The file's text, extracted by GovTribe without its formatting.
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a001 |
| TECHNICAL REPORT – STUDY/SERVICES |
| Design Characteristics |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.2 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Blocks 12 & 13: Submit at design definition.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
See Contract Clause 5252.247-9505, Technical Data and Information for distribution addresses.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
DRRB Chairperson 140402
DD Form 1423-1, 1 Jun 1990
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a002 |
| TECHNICAL REPORT – STUDY/SERVICES |
| Test Data |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.5 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
| LT |
| SEE BLK |
| ASREQ |
| SEE BLK 16 |
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Blocks 12 & 13: Submit at completion of each test.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a003 |
| REAL PROPERTY INVENTORY DETAIL LIST |
| Inventory Updates |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MGMT-80213B |
| PWS Para 3.7.1 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
| LT |
| SEE BLK |
| ASREQ |
| SEE BLK 16 |
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Blocks 12 & 13: Submit NLT 5 WDA identification of change.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a004 |
| TECHNICAL REPORT – STUDY/SERVICES |
| Receiving Documents, Discrepancies & Damage Report |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.6, 3.7.2 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
| LT |
| SEE BLK |
| ASREQ |
| SEE BLK 16 |
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Blocks 12 & 13: Submit NLT 1 DA shipping and receiving verification.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-NDTI-80566 |
| PWS Para 3.1 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
| LT |
| SEE BLK |
| ASREQ |
| SEE BLK 16 |
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Blocks 12-13: Submit NLT 90 days prior to test.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a006 |
| TECHNICAL REPORT – STUDY/SERVICES |
| Inspection/Maintenance Report |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.8 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a007 |
| FUNDS AND LABOR HOUR EXPENDITURE REPORT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-FNCL-81537 |
| PWS Para 3.9.1.2 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
a
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a008 |
| TECHNICAL REPORT – STUDY/SERVICES |
| Material Cost Report |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.9.1.3 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a009 |
| PERSONNEL REPORT |
| Workforce Change Report |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-81419 |
| PWS Para 3.9.1.4 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 13: Submit changes within 24 hours of change.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a00A |
| ACCIDENT/INCIDENT REPORT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-SAFT-81563 |
| PWS Para 3.9.1.5, 3.9.3.1 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
| LT |
| SEE BLK |
| asreq |
| see blk 16 |
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance. Delete reference to reporting accidents/incidents exceeding $10,000. Report all accidents/incidents.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 12 & 13: Submit as defined in Contractor Safety Plan.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a00B |
| TECHNICAL REPORT – STUDY/SERVICES |
| Post Test Review Reports |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.6 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
| LT |
| SEE BLK |
| asreq |
| see blk 16 |
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 12 & 13: Submit NLT 15 DA each test.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a00C |
| PROGRAM PROGRESS REPORT |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MGMT-80555A |
| PWS Para 3.9.1.1 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a00D |
| TECHNICAL REPORT – STUDY/SERVICES |
| Safety Plan |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.9.3.1 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 13: Submit as changes occur.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a00E |
| TECHNICAL REPORT – STUDY/SERVICES |
| INSTRUMENTATION DOCUMENTATION |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.2 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Blocks 12 & 13: Submit at design definition.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a00F |
| Developmental Design Drawings/Models and Associated Lists |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-SESS-81002F |
| PWS Para 3.2 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Blocks 12 & 13: Submit at design definition.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a00G |
| TECHNICAL REPORT – STUDY/SERVICES |
| Shipping Records |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.7.2 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402
CONTRACT DATA REQUIREMENTS LIST
(1 Data Item) Form Approved
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 Contract/PR No. listed in Block E.
| A. CONTRACT LINE ITEM NO. |
| B. EXHIBIT |
| C. CATEGORY: |
| D. SYSTEM/ITEM |
| E. CONTRACT/PR NO. |
| F. CONTRACTOR |
| WSL Test Program Support |
| N68936-14-R-0022 |
| 1. DATA ITEM NO. |
| 2. TITLE OF DATA ITEM |
| 3. SUBTITLE |
| a00H |
| TECHNICAL REPORT – STUDY/SERVICES |
| Engineering Recommendations Report |
| 4. AUTHORITY (Data Acquisition Document No.) |
| 5. CONTRACT REFERENCE |
| 6. REQUIRING OFFICE |
| DI-MISC-80508B |
| PWS Para 3.7.3 |
| NAWCWD Code 418300D |
| 7. DD 250 REQ |
| 9.DIST STATEMENT REQUIRED |
| 10. FREQUENCY |
| 12. DATE OF FIRST SUBMISSION |
| 14. |
DISTRIBUTION
b. COPIES
| 8. APP CODE |
| 16 |
| 11. AS OF DATE |
| 13. DATE OF SUBSEQUENT |
SUBMISSION
N/A
Block 16 Remarks
Block 4: Contractor format is acceptable as long as DID is used for guidance.
Block 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Administrative or Operational Use, 4 February 2014. Other requests shall be referred to Naval Air Warfare Center Weapons Division, Code 418300D, 1 Administration Circle, China Lake, CA 93555-6100.
Block 14: Shall be delivered in an electronic format agreed upon by both Government and Contractor prior to 1st submittal.
Code 254100D
15. TOTAL
| G. PREPARED BY |
| H. DATE |
| I. APPROVED BY |
| J. DATE |
| Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100 |
| 140402 |
140402