Exhibit_AC_NAVY-OY5_Part_B_CDRLs.pdf

Data Requirements List (DD 1423’s) for

P-8A Poseidon Engine Maintenance and Repair Depot

United States Navy

EXHIBIT AC

Contract Data Requirements List (DD 1423’s)

18 May 2016

EXHIBIT AC – OY5 CDRLs

DIN TITLE SUBTITLE

AC01 Engineering Services Memorandum (ESM) Engine Field Assessment Report

AC02 Engineering Services Memorandum (ESM) Engine MRO Assessment Report

AC03 Teardown Deficiency Report Engine MOR/Field Final Repair Report

AC04 Warranty Performance Reports Product Quality Deficiency Report

AC05 Status Report Over and Above Status Report

AC06 RESERVED

AC07 Quality Deficiency Report Deficiency Management

AC08 Parts Management Plan Supply Report

AC09 Conference/Meeting Administration Work Scope Planning/Meeting Minutes

AC0A Mishap Data Reporting Management MDR Management

AC0B Inventory/Utilization Data Report

AC0C Teardown Deficiency Report Part Condition Assessment

AC0D Internal Contractor Technical Data Report Test Cell Correlation Summary Report

AC0E Internal Contractor Technical Data Report Utilization Approval of Used, Rebuilt, Overhauled Engine Parts

AC0F Logbooks and Records, Aircraft and Engine and Component Logbooks Aeronautical Equipment

AC0G Internal Contractor Technical Data Report Engine Part Repair Approval/FAA

DER Approved Substantiation Package

AC0H Internal Contractor Technical Data Report Utilization Approval of Rebuilt and Overhauled Engine Parts/FAA DER Approved Substantiation Package

AC0J Sustainment Functional Cost-Hour Report Contractor Cost Data Reporting (CCDR)

AC0K Engineering Services Memorandum Engineering Investigation Report

AC0L Cost Data Summary Reporting Contractor Cost Data Reporting (CCDR)

AC0M Contract Work Breakdown Structure (CWBS) CWBS Dictionary

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

TDP TM OTHER

MISC

D. SYSTEM|ITEM E. CONTRACT/PR NO. F. CONTRACTOR

P-8A Poseidon Engine Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC01 Engineering Services Memorandum (ESM) Engine Field Assessment Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-MISC-80748 (See Block 16) SOW 3.4.1 PMA-290

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A D N/A See Block 16 Reg Repr

16. REMARKS: See Block 16 1

BLOCK 4: Deliver in a Microsoft Office format (2007 or later); such as, Excel or Access.

Report shall include:

• Date of submittal

• Engine Assessment Date

• Engine/Module Serial Number

• Aircraft BUNO

• Squadron / Location

• Primary failure item nomenclature

• Primary failure item part number

• Primary failure item failure mode

• Need for proposed work

• Description of findings/comments (including major discrepancies/work to be performed and resulting benefits)

• Estimated cost/BOE for engineering, materials and equipment and/or services with

FAR required proposal supporting documentation and information

• GFE required

• Estimated turn-around time (TAT) and completion date

• Signature/Title

BLOCKS 12 & 13: Due within 4 working days after assessment personnel arrival at the aircraft site.

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not available, the Contractor shall ensure the delivery of electronic media via CD ROM to the PMA-290 Data Manager sent via overnight mail.

15. Total 1

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Sharmella Riggs P-8A Propulsion & Power IPTL

Donnie LaRocco P-8A Aircraft Systems IPTL

DD FORM 1423-1, JUN 90 (EG) Previous editions are obsolete Page 1 of 1 Pages

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

P-8A Poseidon Engine Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC02 Engineering Services Memorandum (ESM) Engine MRO Assessment Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-MISC-80748 (See Block 16) SOW 3.5.2, 3.6.1 PMA-290

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A D N/A See Block 16 Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: Deliver in a Microsoft Office format (2007 or greater); such as, Excel or Access.

Report shall include:

• Date of submittal

• Engine Assessment Date

• Engine/Module Serial Number

• Engine Stand Serial Number

• Shipping Activity (Squadron / Location)

• Equipment/Component inventory shortages

• Primary failure item nomenclature

• Primary failure item part number

• Primary failure item failure mode

• Need for proposed work

• Description of findings/comments (including major discrepancies/work to be performed and resulting benefits)

• Estimated cost/BOE for engineering, materials and equipment and/or services with FAR required proposal supporting documentation and information

• GFE required

• Estimated turn-around time (TAT) and completion date

• Signature/Title

BLOCKS 12 & 13: Due within 7 working days after engine is received at the MRO facility, unless significant damage requires additionally negotiated time via the COR.

