Section_J_-_Attachment_01_-_CDRLs.pdf

FA8240-XX-C-7218

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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX05

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**01

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Monthly Status Report

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A

5. CONTRACT REFERENCE

Enterprise PWS 2.1.1.c

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

Monthly

12. DATE OF FIRST SUBMISSION

TBD

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA Block 1. **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA

Block 4. Tailor as follows:

The Status Report shall contain the following items, where applicable:

3.2.1 Milestone/task status. The status of each milestone/task as defined by the statement of work or contract, as applicable:

a. A statement as to whether or not the program/project/task is on schedule; if not, the effort planned to meet the schedule shall be indicated. Include an overall status of each milestone, task, or unit of work. Include update schedule sheets, milestone charts, or task synopsis sheets identifying phase of task & percentage of completion of each task, technical instruction, or order.

b. A comparison of achieved end-product performance capabilities projected against contract baseline values, requirements, or allocations.

c. Effort expended on each task to date, and a brief description of technical developments and accomplishments.

d. Key dates in any testing program and description of tests performed and significant test results. If applicable, a description of the amount and type of down time on the equipment or system under test.

e. A list of all designs completed and a brief description of each item. For designs in process, provide estimated dates for design and drawing completion.

f. A narrative of outstanding problems existing as of the previous status report, and their resolution status.

g. New problem areas encountered or anticipated, their effect on the overall work effort/project and steps being taken to remedy problem situations.

h. Significant results of conferences, trips, or directives for the Contracting officer’s representatives.

i. Any other information which may cause significant changes in the program schedule.

3.2.2 Future plans. Summary of future plans, recommendations and proposals both for the next reporting period and for any long term plans.

3.2.3 Itemized man-hours and costs. Itemized man-hour and cost expenditure incurred for the reporting period by category and task, total contractual expenditures, and funds remaining as of the reporting date.

3.2.4 Contract deliveries status. The status of each deliverable end item, including data deliverables, as required by the contract. Provide item and contract identification, shipping/transmittal data, acceptance status, security classification, and schedule due date information.

3.2.5 Report preparer. Name of person(s) preparing report and telephone number(s).

3.3 Appendices. Appendices where applicable, for tables, references, charts, or other descriptive material. Each appendix shall be identified and referenced in the appropriate area of the report.

Delete Tables IA and IB.

Block 13. When Changes Occur.

Block 14: Copies will be posted electronically in the Enterprise Wide Information System (EWIS) and addressees will be notified via a workflow generated E-Mail developed within the EWIS.

PCO 0 1 0

JPMO

(PCOR)

0 1 0

JPMO (Fin Mgr)

0 1 0

Annex FACs 0 1 0

15. TOTAL 0 4 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITIONS MAY BE USED. Page __1__ of __1__ Pages

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX05

B. EXHIBIT

C. CATEGORY:

TDP _X___ TM ____ OTHER ______

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**02

2. TITLE OF DATA ITEM

Cost/Schedule Status Report (C/SSR)

3. SUBTITLE

Budget, Schedule, and Resource Estimates (C/SSR)

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No)

DI-MGMT-81467

5. CONTRACT REFERENCE

Enterprise PWS PARA 2.2.2

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

Monthly

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA Block 1. **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA

Block 4. Tailored as follows:

7.7.2 Level of detail. Estimates to be provided at the contract level for individual tasks as assigned and segregated by annex.

10.1 Contractor format is acceptable.

Block 12: The report (with narrative explanation including Estimate to Complete (ETC) and Estimate at Completion (EAC) IAW referenced DID paragraph 10.5.2 Variance Analysis) to be submitted NLT COB 10 working days following the end of the first month of contract performance.

Block 13: The report (with narrative explanation including Estimate to Complete (ETC) and Estimate at Completion (EAC) IAW referenced DID paragraph 10.5.2 Variance Analysis) to be submitted NLT COB 10 working days following the end of the month IAW Financial Calendar:

Block 14: Copies will be posted electronically in the Enterprise Wide Information System (EWIS) and addressees will be notified via a workflow generated E-Mail developed within the EWIS.

PCO 0 1 0

JPMO

(PCOR)

0 1 0

JPMO (Fin Mgr)

0 1 0

Annex FACs

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX05

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**03

2. TITLE OF DATA ITEM

Quality Management System Standard

3. SUBTITLE

Quality Management System

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.)

