Exhibit DA.pdf

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA01

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures – Control Display Unit

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA02

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU Power Supply/Connector Interface CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA03

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU Power Supply Module CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA04

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU Discrete I/O Module Assembly

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA05

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU Discrete I/O

CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA06

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU CPU Module Assembly

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA07

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU CPU CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA08

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU Electronic Indicating Panel Assembly

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA09

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU Front Panel

I/O CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA0A

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU Switch Panel (Front Panel) CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA0B

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - CDU Panel, Control, Elect (Faceplate)

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA0C

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - Programmer

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA0D

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - Programmer

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA0E

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - Programmer

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 D Attachment #1 and Block 3 above. Example: For CDRL A001, the subtitle will be "Control Display Unit Acceptance Test Report".

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA0F

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - PGMR Electronic Enclosure Assembly

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA0G

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - PGMR Motherboard No. 1

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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

Block 4: Contract format is acceptable.

Block 7: The contractor shall provide a Letter of Transmittal for each submission and a final LT for the cumulative CDRL.

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 C Room C303, Robins AFB, GA 31098.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments. Modifications to the report shall be documented with future submissions.

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.

Block 12, 13: The Acceptance Test Procedure shall be submitted Not Later Than (NLT) 75 calendar days prior to test. Government response will be provided with 30 calendar days after submittal. Resubmit, if required, to incorporate Government comments within 15 calendar days of receipt of Government comments.

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 0 0 1

15. TOTAL 0 0 1

G. PREPARED BY

JENNIFER NOE

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.

100X

B. EXHIBIT

DA

C. CATEGORY:

TDP TM OTHER NDTI

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

VENDOR X

1. DATA ITEM NO.

DA0H

2. TITLE OF DATA ITEM

Test Procedure

3. SUBTITLE

Acceptance Test Procedures - PGMR CPU CCA

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80603A

5. CONTRACT REFERENCE

2.1.2.1, 2.1.2.2, 2.2.2.1, 2.2.2.2

6. REQUIRING OFFICE

AFLCMC/HBY

7. DD 250 REQ

LT

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:…