FA945311R0287 Amend 1.pdf - Adobe Acrobat Pro.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE

See Block #2

PAGE OF PAGES

2. AMENDMENT/MODIFICATION NO.

3. EFFECTIVE DATE

06 JUN 2012

4. REQUISITION/PURCHASE REQ.NO.

5. PROJECT NO. (If applicable)

6. ISSUED BY AFRL/RVKVV CODE FA9453 7. ADMINISTERED BY (If other than Item 6) CODE

AF RESEARCH LABORATORY (DET 8)

3550 ABERDEEN AVE SE

KIRTLAND AFB, NM 87117-5776

WAYNE W. ZITZKA 505 846-4987

wayne.zitzka@kirtland.af.mil

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code) (X) 9A. AMENDMENT OF SOLICITATION NO.

FA9453-11-R-0287

X

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

CODE FACILITY CODE

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers X is extended, is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

(a) By completing Items 8 and 15, and returning 0 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER.

If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATION OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

(X )

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: ( ) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. ITEM

10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

PURPOSE: This revision makes changes to the Request for Proposal (RFP) numbered FA9453-11-R-0287 entitled "Space Vehicles Advance Technologies (SVAT)" in response to questions from industry.

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER (Type or print).

16A. NAME AND TITLE OF SIGNER (Type or print)

JOEL L. PERRINE

15B. CONTRACTOR/OFFEROR

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA

16C. DATE SIGNED

(Signature of person authorized to sign)

BY________________________________________

(Signature of Contracting Officer)

NSN 7540-01-152-8070 30-105 STANDARD FORM 30 (REV.10-83)

PREVIOUS EDITION UNUSABLE Prescribed by GSA ConWrite Version 6.13.1 FAR (48 CFR) 53.243 Created 07 Jun 2012 2:59 PM

SCHEDULE OF CHANGES

FA9453-11-R-0287 0001

1. This amendment is issued to make the changes as specified below.

2. The due date for receipt of proposals is revised, in Block 9 of the SF Form 33, to:

FROM: 12:00PM MST 11 JUNE 2012

TO: 12:00PM MDT 18 JUNE 2012

3. Section C clause C002 INCORPORATED DOCUMENTS/REQUIREMENTS (AUG 2006)(TAILORED) paragraph (a) is revised as follows:

FROM:

(a) The following documents are a part of this contract:

(1) Exhibit A, DD Form 1423, Contract Data Requirements Lists, dated 15 February 2012.

(2) Attachment 1, Basic Contract Statement of Work entitled "Space Vehicles Advanced Technology (SVAT)," dated 21 November 2011.

(3) Attachment 2, Department of Defense Security Classification Specification, DD 254, dated 1 May 2012.

(4) Attachment 9, Base Support, dated 2 March 2012.

TO:

(a) The following documents are a part of this contract:

(1) Exhibit A, DD Form 1423, Contract Data Requirements Lists, dated 6 June 2012.

(2) Attachment 1, Basic Contract Statement of Work entitled "Space Vehicles Advanced Technology (SVAT)," dated 6 June 2012.

(3) Attachment 2, Department of Defense Security Classification Specification, DD 254, dated 1 May 2012.

(4) Attachment 9, Base Support, dated 6 June 2012.

4. Section J is revised as follows:

FROM:

DOCUMENT PGS DATE TITLE

EXHIBIT A 10 15 FEB 2012 CONTRACT DATA REQUIREMENTS LIST (CDRL)

DD FORM 1423-1, A SERIES (A001 - A019)

ATTACHMENT 1 10 21 NOV 2011 BASIC CONTRACT STATEMENT OF WORK

ENTITTLED SPACE VEHICLES ADVANCED

TECHNOLOGY

ATTACHMENT 2 6 01 MAY 2012 DRAFT DEPARTMENT OF DEFENSE CONTRACT

SECURITY CLASSIFICATION SPECIFICATION DD

ATTACHMENT 3 4 10 FEB 2012 TASK ORDER 0001, STATEMENT OF WORK

ENTITLED "DECISION SUPPORT SYSTEMS (DSS)"

