3.04_Amendment-1_N0010423RNF50.pdf

OMB Approval 2700-0042 https://www.navsup.navy.mil/public/navsup/wss/pi_cd/

NSN 5998 01-224-5031 30-105 STANDARD FORM 30 (REV. 10-83)

PREVIOUS EDITION UNUSABLE Computer Generated Prescribed by GSA

FAR (48 CFR) 53.243

1. CONTRACT ID CODE PAGE OF PAGES

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1 9

2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)

0001 22 SEP 2023 23151-0045

6. ISSUED BY CODE N00104 7. ADMINISTERED BY (If other than Item 6) CODE

NAVSUP Weapon Systems Support MECH

5450 CARLISLE PIKE

MECHANICSBURG, PA 17050-2411

Tonya Nearhood, N744.12, PH: 717-605-1649 E-MAIL: Tonya.Nearhood1@navy.mil

8. NAME AND ADDRESS OF CONTRACTOR (No. Street, county, State and ZIP: Code) () 9A. AMENDMENT OF SOLICITATION NO.

N0010423RNF50

X 9B. DATED (SEE ITEM 11)

06 SEP 2023

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

CODE FACILITY CODE

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended, is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

(a) By completing Items 8 and 15, and returning one (1) copy of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATA SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and data specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS, IT MODIFIES THE CONTRACT/ORDER NO. AS

DESCRIBED IN ITEM 14.

() A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return ___ copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)Subject order is hereby modified as follows:

Amendment 0001 is issued to correct the TDP included with the solicitation.

The solicitation included an attached TDP referencing NIIN 016164763 as pages 47 – 54 of the document.

That TDP is deleted and replaced with the correct TDP which is included as part of this amendment and references the correct NIIN 016164760.

The solicitation closing date is extended to 13 October 2023.

15A. NAME AND TITLE OF SIGNER (Type or print) 16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 16C. DATE SIGNED

(Signature of person authorized to sign)

BY _____________________________________________

(Signature of Contracting Officer) mailto:Tonya.Nearhood1@navy.mil

TECHNICAL DATA PACKAGE

NIIN: 016164760 VERSION: 009 PAGE 1

ITEM NAME: CABLE ASSY AUGUST 23, 2023

1. SCOPE

1.1 This contract/purchase order contains the requirements for manufacture and the contract quality requirements for the CABLE ASSY .

2. APPLICABLE DOCUMENTS

2.1 Applicable Documents - The document(s) listed below form a part of this contract/purchase order including modifications or exclusions.

2.1.1 "Document References" listed below must be obtained by the Contractor. Ordering information is included as an attachment to this contract/purchase order.

2.2 Order of Precedence - In the event of a conflict between the text of this contract/purchase order and the references and/or drawings cited herein, the text of this contract/purchase order shall take precedence. Nothing in this contract/purchase order, however, shall supersede applicable laws and regulations unless a specific exemption has been obtained.

