Exhibit_A_USS_BOISE_CDRLS.ppt

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USS Boise (SSN 764) Engineer Overhaul
Solicitation number
N00024-17-R-4314
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USS Boise (SSN 764) EOH Exhibit A DD 1423 CDRLs

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CONTRACT DATA REQUIREMENTS LIST

(1 Data Item) Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

TDP ________ TM ____________ OTHER _________________________________

1 0

USS BOISE (SSN 764)

N00024-17-R-4314

TBD

A001

DI-MGMT-81919

Section C – SOW

SUPSHIP

LT

OTIME

SEE BLK 16

N/A

A

CLIN 0002

SUPSHIP

1 0

Natalia Argote, PMS392H13 N/A Block 12: Provide 30 business days after the completion of the planning period.

N/A

MGMT

Technical Work Documents Task Group Instructions / Inspection Reports

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

DI-MGMT-80269*

LT

ONE/R *

60 DAC

SEE BLK 16

Block 4: GFM Schedule shall include description of item to include military designator, vendor drawing, and/or part number (if applicable), National Stock Number (NSN), quantity required, date required and source document.

All undocking and Level I SAED/SUBSAFE Items shall be so marked.

Block 5: CLIN 0001, CLIN 0004 and DDGOS 0902-018-2010, 5000-0.

Blocks 10/13: Revisions required for currency.

STATUS OF GOVERNMENT FURNISHED

EQUIPMENT (GFE) REPORT

Schedule of GFM (Exception Report) Material Ordering Schedule

0 1 0

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314

TBD

A002 A

CLIN 0002

PMS392H13

MGMT

Section C - SOW* N/A N/A N/A

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A003

PRODUCT DRAWINGS/ MODELS AND ASSOCIATED LISTS

DI-SESS-81000E

SUPSHIP

LT

(See Blk 16) (See Blk 16) (See Blk 16)

Block 5: Drawings/Tracings shall be provided in an electronic format suitable for reproduction DDGOS 0902-018-2010, 9020.1, NAVSEA SL720-AA-MAN-030 applies to SHIPALTs.

Block 8: Content and format. Allow 10 days for Navy review.

Blocks 10/12/13: In accordance with Block 5 reference requirements.

Block 14: Media requirement EXCEL and PDF with email notification

New And Revised Drawings, Final Tracings

A*

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

SESS

Section C – SOW* 0 1 0

N/A

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A004 Purchase Order (PO)

SUPSHIP

LT

ASREQ*

(See Blk 16) (See Blk 16)

Block 5: CLIN 0001 and DDGOS 0902-018-2010, 5000-0.

Blocks 10/12/13: NLT 10 days after initiation of purchase order.

Material Status Report

DI-MISC-81616

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

MISC

Section C – SOW*

N/A

N/A

N/A 0 1 0 0 1 0 4 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A005

LT

15 DARP

Block 4: Data may be a CD ROM, or as a hard copy. Contractor’s format acceptable. Data shall include both Shipbuilder’s and Vendor’s drawings.

Block 5: CLIN 0001 and DDGOS 0902-018-2010, 5000-0

Ship Construction Report – Drawing/Schedule Status

MTHLY

90 DAC

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW* 0 1 0

DI-MGMT-80368A*

MGMT

N/A N/A

5 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A006

MASS PROPERTIES DATA REPORT

(SUBMARINES)

DI-MISC-81507

LT

See Blk 16

Block 5: DDGOS 0902-018-2010, 9290-1.

Blocks 10/12/13: In accordance with SWLIN 903I01 0SN.0140.0000.

ASREQ

See Blk 16

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

MISC

Section C – SOW* See Blk 16 0 1 0 N/A

6 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A007

LT

Block 5: CLIN 0001 and DDGOS 0902-018-2010, 5000-0.

Block 8: Content and format. Allow 15 days for Navy review.

Block 10: Revisions required to satisfy Navy Comments.

Blocks 10/12: As determined by contractor or directed by Navy.

