CDRL.pdf

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 the Department of Defense, Executive Services and Communications Directorate (0704-0188). 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 organization. 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. 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

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

Page of Pages

0001 A X

Antenna Wire Assembly TBD Rockwell Collins

A001 Certificate of Compliance CoC

DI-MISC-81356A SOW Para 3.0 NSWC Crane Code JXVN

XX

See Block 16

See Block 16

N/A

See Block 16

See Block 16 See Block 16 1 1

0 1 1

Block 4: DI-MISC-81356A - Electronic submittals shall be electronic file submittals and shall be compatible with Microsoft Office

Block 9: DISTRIBUTION STATEMENT D APPLIES- "Warning - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C. Sec 2751 et sea), or Executive Order 12470. Violation of these export laws are subject to severe criminal Penalties."

"Destruction Notice - For classified documents, follow the Procedures in DOD 5200.22-M, Industrial Security Manual, Section 11-19 or DOD 5200-1-R, Information Security Program Regulation, Chapter 1X. For unclassified limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document."

Block 10/12: The Contractor shall submit a Certificate of Compliance with each asset sent to NSWC, Crane, IN.

Block 14:

Angela.parsons1@navy.mil

NSP

0.00

2/16/18 2/16/2018

1 1

PARSONS.ANGELA.D.12

47431450

Digitally signed by PARSONS.ANGELA.D.1247431450 DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=PARSONS.ANGELA.D.1247431450 Date: 2018.02.01 10:42:30 -05'00'

NOEL.KATHRYN.AN

N.1081202466

Digitally signed by

NOEL.KATHRYN.ANN.1081202466

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=NOEL.KATHRYN.ANN.1081202466 Date: 2018.02.16 11:33:01 -05'00'