N6449824R4050_0001_CDRLS_Exhibits A - L.pdf

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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 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

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001 Page of Pages

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

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 1423-1 (BACK), FEB 2001

data_item: A009 title: Government Furnished Material (GFM) by National Stock Number sub: Reporting of Government Inventory Held under Product Support Contractual Arrangements auth: DI-ILSS-80727 ref: SOW Paragraph 4.9 req_ofc: NSWCPD Code 423 dd250: LT appcode: N/A dist: B freq: See Blk 16 asof: See Blk 16 firstsub: See Blk 16 subsub: ASREQ addressee1: COR draft1: 0 reg1: 1 repro1:

addressee2: Tech POC draft2: 0 reg2: 1 repro2:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Tailoring instructions for DI-ILSS-80727:

(A) Block 10.1. Contractor shall deliver the information in digital format that can be read by Microsoft Office 2010 applications (or earlier) and/or Adobe PDF applications.

(B) Block 10.2.e. Change to read: "Inventory requirements (e.g. usage rates) that the Contractor establishes to achieve the performance required by the contract."

(C) Block 10.2.h. Change to read: "Existing Government inventory that the Contractor manages against these requirements."

(D) Block 10.2.i. Change to read: "Existing Government inventory that the Contractor holds in excess of these requirements."

(E) Block 10.2.j. After the word, "position", add: "and submit a written plan for the buying DoD Component's approval that proposes actions for the reuse or disposal of Government inventory identified by the Contractor as access to meeting contract requirements."

Block 9: Distribution Statement B. Distribution authorized to U.S. Government agencies only for contractor performance evaluation, 6 August 2015. Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 S. Broad Street, Building 4, Philadelphia, PA 19112.

Block 10: Submit information as GFM is received by Contractor.

Block 11: Date shall be as of the date of inspection of GFM; Contractor shall submit reports within 15 days of inspection; all GFM shall be inspected within 30 days from receipt.

Block 12: Within fifteen (15) days after inspection of GFM.

Block 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

Email address for TPOC submission shall be as follows, unless otherwise directed by the Government: eric.mcfetridge@navy.mil group:

total_price:

prep_name:

line_item: 0015 exhibit: J xtdp: Off xtm: Off othercat: ILSS system: LM2500 Power Turbine ctr_no: TBD contr: TBD remarksb:

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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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A010 title: Government Property Inventory Report sub: Government Furnished Property Inventory Baseline Report auth: DI-MGMT-80441C ref: SOW Paragraph 4.10 req_ofc: NSWCPD Code 423 dd250: LT appcode: N/A dist: B freq: See Blk 16 asof: See Blk 16 firstsub: See Blk 16 subsub: ASREQ addressee1: COR draft1: 0 reg1: 1 repro1:

addressee2: Tech POC draft2: 0 reg2: 1 repro2:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Tailoring instructions for DI-MGMT-81441C:

(A) General. Delete any reference to Contractor Acquired Property. Abbreviations are not allowed. Acronyms may be used if a term is defined on first usage.

(B) Block 2.B. Change to read: "Manufacturer Commercial and Government Entity (CAGE) Code."

(C) Block 2.E. Delete.

(D) Block 2.H. Delete.

(E) Block 2.N. Delete.

(F) Block 2.O. Delete.

(G) Block 2.Q. Delete.

(H) Block 2.R. Delete.

(I) Block 2.S. Delete.

(J) Block 2.T. Delete.

(K) Block 2.V. Delete.

(L) Block 2.W. Change to read: "Condition of Property."

Block 9: Distribution Statement B. Distribution authorized to U.S. Government agencies only for contractor performance evaluation, 6 August 2015. Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 S. Broad Street, Building 4, Philadelphia, PA 19112.

Block 10: Submit information as GFM is received by Contractor.

Block 11: Date shall be as of the date of inspection of GFM; Contractor shall submit reports within 15 days of inspection; all GFM shall be inspected within 30 days of receipt.

Block 12: Within fifteen (15) days after inspection of GFM.

