3_-_HP_CDRL_A001_Closeout.pdf

C O N T R A C T D A T A R E Q U I R E M E N T S L I S T (1 Data Item) Form Approved 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. B. EXHIBIT C. CATEGORY

0003 A TDP ______ TM- _____ OTHER__ X___

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

Hewlett Packard Data Storage Units

1. DATA ITEM NO. 2. TITLE OF DATA 3. SUBTITLE

A001 Closeout Funds Available for Deobligation Report and Final Invoice

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

Contractor Format with COR approval Agency Requirement DTRA/J9CXQ

7. DD250 REQ

NO

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

Once

12. DATE OF FIRST SUBMISSION

90 DAEO Contract

14. DISTRIBUTION

b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION a. ADDRESSEE Draft Final

N/A N/A 90 DAEO Contract Reg Repro

16. REMARKS Firm Fixed Price Contract

DAEO = Days After End Of

Contractor format is acceptable with COR approval.

Not later than 90 days after the expiration of the base period of performance, the contractor shall submit a Closeout Funds Available for Deobligation Report and Final Invoice.

The Closeout Funds Available for Deobligation report must contain:

Contractor name, and contact information of the preparer of the report; Contract number;

Contract type; Amount of funds on this contract by fiscal year of funds and by ACRN;

Amount expended by ACRN; Total funds remaining on each ACRN that are not required and can be deobligated.

Deliver report electronically in Microsoft Office Suite Software compatible format by email to:

J9/CXQ Program Manager (PM) - Timberlyn Harrington, timberlyn.m.harrington.civ@mail.mil, 703-375-6258 J4CB Division Chief – Linda Mulligan, linda.y.mulligan.civ@mail.mil , 703-767-7897 J4CBS Contracting Officer (KO) – Shreena Lyons, shreena.l.lyons.civ@mail.mil, 703- 767-4769 J4CBS Contract Specialist (CS) – Sovanna Sampels, sovanna.sampels.ctr@mail.mil, 703-767-6842 Contract Closeout: dtra.belvoir.J4-8C.mbx.closeouts@mail.mil

J9CXQ PM 1

J4CBS Division Chief 1

J4CBS KO 1

J4CBS CS 1

Contract Closeout 1

15. TOTAL 5

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Timberlyn Harrington Shreena Lyons

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