Exhibit_A_MSE_CDRLs.xlsx

XLSX spreadsheet 246 KB Posted

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AIR-4. 11 N00421-18-R-0003 Mission Systems Engineering (MSE) supporting AD-4. 11. 3
Solicitation number
N00421-18-R-0003
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CDRLs

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File Type Posted
N0042118R00030002.pdf PDF
N0042118R00030001.pdf PDF
Attachment_6_MSE_Authorized_Key_Personnel.pdf PDF
P2_MSE_Contractor_Performance_Assessment_Questionnaire.pdf PDF
Attachment_5_MSE_Authorized_Subcontractors.pdf PDF
P4_MSE_Streamlined_Rates_for_Order_Pricing.xlsx XLSX spreadsheet
Attachment_3_MSE_-_Data_Item_Transmittal_Acceptance_Rejection_Form.pdf PDF
P7_MSE_Subcontractor_Cost_Summary.xlsx XLSX spreadsheet
Attachment_2_MSE_DD254.pdf PDF
Attachment_8_MSE_QASP_CSP.pdf PDF
Attachment_7_MSE_COR_TBD.pdf PDF
P1_MSE_Past_Performance_Information_Form.pdf PDF
Attachment_1_MSE_Wage_Determination.pdf PDF
P6_MSE_Prime_Cost_Summary_Spreadsheet_(MSE).xlsx XLSX spreadsheet
N00421-18-R-0003_MSE_FINAL.pdf PDF
Attachment_4_MSE_-_OCI_List.pdf PDF
Exhibit_A_MSE_CDRLs.xlsx XLSX spreadsheet
Attachment_6_MSE_Authorized_Key_Personnel.pdf PDF
Attachment_4_MSE_-_OCI_List.pdf PDF
P4_MSE_Streamlined_Rates_for_Order_Pricing.xlsx XLSX spreadsheet
Attachment_8_MSE_QASP_CSP.pdf PDF
Attachment_7_MSE_COR_TBD.pdf PDF
P2_MSE_Contractor_Performance_Assessment_Questionnaire.pdf PDF
P6_MSE_Prime_Cost_Summary_Spreadsheet_(MSE).xlsx XLSX spreadsheet
P1_MSE_Past_Performance_Information_Form.pdf PDF
N00421-18-R-0003_MSE_DRAFT_Solicitation.pdf PDF
Attachment_5_MSE_Authorized_Subcontractors.pdf PDF
Attachment_2_MSE_DD254.pdf PDF
P7_MSE_Subcontractor_Cost_Summary.xlsx XLSX spreadsheet
Attachment_1_MSE_Wage_Determination.pdf PDF
Attachment_3_MSE_-_Data_Item_Transmittal_Acceptance_Rejection_Form.pdf PDF
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ITEMVALUE
A. Contract Line Item NumberCLINs 0001, 0007
B. ExhibitA
D. System/ItemMission System Engineering (MSE)
E. Contract/PR No.TBD
F. ContractorTBD
G. Prepared ByDarrell Mason
I. Approved By:Lance R. Hood II
6. Requiring OfficeAD-4.11.3.4
H. Date Prepared12/19/17
J. Date Approved12/19/17
Total Number of Pages33

A001

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other ADMN
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A001Report, Record of Meeting/Minutes
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-ADMN-81505PWS 3.1.2.2, 3.1.3.6, 3.1.3.7AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDASREQSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
ASee Blk 16See Blk 16RegRepro
16. REMARKSAD-4.11.3.4010
Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blks 11, 12, and 13: Trip reports are due five days after return from travel. Meeting minutes are due five days after completion of meeting. Submit IAW PWS paras.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL010
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage1of33
1007/183

A001 - Back Page

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNELFOR CONTRACTOR PERSONNEL
Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package; TM - Technical Manual; Other - other category of data, such as “Provisioning”, “Configuration Management”, etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Data CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed on the ASSIST website), or onetime DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoD 5230.24).

Item 10. Specify number of time data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addresses and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 12.

Examples are: Tailoring of documents cited in item 4; Clarification of submittal dates in items 12 and 13; Explanation of reproducible copies in item 14.; Desired medium for delivery of the data item. Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor’s performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or the data item.

Estimated Price - Cost to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency or submittal, preparation, control, and quality of the data item.

