CDRL A017 ESM _2_.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved CMB 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 222202-2302, 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.

B. EXHIBIT

C. CATEGORY

TDP TM OTHER X

D. SYSTEM/ITEM.

FOSOV System Technical Support (STS)

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

A017

2. TITLE OF DATA ITEM

Engineering Service Memorandum (ESM)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80748

5. CONTRACT REFERENCE

C.8.1.4

6. REQUIRING OFFICE

SOAL-SW, PM-FOSOV

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

AS REQUESTED

12. DATE OF FIRST

SUBMISSION

SEE BLK 16 14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

SEE BLKS 10 & 16 a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

16 REMARKS

Prepare and submit IAW applicable Task Order.

Reproducible copy shall be sent to the specified e-mail addresses.

BLK 14b – Email Addresses:

SOAL-SW, PM-FOSOV Michael.ellis1@socom.mil

AMSRD-TAR-E mark.fox1@us.army.mil

Distribution shall also include any others specified in the Task Order.

PM-FOSOV 1

AMSRD-TAR-E 1

15. TOTAL 2

G. PREPARED BY

Mark Fox

H. DATE

08 Jun 09

I. APPROVED BY

J. DATE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITIONS ARE OBSOLETE Page of Pages