CDRLs.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved 0MB No. 0704-0 188

The public reporting burden for this collection of information is estimated to average 110 hours per. response, including the tene for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no peroon shall be sublect to any penalty for failing to comply with a collection of information if it does not display a currently valid 0MB control number. Please do not return your form so 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

A

C. CATEGORY:

TOP TM OTHER _______________________________

0. SYSTEM/ITEM E. CONTRACT/PR NO.

FD20201900069

F. CONTRACTOR

1. DATA ITEM NO.

AOOI

2. TITLE OF DATA ITEM

Commercial Asset Visibility AF(CAV AF) End Item Reporting

3. SUBTITLE

CAV AF

4. AUTHORITY /Data Acquisition Document No.)

DI-MGMT-81634C

B. CONTRACT REFERENCE

PWS

6. REQUIRING OFFICE

415 SCMS/GUMBA

7. DO 250 REQ

LT

9. 01ST STATEMENT

REQUIRED

N/A

10. FREQUENCY

See Block 16

12. DATE OF FIRST SUBMISSION

Block 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE 11. AS OF DATE

Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

Block 16 Draft

Final

Reg Repro

16. REMARKS

1. The contractor shall report End Item transactional data through electronic submission in CAV AF using the CAV AF web site or CICA XML lAW the referenced DID and/or Contract Repair PWS. This information will be reviewed, by the applicable Contract Monitor, to ascertain production status.

2. Transactions and data will be submitted by the contractor daily lAW CAV AF Contractor User Guide, Version 9.0.4 or higher. The Contractor shall obtain a valid DoD PKI certificate to log into CAV AF. Each user shall have an Identity Certificate only; an encryption certificate is not required. Reporting must be accomplished for each Contractor facility/location AND any subcontractor locations.

3. Training will be provided by the applicable ICP representative.

4. This DD Form 1423 applies to end item repair CAV AF reporting only contracts, commonly referred to as Contractor Furnished Material (CFM) type contracts.

5. It is imperative the CAV AF Proof of Shipment reporting actions are accomplished by the contractor.

Block 10:

a. Contractor reporting requirements to CAY AF shall be accomplished daily and/or one business day of a maintenance action LAW Contractor Users Guide.

b. The method of communication from the contractor to the Air Logistics Complex (ALC) will be mechanized using the CAV AF Online web site JAW CAV AF Contractor Users Guide.

Block II: Data shall be current within one business day of last End Item maintenance occurrence and reflect an accurate representation/status of all assets at a contractor for repair.

Block 12: Date of first submission shall be within one business day following a maintenance transaction after the contract award date and government training as specified in lAW CAV AF Users Guide.

Block 13: Within one business day of each maintenance action/occurrence, Continued on next page.

OO-ALC

DoDAAC: FB2029

415 SCMS/GUMBA

6012 Fir Avenue

HILL AFB, UTAH

84056-5 820

Attention To:

Production Management

Specialist

Jason Faulkner Phone:

801-777-72 17

E-mail Address:

jason.faulkner@us.af.mi

15.TOTAL 0 1 0

G. PREPARED BY

TLJBI3S.BRAD.H. 1273458103 i5iflV ..iiiiSvi.SDji i2io

H. DATE

9-Feb-18

I. APPROVED BY

FAULKNER.JASON.THOM

muLcsixJAsosrsoMAs

AS. 1158647199 -

iii, ,pi sn, vi vi Sri .07'irY

J.DATE

9-Feb-18

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

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

Adobe Professional 8.0

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

A TDP TM OTHER

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

FD2020 1900069

16. REMARKS (Continued)

The contractor's CAV AF reporting shall reflect their inventory property control management system data records which shall represent timely and accurate accountability of AF inventory assets at the physical location(s) of the contractors repair facility (including subcontractor iicilities); shop floor, bond room and/or receiving/shipping docks, etc. for each repair.

DD FORM 1423-1, FEB 2001 Page 2 of 2 Pages

Form Approved 0MB No. 0704-0 188

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 (0701-01881, 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 0MB control number. Please DO NOT RE1'URN 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: MGMT

TOP TM OTHER _______________________________

D. SYSTEM/ITEM O,I?R F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Government Property Inventory Report

3 SUBTITLE

Annual Government Property Physical Inventory Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80441 CIT

5. CONTRACT REFERENCE

PWS Paragraph:

6. REQUIRING OFFICE

415 SCMS/GUMBA

7. 00 250 RED

LT

9. 01ST STATEMENT

REQUIRED

D

10. FREQUENCY

ANNLY

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft Final

Rag Repro

16. REMARKS

NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

1. Block 4:

a. All reports shall be submitted in the English Language.

2. Blocks 10, 11, 12, 13:

a. This report will be provided annually. Reporting Period is one year.

b. The data is representative of the Contractor's Internal Property Control System and shall be current as of the last day of the annual reporting period. If requested outside of an annual cadence, the data shall be current as of the date requested.

c. The report shall be deliveredwithin seven (7) calendar days of the end of the first reporting period and annually thereafter, or within seven (7) calendar days of government request.

3. Block9:

a. DISTRIBUTATION STATEMENT "D": Distribution authorized to the Department of Defense and U.S. DoD contractors only (Reason for Use). (Date of Determination). Other requests for this document shall be referred to (DoD Controlling Office).

b. EXPORT CONTROL WARNING: All technical documents/data (printed, digital/electronic) that are determined to contain export-controlled technical data, shall be marked with the following statement:

SEE BLK 16

15.TOTAL 0 1 0

G. PREPARED BY

JASON FAULKNER

Name(Contractor Data Mgr)

H. DATE

15-OCT-2018

I. APPROVED BY

JASON FAULKNER

Name (Prgrn. Mgr)

J.DATE

15-OCT-2018

17. PRICE GROUP

NSP

18. ESTIMATED

TOTAL PRICE

0.00

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

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

TDP TM OTHER MGMT

I D. SYSTEM/ITEM F

I Pb2O2O-19-00069

116. REMARKS (Continued)

F. CONTRACTOR

EXPORT CONTROL WARNING: This document contains technical data whose export is restricted by the Anns Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App. 2401 et seq.), as amended.

Violations of these export laws are subject to severe criminal penalties. Disseminate JAW provisions of DoD Directive 5230.25.

c. DESTRUCTION NOTICE: For classified documents, follow the procedures, in DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, or DoD 5200.l -R, Information Security Program Chapter VI. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

4. Block 7, 14: Submit the Annual Government Property Physical Inventory Report to the following email address:

(EMAIL ADDRESS)

JASON.FAULKNER@USAFMIL

DD FORM 1423-1, FEB 2001 Page of 2 Pages

Form Approved 0MB No. 0704-0 188

The public reporting burden for this collection of information in estimated to average 110 hours per responoe, including the time for reviewinp instructions searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information, Send comments regartlnig 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 10701-0188), 1218 Jefferson Davis Highmay, Suite 1204, Arlington, VA 22202-4302. Respondents should be amare 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 0MB control number. Please DO NOT RE1URN 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:

MGMT

TDP TM OTHER

D. SYSTEM/ITEM F. CONTRACTOR

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

Commercial Asset Visibility Air Force (CAV) Reporting

3. SUBTITLE

CFM End Item Reporting

4. AUTHORITY (Gary Acquisir/on Documenr No.)

DI-MGMT-81838/T

5. CONTRACT REFERENCE

SEE BLK 16 FOR REFERENCE

6. REQUIRING OFFICE

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

SEE BLK 16

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

SEE BLK 16

13. DATE OF SUBSEQUENT

SEE BLK 16

Draft

Final

16. REMARKS

NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

1. Block 5: Contract Reference: PWS Paragraph XXX and CAV AF Reporting Requirements Document

2. Block 4: All reporting shall be submitted in the English Language.

3. Blocks 10, 11, 12, 13:

a. Date of first submission shall be within 24 hours following a supply or maintenance transaction, after the contract award date.

b. Contractor reporting requirements to CAV AF shall be submitted daily andlor within 24 hours of a supply or maintenance action occurrence JAW the CAV AF Reporting Requirements Document.

c. Data shall be current within 24 hours of the last End Item maintenance occurrence.

4. Blocks7,8, 14:

a. The contractor shall report End Item transactional data through electronic submission in CAV AF using the CAV AF website or CICA XML.

b. The contractor shall submit a DD Form 250 (Material Inspection and Receiving Report) electronically via the Internet to iRAPT (WAWF) website address: https://wawf.eb.rnil, using DODAAC FA825 1. MARK FOR: Address in block 14A.

c. A Letter of Transmittal shall be submitted in the month the delivery order is completed, covering all reports transmitted for that order. Submit the Letter to the following email address:

(EMAIL ADDRESS)

SEE BLK 16

15.TOTAL E 0 1 0

G. PREPARED BY

JASON FAULKNER

Name (Contractor Data Mgr)

H. DATE

i5-OCT-2018

I. APPROVED BY

JASON FAULKNER

Name (Prgim Mgr)

J.DATE

15-OCT-20i8

17. PRICE GROUP

NSP

18. ESTIMATED

TOTAL PRICE

DO FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page 1 of 1 Pages

Form Approved 0MB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response including the time for reviewing instruct ons 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 o1 this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports 10701-01881, 1216 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 0MB control number. Please DO NOT REliURN 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:

TOP TM OTHER _____________________________

D. SYSTEM/ITEM 61RNO.

F. CONTRACTOR

1. DATA ITEM NO

A004

2. TITLE OF DATA ITEM

Contract Depot Maintenance (CDM) Production Report

3. SUBTITLE

CDM Production Monthly Status Report

4. AUTHORITY (Data Acquisition Document No.)

DI-PSSS-81995/T

5. CONTRACT REFERENCE

PWS Paragraph:

6. REQUIRING OFFICE

7. DD 250 REQ

LT

9. 01ST STATEMENT

REQUIRED

D

10. FREQUENCY

MTHLY

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

SEE BLK 16

13. DATE OF SUBSEQUENT

SUBMMON

Draft Final

16. REMARKS

NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Govermrient CO/ACO without further revision to this CDRL.

1. Block4:

a. All reporting shall be submitted in the English Language.

b. The Contractor's CAV AF Reporting shall reflect their inventory property control management system data records which shall represent timely and accurate accountability of AF inventory assets at the physical location(s) of the contractor's repair facility (including subcontractor facilities); shop floor, bond room and/or receiving/shipping docks, etc. for each repair.

c. The Contractor shall report by contract delivery order on all applicable categories, totals and on-hand balances, providing TABLE I (DI-PSSS-8 1995) for EACH repair location, including subcontractor facilities, for the contracts maintenance occurrence actions during the reporting period.

d. The Contractor shall report on production, providing TABLE I (DI-PSSS-8 1995) for EACH repair location, including subcontractor facilities, for which the contractor produced assets during the reporting period.

2. Blocks 10, 11, 12, 13:

a. The reports shall be provided monthly within 5 (five) business days of the previous month's last calendar date.

b. Reports shall continue to be submitted by the contractor unless the requirement is terminated by the (Requiring Office), Program Manager (PM) or the Production Management Specialist (PMS),

c. The Final Report submitted following the final reporting period on the contract shall be annotated "Final Report"

I

SEE BLK 16

15.TOTAL 0 1 0

G. PREPARED BY

JASON FAULKNER

Name(Contractor Data Mgr)

H. DATE

15-OCT-2018

I. APPROVED BY

JASON FAULKNER

Name(Prgm. Mgr)

J.DATE

15-OCT-18

17. PRICE GROUP

NSP

18. ESTIMATED

TOTAL PRICE

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

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

TDP TM OTHER

D. SYSTEM/ITEM F. CONTRACTOR

16. REMARKS (Continued)

3. Block 9:

a. DISTRIBUTATION STATEMENT "D": Distribution authorized to the Department of Defense and U.S. DoD contractors only (Reason for Use). (Date of Determination). Other requests for this document shall be referred to (DoD Controlling Office)

b. EXPORT CONTROL WARNING: All technical documents/data (printed, digital/electronic) that are determined to contain export-controlled technical data, shall be marked with the following statement:

EXPORT CONTROL WARNING: This document contains technical data whose export is restricted by the Aims Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App. 2401 et seq.), as amended.

