Attachments_1.pdf

FIRST ARTICLE REQUIREMENTS 1. DATE

18 JUL 2019(AFMCI 64-110, AFMCI 23-102 and FAR Part 9, Sub Part 9.3)(Additional Instructions on Page 3)

2. PR / MIPR NUMBER 3. CAGE / REFERENCE NUMBER

19397 / 141213-0001

4. NSN

5998012051273EW

5. FIRST ARTICLE QUANTITY

THE FIRST ARTICLE IS 2 UNIT(S) OF LOT / ITEM 0

AND WILL BE: PART OF PRODUCTION QUANTITY X IN ADDITION TO PRODUCTION QUANTITY

6. ARTICLES

WILL X WILL NOT SERVE AS A MANUFACTURING STANDARD

7. LONG LEAD TIME ITEMS

REQUIRED X NOT REQUIRED

(See FAR 52.209-3 OR -4, alternate II)

8. SPECIAL REQUIREMENT/PRODUCTION FACILITIES (See FAR 52.209-3 OR -4 Alternate I)

X REQUIRED NOT REQUIRED

"The First Article offered must be manufactured at the facilities in which that item is to be produced under the contract, or if the First Article is a component not manufactured by the contractor, such component must be manufactured at the facilities in which the component is to be produced for the contract. A certification to this effect must accompany each First Article which is offered."

9. TEST / INSPECTION REQUIREMENTS

A. X

X

CONTRACTOR TESTING

GOVERNMENT TESTING

Performance or other characteristics which the First Articles must meet are

Contract, Technical Data Package, and all QA provisions of vendor drawings and test requirements documentation.

B. The detailed technical requirements for First Article approval tests are contained in

Contract, Technical Data Package and Government approved Acceptance Test Procedures.

(Cite Spec and Para number)

C. X TEST PLAN REQUIRED

Number of days for government approval / disapproval 15 days.

D. Contractor's notification to ACO and

AFLCMC/WNY, and 408 SCMS/GUEA

(Requesting Activity) of test time and location due 30 days prior to start of testing.

E. X TEST REPORT REQUIRED

(1) Forwarded to

AFLCMC/WNY

235 Byron Street, Suite 19A

Robins AFB, GA 31098

John Fuller

(2) Government written notice of approval / disapproval due 30 days after receipt of contractor's report.

F. FIRST ARTICLE DELIVERY

(1) Due within 90 calendar days from date contract.

(2) Notify 20 calendar days prior to shipment.

(3) Delivered to government at

FD2060 - DLA Central Rcvg, DDWG ER

Special Handling, First Art. Unit

455 Byron Street WR-ALC

Robins AFB, GA 31098-1887

(Set Forth Consignee and Address)

(4) Government written notice of approval / disapproval within 60 days after receipt of first article package.

G. Estimated cost of government testing / inspection evaluation.

$9,000.0000

Page 1 of 2AFMC IMT 260, 20020830, V-3 Version 1Generated by PRPS using Jasper Reports on 28 Oct 2019

18 JUL 2019(AFMCI 64-110, AFMCI 23-102 and FAR Part 9, Sub Part 9.3)(Additional Instructions on Page 3)

10. DISPOSITION OF FIRST ARTICLES

X Approved First Articles will be forwarded to

AFLCMC/WNY

X 2 (insert quantity) First Articles will be expended in testing. Residual components of disapproved First Articles

X will be returned to the contractor will be retained by pending disposition instructions from the contractor.

First Articles will be installed on aircraft/equipment to determine proper fit/function. Approved article will remain on the aircraft/equipment and will not be forwarded to USAF Supply, but will be considered part of the contract quantity.

X Disapproved First Articles

X will be returned to the contractor will be retained by pending disposition instructions from the contractor.

On purchase requests designated as direct shipments the following disposition will apply. (NOTE: Always applicable on Foreign Military Sales (FMS)).

a. Approved First Articles will be returned to the contractor for shipment with production item.

b. Disposition of disapproved First Articles will remain the same as marked above.

Other Disposition:

11. CONDITION(S) FOR WAIVER OF FIRST ARTICLE APPROVAL

a. Offerors who have previously furnished production quantities of the same or similar article to the prime contractor for delivery to the Government, DoD, Air Force.

b. Offerors currently in production of the same or similar article for a Government, DoD, Air Force contract and who have received First Article approval under the existing contract.

c. Offerors who have previously furnished production quantities of the same or similar articles to the Government, DoD, Air Force, provided articles thus furnished, have exhibited satisfactory performance in service in the opinion of the Air Force.

d. Provided not more than months have elapsed since completion of the contract.

e. X First Article testing will not be waived.

f. See Remarks in block 12 below.

