Raytheon_CDRL_A002_FA8540-21-D-0002.pdf

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved OMB No. 0704-0188

The 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 the burden, to the Department of Defense, Executive Services 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

A

C. CATEGORY:

TDP TM OTHER OTHER

D. SYSTEM/ITEM

AAQ-13 LANTIRN

E. CONTRACT/PR NO.

FA8540-21-D-0002

F. CONTRACTOR

RAYTHEON COMPANY

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Engineer Change Proposal

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-CMAN-80639C/T

5. CONTRACT REFERENCE

PWS para 4.0.5, 4.0.7

6. REQUIRING OFFICE

Timothy Blacknik

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

See Blk 16

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

See Blk 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Blk 16 Draft

Final

Reg Repro

16. REMARKS

BLOCK 4: The ECP shall provide an assessment on the impact of the total life cycle cost.

Each ECP shall include a narrative concerning its impact upon safety with any hazards listed, their risk assessment, and impact on the present or proposed system. If no potential hazards exist, the basis for such determination and supporting evidence must be included.

Include a narrative concerning the impact on reliability, supportability, maintainability, and reproducibility. Also, include a factor titled "critical single point failure item". This factor will be used to indicate direct or indirect effect of the ECP on critical single point items.

BLOCK 9: Distribution statement D- "Distribution authorized to the Department of Defense and U.S. DOD contractors only for administrative and operational use, " 31 AUG 2000.

Other request for this document shall be referred to: AFLCMC/WNYBA, 460 Richard Ray Blvd., STE 200, Robins AFB GA 310-98-1813

BLOCK 10, 11, 12 & 13: Submit for any changes to the currently approved configuration documentation or as required. Revisions, as necessary, until approved by the procuring agency.

BLOCK 14: ELECTRONIC MEDIA IS REQUIRED BY AFLCMC/WNYBA.

DOCUMENTS SHALL BE GENERATED USING MICROSOFT OFFICE OR ADOBE

PRODUCTS. Classified portions of this CDRL will be forwarded IAW the

DD-254.

AFLCMC/WNYBA (Program Manager) - Travern.Poole.2@us.af.mil AFLCMC/WNYEDC (System Engineer) - Timothy.Blacknik@us.af.mil

See Blk 16 1

See Blk 16 1

See Blk 16 1

15. TOTAL 0 3 0

G. PREPARED BY

carithers.diane.m.1075543472 Diane Carithers

H. DATE

2021/01/11

I. APPROVED BY

poole.travern.l.1083279598

J. DATE

2021/01/12

18. ESTIMATED

TOTAL PRICE

DD FORM 1423-1, FEB 2001 PREVIOUS EDITION MAY BE USED Page 1 of 1 Pages

17. PRICE GROUP