CDRLs.pdf

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of12 16

FD20601200516HCU-6/E 463L Pallets

A001

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

COMMERCIAL ASSET VISIBILITY AIR FORCE CAVAF

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-MGMT-81634B PWS paragraph 3.6.3 FA8519

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

LT

8. APP Code:

N/A A

11. As of Date: 13. Date of Subsequent Submission:

SEE BLOCK 16

SEE BLOCK 16

See Block 16

a. Addressee:

b. Copies:

Final

Draft Reg Repro

SEE BLOCK 16

16. Remarks:

NAME: Allred, Donna E DATE: 30 MAY 2012

1. The contractor shall report End Item transactional data through electronic submission in CAV AF using the CAV AF web site or CICA XML IAW the referenced DID IAW and/or CAV AF CFM SOW. This information will be accessed by the program office PMS and by 406 SCMS/GUMAAB in order to ascertain production status.

2. Transactions and data will be submitted by the contractor daily IAW CAV AF User Guide, Version 8.0 or higher. The Contractor shall obtain a valid DoD PKI certificate to log into CAV AF.

Each user shall be required to have an Identity Certificate only; an encryption certificate is not required.

3. Training will be provided by 406 SCMS/GUMAAB, (478) 327-6602 or 327-6603.

4. This DD Form 1423-1 applies to Contractor Furnished Material (CFM) type contracts.

Block 10:

a. Contractor reporting requirements to CAV AF shall be accomplished daily and/or within 24 hrs of a supply or maintenance action occurrence IAW Contractor Users Guide.

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

Block 11: Data shall be current within 24 hours of last End Item maintenance occurrence.

Block 12: Date of first submission shall be within 24 hours following a supply or maintenance transaction after the contract award date and government training as specified in IAW CAV AF Users Guide.

Block 13: Same as remarks regarding Block 10 above.

COORDINATORS:

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of22 16

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

G. Prepared By: H. Date I. Approved By: J. Date:

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

478-222-1704 / 472-1704

28 JUN 2012

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of32 16

A002

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Nonstandard Parts Approval Request Nonstandard Parts Approval Request

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-MISC-80071E PWS para 4.5 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

DD

8. APP Code:

A N/A

11. As of Date: 13. Date of Subsequent Submission:

ASREQ

N/A

ASREQ

a. Addressee:

b. Copies:

Final

Draft Reg Repro

ASREQ

G. Prepared By: H. Date I. Approved By: J. Date:

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

The contractor shall prepare Part 1 (blocks 2-22) of a Nonstandard Parts Approval Request (DD 2052) to notify the Government of request for approval of nonstandard parts. Descriptive information shall include, but is not limited to, the T.O. number, figure and index, and approximate cost of nonstandard parts. The completed DD 2052 shall be submitted electronically to the PCO, WR-ALC/GRVKBA, for WR-ALC/GRVEB engineering approval.

Government response will be within 30 days of receipt.

Notification of submission shall be provided to the PCO, PM, DCMA/ACO and DCMA/COR via e-mail.

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil DCMA/COR and ACO specified by PCO at contract award.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of42 16

A003

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Request for Deviation N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-CMAN-80640C PWS para 4.5.3 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

SD

8. APP Code:

A C

11. As of Date: 13. Date of Subsequent Submission:

ASREQ

N/A

ASREQ

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests for this document shall be referred to WR-ALC/GRVEB.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Documents shall be provided via e-mail to:

WR-ALC/GRVEB

ATTN: Casey Jones 460 Richard Ray Blvd Suite 200 Robins AFB GA 31098-1813 e-mail: michael.jones6@robins.af.mil

Notification of submission shall be provided to the PCO, PM, DCMA/ACO and DCMA/COR via e-mail.

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil

DCMA/COR and ACO specified by PCO at contract award.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of52 16

A004

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Engineering Change Proposal N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-CMAN-80639C PWS para 4.5.4 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

SD

8. APP Code:

A C

11. As of Date: 13. Date of Subsequent Submission:

ASREQ

N/A

ASREQ

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests for this document shall be referred to WR-ALC/GRVEB.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Documents shall be provided via e-mail to:

WR-ALC/GRVEB

ATTN: Casey Jones 460 Richard Ray Blvd Suite 200 Robins AFB GA 31098-1813 e-mail: michael.jones6@robins.af.mil

Notification of submission shall be provided to the PCO, PM, DCMA/ACO and DCMA/COR via e-mail.