NOTE TO BUYER: UNDER CONDITIONS A AND C ABOVE, THE COGNIZANT ENGINEERING ACTIVITY WILL DECIDE WHETHER OR NOT THE ITEM HAS EXHIBITED SATISFACTORY PERFORMANCE IN SERVICE AND PREPARE AND RETAIN SUPPORTING DOCUMENTATION TO FULLY JUSTIFY THIS DECISION. THE BUYER MUST SOLICIT DUAL PRICES (That is, both with and without requirement for first article approval) AND MUST FURNISH THE COGNIZANT ENGINEERING ACTIVITY WITH THE FOLLOWING INFORMATION ON THE PREVIOUSLY SUPPLIED ARTICLE:

A. PROCURING OFFICE B. CONTRACT NUMBER C. DATE OF CONTRACT D. SPECIFICATION NUMBER AND REVISION

AFSC (WR-ALC/LNK) F09603-03-M-1378 18 JUL 2003 141213-0001, Rev G

12. REMARKS

13. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR APPROVING TEST

(Name, Organization, Phone)

John Fuller

AFLCMC/WNYCC

478-222-4303

472-4303

14. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR CONDUCTING

TEST (Name, Organization, Phone)

John Fuller

AFLCMC/WNYCC

478-222-4303

472-4303

Page 2 of 2AFMC IMT 260, 20020830, V-3 Version 1Generated by PRPS using Jasper Reports on 28 Oct 2019

28 OCT 2019(AFMCI 64-110, AFMCI 23-102 and FAR Part 9, Sub Part 9.3)(Additional Instructions on Page 3)

2. PR / MIPR NUMBER 3. CAGE / REFERENCE NUMBER

19397 / 141210-0002

4. NSN

5995012042430EW

5. FIRST ARTICLE QUANTITY

THE FIRST ARTICLE IS 2 UNIT(S) OF LOT / ITEM 0

AND WILL BE: PART OF PRODUCTION QUANTITY X IN ADDITION TO PRODUCTION QUANTITY

6. ARTICLES

WILL X WILL NOT SERVE AS A MANUFACTURING STANDARD

7. LONG LEAD TIME ITEMS

REQUIRED X NOT REQUIRED

(See FAR 52.209-3 OR -4, alternate II)

8. SPECIAL REQUIREMENT/PRODUCTION FACILITIES (See FAR 52.209-3 OR -4 Alternate I)

REQUIRED X NOT REQUIRED

"The First Article offered must be manufactured at the facilities in which that item is to be produced under the contract, or if the First Article is a component not manufactured by the contractor, such component must be manufactured at the facilities in which the component is to be produced for the contract. A certification to this effect must accompany each First Article which is offered."

9. TEST / INSPECTION REQUIREMENTS

A. X CONTRACTOR TESTING

GOVERNMENT TESTING

Performance or other characteristics which the First Articles must meet are

Contract, Technical Data Package, and all QA provisions of vendor drawings and test requirements documentation.

B. The detailed technical requirements for First Article approval tests are contained in

Contract, Technical Data Package, and Government approved Acceptance Test procedures.

(Cite Spec and Para number)

C. X TEST PLAN REQUIRED

Number of days for government approval / disapproval 20 days.

D. Contractor's notification to ACO and

AFLCMC/WNY

(Requesting Activity) of test time and location due 30 days prior to start of testing.

E. X TEST REPORT REQUIRED

(1) Forwarded to

AFLCMC/WNY

235 Byron Street, Suite 19A

Robins AFB, GA 31098

Martina Leschinsky

(2) Government written notice of approval / disapproval due 20 days after receipt of contractor's report.

F. FIRST ARTICLE DELIVERY

(1) Due within 120 calendar days from date contract.

(2) Notify 15 calendar days prior to shipment.

(3) Delivered to government at

FD2060-F/A Special Handling

AFSC/GUEB - Jim Gordon

455 Byron Street

Robins AFB, GA 31098

(Set Forth Consignee and Address)

(4) Government written notice of approval / disapproval within 30 days after receipt of first article package.

