Exhibit_A_CDRLs_A001-A009_DD_Form143_FINAL.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 440 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, tQ 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:

X030 A TOP TM OTHER

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

5.1.6 Air Vehicle N00421-15-R-0029 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A001 Contractor Flight and Ground Operations N/A

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

N/A SOW Para. 3.1.2.5 NA WCAD, Code 51DOOMA, COR

7. DO 250 REO 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD

REQUIRED

ANNLY Block 16 b. COPIES

8. APPCODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

A Block 16 suBMI~Y~ck 16 Draft Reg Repro

16. REMARKS GFR I

Blocks 11, 12 &13: Prior to the first flight and annually for review. Format: Paper with accompanying CD.

Contractor Provided Reference NA V AIRINST 3 71 0.1 G , Government Approved.

15. TOTAL 0 1 0

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A002 Requisition Status Report N/A

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

N/A SOW Para. 3.2.8/3.3.5/3.5.1/3.5.3 NA WCAD, Code 51DOOMA, COR

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

LT

REQUIRED

BI-WE Block I6 b. COPIES

8. APPCODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

A Block 16 SUBMIS~If<N k Draft oc I6 Reg Repro

16. REMARKS Competency Manager 1 Block 11, 12 & 13: Submit every other week. Format Electronically in

Government Furnished Format.

15. TOTAL 0 1 0

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A003 Project Status Report DOC Requirements, Problems or Deficiencies

4. AUTHORiTY (Data Acquisition Document No.) ,5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MGMT-80368 SOW Para. 4.3 NA WCAD, Code 51DOOMA, COR

7. DO 250 REO 9. DIST STATEMENT 10.FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT

REQUIRED

MTHLY Block I6 b. COPIES

8. APPCODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

Block 16 SUBMI~r~ck 16 Draft Reg Repro

16. REMARKS COR 1

Block 11, 12 & 13: No Later Than the 15th day of the following month. Format Branch Head 1

Electronically in Government Furnished Format.

' 15.TOTAL 0 2 0

1. DATA ItEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A004 Funds Expenditure Report Monthly Funds Expended!Hours/NMCI

4. AUTHORITY (Data Acquisition Document No.) ,5. CONTRACT REFERENCE

N/A SOW Para. 4.4

7. DD 250 REO 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION

LT

REQUIRED

MTHLY Block I6

8. APPCODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT

Block 16 SUBMISSI~N k

B oc 16

16. REMARKS

Block 11, 12 & 13: No Later Than the 15th day ofthefollowing month. Format

Electronically in Government Furnished Format.

G. PREPARED BY H. DATE I. APPROVED BY

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DD FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED.

6. REQUIRING OFFICE

NAWCAD, Code 51DOOMA, COR

14. DISTRIBUTION

a. ADDRESSEE

COR

15.TOTAL

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b. COPIES

Final Draft

Reg Repro

I

0 I 0

J. DATE

9/1/2015

Page __ of __ Pages

Adobe Professional 8.0

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

CONTRACT OAT A REQUIREMENTS LIST Form Approved OMB No. 0704-0188

The.public reporting burden for this collection of information is estimated tO average 440 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. Pleese 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:

X030 A TOP TM OTHER

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

5.1.6 Air Vehicle N00421-15-R-0029 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A005 Detailed Invoices N/A

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

N/A SOW Para. 4.5 NA WCAD, Code 51DOOMA, COR

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

LT

REQUIRED

MTHLY Block 16 b. COPIES

8. APPCODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

Block 16 SUBMIS~Y~ck 16 Draft

Reg Repro

16. REMARKS COR 1

Block II, 12 & 13: No Later Than the 15th day of the following month.

15.TOTAL 0 1 0

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A006 Safety Program I NIA

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

NIA SOW Para. 7.0 NA WCAD, Code 51DOOMA, COR

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

LT

REQUIRED

One/R Block 16 b. COPIES

8. APPCODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

A Block 16 SUBMIS~I£N k Draft oc 16 Reg Repro

16. REMARKS COR 1

Block II, 12 & 13: No Later Than 30 Days after acceptance of contract and when changes Wing Safety Officer 1 are proposed. Format: Electronically CD Contractor Provided, Government Approved.

15.TOTAL 0 2 0

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A007 Trip/Conference Reports N/A

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

Block 16 SOW Para. 9.1.1 NA WCAD, Code 51DOOMA, COR

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

LT

REQUIRED

ASREQ Block 16 b. COPIES

8. APPCODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

Block 16 SUBMIS~r~ck

Draft Reg Repro

16. REMARKS Team Lead 1 Block 4: Contractor format acceptable. Must address where and when, topics discussed, Branch Head 1 and actions and outcomes. Include this data with project status report.

Blocks 11, 12, and 13: NLT 7 business days after return from travel. 15.TOTAL 0 2 0

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

AOOS Information Assurance (IA) Training Completion Report Info Technology Personnel Security Report

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

NIA SOWPara. 13 NA WCAD, Code 51DOOMA, COR

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

LT

REQUIRED

ANNLY Block 16 b. COPIES 8.APPCODE A 11. AS OF DATE 13. DATE OF SUBSEQUENT a. ADDRESSEE Final

Block 16 SUBMISSI~N Draft

Bock 16 Reg Repro

16. REMARKS COR 1

Blocks 11, 12 & 13: Required when new personnel assigned and require IT access and annually thereafter. Government Format, Electronically.

15.TOTAL 0 1 0

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

STEINER.EDWARD.FRANCIS.I042816805·'·.~~;,'jf£;:.~~~~~ 09/01115 DlsiWI)'oW.odb)'RICHARPJl'UA!.tll474il8m 9/1/2015 RICHARD.JULIA.M.l247408726 ,\:ru~~~~<ll,ou=PKI,<to"llSN, oa.:201MMl ~~~374\W

DO FORM 1423, AUG 96 PREVIOUS EDITION MAY BE USED. Page __ of __ Pages

Adobe Professional 8. 0

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

CONTRACT DATA REQUIREMENTS LIST Form Approved (1 Data Item) OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 440 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the coUection of information. Send comments regarding this burden estimate or any other aspect of this collection, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for lnfonnation, Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202·4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 20503. Please DO NOT RETURN your form to either of these addresses. Send completed fonn to the Government Issuing Contract Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

X030 A TDP TM OTHER MGMT (Security)

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

5.1.6 Air Vehicle Solicitation N00421-15-R-0029 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A009 Operations Security (OPSEC) Plan NA

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

DI-MGMT-80934C SOW para. 8.3 AIR 5.10

7. DD250 REQUIRED 9. DIST STATEMENT 10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD REQUIRED ONE/R See Block 16 S.APPCODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION a. ADDRESSEE b. COPIES

A (see 16) See Block 16 See Block 16

16. REMARKS Draft Final

Reg Repro Block A: PBSOW Para. 8.4 PCO 1 1 0

Block 4: Use the definition of sensitive information given in Title a5, US Code Section AIR5.1DCOR 1 1 0 278g-3(d) (4) Public Law 100-235 (101 STAT 1727). Security policy, procedures and DCMA 0 1 0 requirements for classified information (as defined in FAR-4-401). Are provided in DoD Manual 5220-22-M. National Industrial Security Program Operating manual (NISPOM). Use OPNA VINST 3432.1 and National Security Decision Directive 298 of22 January 1988for the concept of Operations Security, and apply the framework for telecommunications security in DFARS clause 252.239-7016. Add "TEMPEST requirements are not considered separately in the DD Form 254 incorporated into the contract".

Block 9: D; Distribution authorized to Department of Defense (DoD) and DoD Contractors only; Date TBD.

In addition, the words, "FOR OFFICIAL USE ONLY" shall be conspicuously marked at the bottom of the outside cover (if any), on the bottom of each page, and on the bottom of the outside back cover (if any). The front cover (if any) or the first page of the document shall also be conspicuously marked with the following statement: "This document contains information EXEMPT FROM MANDATORY PUBLIC DISCLOSURE under the Freedom oflnfonnation Act. Exemption b (2) applies "These markings shall also be applied in an appropriate manner to any data provided in electronic media transmission. EXEMPTIONS: b (2) shall be used on documents which concern internal working processes or procedures (i.e., OPSEC Plans or Program Protection Implementation Plans).

Blocks 11, 12 and 13: Preliminary draft plan due 90 days after receipt of Government security data. Final plan due 45 days after Government approval of draft. Revisions are required after approval of plan during the performance of this contract ONLY to comply with Government Data Protection Policy document revisions.

Block 14: The plan will be FOUO and cannot be posted on a public website. The plane must be submitted in electronic, hard copy or on an Integrated Data Environment to Naval Air Systems Command ATTN: Karen Abell, 47561 Ranch Road, Bldg 4023, Patuxent River, MD 20670. karen.abell@nayy.mil Phone# (301) 342-5499

15. TOTAL 2 3 0

G. PREPARED BY

H.rq7 J J 2.b)5'""'

I. APPROVED BY

J. D9// I :?01 s-E...t, ...t c..e· .-'llll...Q~ J~M~:t~W.JJf~AdJ 7 ·;q.::i ·.~ XO.A A.

DD FORM 1423-1, JUN 90 Previous editions are obsolete Page I of I