2.3

DRAWING NO. CAGE REV DOC TYPE DISTR CD SHEET NR REV TYPE SIZE

2865896 10001 H D3 0001 49998 0218862 6557908 53711 C D3 0001 49998 0163798 6557908 53711 B 1N D3 0001 B 49998 0042208 6557909 53711 B D3 0001 B 49998 0095915 6557910 53711 B D3 0001 B 49998 0038803 6557910 53711 B D3 0002 A 49998 0116693 6557910 53711 B D3 0003 A 49998 0128774 6557910 53711 B D3 0004 B 49998 0109939 6557910 53711 B D3 0005 B 49998 0146188 6557910 53711 B D3 0006 B 49998 0150425 6557910 53711 B D3 0007 A 49998 0072086 6557910 53711 B D3 0008 A 49998 0154324 6557910 53711 B D3 0009 A 49998 0120985 6557910 53711 B D3 0010 A 49998 0087965 6557910 53711 B D3 0011 B 49998 0120099 6557910 53711 B D3 0012 A 49998 0140887 6557910 53711 B D3 0013 A 49998 0100475 6557910 53711 B D3 0014 B 49998 0062842 6557910 53711 B D3 0015 A 49998 0146400 6557911 53711 B D3 0001 49998 0134736 6557912 53711 B D3 0001 49998 0122957 6557913 53711 D D3 0001 D 49998 1332088 6557914 53711 C D3 0001 C 49998 0087391 6557915 53711 A D3 0001 A 49998 0794337 6557916 53711 A D3 0001 A 49998 0047644 6557917 53711 A D3 0001 49998 0099611 6557918 53711 A D3 0001 49998 0101071 6557919 53711 A D3 0001 A 49998 0075022 6557920 53711 D D3 0001 D 49998 0585824 6557920 53711 D D3 0002 D 49998 0069033 6557920 53711 D D3 0003 D 49998 0068866 6557920 53711 D D3 0004 D 49998 0068973 6557920 53711 D D3 0005 D 49998 0103317 6557920 53711 D D3 0006 D 49998 0105087 6557920 53711 D D3 0007 D 49998 0100631 6557920 53711 D D3 0008 D 49998 0061918 6557920 53711 D D3 0009 D 49998 0065998 6557920 53711 D D3 0010 D 49998 0085150 6557920 53711 D D3 0011 D 49998 0099513 6557920 53711 D D3 0012 D 49998 0083302 6557920 53711 D D3 0013 D 49998 0114026 6557920 53711 D D3 0014 D 49998 0095451 6557920 53711 D D3 0015 D 49998 0033740 6557920 53711 D D3 0016 D 49998 0087636 6557920 53711 D D3 0017 D 49998 0095682 6557920 53711 D D3 0018 D 49998 0105388 6557920 53711 D D3 0019 D 49998 0105687 6557920 53711 D D3 0020 D 49998 0037078 6557920 53711 D D3 0021 D 49998 0051895 6557920 53711 D D3 0022 D 49998 0047424 6557920 53711 D D3 0023 D 49998 0050504 6557920 53711 D D3 0024 D 49998 0101616

NIIN: 016164760 VERSION: 009 PAGE 2

ITEM NAME: CABLE ASSY AUGUST 23, 2023

6557920 53711 D D3 0025 D 49998 0043268 6557920 53711 D D3 0026 D 49998 0094793 6557920 53711 D D3 0027 D 49998 0125762 6557920 53711 D D3 0028 D 49998 0073303 6557921 53711 A D3 0001 49998 0112140 6557942 53711 C D3 0001 49998 0707561 6557944 53711 F A 0001 F 49998 0112329 7339969 53711 C D3 0001 C 49998 0750965 7521581 53711 B A 0001 49998 0791791 8350592 53711 B D3 0001 B 49998 0140748 8485767 53711 A D3 0001 A 49998 3859049

DOCUMENT REFERENCES

SPEC NO. SLASH NO. PART NO REV DATE DISTR CD AMEND CHG NTC SUPP

MIL-STD-12 D 25 SEP 98 A

ASQ Z1.4 01 JAN 03 A

MIL-STD-129 R 24 MAY 18 A

MIL-STD-130 N 16 NOV 12 A

MIL-C-915 0002 A 25 SEP 70 A

ANSI 14.5 M 01 JAN 94 A

DOD-STD-2101 10 MAY 79 A

MIL-S-8660 C 30 SEP 99 A 2

MIL-I-16923 H 13 AUG 91 A

MIL-C-22520 0001 C 06 JUL 81 A 2

MIL-STD-100 E 03 MAR 92 A 01

MIL-HDBK-454 B 15 APR 07 A

ISO9001 17 APR 01 A

NAVSEA S9320-AM-PRO-020/MLDGR2 01 AUG 13 D

3. REQUIREMENTS

3.1 Design, Manufacture, and Performance - Except as modified herein, the CABLE ASSY furnished under this contract/purchase order shall meet the design, manufacture, and performance requirements specified on drawing <7339969> cage <53711> .

3.1.1 <PN: 7339969-3>

3.2 Marking - This item shall be physically identified in accordance with <MIL-STD-129> .

3.3 Changes in Design, Material Servicing, or Part Number - Except for a Code 1 change, which shall be processed as provided in the code statement shown below, no substitution of items shall be made until the SPCC Contracting Officer has been notified and approval has been given by issuance of a written change order. When any change in design, material, servicing or part number is made to replace or substitute any item to be furnished on this contract/purchase order, the Contractor shall furnish, for the substituting/replacement item, a drawing and an explanation of the reason for the change, or a detailed description of the change, explaining the reason therefore.

If finished detail drawings are not available, shop drawings inthe form used by the manufacturer will be acceptable for Government evaluation. When notifying the Contracting Officer of the reasons for making substitutions, the type of change shall be indicated by code number in accordance with one of the following statements:

Code 1: PART NUMBER CHANGE/MINOR DESIGN CHANGE - If the Manufacturer's Part Number or item design indicated thereon has changed, but form, fit and function of the item is not affected thereby, and the design change meets the criteria for minor, by not effecting form, fit, function, reliability or safety , supply the item and advise SPCC immediately of the new part number, furnishing a detail drawing and/or a detailed description of the change, as applicable.

