2829029_CDRL1_REPORT.pdf

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

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Executive Services Directorate (0704-0188).

Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

HH-60

E. CONTRACT / PR NO.

FD20601901090

F. CONTRACTOR

Ballard Tech

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Commercial Asset Visibility Air Force Contractor Furnished Material End Item Reporting

3. SUBTITLE

CAVAF CFM End Item Reporting

4. AUTHORITY

DI-MGMT-81838

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.11

6. REQUIRING OFFICE

411SCMS/GULAA

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

ASREQ

11. AS OF DATE

See block 16

12. DATE OF FIRST

SUBMISSION

See block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Walters, George BNAME: 03 JUN 2019DATE:

Note: Changes to office symbols and/or email addresses, when necessary, shall be made by letter through the Government CO/ACO without further revision to this CDRL.

Block 7: The Contractor shall report End Item transactional data through electronic submission in CAVAF using the CAVAF website or CICA XML. The Contractor shall submit a DD Form 250 (Material Inspection and Receiving Report) electronically via WAWF using DoDAAC FA8524. Mark for: Address in Block 14.

Block 9: Distribution C. Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use; 12-04-12). Other requests for this document shall be referred to 411 SCMS/GULB, Robins AFB GA 31098-1670.

Blocks 11-12: The reports shall be provided within 24 hours of an end item maintenance transaction occurrence.

Block 13: Reports shall continue to be submitted by the Contractor unless the requirement is terminated by the 411th SCMS, Program Manager (PM), or the Production Management Specialist (PMS). The Final Report submitted following the final reporting period on the contract shall be annotated "Final Report".

Block 14: A Letter of Transmittal shall be submitted in the month the delivery order is completed, covering all reports transmitted for that order; submit the CDM Production Monthly Status Reports to the following email addresses:

Program Manager (PM) Rebecca Danson @ rebecca.danson@us.af.mil Production Management Specialist (PMS) Brian Walters @ george.walters.4@us.af.mil or acting PMS

Danson, Rebecca LNAME: 29 APR 2019DATE:

Note: Changes to office symbols and/or email addresses, when necessary, shall be made by letter through the Government CO/ACO without further revision to this CDRL.

Block 7: The Contractor shall report End Item transactional data through electronic submission in CAVAF using the CAVAF website or CICA XML. The Contractor shall submit a DD Form 250 (Material Inspection and Receiving Report) electronically via WAWF using DoDAAC FA8524. Mark for: Address in Block 14.

Block 9: Distribution C. Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use; 12-04-12). Other requests for this document shall be referred to 411 SCMS/GULB, Robins AFB GA 31098-1670.

Blocks 11-12: The reports shall be provided within 24 hours of an end item maintenance transaction occurrence.

Block 13: Reports shall continue to be submitted by the Contractor unless the requirement is terminated by the 411th SCMS, Program Manager (PM), or the Production Management Specialist (PMS). The Final Report submitted following the final reporting period on the contract shall be annotated "Final Report".

Block 14: A Letter of Transmittal shall be submitted in the month the delivery order is completed, covering all reports transmitted for that order; submit the CDM Production Monthly Status Reports to the following email addresses:

See block 16. 0 1 0

0 1 015. TOTAL

Page 1 of 7DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 20 Jun 2019

PREVIOUS EDITION MAY BE USED.

Program Manager (PM) Torey McClain @ torey.mcclain@us.af.mil Production Management Specialist (PMS) Michelle Wilson @ michelle.wilson.19@us.af.mil or acting PMS

COORDINATORS:

G. PREPARED BY

Boarman, Chris P

411 SCMS / GUL

478-926-2730

H. DATE

14 JUN 2019

I. APPROVED BY

//DIGITALLY SIGNED//

CIPOLLA.MARY.L.1280109114

411 SCMS / GULC 478-222-0870 / 472-0870

J. DATE

14 JUN 2019

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

HH-60

E. CONTRACT / PR NO.

FD20601901090

F. CONTRACTOR

Ballard Tech

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Contract Depot Maintenance (CDM) Monthly Production

3. SUBTITLE

CDM Production Monthly Status Report

4. AUTHORITY

DI-PSSS-81995

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS para 4.12

6. REQUIRING OFFICE

411 SMCS GULAB

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

MTHLY

11. AS OF DATE

SEE BLK 16

12. DATE OF FIRST

SUBMISSION

SEE BLK 16

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLK 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Walters, George BNAME: 03 JUN 2019DATE:

NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

1. Block 4:

a. All reporting shall be submitted in the English Language.

b. The Contractor's CAV AF Reporting shall reflect their inventory property control management system data records which shall represent timely and accurate accountability of AF inventory assets at the physical location(s) of the contractor's repair facility (including subcontractor facilities); shop floor, bond room and/or receiving/shipping docks, etc. for each repair.

c. The Contractor shall report by contract delivery order on all applicable categories, totals and on-hand balances,providing TABLE I (DI-PSSS-81995) for EACH repair location, including subcontractor facilities, for the contracts maintenance occurrence actions during the reporting period.

d. The Contractor shall report on production, providing TABLE I (DI-PSSS-81995) for EACH repair location,including subcontractor facilities, for which the contractor produced assets during the reporting period.

