0325-06_-_York_University_Services_-_CDRL_A002.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

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 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.

CLIN 0001

B. EXHIBIT

A

C. CATEGORY:

TDP _ _ TM _ _ OTHER X - MISC

D. SYSTEM/ITEM

SAF-T

E. CONTRACT/PR NO.

N00178-14-

F. CONTRACTOR

York University

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Technical Report - Study/Services

3. SUBTITLE

Technical Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

SOW Para. 3.1, 3.2, 5.2

6. REQUIRING OFFICE

NSWCDD, G82

7. DD 250 REQ

N/A

9. DIST

STATEMENT

D

(SEE BLK 16)

10. FREQUENCY

OTIME

12. DATE OF 1ST SUBMISSION

EOC

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

N/A Draft

Final Reg Repro

16. REMARKS

Blk 9: Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only (Administrative or Operational Use) (7 April 2014). Other requests shall be referred to Naval Surface Warfare Center, Dahlgren Division (NSWCDD), G82, 6096 Tisdale Rd. Suite 307, Dahlgren, VA 22448.

Blk 14: Electronic Media: Submit report by Electronic Mail (Email) as attachment or by compact disc (CD) with Email notification to the following personnel:

Mike Vittoria

NSWCDD G82

6096 Tisdale Rd. Ste 307 Dahlgren, VA 22448 Email: Mike.vitoria@navy.mil

Benjamin Wheeler

6096 Tisdale Rd. Ste 307

Email: Benjamin.wheeler@navy.mil

Benjamin Goldman

6096 Tisdale Rd. Ste 307

Email: Benjamin.goldman@navy.mil

Mike Vittoria 0 1 0 Ben Wheeler 0 1 0 Ben Goldman 0 1 0 See Blk 16

15. TOTAL --------- 0 3 0

G. PREPARED BY

Benjamin Wheeler, G82

H. DATE

7 Apr 14

I. APPROVED BY

Patricia A. Honosky, DM

J. DATE

7 Apr 14

DD Form 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 2 of 3 Pages

18. ESTIMATED

TOTAL PRICE

17. PRICE

GROUP

mailto:Mike.vitoria@navy.mil mailto:Benjamin.wheeler@navy.mil mailto:Benjamin.goldman@navy.mil