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BLOCK 16 ADDENDUM CONTINUED
[N66604-22-RFPREQ-NPT-85-0012 & PR# 1300959286]
CONTRACT DATA REQUIREMENTS LIST
(2 Data Items) Form Approved OMB No. 0704-0188
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, 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 |
| C. | CATEGORY: |
TM
| D. | SYSTEM/ITEM |
| E. | CONTRACT/PR NO. |
| F. | CONTRACTOR |
| FLARED BASE GROUP (FBG) ANTENNA ASSEMBLY PASSIVE ANTENNA Elements |
| N6660423Q0570 |
| MICROWAVE ENGINEERING CORP (CAGE 06351) |
| 1. | DATA ITEM NO. |
| 2. | TITLE OF DATA ITEM |
| 3. | SUBTITLE |
17. PRICE GROUP
| A001 |
| TECHNICAL REPORT/STUDY SERVICES |
| RF TEST DATA |
| 4. | AUTHORITY (Data Acquisition Document No.) |
| 5. | CONTRACT REFERENCE |
| 6. | REQUIRING OFFICE |
| DI-MISC-80508B |
| CLIN 0001-0004 |
| NUWCDIVNPT CODE 34 |
| 7. | DD 250 REQ |
| 9. | DIST STATEMENT |
| 10. | FREQUENCY |
| 12. | DATE OF FIRST SUBMISSION |
| 14. | DISTRIBUTION |
| LT | |
| REQUIRED |
| SEE BLK 16 | |
| SEE BLK 16 | |
b. COPIES
| 8. | APP CODE |
| D | |
| 11. | AS OF DATE |
| 13. | DATE OF SUBSEQUENT |
| SUBMISSION | |
| a. ADDRESSEE | |
| Draft | |
| Final | |
| N/A |
| SEE BLK 16 |
| N/A |
| SEE BLK 16 |
| 16. | REMARKS |
| SEE BLK 16 | |
| 0 | |
| 1 | |
| 0 | |
BLK C: CATEGORY – MISC
BLK 9: SEE BLOCK 16 ADDENDUM
BLK 10: ASREQ - TWENTY (20) SUBMISSIONS ARE ANTICIPATED
BLK 12/13: ASREQ - CONTRACTOR SHALL DELIVER RF TEST DATA FOR ACH UNIT DEMONSTRATING COMPLIANCE WITH SPECIFICATIONS
BLK 14): MEDIA REQUIREMENTS: THE REPORT SHALL BE DELIVERED ELECTRONICALLY IN MICROSOFT 2016 FORMAT WITH EMAIL NOTIFICATION TO ALL ADDRESSEES. BRIAN.C.ROZZERO.CIV@US.NAVY.MIL; NUWC_NPT_3432DATAMGT@NAVY.MIL
| 1. | DATA ITEM NO. |
| 2. | TITLE OF DATA ITEM |
| 3. | SUBTITLE |
17. PRICE GROUP
| A002 |
| Systems Engineering Management Plan (SEMP) |
| N/A |
| 4. | AUTHORITY (Data Acquisition Document No.) |
| 5. | CONTRACT REFERENCE |
| 6. | REQUIRING OFFICE |
DI-MGMT-80368A
SEE BLK 16
| CLIN 0001-0004 |
| NUWCDIVNPT CODE 34 |
| 7. | DD 250 REQ |
| 9. | DIST STATEMENT |
| 10. | FREQUENCY |
| 12. | DATE OF FIRST SUBMISSION |
| 14. | DISTRIBUTION |
b. COPIES
| 8. | APP CODE |
| D | |
| 11. | AS OF DATE |
| 13. | DATE OF SUBSEQUENT |
| SUBMISSION | |
| a. ADDRESSEE | |
| Draft | |
| Final | |
| 16. | REMARKS |
| SEE BLK 16 | |
| 0 | |
| 1 | |
| 0 | |
BLK C: CATEGORY – MGMT
BLK 4: WAIVE DI-MGMT-80368A SECTION 3.2.3
BLK 9: SEE BLOCK 16 ADDENDUM
BLK 14: MEDIA REQUIREMENTS: THE REPORT SHALL BE DELIVERED ELECTRONICALLY IN MICROSOFT 2016 FORMAT WITH EMAIL NOTIFICATION TO ALL ADDRESSEES. BRIAN.C.ROZZERO.CIV@US.NAVY.MIL; NUWC_NPT_3432DATAMGT@NAVY.MIL
| G. | PREPARED BY |
| H. | DATE |
| I. | APPROVED BY |
| J. | DATE |
| BRIAN ROZZERO |
| 22 AUGUST 2023 |
