CDRL_TEST_INSPECTION_REPORT_DD8_MVC_rev1_Signed.pdf

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Attached to
DRY DOCK ELECTRICAL VOLTAGE CIRCUIT LOAD TESTING Federal contract opportunity
Solicitation number
N4215818Q0006
Issued by
Department of the Navy Naval Sea Systems Command

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CONTRACT DATA REQUIREMENTS LIST DD FORM 1423, A0001

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Text version

Load Test DD8 Med Volt Cir JML 8197-0151

G. PREPARED BY

Aaron Roberts

H. DATE

8/17/2018

I. APPROVED BY

Michael Jones

J. DATE

8/17/2018

CONTRACT DATA REQUIREMENTS LIST

(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

A

C. CATEGORY

TDP TM OTHER NDTI 1

D. SYSTEM/ITEM

MEDIUM VOLTAGE ELECTRICAL

SYSTEM

E. CONTRACT/PR NO.

N4215818RC81013

F. CONTRACTOR

TBD

1. DATA ITEM NO

A0001

2. TITLE OF DATA ITEM

TEST/INSPECTION REPORT

3. SUBTITLE

TEST REPORT

4. AUTHORITY (Data Acquisition Doc. No)

DI-NDTI-80809B

5. CONTRACT REFERENCE

SOW, PARAGRAGHS 3.2 & 3.2.1

6. REQUIRING OFFICE

0BNNSY C 980

7.

LT

9. DIST STATEMENT

REQUIRED

A (See blk 16)

10. FREQUENCY

ASGEN

(See Blk !6)

12. DATE OF FIRST SUBMISSION

ASGEN

(See Blk !6)

14. DISTRIBUTION

(SEE BLK 16)

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A ADRESSEES Draft

Final

Reg Repro

16. REMARKS

BLK 9: DISTRIBUTION A. Approved for public release: distribution unlimited.

BLK 10 & 12: Contract shall submit Test Reports for every circuit tested within five (5) business days of completing each test.

BLK 14: Data test report shall be submitted by email to C980 by a level 3 NETA certified technician in contractor format. Notify to the appropriate government organizational entities by email when report is submitted.

POCs:

C980: Aaron Roberts, aaron.m.roberts@navy.mil, (757) 353-2840 NAFAC UEM: Donielle Alexanderblake, donielle.alexanderblake@navy.mil , (757) 328-0468

C980 0 1 0

NAFAC UEM 0 1 0

15. TOTAL 0 2 0

17. PRICE

GROUP

18. ESTIMATED

TOTAL PRICE

NNSY C 980

2018-08-17T11:09:53-0400
ROBERTS.AARON.MOODY.1489944223
2018-08-17T11:53:04-0400
JONES.MICHAEL.LEE.1075794882

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