 (d), (e) and (l).

Paragraph (g) delete everything including and after "by each subcommittee...".

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838

Blocks 10, 12, and 13:

Draft agenda is due no later than thirty (30) calendar days prior to conference.

Government will review and provide comments/revisions within seven (7) calendar days. Final agenda is due no later than ten (10) calendar days prior to conference.

All submissions are considered drafts until final government approval.

Block 14:

One (1) copy of the submittals (to include all revisions) shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.

G.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 10:43:48 -06'00'

(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

0006AA A

ADMN

AN/TMQ-53 TMOS FD2020-14-76004

A004 Conference Minutes

DI-ADMN-81250A PWS: 5.3, 5.3.1, 5.3.2, 5.3.4 AFLCMC/HBZBG

LT

A C

See BLK 16

N/A

See BLK 16

See BLK 16

AFLCMC/HBZBG 1 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039Wardleigh Rd Hill AFB, Utah 84056-5838

HQ AFWA/A5/8 0 1 0

101 Nelson Drive Offutt AFB, NE 68113

1 3 0

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838

Blocks 10, 12, and 13:

Submit draft minutes no later than ten (10) calendar days after scheduled meetings.

Government will review and provide comments within ten (10) calendar days.

Final Conference Minutes are due NLT than seven (7) calendar days after receipt and incorporation of Government comments.

All submissions are considered drafts until final government approval.

Block 14:

One (1) copy of the submittals (to include all revisions) shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.

G.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 10:47:56 -06'00'

(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

0006AA A

ADMN

AN/TMQ-53 TMOS FD2020-14-76004

A005 Presentation Material

DI-ADMN-81373/T PWS: 5.3, 5.3.1, 5.3.2, 5.3.4 AFLCMC/HBZBG

LT

N/A C

See BLK 16

N/A

See BLK 16

See BLK 16

AFLCMC/HBZBG 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

HQ AFWA/A5/8 0 1 0

101 Nelson Drive Offutt AFB, NE 68113

0 3 0

Block 4:

DI-ADMN-81373 is tailored as follows: Delete paragraph 10.1.

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838

Blocks 10, 12, and 13:

Submit hardcopy material NLT the day of meeting with electronic material NLT 10 calendar days after scheduled event.

Block 14:

For meetings, one (1) hardcopy of Microsoft PowerPoint slides will be provided to each person in attendance. One (1) electronic copy of all material shall be provided electronically with minutes to each addressee as indicated in block 14 in Microsoft Office compatible format following the meeting. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.G.

1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 10:50:27 -06'00'

(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

0006AA A

ILSS

AN/TMQ-53 TMOS FD2020-14-76004

A006 Spare Parts Usage Report

DI-ILSS-80483/T PWS: 5.4, 6.3.1, 6.3.2, 7.2, 10 AFLCMC/HBZBG

LT

N/A C

MTHLY

105 DAC

See BLK 16

AFLCMC/HBZBG 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Rd Hill AFB,Utah 84056-5838

HQ AFWA/A5/8 0 1 0

101 Nelson Drive Offutt, NE 68113 68113

0 3 0

Block 4:

DI-ILSS-80483 is tailored as follows: Delete paragraphs 10.4 and following sub-paragraphs.

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838

Blocks 10, 11, 12, and 13:

First report due NLT one hundred five (105) DAC award. Subsequent reports due NLT the 15th of each month for the preceding calendar month.

Block 14:

One (1) copy of the submittal shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.

G.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 10:52:46 -06'00'

(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

0006AA A

QCIC

AN/TMQ-53 TMOS FD2020-14-76004

A008 Quality Assurance Program Plan

DI-QCIC-81794 PWS 5.3.1, 5.5.2 AFLCMC/HBZBG

LT

N/A C

See BLK 16

N/A

30 DAC

See BLK 16

AFLCMC/HBZBG 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

HQ AFWA/A5/8 0 1 0

101 Nelson Drive Offutt AFB, NE 68113

0 3 0

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838.

Blocks 10, 12, and 13:

Submit QAPP NLT thirty (30) days after contract award and annually thereafter.

Block 14:

One (1) copy of the submittal shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.

G.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 10:55:51 -06'00'

(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

0006AA A

CMAN

AN/TMQ-53 TMOS FD2020-14-76004

A009 Engineering Change Proposal (ECP)

DI-CMAN-80639C PWS: 7.1, 7.1.1, 7.1.2, 7.2.1 AFLCMC/HBZBG

LT

A C

See BLK 16

N/A

See BLK 16

See BLK 16

AFLCMC/HBZBG 1 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

HQ AFWA/A5/8 0 1 0

101 Nelson Drive Offutt AFB, NE 68113

1 3 0

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838.

Blocks 10, 12 and 13:

Submit proposed ECP no later than thirty (30) calendar days after identification of requirement. Final ECP is due no later than seven (7) calendar days after receipt and incorporation of government comments.

All submissions are considered drafts until final government approval.

Block 14:

One (1) copy of the initial and subsequent submittals (including all revisions) shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. The draft distribution list is for Inspection. Final distribution is for distribution of the accepted CDRL delivery. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.

G.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 10:58:02 -06'00'

(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

0006AA A

MISC

AN/TMQ-53 TMOS FD2020-14-76004

A011 Technical Report - Study/Services Test Plan/Report

DI-MISC-80508B PWS: 7.1 AFLCMC/HBZBG

LT

A C

See BLK 16

N/A

See BLK 16

See BLK 16

AFLCMC/HBZBG 1 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Hill AFB, Utah 84056-5838

HQ AFWA/A5/8 0 1 0

101 Nelson Drive Offutt AFB, NE 68113

1 3 0

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838.

Blocks 10, 12, and 13:

Submit draft test plan/report no later than 30 calendar days after identification of requirement. Final material is due NLT seven (7) calendar days after receipt of government comments. Revisions will be as required by the government.

All submissions are considered drafts until final Government approval.

Block 14:

One (1) copy of the submittals (including all revisions) shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. The draft distribution list is for Inspection. Final distribution is for distribution of the accepted CDRL delivery. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.

G.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 11:01:07 -06'00'

(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

0006AA A

CMAN

AN/TMQ-53 TMOS FD2020-14-76004

A012 Configuration Management Plan

DI-CMAN-80858B PWS: 6.3.2, 6.5, 7.3.1, 7.3.2 AFLCMC/HBZBG

LT

A C

See BLK 16

N/A

See BLK 16

See BLK 16

AFLCMC/HBZBG 1 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

HQ AFWA/A5/8 0 1 0

101 Nelson Drive Offutt AFB, NE 68113

1 3 0

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838.

Blocks 10, 12, and 13:

Draft Configuration Management Plan is due no later than thirty (30) calendar days after contract award and annually thereafter. Final Configuration Management Plan is due NLT seven (7) calendar days after receipt and incorporation of government comments.

All submissions are considered drafts until final government approval.

Block 14:

One (1) copy of the submittals (including all revisions) shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. The draft distribution list is for Inspection. Final distribution is for distribution of the accepted CDRL delivery. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.

G.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 11:03:48 -06'00'

(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

0006AA A

SAFT

AN/TMQ-53 TMOS FD2020-14-76004

A014 System Safety Program Plan (SSPP) Contractor’s Safety and Health Plan

DI-SAFT-81626 PWS 5.7 & Appendix C AFLCMC/HBZBG

LT

N/A C

ONE/R

N/A

60 DAC

See BLK 16

AFLCMC/HBZBG 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Rd Hill AFB,Utah 84056-5838

HQ AFWA/A5/8

101 Nelson Drive Offutt AFB, NE 68113 0 1 0

0 3 0

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838.

Blocks 10, 12, and 13:

Submit plan no later than 60 DAC award. Plan shall be in accordance with Appendix C and be revised as the contractor's situation changes.

Block 14:

One (1) copy of the submittals (including all revisions) shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.

G.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 11:08:01 -06'00'

(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

0006AA A

SAFT

AN/TMQ-53 TMOS FD2020-14-76004

A015 Accident/Incident Report

DI-SAFT-81563 PWS 5.7 & Appendix C AFLCMC/HBZBG

LT

N/A C

See BLK 16

N/A

See BLK 16

See BLK 16

AFLCMC/HBZBG 0 1 0

6039 Wardleigh Rd Hill AFB, Utah 84056-5838

AFLCMC/PZZKB 0 1 0

6039 Wardleigh Rd Hill AFB,Utah 84056-5838

HQ AFWA/A5/8 0 1 0

101 Nelson Drive Offutt AFB, NE 68113

0 3 0

Block 9:

DISTRIBUTION STATEMENT C: Distribution authorized to U.S. Government Agencies and their contractors for Administrative or Operational Use only, November 2013. Other requests for this document shall be referred to AFLCMC/HBZBG, 6039 Wardleigh Road, Hill AFB, UT 84056-5838.

Blocks 10, 12, and 13:

Submit written or email copy of the mishap/incident notification NLT three (3) calendar days after accident/incident. For information not available at the time of initial notification, the contractor shall provide the remaining information NLT 20 calendar days after the mishap

Block 14:

One (1) copy of the submittals (including all revisions) shall be provided electronically to each addressee as indicated in block 14 in Microsoft Office compatible format. Electronic addresses will be provided upon contract award.

Barbara Moore, GS-12, Program Manager 5 Sep 14 5 Sep 14

MOORE.BARBARA.

G.1253441239

Digitally signed by

MOORE.BARBARA.G.1253441239

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2014.09.05 11:11:07 -06'00'

(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…