CDRL_A002_FAT_Report.pdf

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IDIQ FABRICATION/REFURBISHMENT OF SHIPPING/STORAGE CONTAINERS
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N0016414RWT39
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CDRL A002

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G. PREPARED BY

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, FEB 2001

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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: A
TDP:
TM:
OTHER: X - QCIC
DSYSTEMITEM: AN/ALQ-99
E_CONTRACTPR_NO: N00164-14-R-WT39
FCONTRACTOR: TBD
1_DATA_ITEM_NO: A002
2_TITLE_OF_DATA_ITEM: QUALIFICATION TEST REPORT (QTR)
3_SUBTITLE: First Article Test Report
4_AUTHORITY_Data_Acquisit: DI-QCIC-81890
5_CONTRACT_REFERENCE: SOW paragraph 4.1.7
6_REQUIRING_OFFICE: NSWC Crane Code WXT
7_DID_250_REQ: LT
8_APP_CODE:
DIST_STATEMENT: D
10_FREQUENCY: OTIME
11_AS_OF_DATE:
12_DATE_OF_FIRST_SUBMISSI: SEE BLOCK 16
13_DATE_OF_SUBSEQUENT_SUB:
addressee1: NSWC Block 16
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total_draft: 0
total_repro: 0
16_REMARKS: Block 9 - DISTRIBUTION STATEMENT D APPLIES. Distribution authorized to DoD and U.S. DoD contractors only (2/3/14). Other requests shall be referred to NSWC Crane Spectrum Warfare Systems Department.

Block 12 - First Article Test Report shall be submitted within 10 days after testing is completed.

Block 14 - Report shall be emailed to:

richard.lemons@navy.mil

OMB:
ADN:
send_to:
17_1:
17_b:
17_c:
17_d:
17_PRICE_GROUP:
ESTIMATED_TOTAL_PRICE:
2014-02-05T14:47:58-0500
LEMONS.RICHARD.A.1230327560
H_DATE: 5 Feb 2014
J_DATE: 5 Feb 2014
Page: 2
of_pages: 2
Reset:
reg38t: 1
2014-02-05T15:03:46-0500
WILSON.KATHY.J.1230327382

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