Contract_Data_Requirements_List_Redacted.pdf

DD FORM 1423-1, FEB 2001 Previous editions are obsolete Page 1 of 3

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 hrs per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, & 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, 1213 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/ATTACHMENT NO C CATEGORY

TBD A TDP: TM: OTHER: NDTI

D SYSTEM/ITEM E CONTRACT/PR NO F CONTRACTOR

Anechoic Chamber

TBD

1 DATA ITEM NO 2 TITLE OF DATA ITEM 3 SUBTITLE

A001 Test Inspection Report See BLK 16 4 AUTHORITY (Data Acquisition Doc No ) 5 CONTRACT REFERENCE 6 REQUIRING OFFICE

DI-NDTI-80809B SOW 4.0 & 5.2

7 DD250 REQ 9 DIST STATEMENT REQ 10 FREQUENCY 12 DATE OF FIRST SUBMISSION 14 DISTRIBUTION

LT See BLK 16 2TIME See BLK 16 a ADDRESSEE b COPIES

8 APP CODE 11 AS OF DATE 13 DATE OF SUBSEQUENT SUBMISSION DRAFT FINAL

N/A N/A See BLK 16 REQ REPRO

16 REMARKS 0 1 0

BLK 3: SOW 4.0: Pre-Shipment Testing Report SOW 5.2: On-Site Assembly Testing Report

BLK 9: DISTRIBUTION D. Distribution authorized to Department of Defense and U.S. DoD contractors only (Administrative and Operational Use).

Other request for this document shall be referred to NUWCDIVNPT Code 70.

BLK 10/12/13: Number of submittals, one (1) for each subtitle. Final report to be delivered 5 BUSINESS days after completion of each test.

BLK 14: Email distribution is preferred.

15 TOTAL 0 1 0

G PREPARED BY H DATE I APPROVED BY J DATE

18 July 2019 18 July 2019

DD FORM 1423-1, FEB 2001 Previous editions are obsolete Page 2 of 3

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 hrs per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, & 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, 1213 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/ATTACHMENT NO C CATEGORY

TBD A TDP: TM: OTHER: TMSS

D SYSTEM/ITEM E CONTRACT/PR NO F CONTRACTOR

Anechoic Chamber

1 DATA ITEM NO 2 TITLE OF DATA ITEM 3 SUBTITLE

A002 Commercial Off-The-Shelf (COTS) Manuals and Associated Supplemental Data

Operation Manual, Drawings, Wiring Diagram and Parts List

4 AUTHORITY (Data Acquisition Doc No ) 5 CONTRACT REFERENCE 6 REQUIRING OFFICE

DI-TMSS-80527C SOW 6.0

7 DD250 REQ 9 DIST STATEMENT REQ 10 FREQUENCY 12 DATE OF FIRST SUBMISSION 14 DISTRIBUTION

LT See BLK 16 OTIME EOC a ADDRESSEE b COPIES

8 APP CODE 11 AS OF DATE 13 DATE OF SUBSEQUENT SUBMISSION DRAFT FINAL

N/A N/A N/A REQ REPRO

16 REMARKS 0 2 2

BLK 9: DISTRIBUTION A. Approved for public release: distribution unlimited.

BLK 14: Distribution for REQ copies is hardcopy, and for REPRO copies is

CD/DVD

15 TOTAL 0 2 2

G PREPARED BY H DATE I APPROVED BY J DATE

12 July 2019 18 July 2019

DD FORM 1423-1, ADDENDUM Page 3 of 3

DD FORM 1423, CONTRACT DATA REQUIREMENTS LIST

BLOCK 16 ADDENDUM

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.