Estimated Price - Cost to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV Item should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data. These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Governments’ right to use the data shall be governed by the pertinent provisions of the contract.

DD Form 1423-1, JUN 90Previous editions are obsoletePage2of33
1007/183

A002

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MISC
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A002Technical Report - Study Service
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-MISC-80508BPWS 3.3.1.1, 3.3.1.2, 3.3.1.3, 3.3.1.3.1, 3.3.1.3.2, 3.3.1.4.1, 3.3.1.4.2, 3.3.1.4.3, 3.3.1.5, 3.3.1.5.1, 3.3.1.5.2, 3.3.1.5.3, 3.3.1.6.1, 3.3.2.1, 3.3.2.2.2, 3.3.2.2.3, 3.3.2.2.6, 3.3.2.4.2, 3.3.2.5.4, 3.3.3.1, 3.3.3.1.1, 3.3.3.1.2, 3.3.3.2, 3.3.3.2.1, 3.3.3.3.1, 3.3.3.3.2, 3.3.3.4, 3.3.3.4.1, 3.3.3.4.2, 3.3.3.4.4, 3.3.3.4.5, 3.3.3.4.7AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDASREQSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blks 12 and 13: Final due 10 days after receipt of Government comments on draft submission. Government has 30 days to comment. Submit IAW PWS paras.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage3of33
1007/183

A003

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MGMT
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A003Status ReportInformation Technology Personnel Security Report for NAVAIR Security
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-MGMT-80368A and see Blk 16PWS 3.1.3.3, 3.2.3.1AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDASREQSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 4: Contractor to submit IT Personnel Security Report for all employees requiring access to Government IT systems. Ensure that only the following information is included:

User's Last Name; First Name; MI; Suffix; Employee Type: Civ/Mil/CSS/FN; Contract No.; Customer AIR/PMA/PEO Code; Org: Hddqtrs/NAWC/NATEC, etc.; Duty Location; Work Email Address; IA Training Date (Verified by Transcript); Date of User Signature (SAAR-N Blk 13); Type of Investigation (SAAR-N Blk 33); Date Investigation Finalized (SAAR-N Blk 33a); Date Interim IT Level Designation (Stamp) Granted (SAAR-N Blk 33c) - do not put pending; Highest IT Level (SAAR-N Blk 33c); Date Security Verified Clearance/Investigation (SAAR-N Blk 37); Date COR Signature (SAAR Blk 18b); COR Name (SAAR-N Blk 18); COR Email; Date Rec'd Sigma Customer Support Ctr.; Date System Access Granted and COR Notified; Date System Access No Longer Required; N-ERP IT System (if applic., put N-ERP); Other IT System/s (separate by comma's); Company Name, SS# (last four only).

Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blk 10: Updated report required within 30 days of gain or loss of employee(s) that have or will access Government IT systems.

Blk 12: First report is required 30 days after issuance of the contract and each task order.

Blk 13: Subsequent reports due 365 days after first report, and per Blk 10 requirements.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:

NAVAIR Security, AIR 7.4.4, ATTN: Madeline Gantt 47123 Buse Road, Bldg 2272, R074 Patuxent River, MD 20670 madeline.gantt@navy.mil, phone 301-757-2955 AIR 7.4.4 1 1 0

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL220
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage4of33
1007/183

A004

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MGMT
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A004NAVAIR Operations Security (OPSEC) Plan
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-MGMT-81999 and see Blk 16PWS 3.2.5AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDANNLYSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 4: Contractor format. Use the definition of sensitive information given in Public Law 100.235. Use National Security Decision Directive (NSDD) 298 for the concept of Operations Security.

Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blk 9: Apply and use distribution statements in accordance with the Distribution Statement shown in Blk 13 of DD Form 254 and the guidance of SECNAVINST 5510.36

Blks 10, 12, and 13: Draft OPSEC Plan due 90 DAC. Final due 45 days after Government approval of draft. Revisions required after approval of final plan only to comply with the Government Data Protection Policy Documents revisions. Submit IAW PWS paras." TO " Blks 10, 12, and 13: Draft OPSEC Plan due 90 after issuance of TO. Final due 45 days after Government approval of draft. Revisions required after approval of final plan only to comply with the Government Data Protection Policy Documents revisions. Submit IAW PWS paras.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:

