CDRL_A001.doc

CONTRACT DATA REQUIREMENTS LIST

Form Approved

CMB 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 Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 222202-2302, 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.

0002,0102,0202

B. EXHIBIT

A

C. CATEGORY

TDP

TM

OTHER

D. SYSTEM/ITEM

T63-A-700

E. CONTRACT/PID NO.

N68335-15-R-0167

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM:

INSPECTION, ASSESSMENT, PLANNED REPAIR, AND MAINTENANCE EVALUATION DOCUMENTATION

3. SUBTITLE:

4. AUTHORITY (Data Acquisition Document No.)

See Block 16

5. CONTRACT REFERENCE

SOW PARA 2.3

6. REQUIRING OFFICE

AIR 4.4.6

7. DD 250 REQ

12. DATE OF FIRST SUBMISSION

See Block 16 14.

DISTRIBUTION

As required

b. COPIES

8. APP CODE

LT

SUBMISSION

a. ADDRESSEE

Final

5 DAYS

16. REMARKS

4. Contractor's format. The Letter Report can be submitted as a hard copy or as an electronic file. The emails and attachments shall be scanned for viruses and malicious software.

Hard copy on 8 1/2" X 11" white paper with 12 point black font with 1" border on all sides

Electronic file shall be submitted by email. The file shall be in Microsoft Word (version 7), Microsoft Excel (version 7) or Adobe Acrobat portable document file.format when printed the file shall meet the requirements for hard copy.

12. The Letter Report shall be submitted within 5 days upon completion of the CLIN 0001 requirement. The Government's Technical Point of Contact (TPOC) has 5 days after receipt of the report to review and provide comments and questions, The contractor has 5 days to consider and incorporate the comments or provide the TPOC a comment as to why they don't apply.

14.a ADDRESS: Propulsion Systems Evaluation Facility

Code: AIR 4.4.2 (E. Hille)

Building 2360

22229 Elmer Road

Patuxent River, MD 20670-1534

EMAIL: eric.hille@navy.mil Naval Air Warface Center Aircraft Division Lakehurst

Contracts Department: Code: AIR 2.5.2.3.2 Building 120-166 Highway 547

Lakehurst, NJ 08733

EMAIL: jillian.kohler@navy.mil

AIR 4.4.6

AIR 2.5.2.3.2

15. TOTAL

G. PREPARED BY

Tim Kreimer

H. DATE

4/30/2014

I. APPROVED BY

J. DATE

DD Form 1423-1, JUN 90 Previous editions are obsolete.

Page 1 of 1 Pages