II.D.ii. Attachment CDRL N6660424Q0497_Redacted.pdf

CONTRACT DATA REQUIREMENTS LIST

(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 Service, 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

A

C. CATEGORY

TDP____________ TM___________ OTHER: NDTI

D. SYSTEM/ITEM

Battery Assemblies

E. CONTRACT / PR NO.

N6660424P0497

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM:

TEST/INSPECTION REPORT

3. SUBTITLE

Production Battery Test Report

17. PRICE GROUP

4. AUTHORITY (Date Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

SOW Para# 4.1

6. REQUIRING OFFICE

NUWCDIVNPT, Code 349

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

9. DIST STATEMNT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

LT D ASREQ See Block 16 b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQNT

SUBMISSION

a. ADDRESSEE

Draft Final

N/A See Block 16 N/A See Block 16 Reg Repro

16. REMARKS Code 34## 0 1 0 Block 9: See attached Block 16 addendum. COR 0 1 0

3432 DM 0 1 0

Block 10: Approximately sixty (60) submittals are anticipated per year over a five (5) year period.

Block 12 & 13: The contractor shall deliver the test

Report at the same time as the hardware

Block 14: Media Requirements: The report shall be delivered electronically in Microsoft Word 2016 or Adobe PDF format with email notification to all addressees:

15. TOTAL ______> 0 3 0

G. PREPARED BY:

H. DATE

1 NOV 2022

I. APPROVED BY

J. DATE

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page ____ of ____Pages

CONTRACT DATA REQUIREMENTS LIST

(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 Service, 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.

TBD

B. EXHIBIT

A

C. CATEGORY

TDP____________ TM___________ OTHER: NDTI

D. SYSTEM/ITEM

Battery Assemblies

E. CONTRACT / PR NO.

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM:

TEST/INSPECTION REPORT

3. SUBTITLE

Periodic Inspection Report

17. PRICE GROUP

4. AUTHORITY (Date Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

SOW Para# 4.2

6. REQUIRING OFFICE

NUWCDIVNPT, Code 349

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

9. DIST STATEMNT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

LT D ASREQ See Block 16 b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQNT

SUBMISSION

a. ADDRESSEE

Draft Final

N/A See Block 16 N/A See Block 16 Reg Repro

16. REMARKS Code 34## 0 1 0 Block 9: See attached Block 16 addendum. COR 0 1 0

3432 DM 0 1 0

Block 10: Approximately ten (10) submittals are anticipated per year over a five (5) year period.

Block 12 & 13: The contractor shall deliver the periodic inspection report at the same time as the hardware shipment.

Block 14: Media Requirements: The report shall be delivered electronically in Microsoft Word 2016 or Adobe PDF format with email notification to all addressees:

15. TOTAL ______> 0 3 0

G. PREPARED BY:

H. DATE

1 NOV 2022

I. APPROVED BY

J. DATE

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page ____ of ____Pages

DD FORM 1423, CONTRACT DATA REQUIREMENTS LIST

BLOCK 16 ADDENDUM

PR X

BLOCK 9: The following information is provided in amplification of the Block 9 Distribution Statement shown on each DD FORM 1423.

Distribution Statement paragraphs are in addition to CLASSIFICATION markings of the data.

CDRL A001-A005

Distribution Statement D. Distribution authorized to the Department of Defense and U.S. DoD contractors only (Critical Technology) (13 July 2021). Other requests shall be referred to NUWCDIVNPT Code 3411.

The following 'EXPORT CONTROL WARNING NOTICE' must be used in conjunction with DISTRIBUTION

STATEMENTS identified in the CDRL:

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, as amended, Title 50, U.S.C., App.

2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.