Exhibit A.pdf

PDF 1 MB Posted

Attached to
ALE-47 Countermeasures Dispenser System (CMDS) Hardware Procurement Federal contract opportunity
Solicitation number
FA8523-24-R-0007
Issued by
Department of the Air Force Materiel Command Lifecycle Management Center Robins Air Force Base

About this file

Written by GovTribe AI ·

This document is a Contract Data Requirements List (CDRL) for the ALE-47 Countermeasures Dispenser System (CMDS). It outlines 22 data items required for acceptance testing of the various Line Replaceable Units (LRUs) and Shop Replaceable Units (SRUs) that make up the ALE-47 CMDS. The test/inspection reports must be submitted in accordance with the requirements specified, including distribution, format, and submission timelines. The government will review and provide feedback within 45 days. The reports are subject to Distribution Statement D, restricting distribution to the Department of Defense and its contractors. This CDRL supports the upcoming solicitation for ALE-47 CMDS hardware procurement, which is anticipated to be issued by the Air Force Life Cycle Management Center (AFLCMC) Robins Air Force Base in April 2024 with a contract award around June 2025. The procurement will utilize a firm-fixed price pricing arrangement.

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Other files for this federal contract opportunity

Other files attached to ALE-47 Countermeasures Dispenser System (CMDS) Hardware Procurement, newest first.
File Type Posted
16 January 2025 Questions and Answers.pdf PDF
RFP Attachment 4 - Price Matrix.xlsx XLSX spreadsheet
FA8523-25-R-0002 0002.pdf PDF
2 Dec 2024 Question and Answers.pdf PDF
ALE-47 Section L 7 May_.pdf PDF
FA8523-25-R-0002.pdf PDF
RFP Attachment 5 - Cross Reference Matrix.pdf PDF
Exhibit J.pdf PDF
Exhibit K.pdf PDF
Exhibit Q.pdf PDF
Exhibit U.pdf PDF
Exhibit W.pdf PDF
RFP Attachment 1 - Subcontractor and Teaming Member Consent Form.pdf PDF
RFP Attachment 2 - Past Performance Questionnaire.pdf PDF
RFP Attachment 4 - Price Matrix.xlsx XLSX spreadsheet
Exhibit CA.pdf PDF
Exhibit DA.pdf PDF
Exhibit E.pdf PDF
Exhibit EA.pdf PDF
Exhibit H.pdf PDF
Exhibit T.pdf PDF
ALE-47 Section L 7 May_.pdf PDF
AFMC Form 158 - Packaging.pdf PDF
Questions and Answers 19 August 2024.pdf PDF
Questions and Answers 17 June 2024.pdf PDF
SOW - ALE-47 Prod 3.4 Ctr FINAL.pdf PDF
Exhibit C 20240322.pdf PDF
Exhibit D 20240322.pdf PDF
Exhibit G 20240322.pdf PDF
Exhibit K 20240322.pdf PDF
Exhibit L 20240322.pdf PDF
Exhibit P 20240322.pdf PDF
Exhibit Q 20240322.pdf PDF
Exhibit U 20240322.pdf PDF
RFP Attachment 2 - Past Performance Questionnaire.pdf PDF
RFP Attachment 4 - Price Matrix.xlsx XLSX spreadsheet
Exhibit A 20240322.pdf PDF
Exhibit F 20240322.pdf PDF
Exhibit H 20240322.pdf PDF
Exhibit J 20240322.pdf PDF
RFP Attachment 1 - Subcontractor and Teaming Member Consent Form.pdf PDF
RFP Attachment 5 - Cross Reference Matrix.pdf PDF
FA8523-24-R-0007 Draft RFP 5-20-2024.pdf PDF
ALE-47 GFP List .pdf PDF
Exhibit B 20240322.pdf PDF
Exhibit R 20240322.pdf PDF
Exhibit T 20240322.pdf PDF
Exhibit V 20240322.pdf PDF
Exhibit W 20240322.pdf PDF
Exhibit M 20240322.pdf PDF
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CONTRACT DATA REQUIREMENTS LIST

(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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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

17. PRICE GROUP

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU Power Supply/Connector Interface CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU Power Supply Module CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU Discrete I/O Module Assembly

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU Discrete I/O CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU CPU Module Assembly

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU CPU CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU Electronic Indicating Panel Assembly

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLMCM/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A009

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU Front Panel I/O

CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A00A

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU Switch Panel (Front Panel) CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A00B

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT CDU Panel, Control, Elect (Faceplate)

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A00C

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT Programmer

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A00D

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT Programmer

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A00E

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT Programmer

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A00F

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT PGMR Electronic Enclosure Assembly

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A00G

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT PGMR Motherboard No. 1

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A00H

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT PGMR CPU CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and 13: The Test/Inspection Report shall be submitted in accordance with Exhibit A Attachment #1. The Government will provide approval or disapproval/comments within 45 days of receipt.

Resubmit, if required, to incorporate Government comments within 30 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

Block 9: DISTRIBUTION STATEMENT D: Distribution authorized to Department of Defense and U.S. DOD contractors only [Controlled Technical Information (CTI)] [22 October 2024]. Other requests for this document shall be referred to AFLCMC/HBY 320 Richard Ray Blvd, Bldg. 300 West Wing, Bay B Room 205, Robins AFB, GA 31098.

Block 14: Data Copies shall be submitted in accordance with (IAW) the General Notes. Data shall be in editable electronic document format and Microsoft Office 2016 or newer.

AFLCMC/HBY 1 0 1

15. TOTAL 1 0 1

G. PREPARED BY

NOE.JENNIFER.LYN.1049097049

H. DATE

2024/10/29

I. APPROVED BY

UPSHAW.MEDINA.NANCY.1075468403

J. DATE

2024/10/29

18. ESTIMATED

TOTAL PRICE

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.

000X

B. EXHIBIT

A

C. CATEGORY:

TDP TM OTHER NDTI

D. SYSTEM/ITEM

ALE-47

E. CONTRACT/PR NO. F. CONTRACTOR

VENDOR X

1. DATA ITEM NO.

A00J

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

ACCEPTANCE TEST REPORT PGMR CPU CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

2.1.2, 2.1.4, 2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

Draft

Final

Reg Repro

16. REMARKS

Block 3: Concatenate the subtitle shown on Exhibit A Attachment 1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contractor format is acceptable.

Blocks 8, 12, and…

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