CONTRACT_DATA_REQUIREMENTS_LIST.docx

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FABRICATION AND REFURBISHMENT OF AS-2188/U, AS-4328/U, AND AS-177B/UPX ANTENNA PARTS AND COMPONENTS
Solicitation number
N68335-18-R-0126
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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 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:
TDP ________
TM ______
OTHER________
D. SYSTEM/ITEM
E. CONTRACT/PR NO.
F. CONTRACTOR
1. DATA ITEM NO.
2. TITLE OF DATA ITEM
3. SUBTITLE

17. PRICE GROUP

A002
Refurbished Component Report
4. AUTHORITY (Data Acquisition Document No.)
5. CONTRACT REFERENCE
6. REQUIRING OFFICE

18. ESTIMATED

TOTAL PRICE

7. DD 250 REQ
9. DIST STATEMENT
10. FREQUENCY
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION

REQUIRED

LT

ASREQ

b. COPIES

8. APP CODE

11. AS OF DATE
13. DATE OF SUBSEQUENT SUBMISSION
a. ADDRESSEE

Final

Draft
Reg.
Repro
16. REMARKS
4.11.2.

The Contractor shall submit a report detailing the subcomponents that needed to be refurbished and to notify the TPOC of completion.

15. TOTAL

G. PREPARED BY
H. DATE
I. APPROVED BY :
J. DATE
CONTRACTS DATA REQUIREMENTS LIST
Form Approved
(1 Data Item)
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 Highway, Suite 1204, Arlington, VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, D.C. 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:
TDP_________
TM
Other __

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

N68335-18-R-0126

1. DATA ITEM NO.
2. TITLE OF DATA ITEM

3. SUBTITLE

A001
First Article Test Report (FATR)
First Article Test Reports
4. AUTHORITY (Data Acquisition Document No.)
5. CONTRACT REFERENCE

6. REQUIRING OFFICE

DI-QCIC-81891

SOO Para. 2.5.2
NAWCAD 4.11.2
7. DD 250 REQ
9.DIST STATEMENT
10. FREQUENCY
12. DATE OF FIRST SUBMISSION
14. DISTRIBUTION
LT
REQUIRED
See Block 16
See Block 16

b. COPIES

C

8. APP CODE

11. AS OF DATE
13. DATE OF SUBSEQUENT SUBMISSION
a. ADDRESSEE
Draft
Final

N/A

See Block 16
See Block 16
Reg
Repro

16. REMARKS

NAWCAD 4.11.2
0
1
1

Blocks 10,11,12 &13: Supplied with First Article delivery.

Block 14: Deliverables to be provided in electronic format (Microsoft 2003 or greater).

Hard copy due only upon request.

Block 14 Address:

Department of the Navy

Commander, NAVAIRWARCENACDIV

ATTN: Code 4.11.2, Building 8271

17454 Webster Field Road

St. Inigoes, MD 20684-4012

15. TOTAL
0
1
1

G. PREPARED BY

H. DATE
I. APPROVED BY

J. DATE

DD Form 1423-1, JUN 90

Previous editions are obsolete

Page
8
of
8

1007/183

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