DD_Form_1423.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

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, 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

ALQ-131 Band 5 Directional Coupler

E. CONTRACT / PR NO.

FD20601700268

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Qualification Test Procedure (QTP)

4. AUTHORITY

DI-NDTI-80603A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

A001

6. REQUIRING OFFICE

408 SCMS/GUEA

7. DD 250 REQ

DD

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Mancilla, Lauren MNAME: 16 FEB 2017DATE:

BLK 4: Contractor format is acceptable. Qualification Test Procedure shall be type written in Microsoft Word with support files in Microsoft Excel and Microsoft Project. Qualification Test Procedure shall be formatted for printing on standard 8.5"x 11" paper. Qualification Test Procedure shall document testing of units in accordance with drawing 585R197 paragraph 4.2(A). First submission shall be delivered electronically to the addressees listed in Block 14.

BLK 7: Submit final with DD250 to account for all previously submitted QTP reports. For invoice submittal in Wide Area Work Flow (WAWF), use ship to DoDAAC FA8522.

BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only due to operational use as of 16 February 2017. Other requests shall be referred to AFLCMC/WNYEAA or higher DoD authority.

BLK 8 & 10 -13: First submission shall be no later than 60 prior to qualification testing. Approval/Disapproval of subsequent submissions will be furnished within 20 days of receipt. Revisions shall be furnished to personnel mentioned above within 20 days after receipt of AFLCMC/WNYEAA comments.

COORDINATORS:

Lauren Mancilla, 408

SCMS/GULA

ALQ-131 Logistics Manager lauren.mancilla@us.af.mil

0 1 0

Lisa Morris, AFLCMC/WNYEAA

ALQ-131 Lead Engineer lisa.morris@us.af.mil

0 1 0 ky.pham@us.af.mil

408 SCMS/GUEA

Engineer

0 1 0

0 3 015. TOTAL

G. PREPARED BY

Mancilla, Lauren M

408 SCMS / GULA

478-222-6549

H. DATE

23 FEB 2017

I. APPROVED BY

//DIGITALLY SIGNED//

MITCHELL.DOUGLAS.E.1229985813

408 SCMS / GULB 478-926-6558 / 468-6558

J. DATE

17 FEB 2017

Page 1 of 8DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 14 Mar 2017

PREVIOUS EDITION MAY BE USED.

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

ALQ-131 Band 5 Directional Coupler

E. CONTRACT / PR NO.

FD20601700268

F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Test/Inspection Report

3. SUBTITLE

Qualification Test Report (QTR)

4. AUTHORITY

DI-NDTI-80809B

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

A002

6. REQUIRING OFFICE

408 SCMS/GUEA

7. DD 250 REQ

DD

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Mancilla, Lauren MNAME: 16 FEB 2017DATE:

Blk 4: Contractor format is acceptable. Qualification Test Report shall be type written in Microsoft Word with support files in Microsoft Excel and Microsoft Project. Qualification Test Report shall be formatted for printing on standard 8.5" x 11" paper. Qualification Test Report shall document testing of units in accordance with Government approved QTP.

First submission shall be delivered electronically via e-mail to the addresses in block 14

Subsequent reports shall be stored at contractor's facility for 3 years or until deemed as no longer required by

AFLCMC/WNYEAA.

BLK 7: For WAWF Invoicing, use DoDAAC FA8522.

BLK 8: Approval/Disapproval of first submission will be furnished within 45 days after receipt by AFLCMC/WNYEAA. Approval/Disapproval of subsequent submissions will be furnished within 30 days of receipt.

BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only due to operational use as of 16 February 2017. Other requests shall be referred to AFLCMC/WNYEAA or higher DoD authority.

BLKS 10- 13: Submissions shall be no later than 30 days after qualification testing has completed

COORDINATORS:

408 SCMS/GUEA

406 Richard Ray Blvd,Ste 200 Robins AFB, GA 31098-1813 Attn: Ky Pham ky.pham@us.af.mil

0 1 0

Lauren Mancilla, 408

SCMS/GULA

ALQ-131 Logistics Manager lauren.mancilla@us.af.mil

0 1 0

Lisa Morris, AFLCMC/WNYEAA

ALQ-131 Lead Engineer lisa.morris@us.af.mil

0 1 0

0 3 015. TOTAL

G. PREPARED BY

Mancilla, Lauren M

408 SCMS / GULA

478-222-6549

H. DATE

23 FEB 2017

I. APPROVED BY

//DIGITALLY SIGNED//

MITCHELL.DOUGLAS.E.1229985813

408 SCMS / GULB 478-926-6558 / 468-6558

J. DATE

17 FEB 2017

Page 2 of 8DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 14 Mar 2017

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

ALQ-131 Band 5 Directional Coupler

E. CONTRACT / PR NO.

FD20601700268

F. CONTRACTOR

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedure (ATP)

