FY18_HE-PD_IHD_CDRLs.pdf

CONTRACT DATA REQUIREMENTS SEQUENCE LIST

57mm High Explosive – Point Detonating (HE-PD) Cartridge

DESIGNATED TECHNICAL ACTIVITY: NSWC IHEODTD PICATINNY, G2 NAVSEA

POC: A. SORCHINI, G21 ICAL AEA

E-MAIL: adam.sorchini@navy.mil

PHONE: DSN: 880-6983 COMMERCIAL: 973-724-6983

SEQUENCE DATA ITEM TITLE DID

1 A001 As Built Configuration List (ABCL) DI-CMAN-81516

2 A002 Product Drawings/Models and Associated

Lists

DI-SESS-81000E

3 A003 Configuration Management Plan DI-SESS-80858C

4 A004 Engineering Change Proposal (ECP) DI-SESS-80639D

5 A005 Notice of Revision (NOR) DI-SESS-80642D

6 A006 Request for Variance (RFV) DI-SESS-80640D

7 A007 Configuration Status Accounting

Information

DI-SESS-81253C

8 A008 Quality Program Plan (QPP) DI-QCIC-81722

9 A009 Quality Deficiency Report DI-QCIC-80736

10 A010 Critical Characteristics Control Plan

(CCCP)

DI-MGMT-80004A

11 A011 Contractor Identified Critical

Characteristics List (CICCL)

DI-SAFT-80970A

12 A012 Critical Safety Item, Characteristic and Critical Defect Report

DI-SAFT-80970A

13 A013 CSICDR Restart Request DI-SAFT-80970A

14 A014 Critical Plan of Action (CPOA) DI-MGMT-80004A

15 A015 Statistical Process Control (SPC) Plan DI-MGMT-80004A

16 A016 First Article Test Procedure DI-NDTI-80603A

17 A017 First Article Test/Inspection Report DI-NDTI-80809B

18 A018 Lot Acceptance Test Procedure DI-NDTI-80603A

19 A019 Lot Acceptance Test/Inspection Report DI-NDTI-80809B

20 A020 Failure Analysis and Corrective Action

Report (FACAR)

DI-SESS-81927

21 A021 Measurement System Evaluation DI-QCIC-81960

22 A022 Ammunition Data Card DI-MISC-80043B

23 A023 Report, Record of Meeting/Minutes DI-ADMN-81505

24 A024 Accident/Incident Report DI-SAFT-81563

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

TBD A

CMAN

57mm HE-PD Cartridge TBD TBD

A001 AS BUILT CONFIGURATION LIST (ABCL)

DI-CMAN-81516 SOW Para 3.2.1 NSWC IHEODTD G2

LT

N/A B*

ONE/R*

N/A

90DAC

SEE BLK 16

NSWC IHEODTD GP 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 1 0

PCO 0 1 0

0 5 0

Blk 9: Distribution Statement B: Distribution Authorized to U.S. Government agencies only; Proprietary, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blk 10: The contractor shall revise the ABCL upon a revision to the document(s) used in the production of the System/Item under this contract.

Blk 13: Subsequent submittals shall be required within 15 days of a revision to the document(s) used in the production of the System/Item under this contract.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.Sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

James Jones;

usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 09-29-2017 2 27

JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 13:18:25 -04'00'

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, ou=USN, cn=LAUBACH.ANGELA.G.1388324623 Date: 2017.09.29 13:03:13 -04'00'

(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

TBD A X

57mm HE-PD Cartridge TBD TBD

A002 PRODUCT DRAWINGS/MODELS AND ASSOCIATED

LISTS

Technical Data Package

DI-SESS-81000E* SOW Para 3.2.1 NSWC IHEODTD G2

LT*

N/A D*

ONE/R*

N/A

90DAC

SEE BLK 16

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 1 0

PCO 0 1 0

0 5 0

Blk 4: See attached TDP Option Selection Worksheet.

Blk 7: Government shall provide comments or concurrence within 60 calendar days of receipt of the package.

Blk 9: Distribution Statement D: Distribution Authorized to the DoD and U.S. DoD contractors only; Critical Technology, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000..

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.

Blk 10: Documents shall be submitted within 90 calendar days of contract award.