Code 2: Assembly (or set or kit) not furnished - Used following detail parts.

Code 3: Part not furnished separately - Use assembly.

Code 4: Part redesigned - Old and new parts are completely interchangeable.

Code 5: Part redesigned - New part replaces old. Old part cannot replace new.

Code 6: Part redesigned - Parts not interchangeable.

3.4 Mercury Free - The material supplied under this contract/purchase order is intended for use on submarines/surface ships and therefore shall contain no metallic mercury and shall be free from mercury contamination. Mercury contamination of the material will be cause for rejection.

If the inclusion of metallic mercury is required as a functional part of the material furnished under this

NIIN: 016164760 VERSION: 009 PAGE 3

ITEM NAME: CABLE ASSY AUGUST 23, 2023

contract, the Contractor shall obtain written approval from the Procurement Contracting Officer before proceeding with manufacture. The contractor's request shall explain in detail the requirements for mercury, identify specifically the parts to contain mercury, and explain the method of protection against mercury escape. Such a request will be forwarded directly to the Procurement Contracting Officer with a copy to the applicable Government Inspector. Upon approval by the Contracting Officer, the vendor will provide a "Warning Plate" stating that metallic mercury is a functional part of the item and will include name and location of that part.

The use of mercury, mercury compounds, or mercury-bearing instruments and/or equipment in a manner which might cause contamination in the manufacture, assembly, or test of material on this contract is prohibited. The most probable causes of contamination are direct-connected manometers, mercury vacuum pumps, mercury seals, or the handling of mercury in the immediate vicinity. Mercury switches, mercury in glass thermometers, standard cells and other items containing mercury may be used if they are located so as not to constitute a contamination hazard.

If external contamination by metallic mercury occurs or is suspected, the following test may be used to determine whether contamination by metallic mercury exists or whether corrective cleaning measures have been effective. Enclose the equipment in a polyethylene bag or close-fitting airtight container for eight hours at room temperature (70 degrees F minimum).Sample the trapped air and if mercury vapor concentration is 0.01 mg/cu meter or more, the material is mercury contaminated insofar as the requirements of this contract are concerned.

These requirements shall be included in any subcontract or purchase order hereunder and the Contractor shall insure SubContractor compliance with these requirements.

Technical questions pertaining to these requirements shall be referred to the Procurement Contracting Officer via the cognizant Administrative Contracting Officer. For background, the following information is provided:

Mercury is corrosive to gold, silver, nickel, stainless steels, aluminum and copper alloys. Stainless steels, nickel, and copper alloys are widely used in reactor plants and other submarine/surface ship systems. Accidental trapping of mercury in a component could cause serious damage to vital parts. Mercury is also toxic if inhaled, ingested, or absorbed through the skin. It is evident that grave consequences could result from small amounts of mercury vapor present in an unreplenished submarine/surface ship atmosphere.

3.4.1 NAVSEA S9320-AM-PRO-020/MLDG - Manufacture of this item requires vendor certification in accordance with

NAVSEA S9320-AM-PRO-020/MLDG.

3.5 First Article Approval (Contractor Testing) - First Article Test (FAT) and approval is required.

4. QUALITY ASSURANCE

4.1 Responsibility for Inspection - Unless otherwise specified in the contract/purchase order, the Contractor is responsible for the performance of all inspection requirements as specified herein. Except as otherwise specified in the contract/purchase order, the Contractor may use his own or any other facilities suitable for the performance of the inspection requirements specified herein, unless disapproved by the Government. The Government reserves the right to perform any of the inspections set forth in the specification where such inspections are deemed necessary to assure supplies and services conform to prescribed requirements.

4.2 Quality System Requirements - The supplier shall provide and maintain a quality system acceptable to the Government. The quality system requirements shall be in accordance with ISO 9001.

4.2.1 <Suppliers currently using and maintaining Inspection System Requirements to ISO-9001 are granted permission to utilize MIL-I-45208 if desired.>

4.3 Responsibility for Compliance - All items must meet all requirements of this contract/purchase order. The inspection set forth in this specification shall become a part of the Contractor's overall inspection system or quality program. The absence of any inspection requirements shall not relieve the Contractor of the responsibility of assuring that all products or supplies submitted to the Government for acceptance comply with all requirements of the contract/purchase order. Sampling in quality conformance does not authorize submission of known defective material, either indicated or actual, not does it commit the Government to acceptance of defective material.

