CDRL.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, Executive Services and Communications Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. 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:

A

TDP TM

OTHER SESS

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

AN/ALQ-167(V) Maintenance Cart Assembly

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE 17. PRICE GROUP

A004 Request for Variance (RFV)

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE 18. ESTIMATED

DI-SESS-80640D (SEE BLK 16)

SOW para 2.0, 3.0 NAWCWD Code 539400E TOTAL PRICE

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

REQUIRED

LT D ASREQ SEE BLK 16

b. COPIES

8. APP CODE SEE BLK 16 11. AS OF DATE 13. DATE OF SUBSEQUENT SUBMISSION a. ADDRESSEE Final

A N/A SEE BLK 16 Draft Reg. Repro

16. Remarks: Code 539400E 0 1 0

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

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.

BLOCK 9: Use Distribution Statement D: Distribution authorized to the Department of Defense and U.S. DoD contractors only, Critical Technology, 12 February 2019. Other requests for this document shall be referred to Commander: Naval Air Warfare Center Weapons Division (Code 539400E), Point Mugu, CA 93042-5049.

Block 14: Submit 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. Additional distribution will be provided by individual orders.

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

02/12/2019

DRRB Chairperson

02/25/2019

DD FORM 1423-1, FEB 2001 PREVIOUS EDITONS MAY BE USED