Attachment 004 - Assertion of Restrictions.xlsx

Cover

DISTRIBUTION STATEMENT A: Approved for Public Release; distribution unlimited.

DRAFT

Instructions

1. Item ID: Contractors are instructed to add additional lines as necessary to delineate all rights and data associated with applicable components.

2. Data Description*: The contractor shall enter a description of the technical data or computer software which specifically describes the technical data or computer software and conveys the usage, function, and location of the associated item, component, or process. If computer software, the offeror shall identify if it is object code, executable software, firmware, or source code, etc. If more than one item of data, then enter each on separate item ID's and on separate rows.

3. Technical Data or Computer Software: The contractor shall identify if the data is technical data or computer software.

4. Document Reference No.: The contractor shall enter its document reference number (if applicable). For example: Dwg No. “12345678”.

5. CDRL Number: The contractor shall identify the CDRL number(s) that the technical data or computer software is being delivered under. For example: "CDRL_A024" .

6. The contractor shall indicate if this technical data or computer software pertains to a commercial product per the definition of commercial product in FAR 2.101? (Y/N)

7. The contractor shall indicate if this technical data or computer software pertains to a Commercially available off-the-shelf (COTS) item per the definition of commercial in FAR 2.101? (Y/N)

8. The contractor shall indicate the PPA paragraph(s) to which this technical data or computer software relates.

9. Basis for Assertion**: The contractor shall state the basis for their assertion.

10. Asserted Rights Category***: The contractor shall identify the category of the rights asserted.

11. Identification of the Source for Commercial Item and Commercial License: The contractor shall enter the source(s) of item and source of the commercial computer software license.

12. Name of Person Asserting Restrictions****: The contractor shall enter the Corporation, individual, or other person, as appropriate.

*For technical data (other than computer software documentation) pertaining to items, components, or processes developed at private expense, identify both the deliverable technical data and each such item, component, or process. For computer software or computer software documentation identify the software or documentation.

**Generally, development at private expense, either exclusively or partially, is the only basis for asserting restrictions. For technical data, other than computer software documentation, development refers to development of the item, component, or process to which the data pertain. The Government's rights in computer software documentation generally may not be restricted. For computer software, development refers to the software. Indicate whether development was accomplished exclusively or partially at private expense. If development was not accomplished at private expense, or for computer software documentation, enter the specific basis for asserting restrictions.

***Enter asserted rights category (e.g., government purpose rights from a prior contract, limited, restricted, or government purpose rights under this or a prior contract, SBIR rights, or specially negotiated licenses).

****Corporation, individual, or other person, as appropriate.

Assertion of Restrictions

Date:

Printed Name:

Title:

Signature:

Technical data and computer software including firmware to be furnished Technical data and computer software including firmware with the level of data rights to which the Government is entitled per the OTA

The offeror asserts for itself, or the persons identified below, that the Government's rights to use, release, or disclose the following technical data or computer software including firmware should be restricted:

Assertions - Option - PPA 4.8.1

Date:

Printed Name:

Title:

Signature:

Technical data and computer software including firmware to be furnished Technical data and computer software including firmware with the level of data rights to which the Government is entitled per the OTA

The offeror asserts for itself, or the persons identified below, that the Government's rights to use, release, or disclose the following technical data or computer software including firmware should be restricted:

Assertions - Option - PPA 4.8.2

Date:

Printed Name:

Title:

Signature:

Technical data and computer software including firmware to be furnished Technical data and computer software including firmware with the level of data rights to which the Government is entitled per the OTA

The offeror asserts for itself, or the persons identified below, that the Government's rights to use, release, or disclose the following technical data or computer software including firmware should be restricted:

Assertions - Option - PPA 4.8.3

Date:

Printed Name:

Title:

Signature:

Technical data and computer software including firmware to be furnished Technical data and computer software including firmware with the level of data rights to which the Government is entitled per the OTA

The offeror asserts for itself, or the persons identified below, that the Government's rights to use, release, or disclose the following technical data or computer software including firmware should be restricted: