A006_TECHNICAL_REPORT.pdf

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

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

A

C. CATEGORY:

TDP TM OTHER X

D. SYSTEM/ITEM

RSAF F-15 CLASSIFIED REPAIR & RETURN

E. CONTRACT/PR NO.

FD2060-14-31331

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

TECHNICAL REPORT-STUDY/SERVICES

3. SUBTITLE

SEE BLK 16

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

PWS PARA 4.09

6. REQUIRING OFFICE

AFLCMC/WWQI

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ANNLY

12. DATE OF FIRST SUBMISSION

365DAC

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

O

13. DATE IF SUBSEQUENT SUBM.

Draft

Final Reg Repro

16. REMARKS

BLOCK 9. DISTRIBUTION CODE D. DISTRIBUTION AUTHORIZED TO DEPARTMENT OF DEFENSE

AND DOD CONTRACTORS ONLY. OTHER REQUESTS SHALL BE REFERRED TO AFLCMC/WWQI

OR HIGHER DOD AUTHORITY. EXPORT CONTROLLED.

BLOCK 10-13:

ANNUAL FAILURE DATA: ANNUAL FAILURE DATA REPORT SHALL BE SUBMITTED ANNUALLY. THE

REPORT SHALL BE SUBMITTED WITHIN 30 CALENDAR DAYS OF THE END OF THE REPORTING

PERIOD. ANNUAL TIMEFRAME SHALL SHART AT CONTRACT AWARD. REPORT SHALL IDENTIFY

THE TOP FIVE REPAIRED ITEMS, AS WELL AS ADDITIONAL INFORMATION IAW PWS PARA 4.09.

BLOCK 14: CONTRACTOR SHALL PROVIDE ALL REPORTS ELECTRONICALLY TO THE PROGRAM

MANAGER, PROCUREMENT CONTRACTING OFFICER, AND DCMA REPRESENTATIVE NLT DATES

INDICATED ABOVE. ALL EMAIL ADDRESSES WILL BE PROVIDED WITHIN 10 WORKING DAYS OF

CONTRACT AWARD.

15. TOTAL ▬▬▬▬►

G. PREPARED BY

BRITTANY PROUTY

H. DATE

5 Jun 2014

I. APPROVED BY

DAVIS.VERNE.L.10443 Digitally signed by DAVIS.VERNE.L.1044318756

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, 18756 ou=USAF, cn=DAVIS.VERNE.L.1044318756 Date: 2014.06.05 09:03:24 -04'00'

J. DATE

5 Jun 2014