ATTACHMENT 4 5 10 FEB 2012 TASK ORDER 0002, STATEMENT OF WORK

ENTITLED "GUIDANCE, NAVIGATION, AND

CONTROLS, AND AUTONOMY PROGRAM"

ATTACHMENT 5 7 10 Feb 2012 TASK ORDER 0003, STATEMENT OF WORK

ENTITLED "INTEGRATED STRUCTURAL

SYSTEMS (ISS)"

ATTACHMENT 6 6 10 FEB 2012 TASK ORDER 0004, STATEMENT OF WORK

ENTITLED "ADVANCED SPACE POWER

GENERATION, STORAGE, & DISTRIBUTION"

ATTACHMENT 7 2 10 FEB 2012 TASK ORDER 0005, STATEMENT OF WORK

ENTITLED "SPACE COMMUNICATIONS"

ATTACHMENT 8 2 10 FEB 2012 TASK ORDER 0006, STATEMENT OF WORK

ENTITLED "SPACE SITUATIONAL AWARENESS

(SSA)"

ATTACHMENT 9 3 02 MAR 2012 BASE SUPPORT

TO:

DOCUMENT PGS DATE TITLE

EXHIBIT A 10 06 JUN 2012 CONTRACT DATA REQUIREMENTS LIST (CDRL)

DD FORM 1423-1, A SERIES (A001 - A019)

ATTACHMENT 1 10 06 JUN 2012 BASIC CONTRACT STATEMENT OF WORK

ENTITTLED SPACE VEHICLES ADVANCED

TECHNOLOGY

ATTACHMENT 2 6 01 MAY 2012 DRAFT DEPARTMENT OF DEFENSE CONTRACT

SECURITY CLASSIFICATION SPECIFICATION DD

ATTACHMENT 3 4 10 FEB 2012 TASK ORDER 0001, STATEMENT OF WORK

ENTITLED "DECISION SUPPORT SYSTEMS (DSS)"

ATTACHMENT 4 5 10 FEB 2012 TASK ORDER 0002, STATEMENT OF WORK

ENTITLED "GUIDANCE, NAVIGATION, AND

CONTROLS, AND AUTONOMY PROGRAM"

ATTACHMENT 5 7 06 JUN 2012 TASK ORDER 0003, STATEMENT OF WORK

ENTITLED "INTEGRATED STRUCTURAL

SYSTEMS (ISS)"

ATTACHMENT 6 6 10 FEB 2012 TASK ORDER 0004, STATEMENT OF WORK

ENTITLED "ADVANCED SPACE POWER

GENERATION, STORAGE, & DISTRIBUTION"

ATTACHMENT 7 2 10 FEB 2012 TASK ORDER 0005, STATEMENT OF WORK

ENTITLED "SPACE COMMUNICATIONS"

ATTACHMENT 8 2 06 JUN 2012 TASK ORDER 0006, STATEMENT OF WORK

ENTITLED "SPACE SITUATIONAL AWARENESS

(SSA)"

ATTACHMENT 9 3 06 JUN 2012 BASE SUPPORT

5. Section K is revised as follows:

i. DELETE: FAR clause 52.234-03 NOTICE OF EARNED VALUE MANAGEMENT

SYSTEM - POST AWARD IBR (JUL 2006)

ii. FAR 52.204-08 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (MAR 2012) paragraph (c)(2) is revised:

FROM:

(2) The following certifications are applicable as indicated by the Contracting Officer:

[Contracting Officer check as appropriate.]

X ------(i) 52.219-22, Small Disadvantaged Business Status.

X ------(A) Basic.

X ------(B) Alternate I.

X ------(ii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products.

X ------(iii) 52.222-48, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment Certification.

X ------(iv) 52.222-52 Exemption from Application of the Service Contract Act to Contracts for Certain Services--Certification.

X ------(v) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPA-Designated Products (Alternate I only).

X ------(vi) 52.223-13, Certification of Toxic Chemical Release Reporting.

X ------(vii) 52.227-6, Royalty Information.

X ------ (A) Basic.

X ------ (B) Alternate I.

X ------(viii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.

TO:

(2) The following certifications are applicable as indicated by the Contracting Officer:

[Contracting Officer check as appropriate.]

------(i) 52.219-22, Small Disadvantaged Business Status.

------(A) Basic.

------(B) Alternate I.

---X---(ii) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products.

------(iii) 52.222-48, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment Certification.

------(iv) 52.222-52 Exemption from Application of the Service Contract Act to Contracts for Certain Services--Certification.

---X---(v) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPA-Designated Products (Alternate I only).

---X---(vi) 52.223-13, Certification of Toxic Chemical Release Reporting.

---X---(vii) 52.227-6, Royalty Information.

---X--- (A) Basic.

------ (B) Alternate I.

---X---(viii) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software.

iv. FARS 252.204-7007 ALTERNATE A, ANNUAL REPRESENTATIONS AND CERTIFICATIONS (MAR 2012) paragraph (d)(2) is revised:

FROM:

(2) The following representations or certifications in ORCA are applicable to this solicitation as indicated by the Contracting Officer: [Contracting Officer check as appropriate.]

---- (i) 252.209-7002, Disclosure of Ownership or Control by a Foreign Government.

---- (ii) 252.225-7000, Buy American Act--Balance of Payments Program Certificate.

---- (iii) 252.225-7020, Trade Agreements Certificate.

---- Use with Alternate I.

---- (iv) 252.225-7022, Trade Agreements Certificate--Inclusion of Iraqi End Products.

---- (v) 252.225-7031, Secondary Arab Boycott of Israel.

---- (vi) 252.225-7035, Buy American Act--Free Trade Agreements-Balance of Payments Program Certificate.

---- Use with Alternate I.

---- Use with Alternate II.

---- Use with Alternate III.

TO:

(2) The following representations or certifications in ORCA are applicable to this solicitation as indicated by the Contracting Officer: [Contracting Officer check as appropriate.]

--X-- (i) 252.209-7002, Disclosure of Ownership or Control by a Foreign Government.

--X-- (ii) 252.225-7000, Buy American Act--Balance of Payments Program Certificate.

--X-- (iii) 252.225-7020, Trade Agreements Certificate.

---- Use with Alternate I.

--X-- (iv) 252.225-7022, Trade Agreements Certificate--Inclusion of Iraqi End Products.

--X-- (v) 252.225-7031, Secondary Arab Boycott of Israel.

---- (vi) 252.225-7035, Buy American Act--Free Trade Agreements-Balance of Payments Program Certificate.

---- Use with Alternate I.

---- Use with Alternate II.

---- Use with Alternate III.

6. Exhibit A, Contract Data Requirements List (CDRL), DD Form 1423-1, A Series (A001 - A019), is revised and dated 6 June 2012.

7. Attachment 1, Basic Contract Statement of Work, Entitled Space Vehicles Advanced Technology, is revised and dated 6 June 2012.

8. Attachment 5, Task Order 0003, Statement of Work Entitled "Integrated Structural Systems (ISS)" is revised and dated 6 June 2012.

9. Attachment 8, Task Order 0006, Statement of Work Entitled "Space Situational Awareness (SSA)" is revised and dated 6 June 2012.

10. Attachment 9, Base Support, is revised and dated 6 June 2012.

11. The following are revised in Section L:

i. Paragraph 6.1.3 change as follows:

FROM:

6.1.3 Section G - Contract Administrative Data

Refer to Section G of the solicitation and complete all fill-ins

TO:

6.1.3 Section G - Contract Administrative Data

Refer to Section G of the solicitation.

ii. Paragraph 6.1.4 change as follows:

FROM:

6.1.4 Section H - Special Contract Requirements

Refer to Section H of the solicitation and complete all fill-ins

TO:

6.1.4 Section H - Special Contract Requirements

Refer to Section H of the solicitation.

iii. AFMC Clause 5352.209-9001, Potential Organizational Conflict of Interest (OCT 2010)(TAILORED), paragraph (a)(2) is revised as follows:

FROM:

(2) As a part of the proposal, the offeror shall provide the Contracting Officer with complete information of previous or ongoing work that is in any way associated with the contemplated acquisition.

TO:

(2) As a part of the proposal, the offeror shall provide the Contracting Officer with complete information of previous or ongoing work that is in any way associated with the contemplated acquisition to be included in Volume IV, Contract Documentation, if applicable.

iv. Paragraph 5.4 Funding Profile is revised as follows:

FROM:

Submit funding requirements by type of funds, by fiscal year, supported by monthly/quarterly projections of expenditures, commitments, and termination expense. Note that the funding schedules must be consistent with any imposed Government budgetary constraints.

TO:

Provide funding profiles for each task order (Task Orders 0001-0006) by Offeror Fiscal Year. The proposed funding schedules must be consistent with any imposed Government budgetary constraints (Section L, 1.1 Budget/Funding Information, above).

LIST OF ATTACHMENTS

DOCUMENT PGS DATE TITLE

EXHIBIT A 19 06 JUN 2012 CONTRACT DATA REQUIREMENTS LIST (CDRL),

DD FORM 1423-1, A SERIES (A001 - A019)

ATTACHMENT 1 10 06 JUN 2012 BASIC CONTRACT STATEMENT OF WORK

ENTITLED SPACE VEHICLES ADVANCED

TECHNOLOGY

ATTACHMENT 5 7 06 JUN 2012 TASK ORDER 0003, STATEMENT OF WORK

ENTITLED "INTEGRATED STRUCTURAL

SYSTEMS (ISS)"

ATTACHMENT 8 2 06 JUN 2012 TASK ORDER 0006, STATEMENT OF WORK

ENTITLED "SPACE SITUATIONAL AWARENESS

(SSA)"

ATTACHMENT 9 4 06 JUN 2012 BASE SUPPORT

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.: 0002

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

C. CATEGORY..............................: OTHER – IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A001

2. TITLE OF DATA ITEM............: Contract Funds Status Report

3. SUBTITLE..................................: Task Order Specific

4. AUTHORITY.............................: DI-MGMT-81468

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RVS

7. DD250 REQ................................: Lt

8. APP CODE.................................: No

9. DIST. STATEMENT REQUIRED......: See Blk 16

10. FREQUENCY......................................: See Blk 16

11. AS OF DATE........................................: Contract

Award

12. DATE OF FIRST SUBMISSION: See Blk 16

13. DATE OF SUBSEQUENT SUBM.: See Blk 16

14. DISTRIBUTION

A. ADDRESSEES

B. COPIES

Refer to Block 16 and Task Orders of the SVAT contract for additional distribution instructions. Instructions vary per

Task Order and provide additional guidance in regard to the requirements for Blocks 14A and 14B of this CDRL.

DRAFT FINAL

ACO 0 LT

AFRL/RVS 0 1

AFRL/RVKV 0 LT

15. TOTAL: 0 1

16. REMARKS

BBllkk 44:: TTaaiilloorriinngg

-- CCoonnttrraaccttoorr ffoorrmmaatt iiss eennccoouurraaggeedd.. AAllll ffiinnaanncciiaall ddaattaa sshhoouulldd bbee pprreesseenntteedd iinn aa ffoorrmmaatt tthhaatt ffaacciilliittaatteess iinntteerrpprreettaattiioonn..

BBllkk 99:: All documentation shall be marked I.A.W. DoDD 5230.24 with the following distribution statement: “DISTRIBUTION STATEMENT D. Distribution authorized to DOD and DOD contractors only; Critical Technology, DATE. Other requests for this document shall be referred to the Air Force Research Laboratory/RVSV, RVSS, or RVSE (depending on the Task Order), Contracting Officer Representative (COR), 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, as amended, Title 50, U.S.C. App 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DOD Directive 5230.25.”

Blk 10 - 13: First report submitted within 10 working days after completion of the first full month following task order award.

Monthly thereafter for the duration of the contract. Last submission shall be at contract completion.

Note: Unencrypted E-mail transmittal is not permitted.

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Lawrence Ware, AFRL/RVSV I. APPROVED BY: K. Kinifick

H. DATE: 6 June 2012 J. DATE: 6 June 2012

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 19 Pages

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.: 0002

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

C. CATEGORY..............................: OTHER IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A002

2. TITLE OF DATA ITEM............: STATUS REPORT

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

4. AUTHORITY.............................: DI-MGMT-80368A

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RVS

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

8. APP CODE.................................: No

9. DIST. STATEMENT REQUIRED........:See Blk 16

10. FREQUENCY.......................................: See Blk 16

11. AS OF DATE........................................: Contract

Award

B. COPIES

Refer to Block 16 and Task Orders of the SVAT contract for additional distribution instructions. Instructions vary per

Task Order and provide additional guidance in regard to the requirements for Blocks 14A and 14B of this CDRL.

Blk 4: Tailoring:

- Contractor format is encouraged. All financial data should be presented in a format that facilitates interpretation.

Blk 9: All documentation shall be marked IAW DODD 5230.24 with the following distribution statement: “DISTRIBUTION STATEMENT D. Distribution authorized to DOD and DOD contractors only; CRITICAL TECHNOLOGY; DATE. Other requests for this document shall be referred to the Air Force Research

Laboratory/RVSV, RVSS, or RVSE (depending on the Task Order), 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, as amended, Title 50, U.S.C. App 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.”

Blk 10-13: First report submitted within 10 working days after completion of the first full month following task order award.

Quarterly or monthly thereafter as defined per task order for the duration of the contract. Last submission shall be at contract completion.

G. PREPARED BY: L. Ware AFRL/RVSV I. APPROVED BY: K. Kinifick

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 2 of 19 Pages

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.: 0002

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

C. CATEGORY..............................: OTHER – IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A003

2. TITLE OF DATA ITEM............: Scientific and Technical Report and Checklist

3. SUBTITLE..................................: Final Report

4. AUTHORITY.............................: DI-MISC-80711A

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RVS

7. DD250 REQ................................: DD

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

9. DIST. STATEMENT REQUIRED........:See Blk 16

10. FREQUENCY.......................................: See Blk 16

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

B. COPIES

Refer to Block 16 and Task Orders of the SVAT contract for additional distribution instructions. Instructions vary per Task Order and provide additional guidance in regard to the requirements for Blocks 14A and 14B of this

CDRL.

FINAL CRC

AFRL/RVSS 1 1

AFRL/RVKV LT LT

ACO LT LT

15. TOTAL: 1 1

THIS REPORT WILL BE PUBLISHED WITH THE DEFENSE TECHNICAL INFORMATION CENTER (DTIC) BY AFRL STINFO OFFICE. Under no circumstances shall the contractor submit either the final report or the camera-ready technical report to DTIC.

Blk 4: GUIDANCE FOR PREPARATION OF THE REPORT: The Scientific and Technical Report shall be prepared I.A.W. AFRL ANSI/NISO Standard Z39.18-2005 located at:

http://www.kirtland.af.mil/prs. If the Final Report contains data that is being delivered with company proprietary data rights IAW data rights assertions in this contract, the company proprietary data rights material shall be delivered as a separate, appropriately-marked Volume* to the Final Report.

The contractor shall complete and submit an SF 298 Report Documentation Page, with the final report. The SF 298 is available at:

http://www.kirtland.af.mil/shared/media/document/AFD-070425-037.doc. The contractor shall complete the following blocks of the SF298: Blocks 2-5a, 6, 7, 8 and 13 (if applicable), 14-16c.

The contractor shall complete and sign the AFRL Form 25, AFRL Quality Final Technical Report Checklist, and submit it with the final report. The Checklist is available at:

http://kirtland.af.mil/prs. If the completed and signed AFRL Form 25 does not accompany the final report, the deliverable is considered incomplete. Incomplete final reports will be immediately returned to the contractor. Following AFRL technical and STINFO reviews, any revisions required will be returned to the contractor.

The contractor shall deliver editable electronic copies of the final report. The electronic copies shall be an editable. pdf file and the most current version of Microsoft Word. A CD-ROM

(CD-R) is the acceptable media for submittal. (CD-RWs are not acceptable.) Electronic media shall be marked IAW the AFRL ANSI/NISO Standard Z39.18-2005 guidelines. Submission via unencrypted or unsecure email is not permitted.

Blk7: Submit Final Report with letter of transmittal and the DD250 to the designated project manager. In preparing the final DD250 for the contract, code the shipment number with a “Z”.