DI-QCIC-81449

5. CONTRACT REFERENCE

Enterprise PWS PARA 2.1.9.b

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

Initial/Recur

12. DATE OF FIRST SUBMISSION

TBD

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA Block 1. **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA

Block 4. Tailor as follows:

10.2 General. The Quality Management System Standard shall be in accordance with the requirements of ISO 9001:2008/AS9100. The Quality Management System Standard shall include traceability from the quality elements of the contract to the specific contractor processes that support those elements. Additionally, quality system requirements needed to support the elements shall be described.

10.4 Content. The Quality Management System Standard shall include: (1) documented statements of a quality policy and quality objectives, (2) an overall quality standard, (3) documented procedures as required by the ISO 9001:2008/AS9100 standard and the contract, (4) documents needed by the contractor organization to ensure effective planning, operation, and control of its processes, (5) records as required by the ISO 9001:2008/AS9100 standard and the contract, and (6) provision for each Range Annex under the J-Tech Contract to implement, deploy, and maintain Range-specific Quality Assurance practices as required by the Quality Management System Standard.

10.4.1 Quality Management System Effectiveness. The Quality Management System Standard shall identify the methodology by which the contractor will ensure quality management system effectiveness, management commitment to quality, and the review of data (metrics) such that the results may be used to indicate trends and progress in quality of design, processes, services, fabrication, assembly, test and acceptance as appropriate to the contract.

10.4.2 Updates to the Quality Management System Standard shall consist of notes or changes to the Standard, clearly identified as to where applicable (i.e. system element, page, paragraph, number, etc.) or the release of a revised version of the Standard when updates or changes are such that the release of a revision will aid in the usability or clarity of the Standard.

Block 10. Initial and When Changes Occur.

Block 13. When Changes Occur.

PCO 0 1 0

JPMO

(PCOR)

15. TOTAL 0 2 0

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX05

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**04

2. TITLE OF DATA ITEM

Accident/Incident Report

3. SUBTITLE

Report Environmental, Safety, and Health (ES&H) - Related Incidents and Accidents

17. PRICE

GROUP

4. AUTHORITY (Data Acquisition Document No)

DI-SAFT-81563

5. CONTRACT REFERENCE

PWS PARA 2.1.10.c

6. REQUIRING OFFICE

AFTC/PZSA

18.

ESTIMATED

TOTAL

PRICE 7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

See Block 16

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Rep ro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA Block 1. **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA

Block 4. DI-SAFT 81563 – Use/Relationship Clarification: This report provides the procuring agency with notification and information regarding any major or minor Environmental, Safety, and Health accident/incident (including fire) resulting in any one or more of the following: Fatality or disabling injuries, damages to government property, incidents affecting program planning or production schedules, potential serious hazards requiring corrective action and any major accident or minor incident that adversely affect capabilities to meet contractual obligations.

Clarify items (a-l) listed under Requirements 2 of the DID with (a-n) below:

a. Name (Optional), organization, telephone number of injured employee

b. Name and title of the person(s) reporting the incident

c. Date and time of incident/How long was member on duty?

d. Location of the incident, i.e., building number, facility name

e. Summary of incident giving pertinent details

f. Cause of incident

g. Casualties (fatalities, disabling injuries, major damage to equipment

h. Estimated property damage, if applicable/available

i. Extent of damages; effect on production, operations, training or other activity

j. Corrective actions/preventive measures taken to prevent recurrence; i.e., proper tool/PPE use, equipment provided, qualification training if applicable, etc.

k. Collateral damages or injuries sustained (public or private)

l. Type of vehicle(s) and registration numbers(s), if applicable

m. Was a blood alcohol or drug test administered

n. Other findings of significance to include:

1) Mitigating situation/circumstances leading up to the event

2) Was the employee rushed to complete the task at the time of the incident?

Block 10.

Major Accidents/Incidents: Within two hours, initially report all major happenings (i.e. fatalities, loss of consciousness, hospitalization of three or more employees, disabling damages to equipment, explosions, fire, flood, pressure rupture, major equipment malfunction, etc.) which will adversely affect capability to meet contractual obligations and any event not otherwise considered reportable hereunder which could by its nature, reflect negatively upon the government. Initial reports of major happenings shall be made by telecom, email, etc., to key government representatives the fastest means necessary to achieve positive contact; initial contact must include if information is preliminary, factual, pending investigation, etc. A final report will be rendered at the completion of the investigation.

