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DD FORM 1423-2, AUG 96

CONTRACT DATA REQUIREMENTS LIST

(2 Data Items)

PREVIOUS EDITION MAY BE USED.

Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 220 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 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 13. DATE OF SUBSEQUENT

SUBMISSION

12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

14. DISTRIBUTION

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

Page ____ of ____ Pages

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package; TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

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

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

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

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref.

DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. 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.

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.

a. 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 the performance 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.

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

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

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 requirement 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.

DD FORM 1423-2 (BACK), AUG 96

line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: X system: CIWS Install Support ctr_no: TBD contr: TBD data_item1: A001 title1: Kick Off Meeting Minutes sub1: Meeting Minutes auth1:

ref1: SOW section 3.0 & 3.2.14 req_ofc1: NSWC IHEOD TD Picatinny NJ, G3 dd250_1: L/T appcode1: N/A dist1: N/A freq1: One Time (see blk 16) asof1: N/A firstsub1: See blk 16 subsub1: N/A addr1_1: See Blk 16 draft1_1: 0 reg1_1: 2 repro1_1: 0 addr1_2:

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totaldraft1: 0 totalreg1: 2 totalrepro1: 0 rmks1: Block 10 and 12: Provide list of attendees and items discussed at Kick Off Meeting within 10 days following the meeting.

Block 14:NSWC IHEOD TD Picatinny Det.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 phone: 973-724-3152 email: john.sembrat@navy.mil Attn; Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 e-mail steven.brandl@navy.mil group1:

totalprice1:

data_item2: A002 title2: Contractor's Personnel Roster sub2: Security List auth2: DI-MGMT-81834 ref2: SOW section 3.0 & 3.2.14 req_ofc2: NSWC IHEOD TD Picatinny NJ, G3 dd250_2: L/T appcode2: N/A dist2: N/A freq2: AS REQ (See blk 16) asof2: N/A firstsub2: See blk 16 subsub2: See blk 16 addr2_1: See blk 16 draft2_1: 0 reg2_1: 2 repro2_1: 0 addr2_2:

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totaldraft2: 0 totalreg2: 2 totalrepro2: 0 rmks2: Block 10, 12 and 13: List of personnel with security clearances are due ti the Contracting Officer's Representative (COR) 20 days prior to commencement of shipboard work.

Block 14:

NSWC IHD Picatinny Det.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 phone: 973-724-3152 Attn: Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 email: steven.brandl@navy.mil group2:

totalprice2:

prep_by: Steen Brandl prep_sign:

prep_date: 3/15/17 app_by: Steven Brandl app_sign:

app_date: 3/15/17

Page:

of_pages:

app: Adobe Professional 7.0

Reset:

The public reporting burden for this collection of information is estimated to average 220 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 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

Item 4; Clarification of submittal dates in Items 12 and 13;

conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the and does not require any substantial change to conform to Government requirements with regard to depth of content, format, otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: X system: CIWS Install Support ctr_no: TBD contr: TBD data_item1: A003 title1: Contracting Officer's Management Report sub1: Monthly Status Report auth1: DI-MGMT-81864 ref1: SOW section 3.0 & 3.2.14 req_ofc1: NSWC IHEOD TD Picatinny NJ, G3 dd250_1: L/T appcode1: N/A dist1: D freq1: MTHLY asof1: 10 firstsub1: 30DAC subsub1: 10DARP addr1_1: See blk 16 draft1_1: 0 reg1_1: 2 repro1_1: 0 addr1_2:

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totaldraft1: 0 totalreg1: 2 totalrepro1: 0 rmks1: Block 9: Distribution authorized to DoD and DoD contractors only.

Block 10,11,12 and 13: An update of accomplishments, expenditures and personnel due the Contracting Officer's Representative the 10th of each month.

Block 14:

NSWC IHD Picatinny Det.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 Phone: 973-724-3152 Attn: Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 email: steven.brandl@navy.mil group1:

totalprice1:

data_item2: A004 title2: Status Report sub2: Weekly Status Report auth2: DI-MISC-80368A ref2: SOW section 3.0 & 3.2.14 req_ofc2: NSWC IHEOD TD Picatinny NJ, G3 dd250_2: L/T appcode2: N/A dist2: D freq2: WEEKLY asof2: N/A firstsub2: 4DAC subsub2: 7DARP addr2_1: See blk 16 draft2_1: 0 reg2_1: 2 repro2_1: 0 addr2_2:

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totaldraft2: 0 totalreg2: 2 totalrepro2: 0 rmks2: Block 9: Distribution authorized to DoD and DoD contractors only.

Block 10,12 and 13: Weekly accomplishments shall be provide to the Contracting Officer's Representative (COR) each Monday of the following week.

Block 14:

NSWC IHD Picatinny Det.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 phone: 973-724-3152 email: john.sembrat@navy.mil Attn: Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 email: steven.brandl@navy.mil group2:

totalprice2:

prep_by: Steven Brandl prep_sign:

prep_date: 3/15/17 app_by: Steven Brandl app_sign:

app_date: 3/15/17

Page:

of_pages:

app: Adobe Professional 7.0

Reset:

The public reporting burden for this collection of information is estimated to average 220 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 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

Item 4; Clarification of submittal dates in Items 12 and 13;

conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the and does not require any substantial change to conform to Government requirements with regard to depth of content, format, otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: X system: CIWS Install Support ctr_no: TBD contr: TBD data_item1: A005 title1: Certification/Data Report sub1: Certificate of Conformance auth1: DI-ACIC-80678 ref1: SOW section 3.0 & 3.2.14 req_ofc1: NSWC IHD, PICATINNY NJ, G3 dd250_1: L/T appcode1: N/A dist1: D freq1: AS REQ asof1: N/A firstsub1: 10DAC subsub1: AS REQ addr1_1: See block 16 draft1_1: 0 reg1_1: 2 repro1_1: 0 addr1_2:

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totaldraft1: 0 totalreg1: 2 totalrepro1: 0 rmks1: Block 9: Distribution authorized to DoD and DoD contractors only.

Block 10,12 AND 13: Provide Certificate of Conformance within 10 days of completion of shipboard work to the Contracting Officer's Representative (COR) Block 14: NSWC IHD Picatinny Det.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 phone: 973-724-3152 email: john.sembrat@navy.mil Attn: Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 email: steven.brandl@navy.mil group1:

totalprice1:

data_item2: A006 title2: Quality Assurance Program sub2: Quality Assurance Management Plan auth2: DI-CMAN-81794 ref2: SOW section 3.0 & 3.2.14 req_ofc2: NSWC IHD, PICATINNY NJ, G3 dd250_2: LT appcode2: N/A dist2: D freq2: OTIME asof2: N/A firstsub2: See blk 16 subsub2: N/A addr2_1: See block 16 draft2_1: 0 reg2_1: 2 repro2_1: 0 addr2_2:

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totaldraft2: 0 totalreg2: 2 totalrepro2: 0 rmks2: Block 9: Distribution authorized to DoD and DoD contractors only.

Block 12: the Quality Assurance Plan shall be preapproved by the COR before contractor work begins. The QA Plan is due 10 days after award.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 phone: 973-724-3152 email: john.sembrat@navy.mil Attn: Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 email: steven.brandl@navy.mil group2:

totalprice2:

prep_by: Steven Brandl prep_sign:

prep_date: 3/15/17 app_by: Steven Brandl app_sign:

app_date: 3/15/17

Page:

of_pages:

app: Adobe Professional 7.0

Reset:

The public reporting burden for this collection of information is estimated to average 220 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 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

Item 4; Clarification of submittal dates in Items 12 and 13;

conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the and does not require any substantial change to conform to Government requirements with regard to depth of content, format, otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: X system: CIWS Install Support ctr_no: TBD contr: TBD data_item1: A007 title1: Quality Assurance Provisions sub1: Quality Assurance Report auth1:

ref1: Section 3.0 & 3.2.14 req_ofc1: NSWC IHEOD TD Picatinny NJ, G3 dd250_1: L/T appcode1: N/A dist1: D freq1: AS REQ (See blk 16) asof1: N/A firstsub1: See blk 16 subsub1: See blk 16 addr1_1: See Blk. 16 draft1_1: 0 reg1_1: 2 repro1_1: 0 addr1_2:

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totaldraft1: 0 totalreg1: 2 totalrepro1: 0 rmks1: Block 9: Distribution authorized to DoD and DoD contractors only.

Block 10, 12 and 13:Report shall be provided to the Contracting Officer's Representative (COR) within 10 working days of completion of shipboard work.

Block 14: NSWC IHD Picatinny Det.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 phone: 973-724-3152 email: john.sembrat@navy.mil Attn: Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 email: steven.brandl@navt.mil group1:

totalprice1:

data_item2: A008 title2: Ship Installation Drawing Edits sub2: Changes/Edits to Ship Installation Drawings or other technical information auth2:

ref2: Section 3.0 & 3.2.14 req_ofc2: NSWC IHEOD TD Picatinny NJ, G3 dd250_2: L/T appcode2: N/A dist2: D freq2: OTIME asof2: N/A firstsub2: See Blk 16 subsub2: N/A addr2_1: See Blk 16 draft2_1: 0 reg2_1: 2 repro2_1: 0 addr2_2:

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addr2_11:

draft2_11:

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addr2_12:

draft2_12:

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addr2_14:

draft2_14:

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totaldraft2: 0 totalreg2: 2 totalrepro2: 0 rmks2: Block 9: Distribution authorized to DoD and DoD contractors only.

