Flare Data Logger CDRLs.pdf
PDF 329 KB Posted
- Attached to
- Flare Data Logger Federal contract opportunity
- Solicitation number
- FA8213-20-R-3021
About this file
This document contains seven Contract Data Requirements Lists (CDRLs) for the federal contract opportunity FA8213-20-R-3021 to develop a Flare Data Logger. The CDRLs require the following deliverables: a technical report on studies and services (A001); conceptual design drawings and models (A002); an explosive hazard classification data report (A003); operation and maintenance instructions (A004); status reports on a quarterly basis (A005); a contract summary report after completion (A006); and accident/incident reports within 30 days of occurrence (A007). The requiring agency is the Department of the Air Force Materiel Command Lifecycle Management Center at Hill Air Force Base. Delivery dates and distribution statements are specified for each data item. The electronic receiving report and distribution of reports are to be conducted through the Wide Area Workflow system using DoDAAC FA8213.
View the file
Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| FDL Section L Final.pdf | ||
| FA821320R3021.pdf | ||
| FDL Section M Final.pdf | ||
| AFMC 807 Quality Assurance Provisions_Special Inspection Requirements.pdf | ||
| REPSHIP.pdf | ||
| Flare Data Logger SOW (Final).pdf |
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Text version
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item)
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 Directorate (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 collection 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 MGMT
D. SYSTEM/ITEM
Flare Data Logger
E. CONTRACT/PR NO.
FD2020-20-50172
F. CONTRACTOR
1. DATA ITEM NO.
A001
2. TITLE OF DATA ITEM
Technical Report - Study/Services
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-MGMT-80508B
5. CONTRACT REFERENCE
SOW 4.1.4.1, 4.1.4.1.3.1, 4.1.5.1,
4.1.6.1.2, 4.2.2, 4.3.3, 7.2 and 9.2.
6. REQUIRING OFFICE
AFLCMC/EBHCC
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
C
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
N/A Draft
Final
Reg Repro
16. REMARKS
BLK 4: Follow format and preparations instructions as referenced in the Data Item Description.
BLK 7: Electronic receiving report required via internet Wide Area Work Flow (WAWF, DoDAAC FA8213) at: https://wawf.eb.mil. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement.
BLK 9: DISTRIBUTION STATEMENT C. Distribution authorized to the U.S.
Government agencies and their contractors (Administrative/Operational Use(Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHCC.
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.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
BLK 12: Contractor shall submit Final Contract Summary Report after completion of the initiative.
BLK 14: Submit report electronically in Microsoft Office or PDF format to the e-mail recipient(s) listed in below steve.kas.2@us.af.mil (AFLCMC/EBHCC) heather.schaefer.1@us.af.mil (AFLCMC/EBHCC)
FOB DESTINATION
EBH 20-105 -001
Terry McCurdy, AFLCMC/EBHTC, 586-0535
WAWF 0 1 0
DoDAAC, FA8213
15. TOTAL 0 1 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2020/04/14
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2020/04/16
18. ESTIMATED
TOTAL PRICE
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages
17. PRICE GROUP
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 Directorate (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 collection 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 SESS
D. SYSTEM/ITEM
Flare Data Logger
E. CONTRACT/PR NO.
FD2020-20-50172
F. CONTRACTOR
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM
Conceptual Design Drawings/Models
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SESS-81001E
5. CONTRACT REFERENCE
SOW par 4.1.8 & 4.2.7.1
6. REQUIRING OFFICE
AFLCMC/EBHCC
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
C
10. FREQUENCY
BLK16
12. DATE OF FIRST SUBMISSION
ASREQ
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Conceptual design drawings/ models shall be in the contractors or government’s format as specified on the TDP Option Selection Worksheet incorporated into the contract or purchase order, and in accordance with MIL-STD-31000.
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number, and Nomenclature. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at:
https://wawf.eb.mil.
BLK 8: DD250 will be signed by the Engineering POC addressee listed in BLK. 14(a) after final delivery has been approved by the government.
BLK 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S.
Government agencies and their contractors (Administrative/ Operational Use)(Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHCC.
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.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
BLK14: Submit report electronically in Microsoft Office or PDF format to e-mail recipient(s) listed below.
steve.kas.2@us.af.mil (AFLCMC/EBHCC) heather.schaefer.1@us.af.mil (AFLCMC/EBHCC)
FOB DESTINATION
EBH 20-114-001
Terry McCurdy, AFLCMC/EBHTC, 586-0535
AFLCMC/EBHCC 1 1 0
WAWF 0 1 0
DoDAAC,FA8213
15. TOTAL 1 2 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2020/04/29
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2020/04/29
18. ESTIMATED
TOTAL PRICE
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 Directorate (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 collection 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 SAFT
D. SYSTEM/ITEM
Flare Data Logger
E. CONTRACT/PR NO.
FD2020-20-50172
F. CONTRACTOR
1. DATA ITEM NO.
A003
2. TITLE OF DATA ITEM
Explosive Hazard Classification Data Report (EHCDR)
3. SUBTITLE
Interim Hazard Classification
4. AUTHORITY (Data Acquisition Document No.)
DI-SAFT-81299C
5. CONTRACT REFERENCE
SOW para 4.3.4
6. REQUIRING OFFICE
AFLCMC/EBHCC
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
C
10. FREQUENCY
1TIME
12. DATE OF FIRST SUBMISSION
90 DAC
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
N/A Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor format required.
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at:
https://wawf.eb.mil.
BLK 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S.
Government agencies and their contractors (Administrative/Operational Use)(Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHCC.
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.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
BLK 12: The contractor shall submit report 90 days prior to shipment of items.
BLK 14: Submit report electronically in Microsoft Office or PDF format. When the file size exceeds the limits of WAWF, submit via Optical Media to addressee in block 14 and the e-mail recipients listed below.
steve.kas.2.@us.af.mil (AFLCMC/EBHCC) heather.schaefer.1@us.af.mil (AFLCMC/EBHCC)
FOB DESTINATION
EBH 20-097-001
Terry McCurdy, AFLCMC/EBHTC, 586-0535
AFLCMC/EBHCC 0 1 0
6033 Elm Lane
Bldg 1247
Hill AFB, UT
84056
Attn: Steve Kas
WAWF 0 1 1
DoDAAC, FA8213
15. TOTAL 0 2 1
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2020/04/14
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2020/04/16
18. ESTIMATED
TOTAL PRICE
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 Directorate (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 collection 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 MISC
D. SYSTEM/ITEM
Flare Data Logger
E. CONTRACT/PR NO.
FD2020-20-50172
F. CONTRACTOR
1. DATA ITEM NO.
A004
2. TITLE OF DATA ITEM
Operation and Maintenance Instructions for Research and Development
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-MISC-81414A
5. CONTRACT REFERENCE
SOW par 4.3.5.1
6. REQUIRING OFFICE
AFLCMC/EBHCC
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
C
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
ASREQ
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor's format required.
BLK 7: The electronic receiving report shall be annotated with the National Stock Number and Nomenclature. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at https://wawf.eb.mil.
BLK 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S.
Government agencies and their contractors (Administrative/ Operational Use)(Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHCC.
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.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
BLK14: Submit report electronically in Microsoft Office or PDF format to e-mail recipient(s) listed below.
steve.kas.2@us.af.mil (AFLCMC/EBHCC) heather.schaefer.1@us.af.mil (AFLCMC/EBHCC)
FOB DESTINATION
EBH 20-105-001
Terry McCurdy, AFLCMC/EBHTC, 586-0535
AFLCMC/EBHCC 1 1 0
AFLCMC/EBHKA 1 1 0
DCMA/QAR 1 1 0
DCMA/ACO 1 1 0
15. TOTAL 4 4 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2020/04/14
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2020/04/16
18. ESTIMATED
TOTAL PRICE
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 Directorate (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 collection 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 MGMT
D. SYSTEM/ITEM
Flare Data Logger
E. CONTRACT/PR NO.
FD2020-20-50172
F. CONTRACTOR
1. DATA ITEM NO.
A005
2. TITLE OF DATA ITEM
Status Report
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-MGMT-80368A
5. CONTRACT REFERENCE
SOW para 7.1
6. REQUIRING OFFICE
AFLCMC/EBHCC
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
C
10. FREQUENCY
QTRLY
12. DATE OF FIRST SUBMISSION
ASREQ
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
A
11. AS OF DATE
ASREQ
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor format required.
BLK 7: The electronic receiving report shall be annotated with the Lot Number, National Stock Number and Nomenclature. Electronic receiving report required via internet Wide Area Work Flow (WAWF) at:
https://wawf.eb.mil, DoDAAC, FA8213. The electronic receiving report shall be used only for this data item, do not combine other data item submittals with this requirement.
BLK 8: Comments/approval/disapproval will be submitted within 30 working days of receipt by AFLCMC/EBHCC.
BLK 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S.
Government agencies and their contractors (Administrative/Operational Use) (Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHCC.
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.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
BLK 14: Report shall be in Microsoft Office software or PDF format.