G. Estimated cost of government testing / inspection evaluation.

$3,000.0000

Page 1 of 2AFMC IMT 260, 20020830, V-3 Version 1Generated by PRPS using Jasper Reports on 28 Oct 2019

28 OCT 2019(AFMCI 64-110, AFMCI 23-102 and FAR Part 9, Sub Part 9.3)(Additional Instructions on Page 3)

10. DISPOSITION OF FIRST ARTICLES

Approved First Articles will be forwarded to

X 2 (insert quantity) First Articles will be expended in testing. Residual components of disapproved First Articles will be returned to the contractor

X will be retained by LCMC/WNY pending disposition instructions from the contractor.

First Articles will be installed on aircraft/equipment to determine proper fit/function. Approved article will remain on the aircraft/equipment and will not be forwarded to USAF Supply, but will be considered part of the contract quantity.

Disapproved First Articles will be returned to the contractor will be retained by pending disposition instructions from the contractor.

On purchase requests designated as direct shipments the following disposition will apply. (NOTE: Always applicable on Foreign Military Sales (FMS)).

a. Approved First Articles will be returned to the contractor for shipment with production item.

b. Disposition of disapproved First Articles will remain the same as marked above.

Other Disposition:

11. CONDITION(S) FOR WAIVER OF FIRST ARTICLE APPROVAL

a. Offerors who have previously furnished production quantities of the same or similar article to the prime contractor for delivery to the Government, DoD, Air Force.

b. Offerors currently in production of the same or similar article for a Government, DoD, Air Force contract and who have received First Article approval under the existing contract.

c. Offerors who have previously furnished production quantities of the same or similar articles to the Government, DoD, Air Force, provided articles thus furnished, have exhibited satisfactory performance in service in the opinion of the Air Force.

d. Provided not more than months have elapsed since completion of the contract.

e. X First Article testing will not be waived.

f. See Remarks in block 12 below.

NOTE TO BUYER: UNDER CONDITIONS A AND C ABOVE, THE COGNIZANT ENGINEERING ACTIVITY WILL DECIDE WHETHER OR NOT THE ITEM HAS EXHIBITED SATISFACTORY PERFORMANCE IN SERVICE AND PREPARE AND RETAIN SUPPORTING DOCUMENTATION TO FULLY JUSTIFY THIS DECISION. THE BUYER MUST SOLICIT DUAL PRICES (That is, both with and without requirement for first article approval) AND MUST FURNISH THE COGNIZANT ENGINEERING ACTIVITY WITH THE FOLLOWING INFORMATION ON THE PREVIOUSLY SUPPLIED ARTICLE:

A. PROCURING OFFICE B. CONTRACT NUMBER C. DATE OF CONTRACT D. SPECIFICATION NUMBER AND REVISION

12. REMARKS

13. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR APPROVING TEST

(Name, Organization, Phone)

Moorman, Matthew B

408 SCMS / GU E A

478-222-4360

472-4360

14. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR CONDUCTING

TEST (Name, Organization, Phone)

Martina Leschinsky

LCMC/WNY

478-222-4184

472-4184

Page 2 of 2AFMC IMT 260, 20020830, V-3 Version 1Generated by PRPS using Jasper Reports on 28 Oct 2019

LNERT-F15TEWS-ALE45-127-001

ENVIRONMENTAL STRESS SCREENING (ESS)

REQUIREMENTS FOR

AN/ALE-45 ECSP motherboard (5A10)

December 2004

1 Introduction.

Despite improvements in manufacturing automation in recent years, manufacturing processes for our shop replaceable units (SRUs) continue to randomly insert a number of defects in both parts and workmanship. To the maximum extent possible, these defects must be discovered and corrected/removed before sending the SRUs into field service. Finding and correcting defects in the factory rather than the field has clear military and cost advantages.

This requirement provides an Environmental Stress Screening (ESS) regimen for AN/ALE-45 ECSP motherboards (5A10). The ESS regimen presented here consists of random vibration and thermal cycling exposure. These ESS requirements shall be imposed on all AN/ALE-45 ECSP motherboard products prior to fleet delivery.

2 Environmental Stress Screening (ESS).

ESS shall be conducted as a part of the manufacturing process, on each motherboard produced. The ESS process shall meet the requirements specified herein. All motherboard electrical continuity shall be monitored to demonstrate functional performance capability and for compliance with the requirements of the motherboard specification during each portion of the ESS regimen.

