SBIR CDRLs_19JUL22.pdf

CONTRACT DATA REQUIREMENTS LIST

(2 DATA ITEMS)

Form Approved OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 440 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 complete 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

0001 TDP_______ TM ______________________ OTHER ________X_______________________

D. SYSTEM / ITEM

SIR Prototype

E. CONTRACT / PR NO.

PR 1301XXXXXX

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Technical Report – Study/Services

3. SUBTITLE

OQE Report

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80508B

5. CONTRACT REFERENCE

Section B, Supplies/Services

6. REQUIRING OFFICE

NUWCDIVNPT Code 4022

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT See Block 16 See Block 16 b. COPIES

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

SUBMISSION a. ADDRESSEE Draft

Final

N/A (See Block 16 Addendum)

N/A N/A Reg Repro

16. REMARKS Code 459 (Patty) 0 1 0

Code 4531 (Collins) 0 1 0

Block 4: Contractor format acceptable Block 9: See Distribution Statement Addendum Block 10-12: The Contractor shall deliver OQE Reports within 15 days prior to each delivery of SIR prototypes

Block 14: Reg copy to be delivered via email or electronic submission

15. TOTAL ----------------> 0 2 0

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Certificate of Compliance

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-81356A

5. CONTRACT REFERENCE

Section B, Supplies/Services

6. REQUIRING OFFICE

7. DD 250 REQ 9. DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14. DISTRIBUTION

LT See Block 16 See Block 16 b. COPIES

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

SUBMISSION a. ADDRESSEE Draft

Final

N/A (See Block 16 Addendum)

N/A N/A

16. REMARKS Code 459 (Patty) 0 1 0 Block 4: Contractor format acceptable Code 4531 (Collins) 0 1 0 Block 9: See Distribution Statement Addendum Block 10-12: The Contractor shall deliver a Certificate of Compliance for all hardware deliverables.

Block 14: Reg copy to be delivered via email or electronic submission

15. TOTAL ---------------> 0 2 0

G. PREPARED BY

Vivian Hilton

H. DATE

07/15/22

I. APPROVED BY

Stephannie K Cyr

J. DATE

ERP PR# 1301XXXXXX

DD FORM 1423

CONTRACT DATA REQUIREMENTS LIST

BLOCK 16 ADDENDUM

Block 9: the following information is amplification of the Block 9 Distribution Statement Selected:

Distribution Statement paragraphs is in addition to CLASSIFICATION markings of the data.

Distribution statement D: Applies to CDRL item Nos. A001-A002. Distribution authorized to the DoD and DoD contractors only; CRITICAL TECHNOLOGY (date data generated). Other requests for this document shall be referred to NUWC Division, Newport (Michael Cullinane, Code 4022).

The following “EXPORT CONTROL WARNING NOTICE” must be used in conjunction with DISTRIBUTION STATEMENT identified in the above CDRL items.

Warning – This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C. Sec 27521 et seq.) or the Export Administration Act of 1979, as amended, title 50, U.S.C., App 2401 et seq. Violation of these exports laws are subject to severe criminal penalties. Disseminate in accordance with provisions of DoD Directive 5230.25.