CDRL_A001_Redacted.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 bur den, 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.

ALL CLINS

B. EXHIBIT

A

C. CATEGORY

TDP ______ TM- _____ FFP X

B. X-Ray Preventive Maintenance/Radiation Safety Inspections

E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Closeout Funds Available for Deobligation Report and Final Invoice

3. SUBTITLE

(Applies to Base and Option Years to include closeout)

4. AUTHORITY (Data Acquisition Document No.)

Contractor Format is Acceptable

5. CONTRACT REFERENCE

Agency Requirement

6. REQUIRING OFFICE

DTRA/J3OSAX

7. DD250 REQ

NO

9. DIST

STATEMENT

REQUIRED

N/A

10. FREQUENCY

See Block 16

12. DATE OF FIRST SUBMISSION

90 DAEO Base Period

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

End of Contract and Option(s)

13. DATE OF SUBSEQUENT

SUBMISSION

90 DAEO Each Option a. ADDRESSEE Draft

Final

Reg Repro

16. REMARKS

DAEO – Days After End Of

Contractor format is acceptable with PM approval.

Not later than 90 days after the expiration of the Base period of performance and expiration of each exercised option 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:

J3OSAX PM 1

J4CBS KO 1

J4CBS CS 1

Contract Closeout

15. TOTAL 4

G. PREPARED BY

X

P ro g ra m M a n a g e r

I. APPROVED BY

X C ontract ing O f f ice r

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