SUPSHIP 0 1 0

0 2 0

ASREQ*

PMS 392CA3 0 1 0

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

DI-MISC-80750

MISC

TECHNICAL DATA PACKAGE REVIEW REPORT

Deficiency Forms/Reports & ELAR Deliverables A* N/A N/A

20 DARC

7 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A008

DI-SESS-81732

SUPSHIP

LT

Block 5: CLIN 0001 and DDGOS 0902-018-2010, 9020-1.

Block 8: Content and format. Allow 15 days for Navy review.

Block 10: Revisions required to satisfy Navy Comments.

Blocks 10/12: As determined by contractor or directed by Navy.

20 DARC

PMS392CA3

PMS392CB

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW* E-Forms/ EDFS Deliverables

SESS

0 1 0 0 1 0 0 1 0 N/A N/A 0 3 0 8 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A009

SHIP TRIAL AGENDA

DI-MGMT-81643*

Block 4: Data shall satisfy Block 5 reference requirements. OPNAVINST 4700.8K and CINCLANTFLT/CINCPACFLTINST 4790.3 Joint Fleet Maintenance Manual

Block 5:CLIN 0004, DDGOS 0902-018-2010, 9080-1, and
SWLIN 083A01.

Block 8: Submit for government review 60 days prior to Fast Cruise. Content and format. Allow 30 days for Navy review.

Block 10: Revisions required to satisfy Navy review, comments and as directed by Navy.

Block 12: Final approved NLT 30 days prior to Fast Cruise.

ONE/R*

PMS 392CA3

SHIP

TYCOM

A*

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

MGMT

N/A N/A N/A 0 1 0 0 1 0 0 1 0 0 1 0 0 4 0 9 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A010

Blocks 10/12/13: As required by DDGOS DDGOS 0902-018-2010, 9020-1 and SWLIN 013K03.

Block 14: SUPSHIP will provide distribution.

This item includes changes and updates to all publications affected by availability validated by shipcheck. As a minimum, “Printer Proof” copies of SRD shall be onboard prior to Fast Cruise.

PMS392CA3

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW

QCIC

SUBMARINE SAFETY/ MATERIAL

CERTIFICATION BOUNDARY BOOK

Selected Record Drawings and Data

DI-QCIC-80814

N/A N/A N/A 0 1 0 0 1 0 0 2 0 10 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A011

SUBMARINE SAFETY/ MATERIAL

CERTIFICATION COMPOSITE LISTS

PMS 392

Block 5: DDGOS 0902-018-2010, 9020-0, 5000-0 and NAVSEA 0924-062-0010.

Blocks 10/12: Deferred delivery, retain on file.

Blocks 14/15: Quantity and distribution will be provided by SUPSHIP.

DFDEL*

PMS392CA3

DI-QCIC-80815

DFDEL*

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

QCIC

0 1 0 0 2 0 N/A N/A N/A N/A

SUPSHIP

0 1 0 11 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A012 Test/Inspection Report

Block:4: Applicable URO MRC(s) specified in the Availability Work Package. Submarine Maintenance standard 7650-081-091 for those items not specifically inspected under a URO MRC, (e.g., tanks opened for preservation only vice URO MRC inspection(s).)

Block 5:DDGOS 0902-018-2010, 9110-0 and NAVSEA
0924-062-0010

Blocks 10/12/13/14: In accordance with the applicable inspection document, i.e., URO MRC and/or Submarine Maintenance standard 7650-081-091

DI-NDTI-80809B*

Report, Hull Surveys and Surveillance Inspection See Blk 16

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

NDTI

N/A N/A

12 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A013

INTEGRATED PRODUCTION SCHEDULE (IPS) REPORT

Block 5: CLIN 0001 and DDGOS 0902-018-2010, 9190-1.

Block 8: Content. Allow 7 days for Navy review.

Block 10/12: NLT 60 days before availability commences.