Blk 13: Subsequent submission shall only be required if, for any reason, the documentation is revised.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; Adam.Sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

James Jones;

usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 09-29-2017 3 27

JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:27:09 -04'00'

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 08:35:10 -04'00'

(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

TBD A

SESS

57mm HE-PD Cartridge TBD TBD

A003 SUPPLIER'S CONFIGURATION MANAGEMENT PLAN

DI-SESS-80858C SOW Para 3.2.2 NSWC IHEODTD G2

LT

A* B*

OTIME

N/A

90DAC

N/A

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 1 0

PCO 0 1 0

0 5 0

Blk 8: The Government will have 30 calendar days to review and Approve/Provide comment on provided plan. Plan shall be approved prior to beginning of First Article Test.

Blk 9: Distribution Statement B: Distribution Authorized to U.S. Government agencies only; Proprietary, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.Sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

James Jones;

usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:27:54 -04'00' 09-29-2017

4 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 08:49:46 -04'00'

(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

TBD A

SESS

57mm HE-PD Cartridge TBD TBD

A004 ENGINEERING CHANGE PROPOSAL (ECP)

DI-SESS-80639D* SOW Para 3.2.5 NSWC IHEODTD G2

LT

A* D*

ASREQ*

N/A

ASREQ*

SEE BLK 16

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 1 0

PCO 0 1 0

0 5 0

Blk 4: DD Form 1692 is available upon request from NSWC IHEODTD G22 (usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil). The contractor shall request a Procuring Activity Number (PAN) from NSWC IHEODTD G22 prior to formal submission. The number shall be populated on the change request form when submitted.

Blk 8: Approval of the ECPs will be in accordance with classification as determined by Government configuration management documentation. If submitted, the Government will review draft ECPs and provide comments within 15 days.

Blk 9: Distribution Statement D: Distribution authorized to the DoD and U.S. DoD contractors only; Critical Technology, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blks 10, 12, 13: If a revision is requested by the Government for any reason, the contractor shall resubmit an ECP within 15 calendar days.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

James Jones; usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:35:31 -04'00' 09-29-2017

5 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 08:54:02 -04'00'

(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

TBD A

SESS

57mm HE-PD Cartridge TBD TBD

A005 NOTICE OF REVISION (NOR)

DI-SESS-80642D* SOW Para 3.2.5 NSWC IHEODTD G2

LT

A* D*

ASREQ*

N/A

ASREQ*

SEE BLK 16

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 1 0

PCO 0 1 0

0 5 0

Blk 4: DD Form 1695 is available upon request from NSWC IHEODTD G22 (usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil).

Blk 8: Approval of the NORs will be in accordance with classification as determined by Government configuration management documentation. If submitted, the Government will review draft NORs and provide comments within 15 days.

Blk 9: Distribution Statement D: Distribution authorized to the DoD and U.S. DoD contractors only; Critical Technology, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blks 10, 12, 13: The contractor shall submit a NOR in conjunction with any submitted ECP. If a revision is requested by the Government for any reason, the contractor shall resubmit a NOR within 15 calendar days.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

James Jones; usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:36:03 -04'00' 09-29-2017

6 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 08:54:41 -04'00'

(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

TBD A

SESS

57mm HE-PD Cartridge TBD TBD

A006 REQUEST FOR VARIANCE (RFV)

DI-SESS-80640D* SOW Para 3.2.6 NSWC IHEODTD G2

LT

A* D*

ASREQ*

N/A

ASREQ*

SEE BLK 16

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 1 0

PCO 0 1 0

0 5 0

Blk 4: DD Form 1694 is available upon request from NSWC IHEODTD G22 (usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil). The contractor shall request a Procuring Activity Number (PAN) from NSWC IHEODTD G22 prior to formal submission. The number shall be populated on the change request form when submitted.

Blk 8: Approval of the RFVs will be in accordance with classification as determined by Government configuration management documentation. If submitted, the Government will review draft RFVs and provide comments within 15 days.

