C12_Other_CDRL A001 .pdf
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The document is a Contract Data Requirements List (CDRL) form DD 1423-1 for a naval equipment repair contract. The specific data item (A001) is a Failure Summary and Analysis Report for a WXRWL Oscilloscope Repair, with the requiring office being NSWC Crane, Code WXR. The document specifies that the contractor shall provide a Cost Estimate Report for equipment and services in support of the Statement of Work, including all information according to DI-SESS-80255. The report must be submitted electronically (compatible with Microsoft Office Suite) via email to the Technical Point of Contact identified in the contract, with a final report to be submitted within five days of service completion.
The CDRL includes a distribution statement with a warning that the technical data is export-restricted by the Arms Export Control Act, with potential criminal penalties for violation. The contract details are marked as To Be Determined (TBD) for the contract/PR number and contractor, suggesting this is a preliminary document for a sole-source procurement with Keysight Technologies, Inc. for repair and calibration of a specific oscilloscope (PN: UXR0402A, SN: SG62410101) at Naval Surface Warfare Center Crane.
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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
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. 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
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 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.
DIST
22202-4302.
17. PRICE GROUP
18. ESTIMATED
TOTAL PRICE
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED. Page of Pages
| 1_DATA_ITEM_NO: A001 |
| 2_TITLE_OF_DATA_ITEM: Failure Summary and Analysis Report |
| 3_SUBTITLE: Failure Analysis/Service Notes |
| 4_AUTHORITY_Data_Acquisit: DI-SESS-80255 |
| 5_CONTRACT_REFERENCE: SOW 3.1 |
| 6_REQUIRING_OFFICE: NSWC Crane, Code WXR |
| 7_DID_250_REQ: LT |
| 8_APP_CODE: N/A |
| 10_FREQUENCY: ASREQ |
| 12_DATE_OF_FIRST_SUBMISSI: Block 16 |
| 13_DATE_OF_SUBSEQUENT_SUB: N/A |
| DIST_STATEMENT: D |
| 11_AS_OF_DATE: Block 16 |
| addressee1: Technical POC |
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| 16_REMARKS: BLK 4 - The contractor shall provide a Cost Estimate Report for equipment and services in support of the Statement of Work (SOW) tasking. This report shall include all information in accordance with DI-SESS-80255. |
BLK 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 ct. 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 5200.72-M, Industrial Security Manual, Section II-19 or DoD 5200-1-R, Information Security Program Regulation, Chapter IX. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document."
BLK 11/12 - The contractor shall submit a final report to the Government within five (5) days of service completion.
BLK 14 - Distribution - Submission shall be in electronic format (compatible with Microsoft Office Suite software) delivered via email.
Addressee Lists - Technical POC identified in the contract.
| A_CONTRACT_LINE_ITEM_NO: | |
| B_EXHIBIT: A | |
| TDP: | |
| TM: | |
| OTHER: SESS | |
| DSYSTEMITEM: WXRWL Oscilloscope Repair | |
| E_CONTRACTPR_NO: TBD | |
| FCONTRACTOR: TBD | |
| of_pages: 1 | |
| Reset: | |
| ADN: | |
| send_to: | |
| 17_1: | |
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| ESTIMATED_TOTAL_PRICE: | |
| 2025-06-25T13:09:09-0400 | |
| PICCOLI.DANIEL.RENZO.1600070572 |
| H_DATE: | |
| 2025-06-25T13:35:40-0400 | |
| AIMAN.SAVANNAH.L.1278009137 |
| J_DATE: 06/25/2025 |
| Page: 1 |
| reg38x: |
| reg38t: 1 |
| title: |
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