Minor Accidents/Incidents: Within 2 working days, initially report all minor happenings (i.e., damages resulting in a lost workday case or property damage less than $2,000 unless the exception below applies). Initial reports of minor happenings shall be made by telecom, email, etc., to key government representatives the fastest means necessary to achieve positive contact; initial contact must include if information is preliminary, factual, pending investigation, etc. A final report will be rendered at the completion of the investigation.

Exception: Damages such as small scratches, fair wear and tear, acts of God and no-fault accidents will be reported, but will not be a CDRL requirement. All damages considered for this category must be communicated to the contractor’s Environmental Safety and Health (ES&H) Manager within two working days.

General: Reporting shall include any event not otherwise considered reportable hereunder which by its nature, reflect negatively upon the Government. A joint agreement and validation by the Government/contractor representatives must first be achieved for the incident to be considered non-reportable. Major and minor Environmental happenings (spills, etc.), shall be determined by the applicable annex’s local Base Safety or Environmental Office procedures or policy as part of the investigative process.

Block 12. Reports will be submitted within time frames specified in Block 10.

Block 13. Reports will be submitted within time frames specified in Block 10.

Bl k 14 C i ill b t d l t i ll i th E t i Wid I f ti S t (EWIS) d

PCO 1 1 0

JPMO (PCOR) 1 1 0

Annex FACs 1 1 0 Annex ACOs 1 1 0

15. TOTAL 4 4 0

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX05

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**05

2. TITLE OF DATA ITEM

Internal Security Management Report

3. SUBTITLE

Management Report

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No)

DI-MGMT-80368A

5. CONTRACT REFERENCE

Enterprise PWS 2.3.1.e

6. REQUIRING OFFICE

AFFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

See Block 16

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA Block 1. **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA

Block 10: Personnel shall immediately (not to exceed 24 hours or the next duty day) report to the Contractor Program Security Manager as well as the Government Cognizant Security Activity specified in Block 14 of this Form any incident/infraction involving the protection of classified information/material associated with this contract. The contractor will provide the Security Management Status Report electronically within the first 10 days of the month, and every month thereafter.

DID TAILORING:

10.2 Content: The contractor shall obtain and maintain security clearances for all personnel IAW applicable program and facility security guidelines. Annual training shall consist of procedures for safeguarding classified information and materials. The Status Report shall include the following:

(1) Total number of clearances required, granted, and pending.

(2) Number of personnel with current/non-current Annual Training for the following:

- Information Assurance Training

- Foreign Intelligence Techniques

- Operations Security

- Adverse Information Reporting

- Derivative Classified Marking

- Reporting Fraud, Waste, and Abuse

- Anti-Terrorism/Force Protection

(3) Report all security incidents/infractions/IAW directives. Limit the reporting on monthly summaries to those incidents/infractions involving the protection of classified information/material in association with this contract. The Contractor Program Security manager shall follow up with a written report of the type of incident/infraction within 5 working days. Once notified of the results of the inquiry, corrective action taken (including preventative action to prevent recurrence) will be submitted to the JPMO Program Security Manager within 5 working days of the incident/infraction closeout.

JPMO

(PCOR)

0 1 0

Annex FACs and ACOs

0 2 0

SEC. Mgrs 0 1 0

15. TOTAL 0 5 0

FA8240-13-R-7218

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX05

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**06

2. TITLE OF DATA ITEM

JOCAS Report

3. SUBTITLE

N/A

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No)

DI-MCCR-80700

5. CONTRACT REFERENCE

Enterprise PWS 2.2.2.d

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

See Block 16

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA Block 1. **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA

The contractor shall establish a man-hour reporting interface from the contractor’s cost accounting system to be compatible with the Government Job Order Cost Accounting System (JOCAS). This system must electronically feed into JOCAS per the attached file specification and be delivered no later than the fourth day following calendar month end.

Attachment 1 Legend:

All – Product/service and cost transactions P – Product and service transactions C – Cost Transactions CEH – Contractor entry history

Note 1: Positive (+) sign is optional (default); negative sign (-) is allowed. If used, signs must be in the leftmost position of the field.

Note 2: The values in the quantity, amount, and hours fields will contain decimal points.