Paint Schedule

10 DARC

SHIP

NAVSEA 05UT

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

DI-MGMT-82075*

MGMT

N/A N/A 0 1 0 0 1 0 0 1 0 0 3 0 13 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A014

TEST/INSPECTION REPORT

Block 5: DDGOS 0902-018-2010, 9020-3 and SWLIN 073A01.

Blocks 10/12/13: Data to be delivered in accordance with Block 5.

DI-NDTI-80809B

See Blk 16

PMS 392CA3

SHIP

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

NDTI

Noise Measurement (Submarines) N/A N/A N/A

SUPSHIP

0 1 0 0 1 0 0 1 0 0 3 0 14 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A015

INSPECTION AND TEST PLAN

Block 4: Data shall satisfy Block 5 reference requirements and Availability Work Package requirements.

Block 5: CLIN 0001, DDGOS 0902-018-0210, 9020-0 and SWLINs 022A01, 025A01 and 028B01.

Block 12:Development and submission of test plan schedule (i.e.
POTS/PATS) A – 12 Months
Development and submission of the test plan schedule (i.e. Open and Inspect Plan) A-30 Days

Block 14: SEA05U7T will provide additional distribution as needed.

OTIME

DI-QCIC-81110*

PMS 392CA3

NAVSEA 05UT

Pre-overhaul Material Condition Report

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

QCIC

0 1 0 0 1 0 0 2 0 N/A N/A N/A

15 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A016

INSPECTION AND TEST PLAN

Block 4: To be submitted in digital microsoft project (mpp). Prior approval required to ensure proper sequencing with other scheduled availability events.

Block 5: Including DDGOS 0902-018-2010, 9290-8.

Block 8: Content. Allow 14 days for Navy review.

Block 12: 30 days prior to start of availability.

Block 13: Revise as required to suit availability events scheduled.

ONE/R

DI-QCIC-81110*

SHIP

Compartment Test

A* See Blk 16

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

QCIC

N/A N/A 0 1 0 0 1 0 0 2 0 16 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A017

TEST/ INSPECTION REPORT

Block 4: Completion of all open, inspect, and reporting requirements to identify to fully encompass all open and inspect activities reflected in the AWP and scheduled completion date, will be submitted to the Supervisor for approval and establishment of incentive baseline at least 30 Days prior to the start of the availability. Reports generated during the availability as a result of inspections, test, work requirements, etc., should clearly define the purpose of the inspection or test and include a clear description of condition, comparison of acceptable data vs. actual data, and recommend corrective action required/taken. Data shall be the result of inspections directed on equipment prior to repair, test alteration, etc.

Block 5: CLIN 0004, 0005, & 0006

Blocks 10/12/13: Report required no later than five days after completion of each inspection directed. The contractor shall provide weekly status reports of progress completing Open and Inspect actions to the Open and Inspect Plan.

(See Blk 16)

DI-NDTI-80809B*

SUPSHIP

SHIP

Equipment Inspection Report Prior to Repair/Alteration (See Blk 16)

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

NDTI

0 1 0 0 1 0 N/A N/A N/A 0 2 0 17 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A018

Block 5:Including DDGOS 0902-018-2010, 9110-0, 9020-9
and SWLINS 071A01, 076A01, 073A01, and
087L01.

Blocks 10/12/13: Reports shall be submitted at the time specified in SWLIN and DDGOS sections listed for Block 5 above.

TYCOM

Reports, Hull Structure Tests See Blk 16

SHIP

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

NDTI

TEST/ INSPECTION REPORT

DI-NDTI-80809B

N/A N/A N/A 0 1 0 0 1 0 0 1 0 0 4 0 0 1 0

SEA 08

18 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A019

LT

See Blk 16

Block 5: Including DDGOS 0902-018-2010, 9020-9.

Blocks 12, 13: 30 days after completion of all tests.

Block 14: Data shall consist of one (1) CD per addressee and at the end of the availability provide a complete set of test memorandum.

