A002_Cal_Cert_CDRL.doc

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Master IDIQ - Hydraulic Pressure Gage Adapter and Hydraulic Power Supply Adapter
Solicitation number
N68335-18-Q-0144
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CONTRACT DATA REQUIREMENTS LIST (1 Data Item) FORM APPRVD 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 Services, Directorate for information Operations and Reports, 1215 Jefferson Davis HWY, Suite 1204, Arlington VA, 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-01880, 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 (XX)

QCIC

D. System/Item

MQ-8C Hydraulic Pressure Gage Adapter and

Hydraulic Power Supply Adapter E. Contract/PR No.

TBD

F. Contractor

TBD

1. Data Item No.

A002

2. Title of Data Item

Calibration Certificate

3. Subtitle

N/A

4. Authority (Data ID No.)

DI-QCIC-80798C, See Block 16

5. Contract Reference

SOW Para. 3.2

6. Requiring Office

NAVAIR LKE Code 13400B

7. DD 250 REQ

LT

9. Dist. Statement Req.

“D”

10. Frequency

ASREQ

See Block 16

12. Date of first submission

See Block 16

14. Distribution

See Block 16

8. APPCODE

N/A

See Block 16

11. As of Date

N/A

13. Date of Subsequent Submission

See Block 16

Address
Draft
Reg
Tape

16. Remarks

Block 4: Contractor format acceptable. Use DID for guidance.
13400B

486400B

Block 9: Use Distribution Statement D. Distribution authorized to DoD and DoD
6761400B

Contractors only, (30 January 2007) other U.S. requests shall be referred to Code 13400B.

Blocks 10, 12: A Calibration Certificate shall be shipped with each unit.

It shall be placed in a plastic pouch/bag/envelope and secured to the item using a zip tie or similar temporary fastening device.

Block 13: An electronic copy of each Calibration Certificate shall also be distributed within 15 days of actual hardware delivery for each unit.

Block 14: Delivery Media: Distribution of data shall conform to Electronic Media

Compatible with MS Word or MS-Excel or PDF. Calibration Certificates shall be emailed to the following individuals:

13400B: nancy.mcquillan@navy.mil

486400B: dominic.ziccardi@navy.mil

6761400B: Michael.moncayo@navy.mil

TOTAL

G. Prepared By

Amanda Tanzini H. Date

2 APR 2018

I. Approved By

Dominic Ziccardi

J. Date

2 APR 2018

17. Price Group
18. Estimated Total Price:

DD FORM 1423-1, JUN 90 PREVIOUS EDITION ARE OBSOLOTE PAGE (1) OF (1)

26 August 2014

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