CDRL_FA.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved .

(1 Data Item) OMB No. 0704-0188

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 tl1e coilection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden. to: Department of Defertce, Washington Headquarters Services, Directorate tor information Operations and Reports, 1215 Jefferson Davis Highway. Suite 1204, Arlington VA 22202-4302, and to the Ollice of Management and Budget.

PapetWork Reduction Pro;ect (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either ot these addresses. Send completed lorm to the Goverment-lssuing Contracting Oflicer for the Contract!PR No. listed in Btoci< E.

A. CONTRACT LiNE ITEM NO. B. EXHIBIT I c. CATEGORY

A TOP TM OTHER NDTI

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

FIRST ARTICLE REORTING

599 60 146 44836WF FD2020- 12 - 001 98 17. PRICE GROUP

A0 01 Test/Inspect1on

1. DATA ITEM NOr TITLE OF DATA IT.EM Report ,3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5 . CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED CLIN for Data TOTAL PRICE DI-NDTI - 80809B/T 416 SC:t>lS/GUMAD

7. DO 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION

REQUIRED 14. DISTRIBUTION

DD OTIME BLK 16

b. COPIES

8. APPCODE B 11 . AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION a. ADDRESSEE Final

Draft

BLK BLK 16 Reg Repro

16 . REMARKS SEE BLK 16

1. BLOCK 4: Contractor ' s format is acce p t able .

Paragraph 10.2 of DI - NDTI - 80809B is clarified as f ollm·;s :

a . All dimensions and t olerances s pecified on t h e manufac t u r i ng data shall be listed in one column, with the actual corresponding reading obtai ned from t he inspect i on of the pa r t listed in anoth er column.

b. Material s utilized in the manuf acture of "Firs t Art i cle " item shall be i de nt if i ed and ce r t ified along with a c opy of material purchase r eques ts as conforming to applicable data req ui rements .

c . Material processing , i ncluding fin i sh requir emen ts (pl ating, heat treatme nt , welding , inspec ting, anodize , painting , etc . ) u t ilized in the manufactu re of "First Article" item shall be i dentified and cer t ified a s conforming to applicabl e requirements. A copy o f t he purchase order certifying the process accomplished at o ther than contr actor f acili t y shall be i ncluded .

d . Other r equirements a s called out on Eng ineeri ng Data Req uirement (00- ALC FORM 462 ).

2 - BLOCK 9 : DISTRI BUTION STATEMENT B. Distribution authorized t o u. s. Government agencies only. Rea son :

Test & Evaluation . Da te of Determination: February 2012 . Other reque sts for this documen t sha ll be referred to 41 6 SCHS / GUHAD

WARNING: Thi s document contains t e chnical da t a whose e xport is restri cted by the Arms Expor t Cont r ol Act (Title 22, u. s .c.' Sec 2751 e t seq .) or Executive

Or der 12470 . Vi olations of t he s e expert - c ontr o l laws ' is s ubject to c riminal penal ties . Dissemination of t h is documen t i s control led under DoD Di rect ive 5230 . 25 and AFI 61-2 04

15. TOTAL------> 0 0 0

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

28 Feb 12 J AVAD REFAHIYAT 28 Feb 12

~ A R wdk ENGINEER

DO Form 1423-1, JUN 90(! Computer Generated Previous editions are obsolete Page _ 1_ of~ Pages

Justin.Dalton Typewritten Text

0001AA

Justin.Dalton Typewritten Text

Justin.Dalton Typewritten Text

CONTRACT DATA REQU IREMENTS LIST Form Approved (1 Data Item) OMB No. 0704·0188

Public reporting burden lor ti..-s co::ec1ion of Ill formation is est:mated to average 110 hours per 19sponse. including the time for revieving instructions. searching existing data sources. gathering and maintaon.ng the data needed, and completing and reviewing the col ecllon of onforma~on. Send comments regardong tn s burden estltllate or any other aspect of this collection of itlformalion. including suggestions for reducing this burden, to. Department of Defence, Washington Headquarters Services.

II Directorate for informaron Operations and Reports, 121 5 Jefferson Davis Highway, Suite 1204, Ar11no:on VA 22202-4302, and to the Office ol Management and Budget.

Paperworl<. Reduction Project (0704·0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses, Send completed form to the GovermenHssuing Contracting ONicer for the Contract!PR No. listed In Block E.

A CONTRACT LI NE ITEM NO. 00 B. EXHIBIT I C. CATEGORY

A TOP TM OTHER NDTI

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

FIRST ARTICLE REORTING

5996014 64483 6~oJF FD2020-12-00198 17. PRICE GROUP

1 DATA ITEM NO 2 TITLE OF DATA ITEM

AOOl Test / Inspection Report r· SUBTITLE

4 AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI - NDTI-8080 98/T CLIN f or Data TOTAL PRICE 416 SCMS/GUMAD

7. DO 250 REO 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION

DD REQUIRED OTIME BLK 16

14. DISTRIBUTION

b. COPIES

8. APP CODE B 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION a. ADDRESSEE Final Draft BLK 16 BLK 16 Reg Repro

16. REMARKS

DESTRUCTION NOTICE: For classified documents, f o l low the procedures in DoD 5220 . 22-N, Nati.onal Indus t r i al Security Oper ating t1anual, Chapter 5 , Seet on 7, ppS-704, or DoD 5200 . 1R Information Secur ity Program.

For Unclass ified, l imited documents , des troy by any me thod that will preven t disclosure of contents or reconstruction of the document .

3. BLOCKS 10' 11 , 12, 13 ;

a . For Contractor Testing - submit in acc ordance with the current del ivery schedule . '

b. For Government Test i ng - Report to ass is t: in "First Artic l e" tes t ing by t he Air Force shall be submitted concurrently with the "Firs t Article" i t em

I e ither in the packag i ng of the s hipping con ta ine r or seperately if the repor t wi ll not fit within t he container packaging unfolded. When shipped in the first article conta i ner, the report shall be enclosed in a paper or plas tic envelope .

c. Ship To:

(Mark For 1st Articl e Test , Do Not Pos t ) :

809 MXSS/ HXDEB (First Article Test - Bldg 849) Attent ion: Non-Accountable (Dear J ohn ) Bay

I Hill AFB UT 84056- 5713

FOB DESTINATION

I i

15. TOTAL ...... >

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

~ lt&niu!

28 Feb 12 J AVAD REFAHIYAT 28 Feb 12 I ENGINEER E

DO Form 1423-1, JUN 90 {/ Computer Generated Previcus editions are obsolete P.age ~of~ Pages

Justin.Dalton Typewritten Text

0001AA