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CONTRACT DATA REQUIREMENTS LIST

Form Approved OMB No. 0704-0188

The 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 the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 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

A TDP TM OTHER X

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

ASE Modulators N00164-14-R-GR53 Applied Systems Engineering

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

A001 See BLK 16

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

TOTAL PRICE

DI-MGMT-80269

7. DD 250 REQ 9. DIST STATEMENT 10 FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

LT REQUIRED ANNLY 2/28/2015

F a. ADDRESSEE

b. COPIES

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

Draft Final

N N/A

SUBMISSION

SEE BLK 16 Reg Repro

16. REMARKS

BLOCK 2 – Status of Government Furnished Equipment (GFE)Report

BLOCK 9 - Distribution Statement F, Warning and Destruction Notice Apply.

Further dissemination only as directed by PEO IWS or higher authority. Determination is 28 Feb 2014.

BLOCK 13 – Reports are due each year during contract performance. Reproducible copy shall be PDF format submitted by email to the following:

David.Steward@navy.mil James.Epple@navy.mil Shirley.n.Armstrong@navy.mil

"WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App.

2401 et seq), as amended. Violations of these export laws are subject to severe criminal penalties.

Disseminate in accordance with provisions of DoD Directive 5230.25."

NSWC Crane 3

15. TOTAL -> 0 3 0

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

Naydine Armstrong 8 Jan 2014 Naydine Armstrong 8 Jan 2014

DD Form 1423-1, 1 Jun 90 page 1 of 1

CONTRACT DATA REQUIREMENTS LIST

Form Approved OMB No. 0704-0188

The 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 the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 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

A TDP TM OTHER X

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

ASE Modulators N00164-14-R-GR53 Applied Systems Engineering

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

A002 Test/Inspection Report

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

TOTAL PRICE

DI-NDTI-80809B

7. DD 250 REQ 9. DIST STATEMENT 10 FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

LT REQUIRED SEE BLK 16 SEE BLK 16

F a. ADDRESSEE

b. COPIES

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

Draft Final

N N/A

SUBMISSION

SEE BLK 16 Reg Repro

16. REMARKS

BLOCK 9 - Distribution Statement F, Warning and Destruction Notice Apply.

Further dissemination only as directed by PEO IWS or higher authority. Determination is 28 Feb 2014.

BLOCK 10 – Test data shall be submitted for each production unit shipped.

BLOCK 12/13 Reproducible copy for each individual unit shall be included in shipment with email notification to the following:

David.Steward@navy.mil James.Epple@navy.mil Shirley.n.Armstrong@navy.mil

"WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50, U.S.C., App.

2401 et seq), as amended. Violations of these export laws are subject to severe criminal penalties.

Disseminate in accordance with provisions of DoD Directive 5230.25."

NSWC Crane 3

15. TOTAL -> 0 3 0

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

Naydine Armstrong 8 Jan 2014 Naydine Armstrong 8 Jan 2014

DD Form 1423-1, 1 Jun 90 page 1 of 1

CDRL A001 GFE
CDRL A002 Test Report

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