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not available, the Contractor shall ensure the delivery of electronic media via CD ROM to the PMA-290 Data Manager sent via overnight mail.

Sharmella Riggs, P-8A Propulsion & Power IPTL

Donnie LaRocco

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

ALSS

Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC03 Teardown Deficiency Report Engine MRO/Field Final Repair Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-ALSS-81534 (See Block 16) SOW 3.4.3, 3.5.3 PMA-290

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

A D N/A See Block 16 Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: Items to be included in the report are as follows (if applicable):

• Technical description of the completed assessment and repair including Engine serial number and location during repair, induction date, repair type, repair work, other.

• List of nomenclature/part number(s)/material replaced and/or repaired

• Scrap Material Listing

• Contractor labor codes/titles and associated hours as well as days for repair

• Certificates of compliance or completion

• Associated engine logbook entry data

• List of items noted but not corrected

• Engine test results and supporting measurements data to include

EGT margin restoration ( not applicable to field repairs)

• Other applicable items or remarks of note

• Submission of FAA Form 8130-3

BLOCK 8:

Government comments will be provided to the contractor NLT 30 days after receipt of contractor submittal. Revised contractor submittal shall be provided within 30 days after receipt of Government comments.

BLOCKS 12 & 13: Due As required.

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not

15. Total 1 1

Sharmella Riggs, P-8A Propulsion & Power IPTL

Donnie LaRocco

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

SESS

and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC04 Warranty Performance Reports Product Quality Deficiency Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-SESS-81639 (See Block 16) SOW 7.1 PMA-290

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A D N/A See Block 16 Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: Deliver in a Microsoft Office format (2007 or later); such as, Excel or Access.

Report shall include:

• QDR Number

• Component Serial Number (if applicable)

• Component Part Number

• Receipt Date

• Shipping Activity

• Discrepancy

• Results of Investigation

• Actions taken to correct or prevent future occurrence of discrepancy

BLOCK 12 and 13: 30 days after identification of a discrepancy

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not available, the Contractor

Sharmella Riggs, P-8A Propulsion & Power IPTL Donnie LaRocco

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

MGMT

and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC05 Status Report Over and Above Monthly Status Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-MGMT-80368A (See Block 16) SOW 3.3, 3.5.3 PMA-290

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT MTHLY See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A D N/A See Block 16 Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: The Contractor shall provide Over and Above Monthly Status Report submittals per DID DI-MGMT-80368A with the following exceptions; paragraphs 3.2.1, 3.2.2 and 3.2.3 are not applicable.

BLOCK 12: First submission due NLT 15 days following receipt of the first engine received.

BLOCK 13 Monthly:

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not available, the Contractor

Sharmella Riggs, 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 thus 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 C. CATEGORY:

and Repair Depot

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC06 RESERVED

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

Reg Repr

16. REMARKS

15. Total

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

QCIC

and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC07 Quality Deficiency Report Deficiency Management

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-QCIC-80736 (See Block 16) SOW 7.1 PMA-290

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

16. REMARKS See Block 16 1

BLOCK 4: Deliver in a Microsoft Office format (2007 or later); such as, Word, Excel or Access.

The investigation Report should include, at a minimum, the following data:

• Identify and report deficiency of item

• Identify and report the cause of deficiency for that item

• Recommendations to the Government to alleviate future failures of item

• Manufacturer’s recommendations for the correction of deficiency

• Investigate the following reports submitted against defective items manufactured, repaired, or overhauled by the Contractor or a Sub- Contractor including vendor parts issued through the On-Site Storeroom:

a. Product Quality Deficiency Report (PQDR)

b. Engineering Investigation (EI)

c. Material Deficiency Report (MDR)

d. Acceptance Inspection Deficiency Report (AIDR)

e. Hazardous Material Report (HMR)

f. Technical Publication Deficiency Report (TPDR)

BLOCK 12: Due 30 days after investigation request

BLOCK 13: Due monthly to arrive at PMA-290 NLT the last day of the month, until investigation completion.

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not available, the Contractor

Sharmella Riggs, 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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

SDMP

and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC08 Parts Management Plan Supply Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-SDMP-81748 (See Block 16) SOW 5.1 PMA-290

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT MTHLY 60 DAC b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A D N/A MTHLY Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: Deliver in a Microsoft Office format (2007 or later); such as, Word, Excel or Access.

The plan shall detail the contractor’s parts management program. It shall include provisions for optimizing part reliability and standardization through all phases of the system, subsystem or equipment life cycle. In addition, it shall include the areas or subjects as identified in MIL-STD-3018, Parts Management, Requirement 5.1 (parts management elements).