Blk 9: All technical data containing unlimited rights data (including electronic media) shall be marked I.A.W. DoDD 5230.24 with Distribution Statement B. Distribution authorized to U.S.

Government agencies only; CRITICAL TECHNOLOGY; DATE. Other requests for this document shall be referred to Air Force Research Laboratory/RVS, 3550 Aberdeen Avenue, SE, Kirtland AFB, NM 87117-5776. Other requests for this document shall be referred to Air Force Research Laboratory/RVSV, RVSS, or RVSE (depending on the Task Order), 3550 Aberdeen

Avenue, SE, Kirtland AFB, NM 87117-5776. ADD THIS ENTIRE DISTRIBUTION STATEMENT TO THE BOTTOM OF EVERY PAGE OF THE REPORT EXCEPT THE

SF298.

*Any Volume containing company proprietary data rights material (including electronic media) shall be marked I.A.W. DoDD 5230.24 with Distribution Statement [must enter B or E here]:

Distribution authorized to[fill in statement]; Proprietary Information: DFARS [insert type] Data Rights; [author fill in date of report (ddmmmyy)]. Other requests for this document shall be referred to Air Force Research Laboratory/RVS, 3550 Aberdeen Avenue, SE, Kirtland AFB, NM 87117-5776. Other requests for this document shall be referred to Air Force Research

Laboratory/RVSV, RVSS, or RVSE (depending on the Task Order), 3550 Aberdeen Avenue, SE, Kirtland AFB, NM 87117-5776. ADD THIS ENTIRE DISTRIBUTION STATEMENT

TO THE BOTTOM OF EVERY PAGE OF THE REPORT EXCEPT THE SF298.

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, as amended, Title 50, U.S.C. App 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.”

All technical data (including electronic media) shall be marked with the following statement. “DESTRUCTION NOTICE – For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.”

Blks 10-13: The contractor shall deliver the Scientific and Technical Report, in final format, no later than the date specified in the Schedule, CLIN 0002. The USAF will review and, if necessary, return the final report with comments no later than the date specified in the Schedule, CLIN 0002. If the report is returned to the contractor with comments, the contractor shall deliver the camera-ready copy of the report no later than the date specified in the Schedule, CLIN 0002.

NOTE: Headings in Block 14B, Copies have been changed. “Draft” is changed to “final” and “Final” (in second column) is changed to “CRC” (camera-ready copy).

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 3 of 19 Pages http://www.kirtland.af.mil/prs http://www.kirtland.af.mil/shared/media/document/AFD-070425-037.doc http://kirtland.af.mil/prs

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.: 0002

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

C. CATEGORY..............................: OTHER – IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A004

2. TITLE OF DATA ITEM............: Test and Inspection Report

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

4. AUTHORITY.............................: DI-NDTI-80809B

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RVS

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

8. APP CODE.................................: No

9. DIST. STATEMENT REQUIRED........:See Blk 16

10. FREQUENCY.......................................: See Blk 16

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

B. COPIES

Refer to Block 16 and Task Orders of the SVAT contract for additional distribution instructions. Instructions vary per Task Order and provide additional guidance in regard to the requirements for Blocks 14A and 14B of this

Blk 4: Tailoring:

- Contractor format is encouraged.

Blk 9: All documentation shall be marked IAW DoDD 5230.24 with the following distribution statement; “DISTRIBUTION STATEMENT D. Distribution authorized to DoD and DoD contractors only; Critical Technology, DATE. Other requests for this document shall be referred to the Air Force Research Laboratory/ RVSV, RVSS, or RVSE (depending on the Task Order), SVAT Contracting Officer Representative (COR), 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 1079, as amended, Title 50, U.S.C. App 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.”

Blks 10 - 13: As defined per task order.

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 4 of 19 Pages

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.: 0002

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

C. CATEGORY..............................: OTHER – IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A005

2. TITLE OF DATA ITEM............: System Safety Hazard Analysis Report (SSHA)

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

4. AUTHORITY.............................: DI-SAFT-80101B

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RVS

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

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

9. DIST. STATEMENT REQUIRED........:See Blk 16

10. FREQUENCY.......................................: See Blk 16

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

B. COPIES

Refer to Block 16 and Task Order of the SVAT contract for additional distribution instructions. Instructions vary per Task Order and provide additional guidance in regard to the requirements for Blocks 14A and 14B of this

AFRL/RVS 1 1

AFRL/RVKV LT LT

AFRL/RVOT (SAFETY)

Blk 4: Tailoring:

- Contractor format is encouraged. All data should be presented in a format that facilitates interpretation.

Blk 9: All documentation shall be marked IAW DoDD 5230.24 with the following distribution statement; “DISTRIBUTION STATEMENT D. Distribution authorized to DoD and DoD contractors only; Critical Technology, DATE. Other requests for this document shall be referred to the Air Force Research Laboratory/RVSV, RVSS, or RVSE (depending on the Task Order), SVAT Contracting Officer Representative (COR), 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 1079, as amended, Title 50, U.S.C. App 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.”

Blk 10: Once per task order

Blk 11-12: The draft SSHA shall be delivered within 15 calendar days after initial task order award. The government will review and provide comments to the draft plan within 15 calendar days after receipt of the draft. Upon receipt of the comments, the contractor shall take no more than 15 calendar days to incorporate all required changes and deliver the final version of the report.

Blks 13: Not applicable – one submission per task order IAW Blk 10-12 tailoring instructions.

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 5 of 19 Pages

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.: 0002

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

C. CATEGORY..............................: OTHER – IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A006

2. TITLE OF DATA ITEM............: Environmental Health Safety Plan (EHSP)

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

4. AUTHORITY.............................: DI-ENVR-81375

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RVS

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

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

9. DIST. STATEMENT REQUIRED........:See Blk 16

10. FREQUENCY.......................................: See Blk 16

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

B. COPIES

Refer to Block 16 and Task Orders of the SVAT contract for additional distribution instructions. Instructions vary per Task Order and provide additional guidance in regard to the requirements for blocks 14A and 14B of this

CDRL

DRAFT FINAL

AFRL/RVS 1 1

AFRL/RVKV LT LT

AFRL/RVOT (SAFETY)

Blk 4: Tailoring:

- Contractor Format is encouraged. All data should be presented in a format that facilitates interpretation.

Blk 9: All documentation shall be marked IAW DoDD 5230.24 with the following distribution statement; “DISTRIBUTION STATEMENT D. Distribution authorized to DoD and DoD contractors only; Critical Technology, DATE. Other requests for this document shall be referred to the Air Force Research Laboratory/ RVSV, RVSS, or RVSE (depending on the Task Order), SVAT Contracting Officer Representative (COR), 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 1079, as amended, Title 50, U.S.C. App 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.”

Blk 10: Once per task order

Blk 11, 12: The draft EHSP shall be delivered within 15 calendar days after initial task order award. The government will review and provide comments to the draft plan within 15 calendar days after receipt of the draft. Upon receipt of the comments, the contractor shall take no more than 15 calendar days in incorporate all required changes and deliver the final version of the report.

Blk 13: Not applicable – one submission per task order IAW Blk 10.

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 6 of 19 Pages

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.: 0003

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

C. CATEGORY..............................: OTHER – IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A007

2. TITLE OF DATA ITEM............: Software Design Description (SDD)

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

4. AUTHORITY.............................: DI-IPSC-81435A

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RVS

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

8. APP CODE.................................: N

9. DIST. STATEMENT REQUIRED........:See Blk 16

10. FREQUENCY.......................................: See Blk 16

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

Refer to Block 16 and Task Orders of the SVAT contract for additional distribution instructions. Instructions vary per Task Order and provide additional guidance in regard to the requirements for blocks 14A and 14B of this

CDRL

DRAFT FINAL

AFRL/RVS 0 1

Blk 9: The software design description (SDD) shall be marked IAW DoDD 5230.24 with the following distribution statement; “DISTRIBUTION STATEMENT D.

Distribution authorized to DoD and DoD contractors only; Critical Technology, DATE. Other requests for this document shall be referred to the Air Force Research

Laboratory/RVSV, RVSS, or RVSE (depending on the Task Order), SVAT Contracting Officer Representative (COR), 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 1079, as amended, Title 50, U.S.C. App 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.”