If continuous monitoring is not possible, periodic monitoring may be acceptable, subject to LNERT lead system engineer approval.

An ESS plan shall be prepared and submitted for government review and approval (DI-R-7035).

2.1 ESS Process.

The ESS Procedure shall consist of the processes 1 through 5 listed in Table 1 below and shall be performed in the sequence shown in accordance with the referenced paragraphs. In the event of a failure, the motherboard shall be evaluated, repaired if appropriate, and resubmitted to the ESS process at the start of the next available ESS screen of the type in which the failure was discovered. In the event of a failure that cannot be repaired, the motherboard shall be rejected and replaced. The replacement motherboard will be resubmitted to the ESS process at the beginning (functional pretest). In-house Failure Reporting, Analysis and Corrective Action System (FRACAS), using MIL-STD-785D Task 104 shall be implemented as a guide, to analyze the root cause of each motherboard failure; and then to plan and implement corrective actions in the manufacturing process to reduce the reoccurrence of the indicated failure mode and thus increase the yield of the entire motherboard manufacturing process.

Table. I. ESS Processes Process # Process Name Reference Paragraph

1. Functional Pre-test 2.1.1

2. Random Vibration 2.1.2

3. Temperature Cycling 2.1.3

4. Functional Post-test 2.1.4

5. Final Acceptance Test 2.1.5

2.1.1 Functional Pre-Test.

Initially, each motherboard shall be functionally (bare-board) tested for correct operation in compliance with the technical requirements of the specification before submitting the motherboard to the ESS process. This pre-test shall include tests for shorts, opens, and cross connections on all signal paths (Mil type connectors and board edge connectors). The results of the functional pre-test shall be documented and attached to the product traveler.

2.1.2 Random Vibration.

After passing the initial functional pre-test, each motherboard shall be subjected to 0.04 G 2/Hz random vibration over 80-400 Hz in accordance with the vibration envelope in Figure 1. The vibration shall be applied for 10 minutes in each of the three mutually perpendicular primary motherboard axis for a total of 30 minutes vibration exposure. Vibration equipment and the motherboards vibration spectrum tolerances shall be monitored during the vibration in accordance with MIL-STD-810D, Method 514.3, Section II, Paragraph II-1.1.

2.1.3 Temperature Cycling.

After passing the random vibration screen, each motherboard shall be subjected to a minimum of 10 thermal cycles, with the last cycle to be failure free. The motherboards shall be cycled between -54 degrees Centigrade and +95 degrees Centigrade, and electrically tested during the heating and the temperature extreme portions of each cycle as shown in Figure 2. Electrical connectivity shall be tested a minimum of three times (represented by the 3 cycles on/off in Figure 2) after stabilization at the temperature extremes of each cycle (10 minutes for each power cycle with five minutes off/five minutes on). The motherboard signal voltages shall be constant at 48 VDC during each power cycle of each temperature extreme. The temperature rate of change shall be greater than or equal to 20 degrees Centigrade per minute. The time and temperature profile for each cycle shall be in accordance with Figure 2. Stabilization occurs when the temperature of the motherboard part considered to have the longest thermal lag is within 2 degrees Centigrade of the required temperature extreme.

2.1.4 Functional Post-Test/Final Acceptance Test.

After passing the temperature cycling screen, each motherboard shall be functionally (bare-board) tested for correct operation in compliance with the technical requirements of the specification. The results of the functional post-test on each motherboard shall be documented. Any motherboard found out of compliance with the specification shall be rejected.

3 Tailoring the ESS Regimen.

Tailoring of the requirements identified herein is encouraged in cases where the dynamic response or functional verification of the motherboard product clearly support modification. Modifications may be proposed to support product survivability or enhancements to the overall product verification. Deviations from the ESS requirements established herein for the AN/ALE- 45 motherboard shall be authorized by the LNERT lead systems engineer in writing prior to implementation. Regardless the motivation or nature of the proposed tailoring, strict adherence to the R&M 2000 guidelines dictated by HG USAF is strongly advised.