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not available, the Contractor

Sharmella Riggs, 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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

ADMN

and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC09 Conference/Meeting Administration Work Scope Planning / Meeting Minutes

TOTAL

PRICE

DI-ADMN-81505 (See Block 16) SOW 9.0 PMA-290

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

BLOCK 4: Deliver in a Microsoft Office format (2007 or later); such as, Word, Excel or Access.

BLOCK 12 and 13: Due NLT 5 days after completion of CDRL A002 (Engine MRO Assessment Report) and Meeting Minutes due NLT 5 days after the Work Scope Meeting.

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not available, the Contractor

Sharmella Riggs, DD FORM 1423-1, JUN 90 (EG) Previous editions are obsolete Page 1 of 2 Pages

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

SAFT

and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0A Mishap Data Reporting Management MDR Management

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-SAFT-81563 (See Block 16) SOW 17.0 PMA-290

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A D N/A N/A Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: Deliver in a Microsoft Office format (2007 or later); such as, Word, Excel or Access.

The Investigation Report shall contain the following, at a minimum:

1. Identify and report the nature of mishap

2. Provide information necessary to complete mishap data report as specified in OPNAV instruction 3750.6 series.

3. Estimated material cost to repair damage

4. Estimated labors hours and other direct cost to repair the engine/equipment

5. Estimated date engine will return to service

BLOCK 12: Verbal notification due within 6 hours of incident. To the COR/TPOC Written report due NLT 24 hours after incident.

Block 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not available, the Contractor

Sharmella Riggs, P-8A Propulsion & Power IPTL Donnie LaRocco

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0B Inventory/Utilization Data Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-MISC-81107 (See Block 16) SOW 5.1 PMA-290

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A D N/A ASREQ Reg Repr

BLOCK 4: Deliver in a Microsoft Office format (2007 or later); such as, Excel or Access.

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not available, the Contractor

Sharmella Riggs, 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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

ALSS

Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0C Teardown Deficiency Report Part Condition Assessment

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-ALSS-81534 (See Block 16) SOW 3.5.3 PMA-290

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

A D N/A See Block 16 Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: Items to be included in the report are as follows (if applicable):

Part measurements documented in provided MS Excel spreadsheet Part Condition Assessment (PCA) template: See Attachment 3.

In addition, the condition of the following list of items is to be observed closely and documented during the shop visit:

1) Detailed evaluation of HPT blades

a) Under platform corrosion

b) Airfoil - deposits / build-up / trailing edge burning

c) Cooling passages (corrosion) /

2) HPTN – Visual for TE burning, erosion, deposits / build-up

3) HPT Shroud Hangers – Visual for cooling hole clogging

4) HPT Shrouds – Visual for signs of overtemp

5) HPC Blades – Visual for airfoil erosion, airfoil FOD, deposits / build-up

6) Fan Blade Platforms

7) Oil Coking

a) Specifically feed to #4 bearing.

8) LPT blade - corrosion

9) Evaluate all LLP hardware for cracking indications and corrosion

10) Detailed inspection of fan case (corrosion)

11) External surface of AGB (corrosion)

12) Combustor liner surface (look for excessive spalling or burn through)

a) Include visual review of fuel nozzles

BLOCK 8: Government comments will be provided to the contractor NLT 30 days after receipt of contractor submittal. Revised contractor submittal shall be provided within 30 days after receipt of Government comments.

BLOCKS 12 & 13: Due NLT 15 days following Government acceptance of each engine.

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not

Sharmella Riggs, P-8A Propulsion & Power IPTL Donnie LaRocco

CONTRACT DATA REQUIREMENTS LIST

Form Approved

(1 Data Item) 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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0D Internal Contractor Technical Data Report Test Cell Correlation Summary Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-SESS-81309A (See Block 16) SOW 6.1 PMA-290

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

A D N/A See Block 16 Reg Repr

BLOCK 4: Items to be included in the report are as follows (if applicable):

• Process / procedure used to correlate the Production test cell to the Baseline / Reference Test Cell IAW ARP 741

• Process used to a trend test cell results and determine when a new audit or test cell correlation re-baseline effort is required

• Description/Schematic of each Production Test Cell and Baseline/Reference Test Cell Instrumentation List Description of any test cell configuration change that affects measurement uncertainty or measured pass-off or acceptance parameters

• Method by which primary performance parameters are measured & calculated, e.g., Thrust, Fuel Flow, Turbine Temperature, Engine Inlet Pressure and Temperature, Exhaust Plane Pressure, Air Flow, etc.

• Method used to determine Fuel properties, i.e., Lower Heating Value, Specific Gravity, Viscosity

• Method to calculate acceptance parameters, e.g., thrust margin, SFC margin, EGT margin, etc.

• Measurement Uncertainty assessment for sell parameters

• Plots of full operating line Thrust, Fuel Flow, SFC, EGT comparing

Production Test Cell(s) to the Baseline/Reference Test Cell

• Definition of and justification for any correction factors required to match

Baseline/Reference Test Cell

• Findings and Conclusions required to match baseline performance

BLOCK 8: Government comments will be provided to the contractor NLT 30 days after receipt of contractor submittal. Revised contractor submittal shall be provided within 30 days after receipt of Government comments.

BLOCK 12: 30 Days after contract award.

BLOCK 13: Due NLT 15 days following each test cell status change that requires test cell correlation.

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not

Sharmella Riggs, P-8A Propulsion & Power IPTL Donnie LaRocco

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0E Internal Contractor Technical Data Report Utilization Approval of Rebuilt and Overhauled Engine Parts

TOTAL

PRICE

DI-SESS-81309A (See Block 16) SOW 5.12, 5.2 PMA-290

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

A D N/A See Block 16 Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: PMA holders requesting to be approved for non-type certified parts used by the government will need to apply for approval per the requirements of Exhibit A of Aviation Source Approval and Management Handbook dated 16 March 2011. Documentation to be submitted includes the following

• Part Source Approval Request Package as per requirements listed in Exhibit A of Aviation Source Approval and Management Handbook dated 16 March 2011

• FAA Form 8110-3 and FAA / FAA DER approved substantiation documentation

BLOCK 8: Government comments will be provided to the contractor NLT 30 days after receipt of contractor submittal. Revised contractor submittal shall be provided within 30 days after receipt of Government comments.

BLOCKS 12 & 13: Due As Required

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not

Sharmella Riggs, P-8A Propulsion & Power IPTL Donnie LaRocco

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

MNTY

Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0F Logbooks and Records, Aircraft and Aeronautical Equipment Engine and Component Logbooks

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-MNTY-81067 SOW 4.0 PMA-290

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

A D N/A See Block 16 Reg Repr

16. REMARKS See Block 16 1

BLOCK 8: Government comments will be provided to the contractor NLT 30 days after receipt of contractor submittal. Revised contractor submittal shall be provided within 30 days after receipt of Government comments.

BLOCKS 12 & 13: Due as required.

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not

Sharmella Riggs, P-8A Propulsion & Power IPTL Donnie LaRocco

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0G Internal Contractor Technical Data Report Engine Part Repair Approval/FAA DER Approved Substantiation Package

TOTAL

PRICE

DI-SESS-81309A (See Block 16) SOW 5.1.2, 5.3 PMA-290

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

A D N/A See Block 16 Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: A repair catalog submitted by the Contractor for approval shall require a separate FAA / FAA DER technical data package for each part regardless of their source, i.e. PMA, OEM, or OEM approved vendor.

Each repair submitted shall have FAA Form 8110-3 and FAA / FAA DER approved substantiation documentation.

All repairs and associated Form 8110-3s (including substantiation data) for the same part number are requested to be submitted in a combined package.

BLOCK 8: Government comments will be provided to the contractor NLT 30 days after receipt of contractor submittal. Revised contractor submittal shall be provided within 30 days after receipt of Government comments.

BLOCKS 12 & 13: As Required

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not

Sharmella Riggs, P-8A Propulsion & Power IPTL Donnie LaRocco

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0H Internal Contractor Technical Data Report Utilization Approval of Rebuilt and Overhauled Engine Parts/FAA DER Approved Substantiation Package

TOTAL

PRICE

DI-SESS-81309A (See Block 16) SOW 5.4 PMA-290

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

A D N/A See Block 16 Reg Repr

BLOCK 4: Items to be included in the report are as follows (if applicable):

• Approved FAA Form 8130-3

• Complete set of all maintenance, inspection, and service usage records including accumulated cycles / hours and operators

• Service life remaining for any life-limited part

BLOCK 8: Government comments will be provided to the contractor NLT 30 days after receipt of contractor submittal. Revised contractor submittal shall be provided within 30 days after receipt of Government comments.