4. AUTHORITY

DI-NDTI-80603

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

A003

6. REQUIRING OFFICE

408 SCMS/GUEA

7. DD 250 REQ

DD

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Mancilla, Lauren MNAME: 16 FEB 2017DATE:

BLK 4: Contractor format is acceptable. Acceptance Test Procedure shall be type written in Microsoft Word with support files in Microsoft Excel and Microsoft Project. Acceptance Test Procedure shall be formatted for printing on standard 8.5"x 11" paper. Acceptance Test Procedure shall document testing of units in accordance with drawing 585R197 paragraph 4.2(B). First submission shall be delivered electronically via-email to the addressees listed in Block 14.

BLK 7: Submit final with DD250 to account for all previously submitted ATP reports. For invoice submittal in Wide Area Work Flow (WAWF), use ship to DoDAAC FA8522.

BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only due to operational use as of 16 February 2017. Other requests shall be referred to AFLCMC/WNYEAA or higher DoD authority.

BLK 8, & 10-13: First submission shall be no later than 60 days of contract award. Approval/Disapproval of subsequent submissions will be furnished within 20 days of receipt. Revisions shall be furnished to personnel mentioned above within 20 days after receipt of AFLCMC/WNYEAA comments.

COORDINATORS:

408 SCMS/GUEA

460 Richard Ray Blvd, Ste 200 Robins AFB, GA 31098-1813 Attn: Ky Pham ky.pham@us.af.mil

0 1 0

Lauren Mancilla, 408

SCMS/GULA

ALQ-131 Logistics Manager lauren.mancilla@us.af.mil

0 1 0

Lisa Morris, AFLCMC/WNYEAA

ALQ-131 Lead Engineer lisa.morris@us.af.mil

0 1 0

0 3 015. TOTAL

G. PREPARED BY

Mancilla, Lauren M

408 SCMS / GULA

478-222-6549

H. DATE

23 FEB 2017

I. APPROVED BY

//DIGITALLY SIGNED//

MITCHELL.DOUGLAS.E.1229985813

408 SCMS / GULB 478-926-6558 / 468-6558

J. DATE

17 FEB 2017

Page 3 of 8DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 14 Mar 2017

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

ALQ-131 Band 5 Directional Coupler

E. CONTRACT / PR NO.

FD20601700268

F. CONTRACTOR

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Test/Inspection Report

3. SUBTITLE

Acceptance Test Report (ATR)

4. AUTHORITY

DI-NDTI-80809B

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

A004

6. REQUIRING OFFICE

408 SCMS/GUEA

7. DD 250 REQ

DD

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Mancilla, Lauren MNAME: 16 FEB 2017DATE:

BLK 4: Contractor format is acceptable. Acceptance Test Report shall be type written in Microsoft Word with support files in Microsoft Excel and Microsoft Project. Acceptance Test Report shall be formatted for printing on standard 8.5"x 11" paper. Acceptance Test Report (ATR) shall document testing of units in accordance with Government approved ATP based on Table II from drawing 585R197 Rev J. First submission shall be delivered electronically via-email to the addressees listed in Block 14.

Subsequent reports shall be stored at contractor's facility for 3 years or until deemed as no longer required by

AFLCMC/WNYEAA.

BLK 7: Submit final with DD250 to account for all previously submitted ATR reports. For invoice submittal in Wide Area Work Flow (WAWF), use ship to DoDAAC FA8522.

BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only due to operational use as of 16 February 2017. Other requests shall be referred to AFLCMC/WNYEAA or higher DoD authority.

BLK 11,12, & 13: Submissions shall be no later than 30 days after acceptance testing (Group A) has completed.