NAVAIR Security, AIR 7.4.4, ATTN: Madeline Gantt 47123 Buse Road, Bldg 2272, R074 Patuxent River, MD 20670 madeline.gantt@navy.mil, phone 301-757-2955 AIR 7.4.4 1 1 0

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL220
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage5of33
1007/183

A005

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MGMT
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A005Contractor's Risk Management Plan
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-MGMT-81808PWS 3.3.3.1.1AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDASREQSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blks 12 and 13: Final due 10 days after receipt of Government comments on draft submission. Government has 30 days to comment. Frequency of subsequent submissions will be identified per specific tasking. Submit IAW PWS para.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage6of33
1007/183

A006

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other QCIC
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A006Quality System Plan
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-QCIC-81379PWS 3.1.3.8AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDASREQSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blks 12 and 13: First submission 45 days after award of contract and first task order; ASREQ thereafter. Final due 10 days after receipt of Government comments on draft submission. Government has 30 days to comment. Submit IAW PWS para.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage7of33
1007/183

A007

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MGMT
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A007Integrated Program Management Report (IPMR)Integrated Master Schedule
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-MGMT-81861 and see Blk 16PWS 3.3.2.3, 3.3.2.3.1, 3.3.2.3.2, 3.3.2.3.3, 3.3.2.4.1, 3.3.2.4.2, 3.3.3.1.2AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDMTHLYSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AOSee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 4: Contractor format is acceptable if the intent of DI-MGMT-81861 are met, and the following items are included:

- Cover sheet

- Master schedule: A top-level schedule of key tasks/activities at the summary level of the Work Breakdown Structure (WBS). This will be an integrated roll-up of the Detailed Project Schedules (CDRL A008)

- Major tasks/project milestones, to include due and overdue deliverables, dependencies, schedule baseline, lag times, supporting project critical path identification, and resource loading with assignments

- Identification of new problem areas

- Status of previously identified and open problem areas

- Justification for cost increases/schedule slippages

- Monthly and cumulative labor hours bid and expended per contract labor category (including names of employees charged to each contract labor category) for LOE CLINs.

- Total labor cost per CLIN

- Performance-based evaluation roll-up reporting

- Cumulative self-evaluated depiction displaying Contractor performance

Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blks 12 and 13: NLT 15th of each month following the first full month of performance. Final due 10 days after receipt of Government comments on draft submissions. Government has 30 days to comment. If the Government does not reply within 30 days, the CDRL is considered accepted. Submit IAW PWS paras.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage8of33
1007/183

A008

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MISC
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A008Detailed Project Schedule
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
See Blk 16PWS 3.3.1.1, 3.3.2.1, 3.3.2.1.1, 3.3.2.1.2AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDASREQSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 4: The Detailed Project Schedule shall include at a minimum the following elements: major task/project milestones (to include deliverables), Work Breakdown Structure (WBS) that includes 100% of the work defined by the project scope, task details including dependencies, schedule baseline, lag times, status, supporting project critical path identification, and resource loading with assignments to specific tasks.

Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blk 12 and 13: First report due 15 calendar days after notification of tasking. Final due 10 days after receipt of Government comments on draft submission. Government has 30 days to comment. Frequency of subsequent submissions will be identified per specific tasking. Submit IAW PWS paras.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage9of33
1007/183

A009

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MGMT
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A009Technical and Management Work Plan
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-MGMT-81117PWS 3.3.1.4.1, 3.3.2.1, 3.3.2.1.1, 3.3.2.1.2AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDASREQSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments ).

Blks 12 and 13: Final due 10 days after receipt of Government comments on draft submission. Government has 30 days to comment. Submit IAW PWS paras.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage10of33
1007/183

A010

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MGMT
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A010Status ReportChange Control Report
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-MGMT-80368A and see Blk 16PWS 3.1.3.3, 3.3.2.2.2, 3.3.2.2.3, 3.3.2.2.5AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDASREQSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 4: The Change Control Report shall include, as a minimum, any changes affecting project scope, schedule or costs, to include change identification and change analysis.

Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments ).