Blk 9: Distribution Statement D: Distribution authorized to the DoD and U.S. DoD contractors only; Critical Technology, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blks 10, 12, 13: The Contractor shall submit an RFV when proposing a temporary departure from a requirement of the technical data package. If a revision is requested by the Government for any reason, the Contractor shall resubmit an RFV within 15 calendar days.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

James Jones; usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:36:31 -04'00' 09-29-2017

7 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 08:55:55 -04'00'

(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

TBD A

SESS

57mm HE-PD Cartridge TBD TBD

A007 CONFIGURATION STATUS ACCOUNTING (CSA)

INFORMATION

DI-SESS-81253C* SOW Para 3.2.9 NSWC IHEODTD G2

LT

N/A B*

OTIME

N/A

45DATC*

N/A

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 1 0

PCO 0 1 0

0 5 0

Blk 4: Sections 3.a, 3.b, 3.c, 3.e, 3.f, 3.i. and 3.j do not apply.

Blk 9: Distribution Statement B: Distribution Authorized to U.S. Government agencies only; Proprietary, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blk 12: Configuration Status Accounting information shall be submitted within 45 days after completion of First Article Test.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

James Jones;

usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:37:06 -04'00' 09-29-2017

8 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 08:56:45 -04'00'

(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

TBD A

QCIC

57mm HE-PD Cartridge TBD TBD

A008 QUALITY PROGRAM PLAN (QPP)

DI-QCIC-81722 SOW Para 3.3.2 NSWC IHEODTD G2

LT

A* B*

ONE/R*

N/A

60DPTT*

SEE BLK 16

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 2 0

PCO 0 1 0

0 6 0

Blk 8: The Government will provide Approval/Disapproval and comments on plan within 30 calendar days of submission receipt. Plan shall be approved prior to beginning of First Article Testing (FAT).

Blk 9: Distribution Statement B: Distribution Authorized to U.S. Government agencies only; Proprietary, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blk 10, 12, 13: Plan shall be submitted at least 60 calendar days prior to initiation of First Article Testing. Subsequent submission shall only be required if, for any reason, the documentation is revised. Unless otherwise specified, the contractor shall submit revisions within 14 calendar days of receipt of Government review.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

Bryan Stevens; bryan.m.stevens@navy.mil; 973-724-5087 James Jones; usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:38:03 -04'00' 09-29-2017

9 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 09:06:12 -04'00'

(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

TBD A

QCIC

57mm HE-PD Cartridge TBD TBD

A009 QUALITY DEFICIENCY REPORT

DI-QCIC-80736 SOW Para 3.3.5 NSWC IHEODTD G2

LT

N/A D*

ASREQ*

N/A

ASREQ*

SEE BLK 16

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 2 0

PCO 0 1 0

0 6 0

Blk 9: Distribution Statement D: Distribution authorized to the DoD and U.S.

DoD contractors only; Critical Technology, Export Controlled; September 2017.

Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

BLK 10, 12, 13: Report shall be submitted within 7 calendar days after discovery of any deficient Government Furnished Material (GFM). Subsequent submissions shall only be required if deemed necessary by the Government.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

Bryan Stevens; bryan.m.stevens@navy.mil; 973-724-5087 James Jones; usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil;

973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:38:44 -04'00' 09-29-2017

10 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 10:15:22 -04'00'

(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

TBD A

MGMT

57mm HE-PD Cartridge TBD TBD

A010 MANAGEMENT PLAN Critical Characteristic Control (CCC) Plan

DI-MGMT-80004A* SOW Para 3.3.6.2 NSWC IHEODTD G2

LT

A* B*

ONE/R*

N/A

60DPTT*

SEE BLK 16

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 2 0

PCO 0 1 0

0 6 0

Blk 4: Sections 3.6 and 3.7 do not apply.

Blk 8: The Government will provide approval or comments on plan within 45 calendar days of submission receipt. Plan shall be approved prior to beginning of First Article Test.

Blk 9: Distribution Statement B: Distribution Authorized to U.S. Government agencies only; Proprietary, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blk 10, 12, 13: Plan shall be submitted at least 60 calendar days prior to initiation of First Article Test. Plan shall be submitted concurrently with A016 and A021. Subsequent submission shall only be required if, for any reason, the documentation is revised. Unless otherwise specified, the contractor shall submit revisions within 7 calendar days of receipt of Government review.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

Bryan Stevens; bryan.m.stevens@navy.mil; 973-724-5087 James Jones; usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:39:18 -04'00' 09-29-2017

11 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 10:01:40 -04'00'

(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

TBD A

SAFT

57mm HE-PD Cartridge TBD TBD

A011 CRITICAL SAFETY ITEM, CHARACTERISTIC AND

CRITICAL DEFECT REPORT

Contractor Identified Critical Characteristics List

(CICCL)

DI-SAFT-80970A* SOW Para 3.3.6.4 NSWC IHEODTD G2

LT

A* B*

ONE/R*

N/A

60DPTT*

ASREQ*

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 2 0

PCO 0 1 0

0 6 0

Blk 4: Paragraph 4 does not apply.

Blk 8: The Government will provide Approval/comments on provided contractor identified critical characteristics list within 45 days of submission receipt. List shall be approved prior to beginning of First Article Test.

Blk 9: Distribution Statement B: Distribution Authorized to U.S. Government agencies only; Proprietary, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blk 10, 12, 13: List shall be submitted to the Government at least 60 calendar days prior to beginning of First Article Test. Subsequent submission is required if, for any reason, the documentation is revised. If required, the Contractor shall resubmit within 7 calendar days after receiving comments.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

Bryan Stevens; bryan.m.stevens@navy.mil; 973-724-5087 James Jones; usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:39:41 -04'00' 09-29-2017

12 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 09:08:10 -04'00'

(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

TBD A

SAFT

57mm HE-PD Cartridge TBD TBD

A012 CRITICAL SAFETY ITEM, CHARACTERISTIC AND

CRITICAL DEFECT REPORT

Investigation, Corrective Action, and Segregated Suspect Material Use

DI-SAFT-80970A* SOW Para 3.3.6.5.3, 3.3.6.5.4, 3.3.6.5.5. NSWC IHEODTD G2

LT

A* B*

ASREQ*

N/A

ASREQ*

SEE BLK 16

NSWC IHEODTD GP 0 1 0

NSWC IHEODTD G21 0 1 0

NSWCDD E33 0 1 0

NSWC IHEODTD G22 0 2 0

PCO 0 1 0

0 6 0

Blk 4: Paragraphs 3.3 and 4.1 do not apply.

Blk 8: The Government will provide approval/comments on provided Contractor report within 30 days of submission receipt. Report shall be approved prior to operations being resumed.

Blk 9: Distribution Statement B: Distribution Authorized to U.S. Government agencies only; Proprietary, Export Controlled; September 2017. Other requests for this document shall be referred to NAVSEASYSCOM, 2T Ammo Commodity Management Office, GP, NSWC Indian Head Explosive Ordnance Disposal Technology Division, Detachment Picatinny, Picatinny Arsenal, NJ 07806-5000.

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.

Blk 10, 12, 13: Report shall be submitted to the Government no later than 30 calendar days after notification of a critical non-conformance. Subsequent submission is required if, for any reason, the documentation is revised. If required, the Contractor shall resubmit within 7 calendar days after receiving comments.

Blk 14: Any submission or transmittal of unclassified but other than unlimited distribution data performed under this contract shall be via the AMRDEC Safe Access File Exchange (SAFE) system located at https://safe.amrdec.army.mil/safe/ or secure email system providing secured, but unclassified, transmittance.

NSWC IHEODTD GP:

Mikki Friedman; mikki.friedman@navy.mil; 973-724-1958

NSWC IHEODTD G21:

Adam Sorchini; adam.sorchini@navy.mil; 973-724-6983

NSWCDD E33:

Nathan Green; nathaniel.b.green@navy.mil; 540-653-9492

NSWC IHEODTD G22:

Bryan Stevens; bryan.m.stevens@navy.mil; 973-724-5087 James Jones; usn.pica.peo-ammo.mbx.nswc-ihd-g2-cfg-mgt@mail.mil; 973-724-9148

PCO: TBD

09-29-2017 JONES.JAMES.L.

1026128125

Digitally signed by

JONES.JAMES.L.1026128125

Date: 2017.09.29 10:40:12 -04'00' 09-29-2017

13 27

LAUBACH.ANGEL

A.G.1388324623

Digitally signed by

LAUBACH.ANGELA.G.1388324623

DN: c=US, o=U.S. Government, ou=DoD, ou=PKI, Date: 2017.09.29 09:08:48 -04'00'

(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).