Block 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

Email address for TPOC submission shall be as follows: eric.mcfetridge@navy.mil group:

total_price:

prep_name:

line_item: 0016 exhibit: K xtdp: Off xtm: Off othercat: MGMT system: LM2500 Power Turbine ctr_no: TBD contr: TBD remarksb:

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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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A012 title: Small Business Utilization Report sub: N/A auth: DI-MGMT-82041A ref: Section J, Attachment 4 req_ofc: MDA/SB dd250: DD appcode: A dist: E freq: SEMIA asof: See Blk16 firstsub: See Blk16 subsub: See Blk16 addressee1: MDA/SB draft1: 1 reg1: 1 repro1: 0 addressee2: PCO draft2: 0 reg2: 1 repro2: 0 addressee3:

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total_draft: 1 total_reg: 2 total_repro: 0 remarks: Block 4: Contractor format is acceptable.

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.

Small Business Utilization Report shall be in contractor format or as specified in the contract, and include: (1) Name of the small business subcontractor(s), whether the subcontractor(s) is: (a) Small Business; (b) Veteran-Owned Small Business; (c) Service Disabled Veteran-Owned Small Business; (d) HUBZONE Small Business; (e) Small Disadvantaged Business; (f) Women-Owned Small Business. Also, briefly describe the subcontractor(s) efforts performed.

The contractor shall report actual achievements relative to proposed small business utilization in performance of the contract (including subcontracting dollars/percentages), and the results of efforts to:

(1) Expand the pool of qualified small businesses through increased competition for acquisition of components, parts (includes hardware and software), and/or to perform sustainability or support services for {Insert title of acquisition}.

(2) Engage small businesses to serve as alternative sources in order to mitigate the risks of single point failures in the supply chain and increase the quality of supplies or services.

(3) Leverage Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) program funded technologies with high potential for transition into the {Insert title of acquisition}.

- Report the number and dollar amount of Phase III SBIR or STTR contracts (DoDI 5000.02).

Block 8: Government review and approval (or disapproval) and comments will be provided within 30 days after receipt of each submittal or revision unless otherwise specified. If the Government provides any comments, submit an update incorporating Government comments within 15 days after receipt of Government comments unless otherwise specified.

Block 9: Distribution Statement E: Distribution authorized to DoD Components only (Proprietary Information). Other requests shall be referred to (MDA/SB -VB III SB Office) group:

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line_item: 0017 and ALL CLINs exhibit: L xtdp: Off xtm: Off othercat: MGMT system: LM2500 Power Turbine ctr_no: TBD contr: TBD remarksb:

Block 10: The semiannual report shall be submitted for the six month reporting period ending March 31 and the twelve month reporting period ending September 30.

Blocks 11/12/13: Reports are due 30 days after the close of each reporting period and within 30 days of contract completion.

WARNING – This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.) or the Export Administration Act of 1979 (Title 50 U.S.C., App. 2401 et seq.), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Limited Rights technical data and/or Restricted Rights computer software shall not be incorporated into the design of any systems, diagrams, design documentation packages, prototypes, and/or models simulation thereof under this contract without the prior written authorization of the Contracting Officer.

Technical data or computer software that is not properly included on a data rights assertion list incorporated into the contract shall NOT be delivered with any restrictive markings.

Under no circumstances shall technical data or computer software to be delivered under or in conjunction with this CDRL, be marked "Proprietary" (or similar Nonconforming marking(s)).

Block 14. Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications. Email address for MDA/SB submissions shall be as follows unless otherwise directed by the Government: Gerry Furey at Gerald.Furey@navy.mil.

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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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A001 title: Incoming Inspection Summary Report sub: Incoming Inspection Summary Report auth: DI-QCIC-80376A ref: SOW, Para. 4.1 req_ofc: NSWCPD C/423 dd250: LT appcode: N/A dist: C* freq: ASREQ asof: See Blk 16 firstsub: See Blk 16 subsub: ASREQ addressee1: PCO draft1: 0 reg1: 1 repro1:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Block 9: Distribution Statement C. Distribution authorized to U.S. Government Agencies and their contractors for administrative and operational use, 3 April 2020.Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 South Broad Street, Building 4, Philadelphia, PA 19112.

Blocks 10,11,12,13: 1. Within five (5) working days after receipt of the US Navy LM2500 PTA, the contractor shall contact NSWCPD Code 423 and the COR, to provide the serial number of the PTA, and physical condition of the shipping container. 2. If the shipping container is unable to hold the nitrogen charge when the container is received, or at any other time when the power turbine is stored in the shipping container, the contractor shall notify NSWCPD Code 423 and the COR within two (2) working days. 3. Within five (5) calendar days of container opening and receipt inspection of the US Navy LM2500 PTA, the repair activity shall contact NSWCPD Code 423 and the COR to report all parts/components that are missing, damaged or cannibalized.

