CDRL_A004_CalReport_Flow_Standard_CDM_Cert_02.21.2018.doc

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.

17. PRICE GROUP

II

18. ESTIMATED

DI-QCIC-80798B

(See Block 16) SOW Paragraph: 5.1.12 and CSS 06-184 paragraph 3.7.7 (See Block 16) NSWC, Corona Division

TOTAL PRICE

LT

2TIMES

(See Block 16)

A

b. COPIES

8. APP CODE

Final

A

Block 4/5: DI-QCIC-80798B shall be used as guidance and is provided as reference. SOW paragraph 5.1.12 and CSS 06-184 paragraph 3.7.7 are mandatory to this requirement and are provided for guidance. This requirement is for format only, no actual data for workload calibrations. Information items in DI-QCIC-80798B that are not relevant to the procured unit do not need to be included in format.

Block 8: Certificate of Calibration Report (CDRL A004 subtitle) requires Government approval. The Contractor shall provide a preliminary draft to the Government for review, comment, and approval of the format no later than (NLT) 60 calendar days prior to initial operating capability (IOC) for each system. Government will provide the contractor with approval/disapproval of format including comments within 15 days of receipt of preliminary draft. Contractor shall provide a Government approved final version with incorporated comments NLT 30 days prior to IOC for each system.

Block 10: Frequency of submission shall be one (1) draft and (1) final.

Block 12: Date of first submission shall be no later than (NLT) 60 calendar days prior to initial operating capability (IOC) of the first system procured.

Block 14: Submission in Contractor format is acceptable. Electronic format is preferred if in a widely available commercial document format such as MS-Excel or MS Word. Electronic submission of data is also accepted on CD-ROM. Quantity and copies shall be provided in accordance with (IAW) CDRL distribution (Block 14). Addressee's POC information provided on CDRL supplemental page 2.

Block 16: This CDRL requirement refers only to the formatting of the Certificate of Calibration Report printed by the calibration standard, it is not intended that the Contractor run actual US Navy workload for calibration.

NSWC Corona Division

NSWC Corona Division

G. PREPARED BY

DD Form 1423-1 JUN 90 Previous editions are obsolete.

Page 1 of 2 Pages DD FORM 1423 (CDRL) Supplemental

BLOCK 14 ENTRY COMPLETE ADDRESS

Daniel M Martinez, NSWC, Corona MS35, daniel.m.martinez@navy.mil NSWC Corona Division

MS Department (Attn: Daniel M Martinez, MS35, Building 521)

PO Box 5000

Corona CA 92878-5000 Patrick Brown, NSWC, Corona MS33, patrick.w.brown@navy.mil NSWC Corona Division

MS Department (Attn: Pat Brown, MS33, Building 521)

PO Box 5000

Corona CA 92878-5000 Page 2 of 2 Pages