CDRL_2.pdf

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:

TBD A TDP_______________ TM_______________ OTHER_____MISC_________________

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

ALIC Chassis and mechanical assemblies

N/A N/A

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

A001 Certification / Data Report Quality Assurance Certification

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

DI-MISC-80678 SOW Para 4 NAWCWD CODE 486M00E

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION

LT E

SEE BLK 16 SEE BLK 16

b. COPIES

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

SUBMISSION

a. ADDRESSEE Draft

Final

N/A

N/A SEE BLK 16

Reg

Repro

Block 4: Contractor format is acceptable as long as DID is used for guidance.

Block 9: Use Distribution Statement E: Distribution Statement E.

Distribution authorized to DoD components only, Administrative or Operational Use, 1 September 2016, Other requests for this document shall be referred to NAWCWD Point Mugu, Code

486M00E.

Blocks 10, 12 & 13: Shall be delivered concurrent with hardware.

Block 14: Submit in an electronic format agreed upon by both

Government and Contractor prior to 1 st submittal.

See Contract Clause 5252.247-9505, Technical Data and

Information for distribution addresses.

Code 486M00E 0 1 0

Code 254300D 0 LTR ONLY

15. TOTAL 0 1 0

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

Naval Air Warfare Center Weapons

Division

China Lake, CA 93555-6100

170315 Jennifer Ambrecht

DRRB Chairperson

170412