Block 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

group:

total_price:

prep_name:

line_item: 0007 exhibit: A xtdp: Off xtm: Off othercat: QCIC system: LM2500 Power Turbine ctr_no: TBD contr: TBD remarksb:

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DESHMUKH.DESIREE.1241432439

app_date:

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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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A002 title: Disassembly Inspection Report (DIR) sub: Disassembly Inspection Report (DIR) auth: DI-QCIC-80376A ref: SOW, Para. 4.2 req_ofc: NSWCPD C/423 dd250: LT appcode: N/A dist: C* freq: ASREQ asof: See Blk 16 firstsub: See Blk 16 subsub: ASREQ addressee1: PCO draft1: 0 reg1: 1 repro1:

addressee2: TPOC draft2: 0 reg2: 1 repro2:

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total_draft: 0 total_reg: 3 total_repro: 0 remarks: Block 4:The contractor shall compile a DIR containing the below data elements in the contractor’s format. At a minimum, the DIR shall contain the following data elements :

All incoming inspection results with teardown inspection records.

All inspection data and damage reports.

PTA serial number and selected component serial and part numbers.

Illustration and pictures of damage found.

List of all technical directives, mandatory upgrades and service bulletins pending.

Metallurgical evaluation and laboratory reports.

All parts, components missing.

Condition (Serviceable / Not Serviceable) or Applicability (PTA) Replace / Rework Findings Summary (FOD, MFG design, etc) Conditions found (dimensions vs. spec) Assembly nomenclature / part number Inspection and discrepancies found Assembly manufacturer Part number Removal date

Removal location (installed location) CONCLUSIONS: Removal reason, Summary, Engineering comments

Block 9: Distribution Statement C. Distribution authorized to U.S. Government Agencies and their contractors for administrative and operational use, 3 April 2020.Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 South Broad Street, Building 4, Philadelphia, PA 19112.

Blocks 10, 11, 12, 13: Within forty five (45) working days after induction of the US Navy LM2500 PTA, the contractor shall provide an "initial" DIR to NSWCPD Code 423 and the COR to report all parts/components inspection results including those parts that have failed inspection. Within seventy five (75) working days after induction the contractor shall provide a "complete and final" DIR to NSWCPD Code 423 and the COR to report all final parts/components inspection results including findings from outsourced vendors.

Block 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

group:

total_price:

prep_name:

line_item: 0008 exhibit: B xtdp: Off xtm: Off othercat: QCIC system: LM2500 Power Turbine ctr_no: TBD contr: TBD remarksb:

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app_date:

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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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A003 title: Overhaul Repair Report sub: Overhaul Repair Report auth: DI-ILSS-80755 ref: SOW, Para. 4.3 req_ofc: NSWCPD C/423 dd250: LT appcode: N/A dist: C* freq: ASREQ asof: See Blk 16 firstsub: See Blk 16 subsub: ASREQ addressee1: PCO draft1: 0 reg1: 1 repro1:

addressee2: TPOC draft2: 0 reg2: 1 repro2:

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Block 4: This report at a minimum shall contain:

-Table of contents.

-All incoming inspection results with teardown inspection records.

-All inspection data and damage reports.

-Total overhaul work scope.

-Provide a condition report showing the technical manual figure and item, part number, description, quantity, disposition, and details of the part condition and action taken to correct. A photographic disassembly and condition report of the PT at induction and all sub-assemblies during teardown and inspection. Include photographs of components when required to show damage or unusual occurrences in the appropriate sub-assembly condition report.

-The condition reports shall be segregated by PT sub-assembly as follows:

Turbine Rotor Assembly Stator Case Assembly Turbine Rear Frame

-A list of all parts replaced and/or upgraded (e.g. part numbers, serial numbers and work performed).

-Metallurgical evaluations and laboratory reports.

-Assembly records, a detailed step-by-step record of PT assembly.

-Test records from all testing performed.

-List of all technical directives, and industrial service bulletins incorporated.

-All authorized deviations from US Navy LM2500 depot level technical manuals.

group:

total_price:

prep_name:

line_item: 0009 exhibit: C xtdp: Off xtm: Off othercat: ILSS system: LM2500 Power Turbine ctr_no: TBD contr: TBD remarksb: -Final invoice including cost profile by sub-assembly.

-Method of shipment and location shipped to.

-Include pre-canning photographs of PT (front/profile/rear).