Violations of these export laws are subject to severe criminal penalties. Disseminate JAW provisions of DoD Directive 5230.25.

c. DESTRUCTION NOTICE: For classified documents, follow the procedures, in DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, or DoD 5200. 1-R, Information Security Program Chapter VI. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

4. Block 7, 14: Submit the CDM Production Monthly Status Reports to the following email address:

(EMAIL ADDFRESS)

JASON.FAULKNER@US.AF.MIL

DD FORM 1423-1, FEB 2001 Page of 1 Pages

Form Approved

0MB No. 0704-0188

The public reporting burden for thin 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 informstion. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate 0704-01881. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to cowply with a collection of inforwation if it does not display a currently valid 0MB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No, listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT

B

C. CATEGORY:

TOP TM OTHER ILSS

D. SYSTEM/ITEM

See BIk 16

E. CONTRACT/PR NO.

FD2020-19-00069

F. CONTRACTOR

1. DATA ITEM NO.

BOO I

2. TITLE OF DATA ITEM

Repairable Item Inspection Report

3. SUBTITLE

Maintenance Data Collection

4. AUTHORITY (Data Acquisition Document No.)

DI-ILSS -80386

5. CONTRACT REFERENCE

PWS 10.2

6. REQUIRING OFFICE

415 SCMS/GUMBB

7. OD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASGEN

12. DATE OF FIRST SUBMISSION

ASGEN

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

IN/ft

11. AS OF DATE

SeBlk16

13. DATE OF SUBSEQUENT

SUBMISSION

SeeBlk16 Draft

Final

Peg Repro

16. REMARKS

Changes to names and office symbols, when necessary, shall be made by letter through the CO/ACO without revision to this CDRL.

Block D:AN/MST-TI (V) Miniature-Multiple Threat Emitter System (Mini-MUTES) Distribution Box Assembly in TX35,NSN: 6110-01-481-1994 Block 4: Paragraph 10.1.1 Shall be modified to remove items a, f, and i.

Paragraph 10.1.1 items b, c, d and e refer to the assembly submitted for repair.

Paragraph 1 0.1 .1 item h refers to the part(s) that were replaced, repaired, calibrated, cleaned, etc. to return the assembly to operational condition. Reportable data includes (1) NSN and part number (if available) of failed part, (2) description or name of failed part, (3) location of failed part in the assembly (sufficient to uniquely identify the specific part when the failed part exists in niultiple locations in the assembly).

An electronic template containing the preferred format for submitting the data is available.

If it is not attached to tile solicitation, it may be obtained from the 415 SCMS/GUMAD engineer through the CO/ACO.

Blocks 10, 11, 12 & 13: Contractor shall deliver the Repairable Item Inspection report within 7 days after the completion of each repair.

Block 14: Document submission shall be made electronically using MS Office 2010 or newer format or Portable Document Format (PDF).

Address e-mail submissions to: USAF AFMC 415 SCMS/EN, 4 I5SCMS.en@us.af.mil 415 SCMS engineer tony.1ewis.5us.af.mil AFMC OL:1-l/PZAAA. PCO (TBD) @us.af.mil (For PCO name see contract) DODAAC (if applicable): FY2073 Address Line I: FY2073 GLSC 415 SCMS Address Line 2: BLDG 1239 CP 801 586 1368 Address Line 3: 6012 FIR AVE Address Line 4: HILL AFB UT 84056-5820

Block 9:

DISTRIBUTION STATEMENT D: Distribution is limited to DoD and U.S. DoD contractors only for administrative or operational use only. Other requests for this data shall be referred to 415 SCMS/GUMBB, HILL AFB, UT 84056.