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil

DCMA/COR and ACO specified by PCO at contract award.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of62 16

A005

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Notice of Revision (NOR) N/A

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-CMAN-80642C PWS para 4.5.4 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

SD

8. APP Code:

A C

11. As of Date: 13. Date of Subsequent Submission:

ASREQ

N/A

ASREQ

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests for this document shall be referred to WR-ALC/GRVEB.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Documents shall be provided via e-mail to:

WR-ALC/GRVEB

ATTN: Casey Jones 460 Richard Ray Blvd Suite 200 Robins AFB GA 31098-1813 e-mail: michael.jones6@robins.af.mil

Notification of submission shall be provided to the PCO, PM, DCMA/ACO and DCMA/COR via e-mail.

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil

DCMA/COR and ACO specified by PCO at contract award.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of72 16

A006

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Repairable Item Inpsection Report Damaged Item Inspection Report

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-ILSS-80386/T PWS para 4.8.2 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

LT

8. APP Code:

N/A A

11. As of Date: 13. Date of Subsequent Submission:

30 ARO

See BLK 16

MTHLY

a. Addressee:

b. Copies:

Final

Draft Reg Repro O

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

TABLE IN PARAGRAPH 4.8.2 OF THE PWS SHALL BE FILLED OUT AND REPORTED

ELECTRONICALLY BACK TO ROBINS ON A MONTHLY BASIS. IF FAT IS REQUIRED,

DATA SHALL BE REPORTED 390 DAYS AFTER CONTRACT AWARD. IF FAT IS NOT

REQUIRED, DATA SHALL BE REPORTED UPON FIRST SHIPMENT OF PALLETS AND

EACH MONTH AFTERWARDS OVER THE DURATION OF THE CONTRACT.

BLK 13: AFTER FIRST SUBMISSION OF THE REPORT, ALL SUBSEQUENT REPORTS ARE

DUE BY THE 10TH OF THE MONTH.

BLK 14: DOCUMENTS SHALL BE PROVIDED VIA ELECTRONIC MEDIA UTILIZING

STANDARD MICROSOFT OFFICE APPLICATIONS. DOCUMENTS SHALL BE PROVIDED

VIA E-MAIL TO:

PROCURING CONTRACT OFFICER (PCO) MANDY.MATHEWS@ROBINS.AF.MIL

PROGRAM MANAGER (PM) MICHAEL.SLYFIELD3@ROBINS.AF.MIL

COGNIZANT ENGINEER GRVEB MICHAEL.JONES6@ROBINS.AF.MIL

DCMA/ COR AND ACO SPECIFIED BY PCO AT CONTRACT AWARD.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of82 16

A007

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Test Procedure First Article Test Procedure

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-NDTI-80603A PWS para 4.10.2.1 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

DD

8. APP Code:

A C

11. As of Date: 13. Date of Subsequent Submission:

60 ARO

N/A

ONE/P

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

BLK 8: The Government will have 15 calendar days after receipt of the test procedures for approval/disapproval. The contractor shall have 5 calendar days after receipt of the Government comments to resubmit the procedures.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests for this document shall be referred to WR-ALC/GRVEB.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Both hard copies and CD-ROM or DVD shall be submitted to:

WR-ALC/GRVEB

ATTN: Casey Jones 460 Richard Ray Blvd Suite 200 Robins AFB GA 31098-1813 e-mail: michael.jones6@robins.af.mil

Notification of submission shall be provided to the PCO, PM, DCMA/ACO and DCMA/COR via e-mail.

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil

DCMA/COR and ACO specified by PCO at contract award.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of92 16

A008

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Test/Inspection Report First Article Test Report

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-NDTI-80809B PWS para 4.10.2.4 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

SD

8. APP Code:

A C

11. As of Date: 13. Date of Subsequent Submission:

375 ARO

N/A

ONE/P

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

BLK 8: The Government will have 15 calendar days after receipt of the test report for approval/disapproval. The contractor shall have 5 calendar days after receipt of the Government comments to resubmit the report.

BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to US Government agencies and their contractors. Other requests for this document shall be referred to WR-ALC/GRVEB.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Both hard copies and CD-ROM or DVD shall be submitted to:

WR-ALC/GRVEB

ATTN: Casey Jones 460 Richard Ray Blvd Suite 200 Robins AFB GA 31098-1813 e-mail: michael.jones6@robins.af.mil

Notification of submission shall be provided to the PCO, PM, DCMA/ACO and DCMA/COR via e-mail.

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil

DCMA/COR and ACO specified by PCO at contract award.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of102 16

A009

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Quality Conformance Inspection Test Monthly Lot Sample Size Test Report

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-RELI-80322/T PWS para 4.10.4.3 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

LT

8. APP Code:

N/A A

11. As of Date: 13. Date of Subsequent Submission:

30 DAC

See BLK 16

MTHLY

a. Addressee:

b. Copies:

Final

Draft Reg Repro O

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

Refer to Overhaul of Pallets PWS Paragraph 4.10.4.3 for content in addition to DI-RELI-80322.

Table in Paragraph 4.10.4.3 of the PWS shall be filled out and reported electronically back to Robins on a monthly basis. If FAT is required, data shall be reported 390 days after contract award. If FAT is not required, data shall be reported upon first shipment of pallets and each month afterwards over the duration of the contract.

BLK 13: After first submission of the report, all subsequent submissions are due by the 10th of each month.

BLK 14: Documents shall be provided via electronic media utilizing Microsoft Office.

Reproducible copy is to be submitted electronically by e-mail to:

Procuring Contract Officer (PCO) Mandy.Mathews@robins.af.mil Program Manager (PM) Michael.Slyfield3@robins.af.mil Cognizant Engineer (EN) GRVEB Michael.Jones6@robins.af.mil DCMA COR specified by PCO at contract award.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of112 16

A010

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Repairable Item Inspection Report Maintenance and Overhaul Report

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-ILSS-80386/T PWS para 4.10.6 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

LT

8. APP Code:

N/A A

11. As of Date: 13. Date of Subsequent Submission:

30 ARO

See BLK 16

MTHLY

a. Addressee:

b. Copies:

Final

Draft Reg Repro O

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

Refer to Maintenance and Overhaul Report PWS Paragraph 4.10.6 for content requirements in addition to DI-ILSS-80386.

BLK 13: After first submission of the report, all subsequent submissions are due by the 10th of each month.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Documents shall be provided via e-mail to:

Procuring Contract Officer (PCO) Mandy.Mathews@robins.af.mil Program Manager (PM) Michael.Slyfield3@robins.af.mil Item Manager (IM) Rose.Cruz@robins.af.mil DCMA and ACO specified by PCO at contract award.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of122 16

A011

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Accident/Incident Report Mishap Notification and Reporting

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-SAFT-81563/T PWS para 4.14.2 WR-ALC/GRVK

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

DD

8. APP Code:

N/A D

11. As of Date: 13. Date of Subsequent Submission:

ASREQ

ASREQ

ASREQ

a. Addressee:

b. Copies:

Final

Draft Reg Repro

ASREQ

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 01 JUN 2012

Block 4: DID para 2. c. thru k. not required. Other pertinent information for Para 2.l. shall be expansion of days off due to injury. This shall be the same information the Contractor reports on OSHA 300 log. Contractor format acceptable.

Block 7: The Government will accept Receiving Report through WAWF. Contractor shall submit the Receiving Report upon final submission.

Block 9: Distribution authorized to the Department of Defense and U.S. DoD contractors only.

Other requests shall be referred to the contract management team, office symbol (WR-ALC/GRVK), street address (235 Byron St., Suite 19A), Robins AFB, GA 31098.

Blocks 10-13: Contractor shall submit annual updates as required.

Block 14: Procuring Officer(s) e-mail along with Integrated Product Team e-mail distro list will be provided as required. Electronic media shall be provided by CD/DVD media in Microsoft Office compatible format.

Submitted electronically to:

PCO Mandy.Mathews@robins.af.mil PM Michael.Slyfield3@robins.af.mil DCMA/ COR and ACO specified by PCO at contract award.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of132 16

A012

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Alerts/Safe-Alerts GIDEP GIDEP Alert Response

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-QCIC-80125B PWS para 4.14.5 WR-ALC/GRVEb

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

DD

8. APP Code:

N/A N/A

11. As of Date: 13. Date of Subsequent Submission:

BLK 16

ASREQ

ASREQ

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

BLK 12: The contractor shall prepare an ALERT (DD Form 1938) to notify the Government of Material Deficiencies which have adversely impacted or have the potential to adversely impact the program during the duration of the contract.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Documents shall be provided via e-mail to:

WR-ALC/GRVEB

ATTN: Casey Jones 460 Richard Ray Blvd Suite 200 Robins AFB GA 31098-1813 e-mail: michael.jones6@robins.af.mil

Notification of submission shall be provided to the PCO, PM, DCMA/ACO and DCMA/COR via e-mail.

