Exhibit_B_CDRLs.pdf

PDF 111 KB Posted

Attached to
C-26 CLS RFP Federal contract opportunity
Solicitation number
N00019-15-R-0089
Issued by
Department of the Navy Naval Air Systems Command

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C-26 Exhibit B - CDRLs

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DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED.

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

B001

2. TITLE OF DATA ITEM

Trip/Travel Report

3. SUBTITLE

Travel Summary Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81943 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.13

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

AS PER OCCUR

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 30 calendar days after each travel event.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT.

Utility Lift IPTL

COR / TPOC

AIR 6.6.1.1

AIR 4.1.1.3

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

David A. Adams

J. DATE

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

B002

2. TITLE OF DATA ITEM

Contract Funds Status Report (CFSR)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81468 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.14

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

QTRLY

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: The Contractor shall format in accordance with attached supplement.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Submit the first deliverable within 15 calendar days after the first completed Government fiscal quarter of the contract.

Subsequent deliverables shall be submitted within 15 calendar days of the completion of each Government Fiscal Quarter.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT.

AIR 4.1.1.3

AIR 6.6.1.1

Utility Lift IPTL

DCMA

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

5/5/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

A

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

B003

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Teardown Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B (See Block 16)

5. CONTRACT REFERENCE

PWS Para 7.4, 8.4, 9.4, 10.5.1 & 10.6.2

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 18 May 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Reports are due 10 days after each teardown event.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPTL.

AIR 4.1.1.3

AIR 6.6.1.1

(See Block 16) Utility Lift IPTL

COR / TPOC

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

B004

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Final Depot Summary Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 7.5, 8.5, 9.5 &

10.5.2

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

See Block 16

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: The Contractor shall indicate compliance with Service Actions and Service Bulletins; indicate the overall condition and cycle (reset) information; and address applicable FAA documentation for both Functional Check Flight(s) and weight-and-balance.

Block 7: The Contractor shall include signed DD-250 and all documentation associated with completion of the inspection, overhaul, rework or repair action.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Submit the final report no later than 60 calendar days after each maintenance action is completed.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT. The Government considers the data delivered herein as necessary for Operation, Maintenance, Installation or Training (OMIT) of the C-26.

AIR 6.6.1.1

Utility Lift IPTL (See Block 16)

AIR 4.1.1.3

COR / TPOC

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

B005

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Engineering Investigation Reports

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 10.9

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 15 calendar days after the completion of each Engineering Investigation.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-26.

AIR 4.1.1.3

Utility Lift IPTL

AIR 6.6.1.1- DAPML

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BA01

2. TITLE OF DATA ITEM

Trip/Travel Report

3. SUBTITLE

Travel Summary Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81943 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.13

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

AS PER OCCUR

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 18 May 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 30 calendar days after each travel event.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT.

Utility Lift IPTL

COR / TPOC

AIR 6.6.1.1

AIR 4.1.1.3

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BA02

2. TITLE OF DATA ITEM

Contract Funds Status Report (CFSR)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81468 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.14

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

QTRLY

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: The Contractor shall format in accordance with attached supplement.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Submit the first deliverable within 15 calendar days after the first completed Government fiscal quarter of the contract.

Subsequent deliverables shall be submitted within 15 calendar days of the completion of each Government Fiscal Quarter.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT.

AIR 4.1.1.3

AIR 6.6.1.1

Utility Lift IPTL

DCMA

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

A

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BA03

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Teardown Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B (See Block 16)

5. CONTRACT REFERENCE

PWS Para 7.4, 8.4, 9.4, 10.5.1 & 10.6.2

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Reports are due 10 days after each teardown event.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPTL.

AIR 4.1.1.3

AIR 6.6.1.1

(See Block 16) Utility Lift IPTL

COR / TPOC

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BA04

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Final Depot Summary Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 7.5, 8.5, 9.5 &

10.5.2

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

See Block 16

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: The Contractor shall indicate compliance with Service Actions and Service Bulletins; indicate the overall condition and cycle (reset) information; and address applicable FAA documentation for both Functional Check Flight(s) and weight-and-balance.

Block 7: The Contractor shall include signed DD-250 and all documentation associated with completion of the inspection, overhaul, rework or repair action.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Submit the final report no later than 60 calendar days after each maintenance action is completed.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT. The Government considers the data delivered herein as necessary for Operation, Maintenance, Installation or Training (OMIT) of the C-26.

AIR 6.6.1.1

Utility Lift IPTL (See Block 16)

AIR 4.1.1.3

COR / TPOC

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BA05

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Engineering Investigation Reports

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 10.9

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 15 calendar days after the completion of each Engineering Investigation.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-26.

AIR 4.1.1.3

Utility Lift IPTL

AIR 6.6.1.1- DAPML

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BB01

2. TITLE OF DATA ITEM

Trip/Travel Report

3. SUBTITLE

Travel Summary Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81943 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.13

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

AS PER OCCUR

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 18 May 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 30 calendar days after each travel event.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT.

Utility Lift IPTL

COR / TPOC

AIR 6.6.1.1

AIR 4.1.1.3

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BB02

2. TITLE OF DATA ITEM

Contract Funds Status Report (CFSR)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81468 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.14

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

QTRLY

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: The Contractor shall format in accordance with attached supplement.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Submit the first deliverable within 15 calendar days after the first completed Government fiscal quarter of the contract.

Subsequent deliverables shall be submitted within 15 calendar days of the completion of each Government Fiscal Quarter.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT.

AIR 4.1.1.3

AIR 6.6.1.1

Utility Lift IPTL

DCMA

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

A

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BB03

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Teardown Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B (See Block 16)

5. CONTRACT REFERENCE

PWS Para 7.4, 8.4, 9.4, 10.5.1 & 10.6.2

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Reports are due 10 days after each teardown event.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPTL.

AIR 4.1.1.3

AIR 6.6.1.1

(See Block 16) Utility Lift IPTL

COR / TPOC

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BB04

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Final Depot Summary Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 7.5, 8.5, 9.5 &

10.5.2

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

See Block 16

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: The Contractor shall indicate compliance with Service Actions and Service Bulletins; indicate the overall condition and cycle (reset) information; and address applicable FAA documentation for both Functional Check Flight(s) and weight-and-balance.

Block 7: The Contractor shall include signed DD-250 and all documentation associated with completion of the inspection, overhaul, rework or repair action.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Submit the final report no later than 60 calendar days after each maintenance action is completed.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT. The Government considers the data delivered herein as necessary for Operation, Maintenance, Installation or Training (OMIT) of the C-26.

AIR 6.6.1.1

Utility Lift IPTL (See Block 16)

AIR 4.1.1.3

COR / TPOC

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BB05

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Engineering Investigation Reports

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 10.9

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 15 calendar days after the completion of each Engineering Investigation.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-26.

AIR 4.1.1.3

Utility Lift IPTL

AIR 6.6.1.1

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BC01

2. TITLE OF DATA ITEM

Trip/Travel Report

3. SUBTITLE

Travel Summary Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81943 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.13

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

AS PER OCCUR

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 30 calendar days after each travel event.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT.

Utility Lift IPTL

COR / TPOC

AIR 6.6.1.1

AIR 4.1.1.3

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BC02

2. TITLE OF DATA ITEM

Contract Funds Status Report (CFSR)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81468 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.14

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

QTRLY

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: The Contractor shall format in accordance with attached supplement.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Submit the first deliverable within 15 calendar days after the first completed Government fiscal quarter of the contract.

Subsequent deliverables shall be submitted within 15 calendar days of the completion of each Government Fiscal Quarter.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT.

AIR 4.1.1.3

AIR 6.6.1.1

Utility Lift IPTL

DCMA

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

A

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BC03

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Teardown Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B (See Block 16)

5. CONTRACT REFERENCE

PWS Para 7.4, 8.4, 9.4, 10.5.1 & 10.6.2

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Reports are due 10 days after each teardown event.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPTL.

AIR 4.1.1.3

AIR 6.6.1.1

(See Block 16) Utility Lift IPTL

COR / TPOC

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BC04

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Final Depot Summary Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 7.5, 8.5, 9.5 &

10.5.2

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

See Block 16

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: The Contractor shall indicate compliance with Service Actions and Service Bulletins; indicate the overall condition and cycle (reset) information; and address applicable FAA documentation for both Functional Check Flight(s) and weight-and-balance.

Block 7: The Contractor shall include signed DD-250 and all documentation associated with completion of the inspection, overhaul, rework or repair action.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Submit the final report no later than 60 calendar days after each maintenance action is completed.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT. The Government considers the data delivered herein as necessary for Operation, Maintenance, Installation or Training (OMIT) of the C-26.

AIR 6.6.1.1

Utility Lift IPTL (See Block 16)

AIR 4.1.1.3

COR / TPOC

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BC05

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Engineering Investigation Reports

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 10.9

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 15 calendar days after the completion of each Engineering Investigation.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-26.

AIR 4.1.1.3

Utility Lift IPTL

AIR 6.6.1.1

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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 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

B

C. CATEGORY

MISC

D. SYSTEM/ITEM

C-26D

E. CONTRACT/PR NO.

N00019-15-R-0089

F. CONTRACTOR

1. DATA ITEM NO.

BD01

2. TITLE OF DATA ITEM

Trip/Travel Report

3. SUBTITLE

Travel Summary Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81943 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.13

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

AS PER OCCUR

12. DATE OF FIRST

SUBMISSION

See Block 16

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

See Block 16

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 3 June 2015. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 30 calendar days after each travel event.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPT.

Utility Lift IPTL

COR / TPOC

AIR 6.6.1.1

AIR 4.1.1.3

(See Block 16)

15. TOTAL

G. PREPARED BY

Michelle Pedersen

H. DATE

4/30/2015

I. APPROVED BY

18. ESTIMATED

TOTAL PRICE

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.

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