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CONTRACT DATA REQUIREMENTS LIST

(1 Data Item) Form Approved 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 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:

0001,1001,2001,3001,4001
A

TDP

TM

OTHER
MGMT

D.

SYSTEM/ITEM

E.

CONTRACT/PR NO.

F.

CONTRACTOR

LCAC Maintenance, Modification, Repair, Trial and Expeditionary Warfare Program Support

1.

DATA ITEM NO.

2.

TITLE OF DATA ITEM

3.

SUBTITLE

17. PRICE GROUP

A001
Contracting Officer’s Management Report
Monthly Contract Status Reports

4.

AUTHORITY (Data Acquisition Document No.)

5.

CONTRACT REFERENCE

6.

REQUIRING OFFICE

DI-MGMT-81864
SOW Paragraph 3.6
NSWC PCD Code E32

ESTIMATED

TOTAL PRICE

7.

DD 250 REQ

9.

DIST STATEMENT

10.

FREQUENCY

12.

DATE OF FIRST SUBMISSION

14.

DISTRIBUTION

LT

REQUIRED

MTHLY
SEE BLK 16

b. COPIES

8.

APP CODE

D
11.

AS OF DATE

13.

DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE
Draft
Final
N/A
SEE BLK 16

SEE BLK 16

Reg
Rep

16.

REMARKS

NSWC PCD Code E32
0
1
0

Blk 4: Contractor format is acceptable for this data deliverable. The DID is cited for guidance only as to content. Report shall be segregated by Task Order issued and active under the contract Blk 9: Data shall be marked in accordance with Section D of the contract Blks 12,13: First submission due 30 days after the issuance of the first task order under the contract. Subsequent submissions due by the 10th of each month during the contract period of performance.

Blk 14: MEDIA REQUIREMENTS: Deliverable copy shall be 100% compatible Microsoft® Office 2010 files delivered via e-mail. E-mail addresses will be provided at award of the contract.

NSWC PCD Code 023
00
1
0
NSWC PCD COR
0
1
0

15.

TOTAL

0
3
0

G.

PREPARED BY

H.

DATE

I.

APPROVED BY

J.

DATE

G. Campbell, NSWC PCD Code E32

10/28/2015

W.T. Sawyer, CSS Code 0213

DD Form 1423-1, JUN 90
Previous editions are obsolete
Page
1
Of
3
Pages

CONTRACT DATA REQUIREMENTS LIST

Form Approved

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 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.

B.

EXHIBIT

C.

0001,1001,2001,3001,4001
A

TDP

TM

OTHER
MGMT

D.

E.

CONTRACT/PR NO.

F.

LCAC Maintenance, Modification, Repair, Trial and Expeditionary Warfare Program Support

1.

2.

TITLE OF DATA ITEM

3.

SUBTITLE

17. PRICE GROUP

A002
Quality System Plan
Quality Assurance Plan

4.

5.

CONTRACT REFERENCE

6.

DI-QCIC-81379
SOW Paragraph 3.7
NSWC PCD Code E32

ESTIMATED

TOTAL PRICE

7.

DD 250 REQ

9.

DIST STATEMENT

10.

FREQUENCY

12.

DATE OF FIRST SUBMISSION

14.

LT

ONE/R
30 DAC

b. COPIES

8.

D
11.

AS OF DATE

13.

DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE
Draft
Final
A
SEE BLK 16

SEE BLK 16

Reg
Rep

16.

NSWC PCD Code E32
1
1
0

BLK 4: Contractor format is acceptable. Plan shall be tailored as appropriate for a services contract with the primary deliverables being maintenance and technical data.

BLK 8,10,12,13: First submittal due 30 days after contract award. Approval shall be for technical content. The Government will review the initial submittal and provide comments within 10 days after receipt. All NSWC PCD comments shall be incorporated and the document resubmitted within 5 days after receipt of comments. The document shall be revised as changes in the projects occur that require modification of the plan, BLKs 9,14: Same as A001.

LT ONLY

NSWC PCD Code 023

NSWC PCD COR

15.

1
1
0

G.

H.

DATE

I.

APPROVED BY

J.

DD Form 1423-1, JUN 90
Previous editions are obsolete
Page
2
Of
3
Pages

CONTRACT DATA REQUIREMENTS LIST

Form Approved

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 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.

B.

EXHIBIT

C.

0001,1001,2001,3001,4001
A

TDP

TM

OTHER
MGMT

D.

E.

CONTRACT/PR NO.

F.

LCAC Maintenance, Modification, Repair, Trial and Expeditionary Warfare Program Support

1.

2.

TITLE OF DATA ITEM

3.

SUBTITLE

17. PRICE GROUP

A004
Environmental Health and Safety Plan (HSP)
Safety Plan

4.

5.

CONTRACT REFERENCE

6.

DI-ENVR-81375
SOW paragraph 3.8
NSWC PCD Code E32

ESTIMATED

TOTAL PRICE

7.

DD 250 REQ

9.

DIST STATEMENT

10.

FREQUENCY

12.

DATE OF FIRST SUBMISSION

14.

LT

ONE/R
30 DAC

b. COPIES

8.

D
11.

AS OF DATE

13.

DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE
Draft
Final
A
SEE BLK 16

SEE BLK 16

Reg
Rep

16.

NSWC PCD Code E32
1
1
0

Blk 4: Contractor format is acceptable for this data deliverable. The DID is cited for guidance only as to content.

Blk 9: Data shall be marked in accordance with Section D of the contract

Blks 8,10,12,13: The Government will review the first submittal for approval of technical content and will provide review comments within 20 days after receipt. Comments shall be incorporated and the plan submitted as final 10 days after receipt of comments. The Plan shall be revised as required throughout the life of the contract as changes occur to DoD and DoN software development policy and procedures.

Blk 14: MEDIA REQUIREMENTS: Deliverable copy shall be 100% compatible Microsoft® Office 2010 files delivered via e-mail. E-mail addresses will be provided at award of the contract.

(LT ONLY)

NSWC PCD Code 023

NSWC PCD COR

15.

1
1
0

G.

H.

DATE

I.

APPROVED BY

J.

DD Form 1423-1, JUN 90
Previous editions are obsolete
Page
3
Of
3
Pages

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