PACKAGING REQUIREMENTS

PURCHASE INSTRUMENT NUMBER: FD20602000204-00 VERSION: 1

MIL-STD 129 REVISION: R MIL-STD 2073-1 REVISION: E

THE FOLLOWING STATEMENT IS IN COMPLIANCE WITH THE UNITED NATIONS-IMPLEMENTED RESTRICTIONS ON WOOD PACKAGING MATERIAL (WPM). THIS REQUIREMENT IS SPECIFICALLY CONCERNED WITH INVASIVE SPECIES SUCH AS THE PINEWOOD NEMATODE. WPM IS DEFINED AS WOOD PALLETS, SKIDS, LOAD BOARDS, PALLET COLLARS, WOODEN BOXES, REELS, DUNNAGE, CRATES, FRAMES, AND CLEATS. THE STATEMENT BELOW CITES THE REQUIREMENTS IN DETAIL AND COVERS LUMBER FOR BUILDING CONTAINERS AND PALLETS USED FOR DELIVERIES RESULTING IN SHIPMENTS WORLDWIDE (DIRECT, OR THROUGH AIR LOGISTICS CENTERS (ALC), CONTAINER CONSOLIDATION POINTS (CCP), OR OTHER BASES). WOODEN LUMBER, WOODEN

PALLET AND PACKAGING/CONTAINER STATEMENT:

ALL WOODEN LUMBER, WOODEN PALLET'S, AND WOODEN CONTAINERS PRODUCED ENTIRELY OR IN PART OF WOOD PACKING MATERIAL (WPM) SHALL BE CONSTRUCTED FROM DEBARKED WOOD IN ADDITION TO THE APPLICATION OF HEAT-TREATED (HT) MATERIAL (HT TO 56 DEGREES CENTIGRADE OR 133 DEGREES FAHRENHEIT FOR 30 MINUTES). CERTIFICATION/MARKING IS REQUIRED BY AN ACCREDITED AGENCY RECOGNIZED BY THE AMERICAN LUMBER STANDARDS COMMITTEE (ALSC). FOR REFERENCE DOCUMENTATION, SEE LATEST REVISION OF "INTERNATIONAL STANDARDS FOR PHYTOSANITARY MEASURES" (ISPM)NO.15), "REGULATION OF WOOD PACKAGING MATERIAL IN INTERNATIONAL TRADE."

PACRN: PACKAGING REQUIREMENT: PRESERVATION LEVEL: PACKAGING LEVEL: SPI: SPI REV: SPI DATE:

AAA No Packaging Data Required

ITEM(S):

5996FAL200005EW

CODED DATA:

QUP ICQ

PRES

METH CD

PRES

MTL

WRAP

MTL

CUSH

DUNN CT

UNIT

CONT

INT

CONT UCL

SPEC

MKG

UNIT PACK

WEIGHT

UNIT PACK

LENGTH

UNIT PACK

WIDTH

UNIT PACK

DEPTH

UNIT PACK

CUBE OPI

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

SUPPLEMENTAL PACKAGING INSTRUCTION TEXT:

VENDOR PACKAGING INSTRUCTIONS:

PACRN: PACKAGING REQUIREMENT: PRESERVATION LEVEL: PACKAGING LEVEL: SPI: SPI REV: SPI DATE:

AAB MIL Long Line Packaging MIL B

ITEM(S):

5995012042430EW

CODED DATA:

QUP ICQ

PRES

METH CD

PRES

MTL

WRAP

MTL

CUSH

DUNN CT

UNIT

CONT

INT

CONT UCL

SPEC

MKG

UNIT PACK

WEIGHT

UNIT PACK

LENGTH

UNIT PACK

WIDTH

UNIT PACK

DEPTH

UNIT PACK

CUBE OPI

1 000 33 1 00 EA NA A NS 00 B 17 0.70 6.3 5.3 4.0 0.077 M

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

SUPPLEMENTAL PACKAGING INSTRUCTION TEXT:

VENDOR PACKAGING INSTRUCTIONS:

Military Packaging and Marking Items shall be packaged in accordance with MIL-STD-2073-1, Standard Practice for Military Packaging. Shipping and storage markings shall be in accordance with MIL-STD-129, Standard Practice for Military Marking.

Page 1 of 3AFMC 158 Version 1Generated by PRPS using Jasper Reports on 06 Nov 2019

Shipping Container Marking Shipping containers shall be marked meeting the following criteria: (a) MIL-STD-129, Standard Practice for Military Marking. (b) Additional marking and/or bar coding requirements exceeding those of MIL-STD-129 (e.g., unit serial numbers, original equipment manufacturers (OEM) name, or OEM model number, as specified on the AFMC Form 158.

