N55236-15-R-0003_CDRLS.pdf

CONTRACT DATA REQUIREMENTS LIST (CDRL)

(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 C. CATEGORY:

0002 A TDP TM _____ OTHER MGMT

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

FLEET TECHNICAL SUPPORT N55236-15-R-0003 TBD

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

A001 SERVICE/WORK REQUEST REPORT TEST & INSPECTION PLAN (TIP)

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

TOTAL PRICE

DI-MGMT-81893 See Section C PWS Para C.2.11 CIS CODE 300 AND QA CODE 131

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

LT REQUIRED AS REQ SEE BLK 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D (SEE BLK 16)

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft Final

N/A SEE BLK16 SEE BLK16* Reg Repro

16. REMARKS RICHARD MEDINA (SBS) 0 1 0

BLOCK A: APPLICABLE TO ALL CLINS; SEE BLOCK 5 FOR SPECIFIC REPORTING DETAILS.

BLOCK 4: PARA 1 "COMMAND FACILITY MANAGEMENT" DOES NOT APPLY.

BLOCK 7: LETTER OF TRANSMITTAL SHALL BE VIA EMAIL.

BLOCK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF

DEFENSE AND U.S. DOD CONTRACTORS ONLY (OPERATIONAL USE) (22 MAY 2013). OTHER

REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO COMMANDER, SOUTHWEST

REGIONAL MAINTENANCE CENTER CODE 400, NAVAL BASE SAN DIEGO, 3755 BRINSER STREET

SUITE 1, SAN DIEGO CA 92136.

BLOCKS: 10, 12 AND 13: THE REPORT SHALL BE SUBMITTED NO LATER THAN ONE DAY PRIOR

TO THE START OF PRODUCTIVE WORK.

BLOCK 14, MEDIA REQUIREMENT: THE TEST AND INSPECTION PLAN SHALL BE DELIVERED IN

MICROSOFT OFFICE SUITE, VERSION 2007, IN AN EMAIL ATTACHMENT WITH NOTIFICATION TO

ALL ADDRESSEES:

RICHARD.MEDINA@NAVY.MIL

TERENCE.P.MURPHY@NAVY.MIL

TERRY MURPHY (QA) 0 1 0

SEE BLK 16 0 0 0

0 0 0

15. TOTAL ▬▬▬▬► 0 2 0

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

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 6 Pages

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 C. CATEGORY:

0002 A TDP TM _____ OTHER MGMT

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

FLEET TECHNICAL SUPPORT N55236-15-R-0003 TBD

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

A002 WORK AUTHORIZATION FORM REPORT WAF

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

DI-MGMT-81912 See Section C PWS Para C.2.13 SHIP'S MAINTENANCE CENTER

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

LT REQUIRED ASREQ SEE BLK16

a. ADDRESSEE

b. COPIES

8. APP CODE

D (SEE BLK 16)

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft Final

N/A N/A N/A Reg Repro

16. REMARKS RICHARD MEDINA 0 1 0

BLOCK A: APPLICABLE TO ALL CLINS; SEE BLOCK 5 FOR SPECIFIC REPORTING DETAILS.

BLOCK 4: PARA 1 "DIVING" DOES NOT APPLY.

BLOCK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF

DEFENSE AND U.S. DOD CONTRACTORS ONLY (OPERATIONAL USE) (22 MAY 2013). OTHER

REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO COMMANDER, SOUTHWEST

REGIONAL MAINTENANCE CENTER CODE 400, NAVAL BASE SAN DIEGO, 3755 BRINSER STREET

SUITE 1, SAN DIEGO CA 92136.

BLOCKS 10, 12 AND 13: THE REPORT SHALL BE DELIVERED NO LATER THAN 1 DAY PRIOR TO

START OF PRODUCTIVE WORK.

BLOCK 14: MEDIA: THE WORK AUTHORIZATION FORM MEDIA SHALL BE IN ADOBE ACROBAT

(PDF) AND DELIVERED TO SHIP BUILDING SPECIALIST (SBS):

RICHARD.S.MEDINA@NAVY.MIL

SEE BLK 16 0 0 0

15. TOTAL ▬▬▬▬► 0 1 0

DONNA S. WILLIAMS, N00AL132

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 2 of 6 Pages

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 C. CATEGORY:

0002 A TDP TM _____ OTHER MGMT

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

FLEET TECHNICAL SUPPORT N55236-15-R-0003 TBD

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

A003 CONDITIONS FOUND REPORT (CFR) INSPECTION/DEFICIENCY REPORT

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

OT-14- Section C Para C.3.1 and C.3.2 CIS CODE 300

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

LT REQUIRED AS REQ SEE BLK 16

a. ADDRESSEE

b. COPIES

8. APP CODE

D (SEE BLK 16)

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft Final

N/A N/A SEE BLK 16 Reg Repro

16. REMARKS RICHARD MEDINA (SBS) 0 1 0

BLOCK A: APPLICABLE TO ALL CLINS; SEE BLOCK 5 FOR SPECIFIC REPORTING DETAILS.