FOB DESTINATION
EBH 20-105-001
Terry McCurdy, AFLCMC/EBHTC, 586-0535
WAWF 0 1 0
DoDAAC FA8213
15. TOTAL 0 1 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2020/04/14
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2020/04/16
18. ESTIMATED
TOTAL PRICE
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 Directorate (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 collection 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 MGMT
D. SYSTEM/ITEM
Flare Data Logger
E. CONTRACT/PR NO.
FD2020-20-50172
F. CONTRACTOR
1. DATA ITEM NO.
A006
2. TITLE OF DATA ITEM
Contract Summary Report
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-MGMT-80447
5. CONTRACT REFERENCE
SOW para 8.3
6. REQUIRING OFFICE
AFLCMC/EBHCC
7. DD 250 REQ
DD
9. DIST STATEMENT
REQUIRED
C
10. FREQUENCY
BLK16
12. DATE OF FIRST SUBMISSION
BLK 16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
N/A
13. DATE OF SUBSEQUENT
SUBMISSION
N/A Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor's format required.
BLK 7: The electronic receiving report required via internet Wide Area Work Flow (WAWF, DoDAAC, FA8213) at https://wawf.eb.mil. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement.
Electronic receiving report shall be annotated to reflect if additional submittals are to be furnished or if this is the final submittal of data.
BLK 9: DISTRIBUTION STATEMENT C. Distribution authorized to U.S.
Government agencies and their contractors (Administrative/Operational Use)(Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHCC.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
WARNING - This document contains technical data whose export is restricted by the Arms Export Controls 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: Contractor shall submit Final Contract Summary Report ### after completion of the initiative.
BLK 14: Submit report electronically in Microsoft Office or PDF format to the e-mail recipient(s) listed in below:
steve.kas.2@us.af.mil (AFLCMC/EBHCC) heather.schaefer.1@us.af.mil (AFLCMC/EBHCC)
FOB DESTINATION
EBH 20-105-001
Terry McCurdy, AFLCMC/EBHTC, 586-0535
WAWF 0 1 0
DoDAAC, FA8213
15. TOTAL 0 1 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2020/04/14
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2020/04/16
18. ESTIMATED
TOTAL PRICE
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 Directorate (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 collection 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 SAFT
D. SYSTEM/ITEM
Flare Data Logger
E. CONTRACT/PR NO.
FD2020-20-50172
F. CONTRACTOR
1. DATA ITEM NO.
A007
2. TITLE OF DATA ITEM
Accident/Incident Report
3. SUBTITLE
4. AUTHORITY (Data Acquisition Document No.)
DI-SAFT-81563
5. CONTRACT REFERENCE
SOW para 9.1
6. REQUIRING OFFICE
AFLCMC/EBHCC
7. DD 250 REQ
NO
9. DIST STATEMENT
REQUIRED
C
10. FREQUENCY
ASREQ
12. DATE OF FIRST SUBMISSION
BLK16
14. DISTRIBUTION
a. ADDRESSEE
b. COPIES
8. APP CODE
N/A
11. AS OF DATE
ASREQ
13. DATE OF SUBSEQUENT
SUBMISSION
ASREQ
Draft
Final
Reg Repro
16. REMARKS
BLK 4: Contractor format is acceptable. Follow content preparation instructions as referenced in the Data Item Description.
BLK 7: Electronic receiving report required via internet WAWF at:
https://wawf.eb.mil. The electronic receiving report shall be used only for this data item; do not combine other data item submittals with this requirement.
BLK 9: DISTRIBUTION STATEMENT C: Distribution authorized to U.S.
Government agencies and their contractors (Administrative/Operational Use)(Date of Contract Award). Other requests for this document shall be referred to AFLCMC/EBHCC.
DESTRUCTION NOTICE - Destroy by any method that will prevent disclosure of contents or reconstruction of the document.
WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Tile 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: Report shall be submitted Microsoft Office or PDF format within 30 days of accident/incident.
Submit reports to addressee listed in block 14 and to the e-mail recipient(s) listed below.
steve.kas.2@us.af.mil (AFLCMC/EBHCC)
FOB DESTINATION
EBH 20-105-001
Terry McCurdy, AFLCMC/EBHTC, 586-0535
WAWF 0 1 0
DODAAC, FA8213
AFLCMC/EBHCC 0 1 0
6033 Elm Lane
Bldg 1247
Hill AFB UT
84056-5819
Attn: Steve Kas
15. TOTAL 0 2 0
G. PREPARED BY
mccurdy.terry.d.1075978215
H. DATE
2020/04/14
I. APPROVED BY
hargrove.eric.v.1167016843
J. DATE
2020/04/16
18. ESTIMATED
TOTAL PRICE
| A001 - A007 |
| A002 |
| A001 - A007 |
File details come from the government source that posted it. Updated .