14-R-0144_Exhibit_A.pdf

Exhibit A Page 1

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:

A TDP TM OTHER: MGMT

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

Repair of I/J Band MPM N68936-14-R-0144

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A001 PROGRAM PROGRESS REPORT

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-MGMT-80555A SOW para 3.1, 3.3.2, 3.5.4, 5.0 NAWCWD CODE 539400E

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

LT SEE BLOCK MTHLY 35 DAC b. COPIES

8. APP CODE 16 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

N/A N/A EOM+5 DAYS

Reg

Repro

16. Remarks

BLOCK 4: Contractor format is acceptable.

BLOCK 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only; administrative or operational use only; 15 April 2005. Other requests for this document shall be referred to Commander, Naval Air Warfare Center Weapons Division (Code 539044E), Point Mugu, CA 93042-5003.

DESTRUCTION NOTICE - for unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

Block 14: Data shall be delivered in electronic format agreed upon by both Government and Contractor prior to first submittal.

See Contract Clause 5252.247-9505, Technical Data and Information for distribution addresses.

Code 539400E 0 3 0 Code 254300D 0 1 0

DCMA 0 1 0

15. TOTAL 0 5 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

Naval Air Warfare Center, Weapons Division, China Lake, CA 93555-6100

3 March 2014

DRRB Chairperson

141007

DD Form 1423-1, 1 Jun 9090

Sandra K. Passwater mailto:sue.casey@navy.mil

Exhibit A Page 2

(1 Data Item)

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:

A TDP TM OTHER: CMAN

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

Repair I/J Band MPM N68936-14-R-0144

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A002 ENGINEERING CHANGE PROPOSAL (ECP)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-CMAN-80639C SOW para 3.2, 5.0 NAWCWD CODE 539400E

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

LT SEE BLOCK ASREQ SEE BLOCK 16 b. COPIES

8. APP CODE 16 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

A N/A SEE BLOCK 16

BLOCK 4: Contractor format is acceptable.

BLOCKS 8, 12 and 13: Contractor to submit 15 DA identification of need for change. Government has 30 days after receipt for review. Contractor has 30 DARC to submit with comments incorporated for Government Approval.

BLOCK 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only; administrative or operational use only; 15 April 2005. Other requests for this document shall be referred to Commander, Naval Air Warfare Center Weapons Division (Code 539044E), Point Mugu, CA 93042-5003.

DESTRUCTION NOTICE - for unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

Block 14: Data shall be delivered in electronic format agreed upon by both Government and Contractor prior to first submittal. Submit transmittal and all enclosures to NAWCWD 539400E. Submit a copy of the letter of transmittal only to DCMA and NAWCWD 254300D.

539400E 3 3 0

254300D LTR ONLY

DCMA LTR ONLY

15. TOTAL 3 3 0

Naval Air Warfare Center, Exhibit A Page 3

(1 Data Item)

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:

A TDP TM OTHER: CMAN

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

Repair I/J Band MPM N68936-14-R-0144

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A003 NOTICE OF REVISION (NOR)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-CMAN-80642C SOW para 3.2, 5.0 NAWCWD CODE 539400E

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

LT SEE BLOCK ASREQ SEE BLOCK 16 b. COPIES

8. APP CODE 16 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

BLOCK 4: Contractor format is acceptable.

BLOCKS 8, 12 and 13: Contractor to submit 15 DA identification of need for change. Government has 30 days after receipt for review. Contractor has 30 DARC to submit with comments incorporated for Government Approval.

BLOCK 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only; administrative or operational use only; 15 April 2005. Other requests for this document shall be referred to Commander, Naval Air Warfare Center Weapons Division (Code 539044E), Point Mugu, CA 93042-5003.

DESTRUCTION NOTICE - for unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

Block 14: Data shall be delivered in electronic format agreed upon by both Government and Contractor prior to first submittal. Submit transmittal and all enclosures to NAWCWD 539400E. Submit a copy of the letter of transmittal only to DCMA and NAWCWD 254300D.

Naval Air Warfare Center, Exhibit A Page 4

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:

A TDP TM OTHER: CMAN

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

Repair I/J Band MPM N68936-14-R-0144

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A004 REQUEST FOR DEVIATION (RFD)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-CMAN-80640C SOW para 3.2, 5.0 NAWCWD CODE 539400E

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

LT SEE BLOCK ASREQ SEE BLOCK 16 b. COPIES

8. APP CODE 16 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

BLOCK 4: Contractor format is acceptable.

BLOCKS 8, 12 and 13: Contractor to submit 15 DA identification of need for change. Government has 30 days after receipt for review. Contractor has 30 DARC to submit with comments incorporated for Government Approval.

BLOCK 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only; administrative or operational use only; 15 April 2005. Other requests for this document shall be referred to Commander, Naval Air Warfare Center Weapons Division (Code 539044E), Point Mugu, CA 93042-5003.

DESTRUCTION NOTICE - for unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

Block 14: Data shall be delivered in electronic format agreed upon by both Government and Contractor prior to first submittal. Submit transmittal and all enclosures to NAWCWD 539400E. Submit a copy of the letter of transmittal only to DCMA and NAWCWD 254300D.

Naval Air Warfare Center, Exhibit A Page 5

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:

A TDP TM OTHER: NDTI

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

Repair I/J Band MPM N68936-14-R-0144

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

A005 TEST/INSPECTION REPORT PRODUCTION TEST DATA

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-NDTI-80809B SOW para 3.5.3, 5.0 NAWCWD CODE 539400E

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

LT SEE BLOCK ASGEN SEE BLOCK 16 b. COPIES

8. APP CODE 16 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

Final

N/A N/A SEE BLOCK 16

BLOCK 4: Report shall consist of completed test data sheets and certificate of conformance provided to the Government electronically.

BLOCK 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only; administrative or operational use only; 15 April 2005. Other requests for this document shall be referred to Commander, Naval Air Warfare Center Weapons Division (Code 539044E), Point Mugu, CA 93042-5003.

BLOCKS 10, 12 and 13: Submit to the Government NLT 2 weeks after test completion.

DESTRUCTION NOTICE - for unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.

Block 14: Data shall be delivered in electronic format agreed upon by both Government and Contractor prior to first submittal.

539400E 0 1 0

15. TOTAL 0 1 0

Naval Air Warfare Center,