4.4 Records of Inspection - (This requirement is not applicable to Government Purchase Orders) Records of all inspection work performed by the Contractor, as referenced elsewhere in this contract, shall be kept complete and available to the Government during the performance of the contract and for a period of four years after final delivery of supplies.

4.5 First Article Test Procedures - (Government Approval) - The Contractor shall prepare and submit test procedures in accordance with the Contract Data Requirements List (DD Form 1423). The test procedures shall be approved prior to production.

There is hereby created an option for the Government to waive the requirement for submission of a test procedure. If the Offeror has had its test procedure previously approved by the Government, furnish the name of the approval activity, date of approval, and contract number under which the test procedure was approved.

In the event the Government exercises the option to waive submission of a test procedure, the previously approved procedure shall apply to the contract/purchase order.

NIIN: 016164760 VERSION: 009 PAGE 4

ITEM NAME: CABLE ASSY AUGUST 23, 2023

4.6 First Article Test/Inspection Report - The Contractor shall prepare and submit a report in accordance with the Contract Data Requirements List (DD Form 1423). The report shall be approved prior to production.

5. PACKAGING

5.1 Preservation, Packaging, Packing and Marking - Preservation, Packaging, Packing and Marking shall be in accordance with the Contract/Purchase Order Schedule and as specified below.

MIL-STD 2073 PACKAGING APPLIES AS FOUND ELSEWHERE IN THE SCHEDULE

6. NOTES

6.1 Ordering Information for Document References - The Department of Defense Single Stock Point (DODSSP), Website http://www.dsp.dla.mil/, provides product information for the Department Of Defense Index Of Specifications and Standards (DODISS) (i.e.Military/Federal Specifications and Standards), Data Item Descriptions (DIDs), and other DODSSP Products.

A. Availability of Cancelled Documents - The DODSSP offers cancelled documents that are required by private industry in fulfillment of contractual obligations in paper format. Documents can be requested by phoning the Subscription Services Desk.

B. Commercial Specifications, Standards, and Descriptions - These specifications, standards and descriptions are not available from Government sources. They may be obtained from the publishers of the applicable societies.

C. Ordnance Standards (OS), Weapons Specifications (WS), and NAVORD OSTD 600 Pages - These type publications may be obtained by submitting a request to:

Commander, Indian Head Division, Naval Surface Warfare Center Code 8410P, 101 Strauss Avenue Indian Head, MD 20640-5035

D. On post-award actions, requests for "Official Use Only" and "NOFORN" (Not Releasable To Foreign Nationals) documents must identify the Government Contract Number, and must be submitted via the cognizant Defense Contract Management Command (DCMC) for certification of need for the document. On pre-award actions such requests must be submitted to the PCO for certification of need for the document.

E. NOFORN Military Specifications and Standards (including Amendments, Change Notices and Supplements, but NOT interim Changes) to be ordered from:

Contracting Officer

NAVICP-MECH

Code 87321 5450 Carlisle Pike P.O. Box 2020 Mechanicsburg, Pa. 17055-0788

F. Nuclear Reactor Publications Assigned NAVSEA Documents and Identification Numbers (i.e. NAVSEA Welding Standard, NAVSEA 250-1500-1) are to be ordered from:

Commanding Officer

NAVICP-MECH

Code 009 5450 Carlisle Pike P.O. Box 2020 Mechanicsburg, Pa. 17055-0788

G. Technical Manuals Assigned NAVSEA Identification Numbers (i.e. NAVSEA Welding And Brazing Procedure, NAVSEA S9074-AQ-GIB-010/248) are to be ordered from:

Naval Inventory Control Point Code 1 Support Branch 700 Robbins Avenue Phildelphia, Pa. 19111-5094

H. Interim Changes and Classified Specifications shall be obtained by submitting a request on DD Form 1425 to

NAVICP-MECH.

6.2 Notice To Distributors/Offerors - Consideration for award of contract shall be given only to authorized distributors of the original manufacturer's item represented in this solicitation. If you desire to be considered as a potential source for award of this contract, proof of being an authorized distributor shall be provided on company letterhead signed by a responsible company official and sent with your offer to the Procurement Contracting Officer.

6.3 In accordance with OPNAVINST 5510.1 all documents and drawings provided by the U.S. Navy to perspective Contractors must include a "Distribution Statement" to inform the contractor of the limits of distribution, and the

NIIN: 016164760 VERSION: 009 PAGE 5

ITEM NAME: CABLE ASSY AUGUST 23, 2023

safeguarding of the information contained on those documents and drawings.

There are 7 (seven) seperate distribution statement codes used for non-classified documents and drawings. The definition for each is as follows:

A... approved for public release; distribution is unlimited.

B... distribution authorized to US Governments agencies only.

C... distribution authorized to US Government agencies and their contractors.

D... distribution authorized to DoD and DoD contractors only.

E... distribution authorized to DoD Components only.

F... further distribution only as directed by Commander, Naval Sea

Systems Command, code 09T.

X... distribution is authorized to US Government agencies and private individuals or enterprises eligible to obtain export controlled technical data in accordance with OPNAVINST 5510.161.

6.4 <VENDOR MUST BE PRO-20 CERTIFIED AND OBTAIN 53711 NAVAL ENGINEERING APPROVAL IN ORDER TO QUALIFY AS A SOURCE

TO MANUFACTURE THIS ITEM>

B

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B 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

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, Previous editions are obsolete searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

1. DATA ITEM NO.

1. DATA ITEM NO.

(2 Data Items) Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM ________ OTHER ______________________________

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

DD Form 1423-2, JUN 90

S/N 0102-LF-010-5600

Page ______ of ______ Pages

2. TITLE OF DATA ITEM

2. TITLE OF DATA ITEM

18. ESTIMATED

TOTAL PRICE

18. ESTIMATED

TOTAL PRICE

CONTRACT DATA REQUIREMENTS LIST

I

I

17. PRICE GROUP

17. PRICE GROUP3. SUBTITLE

3. SUBTITLE

7. DD 250 REQ

7. DD 250 REQ

8. APP CODE

8. APP CODE

DIST STATEMENT

DIST STATEMENT

REQUIRED

REQUIRED

9.

9.

10. FREQUENCY

10. FREQUENCY

11. AS OF DATE

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

12. DATE OF FIRST SUBMISSION

DATE OF SUBSEQUENT

DATE OF SUBSEQUENT

SUBMISSION

SUBMISSION

13.

13.

14. DISTRIBUTION

14. DISTRIBUTION

b. COPIES

b. COPIES

4. AUTHORITY

4. AUTHORITY

(Data Acquisition Document No.)

(Data Acquisition Document No.)

5. CONTRACT REFERENCE

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

6. REQUIRING OFFICE

16. REMARKS

16. REMARKS

a. ADDRESSEE

a. ADDRESSEE

Draft

Draft

Repro

Repro

Reg

Reg

Final

Final

15. TOTAL

15. TOTAL

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

X

CABLE ASSY

F.A.T ART. QUALIFICATION PROC.

FIRST ARTICLE QUALIFICATION TEST PLAN

DI-NDTI-81307A FAR 52,SUBPR52.209-3 NAVSUP-WSS

SS ONE/R ASREQ

A E NA NA

DCMA 00 01 00

<Approval authority for firt article test and inspection report is NUWCDIVNPT Code 4124.Send to: NAVSUP MECH N7 00 01 00 Benjamin Lessard benjamin.w.lessard.civ@us.navy.mil NUWC CODE 4024 00 01 00

PH# (401) 832-4175 >

<<Approval of the Procedure by NUWC Code 4024 is required prior to commencement of first article unit.>> <An approved copy of the first article qualification test plan and procedure will be provided to the DCMA quality assurance representative, the DCMA QAR will utilize the report to validate and sign the DD250 in the wide area work flow(WAWF).>

00 03 00

FIRST ARTICLE/INSP.TEST REPORT

TEST REPORT

DI-NDTI-80809B FAR 52,SUBPR52.209-3 NAVSUP-WSS

SS ONE/R ASREQ

A A NA NA

DCMA 00 01 00

<Acceptance authority for first article test and inspection report is NUWCDIVNPTCode 4124.Send to: NAVSUP MECH N7 00 01 00 Benjamin Lessard benjamin.w.lessard.civ@us.navy.mil NUWC CODE 4024 00 01 00 Phone: 401-832-4793>

<<APPROVAL OF THE REPORT BY NSWC PHILADELPHIA DIVISION IS

REQUIRED PRIOR TO COMMENCEMENT OF PRODUCTION LOT UNITS.>>

<A copy of the First Article Test Report will be provided to the DCMA QAR.>

00 03 00

KLMNOPQRST

NAVSUP WSS N97131.26 2023 JUN 06 ANDREW J DAMAN 2023 JUN 06

1 2

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B 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

