C-12_CDRLS_N00019-15-R-5500.pdf

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C-12 Contractor Logisitics Services
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N00019-15-R-5500
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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

A

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Material Utilization and Forecasting Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81947 (T) (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 4.1.2, 5.8.4

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

1TIME

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

N/A

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable. Tailored as follows:

Disregard National Stock Number unless assigned to part.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. Other requests for this document shall be referred to PMA-207.

Block 12: Semi-annual event. If CLIN 0001 is ordered, the Contractor shall submit the deliverable within 30 calendar days after the materials inventory audit conducted in the Transition Phase-In 60 calendar day period. If CLIN 0001 is not ordered, the Contractor shall submit the deliverable on 31 December 2016.

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-12.

Utility Lift IPTL (See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

11/19/2014

I. APPROVED BY

David 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

A

C. CATEGORY

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Ordnance Certification Status Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.1.6

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

MTHLY

12. DATE OF FIRST

SUBMISSION

40 DACS

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: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. Other requests for this document shall be referred to PMA-207.

Block 13: Subsequent deliverables shall be submitted on the 10th of every month.

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-12.

AIR 6.6.1.1

AIR-6.6.2.9

AIR 4.1.1.3

COR / TPOC

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

11/19/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

AIRCRAFT STATUS REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.8.5

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

MTHLY

12. DATE OF FIRST

SUBMISSION

40 DACS

8. APP CODE

A (See Block 16)

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 8: The UL IPTL will send an e-mail notification for disposition of the deliverable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. Other requests for this document shall be referred to PMA-207.

Block 13: Submit no later than the 10th of each month. The USG has 30 calendar days for review and comment from date of receipt.

Draft report will be considered approved after 30 calendar days of USG receipt unless otherwise notified.

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-12.

AIR 6.6.1.1

AIR-6.6.2.9

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

11/19/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Five Year Overhaul and Rework Projections Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.4

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: Contractor format is acceptable. Must be delivered in MS Excel.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. 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. 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. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-12.

AIR 6.6.1.1

AIR-6.6.2.9

AIR 4.1.1.3

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

11/19/2014

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

SESS

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

A005

2. TITLE OF DATA ITEM

Configuration Status Accounting Information

3. SUBTITLE

Configuration Status Accounting Report

4. AUTHORITY (Data Acquisition Document No.)

DI-CMAN-81253A (See Block 16)

5. CONTRACT REFERENCE

PWS Para 5.6.1 & 5.6.2

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: Contractor format is acceptable. The deliverable shall be done in MS Excel.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. 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. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-12.

AIR 4.1.1.3

AIR 6.6.1.1

AIR-6.6.2.9

PMA207CM

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

11/19/2014

I. APPROVED BY

David A. Adams

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Technical Directive Compliance Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80224B (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.6.3

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 10 December 2014. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 10 calendar days after every depot event that had Technical Directive incorporations accomplished.

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-12.

AIR 4.1.1.3

AIR 6.6.1.1

AIR-6.6.2.9

OSGR

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

11/19/2014

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

SAFT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

A007

2. TITLE OF DATA ITEM

Accident / Incident Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-SAFT-81563 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.7

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 10 December 2014. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 24 hours after each accident and incident event.

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-12.

Utility Lift IPTL

AIR 4.1.1.3

AIR 6.6.1.1

AIR-2.4.3.1.5

PMA 273E

AIR-6.6.2.9

COR / TPOC

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

11/19/2014

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

SESS

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

A008

2. TITLE OF DATA ITEM

Source Data for Forecasting Diminishing Manufacturing Sources and Material Shortages

(DMSMS)

3. SUBTITLE

Obsolescence and DMSMS Summary

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-81656 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.8.6

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: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. 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 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. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-12.

AIR 4.1.1.3

AIR 6.6.1.1

AIR-6.6.2.9

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

11/19/2014

I. APPROVED BY

David A.Adams

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

A009

2. TITLE OF DATA ITEM

Briefing Material

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81605 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.12.1.2

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 10 December 2014. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted 10 calendar days prior to every Program Management Review.

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-12.

Utility Lift IPTL

AIR 2.3.5.1

AIR 4.1.1.3

AIR 6.6.1.1

PMA 273E

AIR-6.6.2.9

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

11/19/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AA01

2. TITLE OF DATA ITEM

Material Utilization and Forecasting Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81947 (T) (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.8.4

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

(See Block 16)

12. DATE OF FIRST

SUBMISSION

30 June 2017

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

31 December 2017

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable. Tailored as follows:

Disregard National Stock Number unless assigned to part.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. Other requests for this document shall be referred to PMA-207.

Block 10: Semi-annual event.

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-12.

Utility Lift IPTL (See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AA02

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Ordnance Certification Status Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.1.6

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

MTHLY

12. DATE OF FIRST

SUBMISSION

40 DAC

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: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. Other requests for this document shall be referred to PMA-207.

Block 13: Subsequent deliverables shall be submitted on the 10th of every month.

Block 14: Place on Web-base Information System (WIS) and send an e-mail notification to the UL IPTL. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-12.

AIR 6.6.1.1

AIR-6.6.2.9

AIR 4.1.1.3

COR / TPOC

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AA03

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

AIRCRAFT STATUS REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.8.5

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

MTHLY

12. DATE OF FIRST

SUBMISSION

40 DACS

8. APP CODE

A (See Block 16)

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 8: The UL IPTL will send an e-mail notification for disposition of the deliverable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. Other requests for this document shall be referred to PMA-207.

Block 13: Submit no later than on the 10th of each month. The USG has 30 calendar days for review and comment from date of receipt.

Draft report will be considered approved after 30 calendar days of USG receipt unless otherwise notified.

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-12.

AIR 6.6.1.1

AIR-6.6.2.9

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AA04

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Five Year Overhaul and Rework Projections Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.4

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: Contractor format is acceptable. Must be delivered in MS Excel.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. 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 quarter of the contract. Subsequent deliverables shall be submitted within 15 calendar days of the completion of each quarter.

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-12.

AIR 6.6.1.1

AIR-6.6.2.9

AIR 4.1.1.3

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

SESS

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AA05

2. TITLE OF DATA ITEM

Configuration Status Accounting Information

3. SUBTITLE

Configuration Status Accounting Report

4. AUTHORITY (Data Acquisition Document No.)

DI-CMAN-81253A (See Block 16)

5. CONTRACT REFERENCE

PWS Para 5.6.1 & 5.6.2

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: Contractor format is acceptable. The deliverable shall be done in MS Excel.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. 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. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-12.

AIR 4.1.1.3

AIR 6.6.1.1

AIR-6.6.2.9

PMA207CM

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AA06

2. TITLE OF DATA ITEM

Technical Directive Compliance Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80224B (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.6.3

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 10 December 2014. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 10 calendar days after every depot event that had Technical Directive incorporations accomplished.

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-12.

AIR 4.1.1.3

AIR 6.6.1.1

AIR-6.6.2.9

OSGR

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

SAFT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AA07

2. TITLE OF DATA ITEM

Accident / Incident Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-SAFT-81563 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.7

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 10 December 2014. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted within 24 hours after each accident and incident event.

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-12.

Utility Lift IPTL

AIR 4.1.1.3

AIR 6.6.1.1

AIR-2.4.3.1.5

PMA 273E

AIR-6.6.2.9

COR / TPOC

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

SESS

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AA08

2. TITLE OF DATA ITEM

Source Data for Forecasting Diminishing Manufacturing Sources and Material Shortages

(DMSMS)

3. SUBTITLE

Obsolescence and DMSMS Summary

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-81656 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.8.6

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: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. 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. The Government considers the data delivered herein as necessary for operation, maintenance, installation, or training (OMIT) of the C-12.

AIR 4.1.1.3

AIR 6.6.1.1

AIR-6.6.2.9

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AA09

2. TITLE OF DATA ITEM

Briefing Material

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81605 (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.12.1.2

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 10 December 2014. Other requests for this document shall be referred to PMA-207.

Blocks 12 & 13: Deliverables shall be submitted 10 calendar days prior to every Program Management Review.

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-12.

Utility Lift IPTL

AIR 2.3.5.1

AIR 4.1.1.3

AIR 6.6.1.1

PMA 273E

AIR-6.6.2.9

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AB01

2. TITLE OF DATA ITEM

Material Utilization and Forecasting Report

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-81947 (T) (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.8.4

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

(See Block 16)

12. DATE OF FIRST

SUBMISSION

30 June 2018

8. APP CODE

N/A C (See Block 16)

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

31 December 2018

14. DISTRIBUTION

b. COPIES

a. ADDRESSEE Final

Draft Reg. Repro

16. REMARKS

Block 4: Contractor format is acceptable. Tailored as follows:

Disregard National Stock Number unless assigned to part.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. Other requests for this document shall be referred to PMA-207.

Block 10: Semi-annually.

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-12.

Utility Lift IPTL (See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AB02

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

Ordnance Certification Status Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.1.6

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

MTHLY

12. DATE OF FIRST

SUBMISSION

40 DAC

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: Contractor format is acceptable.

Block 9: Distribution authorized to U.S. Government Agencies and their contractors for Administrative and Operational Use determined on 10 December 2014. Other requests for this document shall be referred to PMA-207.

Block 13: Subsequent deliverables shall be submitted on the 10th of every month.

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-12.

AIR 6.6.1.1

AIR-6.6.2.9

AIR 4.1.1.3

COR / TPOC

(See Block 16)

15. TOTAL

G. PREPARED BY

Cindy DuBois

H. DATE

12/30/2014

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

MGMT

D. SYSTEM/ITEM

C-12

E. CONTRACT/PR NO.

N00019-15-R-5500

F. CONTRACTOR

1. DATA ITEM NO.

AB03

2. TITLE OF DATA ITEM

Status Report

3. SUBTITLE

AIRCRAFT STATUS REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A (See Block 16)

5. CONTRACT REFERENCE

PWS PARA 5.8.5

6. REQUIRING OFFICE

PMA-207

7. DD 250

REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

MTHLY

12. DATE OF FIRST

SUBMISSION

40 DACS

8. APP CODE

A (See Block 16)

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…

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