CDRLSmallBusinessParticipation.pdf

CONTRACT DATA REQUIREMENTS LIST (CDRL)

(1 Data Item) Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to the Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

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

TDP X TM OTHER

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

Component Repair, OBN-10-036 TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A010 Status Report

See Block 16

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

TOTAL PRICE

DI-MGMT -S036S/T IAW PWS 4.3.10 417 SCMS

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT REQUIRED Twice/year SEE BLK 16

a. ADDRESSEE

b. COPIES

8. APP CODE

B

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION Draft Final

SEE BLK 16 Reg Repro

16. REMARKS 748 SCMG/PKAB 1 1

Blk 3: Funding Actions and Small Business Participation Data.

Blk 4: Electronic format in Microsoft Excel, using template provided by the contracting

Contract Office. The reports shall be cumulative. The report shall include each funded

Contracting action during the reporting period. One contracting action per line.

Blk 9 & 14: See General Notes for details pertaining to the distribution statement and electronic submittal of data.

Blks 10,11, 12, and 13: Reports shall be submitted on 1 May and 1 November.

Blk 14: Email to LGR2 (748 SCMG/PKAB) Contracting Officer.

15. TOTAL ▬▬▬▬► 0 1 1

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

Kim Tingey //SIGNED// Program Manager 27 Jun 2011

Jared Butterfield //SIGNED// Engineering Flight Chief 27 Jun 2011

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