Public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, Previous editions are obsolete searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

1. DATA ITEM NO.

1. DATA ITEM NO.

(2 Data Items) Form Approved OMB No. 0704-0188

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TDP ________ TM ________ OTHER ______________________________

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

DD Form 1423-2, JUN 90

S/N 0102-LF-010-5600

Page ______ of ______ Pages

2. TITLE OF DATA ITEM

2. TITLE OF DATA ITEM

18. ESTIMATED

TOTAL PRICE

18. ESTIMATED

TOTAL PRICE

CONTRACT DATA REQUIREMENTS LIST

I

I

17. PRICE GROUP

17. PRICE GROUP3. SUBTITLE

3. SUBTITLE

7. DD 250 REQ

7. DD 250 REQ

8. APP CODE

8. APP CODE

DIST STATEMENT

DIST STATEMENT

REQUIRED

REQUIRED

9.

9.

10. FREQUENCY

10. FREQUENCY

11. AS OF DATE

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

12. DATE OF FIRST SUBMISSION

DATE OF SUBSEQUENT

DATE OF SUBSEQUENT

SUBMISSION

SUBMISSION

13.

13.

14. DISTRIBUTION

14. DISTRIBUTION

b. COPIES

b. COPIES

4. AUTHORITY

4. AUTHORITY

(Data Acquisition Document No.)

(Data Acquisition Document No.)

5. CONTRACT REFERENCE

5. CONTRACT REFERENCE

6. REQUIRING OFFICE

6. REQUIRING OFFICE

16. REMARKS

16. REMARKS

a. ADDRESSEE

a. ADDRESSEE

Draft

Draft

Repro

Repro

Reg

Reg

Final

Final

15. TOTAL

15. TOTAL

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

X

CABLE ASSY

CERTIFICATE OF CONFORMANCE

CERTIFICATION/DATA REPORT

DI-MISC-80678 SEE SEC E PARA 4. NAVSUP WSS

SS ONE/R ASREQ

NA A NA NA

DCMA 00 01 00

<The vendor is required to add a test report and CoC in the box with the cables NAVSUP N7 00 01 00 Vendor format is acceptable>

NUWC CODE 4124 00 01 00

00 03 00

KLMNOPQRST

NAVSUP WSS N97131.26 2023 JUN 06 ANDREW J DAMAN 2023 JUN 06

2 2

A003

DD FORMo1423-2 REVERSE, JUN 90

5010.12-L (AMSDL), or one-time DID number, that defines data

Package; TM - Technical Manual; Other - other category of data, such as "Provisioning," "Configuration Management", etc.

(See DoD 5010. 12-M for detailed instructions.)

Use for additional/clarifying information for Items 1 through 15. Examples are: Tailoring of documents cited in Item 4;

Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14,; Desired medium for delivery of the data item.

Enter total number of draft/final copies to be delivered.

Enter addresses and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Specify when subsequent submittals are required, when applicable.

Specify when first submittal is required.

Specify as-of date of data item, when applicable.

Specify number of times data items are to be delivered.

For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoD 5230.24).

Specify requirement for approval of a draft before preparation of the final data item.

Specify requirement for inspection/acceptance of the data item by the Government.

Enter technical office responsible for ensuring adequacy of the data item.

Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD content and format requirements.

Enter subtitle of data item for further definition of data item (optional entry).

Enter title as it appears on data acquisition document cited in Item 4.

Date CDRL was approved.

Signature of CDRL approval authority.

Date CDRL was prepared.

Signature of preparer of CDRL.

Enter name of system/item being acquired that data will support

Self-explanatory

INSTRUCTIONS FOR COMPLETING DD FORM 1423

FOR GOVERNMENT PERSONNEL

Item A.

Item B.

Item C.

Self-explanatory

Mark (X) appropriate category: TDP - Technical Data

Item D.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G.

Item H.

Item I.

Item J.

Item 1.

Item 2.

See Dod FAR Supplement Subpart 4.71 for proper numbering.

Item 3.

Item 4.

Item 5.

Item 6.

Item 7.

Item 8.

Item 9.

Item 10.

Item 11.

Item 12.

Item 13.

Item 14.

Item 15.

Item 16.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

b. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to theperformance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data.

These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirements to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data.

The Government's right to use the data shall be governed by the pertinent provisions of the contract.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essentialdata item without conforming to Government requirements,and the administrative and other expenses related toreproducing and delivering such data item to the Government.