2. Blocks 10, 11, 12, 13:

a. The reports shall be provided monthly within 5 (five) business days of the previous month's last calendar date.

b. Reports shall continue to be submitted by the contractor unless the requirement is terminated by the (Requiring Office), Program Manager (PM) or the Production Management Specialist (PMS),

c. The Final Report submitted following the final reporting period on the contract shall be annotated "Final Report".

3. Block 9:

a. DISTRIBUTATION STATEMENT "D": Distribution authorized to the Department of Defense and U.S. DoD contractors only (Reason for Use). (Date of Determination). Other requests for this document shall be referred to (DoD Controlling Office)

b. EXPORT CONTROL WARNING: All technical documents/data (printed, digital/electronic) that are determined to contain export-controlled technical data, shall be marked with the following statement:

EXPORT CONTROL WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App.

2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate IAW provisions of DoD Directive 5230.25.

c. DESTRUCTION NOTICE: For classified documents, follow the procedures, in DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, or DoD 5200.1-R, Information Security Program Chapter VI. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or

Lindley, Loretta BNAME: 25 FEB 2019DATE:

NOTE: Changes to office symbols and/or e-mail addresses, when necessary shall be made by letter through the Government CO/ACO without further revision to this CDRL.

Email: 411 SCMS/GULAA Program Manager (PM) PM email provided on Contract Award

0 1 0

Email: PMS email provided on Contract Award. PMS Workflow @411SCMS.PMS@us.af.mil if PMS email is not provided.

0 1 0

0 2 015. TOTAL

Page 2 of 7DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 20 Jun 2019

1. Block 4:

a. All reporting shall be submitted in the English Language.

b. The Contractor's CAV AF Reporting shall reflect their inventory property control management system data records which shall represent timely and accurate accountability of AF inventory assets at the physical location(s) of the contractor's repair facility (including subcontractor facilities); shop floor, bond room and/or receiving/shipping docks, etc. for each repair.

c. The Contractor shall report by contract delivery order on all applicable categories, totals and on-hand balances,providing TABLE I (DI-PSSS-81995) for EACH repair location, including subcontractor facilities, for the contracts maintenance occurrence actions during the reporting period.

d. The Contractor shall report on production, providing TABLE I (DI-PSSS-81995) for EACH repair location,including subcontractor facilities, for which the contractor produced assets during the reporting period.

2. Blocks 10, 11, 12, 13:

a. The reports shall be provided monthly within 5 (five) business days of the previous month's last calendar date.

b. Reports shall continue to be submitted by the contractor unless the requirement is terminated by the (Requiring Office), Program Manager (PM) or the Production Management Specialist (PMS),

c. The Final Report submitted following the final reporting period on the contract shall be annotated "Final Report".

3. Block 9:

a. DISTRIBUTATION STATEMENT "D": Distribution authorized to the Department of Defense and U.S. DoD contractors only (Reason for Use). (Date of Determination). Other requests for this document shall be referred to (DoD Controlling Office)

b. EXPORT CONTROL WARNING: All technical documents/data (printed, digital/electronic) that are determined to contain export-controlled technical data, shall be marked with the following statement:

EXPORT CONTROL WARNING: This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App.

2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate IAW provisions of DoD Directive 5230.25.

c. DESTRUCTION NOTICE: For classified documents, follow the procedures, in DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, or DoD 5200.1-R, Information Security Program Chapter VI. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or

COORDINATORS:

G. PREPARED BY

Boarman, Chris P

411 SCMS / GUL

478-926-2730

H. DATE

14 JUN 2019

I. APPROVED BY

//DIGITALLY SIGNED//

CIPOLLA.MARY.L.1280109114

411 SCMS / GULC 478-222-0870 / 472-0870

J. DATE

14 JUN 2019

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

HH-60

E. CONTRACT / PR NO.

FD20601901090

F. CONTRACTOR

Ballard Tech

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

Annual Inventory Report

3. SUBTITLE

Annual Inventory Report

4. AUTHORITY

DI-MGMT-80441C

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Reference Para 4.13

6. REQUIRING OFFICE

411 SCMS/GULAA

7. DD 250 REQ

LT

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

A

10. FREQUENCY

ANNLY

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Walters, George BNAME: 03 JUN 2019DATE:

BLK 4: The data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract.