JPMO (PCOR) 0 1 0

JPMO Fin. Mgr 0 1 0 FACs at Annexes 1,2,3

Record Use

Type Item Columns Format

All required aid 1-2 alpha

All required JON 3-10 alpha

All required charge_date (DD-MON-YYYY format) 11-21 alpha

All required fc 22-23 alpha

All required wbs 24-27 alpha

All required rccc 28-33 alpha

P required ps_code 34-38 alpha

C required eeic 39-43 alpha

All required trans_type 44-44 alpha

P, C required quantity (see note) 45-58 numeric

C required amt (see note) 59-72 numeric

All required fy (YYYY format) 73-76 numeric

Reserved 76-116

All optional local_use 117-122 alpha

P optional remarks 123-147 alpha

CEH optional contract_number 148-158 alpha

Reserved 159-159

CEH optional fund_source 160-160 alpha

Reserved 161-166

CEH optional job_type 167-168 alpha

CEH optional contractor_org_code 169-172 alpha

CEH optional work_phase_code 173-173 alpha

CEH optional facility_code 174-187 alpha

CEH optional main_effort 188-193 alpha

CEH optional sub_effort 194-196 alpha

CEH optional sow_annex 197-198 alpha

CEH optional oban_yr 199-199 alpha

All optional oban 200-201 alpha

All optional oac 202-203 alpha

CEH optional pec 204-209 alpha

CEH optional rmb_ind 210-210 alpha

CEH optional location_code 211-212 alpha

CEH optional test_number 213-217 alpha

CEH optional contractor_support_card 218-222 alpha

CEH optional won 223-230 alpha

CEH optional equip_id_number 231-240 alpha

CEH optional location_area 241-240 alpha

CEH optional location_complex 243-244 alpha

CEH optional location_pad 245-245 alpha

C optional comments 246-225 alpha

All required bpac (3600 only) 326-331 alpha

All required ba (3400 only) 332-333 alpha

C optional sales_code 334-336 alpha

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX05

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**07

2. TITLE OF DATA ITEM

Contract Funds Status Report (CFSR)

3. SUBTITLE

N/A

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No)

DI-MGMT-81468

5. CONTRACT REFERENCE

Enterprise PWS PARA 2.2.2.a

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

See Block 16

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA Block 1. **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA

The contractor shall establish a monthly Contract Funds Status Report (CFSR) and reporting procedure to supply funding data about J-Tech II contracts to the PCO, JPMO, Annex FACs, and Program Manager for: (a) updating and forecasting contract funds requirements, (b) planning and decision making on funding changes to contracts, (c) developing funds requirements and budget estimates in support of approved programs, (d) determining funds in excess of contract needs and available for de-obligation, and (e) obtaining rough estimates of termination costs. The CFSR should be based on DI-MGMT-81468 and may be tailored to provide the best business practices for the program.

The report shall highlight any current or anticipated funding shortages or overages. Report shall track the actual incurred overtime premium pay and compares it to the amount of overtime premium pay that has been authorized via formal contract modification. Any shortages or concerns shall be noted.

The Contract Funds Status Report shall provide the following items:

Actual Expenditures Incurred Data- cumulative by CLIN Funding Authorized to Date Data Commitments Data Potential Overhead Rate Impact Data Estimate at Complete (EAC) Data Expenses and Rates monthly financial statement.

Estimate at Complete (EAC) Data.

Overtime Data.

Summary of Funding (Funding Required, Total over/under, 75% of Funds Authorized

Data shall be posted in the contractor EWIS and releasing workflow distribution to notify all users that the updated Contract Funds Status Report is available for review. Files to be updated bi-monthly upon release of vouchers

PCO 0 1 0

JPMO (PCOR) 0 1 0

JPMO Fin. Mgr 0 1 0 Annex FACs 0 1 0

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX05

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**08

2. TITLE OF DATA ITEM

Contract Transition-Out Plan

3. SUBTITLE

Phase-Out Transition

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No)

DI-MGMT-81945

5. CONTRACT REFERENCE

Enterprise PWS PARA 4.1.3

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

Initial/Final

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft

Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA Block 1. **= AA BA CA DA EA FA GA HA JA KA LA MA NA PA QA

Block 4 DI-MGMT-81945 Tailoring as follows:

The Phase-Out Transition Plan shall include:

a. A written comprehensive plan explaining actions required to complete the total transition effort within a sixty (60) calendar day transition period.

b. Details of accounts and subscription services to be terminated or transferred.

c. Process to conduct a full joint inventory and transference of all Government Furnished Material inventory including all records.

d. Status of all items in inventory as well as the items that have been inducted into repair facilities, being modified or are being purchased.

e. Details for the removal of all contractor owned items.

f. Critical path schedule for risk mitigation of the transition period.

g. Plan to make training and certification records available of contractor personnel who are considering employment with the succeeding contractor.