Blks 12 and 13: Draft report due within 7 calendar days of any change. Final due 10 days after receipt of Government comments on draft submission. Government has 30 days to comment. Frequency of subsequent submissions will be identified per specific tasking. Submit IAW PWS paras.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage11of33
1007/183

A011

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MISC
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A011Scientific and Technical ReportsElements, Organization, and Design
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
ANSI-Z39.18PWS 3.3.1.1.1, 3.3.1.2, 3.3.1.3, 3.3.1.3.2, 3.3.1.4.2., 3.3.1.4.3, 3.3.1.6.1, 3.3.3.3.4AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDASREQSee Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blks 12 and 13: Final due 10 days after receipt of Government comments on draft submission. Government has 30 days to comment. Submit IAW PWS paras.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage12of33
1007/183

A012

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MISC
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A012Technical Information ReportProject Closeout Report
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-MISC-80652PWS 3.1.3.3AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDSee Blk 16See Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blks 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blks 10, 12, and 13: Submit 30 days after completion of tasking. Submit IAW PWS para.

Blks 12 and 13: Final due 10 days after receipt of Government comments on draft submission. Government has 30 days to comment.

Blks 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage13of33
1007/183

A013

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MISC
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A013Period Close-out
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
See Blk 16PWS 3.1.3.1, 3.1.3.3AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDSee Blk 16See Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 4: Submit per required format PWS paras.

Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blk 10, 12, and 13: Within 90 days after completing each Task Order. Final due 10 days after receipt of Government comments on draft submission. Government has 30 days to comment.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

At a minimum, the report shall include expenditures data, budgeted versus actual, contract deliverable(s) status, disposition of contractor furnished materials, a list of Government furnished materials, and outside services employed in completion of the task.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage14of33
1007/183

A014

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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 this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson 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 form to the Government issuing Contracting Officer for the Contract/PR No. listed in Block E.
A. CONTRACT LINE ITEM NO.B. EXHIBITC. CATEGORY:
CLINs 0001, 0007ATDP_________TM ________Other MGMT
D. SYSTEM/ITEME. CONTRACT/PR NO.F. CONTRACTOR
Mission System Engineering (MSE)TBDTBD
1. DATA ITEM NO.2. TITLE OF DATA ITEM3. SUBTITLE
A014Contracting Officer's Management ReportSegregation of Costs and Invoice Requirements Reporting
4. AUTHORITY (Data Acquisition Document No.)5. CONTRACT REFERENCE6. REQUIRING OFFICE
DI-MGMT-81864APWS 3.1.3.1, 3.1.3.4AD-4.11.3.4
7. DD 250 REQ9. DIST STATEMENT10. FREQUENCY12. DATE OF FIRST SUBMISSION14. DISTRIBUTION
See Blk 16
XXREQUIREDSee Blk 16See Blk 16b. COPIES
D
8. APP CODE11. AS OF DATE13. DATE OF SUBSEQUENT SUBMISSIONa. ADDRESSEEDraftFinal
AN/ASee Blk 16RegRepro
16. REMARKSAD-4.11.3.4110
Blk 7: Acceptance will be by the COR via the Data Item Transmittal/Acceptance/Rejection form (See Contract Section J Attachments).

Blks 10, 12, and 13: Draft format of this deliverable will be due 30 days after award of the contract and each Task Order. Government has 30 days to comment. Final due 10 days after Government approval of draft. If the Government does not reply within 30 days, the CDRL is considered accepted. Report shall be submitted concurrently with each invoice to the COR and shall be for the exact dollar amount and period of performance as the invoice.

The Contractor shall segregate costs incurred under this contract and each Task Order at the lowest level of performance, either by tasks or by subtask, rather than only on a Contract Line Item Number (CLIN) or total contract basis, and shall submit invoices reflecting costs incurred at that level. In addition, the Contractor shall submit invoices containing summaries of work charged during the period covered.

Blk 14: Distribution and submittal by electronic media wherever possible. Electronic deliverables shall be compatible with Office 2010 unless otherwise approved by the Government.

Deliver to:
NAWCAD ISR Systems Engineering Branch, AD-4.11.3.4
17149 Communications Lane, Bldg 8222, St. Inigoes, MD 20684-0010
Mark for: COR <insert contract number>15. TOTAL110
G. PREPARED BYH. DATEI. APPROVED BYJ. DATE
Darrell Mason12/19/17Lance R. Hood II12/19/17
DD Form 1423-1, JUN 90Previous editions are obsoletePage15of33
1007/183

A015

CONTRACTS DATA REQUIREMENTS LISTForm Approved
(1 Data Item)OMB No. 0704-0188
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

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