Block 10 and 12: Documentation of changes to Ship Installation Drawings or other technical instructions are due to the Contracting Officer's Representative (COR) and Technical Point of Contact (TPOC) within 15 days after task completion.

Block 14: NSWC IHD Picatinny Det.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 phone: 973-724-3152 email: john.sembrat@navy.mil Attn: Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 email: steven.brandl@navt.mil group2:

totalprice2:

prep_by: Steven Brandl prep_sign:

prep_date: 3/1517 app_by: Steven Brandl app_sign:

app_date: 3/15/17

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The public reporting burden for this collection of information is estimated to average 220 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 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

Item 4; Clarification of submittal dates in Items 12 and 13;

conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the and does not require any substantial change to conform to Government requirements with regard to depth of content, format, otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any line_item: TBD exhibit: A xtdp: Off xtm: Off othercat: X system: CIWS Install Support ctr_no: TBD contr: TBD data_item1: A009 title1: HAZMAT Environmental Impact sub1: HAZMAT Environmental Impact auth1:

ref1: SOW SECTION 3.0 & 3.2.14 req_ofc1: NSWC IHEOCTD, Picatinny, NJ G3 dd250_1: L/T appcode1: N/A dist1: D freq1: AS REQ (See blk 16) asof1: N/A firstsub1: See blk 16 subsub1: N/A addr1_1: See block 16 draft1_1: 0 reg1_1: 2 repro1_1: 0 addr1_2:

draft1_2:

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addr1_3:

draft1_3:

reg1_3:

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draft1_4:

reg1_4:

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addr1_5:

draft1_5:

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addr1_6:

draft1_6:

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addr1_7:

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addr1_8:

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addr1_11:

draft1_11:

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addr1_12:

draft1_12:

reg1_12:

repro1_12:

addr1_13:

draft1_13:

reg1_13:

repro1_13:

addr1_14:

draft1_14:

reg1_14:

repro1_14:

totaldraft1: 0 totalreg1: 2 totalrepro1: 0 rmks1: Block 9: Distribution authorized to DoD and DoD contractors only.

Block 10 and 12: Report any new information in regards to HAZMAT use under this contract to the Contracting Officer's Representative (COR) and Technical Point of Contact (TPOC) within 5 days or an environmental incident occurring involving HAZMAT within 24 hours.

Block 14: NSWC IHD Picatinny Det.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 phone: 973-724-3152 email: john.sembrat@navy.mil Attn: Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 email: steven.brandl@navy.mil group1:

totalprice1:

data_item2: A010 title2: Nondisclosure Agreement sub2: Nondisclosure Agreement auth2:

ref2: SOW Section 3.0 & 3.2.14 req_ofc2: NSWC IHEOCTD, Picatinny, NJ G3 dd250_2: L/T appcode2: N/A dist2: N/A freq2: AS REQ (See blk 16) asof2: N/A firstsub2: See blk 16 subsub2: N/A addr2_1: See block 16 draft2_1: 0 reg2_1: 2 repro2_1: 0 addr2_2:

draft2_2:

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addr2_3:

draft2_3:

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repro2_3:

addr2_4:

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addr2_5:

draft2_5:

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addr2_6:

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draft2_13:

reg2_13:

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addr2_14:

draft2_14:

reg2_14:

repro2_14:

totaldraft2: 0 totalreg2: 2 totalrepro2: 0 rmks2: Block 10 and 12: Contractor is required to retain employees' Nondisclosure Agreement on file and made available to the Contracting Officer's Representative (COR) upon request.

Block 14: NSWC IHD Picatinny Det.

Attn: John Sembrat, G21, COR Maintenance & Life Cycle Branch G31 3rd Ave, Bldg.61N Picatinny Arsenal, NJ 07806-5000 phone: 973-724-3152 email: john.sembrat@navy.mil Attn: Steven Brandl, G32, TPOC Whiter Road, Bldg. 3356 Picatinny Arsenal, NJ 07806 Phone: 973-494-4986 email: steven.brandl@navy.mil group2:

totalprice2:

prep_by: Steven Brandl prep_sign:

prep_date: 2/16/17 app_by: Steven Brandl app_sign:

app_date: 2/16/17

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