See Data Item Description at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: Enter the applicable code as listed in DOD 5010.12-M, Chapter 3. (Enter LT for Letter of Transmittal if not separately priced or DD if separately priced). WAWF E-DD FORM 250 shall be required for separately priced data. E- DD FORM 250 shall be submitted to FA8524 Program Manager (PM/ and Production Management Specialist PMS EMAIL ADDRESS) for acceptance.

Block 8: Approval (written) is not required. However, the data item will be reviewed and accepted/rejected, based on its

Email:

411 SCMS/GULAA Program Manager (PM) PM email provided on Contract Award

0 1 0

Email:

PMS email provided on Contract Award PMS Workflow @ 411SCMS.PMS@us.af.mil if PMS email is not provided

0 1 0

0 2 015. TOTAL

Page 3 of 7DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 20 Jun 2019 conforming to the requirements of the DID, and within the review time specified in Block 16, items 10-13.

BLK 9: "A" Approved for Public Release; distribution is unlimited.

Block 10-13: The annual physical inventory report shall be provided within seven (7) calendar days of the end of each option/ordering period for the contract. The data is representative of the Contractor's Internal Property Control System and shall be current as of the last day of the option/ordering reporting period. If requested outside of an annual cadence, the data shall be current as of the date requested.

BLK 14: EMAIL electronic Annual Physical Inventory Report t to the Production Management Specialist (PMS) and Program Manager (PM). Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in Microsoft Office Excel format for all reports.

COORDINATORS:

G. PREPARED BY

Boarman, Chris P

411 SCMS / GUL

478-926-2730

H. DATE

14 JUN 2019

I. APPROVED BY

//DIGITALLY SIGNED//

CIPOLLA.MARY.L.1280109114

411 SCMS / GULC 478-222-0870 / 472-0870

J. DATE

14 JUN 2019

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

HH-60

E. CONTRACT / PR NO.

FD20601901090

F. CONTRACTOR

Ballard Tech

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Item Unique Identification (IUID) - Marking Plan

3. SUBTITLE

IUID Marking Plan

4. AUTHORITY

DI-MGMT-81803

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Reference Para 4.10.1

6. REQUIRING OFFICE

411 SCMS/GULAA

7. DD 250 REQ

LT

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Walters, George BNAME: 03 JUN 2019DATE:

BLK 4: The Data Item Description (DID) contains format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract. See Data Item Description at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: Applicable code as listed in DOD 5010.12-M, Chapter 3. (LT for Letter of Transmittal if not separately priced or DD if separately priced). WAWF E-DD FORM 250 shall be required for separately priced data. E-DD FORM 250 shall be submitted to FA8524 (PM EMAIL ADDRESS) for acceptance.

BLK 9: "C" Distribution authorized to U.S. Government Agencies and their contractors (Administrative or Operational use) (28 April 16). Other requests shall be referred to the contract management team, AFSC/PZAAA, 460 Richard Ray Blvd, Ste 221, Robins AFB, GA 31098.

BLKS 10-12: Contractor shall submit an IUID Marking Plan, to the Engineer, AFLCMC/WIUEC, within 10 working days after contract award. Written Government acceptance/comments/rejection will be within 10 working days after receipt of Plan from the Contractor. Contractor final submission shall be submitted within 10 working days of receiving Government comments. Acceptance by the Government is required prior to formal distribution.

BLK 13: If, during the performance of this contract, changes to the IUID Marking Plan are required, submit the revised IUID Marking Plan to Engineering Office, AFLCMC/WIUEC, 235 Byron Street, Suite 19A, Robins AFB, GA 31098.

Procedures identified for blocks 8 & 10-12 will apply.

