Attachment_2-_CDRL.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........: ASSISTT

E. CONTRACT/PR NO. FA9453-17-S-0005 CALL 002

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..............: RVSV

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

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

9. DIST. STATEMENT REQUIRED......: E

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/RVSV 0 1

AFRL DET 8/RVKV 0 LT

ACO 0 LT

15. TOTAL: 0 1

16. REMARKS

Blk 4: Tailored: Only 10.1-10.2.2, 10.2.4-10.2.10, 10.2.11.3-10.2.11.4, 10.2.11.9, 10.2.13; 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 Distribution Statement E, and other required markings, shown indented below:

“Distribution authorized to DoD components only; Proprietary Information; Critical Technology, Export Controlled; [contractor fill in date of report (dd mmm yy)]. Other requests for this document shall be referred to AFRL/RVSV, 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.)

“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 I.A.W. the provisions of the DoD Directive 5230.25.” (ADD “WARNING: EXPORT CONTROLLED” TO THE BOTTOM OF EVERY PG 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 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: Andrew Williams I. APPROVED BY: Mark Cruz H. DATE: 21 December 2017 J. DATE: 10 January 2018

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

E. CONTRACT/PR NO. FA9453-17-S-0005 CALL 002

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

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

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

3. SUBTITLE..................................: Quarterly Report

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

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

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

9. DIST. STATEMENT REQUIRED......: D

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

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

AFRL DET 8/RVKV 0 Ltr ACO 0 Ltr

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 Distribution Statement D, and other required markings, shown indented below:

“Distribution authorized to DoD and U.S. DoD contractors only; Critical Technology, Export Controlled; [contractor fill in date of report (dd mmm yy)]. Other requests for this document shall be referred to AFRL/RVSV, 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.)

“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 I.A.W. the provisions of the DoD Directive 5230.25.” (ADD “WARNING: EXPORT CONTROLLED” TO THE BOTTOM OF EVERY PG OF THE REPORT EXCEPT THE SF

“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 calendar quarter following award. Quarterly 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: 21 December 2017 J. DATE: 10 January 2018

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 2 of 4 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.: TBD

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

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

D. SYSTEM/ITEM........: ASSISTT

E. CONTRACT/PR NO. FA9453-17-S-0005 CALL 002

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

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

2. TITLE OF DATA ITEM............: Operation and Maintenance Instructions for Research and Development (R&D) Equipment

3. SUBTITLE..................................: Prototype Design and Operation Document

4. AUTHORITY.............................: DI-MISC-81414 (http://quicksearch.dla.mil)

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

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

9. DIST. STATEMENT REQUIRED......: D

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

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

AFRL DET 8/RVKV 0 Ltr ACO 0 Ltr

Blk 4: This report shall include complete design documentation of the prototype device developed under this contract. This document must include operation, installation, and preventive maintenance instructions. Required data includes safety considerations, interconnection diagrams, logical diagrams, operating procedures, parts and components list, test print list, and normal operating parameters. CONTRACTOR FORMAT IS PREFERRED. Submission via unencrypted or unsecure email is not permitted.

Blk 9: All technical data (including electronic media/CD-R) shall be marked I.A.W. DoDI 5230.24 with Distribution Statement D, and other required markings, shown indented below:

“Distribution authorized to DoD and U.S. DoD contractors only; Critical Technology, Export Controlled; [contractor fill in date of report (dd mmm yy)]. Other requests for this document shall be referred to AFRL/RVSV, 3550 Aberdeen Avenue, SE, Kirtland AFB, NM 87117-5776.” (ADD THIS ENTIRE DISTRIBUTION STATEMENT TO

“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 I.A.W. the provisions of the DoD Directive 5230.25.” (ADD “WARNING: EXPORT CONTROLLED” TO THE BOTTOM OF EVERY PG OF THE REPORT EXCEPT THE SF

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

Blks 12: The final “as built” design documentation package(s) shall be delivered in accordance with the Statement of Work and/or contract schedule.

Blk 14: The contractor shall distribute the design documentation package(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: 21 December 2017 J. DATE: 10 January 2018

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 3 of 4 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.: TBD

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

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

D. SYSTEM/ITEM........: ASSISTT

E. CONTRACT/PR NO. FA9453-17-S-0005 CALL 002

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

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

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

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

4. AUTHORITY.............................: DI-MISC-80711A (http://quicksearch.dla.mil)

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

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

9. DIST. STATEMENT REQUIRED......: D

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

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

FINAL CRC

AFRL/RVSV 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 Distribution Statement D, and other required markings, shown indented below:

“Distribution authorized to DoD and U.S. DoD contractors only; Critical Technology, Export Control; [contractor fill in date of report (dd mmm yy)]. Other requests for this document shall be referred to AFRL/RVSV, 3550 Aberdeen Avenue, SE, Kirtland AFB, NM 87117-5776.” (ADD THIS ENTIRE DISTRIBUTION STATEMENT TO

“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 I.A.W. the provisions of the DoD Directive 5230.25.” (ADD “WARNING: EXPORT CONTROLLED” TO THE BOTTOM OF EVERY PG OF THE REPORT EXCEPT THE SF

“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 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».

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: 21 December 2017 J. DATE: 10 January 2018

DD Form 1423-1, SEP 97 (EG) (Computer Generated) PREVIOUS EDITIONS ARE OBSOLETE Page 4 of 4 Pages http://quicksearch.dla.mil/ http://www.afrlnewmexico.com/stinfo-1

A. ADDRESSEES