CDRL_A0005_Monthly_Status_Report.docx

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 __X__

D. SYSTEM/ITEM

LADSS

E. CONTRACT/PR NO.

HQ0147-13-R-0005

F. CONTRACTOR

17. PRICE GROUP

IV (NSP)

1. DATA ITEM NO.

A0005

2. TITLE OF DATA ITEM

Monthl y Status Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A

5. CONTRACT REFERENCE

PWS Paragraph 4.2

6. REQUIRING OFFICE

18. ESTIMATED TOTAL PRICE

)MDA/DACF

7. DD 250 REQ

9. DIST

STATEMENT

10. FREQUENCY

MONTHLY

12. DATE OF 1ST SUBMISSION

SEE BLK 16

14. DISTRIBUTION

8. APP CODE

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT SUBMISSION SEE BLK 16

16. REMARKS

BLOCK 4: Contractor devised and Government approved format. Electronic submission shall be made using Microsoft Office Products.

BLOCK 9: Distribution Statement F. Further distribution only as directed by MDA/DAU (LADSS Program) or higher DoD authority.

BLOCK 12: Initial report is to cover period to end of first full month following award.

BLOCK 13: Subsequent reports due 15 days after completion of each month’s effort.

BLOCK 14: Electronic submission required. Hard copies will be made available upon request. CDRLs due on weekends and holidays shall be due the morning of the next business day.

DAU COR

MDA/DACF

15. TOTAL ---------

G. PREPARED BY

Karen C. Byrd

H. DATE

24 October 2013

I. APPROVED BY

J. DATE