BLK 14: EMAIL electronic IUID Marking Plan to the Procuring Contract Officer (PCO), DCMA/ACO, Program Manager (PM) 411 SCMS/GULAA, and Engineer AFLCMC/WIUEC. Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

COORDINATORS:

Email Engineer: Madeline Valdes AFLCMC/WIU madeline.valdes.1@us.af.mil

1 1 0

Email:

411 SCMS/GULAA Program Manager (PM)/COR Provided on Contract Award

1 1 0

Email:

AFSC/PZAAA Contracting Officer (PCO) Provided on Contract Award

0 1 0

Email:

DCMA/ACO

0 1 0

Email: Email 411 SCMC/PMS Workflow @ 411SCMS.PMS@us.af.mil if PMS email is not provided

1 1 0

3 5 015. TOTAL

Page 4 of 7DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 20 Jun 2019

G. PREPARED BY

Boarman, Chris P

411 SCMS / GUL

478-926-2730

H. DATE

14 JUN 2019

I. APPROVED BY

//DIGITALLY SIGNED//

CIPOLLA.MARY.L.1280109114

411 SCMS / GULC 478-222-0870 / 472-0870

J. DATE

14 JUN 2019

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

HH-60

E. CONTRACT / PR NO.

FD20601901090

F. CONTRACTOR

Ballard Tech

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

Item Unique Identification

3. SUBTITLE

IUID Marking Activity and Verification Report

4. AUTHORITY

DI-MGMT-81804A

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS PARA 4.10.1

6. REQUIRING OFFICE

411 SCMS/GULAA

7. DD 250 REQ

LT

8. APP CODE

See Block 16

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Walters, George BNAME: 03 JUN 2019DATE:

BLK 4: The Data Item Description (DID) contains format and content preparation instructions for the data product generated by the specific and discrete task requirement as delineated in the contract. See Data Item Description at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: Applicable code as listed in DOD 5010.12-M, Chapter 3. (LT for Letter of Transmittal if not separately priced or DD if separately priced). WAWF E-DD FORM 250 shall be required for separately priced data. E-DD FORM 250 shall be submitted to FA8524 (PM EMAIL ADDRESS) for acceptance.

BLK 8: Approval (written) is not required. However, the data item will be reviewed and accepted/rejected, based on its conforming to the requirements of the DID, and within the review time specified in Block 16, items 10-12.

BLK 9: "C" Distribution authorized to U.S. Government Agencies and their contractors (Administrative or Operational use) (28 April 16). Other requests shall be referred to the contract management team, AFSC/PZAAA, 460 Richard Ray Blvd, Suite 221, Robins AFB, GA 31098.

BLKS 10-13: Contractor shall submit an IUID Marking Activity and Verification Report, to the Engineer, AFLCMC/WIUEC, every three months (quarterly). Written Government acceptance/comments/rejection will be within 10 working days after receipt of Plan from the Contractor. Contractor final submission shall be submitted within 10 working days of receiving Government comments. Acceptance by the Government is required prior to formal distribution.

BLK 14: EMAIL electronic IUID Marking Activity and Verification Report to the Procuring Contract Officer (PCO), DCMA/ACO, Program Manager (PM) 411 SCMS/GULAA, and Engineer AFLCMC/WIUEC. Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

COORDINATORS:

Email 411 SCMC/PMS Workflow @ 411SCMS.PMS@us.af.mil if PMS email is not provided

0 1 0

Email:

411 SCMS/GULAA Program Manager (PM)/COR Provided on Contract Award

0 1 0

Email:

AFSC/PZAAA Contracting Officer (PCO) Provided on Contract Award

0 1 0

Email:

DCMA/ACO

0 1 0

Email: Madeline Valdes

AFLCMC/WIU

madeline.valdes.@us.af.mil

0 1 0

0 5 015. TOTAL

G. PREPARED BY

Boarman, Chris P

411 SCMS / GUL

478-926-2730

H. DATE

14 JUN 2019

I. APPROVED BY

//DIGITALLY SIGNED//

CIPOLLA.MARY.L.1280109114

411 SCMS / GULC 478-222-0870 / 472-0870

J. DATE

14 JUN 2019

Page 5 of 7DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 20 Jun 2019

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

HH-60

E. CONTRACT / PR NO.

FD20601901090

F. CONTRACTOR

Ballard Tech

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

QUALITY CONTROL PLAN

3. SUBTITLE

QUALITY CONTROL PLAN

4. AUTHORITY

DI-QCIC-81722

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS para 5.8

6. REQUIRING OFFICE

411 SCMS/GULAB

7. DD 250 REQ

LT

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

1 XTIME

11. AS OF DATE

See block 16

12. DATE OF FIRST

SUBMISSION

See block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Walters, George BNAME: 14 JUN 2019DATE:

Block 4: Contractor format acceptable.

Block 7: Submit final with DD Form 250 to account for all previously submitted via WAWF for acceptance under

DODAAC: FA8524.

BLK 9: Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative and Operational use. Other requests for this document shall be referred to the Program Manager Rebecca Danson, 411 SCMS/GULAB rebecca.danson@us.af.mil Block 10, 11, 12, 13: One submission is required for contract. The government will have 30 calendar days to review and provide comments, subsequently the contractor will have 20 calendar days to correct and resubmit.