CONTRACT DATA REQUIREMENTS LIST
(2 Data Items) Form Approved OMB No. 0704-0188
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, 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 |
| C. | CATEGORY: |
TM
| D. | SYSTEM/ITEM |
| E. | CONTRACT/PR NO. |
| F. | CONTRACTOR |
| FLARED BASE GROUP (FBG) ANTENNA ASSEMBLY PASSIVE ANTENNA Elements |
| N6660423Q0570 |
| MICROWAVE ENGINEERING CORP (CAGE 06351) |
| 1. | DATA ITEM NO. |
| 2. | TITLE OF DATA ITEM |
| 3. | SUBTITLE |
17. PRICE GROUP
| A003 |
| CERTIFICATE OF COMPLIANCE |
| N/A |
| 4. | AUTHORITY (Data Acquisition Document No.) |
| 5. | CONTRACT REFERENCE |
| 6. | REQUIRING OFFICE |
| DI-MISC-81356A |
| CLIN 0001-0004 |
| NUWCDIVNPT CODE 34 |
| 7. | DD 250 REQ |
| 9. | DIST STATEMENT |
| 10. | FREQUENCY |
| 12. | DATE OF FIRST SUBMISSION |
| 14. | DISTRIBUTION |
| LT | |
| REQUIRED |
| SEE BLK 16 | |
| SEE BLK 16 | |
b. COPIES
| 8. | APP CODE |
| D | |
| 11. | AS OF DATE |
| 13. | DATE OF SUBSEQUENT |
| SUBMISSION | |
| a. ADDRESSEE | |
| Draft | |
| Final | |
| N/A |
| SEE BLK 16 |
| N/A |
| SEE BLK 16 |
| 16. | REMARKS |
| SEE BLK 16 | |
| 0 | |
| 1 | |
| 0 | |
BLK 9: SEE BLOCK 16 ADDENDUM
BLK 10: ASREQ - CONTRACTOR SHALL DELIVER A CERTIFICATE OF COMPLIANCE FOR EACH UNIT THAT IS DELIVERED
BLK 12/13: ASREQ – AT TIME OF SHIPMENT
BLK 14: THE CERTIFICATE OF COMPLIANCE SHALL INCLUDE A MERCURY FREE STATEMENT. NATIONAL STOCK NUMBER (NSN) NOT AVAILABLE; PART NUMBER AND REVISION SHALL BE PROVIDED ON GOVERNMENT DRAWINGS. MEDIA REQUIREMENTS: THE REPORT SHALL BE DELIVERED ELECTRONICALLY IN MICROSOFT 2016 FORMAT WITH EMAIL NOTIFICATION TO ALL ADDRESSEES. BRIAN.C.ROZZERO.CIV@US.NAVY.MIL; NUWC_NPT_3432DATAMGT@NAVY.MIL;
| 1. | DATA ITEM NO. |
| 2. | TITLE OF DATA ITEM |
| 3. | SUBTITLE |
17. PRICE GROUP
A004
| 4. | AUTHORITY (Data Acquisition Document No.) |
| 5. | CONTRACT REFERENCE |
| 6. | REQUIRING OFFICE |
| 7. | DD 250 REQ |
| 9. | DIST STATEMENT |
| 10. | FREQUENCY |
| 12. | DATE OF FIRST SUBMISSION |
| 14. | DISTRIBUTION |
REQUIRED
b. COPIES
8. APP CODE
| 11. | AS OF DATE |
| 13. | DATE OF SUBSEQUENT |
| SUBMISSION | |
| a. ADDRESSEE | |
| Draft | |
| Final | |
16. REMARKS
THIS PAGE INTENTIONALLY LEFT BLANK
15. TOTAL
| G. | PREPARED BY |
| H. | DATE |
| I. | APPROVED BY |
| J. | DATE |
| BRIAN ROZZERO |
| 22 AUGUST 2023 |
| DD Form 1423-2, AUG 96 (EG) |
| PREVIOUS EDITION MAY BE USED |
| Page 1 of 3 |
BLOCK 16 ADDENDUM
N6660423Q0570
BLOCK 9 (CDRL A001-A003): 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.
DISTRIBUTION STATEMENT D: DISTRIBUTION AUTHORIZED TO DEPARTMENT OF DEFENSE AND U.S. DOD CONTRACTORS ONLY CRITICAL TECHNOLOGY (30 SEPTEMBER 2020). OTHER REQUESTS SHALL BE REFERRED TO NUWCDIVNPT, CODE 349.
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