J-16_CDRL_A036_Certification_Data_Report.pdf

DD FORM 1423-1, FEB 2001

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

PREVIOUS EDITION MAY BE USED.

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 and Communications 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:

TDP ________ TM _______ OTHER

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

15. TOTAL

16. REMARKS

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

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

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Change Paragraph 7.2 to read: The technical content requirements for this item shall be specified in the contract.

Delete Paragraph 10.1.

Change Paragraph 10.2 to read: The report shall contain the contract number and shall contain a statement that specifically identifies the purpose and applicability of this certification.

Change Paragraph 10.2.1 to read: Certification that tests have been performed, inspections made, parts/assemblies/equipment/systems have been installed, tested, inspected and are ready for operation.

Delete Paragraphs 10.2.2, 10.2.3, and 10.2.4.

Delete Paragraph 10.3.1.

Delete Paragraph 10.5.

BLOCK 9: “DISTRIBUTION STATEMENT D. Distribution authorized to the Department of Defense and U.S. DoD contractors only for Administrative or Operational use (July 2017). Other requests shall be referred to PSNS&IMF, C/451, Everett, WA 98207.

BLOCKS 10, 12 and 13: The certification report shall be submitted within 3 calendar days of key event completion. Revisions shall be submitted within 4 calendar days of key event completion or correction of discrepancies, whichever occurs first.

BLOCK 14: Media requirement. The certification report shall be delivered electronically to the Navy Maintenance Database (NMD) as specified in the contract and shall be provided in Microsoft Excel or other electronic media that allows for sorting.