CDRL_A018_-_System_Safety_Program_Plan_07March2014.pdf

A. CONTRACT DATA REQUIREMENTS LIST (1 Data Item) Form Approval OMB No. 0704-0188 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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.: 0004

B. EXHIBIT....................................: A

C. CATEGORY..............................:

D. SYSTEM/ITEM........: RASTER

E. CONTRACT/PR NO. FA9451-13-R-0243

F. CONTRACTOR.........:

1. DATA ITEM NO........................: A018

2. TITLE OF DATA ITEM............: System Safety Program Plan

3. SUBTITLE..................................:

4. AUTHORITY.............................: DI-SAFT-81626

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RDS

7. DD250 REQ................................: LT

8. APP CODE.................................: A

9. DIST. STATEMENT REQUIRED......: B

10. FREQUENCY......................................: ASREQ

11. AS OF DATE........................................: See Blk 16

12. DATE OF FIRST SUBMISSION: 90 DAC

13. DATE OF SUBSEQUENT SUBM.: See Blk 16

14. DISTRIBUTION A. ADDRESSEES B. COPIES

DRAFT FINAL

AFRL/RDS TOO 1 1

AFRL/RVKDP LT LT

ACO LT LT

15. TOTAL: 1 1

16. REMARKS

Blk 4: DI-SAFT-81626 is tailored as follows:

A. General: Electronic media format. Submission via unencrypted or unsecure email is not permitted. Task order specific updates shall be addressed on a task order specific need.

Blk 9: DISTRIBUTION STATEMENT B: Distribution authorized to U.S. Government agencies, Critical Technology, Export Controlled, 20 FEB 2013. Other requests shall be referred to Air Force Research Laboratory, AFRL/RDS, 3550 Aberdeen Ave SE, Kirtland AFB, NM 87117-5776.

EXPORT CONTROL WARNING: All technical data shall be marked as follows: “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 in accordance with provisions of DoD Directive 5230.25.”

Blk 10, 12, 13, 14: Updates will occur as required based on changes in the Experiment Support or Infrastructure needs. All changes shall be directed by the Government in task order specific guidance or by civil engineering depending on the project. The Government will review, edit and return the draft no later than 10 business days.

Upon receipt of the reviewed and edited draft, the contractor shall take no more than 10 business days to incorporate all required changes and deliver a final version.

Blk 14: Additional copies may need to be provided to the site facilities officer and/or local civil engineering for review and comment. Distribution will be determined by the Task Order Officer.

DESTRUCTION NOTICE - For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Maj Daniel Wheeler I. APPROVED BY: Kim Kinifick H. DATE: 7 Mar 2013 J. DATE:7 Mar 2013

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1_ of 1 _ Pages

EXHIBIT A