Block 9: Distribution Statement C. Distribution authorized to U.S. Government Agencies and their contractors for administrative and operational use, 3 April 2020.Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 South Broad Street, Building 4, Philadelphia, PA 19112.

Blocks 10, 11, 12, 13: The contractor shall compile a PT overhaul report in the contractor’s format. This report shall be submitted to NSWCPD Code 423 and the COR within sixty (60) days after completion of overhaul.

Block 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

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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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A004 title: Request for Waivers (RFW) sub: Request for Waiver or Deviation auth: DI-SESS-81732 ref: SOW, Para. 4.4 req_ofc: NSWCPD C/423 dd250: DD appcode: A dist: C* freq: ASREQ asof: See Blk 16 firstsub: See Blk 16 subsub: ASREQ addressee1: PCO draft1: 0 reg1: 1 repro1:

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Block 4: Deviations from the latest revisions of US Navy LM2500 depot level technical manuals, listed in Section 2.0 of the SOW, such as waivers, engineering change proposals, material substitutions, engineering directives or alternate overhaul methods, not specifically stated in these manuals shall only be permitted after processing deviations and obtaining written approval from NSWCPD Code 423/424.

At a minimum, requests should include the following information:

1. Part nomenclature

2. Part number

3. Findings

4. Proposed alternate procedure including chapter/figure/table reference

5. Copy of proposed alternate procedure

6. Applicable US Navy LM2500 depot level technical manual chapter/figure/table reference

7. Deviation description

8. Reason for proposed deviation/waiver request/material substitution

BLOCK 8: APPROVAL WILL BE BASED UPON IMPACT OF DEPARTURES ON ITEM FORM, FIT OR FUNCTION. GOVERNMENT REQUIRES 15 DAYS (TOTAL) REVIEW TIME. ALL DEPARTURES SHALL BE FORWARDED TO NSWCPD CODE 423 FOR REVIEW AND COMMENT. CODE 423 WILL FORWARD DEPARTURES WITH COMMENTS ON DD FORM 1998 DIRECTLY TO NSWCPD CODE 424 WITH A COPY OF THE DEPARTURE TRANSMITTAL TO THE CONTRACT OFFICER FOR REVIEW AND DISPOSITION.

Block 9: Distribution Statement C. Distribution authorized to U.S. Government Agencies and their contractors for administrative and operational use, 3 April 2020.Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 South Broad Street, Building 4, Philadelphia, PA 19112.

BLOCKS 10, 11, 12, 13: SUBMISSION REQUIRED WHENEVER A DEPARTURE FROM SPECIFICATION HAS OCCURRED OR IS ANTICIPATED.

Block 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

group:

total_price:

prep_name:

line_item: 0010 exhibit: D xtdp: Off xtm: Off othercat: SESS system: LM2500 Power Turbine ctr_no: TBD contr: TBD remarksb:

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app_date:

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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 conformance with Government requirements, and the required to perform additional work to conform to Government without conforming to Government requirements, and the contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any data_item: A005 title: Qualification Test Report (QTR) sub: Performance Test Data auth: DI-QCIC-81890 ref: SOW, Para. 4.5 req_ofc: NSWCPD C/423 dd250: LT appcode: N/A dist: C* freq: ASREQ asof: See Blk 16 firstsub: See Blk 16 subsub: ASREQ addressee1: PCO draft1: 0 reg1: 1 repro1:

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Block 9: Distribution Statement C. Distribution authorized to U.S. Government Agencies and their contractors for administrative and operational use, 3 April 2020.Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 South Broad Street, Building 4, Philadelphia, PA 19112.

Blocks 10, 11, 12, & 13: Within fourteen (14) calendar days prior to any power turbine testing, the contractor shall notify NSWCPD Code 423 and the COR in order for a Government representative to be present during the testing. Within five (5) working days after completion of performance test of the US Navy LM2500 PTA, the contractor shall provide performance (vibration) data.

Block 14: Submit via electronic mail in a digital format that can be read by Microsoft Office 2010 applications (or earlier) or Adobe PDF applications.

group:

total_price:

prep_name:

line_item: 0011 exhibit: E xtdp: Off xtm: Off othercat: QCIC system: LM2500 Power Turbine ctr_no: TBD contr: TBD remarksb:

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app_by:

2020-04-07T11:49:47-0400

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app_date:

Page: 1 of_pages: 2 app: Adobe Professional 8.0

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 one-