First Article Test Report.pdf

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 (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 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

001 A X-NDTI

W4 Cable Assembly FD20202500398

A001 Test/Inspection Report First Article Test Report

DI-NDTI-80809 FD20202500398 GUMCB

LT

A D

One/R

N/A

120DAC

N/A Submit electronically in

Wide Area Work Flow

(WAWF). Upload as an attachment during the invoice process.

Provide notification of delivery to:

414gumc.buycontracts

@us.af.mil eddie.diehl@us.af.mil 1 1 naomi.strickler@us.af. 1 1 mil khalid.snounou@us.af. 1 1 mil

3 3 0

Block 4: Contractor format acceptable.

Paragraph 10.2 clarified as follows:

a. All dimensions and tolerances specified on the manufacturing data shall be listed in one column, with the actual corresponding reading obtained from the inspection of the part listed in another column.

b. Materials used in the manufacture of the "First Article" shall be identified and certified along with a copy of material purchase requirements as conforming to applicable data requirements.

c. Material processing, including finish requirements (plating, heat treatment, welding, anodizing, painting, etc.) utilized in the manufacture of "First Article" item shall be identified and certified as conforming to applicable requirements. A copy of the purchase order certifying the process accomplished at other than contractor facility shall be included.

Block 9: Per DoDI 5200.48 CUI markings for unclassified DoD documents will include the acronym “CUI” in the banner and footer of every page of the document. Data submittal shall be marked with the following on the cover page:

Distribution Statement D: Distribution authorized to the Department of Defense and U.S.

DoD contractors only CTI 31-Dec-2024. Other requests for this document must be referred to 414 SCMS/GUEA, 6031 Gum Lane, Bldg. 1227, Hill AFB, UT 84056-5826.

WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Section 2751 of Title 22, United States Code) or the Export Control Reform Act of 2018 (Chapter 58 Sections 4801-4852 of Title 50, United States Code). Violations of these export laws are subject to severe criminal penalties.

Disseminate in accordance with provisions of DoD Directive 5230.25 and DoD Instruction 2040.02.

DESTRUCTION NOTICE: For classified documents follow the procedures in DoD 5220.22-M, National Industrial Security Program Operating Manual (NISPOM), Section 5-705, or DoD 5200.1-R, Information Security Program, Chapter 6. For unclassified documents destroy by any method that will prevent disclosure of contents or reconstruction of the document.

Controlled by: USAF Controlled by: 414 SCMS CUI Category: Controlled Technical Information/ Export Controlled Distribution/Dissemination Control: Distribution Statement D POC: Eddie Diehl, eddie.diehl@us.af.mil

NSP

0.00

STRICKLER.NAOMI.M.15073272

Digitally signed by

STRICKLER.NAOMI.M.1507327296

Date: 2024.12.31 12:43:09 -07'00'

12/31/2024 SNOUNOU.KHALID.S.1522

719745

Digitally signed by

SNOUNOU.KHALID.S.1522719745

Date: 2025.01.06 08:54:31 -07'00'

1/6/2025

1 3 Adobe Professional 8.0

CONTRACT DATA REQUIREMENTS LIST

(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

001 A X-NDTI

W4 Cable Assembly FD20202500398

Block 10: Report shall be submitted concurrently with the "First Article" item either in the shipping container or separately if the report will not fit within the container unfolded. When shipped in the "First Article" container, report shall be enclosed in a paper or plastic envelope. NOTE: If report is shipped separate from the "First Article" send to Block 14 addressee.

Block 14: Submit Final FA Report electronically in Wide Area Work Flow (WAWF). Upload as an attachment during the invoice process.

Nomenclature:

NSN: 6150013093001; PN 25-63375-4; Lead, Test - W4 of Cable Assembly Set

2 3