WARN ING: Export Controlled DESTRUCTION NOTICE: Destroy by any means that will prevent disclosure of the contents or reconstruction of the document

415 SCMS/GUMBB

415 SCMS/EN

AFMC OL:H/PZAAA

15.TOTAL 0 1 2

G. PREPARED BY

Engineer 415 SCMS/GUMBB

LEWIS.TONY.G. 1546662744

H. DATE I. APPROVED BY

Bryson Kent 415 SCMS/GUMBB

KENT.BRYSONC. 13855179 Di5iiy5,Jhy

86 'i,. ,iiisni iri,-i irs lw,, J.DATE

01/17/2018

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Adobe Professional 8,0

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

B TOP TM OTHER ILSS

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

See BIk 16 FD2020-19-00069

16. REMARKS (Continued)

DD FORM 1423-1. FEB 2001 Page of Pages

Form Approved 0MB No. 0704-0 188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-01881. 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 0MB control number. Please do not return your form to the above organization. Send completed form to the Goeernment Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT

C

C. CATEGORY:

TOP TM OTHER MISC

D. SYSTEM/ITEM

See Blk 16

E. CONTRACT/PR NO.

FD2020-19-00069

F. CONTRACTOR

1. DATA ITEM NO.

COOl

2. TITLE OF DATA ITEM

Counterfeit Prevention Plan

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-8 1832

5. CONTRACT REFERENCE

PWS Paragraph 10.3

6. REQUIRING OFFICE

415 SCMS

7. DD 250 REO

DD

9. DIST STATEMENT

REQUIRED

D

10. FREOUENCY

1TIME

12. DATE OF FIRST SUBMISSION

3ODAC

14. DISTRIBUTION

a. ADDRESSEE b.COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A 0 ft

Final

16. REMARKS

Changes to office symbols and/or e-mail addresses, when necessary, shall be made by letter thi'ough the CO/ACO without further revision to this CDRL.

Block D: AN/MST-Tl(V) Mini-MUTES, Distribution Box Assembly, 6110-01-481-1994

Block 4: Plan shall include all items from section 4 of SAE AS5553.

Block 12: Contractor shall deliver the Counterfeit Prevention Plan within 30 days of contract award. Government comments provided to the contractor within 14 days after receipt, with contractor re-submittal due 7 days after receipt of comments.

Block 14: Document submission shall be made electronically using MS Office 2010 or newer format or Portable Document Format (PDF).

Address e-mail submissions to: USAF AFMC 415 SCMS/EN, 415SCMS.en@us.afmil 415 SCMS engineer tony.lewis.5us.af.mil AFMC OL:HJPZAAA. PCO (TBD) @us.af.mil (For PCO name see contract) DODAAC (if applicable): FY2073 Address Line I: FY2073 GLSC 415 SCMS Address Line 2: BLDG 1239 CP 801 586 1368 Address Line 3: 6012 FIR AVE Address Line 4: HILL AFB UT 84056-5820

Block9:

DISTRIBUTION STATEMENT D: Distribution authorized to the Department of Defense and U.S. DoD contractors only for administration and operational purposes, contains limited access information, 21 Nov 2008. Other requests for this document shall be referred toOO-ALC/AFMC4IS SCMS/GUMBB.

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

415 SCMS 1

415 SCMS/EN

AFMC OL:H/PZAAA

15.TOTAL 0 1 2

G. PREPARED BY

Engineer 415 SCMS/GUMBB

LEWIS.TONY.G. 1546662744

H. DATE I. APPROVED BY

Bryson Kent KENT.BRYSON.C, 13855179 °d"°Yw"7

86 5..7111 S III 171715-Sr -tO-In

J.DATE

01/17/2018

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page of Pages Adobe Professional 8.0

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

C TOP TM OTHER MISC

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

See BIk 16 FD2020-19-00069

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page ot Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DOD 5010. 12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL I FOR THE CONTRACTOR

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (Xl appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning," "Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item C. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered

Item 11. Specify as-of date of data item, when applicable

Item 12. Specify when first submittal is required.

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group Ill. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Item 13. Specify when subsequent submittals are required, when Estimated Price - Group IV items should normally be shown applicable, on the DD Form 1423 at no cost.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

IiTJ

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.