CDRLs_N66604-19-R-0824.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.

B. EXHIBIT

A

C. CATEGORY

TDP________ TM___________ OTHER MISC

D. SYSTEM/ITEM

CIP 2 - Handling Components

E. CONTRACT / PR NO.

1300757702

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM:

Cerfiticate of Compliance

3. SUBTITLE

See Block 16

17. PRICE GROUP

4. AUTHORITY (Date Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

NUWCDIVNPT Code 40

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ

LT

9. DIST STATEMNT

REQUIRED

10. FREQUENCY

12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

D See Block 16 See Block 16 b. COPIES

8. APP CODE 11. AS OF DATE 13. DATE OF SUBSEQNT

SUBMISSION

a. ADDRESSEE Draft Final

N/A (See Block 16) N/A N/A Reg Repro

16. REMARKS Code 4023

(BS)

0 1 0

Block 3:

• Upper Port FWD Extension Track Assy, NAVSEA DWG 752-7068482, Assembly A1

• AFT Port Extension Track Assy, NAVSEA DWG 752- 7068482, Assembly A25

• Loading Pole Assy, NAVSEA DWG 752-7068475, Assembly

A15

• Upper Port Breech Bracket, NAVSEA DWG 752-7068514

Assembly A8

Block 10 & 12: The contractor shall deliver a certificate of compliance for each hardware deliverable within 5 days after delivery of corresponding hardware item.

Block 14: Reg copy to be delivered via email or electronic submission

15. TOTAL

0 2 0

G. PREPARED BY:

Maureen E. Sharpe

H. DATE

12/07/2018

I. APPROVED BY

J. DATE

DD Form 1423-1, Feb 2001 Previous Edition May be Used Page __1__ of __ 1 Pages

DD FORM 1423

CONTRACT DATA REQUIREMENTS LIST

BLOCK 16 DISTRIBUTION STATEMENT ADDENDUM

Block 9: the following information is amplification of the Block 9 Distribution Statement Selected:

Distribution Statement paragraph is in addition to CLASSIFICATION markings of the data.

Distribution Statement D: Applies to CDRL item No. A001. Distribution authorized to the DoD and U.S. DoD contractors only; CRITICAL TECHNOLOGY (date data generated). Other requests for this document shall be referred to NUWC Division, Newport (Code 40).

The following “EXPORT CONTROL WARNING NOTICE” must be used in conjunction with DISTRIBUTION STATEMENT identified in the above CDRL items.

Warning – This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C. Sec 27521 et seq.) or the Export Administration Act of 1979, as amended, title 50, U.S.C., App 2401 et seq. Violation of these exports laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.

Refer to the security classification guide applicable to the order.

Block 9: the following information is amplification of the Block 9 Distribution Statement Selected:

Text2: 5/3/19