Block 14: Submissions shall be IAW CDRL instructions and PWS

Altman, Tasha TNAME: 27 AUG 2018DATE:

Block 4: Contractor format acceptable.

Block 7: Submit final with DD Form 250 to account for all previously submitted via WAWF for acceptance under DODAAC: FA8524.

BLK 9: Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative and Operational use. Other requests for this document shall be referred to the Program Manager Chris Boarman, 411 SCMS/GULAB chris.boarman.1@us.af.mil Block 10, 11, 12, 13: One submission is required for contract. The government will have 30 calender days to review and provide comments, subsequently the contractor will have 60 calender days to correct and resubmit.

Block 14: Submissions shall be IAW CDRL instructions and PWS

COORDINATORS:

411 SCMS/GULAA Program Manager (PM) Provided on Contract Award

1 1 0

Email: Madeline Valdes

AFLCMC/WIU

madeline.valdes.1@us.af.mil

1 1 0

2 2 015. TOTAL

G. PREPARED BY

Boarman, Chris P

411 SCMS / GUL

478-926-2730

H. DATE

14 JUN 2019

I. APPROVED BY

//DIGITALLY SIGNED//

CIPOLLA.MARY.L.1280109114

411 SCMS / GULC 478-222-0870 / 472-0870

J. DATE

14 JUN 2019

Page 6 of 7DD FORM 1423-1, FEB 2001 Version 2Generated by PRPS using Jasper Reports on 20 Jun 2019

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

HH-60

E. CONTRACT / PR NO.

FD20601901090

F. CONTRACTOR

Ballard Tech

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

Counterfeit Prevention Plan

3. SUBTITLE

CPP

4. AUTHORITY

DI-MISC-81832

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS REFERENCE PARA 4.14

6. REQUIRING OFFICE

411 SCMS/GULAA

7. DD 250 REQ

LT

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

C

10. FREQUENCY

See Block 16

11. AS OF DATE

See Block 16

12. DATE OF FIRST

SUBMISSION

See Block 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Walters, George BNAME: 03 JUN 2019DATE:

BLK 4: The Data Item Description contains the format and content preparation instructions for the data product generated by the specific and discrete task requirements delineated in the statement of work. See Data Item Description at http://quicksearch.dla.mil/ for content requirements and most current version.

BLK 7: Applicable code as listed in DOD 5010.12-M, Chapter 3. (LT for Letter of Transmittal if not separately priced or DD if separately priced). WAWF E-DD FORM 250 shall be required for separately priced data. E-DD FORM 250 shall be submitted to FA8524 Program Manager (PM) for acceptance.

BLK 9: "C" Distribution authorized to U.S. Government Agencies and their contractors (Administrative or Operational use) (28 April 16). Other requests shall be referred to the contract management team, AFSC/PZAAA, 460 Richard Ray Blvd, Suite 221, Robins AFB, GA 31098.

BLKS 10-13: Draft Counterfeit Prevention Plan shall be submitted electronically within 30 workdays after contract award. Contractor shall provide quarterly updates as necessary until final at completion of program. The Government will have 15 workdays to approve, submit comments, or disapprove all submissions. The contractor shall have 15 workdays to resubmit report if changes were deemed necessary by the Government.

BLK 14: EMAIL electronic Counterfeit Prevention Plan to the Procuring Contract Officer (PCO) AFSC/PZAAA, DCMA/ACO, Program Manager (PM) 411 SCMS/GULAA and Engineer AFLCMC/WIUEC. CDRL Distribution Points of Contact will be provided to the Contractor at Contract Award. Submit digital copy in a Microsoft Office compatible format or Adobe Portable Document Format for all reports.

COORDINATORS:

Email 411 SCMC/PMS Workflow @ 411SCMS.PMS@us.af.mil if PMS email is not provided

1 1 0

Email:

411 SCMS/GULAA Program Manager (PM) Provided on Contract Award

1 1 0

Email:

AFSC/PZAAA Contracting Officer (PCO) Provided on Contract Award

0 1 0

Email:

DCMA/ACO

0 1 0

Email: Madeline Valdes

AFLCMC/WIU

madeline.valdes.1@us.af.mil

0 1 0

2 5 015. TOTAL

G. PREPARED BY

Boarman, Chris P

411 SCMS / GUL

478-926-2730

H. DATE

14 JUN 2019

I. APPROVED BY

//DIGITALLY SIGNED//

CIPOLLA.MARY.L.1280109114

411 SCMS / GULC 478-222-0870 / 472-0870

J. DATE

14 JUN 2019

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