CDRLs_Redacted.pdf

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 Service, 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.

CLIN 00001

B. EXHIBIT

A

C. CATEGORY

TDP_________ TM___________ OTHER____MISC_____________

D. SYSTEM/ITEM

AVCIP

E. CONTRACT / PR NO.

N66604-17-P-2868

PR 1300650467

F. CONTRACTOR

TBD

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM:

Test/Inspection Report

3. SUBTITLE

Test Inspection Report

4. AUTHORITY (Date Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

See Block A.

6. REQUIRING OFFICE

NUWCDIVNPT Code 7021

7. DD 250 REQ

LT

9. DIST STATEMNT

REQUIRED

10. FREQUENCY

See Block

12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

D See Block 16 b. COPIES

8. APP CODE See Block

11. AS OF DATE 13. DATE OF SUBSEQNT

SUBMISSION

a. ADDRESSEE Draft Final

N/A N/A N/A Reg Repro

16. REMARKS . 1

BLOCK 4: An electronc copy of each report shall be provided as Microsoft Excel plots including tabulated data used to create the plots and shall be sent to the address.

BLOCK 9: SEE BLOCK 16 ADDENDUM.

BLOCK 10 & 12: One report for each test will be provided for each hardware deliverable (CLIN) at the time of shipment (i.e, hydrostatic pressure, electrical, and acoustic tests).

All tests (hydrostatic pressure, electrical, and acoustic tests) need to be conducted on each transducer. One (1) consolidated report, per Transducer, containing all test results is required.

The criteria for each test are identified in the technical specifications.

15. TOTAL ______> 1

G. PREPARED BY:

H. DATE

6-27-2017

I. APPROVED BY

J. DATE

7-14-2017

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page ____ of __ Pages

DD FORM 1423

CONTRACT DATA REQUIREMENTS LIST

BLOCK 16 ADDENDUM

PR 1300650467

BLOCK 9: The following information is specifically included in amplification of the Block 9 Distribution Statement selected:

Distribution Statement paragraphs are in addition to CLASSIFICATION markings of the data.

CDRL A001

BLOCK 9:

Distribution Statement D: Distribution authorized to DoD and DoD Contractors only; Critical Technology; 24 April 2017. Other requests for this document shall be referred to NUWCDIVNPT Code 7021.

BLOCK 14:

NAVAL Undersea Warfare Center, Division Newport 1176 Howell Street Newport, RI 02841-1708

ATTN:

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 Action of 1979, as amended, Title 50, U.S.C., App. 2401 et. seq. Violations of these export control laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.