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CONTRACT DATA REQUIREMENTS LIST

(1 Data Item) Form Approved

OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 (0704- 0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A.CONTRACT LINE ITEM NO.

B.EXHIBIT

C.CATEGORY:

TDP TM OTHER

D. SYSTEM/ITEM

E.CONTRACT/PR

NO.

F.CONTRACTOR

1.DATA ITEM NO.

A001

2.TITLE OF DATA ITEM

Test Procedure

3.SUBTITLE

17.PRICE GROUP

4.AUTHORITY (Data Acquisition Document No.) 5.CONTRACT REFERENCE

6.REQUIRING OFFICE 18.ESTIMATED

TOTAL PRICE

DI-NDTI-80603A ALL DRAWINGS NUWC DIV KEYPORT CODE 423

7.DD250 REQ

DD

9.DIST STATEMENT

REQUIRED

10.FREQUENCY

ONE TIME

12.DATE OF FIRST

SUBMISSION

14.DISTRIBUTION

D

60 DAC

a. ADDRESSEE

b. COPIES

8.ADP CODE

A

11.AS OF

DATE

13.DATE OF SUBSEQUENT

Draft

Final

Reg Repro

16.REMARKS SEE BLOCK 16 0 1 0

THE PLAN IS TO SPECIFY PROCESS CONTROL INSTRUCTIONS AND INSPECTION

PROCEDURES NEEDED TO ENSURE PRODUCT CONFORMANCE TO DRAWINGS,

SPECIFICATIONS, AND CONTRACT REQUIREMENTS IAW ANSI/ASQC Q9000-2000 OR

EQUIVALENT. THE PLAN IS TO INCLUDE FIRST ARTICLE AND PRODUCTION LOT

QUALITY CONFORMANCE INSPECTION PROCEDURES IAW DI-NDTI-80603A ALONG

WITH ALL APPLICABLE DATA ENTRY SHEETS TO BE USED TO DOCUMENT PROCESS

INSPECTIONS.

BLK 14: DISTRIBUTION ADDRESS

N00104

COMMANDING OFFICER

NAVSUP WEAPON SYSTEMS SUPPORT

ATTN: CODE N772

5450 CARLISLE PIKE

P.O. BOX 2020

MECHANICSBURG, PA 17055-0788

Aaron.Heit@navy.mil

15.TOTAL 0 1 0

G. PREPARED BY:

Margaret Bowerman

H. DATE

2 August 2018

I. APPROVED BY:

Jeremy Hilliker

J. DATE

2 August

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 5 Pages mailto:Aaron.Heit@navy.mil

The public reporting burden for this collection of information is estimated to average 220 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 (0704- 0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A.CONTRACT LINE ITEM NO.

0001AA

D. SYSTEM/ITEM

E.CONTRACT/PR NO.

A002

2.TITLE OF DATA ITEM

Test/Inspection Report

3.SUBTITLE

Pre-Production & Production Test

DI-NDTI-80809B ALL DRAWINGS NUWC DIV KEYPORT CODE 423

DD

REQUIRED

10.FREQUENCY

PER LOT

SEE BLOCK 16

a. ADDRESSEE

b. COPIES

8.ADP CODE

16.REMARKS SEE BLOCK 16 0 1 0

THE REPORT IS TO VERIFY PRODUCTION LOT CONFORMANCE TO THE APPLICABLE

DRAWINGS, SPECIFICATIONS, AND CONTRACT REQUIREMENTS. THE REPORT

CONSISTS OF THE PLAN (A001) CONTAINING ALL REQUIRED INSPECTION

RESULTS DOCUMENTED ON THE PLAN’S DATA ENTRY SHEETS. IN ADDITION, THE

REPORT IS TO INCLUDE MATERIAL CERTIFICATIONS AND ALL OTHER PERTINENT

OBJECTIVE QUALITY EVIDENCE. THE REPORT MUST BE APPROVED BY NAVSUP

WSS CONTRACTING OFFICER BEFORE FINAL ACCEPTANCE OF THE LOT.

BLK 12: DATE OF PRE-PRODUCTION TEST REPORT SUBMISSION – NLT 15 DAYS

AFTER FIRST ARTICLE TEST COMPLETION.

BLK 13: DATE OF SUBSEQUENT SUBMISSION – NLT 15 DAYS AFTER LOT

ACCEPTANCE TESTING OF SECOND LOT AND BEYOND.

