DD_1423s_-_N65540-15-T-5128.pdf

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 440 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

TDP ____X_________ TM _____________ OTHER _____________________________

D. SYSTEM/ITEM

Cert if icat ion and Accreditat ion (C&A) Packages

E. CONTRACT/PR NO.

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Monthly Performance & Progress / Status Reports

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

SOW

6. REQUIRING OFFICE

NSWC PA Code 104

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

monthly

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

a. ADDRESSEE b. COPIES

8. APP CODE

11. AS OF DATE

See Block 16

13. DATE OF SUBSEQUENT SUBMISSION

N/A

EVERy

NSWC PA CIO and

TPOC

Draft Final

Repro Reg

16. REMARKS

Code 104 1

As required per SOW Page 2 (CDRL 001) – Status Reports and Page 8

Monthly Status Reports.

Code 10432 1

15. TOTAL 2

A002

2. TITLE OF DATA ITEM

Progress Brief ings

10. FREQUENCY

monthly

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT SUBMISSION

NSWC PA CIO and

TPOC

Draft Final

As required per SOW Page 2 (CDRL 001) – Progress Brief ings. Code 10432 1

A003

2. TITLE OF DATA ITEM

Plan of Act ions and Milestones (POA&M)

10. FREQUENCY

monthly

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT SUBMISSION

N/A NSWC PA CIO and

TPOC

Draft Final

As required per SOW Page 2 (CDRL 002) – Plan of Act ion & Milestones

(POA&M)

Code 10432 1

A004

2. TITLE OF DATA ITEM

Complete C&A Packages

10. FREQUENCY

Monthly

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT SUBMISSION

N/A NSWC PA TPOC Draft Final

As required per SOW Page 3 (CDRL 003) – Complete C&A Packages Code 10432 1

15. TOTAL 1

G. PREPARED BY

Adrienne B. Rhoades

H. DATE

10/15/14

APPROVED BY

J. DATE

DD Form 1423, JUN 90 Page 1 of 2 Enclosure (4)

CONTRACT DATA REQUIREMENTS LIST Form Approved

OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 440 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

TDP ____X_________ TM _____________ OTHER _____________________________

D. SYSTEM/ITEM

Cert if icat ion and Accreditat ion (C&A) Packages

E. CONTRACT/PR NO.

F. CONTRACTOR

A005

2. TITLE OF DATA ITEM

Formal Out-Brief

10. FREQUENCY

Once

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT SUBMISSION

EVERy

NSWC PA CIO,

IAM and TPOC

Draft Final

As required per SOW Page 5 (CDRL 005) – Formal Out-Brief Code 10432 1

Code 10402 1

15. TOTAL 3

1. DATA ITEM NO.

A006

2. TITLE OF DATA ITEM

Proof of Cert if icat ion

10. FREQUENCY

Once at hiring

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT SUBMISSION

NSWC PA TPOC Draft Final

As required per SOW Page 5 (CDRL 006) – Proof of Cert if icat ion. Code 10432 1

A007

2. TITLE OF DATA ITEM

Planned C&A Package Delivery Schedule

10. FREQUENCY

monthly

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT SUBMISSION

N/A NSWC PA TPOC Draft Final

As required per SOW Page 7 – Planned C&A Package Delivery Schedule Code 10432 1

A008

2. TITLE OF DATA ITEM

Wide Area Workf low (WAWF) Invoices

10. FREQUENCY

Monthly

12. DATE OF FIRST SUBMISSION

See Block 16

14. DISTRIBUTION

13. DATE OF SUBSEQUENT SUBMISSION

N/A NSWC PA TPOC Draft Final

As required per SOW Page 8 – WAWF Invoices Code 10432 1

G. PREPARED BY

Adrienne B. Rhoades

H. DATE

10/15/14

APPROVED BY

J. DATE