BLOCK 7: LETTER OF TRANSMITTAL SHALL BE VIA EMAIL.

BLOCK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF

DEFENSE AND U.S. DOD CONTRACTORS ONLY (OPERATIONAL USE) (22 MAY 2013). OTHER

REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO COMMANDER, SOUTHWEST

REGIONAL MAINTENANCE CENTER CODE 400, NAVAL BASE SAN DIEGO, 3755 BRINSER STREET

SUITE 1, SAN DIEGO CA 92136.

BLOCKS 10, 12 AND 13: THE REPORT SHALL BE DELIVERED NO LATER THAN 1 DAY PRIOR TO

THE START OF PRODUCTIVE WORK.

BLOCK 14: THE REPORT SHALL BE DELIVERED IN MICROSOFT OFFICE SUITE, VERSION 2007,

AND EMAIL ATTACHEMENT WITH NOTIFICATION TO ALL ADDRESSES:

RICHARD.MEDINA@NAVY.MIL

SEE BLK 16

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 3 of 6 Pages

DATA ITEM DESCRIPTION

Title: Conditions Found Report (CFR)

Number: Approval Date:

ASMC Number: N/A Limitation: N55236-15-R-0003 DTIC Applicable: N/A GIDEP Applicable: N/A Office of Primary Responsibility: SH/SWRMC300

Use/relationship: The Conditions Found Report informs the Government of deficiency’s found during inspections and includes recommended actions. Prior to the start of work, the Contractor shall submit a Conditions Found Report (CFR) to the Ship Building Specialist (SBS) identifying discrepancies associated with the equipment specified in each delivery order.

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

Requirements:

1. Format. The report shall be in the Contractor’s format.

2. Content. The report shall identify discrepancies and damages associated with the description of work to the SBS.

3. Media Requirement. The report shall be in Microsoft Office Suite, Version 2007.

4. End of STANDARD DID

Title: Conditions Found Report (CFR)

Number: Approval Date:

ASMC Number: N/A Limitation: N55236-15-R-0003 DTIC Applicable: N/A GIDEP Applicable: N/A Office of Primary Responsibility: SH/SWRMC300

Use/relationship: The Conditions Found Report informs the Government of deficiency’s found during inspections and includes recommended actions. Prior to the start of work, the Contractor shall submit a Conditions Found Report (CFR) to the Ship Building Specialist (SBS) identifying discrepancies associated with the equipment specified in each delivery order.

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

This DID is for One-Time use on Solicitation N55236-15-R-0003 only.

Requirements:

1. Format. The report shall be in the Contractor’s format.

2. Content. The report shall identify discrepancies and damages associated with the description of work to the SBS.

3. Media Requirement. The report shall be in Microsoft Office Suite, Version 2007.

4. End of OT or STANDARD DID

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 C. CATEGORY:

0002 A TDP TM _____ OTHER MGMT

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

FLEET TECHNICAL SUPPORT N55236-15-R-0003 TBD

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

A004 STATUS REPORTS CFR, WAF, TIP, IDR AND CHECKPOINTS

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

DI-MGMT-8036BA See Section C PWS Para C.18 CIS CODE 300

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

LT REQUIRED AS REQ SEE BLK16

a. ADDRESSEE

b. COPIES

8. APP CODE

D (SEE BLK 16)

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft Final

N/A N/A SEE BLK16 Reg Repro

16. REMARKS RICHARD MEDINA (SBS) 0 1 0

BLOCK A: APPLICABLE TO ALL CLINS; SEE BLOCK 5 FOR SPECIFIC REPORTING DETAILS.

BLOCK 4: PARA 3.2.1(A), (B), (D), (E), (H); 3.2.3; 3.2.4; AND 3.3 DO NOT APPLY.

BLOCK 7: HARD COPIES SHALL BE DELIVERED.

BLOCK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF

DEFENSE AND U.S. DOD CONTRACTORS ONLY (OPERATIONAL USE) (22 MAY 2013). OTHER

REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO COMMANDER, SOUTHWEST

REGIONAL MAINTENANCE CENTER CODE 400, NAVAL BASE SAN DIEGO, 3755 BRINSER STREET

SUITE 1, SAN DIEGO CA 92136.

BLOCK 10, 12 AND 13: THE REPORT SHALL BE DELIVERED WITH BILLING/INVOICES.

BLOCK 14: MEDIA REQUIREMENT. REPORT SHALL BE DELIVERED AT THE TIME OF BILLING/

INVOICING IN TWO HARD COPIES AND DELIVERED TO THE SBS.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 4 of 6 Pages

Title: Check Points

Number: STD Approval Date: XXXXXXX ASMC Number: N/A Limitation: N55236-15-R-0003 DTIC Applicable: N/A GIDEP Applicable: N/A Office of Primary Responsibility: SH/SWRMC300

Use/relationship: Check Points establish a point in the sequence of accomplishment of work at which time the Ship Building Specialist (SBS) shall be notified by the prime contractor in all cases to permit observation of a specific test or inspection by the government.