BLK 14: DISTRIBUTION ADDRESS

N00104

COMMANDING OFFICER

NAVSUP WEAPON SYSTEMS SUPPORT

ATTN: CODE N772

5450 CARLISLE PIKE

P.O. BOX 2020

Margaret Bowerman

H. DATE

2 August 2018

I. APPROVED BY:

Jeremy Hilliker

J. DATE

2 August 2018

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 2 of 5 Pages

The public reporting burden for this collection of information is estimated to average 220 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 (0704- 0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A.CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

MK54 TORPEDO - PERIODIC

MAINTENANCE KIT

A003

2.TITLE OF DATA ITEM

Certificate of Compliance

3.SUBTITLE

COC

DI-MISC-81345A All Drawings-7608938 NUWC DIV KEYPORT CODE 423

LT

REQUIRED

10.FREQUENCY

One time each w/ FAT and Production Lot.

With First Article (if required)

a. ADDRESSEE

Per Production Lot

16.REMARKS SEE BLOCK 16 0 1 0

CERTIFICATES OF CONFORMANCE ARE TO BE PROVIDED TO SHOW CONFORMANCE TO

ALL DRAWINGS AND ALL SPECIFICATIONS NOTED, AND CONTRACT REQUIREMENTS

AS PROVIDED IN TECHNICAL DATA PACKAGE. SHALL BE SUBMIITED WITH THE

FIRST ARTICLE (IF REQUIRED) AND PRODUCTION LOT, AND ANY SUBSEQUENT

OPTION LOTS THAT GET EXERCISED.

BLK 12: DATE OF PRE-PRODUCTION TEST REPORT SUBMISSION – NLT 15 DAYS

AFTER FIRST ARTICLE TEST COMPLETION.

BLK 13: DATE OF SUBSEQUENT SUBMISSION – NLT 15 DAYS AFTER LOT

ACCEPTANCE TESTING OF SECOND LOT AND BEYOND.

BLK 14: DISTRIBUTION ADDRESS

N00104

COMMANDING OFFICER

NAVSUP WEAPON SYSTEMS SUPPORT

ATTN: CODE N772

5450 CARLISLE PIKE

P.O. BOX 2020

Margaret Bowerman

H. DATE

2 August 2018

I. APPROVED BY:

Jeremy Hilliker

J. DATE

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 3 of 5 Pages

The public reporting burden for this collection of information is estimated to average 220 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 (0704- 0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A.CONTRACT LINE ITEM NO.

D. SYSTEM/ITEM

MK54 REXTORP – REXTORP

A004

2.TITLE OF DATA ITEM

Lot Report

3.SUBTITLE

TEST REPORT

DI-NDTI-80809B ALL DRAWINGS-7608938 NUWC DIV KEYPORT CODE 423

SD

REQUIRED

10.FREQUENCY

PER LOT

16.REMARKS SEE BLOCK 16 0 1 0

THE REPORT IS TO VERIFY PRODUCTION LOT CONFORMANCE TO THE APPLICABLE

DRAWINGS, SPECIFICATIONS, AND CONTRACT REQUIREMENTS. THE REPORT

CONSISTS OF ALL REQUIRED INSPECTION RESULTS DOCUMENTED ON DATA ENTRY

SHEETS. IN ADDITION, THE REPORT IS TO INCLUDE MATERIAL

CERTIFICATIONS AND ALL OTHER PERTINENT OBJECTIVE QUALITY EVIDENCE.

DCMA REVIEW IS REQUIRED PRIOR TO SUBMITTAL NAVSUP WSS. THE REPORT

MUST BE APPROVED BY NAVSEA KEYPORT BEFORE FINAL ACCEPTANCE OF THE

LOT.

BLK 12: DATE OF PRE-PRODUCTION TEST REPORT SUBMISSION – NLT 15 DAYS

AFTER FIRST ARTICLE TEST COMPLETION.

BLK 13: DATE OF SUBSEQUENT SUBMISSION – NLT 15 DAYS AFTER LOT

ACCEPTANCE TESTING OF SECOND LOT AND BEYOND.

BLK 14: DISTRIBUTION ADDRESS

N00104

COMMANDING OFFICER

NAVSUP WEAPON SYSTEMS SUPPORT

ATTN: CODE N772

5450 CARLISLE PIKE

P.O. BOX 2020

MECHANICSBURG, PA 17055-0788

Aaron.Heit@navy.mil

15.TOTAL 0 1 0

G. PREPARED BY:

Margaret Bowerman

H. DATE

2 August

I. APPROVED BY:

Jeremy Hilliker

J. DATE

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 4 of 5 Pages

The public reporting burden for this collection of information is estimated to average 220 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 (0704- 0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A.CONTRACT LINE ITEM

NO.

