CDRL_A005_-_Acceptance_Test_Report_V3.0_signed.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

Page of Pages

BLK 9: Affix the following distribution statement on all documents: "DISTRIBUTION STATEMENT C: Distribution authorized to US Government Agencies and their contractors, Administrative and Operational Use, 1 Jan 2016. Other requests for this document shall be referred to Naval Surface Warfare Center, Corona Division, ATTN: Neal Nakafuji, RS31, P.O. Box 5000, Corona, CA 92878-5000."

BLK 12: First draft to be provided no more than 10 business days after acceptance testing is completed. Government will review for technical content and submit comments/changes to contractor no more than 5 days after receipt of first draft.

BLK 13: Final to be provided no more than business 5 days after Government comments/changes are submitted to contractor.

BLK 14: If the contractor elects to send an electronic copy of this documentation, it shall be sent by e-mail in a Microsoft Office application format, such as Microsoft Word, Excel, Project, Visio, and PowerPoint. Electronic and hard copies shall be provided to:

E-mail: neal.nakafuji@navy.mil

Address: NSWC Corona Division Attn: Neal Nakafuji (RS31) P.O. Box 5000 Corona, CA 92878-5000