Blk 10-13: As agreed to between Government and Contractor. Contractor Format is acceptable. Submission via unencrypted or unsecure email is not permitted.

G. PREPARED BY: L. Ware AFRL/RVSS I. APPROVED BY: K. Kinifick

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 7 of 19 Pages

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.: 0003

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

C. CATEGORY..............................: OTHER – IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A008

2. TITLE OF DATA ITEM............: Software Requirements Specification

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

4. AUTHORITY.............................: DI-IPSC-81433A

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RVS

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

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

9. DIST. STATEMENT REQUIRED........:See Blk 16

10. FREQUENCY.......................................: See Blk 16

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

Refer to Block 16 and Task Orders of the SVAT contract for additional distribution instructions. Instructions vary per Task Order and provide additional guidance in regard to the requirements for blocks 14A and 14B of this

CDRL

DRAFT FINAL

AFRL/RVS 1 1

Blk 4: Contractor Format is encouraged. Specifications should be presented in a format that facilitates interpretation.

Blk 9: All documentation shall be marked IAW DoDD 5230.24 with the following distribution statement; “DISTRIBUTION STATEMENT D. Distribution authorized to DoD and DoD contractors only; Critical Technology, DATE. Other requests for this document shall be referred to the Air Force Research Laboratory/ RVSV, RVSS, or RVSE (depending on the Task Order), SVAT Contracting Officer Representative (COR), 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 1079, as amended, Title 50, U.S.C. App 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.”

Blk 10-13: Format and frequency as agreed to between Government and contractor.

Final Software Requirements Specifications will be submitted when requirement specification are completed. The task order manager may direct preparation of interim requirements specifications as might be in the government’s interest. Final and interim submissions are due no more than 60 calendar days after the draft is returned from the Government. Contractor format is acceptable. Submission via unencrypted or unsecure email is not permitted.

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 8 of 19 Pages

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.: 0003

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

C. CATEGORY..............................: OTHER – IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A009

2. TITLE OF DATA ITEM............: Software Test Report

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

4. AUTHORITY.............................: DI-IPSC-81440A

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..............: AFRL/RVS

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

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

9. DIST. STATEMENT REQUIRED.......:See Blk 16

10. FREQUENCY......................................: See Blk 16

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

Refer to Block 16 and Task Orders of the SVAT contract for additional distribution instructions. Instructions vary per Task Order and provide additional guidance in regard to the requirements for blocks 14A and 14B of this

CDRL

DRAFT FINAL

AFRL/RVS 1 1

Blk 4: Contractor Format is encouraged. All data should be presented in a format that facilitates interpretation.

Blk 9: All documentation shall be marked IAW DoDD 5230.24 with the following distribution statement; “DISTRIBUTION STATEMENT D. Distribution authorized to DoD and DoD contractors only; Critical Technology, DATE. Other requests for this document shall be referred to the Air Force Research Laboratory/ RVSV, RVSS, or RVSE (depending on the Task Order), SVAT Contracting Officer Representative (COR), 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 1079, as amended, Title 50, U.S.C. App 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.”

Blk 10-13: Format and frequency as agreed to between Government and contractor.

No more than 60 calendar days after the draft is returned from the Government. Contractor format is acceptable. Submission via unencrypted or unsecure email is not permitted.

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 9 of 19 Pages

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.: 0002

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

C. CATEGORY..............................: OTHER – IDIQ Contract

D. SYSTEM/ITEM........: Space Vehicles Advanced Technology (SVAT)

E. CONTRACT/PR NO.: FA9453-11-R-0287

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

1. DATA ITEM NO........................: A010

2. TITLE OF DATA ITEM............: Contract Performance Report (CPR)

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

4. AUTHORITY.............................: DI-MGMT-81466A

5. CONTRACT REFERENCE......: Task Order Specific

6. REQUIRING OFFICE..............: AFRL/RVS

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

8. APP CODE.................................: No

9. DIST. STATEMENT REQUIRED........:See Blk 16

10. FREQUENCY.......................................: See Blk 16

11. AS OF DATE..................................