D. SYSTEM/ITEM

MK54 REXTORP – REXTORP

1. DATA ITEM NO.

A005

2.TITLE OF DATA ITEM

Production Line Of Balance Status

3.SUBTITLE

Production Progress Report

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

DI-MGMT-80034 See Block 16 NUWC Keyport Division Code N421

LT

9.DIST STATEMENT

AS REQUIRED

10.FREQUENCY

MTHLY

N/A

16.REMARKS NUWC Keyport 0 1 (Block 5) Contractor shall submit a monthly progress report (DD Form 375) describing the NAVSUP WSS 1 0 contractor's current progress in a graphic form by comparison of planned objectives for flow of NAVSUP ALC 0 1 materials and Components into manufacturer of end items as related to delivery requirements.

(Block 12) Date for First Submission: 30 days after start of production.

Report shall be submitted to:

Commanding Officer NUWC Keyport Division Attn: Code N421 610 Dowell Street Keyport, WA 98325 nicole.lerner@navy.mil

Commanding Officer NAVSUP Weapons Systems Support P.O. Box 2020 Mechanicsburg, PA 17055-0788 Aaron.Heit@navy.mil

Officer In Charge NAVSUP Ammunition Logistics Center Attn: Code A112 Bldg. 407N Mechanicsburg, PA 17055-0735 margaret.bowerman@navy.mil

(Block 16) Date of Subsequent Submission: Subsequent reports to be submitted no later than the

5th day of the month (for the month proceeding). Local DCASMA verification required on all

Status reports.

15.TOTAL 0 1 2

G. PREPARED BY

Margaret Bowerman

H. DATE

2 August 2018

I.APPROVED BY

Jeremy Hilliker

J. DATE

2 August 2018

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED 5 5 mailto:nicole.lerner@navy.mil mailto:margaret.bowerman@navy.mil

Distribution of Contract Documents

(See key below)

A B C D

(X) (X) (X) (X) margaret.bowerman@navy.mil

(X) (X) (X) (X) warren.eslinger@navy.mil

(X) (X) (X) (X) nicole.lerner@navy.mil

(X) (X) (X) (X) christian.nazario@navy.mil

(X) (X) (X) (X) john.d.knecht@navy.mil

(X) (X) (X) (X) MECH_NOLSC_PRP@navy.mil

( ) ( ) (X) (X) jdelrio@alionscience.com

( ) ( ) (X) (X) richard.greene2@navy.mil

( ) ( ) (X) (X) DCMA

Key:

A- Solicitation/Amendments B- Preliminary Notice of Award Sheet C- Contract D- Contract Amendments mailto:margaret.bowerman@navy.mil mailto:warren.eslinger@navy.mil mailto:nicole.lerner@navy.mil mailto:christian.nazario@navy.mil mailto:john.d.knecht@navy.mil mailto:MECH_NOLSC_PRP@navy.mil mailto:jdelrio@alionscience.com mailto:richard.greene2@navy.mil

DATE
EXTENSION
EST UNIT PRICE
CONTRACTUAL DETAIL
CONTRACT NO. & DATE
SUPPLIER AND LOCATION
TYPE PROC
QYT
DELS ON SCH
SECTION C
PROCUREMENT SPECIFICATION
SECTION D
Packaging, Packing, Preservation and Transportation
Packaging, Packing, Preservation and Transportation
Packaging, Packing, Preservation and Transportation
SECTION E
INSPECTION AND ACCEPTANCE
MIL-I- 45208.
NOTE:
QUALITY ASSURANCE REQUIREMENTS
SECTION E
52.246-15 -- Certificate of Conformance.
SECTION G – ACCOUNTING DATA
Accounting data will be cited at time of award.
SECTION H – ADMINISTRATIVE POINTS OF CONTACT (MARCH 2016)
SECTION I
FAR 52.242-2 PRODUCTION PROGRESS REPORTS DD Form 375 OR EQUIVALENT
CONTRACT DATA REQUIREMENTS LIST
Form Approved
B.EXHIBIT
CONTRACT DATA REQUIREMENTS LIST
Form Approved
B.EXHIBIT
CONTRACT DATA REQUIREMENTS LIST
Form Approved
B.EXHIBIT
CONTRACT DATA REQUIREMENTS LIST
Form Approved
B.EXHIBIT

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