COORDINATORS:

408 SCMS/GUEA

460 Richard Ray Blvd, Ste 200 Robins AFB, GA 31098-1813 Attn: Ky Pham ky.pham@us.af.mil

0 1 0

Lauren Mancilla, 408

SCMS/GULA

ALQ-131 Logistics Manager lauren.mancilla@us.af.mil

0 1 0

Lisa Morris, AFLCMC/WNYEAA

ALQ-131 Lead Engineer lisa.morris@us.af.mil

0 1 0

0 3 015. TOTAL

G. PREPARED BY

Mancilla, Lauren M

408 SCMS / GULA

478-222-6549

H. DATE

23 FEB 2017

I. APPROVED BY

//DIGITALLY SIGNED//

MITCHELL.DOUGLAS.E.1229985813

408 SCMS / GULB 478-926-6558 / 468-6558

J. DATE

17 FEB 2017

Page 4 of 8DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 14 Mar 2017

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

ALQ-131 Band 5 Directional Coupler

E. CONTRACT / PR NO.

FD20601700268

F. CONTRACTOR

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

Counterfeit Prevention Plan

3. SUBTITLE

CPP

4. AUTHORITY

DI-MISC-81832

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

A005

6. REQUIRING OFFICE

408 SCMS/GUEA

7. DD 250 REQ

DD

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

As Required

12. DATE OF FIRST

SUBMISSION

30 DAC

13. DATE OF SUBSEQUENT

SUBMISSION

As Required

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Mancilla, Lauren MNAME: 16 FEB 2017DATE:

Block 4: Contractor format is acceptable. Counterfeit Prevention Plan (CPP) shall be type written in Microsoft Word with support files in Microsoft Excel and Microsoft Project. CPP shall be formatted for printing on standard 8.5" x 11" paper and delivered electronically to the addressees in block 14.

BLK 7: For invoice submittal in Wide Area Work Flow (WAWF), use ship to DoDAAC FB2065.

BLKS 8 & 10-13: Submit NLT 30 Days after contract award. Government comments/approval will be provided within 30 days after receipt. The contractor shall resubmit within 15 days after receipt of Government comments.

BLK 9: Distribution D. Distribution authorized to Department of Defense and U.S. DoD contractors only due to operational use as of 16 February 2017. Other requests for this document shall be referred to AFLCMC/WNYEAA or higher DoD authority.

COORDINATORS:

Lauren Mancilla, 408

SCMS/GULA

ALQ-131 Logistics Manager lauren.mancilla@us.af.mil

0 1 0

Lisa Morris, AFLCMC/WNYEAA

ALQ-131 Lead Engineer lisa.morris@us.af.mil

0 1 0

Matt Moorman, 408

SCMS/GUEA

ALQ-131 Engineer matthew.moorman.3@us.af.mi l

0 1 0

0 3 015. TOTAL

G. PREPARED BY

Mancilla, Lauren M

408 SCMS / GULA

478-222-6549

H. DATE

23 FEB 2017

I. APPROVED BY

//DIGITALLY SIGNED//

MITCHELL.DOUGLAS.E.1229985813

408 SCMS / GULB 478-926-6558 / 468-6558

J. DATE

17 FEB 2017

Page 5 of 8DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 14 Mar 2017

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

ALQ-131 Band 5 Directional Coupler

E. CONTRACT / PR NO.

FD20601700268

F. CONTRACTOR

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Item Unique Identification (IUID) Marking Plan

3. SUBTITLE

IUID Marking Plan

4. AUTHORITY

DI-MGMT-81803

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

A006

6. REQUIRING OFFICE

AFLCMC/WNYEAA

7. DD 250 REQ

DD

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Mancilla, Lauren MNAME: 13 FEB 2017DATE:

Block 4: Contractor format is acceptable. IUID Marking Plan shall be type written in Microsoft Word with support files in Microsoft Excel and Microsoft Project. IUID Marking Plan shall be formatted for printing on standard 8.5" x 11" paper.

BLK 7: For invoice submittal in Wide Area Work Flow (WAWF), use ship to DoDAAC FA8522.

BLK 9: Distribution D. Distribution authorized to Department of Defense and U.S. DoD contractors only due to operational use as of 13 February 2017. Other requests for this document shall be referred to AFLCMC/WNYEAA or higher DoD authority.

BLKS 8 & 10-13: Submit NLT 30 Days after contract award. Government comments/approval will be provided within 30 days after receipt. The contractor shall resubmit within 15 days after receipt of Government comments.