PACRN: PACKAGING REQUIREMENT: PRESERVATION LEVEL: PACKAGING LEVEL: SPI: SPI REV: SPI DATE:

AAC No Packaging Data Required

ITEM(S):

5996DTL200068EW

CODED DATA:

QUP ICQ

PRES

METH CD

PRES

MTL

WRAP

MTL

CUSH

DUNN CT

UNIT

CONT

INT

CONT UCL

SPEC

MKG

UNIT PACK

WEIGHT

UNIT PACK

LENGTH

UNIT PACK

WIDTH

UNIT PACK

DEPTH

UNIT PACK

CUBE OPI

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

SUPPLEMENTAL PACKAGING INSTRUCTION TEXT:

VENDOR PACKAGING INSTRUCTIONS:

PACRN: PACKAGING REQUIREMENT: PRESERVATION LEVEL: PACKAGING LEVEL: SPI: SPI REV: SPI DATE:

AAD No Packaging Data Required

ITEM(S):

5996FAL200006EW

CODED DATA:

QUP ICQ

PRES

METH CD

PRES

MTL

WRAP

MTL

CUSH

DUNN CT

UNIT

CONT

INT

CONT UCL

SPEC

MKG

UNIT PACK

WEIGHT

UNIT PACK

LENGTH

UNIT PACK

WIDTH

UNIT PACK

DEPTH

UNIT PACK

CUBE OPI

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

SUPPLEMENTAL PACKAGING INSTRUCTION TEXT:

VENDOR PACKAGING INSTRUCTIONS:

Page 2 of 3AFMC 158 Version 1Generated by PRPS using Jasper Reports on 06 Nov 2019

PACRN: PACKAGING REQUIREMENT: PRESERVATION LEVEL: PACKAGING LEVEL: SPI: SPI REV: SPI DATE:

AAE MIL Long Line Packaging MIL B

ITEM(S):

5998012051273EW

CODED DATA:

QUP ICQ

PRES

METH CD

PRES

MTL

WRAP

MTL

CUSH

DUNN CT

UNIT

CONT

INT

CONT UCL

SPEC

MKG

UNIT PACK

WEIGHT

UNIT PACK

LENGTH

UNIT PACK

WIDTH

UNIT PACK

DEPTH

UNIT PACK

CUBE OPI

1 000 33 1 00 EA NA A NS 00 B 17 4.20 18.5 12.5 3.0 0.401 M

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

SUPPLEMENTAL PACKAGING INSTRUCTION TEXT:

VENDOR PACKAGING INSTRUCTIONS:

Military Packaging and Marking Items shall be packaged in accordance with MIL-STD-2073-1, Standard Practice for Military Packaging. Shipping and storage markings shall be in accordance with MIL-STD-129, Standard Practice for Military Marking.

Shipping Container Marking Shipping containers shall be marked meeting the following criteria: (a) MIL-STD-129, Standard Practice for Military Marking. (b) Additional marking and/or bar coding requirements exceeding those of MIL-STD-129 (e.g., unit serial numbers, original equipment manufacturers (OEM) name, or OEM model number, as specified on the AFMC Form 158.

ORGANIZATION / OFFICE SYMBOL:

406 SCMS / GULAA

PACKAGING SPECIALIST:

Kerr, Jason B

PHONE NUMBER:

478-327-6316 / 497-6316

SIGNATURE:

//SIGNED//Kerr, Jason B

DATE:

19310 - 06 NOV 2019

Page 3 of 3AFMC 158 Version 1Generated by PRPS using Jasper Reports on 06 Nov 2019

TRANSPORTATION DATA FOR SOLICITATIONS

COMMODITY: See Continuation

PURCHASE INSTRUMENT NUMBER:

FD20602000204-00

DATE INITIATED:

06 NOV 2019

STOCK NUMBER: See Continuation

X ORIGIN DESTINATION OTHER X DATA / FIRST ARTICLE F.O.B. DESTINATION(Specify)

F.O.B. TERMS RECOMMENDED AS BEST SUITED FOR THIS PROCUREMENT

TRANSPORTATION PROVISIONS / CLAUSES FAR CITATION

F.O.B. Origin 52.247-29 Freight Classification Description 52.247-53 Contact DCMA Transportation Contact DCMA Transportation on ALL "DCMA Administered" contracts prior to shipment for shipping instructions using the DCMA Shipment Instruction Request (SIR) eTool System, at http://www.dcma.mil <http://www.dcma.mil/> for ALL FOB:

Origin, Foreign Military Sales (FMS), and FOB: Destination OCONUS/Export movements to obtain the appropriate DOD regulatory clearances, shipping documentation and instructions from your cognizant DCMA Transportation Office. If you are new to DCMA, and do not already have a SIR eTool account, you will first need to request an account via DCMA External Web Access Management (EWAM) application which can be accessed at http://www.dcma.mil. If you need additional assistance, email DCMA Transportation Group at: Transportation.Division@dcma.mil. Do not move any freight to a water or aerial port prior to contacting DCMA or it will become frustrated. Failure to contact the responsible DCMA may result in vendor incurring additional expenditures.

