Attachment_3-_CDRLs.pdf

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.: TBD

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

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

D. SYSTEM/ITEM........: SCOTCH

E. CONTRACT/PR NO. FA9453-17-S-0005 CALL 001

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

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

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

3. SUBTITLE..................................: Monthly Report

4. AUTHORITY.............................: DI-MGMT-81468 (http://quicksearch.dla.mil)

5. CONTRACT REFERENCE.....:

SOO Para: TBD

6. REQUIRING OFFICE..................: AFRL/RVB

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

12. DATE OF FIRST SUBMISSION……: See Blk 16

13. DATE OF SUBSEQUENT SUBM…...: See Blk 16

14. DISTRIBUTION

A. ADDRESSEES

B. COPIES

Draft Final

AFRL/RVB 0 1

AFRL DET 8/RVKV 0 LT

ACO 0 LT

15. TOTAL: 0 1

16. REMARKS

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

Blk 9: All technical data (including electronic media/CD-R) shall be marked I.A.W. DoDI 5230.24 with the following distribution statement:

“DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors only; Critical Technology, dd mmm yy” and other required markings below:

“Other requests for this document shall be referred to AFRL/RVBYE, 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 SF 298.)

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

Blk 10 - 13: First report submitted within 10 working days after completion of the first full month following contract award. Monthly thereafter for the duration of the contract. Last submission shall be at contract completion.

Note: Unencrypted E-mail transmittal is not permitted.

Blk 14: The contractor shall distribute Contract Funds Status Reports in accordance with Blk 14. When the addressee’s copy is identified by “Ltr”, send only a copy of the transmittal letter to that addressee.

17. PRICE GROUP: 18. ESTIMATED TOTAL PRICE :

G. PREPARED BY: Kimberly Knobel I. APPROVED BY: Mark Cruz H. DATE: 1 December 2017 J. DATE: 19 December 2017

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 3 Pages http://quicksearch.dla.mil/

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.: TBD

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

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

D. SYSTEM/ITEM........: SCOTCH

E. CONTRACT/PR NO. FA9453-17-S-0005 CALL 001

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

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

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

3. SUBTITLE..................................: Monthly Report

4. AUTHORITY.............................: DI-MGMT-80368A (http://quicksearch.dla.mil)

5. CONTRACT REFERENCE......:

SOO Para: TBD

6. REQUIRING OFFICE...................: RVB

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

Draft Final

AFRL/RVB 0 1

AFRL DET 8/RVKV 0 Ltr ACO 0 Ltr

15. TOTAL: 0 1

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

Blk 9: All technical data (including electronic media/CD-R) shall be marked I.A.W. DoDI 5230.24 with the following distribution statement:

“DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors only; Critical Technology, dd mmm yy” and other required markings below:

“Other requests for this document shall be referred to AFRL/RVBYE, 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 SF 298.)

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

Blk 10 - 13: First report submitted within 10 working days after completion of the first full month following contract award. Monthly thereafter for the duration of the contract. Last submission shall be at contract completion.

Note: Unencrypted E-mail transmittal is not permitted.

Blk 14: The contractor shall distribute Status Reports in accordance with Blk 14. When the addressee’s copy is identified by “Ltr”, send only a copy of the transmittal letter to that addressee.

H. DATE: 1 December 2017 J. DATE: 19 December 2017

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 2 of 3 Pages http://quicksearch.dla.mil/

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.: TBD

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

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

D. SYSTEM/ITEM........: SCOTCH

E. CONTRACT/PR NO. FA9453-17-S-0005 CALL 001

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

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 (http://quicksearch.dla.mil)

5. CONTRACT REFERENCE......:

6. REQUIRING OFFICE..................: RVB

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

FINAL CRC

AFRL/RVB 1 1

AFRL DET 8/RVKV Ltr Ltr ACO Ltr Ltr

15. TOTAL: 1 1

THE REPORT WILL BE PUBLISHED WITH THE DEFENSE TECHNICAL INFORMATION CENTER (DTIC) BY AFRL STINFO OFFICE. Under no circumstances shall the contractor submit any version of the scientific and technical report to DTIC.

Blk 4: GUIDANCE FOR PREPARATION OF THE REPORT: The Scientific and Technical Report shall be prepared I.A.W. the most current AFRL ANSI/NISO Standard Z39.18-2005, or other most current report preparation guidance. The contractor shall complete the most current SF 298 Report Documentation Page, and submit it with the report.

The contractor shall complete the following blocks of the SF 298: Blocks 2-5a, 6, 7, 8 and 13 (if applicable), and 14-16c. Incomplete reports will be immediately returned to the contractor. Following AFRL technical and STINFO reviews, any revisions required will be returned to the contractor. NOTE: The report preparation guidance and SF 298, are available at: http://www.afrlnewmexico.com/stinfo-1.

The contractor shall deliver two editable electronic copies of the 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 I.A.W. the AFRL ANSI/NISO Standard Z39.18-2005 guidelines, or other most current report preparation guidance. Submission via unencrypted or unsecure email is not permitted.

Blk 7: UPON NOTIFICATION OF ACCEPTANCE OF THE SCIENTIFIC AND TECHNICAL REPORT FROM THE PROGRAM OFFICE, the contractor shall submit the final Receiving Report (DD Form 250) in WAWF. In preparing the final DD Form 250, code the shipment number with a “Z.” Do not upload the Scientific and Technical Report into WAWF or DTIC. NOTE: SUBMITTAL OF THE DD FORM 250Z PRIOR TO ACCEPTANCE NOTIFICATION WILL RESULT IN REJECTION OF THE DD FORM

250Z FINAL RECEIVING REPORT.

Blk 9: All technical data (including electronic media/CD-R) shall be marked I.A.W. DoDI 5230.24 with the following distribution statement:

“DISTRIBUTION STATEMENT C. Distribution authorized to U.S. Government agencies and their contractors only; Critical Technology, dd mmm yy” and other required markings below:

“Other requests for this document shall be referred to AFRL/RVBYE, 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 SF 298.)

“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 TBD». The USAF will review and, if necessary, return the report with comments no later than the date specified in the Schedule, «CLIN TBD». 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 TBD».

Blk 14: The contractor shall distribute the Scientific and Technical Report (final/CRC version(s)) in accordance with Blk 14. When the addressee’s copy is identified by “Ltr”, send only a copy of the transmittal letter to that addressee.

H. DATE: 2 December 2017 J. DATE: 19 December 2017

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 3 of 3 Pages http://quicksearch.dla.mil/ http://www.afrlnewmexico.com/stinfo-1

A. ADDRESSEES