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil

DCMA/COR and ACO specified by PCO at contract award.

BLK 16: DD 250 requirement for inspection and acceptance is applicable only to the first addressee in Block 14. A letter of transmittal will be used to send to other addressees.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of142 16

A013

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Alerts/Safe-Alerts GIDEP GIDEP Alert Report

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-QCIC-80126B PWS para 4.14.5 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

DD

8. APP Code:

N/A B

11. As of Date: 13. Date of Subsequent Submission:

BLK 16

ASREQ

ASREQ

a. Addressee:

b. Copies:

Final

Draft Reg Repro N/A

G. Prepared By: H. Date I. Approved By: J. Date:

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

BLK 12: The contractor shall prepare a response to an ALERT/SAFE-ALERT to provide the Government with information on the applicability, impact, and corrective action or disposition of Alerted parts, assemblies and units containing Alerted parts.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Documents shall be provided via e-mail to:

WR-ALC/GRVEB

ATTN: Casey Jones 460 Richard Ray Blvd Suite 200 Robins AFB GA 31098-1813 e-mail: michael.jones6@robins.af.mil

Notification of submission shall be provided to the PCO, PM, DCMA/ACO and DCMA/COR via e-mail.

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil

DCMA/COR and ACO specified by PCO at contract award.

BLK 8: DD 250 requirement for inspection and acceptance is applicable only to the first addressee in Block 14. A letter of transmittal will be used to send to other addressees.

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

COORDINATORS:

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of152 16

A014

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

1. Data Item No.: 2. Title of Data Item: 3. Subtitle:

Alerts/Safe-Alerts GIDEP GIDEP Annual Progress Report

4. Authority(Data Acquisition Document No.): 5. Contract Reference: 6. Requiring Office:

DI-QCIC-80127A PWS para 4.14.5 WR-ALC/GRVEB

7. DD250 Req: 9. Dist.Statement Required:

10. Frequency: 12. Date of First Submission:

14. Distribution:

XX

8. APP Code:

See Block 1 N/A

11. As of Date: 13. Date of Subsequent Submission:

375 ARO

See BLK 16

ANNLY

a. Addressee:

b. Copies:

Final

Draft Reg Repro O

See BLK 16 0 2 0

15. Total: 0 2 0

16. Remarks:

NAME: Jones, Michael C DATE: 31 MAY 2012

The GIDEP Annual Progress report provides reduction or elimination of unplanned expenditures from the use of this information.

WR-ALC/GRVEB

ATTN: Casey Jones 460 Richard Ray Blvd Suite 200 Robins AFB GA 31098-1813 e-mail: michael.jones6@robins.af.mil

Notification of submission shall be provided to the PCO, PM, DCMA/ACO and DCMA/COR via e-mail.

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil

DCMA/COR and ACO specified by PCO at contract award.

BLK 7 & 8: DD for first addressee in BLK 14, with approval code of A. All others LT with approval code of N/A.

BLK 13: After first submission, subsequent reports are due every 365 days.

BLK 14: Documents shall be provided via electronic media utilizing standard Microsoft Office applications. Documents shall be provided via e-mail to:

Procuring Contract Officer (PCO): Mandy.Mathews@robins.af.mil Program Manager (PM): Michael.Slyfield3@robins.af.mil

COORDINATORS:

DD Form 1423-1, JUN 90 (EF) Generated By PRPS Using Oracle Reports Version Page of162 16

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB NO.0704-D188

(1 Data Item)

Public reporting burden for this collection of information will reflect 110 hours per data item (5 data items would be 550 hours), 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188) Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. 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: E. Contract/Pr No.: F. Contractor:

G. Prepared By: H. Date I. Approved By: J. Date:

Jones, Michael C

WR-ALC / GRVEB

478-222-1365

28 JUN 2012 //DIGITALLY SIGNED//

WR-ALC / GRVEA

ROZEBOOM.VICTOR.E.JR.1026994850