OTIME

Engineering Documents / Final Set of Test Reports 0 0 4

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

NDTI

DI-NDTI-80809B

N/A N/A N/A

SHIP FORCE

ISIC

SUBMEPP

19 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A020

VESSEL DOCKING AND UNDOCKING PLAN

PMS 392

LT

(See Blk 16)

Block 4: NSTM Chapter 997 and NAVSEA Forms 9997-1, 9997-2, 9997-3, and/or 9997-4 as applicable

Block 5: CLIN 0004 and DDGOS 0902-018-2010, 5000-0

Blocks 10/12/13: As directed by work package.

Docking Reports

5 0

SUPSHIP

SHIP

TYCOM

Planning Yard

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

MGMT

DI-MGMT-82094*

N/A N/A N/A

20 45

NAVSEA 05U7T

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A021

TEST/ INSPECTION REPORT

DI-NDTI-80809B

SUPSHIP

LT

See Blk 16

Block 5: Including DDGOS 0902-018-2010, 9670-1.

Blocks 10/12/13: Submit in accordance with the applicable test schedules.

Reports, Test, Pre-Installation of Coaxial Cables

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

NDTI

N/A N/A N/A 0 1 0 0 1 0 21 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A022

CERTIFICATE OF COMPLIANCE

SUPSHIP

LT

See Blk 16

Block 5: DDGOS 0902-018-2010, 9210-1, NAVSEA S9086-S4-STM-010, Chapter 556, Section 8 and SWLINs 534A01, 518A01, 552A01, 553A01.

Blocks 10/12/13: Reporting shall be in accordance with DDGOS Section 9210-1.

Report Of Cleanliness of Hydraulic Fluid;

Poser and Control Systems

2 0

ASREQ*

DI-MISC-81356A

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

MISC

N/A N/A N/A

22 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A023

TEST PROCEDURE

DI-NDTI-80603A*

SUPSHIP

LT

Block 4:Data shall consist of procedures required for all
shipboard tests. These procedures shall specify, as
appropriate, prerequisites, ship conditions, system
status, precautions, and steps to be followed during
conduct of the test & technically will provide evidence,
including appropriations data, of the acceptability of
the system and components with specification
requirements. System status is defined as the specific
lineup of system valves, circuit breakers, fuses, freeze
seals, blank flanges, etc., in sufficient detail to assure
that scheduled testing can be safely accomplished.
Also, preliminary memoranda, if required.
Block 5:Including DDGOS 0902-018-2010, 9020-9, and
SWLINs 071A01, 076A01, 073A01, 087L01
Block 8:Adequacy of test procedures to demonstrate compliance
with all requirements and for protection of the ship.
Allow 30 days for Navy review.

Blocks 12/13: Initial submit request. Final no later than 30 days prior to availability.

See Blk16

2 0

Integrated Test Package

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

NDTI

N/A N/A

SEA 08

23 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

14. DISTRIBUTION

b. COPIES Draft Final Reg Report

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

16. REMARKS

G. PREPARED BY

I. APPROVED BY

H. DATE

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete Page ____ of ____ Pages 1007/183

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 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.

A024

CERTIFICATE OF COMPLIANCE

SUPSHIP

LT

Block 5: Including DDGOS 0902-018-2010, 9020-0.

Blocks 10/12/13: Provide information required by DDGOS as

required on a case by case basis, prior to use
of products. Submit Inspection and Material
Identification as requirements become known.

Commercial Brand Name Product Equivalency Certificate

DI-MISC-81356A

PMS392H

USS BOISE (SSN 764)

N00024-17-R-4314 Competitive A

CLIN 0002

PMS392H13

Section C – SOW*

MISC

N/A N/A N/A 24 45

Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY

F. CONTRACTOR

E. CONTRACT/PR NO.

D. SYSTEM/ITEM

1. DATA ITEM NO.

2. TITLE OF DATA ITEM

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

7. DD 260 REQ

8. APP CODE

10. FREQUENCY

9. DIST STATEMENT

REQUIRED

12. DATE OF FIRST SUBMISSION

11. AS…

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