Exh A_CDRL DD Form 1423-Redacted.pdf
PDF 227 KB Posted
- Attached to
- Buoy Shell Cases Federal contract opportunity
- Solicitation number
- N66604-22-Q-9009
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| N6660422Q90090003.pdf | ||
| N6660422Q90090002.pdf | ||
| N6660422Q90090001.pdf | ||
| N6660422Q9009.pdf |
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Text version
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.
TBD
B. EXHIBIT
A
C. CATEGORY
TDP____________ TM___________ OTHER: MISC
D. SYSTEM/ITEM
Ant Buoy Case IDIQ
E. CONTRACT / PR NO.
1300920262
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A001
2. TITLE OF DATA ITEM:
CERTIFICATION DATA FOR NON-NUCLEAR
LEVEL I MATERIAL
3. SUBTITLE
N/A
17. PRICE GROUP
4. AUTHORITY (Date Acquisition Document No.)
DI-MISC-81020
5. CONTRACT REFERENCE
SOW Para# 4.1, 4.2
6. REQUIRING OFFICE
NUWCDIVNPT
18. ESTIMATED
TOTAL PRICE
7. DD 250 REQ 9. DIST STATEMNT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST
SUBMISSION
14. DISTRIBUTION
LT D ASREQ 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 See Block 16 Reg Repro
16. REMARKS PI 0 1 0
Block 9: See attached Block 16 addendum. 3432 DM 0 1 0
Block 10: Approximately ten (10) submittals are anticipated per year over a five (5) year period.
Block 12 & 13: The contractor shall deliver certification data with the hardware shipment.
Block 14: Media Requirements: The report shall be delivered electronically in Microsoft Word 2016 or
Adobe PDF format with email notification to all addressees:
PI:
15. TOTAL ______> 0 2 0
G. PREPARED BY:
H. DATE
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page __1__ of __5__Pages
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.
TBD
B. EXHIBIT
A
C. CATEGORY
TDP____________ TM___________ OTHER: NDTI
D. SYSTEM/ITEM
Ant Buoy Case IDIQ
E. CONTRACT / PR NO.
1300920262
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A002
2. TITLE OF DATA ITEM:
TEST/INSPECTION REPORT
3. SUBTITLE
Magnetic Particle Inspection Report
17. PRICE GROUP
4. AUTHORITY (Date Acquisition Document No.)
DI-NDTI-80809B
5. CONTRACT REFERENCE
SOW Para# 4.1, 4.2
6. REQUIRING OFFICE
NUWCDIVNPT,
18. ESTIMATED
TOTAL PRICE
7. DD 250 REQ 9. DIST STATEMNT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST
SUBMISSION
14. DISTRIBUTION
LT D ASREQ 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 See Block 16 Reg Repro
16. REMARKS PI 0 1 0
Block 9: See attached Block 16 addendum. 3432 DM 0 1 0
Block 10: Approximately ten (10) submittals are anticipated per year over a five (5) year period.
Block 12 & 13: The contractor shall deliver the magnetic particle inspection reportat the same time as the hardware shipment.
delivered electronically in Microsoft Word 2016 or Adobe PDF format with email notification to all
H. DATE J. DATE
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page __2__ of __5__Pages
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.
TBD
B. EXHIBIT
A
C. CATEGORY
TDP____________ TM___________ OTHER: NDTI
D. SYSTEM/ITEM
Ant Buoy Case IDIQ
E. CONTRACT / PR NO.
1300920262
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A003
2. TITLE OF DATA ITEM:
TEST/INSPECTION REPORT
3. SUBTITLE
Ultrasonic Inspection Report
17. PRICE GROUP
4. AUTHORITY (Date Acquisition Document No.)
DI-NDTI-80809B
5. CONTRACT REFERENCE
SOW Para# 4.1, 4.2
6. REQUIRING OFFICE
NUWCDIVNPT,
18. ESTIMATED
TOTAL PRICE
7. DD 250 REQ 9. DIST STATEMNT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST
SUBMISSION
14. DISTRIBUTION
LT D ASREQ 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 See Block 16 Reg Repro
16. REMARKS PI 0 1 0
Block 9: See attached Block 16 addendum. 3432 DM 0 1 0
Block 10: Approximately ten (10) submittals are anticipated per year over a five (5) year period.
Block 12 & 13: The contractor shall deliver the ultrasonic inspection report at the same time as the hardware shipment.
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page __3__ of _5___Pages
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.
TBD
B. EXHIBIT
A
C. CATEGORY
TDP____________ TM___________ OTHER: MISC
D. SYSTEM/ITEM
Ant Buoy Case IDIQ
E. CONTRACT / PR NO.
1300920262
F. CONTRACTOR
TBD
1. DATA ITEM NO.
A004
2. TITLE OF DATA ITEM:
CERTIFICATE OF COMPLIANCE
3. SUBTITLE
N/A
17. PRICE GROUP
4. AUTHORITY (Date Acquisition Document No.)
DI-MISC-81356A
5. CONTRACT REFERENCE
SOW Para# 4.1, 4.2
6. REQUIRING OFFICE
NUWCDIVNPT,
18. ESTIMATED
TOTAL PRICE
7. DD 250 REQ
9. DIST STATEMNT
REQUIRED
10. FREQUENCY 12. DATE OF FIRST
SUBMISSION
14. DISTRIBUTION
LT D ASREQ 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 See Block 16 Reg Repro
16. REMARKS PI 0 1 0
Block 9: See attached Block 16 addendum. 3432 DM 0 1 0
Block 10: Approximately ten (10) submittals are anticipated per year over a five (5) year period.
Block 12 & 13: The contractor shall deliver the certificate of compliance with each hardware shipment.
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page __4__ of __5__Pages
DD FORM 1423, CONTRACT DATA REQUIREMENTS LIST
BLOCK 16 ADDENDUM
PR 1300920262
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.
CDRL A001-A004
Distribution Statement D. Distribution authorized to the Department of Defense and U.S. DoD contractors only (Critical Technology) (13 July 2021). Other requests shall be referred to NUWCDIVNPT
The following 'EXPORT CONTROL WARNING NOTICE' must be used in conjunction with DISTRIBUTION STATEMENTS identified in the CDRL:
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.
DD Form 1423-1, Feb 2001 Previous Edition May be Used Page __5__ of __5__Pages
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