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

NAVSEA Standard Items 009-04 can be obtained as specified in the contract.

Requirements:

1. Format. Data shall be submitted using contractor’s format.

2. Content. The report shall contain information as per guidance from NAVSEA Standard Items 009-04

3. End of STD-14-XXXXXX

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 C. CATEGORY:

0002 A TDP TM _____ OTHER MGMT

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

FLEET TECHNICAL SUPPORT N55236-15-R-0003 TBD

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

A005 STATUS REPORT INSPECTION DISCREPANCY REPORT (IDR)

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

DI-MGMT-8036BA See Section C PWS Para C.2.7 CIS CODE 300

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

LT REQUIRED AS REQ SEE BLK16

a. ADDRESSEE

b. COPIES

8. APP CODE

D (SEE BLK 16)

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft Final

N/A N/A SEE BLK16 Reg Repro

16. REMARKS RICHARD MEDINA (SBS) 0 1 0

BLOCK A: APPLICABLE TO ALL CLINS; SEE BLOCK 5 FOR SPECIFIC REPORTING DETAILS.

BLOCK 4: PARA 3.2.1(A), (B), (D), (E), (H); 3.2.3; 3.2.4; AND 3.3 DO NOT APPLY.

BLOCK 7: HARD COPIES SHALL BE DELIVERED.

BLOCK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF

DEFENSE AND U.S. DOD CONTRACTORS ONLY (OPERATIONAL USE) (22 MAY 2013). OTHER

REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO COMMANDER, SOUTHWEST

REGIONAL MAINTENANCE CENTER CODE 400, NAVAL BASE SAN DIEGO, 3755 BRINSER STREET

SUITE 1, SAN DIEGO CA 92136.

BLOCK 10, 12 AND 13: THE REPORT SHALL BE PROVIDED VERBALLY AND IN WRITING

IMMEDIATELY OF DIFFICULTIES THAT MAY JEOPARDIZE THE COMPLETION OF SPECIFIED WORK.

BLOCK 14: MEDIA REQUIREMENT. REPORT SHALL BE DELIVERED AT THE TIME OF BILLING/

INVOICING IN TWO HARD COPIES AND DELIVERED TO THE SBS.

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 4 of 6 Pages

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 C. CATEGORY:

0002 A TDP TM _____ OTHER MGMT

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

FLEET TECHNICAL SUPPORT N55236-15-R-0003 TBD

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

A006 CHECK POINTS G CHECK POINTS

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

OTIME DID PWS Para C.9.4 and C.9.8 CIS CODE 300

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

LT REQUIRED AS REQ SEE BLK16

a. ADDRESSEE

b. COPIES

8. APP CODE

D (SEE BLK 16)

11. AS OF DATE 13. DATE IF SUBSEQUENT SUBM.

Draft Final

N/A N/A SEE BLK 16 Reg Repro

16. REMARKS RICHARD MEDINA (SBS) 0 1 0

BLOCK A: APPLICABLE TO ALL CLINS; SEE BLOCK 5 FOR SPECIFIC REPORTING DETAILS.

BLOCK 7: LETTER OF TRANSMITTAL SHALL BE VIA EMAIL.

BLOCK 9: DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF

DEFENSE AND U.S. DOD CONTRACTORS ONLY (OPERATIONAL USE) (22 MAY 2013). OTHER

REQUESTS FOR THIS DOCUMENT SHALL BE REFERRED TO COMMANDER, SOUTHWEST

REGIONAL MAINTENANCE CENTER CODE 400, NAVAL BASE SAN DIEGO, 3755 BRINSER STREET

SUITE 1, SAN DIEGO CA 92136.

BLOCKS 10, 12, 13: THE CHECKPOINT REPORT SHALL BE DELIVERED ONE DAY PRIOR TO START

OF PRODUCTIVE WORK.

BLOCK 14: MEDIA REQUIREMENT: THE REPORT SHALL BE DELIVERED IN MICROSOFT OFFICE

SUITE, VERSION 2007, AND EMAIL ATTACHMENT WITH NOTIFICATION TO ALL ADDRESSES:

RICHARD.MEDINA@NAVY.MIL

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 5 of 9 Pages

Title: Check Points

Number: Approval Date: XXXXXXX ASMC Number: N/A Limitation: N55236-15-R-0003 DTIC Applicable: N/A GIDEP Applicable: N/A Office of Primary Responsibility: SH/SWRMC300

Use/relationship: Check Points establish a point in the sequence of accomplishment of work at which time the Ship Building Specialist (SBS) shall be notified by the prime contractor in all cases to permit observation of a specific test or inspection by the government.

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

This DID is for One-Time use on Solicitation N55236-15-R-0003 only.

NAVSEA Standard Items 009-04 can be obtained as specified in the contract.

Requirements:

1. Format. Data shall be submitted using contractor’s format.

2. Content. The report shall contain information as per guidance from NAVSEA Standard Items 009-04

3. End of OT-14-XXXXXX