CDRL.pdf

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:

TBD A TDP ____ TM _____ OTHER X NDTI

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

COX FLOW METERS TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A001 TEST/INSPECTION REPORT WRITTEN CALIBRATION REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-NDTI-80809B SOW, SEE BLK 16 N00253

7. DD 250 REQ 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD REQUIRED ASREQ, SEE

BLK 16

SEE BLK 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D (SEE BLK 16)

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft

Final

A N/A SEE BLK 16 Reg Repro

16. REMARKS TECHNICAL POC 0 1

BLK 5: ALL WRITTEN CALIBRATION DATA REQUIRED IN ACCORDANCE WITH THE STATEMENT OF

WORK SHALL ACCOMPANY THE DELIVERY OF EACH SERIALIZED FLOW METER.

BLK 5: ALL TEST RESULTS AND QUALITY REPORTS IN ACCORDANCE WITH THE STATEMENT OF

WORK SHALL BE INCLUDED WITH DELIVERY. SUBJECT TO REJECTION WITHOUT THE

FOLLOWING REPORTS:

- CERTIFICATE OF CALIBRATION

- MATERIAL: IDENTIFICATION OF MATERIAL USED TO CALIBRATE (SEE STATEMENT OF WORK

FOR CALIBRATION REQUIRMENTS)

BLK 9: DISTRIBUTION STATEMENT D:

DISTRIBUTION IS AUTHORIZED TO DOD AND DOD CONTRACTORS ONLY. OTHER REQUEST FOR

THIS DOCUMENT SHALL BE REFERRED TO THE SECURITY MANAGER, NAVAL UNDERSEA

WARFARE CENTER, DIVISION KEYPORT, 610 DOWELL STREET, KEYPORT, WA 98345

DESTRUCTION NOTICE: DESTROY BY ANY METHOD THAT WILL PREVENT DISCLOSURE OF

CONTENTS, OR RECONSTRUCTION OF DOCUMENT.

BLKS 10, 12-13: TEST DATA IS TO BE DELIVERED WITH EACH SHIPMENT OF SERIALIZED

MATERIAL

BLK 14: DELIVERABLE FORMAT:

TEXT DOCUMENT: ADOBE PDF (.PDF, SEARCHABLE) OR MICROSOFT WORD (.DOC)

PRESENTATION: ADOBE PDF (.PDF, SEARCHABLE) OR MICROSOFT POWERPOINT (.PPT)

SPREADSHEET: MICROSOFT EXCEL (.XLS)

DISTRIBUTION ADDRESSEES AND ELECTRONIC MAILING ADDRESSES ARE PROVIDED BELOW:

1) NUWC DIVISION KEYPORT, ADAM VOGT, TECH POC, ADAM.J.VOGT@NAVY.MIL

2) NUWC DIVISION KEYPORT, MONIQUE KLOSE, PCO (CONTRACTING OFFICER),

MONIQUE.KLOSE@NAVY.MIL

3) NUWC DIVISION KEYPORT, XXXXXXXXXXX, CONTRACT SPECIALIST

MAILING ADDRESS:

COMMANDER

NAVAL UNDERSEA WARFARE CENTER

DIVISION KEYPORT

610 DOWELL STREET

KEYPORT, WA 98345-7610

PCO 0 1

CONTRACT SPECIALIST 0 1

15. TOTAL ▬▬▬▬► 0 3

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

ADAM VOGT

8 Jun 2018

TRACEY MCFARLAND

12 Jun 2018

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages