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CONTRACT DATA REQUIREMENTS LIST (CDRL)
(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. |
| B. EXHIBIT |
| C. CATEGORY: |
| A |
| TDP ____ |
| TM _____ |
| OTHER X - MISC |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| CIAT HARDWARE & SUPPORT |
| N00178-16- |
| SELECTED PRIME CONTRACTOR |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| A001 |
| TECHNICAL REPORT - STUDY/SERVICES |
| AFTER ACTION REPORT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-MISC-80508B |
| SOW Para 4.1 |
| NSWC DAHLGREN, V41 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| LT |
| REQUIRED |
| OTIME |
| SEE BLK 16 |
| a. ADDRESSEE |
| b. COPIES |
| 8. APP CODE |
| D (SEE BLK 16) |
| 11. AS OF DATE |
| 13. DATE IF SUBSEQUENT SUBM. |
N/A
| 16. REMARKS |
| V41 TPOC |
| 0 |
| 1 |
| 0 |
BLK 9: DISTRIBUTION STATMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY, ADMINISTRATIVE OR OPERATIONAL USE, 4 APRIL 2016. OTHER REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO THE NAVAL SURFACE WARFARE CENTER, DAHLGREN DIVISION (NSWCDD), V41, 17214 AVENUE B BUILDING1525, DAHLGREN, VA 22448-5147.
BLKS 10, 12: SUBMISSION DUE 5 DAYS AFTER INSTALLATION AND INTEGRATION IS COMPLETED.
BLK 14: ELECTRONIC MEDIA: SUBMIT VIA EMAIL IN MICROSOFT (MS) OFFICE 2010 APPLICATIONS (OR EARLIER) OR ADOBE PDF TO THE TECHNICAL POINT OF CONTACT (TPOC)
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 2 Pages