Vendor Transportation Instructions

IAW BASIC CONTRACT FD20602000204-00

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 97X4930.FC04 640 47GR 15640P 01N000 00000 000000 503000 F03000 FSR: 013408 PSR: K22921

First Destination Transportation Account Code: FRS6

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA:

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 5998012051273EW

Purchase Instrument Line Item Number: 0001

Ship to (DoDAAC / MAPAC): SW3119

Mark For:

Ship To (Address): DLA DISTRIBUTION WARNER ROBINS

ROBINS A F B GA 31098-1887

31098 - 1887

USA

WPOD:

APOD:

BBP / CCP:

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

455 BYRON STREET BLDG 376

Ship To (Remarks):

Page 1 of 3DD FORM 1653 Version 1Generated by PRPS using Jasper Reports on 06 Nov 2019

NSN / Pseudo NSN: 5995012042430EW

Purchase Instrument Line Item Number: 0002

Ship to (DoDAAC / MAPAC): SW3119

Mark For:

Ship To (Address): DLA DISTRIBUTION WARNER ROBINS

ROBINS A F B GA 31098-1887

31098 - 1887

USA

WPOD:

APOD:

BBP / CCP:

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

455 BYRON STREET BLDG 376

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

OTHER TRANSPORTATION DATA:

TACRN:

AAB

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 97X4930.FC04 640 47GR AS9999 01N000 00000 000000 503000 F03000 FSR: 013408 PSR: K22981

First Destination Transportation Account Code: FRS6

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA:

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 5996DTL200068EW

Purchase Instrument Line Item Number: 0005

Ship to (DoDAAC / MAPAC): SW3119

Mark For:

Ship To (Address): DLA DISTRIBUTION WARNER ROBINS

ROBINS A F B GA 31098-1887

31098 - 1887

USA

WPOD:

APOD:

BBP / CCP:

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

455 BYRON STREET BLDG 376

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

Page 2 of 3DD FORM 1653 Version 1Generated by PRPS using Jasper Reports on 06 Nov 2019

OTHER TRANSPORTATION DATA:

TACRN:

AAC

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 97X4930.FC04 640 47GR 15640P 01N000 00000 000000 503000 F03000 FSR: 013408 PSR: K22921

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA:

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 5996FAL200005EW

Purchase Instrument Line Item Number: 0003

Ship to (DoDAAC / MAPAC):

Mark For:

Ship To (Address): FD2060 - DLA Central Rcvg, DDWG ER

Robins AFB, GA

31098 - 1887

USA

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number:

Supplemental Address:

FMS Case:

455 Byron Street WR-ALC

Ship To (Remarks):

NSN / Pseudo NSN: 5996FAL200006EW

Purchase Instrument Line Item Number: 0004

Ship to (DoDAAC / MAPAC):

Mark For:

Ship To (Address): FD2060-DLA Central Receiving,DDWG ER

Robins AFB, GA

31098 - 1887

United States

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number:

Supplemental Address:

FMS Case:

455 Byron Street WR-ALC

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

OTHER TRANSPORTATION DATA:

NAME

Carter, Glenn A

ORGANIZATION / OFFICE

SYMBOL

406 SCMS / GULAA

COMMERCIAL / DSN

PHONE

478-327-7399 / 497-7399

SIGNATURE

//SIGNED//Carter, Glenn A

DATE

06 NOV 2019

Page 3 of 3DD FORM 1653 Version 1Generated by PRPS using Jasper Reports on 06 Nov 2019

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications 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

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Page of Pages

(1 Data Item)

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

TDP ________ TM _______ OTHER

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

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423-1 (BACK), FEB 2001

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications 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

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

TDP ________ TM _______ OTHER

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

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications 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

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

TDP ________ TM _______ OTHER

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

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications 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

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

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

TDP ________ TM _______ OTHER

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

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before…