COORDINATORS:

Lauren Mancilla, 408

SCMS/GULA

ALQ-131 Logistics Manager lauren.mancilla@us.af.mil

0 1 0

Lisa Morris, AFLCMC/WNYEAA

ALQ-131 Lead Engineer lisa.morris@us.af.mil

0 1 0

Matt Moorman, 408

SCMS/GUEA

ALQ-131 Engineer matthew.moorman.3@us.af.mi l

0 1 0

0 3 015. TOTAL

G. PREPARED BY

Mancilla, Lauren M

408 SCMS / GULA

478-222-6549

H. DATE

23 FEB 2017

I. APPROVED BY

//DIGITALLY SIGNED//

MITCHELL.DOUGLAS.E.1229985813

408 SCMS / GULB 478-926-6558 / 468-6558

J. DATE

17 FEB 2017

Page 6 of 8DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 14 Mar 2017

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

ALQ-131 Band 5 Directional Coupler

E. CONTRACT / PR NO.

FD20601700268

F. CONTRACTOR

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

Item Unique Identification (IUID) Marking Activity and Verification Report

3. SUBTITLE

IUID Marking Activity and Verification Report

4. AUTHORITY

DI-MGMT-81804A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

A007

6. REQUIRING OFFICE

AFLCMC/WNYEAA

7. DD 250 REQ

DD

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

11. AS OF DATE

As Required

12. DATE OF FIRST

SUBMISSION

30 DAC

13. DATE OF SUBSEQUENT

SUBMISSION

As Required

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Mancilla, Lauren MNAME: 13 FEB 2017DATE:

Block 4: Contractor format is acceptable. 100% of the units shall be inspected, evaluated and added to the Activity and Verification Report.

Initial report during each production cycle shall be delivered electronically via E-mail to the addressees listed in block 14.

All subsequent reports will be stored for 3 years within the contractor's facility or until deemed no longer required by

AFLCMC/WNYEAA.

BLK 7: For invoice submittal in Wide Area Work Flow (WAWF), use ship to DoDAAC FA8522.

BLK 9: Distribution D. Distribution authorized to Department of Defense and U.S. DoD contractors only due to operational use as of 13 February 2017. Other requests for this document shall be referred to AFLCMC/WNYEAA or higher DoD authority.

COORDINATORS:

Lauren Mancilla, 408

SCMS/GULA

ALQ-131 Logistics Manager lauren.mancilla@us.af.mil

0 1 0

Lisa Morris, AFLCMC/WNYEAA

ALQ-131 Lead Engineer lisa.morris@us.af.mil

0 1 0

Matt Moorman, 408

SCMS/GUEA

ALQ-131 Engineer matthew.moorman.3@us.af.mi l

0 1 0

0 3 015. TOTAL

G. PREPARED BY

Mancilla, Lauren M

408 SCMS / GULA

478-222-6549

H. DATE

23 FEB 2017

I. APPROVED BY

//DIGITALLY SIGNED//

MITCHELL.DOUGLAS.E.1229985813

408 SCMS / GULB 478-926-6558 / 468-6558

J. DATE

17 FEB 2017

Page 7 of 8DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 14 Mar 2017

A. CONTRACT LINE ITEM NO. B. EXHIBIT

A

C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

ALQ-131 Band 5 Directional Coupler

E. CONTRACT / PR NO.

FD20601700268

F. CONTRACTOR

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

Monthly Status Report

3. SUBTITLE

Status Report

4. AUTHORITY

DI-MGMT-80368A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

A008

6. REQUIRING OFFICE

408 SCMS/GULA

7. DD 250 REQ

DD

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

MTHLY

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Mancilla, Lauren MNAME: 13 FEB 2017DATE:

BLK 4: Contractor format acceptable. Reports shall be delivered electronically in Microsoft Word to the addressees in Block 14.

BLK 7: Submit final monthly status report with DD250 to account for all previously submitted monthly status reports.

For invoice submittal in Wide Area Work Flow (WAWF), use ship to DoDAAC FA8522.

BLK 9: DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only due to operational use as of 13 February 2017. Other requests shall be referred to 408 SCMS/GUEA or higher DoD authority.

BLK 10-13: The first report shall be submitted within 10 days after the first full month after contract award. The first report shall be submitted within 10 days after the first full month after contract award. Reporting shall continue on a monthly basis to be received on later than the 10th day of the month following the end of the report period. Monthly reports shall be submitted via e-mail.

COORDINATORS:

Lauren Mancilla, 408

SCMS/GULA

ALQ-131 Logistics Manager lauren.mancilla@us.af.mil

0 1 0

Matt Moorman, 408

SCMS/GUEA

ALQ-131 Engineer matthew.moorman.3@us.af.mi l

0 1 0

0 2 015. TOTAL

G. PREPARED BY

Mancilla, Lauren M

408 SCMS / GULA

478-222-6549

H. DATE

23 FEB 2017

I. APPROVED BY

//DIGITALLY SIGNED//

MITCHELL.DOUGLAS.E.1229985813

408 SCMS / GULB 478-926-6558 / 468-6558

J. DATE

17 FEB 2017

Page 8 of 8DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 14 Mar 2017