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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: |
| 0001 |
| A |
| TDP ____ |
| TM _____ |
| OTHER |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| Dual Domain Audio Analyzer |
| TBD/1300XXXXXX |
| TBD |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
17. PRICE GROUP
| A001 |
| TEST/INSPECTION REPORT |
| N/A |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
18. ESTIMATED
TOTAL PRICE
| DI-NDTI-80809B |
| Statement of Work |
| N00253 |
| 7. DD 250 REQ |
| 9. DIST STATEMENT |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. DISTRIBUTION |
| SD |
| REQUIRED |
| ONCE |
| SEE BLK 16 |
| a. ADDRESSEE |
| b. COPIES |
| 8. APP CODE |
| SEE BLK 16 |
| 11. AS OF DATE |
| 13. DATE IF SUBSEQUENT SUBM. |
SEE BLK 16
BLK 5: ALL WRITTEN TEST DATA IN ACCORDANCE WITH ISO 17025:2005 SHALL BE INCLUDED WITH THE DUAL DOMAIN AUDIO ANALYZER. AT A MINMUM A REPORT WITH INITIAL MEASUREMENTS (AS RECEIVED) AND FINAL MEASUREMENTS (AFTER ADJUSTMENTS) SHALL BE PROVIDED.
BLK 8: NUWC DIVISION KEYPORT IS THE APPROVING ACTIVITY AND APPROVAL WILL BE FOR TECHNICAL CONTENT ONLY. ALLOW 30 DAYS FOR GOVERNMENT REVIEW.
BLK 9: DISTRIBUTION STATEMENT D. DISTRIBUTION AUTHORIZED TO DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY. CRITICAL TECHNOLOGY: (INSERT DATE). OTHER REQUEST FOR THIS DOCUMENT SHALL BE REFERRED TO //APPROPRIATE PROGRAM OFFICE//). OR OTHER APPROPRIATE DISTRIBUTION GUIDANCE.
BLK 12: REPORTS SHALL BE SUBMITTED UPON DELIVERY OF CONTRACT ITEM 0001, 0002, AND 0003.
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| JESSICA ENSSLEN |
| 04/24/2019 |
25 Apr 2019
DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages image1.emf