Block 12:

The contractor shall provide a transition-out plan two years prior to contract conclusion. The plan should include, but not be limited to, identification and transfer of property, software, cost, or other contract performance data.

PCO 0 1 0

JPMO

(PCOR)

0 1 0

Range Directors

15. TOTAL 0 3 0

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX15

B. EXHIBIT

C. CATEGORY:

TDP _X___ TM ____ OTHER ______

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**01

2. TITLE OF DATA ITEM

Cost/Schedule Status Reports (C/SSR)

3. SUBTITLE

Cost Rates Spreadsheet

4. AUTHORITY (Data Acquisition Document No)

DI-MGMT-81467

5. CONTRACT REFERENCE

Annex 1 PWS PARA A1.2.2.2.a

6. REQUIRING OFFICE

AFTC/PZSA

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

Monthly

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AB BB CB DB EB FB GB HB JB KB LB MB NB PB QB Block 1. **= AB BB CB DB EB FB GB HB JB KB LB MB NB PB QB

Contractor shall provide monthly Cost and schedule status reports (C/SSR) by Sub- Annex project and Job Order Number (JON). The purpose of this report is contractor reporting of actual costs incurred for year-to-date and total-year budgets. Annex 1 Cost Reports shall provide the following details:

Ac tu al C os ts

La bo r

Straight Time Labor: This cost class consists of labor only (indirect rates are applied: Fringe, Annex Unique and Contractor Overhead), Management and G&A

Overtime Premium Pay Other Premiums/Pay Team/Subcontractor Labor:

This cost class should contain teammate/2nd tier subcontract labor costs. Billing rates for teammates may already include their company specific indirect load.

Contractor loads are applied with the following: Annex unique OH, Contractor Management and G&A.

Team/Sub Overtime Premium Team/Sub Other Premiums/Pay

O D Cs Other Direct Costs:

Consultants, 3rd Tier Subcontractor Cost, Temporary Cost, Temporary Personnel, Relocation/ Recruiting, Materials, Vehicles/Fuel, Non-Capital Equipment, Computer Expenses, Occupancy and other expenses

Tr av el Team Subcontractor Travel

Travel

To ta ls

Total Costs Incurred Award Fee Total Budget

To D at e Commitments

Cumulative Actuals Budget Variance (between Actuals and Budget amounts)

Ye ar ly Estimate to Complete (ETC)

Estimate at Complete (EAC) Variance

Data shall be posted in the contractor Electronic Data Management System (EDMS) and have the ability to release a workflow distribution to notify all users the Cost/Schedule Report is available for review. Files to be submitted NLT 10th of each month.

JPMO Fin Mgr

Range POC 0 1 0

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX25

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**01

2. TITLE OF DATA ITEM

Government Furnished Equipment Detail Transaction Status Data

3. SUBTITLE

All Inclusive List of Vehicles (GFE &

CFE)

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No)

DI-MGMT-80377

5. CONTRACT REFERENCE

PWS PARA A2N.2.1.8.A, A2g.2.1.8.a

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

As Required

12. DATE OF FIRST SUBMISSION

Initial, See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AC BC CC DC EC FC GC HC JC KC LC MC NC PC QC Block 1. **= AC BC CC DC EC FC GC HC JC KC LC MC NC PC QC

Block 4. Tailored to allow contractor format.

Block 12. Coordinate vehicle requirements with RSS Contractor immediately at contract start.

Block 13. Update as required.

Block 14: Copies will be posted electronically in an Enterprise-wide Information System (EWIS) and addresses will be notified via a workflow generated E-Mail developed within the EWIS.

Annex FAC 0 1 0

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX35

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**01

2. TITLE OF DATA ITEM

Mission Support Report

3. SUBTITLE

N/A

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No)

DI-MGMT-80909

5. CONTRACT REFERENCE

Annex 3 PWS A3.3.9.1.h

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

As Required

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AD BD CD DD ED FD GD HD JD KD LD MD ND PD QD Block 1. **= AD BD CD DD ED FD GD HD JD KD LD MD ND PD QD

Block 4. Tailored to allow contractor format.

Block 10. Required when priority changes result in a significant cost or schedule change (weekends or overtime).

Block 12. Submitted NLT COB 5 working days after notification of priority changes result in a significant cost or schedule change (weekends or overtime).

Block 13. Submit.led NLT COB 5 working days after notification of priority changes result in a significant cost or schedule change (weekends or overtime).

Block 14. Copies will be posted electronically in the Enterprise Wide Information System (EWIS) and addressees will be notified via a workflow generated E-Mail developed within the EWIS.

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**02

2. TITLE OF DATA ITEM

Program Plan

3. SUBTITLE

Mission Support Report

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No)

DI-MGMT-80909

5. CONTRACT REFERENCE

Annex 3 PWS A3.3.9.1.h

6. REQUIRING OFFICE

AFTC/PK

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

As Required

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AD BD CD DD ED FD GD HD JD KD LD MD ND PD QD Block 1. **= AD BD CD DD ED FD GD HD JD KD LD MD ND PD QD

Block 4. Tailored to allow contractor format.

Block 10. The contractor shall update the Mission Support Report Database (or equivalent) and provide a Mission Support Report (MSR) no later than 1 working day after mission completion 95% of the time (PRS #XX). The report shall include at a minimum the mission title, Job Order Number (JON), mission code, mission status, date, room ready time, system release times, resource/system utilization, target sites, weapons employed, and problems encountered.

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX45

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**01

2. TITLE OF DATA ITEM

Financial Status Report

3. SUBTITLE

Cost Distribution Account (CDA) Report

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81467

5. CONTRACT REFERENCE

Annex 4 PWS A4.2.2.2a

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

Monthly

12. DATE OF FIRST SUBMISSION

TBD

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block 16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AE BE CE DE EE FE GE HE JE KE LE ME NE PE QE Block 1. **= AE BE CE DE EE FE GE HE JE KE LE ME NE PE QE

Block 4. Tailor as follows:

The Status Report shall contain the following items, where applicable:

A4CL/SR.2.2.2.a – The Cost Distribution Account (CDA) Report shall provide the following detailed information for each accounting period, with a detailed cost report/cost total to match the voucher submission amount. It shall include:

(a) Task Order Number

(b) Date

(c) Range

(d) Work Center

(e) Chargeable Object (CO)

(f) Employee Name or Purchase Order (PO) Number

(g) Regular Hours and Cost

(h) Overtime Hours and Cost

(i) Double Time Hours and Cost

(j) Other Direct Costs (ODC)

Block 12. NLT than the 5th working day following receipt of the first voucher to Annex 4 Business Manager.

Block 13. NLT the 5th working day following receipt of each voucher to Annex 4 Business Manager.

Block 14: Copies will be posted electronically in the Enterprise Wide Information System (EWIS) and addressees will be notified via a workflow generated E-Mail developed within the EWIS.

PCO 0 1 0

Annex FAC 0 1 0

GOVT

Business

MGR

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.

XX45

B. EXHIBIT

C. CATEGORY:

TDP ____ TM ____ OTHER ___X___

D. SYSTEM / ITEM

J-TECH II

E. CONTRACT / PR NO.

FA8240-XX-C-7218

F. CONTRACTOR

TBD

1. DATA ITEM NO.

**02

2. TITLE OF DATA ITEM

Quality Control Report

3. SUBTITLE

Quality Assessment Report

17. PRICE GROUP

4. AUTHORITY (Data Acquisition Document No.)

DI-QCIC-81187

5. CONTRACT REFERENCE

Annex 4 PWS A4.2.1.9.b, c, d, e, f

6. REQUIRING OFFICE

AFTC/PZSA

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

Weekly

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION

See Block16 Draft Final

Reg Repro

16. REMARKS

Contract Year 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 Block A XX= 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 Block B **= AE BE CE DE EE FE GE HE JE KE LE ME NE PE QE Block 1. **= AE BE CE DE EE FE GE HE JE KE LE ME NE PE QE

Block 4. Tailor as follows:

Block 12. First work day following the end of the first week of contract performance.

Block 13. Weekly.

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number.