BLOCKS 12 & 13: As Required

BLOCK 14: All deliverables shall be delivered via the AMRDEC website along with 1 CD ROM to the MPRA Library. If the AMRDEC is not

Sharmella Riggs, P-8A Propulsion & Power IPTL Donnie LaRocco

(1 Data Item) 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 thus 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 C. CATEGORY:

5087 AC

FNCL

and Repair Depot

TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0J Sustainment Functional Cost-Hour Report

(DD1921-5)

Contractor Cost Data Reporting

(CCDR)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-FNCL-81992 (See Block 16) SOW 3.1 NAVAIR 4.2

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT See Block 16 See Block 16 b. COPIES

8. APP CODE See Block 16 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A See Block 16 See Block 16 Reg Repr

Blocks 10 - 13: Prepare the Sustainment Functional Cost Hour Report (SFCHR) in accordance with DI-FNCL-81992 (or the most recently approved version) and the OSD Deputy Director, Cost Assessment (DDCA)-approved contract CSDR Plan.

The DID, DI-FNCL-81992, is available from the Defense Cost and Resource Center (DCARC) website at http://cade.osd.mil/csdr/FormsReporting.aspx#DIDs. The CSDR Plan is included as a contract attachment 18.

Contractors shall be required to submit the Contractor Cost Data Reports (CCDRs) at frequencies specified in the OSD DDCA-approved CSDR plan and in the contract. The contract CSDR plan uses the event field as the driver for the submission of the reports, not the "as of date." If the event slips, the contractor must notify the Government Program Office that a date change is needed. It is the responsibility of the Government Program Office to submit a request for change in the event-driven date for reporting through the CSDR Submit- Review system for DCARC approval before the date reflected in the OSD DDCA-approved CSDR Plan.

All CCDRs shall be submitted electronically using the CSDR Submit-Review System. The required form and file type for each CCDR is specified in its Data Item Description (DID). Data submitters must register through the DCARC website and possess a DoD-approved ECA digital certificate or DoD-issued CAC to obtain a DCARC Portal account and be authorized to upload CSDR content. Users can obtain access by submitting user information about themselves and their organizations to the DCARC Portal and requesting a CSDR submitter user role. After the registration information has been verified, the DCARC shall authorize the user account and requested roles. All DCARC Portal accounts need to be renewed at least annually.

Subcontractor Reporting: Prime contractors are responsible for flowing down CSDR requirements contained in their prime contracts to all subcontractors who meet the reporting thresholds specified in the DoDI 5000.02, or as required by the CWIPT. This includes requiring subcontractors to electronically report directly to the DCARC using the CSDR Submit-Review System. The prime contractor shall be required to work with the CWIPT and all appropriate subcontractors to prepare separate subcontract CSDR plans for submission to the DCARC for DDCA approval.

DCARC

R L Gage P-8A IPS/O&S Cost Team Lead

Donnie LaRocco http://cade.osd.mil/csdr/FormsReporting.aspx#DIDs

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 thus burden estimate or any other aspect of this collection o f 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 C. CATEGORY:

5087 AC

Maintenance and Repair Depot

TBD TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0K Engineering Services Memorandum (ESM) Engineering Investigation Report

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18.

ESTIMATED

TOTAL

PRICE

DI-MISC-80748 (See Block 16) SOW 3.7 PMA-290

7. DD 250 REQ 9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT ASREQ See Block 16 b. COPIES

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

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A D N/A ASREQ (See Block 16) Reg Repr

16. REMARKS See Block 16 1

BLOCK 4: The Contractor shall follow the COMNAVAIRFORINST 4790.2 when submitting reports. The Contractor shall deliver in a Microsoft Office format (2007 or later)

Report shall include:

• Component Information & Failure Data

• Background

• Findings

• Conclusions

• Recommendations

• Related Information

• Pending Corrective Actions

BLOCK 12: Due within 60 days of receipt of the failed asset at the Contractors facility

BLOCK 13: The Government will have 45 days for review and acceptance or rejection of the submission. The Contractor will have 20 days to respond to rejection.

BLOCK 14: All deliverables shall be delivered via the PMA-290 website along with 1 CD ROM to the MPRA Library. If the website is not available, the Contractor shall ensure the delivery of electronic media via CD ROM to the PMA-290 Data Manager sent via overnight mail.

Sharmella Riggs P-8A Propulsion & Power IPTL

Donnie LaRocco

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 thus 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 C. CATEGORY:

5087 AC

P-8A Poseidon Depot Maintenance- Airframe

TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

AC0L Cost Data Summary Reporting (DD1921) Contractor Cost Data Reporting

(CCDR)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-FNCL-81565C (See Block 16) SOW 3.1 NAVAIR 4.2

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT See Block 16 See Block 16 b. COPIES

8. APP CODE See Block 16 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A See Block 16 See Block 16 Reg…