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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 |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| A001 |
| WRITTEN TEST REPORTS FOR COBRA 200 VME VIDEO CARD |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| SD |
| REQUIRED |
| ASREQ |
| SEE BLK 16 |
| a. ADDRESSEE |
| b. COPIES |
| 8. APP CODE |
| D |
| 11. AS OF DATE |
| 13. DATE IF SUBSEQUENT SUBM. |
| 16. REMARKS |
| TECHNICAL POC |
| 1 |
| 1 |
BLK 5: ALL WRITTEN TEST DATA, ANALYSIS DATA, TEST RESULTS, AND MEASUREMENTS IN ACCORDANCE WITH PART NUMBER SVME-C778-0-9701, SHALL ACCOMPANY THE DELIVERY OF ALL UNITS. A CERTIFICATE OF CONFORMANCE WILL ALSO ACCOMPANY EACH DELIVERY OF MATERIAL. ALL DATA ENTRIES REQUIRE A SIGN OFF FROM THE MECHANIC/TECHNICIAN THAT ACCOMPLISHED THE MEASUREMENT. THE SIGNATURE VERIFIES THAT THE DATA HAS BEEN PROPERLY MEASURED BY A QUALIFIED INDIVIDUAL. EACH SIGNATURE SHOULD ALSO BE ACCOMPANIED BY THE PRINTED NAME, COMPANY, AND DATE. IF A SPECIFIC SPACE FOR THE SIGNATURE IS NOT PROVIDED, THE SIGNATURE AND INFORMATION IS STILL REQUIRED. IF THE MEASUREMENT OR DATA TAKEN FALLS OUTSIDE SPECIFICATIONS IN ANY APPLICABLE REFERENCE, CONTRACTING ACTIVITY MUST INFORM THE POC UPON DISCOVERY OF THE DEFICIENCY.
BLK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO THE US. DEPARTMENT OF DEFENSE AND DOD CONTRACTORS ONLY (ADMINISTRATIVE/OPERATIONAL USE). OTHER REQUESTS SHALL BE REFERENCE TO COMNAVSEASYSCOM OR HIGHER DOD AUTHORITY.
BLKS 12-13: TEST DATA IS TO BE DELIVERED WITH EACH SHIPMENT OF MATERIAL. (SEE CONTRACT FOR DELIVERY SCHEDULE)
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages