CDRL Pkg_21583806_Boring Mill Upgrade_Exhibit_REV1.pdf

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT 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. Date 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 in DoD 5010.12-L (AMSDL), or one-time 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.

DoDD 5230.24).

Item 10. Specify number of times 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 addressees 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 15. 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.

FOR THE CONTRACTOR

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed 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 quality of the data item.

Estimated Price - Costs 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 of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs 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 items 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 Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423 (BACK), AUG 96

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 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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information 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, DC 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. EXHIBIT C. CATEGORY:

0002 A TDP TM OTHER

MISC

X

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

ACRA Horizontal Boring Mill

N4523A23Q5704 / 2158-3806 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A001 CERTIFICATION/DATA REPORT INSPECTION RECORDS

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-82386 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material/contractl via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 1/25/2023. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document No.: 2158-3806

15. Total 0 1 0

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

/s/ Mercedes Flerx S/31 1/25/2023 /s/ Malvin Doinog 1/25/2023

D FORM 1423-1, JUN 90 (EG) Page 1 of 1 Pages

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information 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, DC 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. EXHIBIT C. CATEGORY:

0002 A

TDP

TM OTHER

MISC

X

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

ACRA Horizontal Boring Mill N4523A23Q5704 / 2158-3806 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A002 CERTIFICATION/DATA REPORT

OSHA CERTIFICATION REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A

Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.4, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 1/25/2023. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document No.: 2157-3805/3806/3807

15. Total 0

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

/s/ Mercedes Flerx 1/25/2023 /s/ Malvin Doinog 1/25/2023

DD FORM 1423-1, JUN 90 (EG)

Page 1 of 1 Pages

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information 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, DC 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. EXHIBIT C. CATEGORY:

MISC

X

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

ACRA Horizontal Boring Mill N4523A23Q5704 / 2158-3806 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

A004 CERTIFICATION/DATA REPORT

TEST CERTIFICATIONS

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 1/25/2023. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

Document No.: 2158-3806

/s/ Mercedes Flerx S/31 1/25/2023 /s/ Malvin Doinog 1/25/2023

DISTRIBUTION STATEMENT A. Approved for public release. Distribution is unlimited.

DATA ITEM DESCRIPTION

Title: CERTIFICATION DATA REPORT

Number: DI-MISC-82386 Approval Date: 20220712

AMSC Number: N10332 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: SH Project Number: MISC-2022-003

Applicable Forms: N/A

Use/Relationship: The Certification Data Report is required to verify that specific qualifications have been obtained, tests have been performed, parts/assemblies/equipment/systems have been installed, tested, inspected and are ready for operation; that personnel have specific qualifications to perform assignments/operations/inspections; or to certify identicalness, interchangeability, compatibility, reliability, or completeness of documentation being prepared or reviewed by a contractor. The technical effort involved will be the result of equipment, procurement, or contract requirements.

This Data Item Description (DID) contains the format and content preparation instructions for the data product generated by specific and discrete task requirements as delineated in the contract.

This DID supersedes DI-MISC-80678.

Requirements:

1. Reference Documents: N/A

2. Format. The report shall be typewritten in narrative format. Contractor’s format is acceptable.

3. Content: The report shall contain the contract number and data item sequence number, and shall contain a statement that specifically identifies the purpose and applicability of this certification.

4. Technical Content: The technical content shall be in accordance with the appendix entitled

“Certification Data/Report Technical Content Requirements,” contained in the applicable military specification as stated in the DD Form 1423, Contract Data Requirements List. The technical content shall be as specified on the DD Form 1423, Contract Data Requirements List and the contract requirements.

5. Certification of Completion. Certification that tests have been performed, inspections made, parts/assemblies/equipments/systems have been installed, tested, inspected, and are ready for operation, or that specific qualifications have been obtained shall provide objective evidence in support of the certification. Objective evidence may include such items as spectrographs, radiographs, material sampling, analysis, inspection and testing reports, or any other necessary documentation.

Source: http://assist.dla.mil -- Downloaded: 2023-02-01T23:32Z Check the source to verify that this is the current version before use.

DI-MISC-82386

6. Certification of Personnel. Certifications that personnel have specific qualifications shall be supported by licenses, permits, tests, statements of competency, or other documentation. The specific capabilities to perform an assignment, inspection, or other operations shall be stated in the certification.

7. Certification of Compliance. Certification of compliance to specific specification requirements shall be a statement to the effect that the contractor has complied.

8. Supplemental Information. Additional specific material, drawings, sketches, photographs, etc., in support of these certifications shall be as defined in the DD Form 1423 and the contract requirements.

9. Signature. The Certification Report shall contain the signature of the contractor's authorized representative. Electronic signatures are acceptable.

End of DI-MISC-82386

Source: http://assist.dla.mil -- Downloaded: 2023-02-01T23:32Z

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information 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, DC 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. EXHIBIT C. CATEGORY:

NDTI

X

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

ACRA Horizontal Boring Mill N4523A23Q5704 / 2158-3806 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

A006 TEST/INSPECTION REPORT

VISUAL INSPECTION

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

DI-NDTI-80809B PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 1/25/2023. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12: Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report

Document No.: 2157-3805/3806/3807

/s/ Mercedes Flerx 1/25/2023 /s/ Malvin Doinog 1/25/2023

DATA ITEM DESCRIPTION I Form Approved OMB No.0704.0188

1.nTLE 2.IOENTIFICATIONNUMBER

TEST/ INSPECTION REPORT DI-NM’I-80809B

L OESCRIPTlOtVPURPOSE

3.1 The testl inspection report is used to document testl inspection results, findings, and analyses that will enable the government or contracting agency to evaluate compliance with system requirements, performance objectives, specifications, and test linspection plans.

1.APPROVALDATE 5.OFFICEOFPRIMARYRESPONSIBILITY(OPB) Ea.DTICAPPLICABLE 6b.CWIEP AppliCable

(YVMMOD)

F/AFMC-DCJP

970124

,.APPLlCAT\0NflNTER7iElAT10NSH1P

7.1 This data item description (DID) contains the format and content preparation instructions for the data product generated by the specific and discrete task requirement

I as delineated in the contract.

I

7.2 This DID is applicable to engineering (developmental ), preliminary qualification, qualification, and acceptance testing.

7.3 This DID supersedes DI-NDTI-80809A and DI-MISC-80653

1.APPROVALLIMITATION 9a.APPLICABLEFORMS 9b.AMSCNUMBER

F7231

10,PREPARATIONlNSTRUCnONS

10.1 Format. Contractor format is acceptable.

paragraph 10.2 and its subparagraphs in a manner understanding

10.2 CQnL!aL. The test/inspection report shall

applicable.

Organize the information required by that facilitates presentation and contain the following information, as

10. 2.1 Cove. and tile uaae. The following information shall appear on the outside front :over and title page:

a. Report date.

b. Report number (contractor or government)

Contractor’ s name, address, and commercia 1 and government entity code.

Contract number and contract line item number or sequence number (if applicable)

e. ‘fvpe of test/inspection (for example. first article acceptance test, aualitv con formanc-e-inspection, d-evelopmental test-, qualification test, f Identification of item tested/inspected.

9. Date or period of test/inspection.

h. Name and address of requiring government activity.

i. Security classification, downgrading and declassifying environmental Lest) .“ information, if applicable.

(Continued on page 2 )

1.DIS77UBUTIONSTATEMEW

DISTRIBUTION STATEMRNT A : APPROVED FOR PUBLIC RELBASE; DISTRIBUTION IS UNLIMITED.

ID Form 1664,APR 89 PreviOLIsedtliomwe obsdem. Page 1 of & Pages 39123

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DI-NDTI-80809B

Block 10, Preparation Instructions (continued)

10.2.2 ~. The table of contents shall identify the following:

a. The title and starting page of each major section, paragraph, and apPendix of the report.

b. The page, identifying number, and title of each illustration (for example; figure, table, photograph, chart, and drawing)

10 .2.3 -ductim. The introduction shall include the following information:

10.2 .3.1 obyectlve W. The specific test/ inspection objective (s) as specified in the contract tasking document.

10. 2.3.2 L.temls) tes~. Complete identification of the item(s) testedl inspected including the following:

a. Nomenclature.

b. National stock number.

Model number, part number t and serial number :: Type of item (for example, prototype, production item, laboratory model )

e. Serial or lot number.

f. Applicable engineering changes

9. Production item specification, if applicable.

h. Date of manufacture.

10.2 .3.3 Complete inspection requirements correlated to contractual following:

Required testl inspection parameters :: Performance requirements, acceptance or environmental criteria.

10.2.4 ~. Complete test/inspection report following:

identification of the testl requirements including the compliance limits, and summary including the

a. A brief discussion of the significant test/inspection results, ObSerVati Qns, conclusions, and recommendations covered in greater detail elsewhere in the report.

b. Proposed corrective actions and schedules for failures or problems encountered.

c. Identification of deviations, departures, or limitations encountered, referenced to the contract requirements.

d. Tables, graphs, illustrations, or charts as appropriate to simplify the summary data.

10.2.5 ~. Complete identification of all documents referenced in the test finspection report including the following, as applicable:

a. Prior testf inspection reports on the same item.

b. Test /inspection plans and procedure documents

c. Prior certifications of compliance.

d. Contractor’ s file designation where test/ inspection records are maintained.

e. Input parameters used.

The applicable issue of the documents cited therein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

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10.2.6 ~. The body of the testlinspection report shall be as follows :

10 .2.6.1 KzZL_ + de.tlflca~.

Complete identification of each item of test equipment used in the testlinspection including the following:

a.

b.

c.

d.

e.

f.

9.

10. 2.6.2

Nomenclature.

Model number.

Serial number.

Manufacturer.

Calibration status.

Accuracy data.

Comments, if applicable.

Testlinmection kuhtv mstd.b&mn and set–w. Complete description of the physical set-up used in conducting the test/inspection to include the following:

a. Location or orientation of the item.

b. Location. orientation, or settinm of test equipment and instrumentation.

c. Location, orientation, or settings of sensors and probes

d. Location or orientation of interconnections, cables, and hoop-ups.

e. Electrical power, pneumatic, fluidic, and hydraulic requirements.

Drawings, illustrations, and photographs maY be used for clarification.

10 .2.6.3 wrocedur~. Complete description of the procedures used in conducting the test/inspection to include the following:

a. Item selection and inspection that verified suitability for test/ inspection.

b. Summarized sequence of testing/inspection steps, including a description of how the item was operated during the test/inspection, and any control conditions imposed.

10 .2.6.4 A copy of all testlinspection results and analysis to include the following:

10.2.6 .4.1 ~. The actual recorded data (for example, log book entries, oscillographs, instrument readings, plotter graphs) If the recorded data is extensive, provide it in an appendix.

10. 2.6.4.2 Test/ insQec!iion resu. Identification of all testlinspection results to include the following:

a. Matrices comparing results achieved against test/inspection objectives or requirements

b. A discussion of these matrices as to their significance, and how they compare to any prior testlinspections.

Calculation examples.

;; Discussion of anomalies, deviations, discrepancies, or failures, including their impact, causes, and proposed corrective actions The discussion shall address discrepancies between design requirements and the tested/inspected Configuration.

10. 2.6.5 Conclusicxls Test/ inspection conclusions distinguished between objective and subjective to include the following:

a. The effectiveness of the testlinspection procedures in measuring item performance.

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b. The success or failure of the item to meet required test/inspection objectives.

c. The need for repeat, additional, or alternative tests linspections.

d. The need for item redesign or further development.

e. The need for improved test/inspection procedures, techniques, or facilities.

f. The adequacy and completeness of the test/inspection requirements.

10.2 .6.6 Recommendations appropriate to the test/inspection results and conclusions including the following:

a b.

c.

d.

e.

f.

9.

h.

Acceptability of the item tested/inspected (pass or fail) Additional testing/inspection required. ,.

Redesign required.

Problem resolution.

Test/inspection procedure or facility improvements Disposition of items tested/inspected.

Documentation changes required.

Testing/ inspection improvements

10.2.7 The following certifications shall be included, .as

applicable:

10.2 .7.1 A statement that the testlinspection was performed in accordance with applicable testlinspection plans and procedures, and that the results are true and accurate. The authentication shall include the signature of the contractor personnel that performed the test(s) /inspection(s) , a contractor representative authorized to make such certification, and any government witnesses

10.2 .7.2 A statement identifying those requirements not tested/inspected or measured that were previously validated.

Include identification of the data and method employed for such validation (for example, prior test/inspection, analytical verification, equivalent item, and so on) The authentication shall include the signature of a contractor representative authorized to make such authentication and any government witness.

10.2 .7.3 A statement that the item tested/ inspected either passed or failed item acceptability requirements This authentication shall include the signature of a contractor representative authorized to make such authentication and any government witness

10.2.8 Appendices shall be used to append detailed

test/inspection daia, drawings, photographs , or other documentation too voluminous to include in the main body of the report This includes referenced documentation not previously provided by the government, and test/ inspection reports from any associated test/inspection activity that may have performed some of the testing/inspecting requirements.

Page 4 of 4 Pages Source: http://assist.dla.mil -- Downloaded: 2023-02-02T22:34Z

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 thus burden estimate or any other aspect of this collection o f information, including suggestions for reducing this burden, to Department of Defense, Washington Headquarters Services, Directorate for Information 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, DC 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. EXHIBIT C. CATEGORY:

0002 A

TDP TM OTHER

SESS

X

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

ACRA Horizontal Boring Mill N4523A23Q5704 / 2158-3806 TBD

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE

GROUP

A007 WARRANTY PERFORMANCE REPORT WARRANTY DOCUMENTATION

5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

TOTAL PRICE

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-81639B PER CONTRACT PURCHASING ACTIVITY

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

DD ONE/R SEE BLOCK 16 b. COPIES

8. APP CODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE DRAFT FINAL

N/A N/A N/A Reg Repr o

16. REMARKS N4523A 0 1 0

Block 4 - Tailored to allow vendor to provide only 3.1.1 (a, c, d, e), 3.1.2 (a, b, c, d, e, f, g, h, j, k, l, m).

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 2/2/2023. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e-Business Suite. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document No.: 2157-3805/3806/3807

15. Total 0 1 0

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

/s/ Mercedes Flerx 2/2/2023 /s/ Malvin Doinog 2/2/2023

DD FORM 1423-1, JUN 90 (EG) Page 1 of 1 Pages

DATA ITEM DESCRIPTION

Title: WARRANTY PERFORMANCE REPORT

Number: DI-SESS-81639B Approval Date: 20220616

AMSC Number: F10327 Limitation: N/A

DTIC Applicable: No GIDEP Applicable: No

Preparing Activity: 170 (AFLCMC F-16) Project Number: SESS-2021-019

Applicable Forms: DD Form 250 Office of Management and Budget (OMB) Control Number 0704-0248

Use/Relationship: The Warranty Performance Report provides information on items under warranty; contractor repair, replacement, and reimbursement; and equipment failure data associated with Reliability Improvement Warranties (RIW).

a. The data is used to track and assess the effectiveness and implementation of the contract warranty provisions; to apprise the government of the type, severity, and frequency of failures; to verify warranty coverage for each item delivered; and to document warranty periods and delivery schedules.

b. This Data Item Description (DID) contains the format, content, and intended use information for the data deliverable resulting from the work task described in the contract.

c. The warranty status section of this DID is used to warranty provisions where individual warranted item identification is required, and remedies include repair, replacement, and reimbursement. The warranty data section is used to warranty provisions where a RIW is delineated in the contract or data on reliability and performance achievement is required.

d. This DID supersedes DI-SESS-81639A.

Requirements:

1. Reference documents. The applicable issue of the documents cited herein, including their approval dates and dates of any applicable amendments, notices, and revisions, shall be as specified in the contract.

2. Format. The Warranty Performance Report shall be in government-approved contractor format.

3. Content. The Warranty Performance Report shall delineate data for each contract line item (CLIN) covered by the warranty. The Report shall contain the following:

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DI-SESS-81639B

3.1 Warranty status information, including:

3.1.1 Header information. The header information shall include:

a. Contract number.

b. Calendar reporting period covered by the report.

c. Warrantor’s name.

d. Repair facility address, including city, state, and zip code.

e. Warrantor’s Commercial and Government Entity (CAGE) code.

f. Warrantor’s Department of Defense Activity Address Code (DoDAAC).

3.1.2 Warranted item information. The warranted item information for each CLIN covered by a warranty delivered to the Government during the reporting period, which shall include:

a. CLIN.

b. National Stock Number (NSN).

c. Government issued nomenclature (noun) in accordance with MIL-STD-1812 Aeronautical and Support Equipment Type Designation System.

d. Serial Number (SN).

e. Part Number.

f. Delivery date. Completed DD Form 250, Material Inspection and Receiving Report.

(Copies of this form are available online at https://www.esd.whs.mil/Directives/forms/)

g. Shipping date.

h. Shipping destination.

i. In-service date (i.e., Date when the warranted items are turned over to field users).

j. Contract date.

k. Warranty date.

l. Warranty length.

m. Warranty end date.

m. Applicable weapon system(s).

n. Cumulative data of 3.1.2 for CLIN items delivered under the contract to the Government from start date of contract award to the end date of the reporting period.

o. Cumulative data of 3.1.2 for CLIN items delivered under the contract to the Government for which the warranty has expired from the start date of contract award to the end date of the reporting period.

3.1.3 Contractor’s plant warranty repair or replacement information. For CLINs returned for repair or replacement at the contractor’s facility during the reporting period, the following information shall be included:

a. NSN and Government issued nomenclature of the returned CLIN.

b. Date returned CLIN received at contractor’s facility.

c. SN.

d. Action taken (i.e., Repaired, replaced, awaiting action, or shipped).

e. NSN(s), part number(s), and quantity of repair parts used.

f. Cost (U.S. dollars) of repair or replacement, including parts and labor, and base year for the dollar amounts.

g. Cost (U.S. dollars) of failure, and base year for the dollar amounts.

3.1.4 On-site contractor warranty repair or replacement. For CLINs repaired or replaced during the reporting period, for which repairs or replacements are performed by the contractor or the contractor’s designated representative at the contractor’s facility or dealership, the following information shall be included:

a. NSN and Government issued nomenclature of the CLIN.

b. SN.

c. Action taken (i.e., Repaired, replaced, awaiting action, or shipped).

d. NSN(s), part number(s), and quantity of repair parts used.

e. Cost (U.S. dollars) of repair or replacement, including parts and labor, and base year for the dollar amounts.

f. Cost (U.S. dollars) of failure, and base year for the dollar amounts.

3.1.5 Warranty repair contractor reimbursements to the Government. When the Government submits a warranty claim reimbursement to the contractor for Government costs expended for warranty repair during the reporting period, the contractor’s reimbursement to the Government shall include the following:

a. Government warranty claim number.

b. NSN and Government issued nomenclature.

c. Government claim (U.S. dollars) amount, and base year for the dollar amount.

d. Contractor reimbursement (U.S. dollars) amount, and base year for the dollar amount.

e. Reason for denial of reimbursement, if applicable.

f. Reason for lesser amount of reimbursement than Government claim amount, if applicable.

g. Status of claim.

3.1.6 Cumulative data. Cumulative data for 3.1.3, 3.1.4, and 3.1.5 shall be included from the start date of contract award to the end date of the reporting period.

3.1.7 Remarks. Contractor comments and recommendations regarding the warranty status information, including improvements, changes, or other specific details, shall be provided, as needed.

3.2 Warranty data.

3.2.1 Program summary. The program summary information shall include:

a. Program detail. The program or RIW start date, reporting period start date, and reporting period cut-off date.

b. Utilization details. The average operating time (AOT) and total operating hours (TOH) for the average quantity of installed systems.

c. Repair detail. The quantity of units returned subdivided by: exclusions, which shall include a quantity and a percent of total units returned; non-verified failures, which shall include a quantity and a percent of total units returned; and quantity of warranted failures, warranty units repaired, and quantity of total repair days.

d. Performance statistics. The achieved mean time between failures (MTBF) and average turn-around time (TAT).

e. Program status. The number of days from the start of the contract warranty, TOH from start of the contract warranty, warranty used, and warranty remaining.

3.2.2 Unit summary. A unit summary of the activity for each type unit, line replaceable unit (LRU), and shop replaceable unit (SRU), which shall include:

a. Delivery and processing status. The number of total units delivered and units returned subdivided by: exclusions, which shall include a quantity and a percentage of total units returned; non-verified failures, which shall include a quantity and a percentage of total units returned; and quantity of warranted failures, quantity in repair, quantity in secure storage, quantity shipped, quantity condemned or lost, quantity on consignment, repair man hours, repair parts, and material costs.

b. Utilization details. The average quantity of units installed and TOH.

c. Unit cycle time. The unit cycle time shall include the average days for the following segments: shipment-to-contractor-receipt, contractor-receipt-to-storage, storage-to-shipment, shipment-to-installation, installation-to-removal, and removal-to-shipment.

d. Unit performance, including: MTBF guaranteed, MTBF achieved, TAT guaranteed, and TAT achieved.

e. Unit detail. Historical activity of all delivered units as follows: unit SN; date sent to or located in storage; date of material release order (MRO); date shipped; elapsed time indicator (ETI) read in; ETI read out; configuration codes; shipping destination; date installed; aircraft and equipment type, tail number, and SN; date removed; date shipped to contractor; date received by contractor; originating activity; and RIW repair code (e.g., warranty exclusion, non-verified failure, warranty failure).

3.2.3 Modification status summary. A modification status summary for each type unit, LRU, and SRU, which shall contain all engineering change proposals (ECP) submitted for reliability improvements as follows: ECP number, date submitted, date approved, status code (e.g., government approval, automatic approval, disapproval), configuration code(s) applicable to the specific weapon system (e.g., F-16 A-Model block 01/05/10/15 Type/Version [T/V]:61]; B-Model block 01/05/10/15 T/V:62; C-Model block 25/30/32 T/V:5C), production effectivity (date), quantity of units, total percentage of units affected by the ECP, and total percentage of units with the ECP completed.

3.2.4 Consignment spares inventory list. The consignment spares inventory list shall include the following for each consignment spare: number of units, if the spare is a LRU or a SRU, if the spare is on consignment or loan to the Government include the date of consignment, nomenclature, and SN.

3.2.5 Parts consumption list. The parts consumption list shall include a list organized in alphabetical or numerical order, of all parts associated with or contained in the equipment under warranty, including the total quantity of each part consumed during repair actions, and a description of all repair actions completed from the warranty start date through the required report cut-off date.

End of DI-SESS-81639B.