Att._11-_Exhibit_A _DD_Form_1423_(CDRLs).pdf
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Attachment 11 Exhibit A DD Form 1423 (CDRLs)
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DD FORM 1423, CONTRACT DATA REQUIREMENTS LIST
BLOCK 16 ADDENDUM
BLOCK 9: The following information is provided in amplification of the Block 9 Distribution Statement shown on each DD FORM 1423.
Distribution Statement paragraphs are in addition to CLASSIFICATION markings of the data.
CDRLs A001 through A007
DISTRIBUTION E. Distribution authorized to DoD Components only (Operations
Security) (date data generated). Other requests for this document shall be referred to
NUWCDIVNPT Code 1051)
The following 'EXPORT CONTROL WARNING NOTICE' must be used in conjunction with DISTRIBUTION STATEMENTS identified in all CDRL Items:
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, as amended, Title 50, U.S.C., App. 2401 et seq. Violations of these export laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.
CONTRACT DATA REQUIREMENTS LIST
(2 Data Items)
Form Approved OMB No. 0704-0188
The public reporting burden for this collection of information is estimated to average 220 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, (0704-0188) 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. 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:
A TDP TM OTHER X
D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR
ESS/IDS Eng/Tech Support 1300455963
1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE
A001 See Block 16
Installation – Engineering Plan
4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE
DI-QCIC-80509 SOW 4.1.1 and 4.1.2 NUWCDIVNPT 1051
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
LT See Block 16 See Block 16 b. COPIES
8. APP CODE E 11. AS OF DATE 13. DATE OF SUBSEQUENT
SUBMISSION
a. ADDRESSEE
Final
A N/A N/A Draft Reg Repro
16.
REMARKS
Blocks 2/4 Contractor’s format acceptable Block 3 SOW 4.1.1 New Installations plans SOW 4.1.2 Removals, Relocations, Reinstallations plans Block 9 – See block 16 Addendum
Blocks 10/12 /13 Estimated submittals are 24 reports per year for a 5 year period. The contractor shall submit draft within 14 days after receipt of GFI.
Government will review and comment within 7 days. The contractor shall Submit final plan within 7 days after Government comments.
Code 105
COR
Block 14a – COR Letter of Transmittal
15. TOTAL 1 1
1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE
A002 Test Plan See Block 16 See B
4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE
DI-NDTI-80566A SOW 4.1.1 and 4.1.2 NUWCDIVNPT CODE 1051
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
LT See Block 16 See Block 16 b. COPIES
8. APP CODE E 11. AS OF DATE 13. DATE OF SUBSEQUENT
A N/A See Block 16
REMARKS:
Blocks 2/4 Contractor’s format acceptable.
Block 9 – See Block 16 Addendum
Blocks 10/12 Estimated submittal 24 per year for a 5 year period.
The contractor shall submit draft within 14 days after receipt of GFI.
Submit final plan within 7 days after Government comments.
Block 14a Letter of Transmittal to COR
15. TOTAL
G. PREPARED BY:
Noel Roberts
H. DATE
10-28-2015
I. APPROVED BY
Martha Merriwether
J. DATE
10-28-2015
DD FORM 1423-2, AUG 96 (EG)
PREVIOUS EDITION MAY BE USED Page of
Pages
Form Approved OMB No. 0704-0188
The public reporting burden for this collection of information is estimated to average 220 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, (0704-0188) 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. 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:
A TDP TM OTHER X
D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR
ESS/IDS Eng/Tech Support 1300455963
A003 Test/Inspection Report See Block 16
4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE
DI-NDTI-80809B SOW 4.1.1 and 4.1.2 NUWCDIVNPT 1051
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
LT See Block 16 See Block 16 b. COPIES
8. APP CODE E 11. AS OF DATE 13. DATE OF SUBSEQUENT
N/A N/A N/A
Blocks 2/4 Contractors format acceptable
Block 3 SOW 4.1.1 New Installations test results SOW 4.1.2 Removal, Relocations, Reinstallations test result
Block 9 – See block 16 Addendum
Blocks 10/12 Estimated submittals are 24 reports per year for a 5 year period.
Tests to be conducted in accordance with test schedules (GFI) Contractor will submit report within 7 days after completion of tests.
A004 Computer Software Product End Items AutoCAD Files on CD
DI-MCCR-80700 SOW 4.1.2 NUWCDIVNPT CODE 1051
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
LT See Block 16 See Block 16 b. COPIES
8. APP CODE E 11. AS OF DATE 13. DATE OF SUBSEQUENT
Block 9 – See Block 16 Addendum
Blocks 10/12 Estimated submittal 24 per year for a 5 year period.
G. PREPARED BY:
Noel Roberts
H. DATE
10-28-2015
I. APPROVED BY
Martha Merriwether
J. DATE
ENCLOSURE
Form Approved OMB No. 0704-0188
The public reporting burden for this collection of information is estimated to average 220 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, (0704-0188) 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. 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:
A TDP TM OTHER X
D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR
ESS/IDS Eng/Tech Support 1300455963
1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE
A005 Equipment Maintenance Guide
Technical Report – Study/Services
4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE
DI-MGMT-80508B SOW 4.2.1 NUWCDIVNPT 1051
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
LT 1Time See Block 16 b. COPIES
8. APP CODE E 11. AS OF DATE 13. DATE OF SUBSEQUENT
A N/A N/A
Block 9 – See block 16 Addendum
Block 10/12/13 The contractor shall submit draft 30 DAC
Submit final guide within 7 days after Government comments.
1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE
A006 Maintenance Service Reports
Maintenance Service Report
4. AUTHORITY (Date Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE
DI-MGMT-80995A SOW 4.2.1, 4.2.2, 4.3 NUWCDIVNPT CODE 1051
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
LT See Block 16 See Block 16 b. COPIES
8. APP CODE E 11. AS OF DATE 13. DATE OF SUBSEQUENT
Block 9 – See Block 16 Addendum
Blocks 10/12 Estimated submittal 24 per year for a 5 year period. Submit 2 days after each Maintenance event
G. PREPARED BY:
Noel Roberts
H. DATE
10-28-2015
I. APPROVED BY
Martha Merriwether
J. DATE
Form Approved OMB No. 0704-0188
The public reporting burden for this collection of information is estimated to average 220 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, (0704-0188) 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. 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:
A TDP TM OTHER X
D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR
ESS/IDS Eng/Tech Support 1300455963
A007 Status Report See Block 16
DI-MGMT-80368A SOW 5.0 NUWCDIVNPT 1051
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
LT MTHLY See Block 16 b. COPIES
8. APP CODE E 11. AS OF DATE 13. DATE OF SUBSEQUENT
N/A 0 Mthly thereafter
Block 9 – See block 16 Addendum
7. DD 250 REQ 9. DIST STATEMENT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION
b. COPIES
8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQUENT
Intentionally left blank
G. PREPARED BY:
Noel Roberts
H. DATE
10-28-2015
I. APPROVED BY
Martha Merriwether
J. DATE
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