SPMYM2-21-Q-1885 (CDRLS) TEST WEIGHTS.pdf

0015AA A

A001

CONTRACT DATA REQUIREMENTS LIST Form Approved

(2 Data Items) 0MB No. 0704-0188

The public reporting burden lor this coll ectlon of lnformaUon is esttmeted to aver•ge 220 houri per response. Including the time for reviewing •n•trucUons, aeerchlng exls11no data 1ourca1, gathering an d maintaining tho data needed, 1nd C4mpletlng and reviewing the collection ol lnlormatlon Send comments regarding this burden estimate or any other aspect ol thlt collection or lnlorm allon, Including suggutlona for reducing the burden, to the Department ol Delense, E•ecutlvo Servlcu Directorate (0704-0188). Rupondent■ thould be aware that notwithstanding any other provision of law, no person shall h 1ublect to an y penalty for railing to comply with a collectlon of Information II It does nol display a currantly valid 0MB control number Pleue do not nitum your form lo the above organlutlon. Send completed lorm to the Govamment Issuing Contracting Officer for the Cont,act1PR No, ll1tod In Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C.CATEGORY

TOP

TM OTHER_NDTI/MISC

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

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

TEST/INSPECTION REPORT WELD REPAIR CERTIFICATION

4, AUTHORITY (Data Acqu/$/litn Document No.) I '· CONTRACT REFERENCE 6. REQUIRING OFFICE DI-NDTl-80809B PER CONTRACT PURCHASING ACTIVITY

7. 00250 flf<Q 9. DIST STATEMENT 10. FREQUENCY t?. DATE OF flRST SUBMISSION 14. DISTRIBUTION

DD REQUIRED ASREQ SEE BLOCK 16

b. COPIES 11.APP cooe

11. AS OF DATE 1l. DATE OF SUBSEQUENT

N/A N/A SUBMl;SSION a. AOORESSEE Final

NIA Reg Repro

111. REMARKS N4523A 0 1 0

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

�dministration and operations only, effective 6/9/2021. Other U.S. requests shall be referred to

�OMNAVSEASYSCOM.

Block 10 - Submit documentation per Dl•NDTl-80809B staling weld repairs performed.

Block 12 - Certification/Data Report documentation shaU be attached in the Wide Area lworkflow r,JVAWF) e-Buslness Suite. Acceptance/Rejection of Certification/Data Report lctocumentation will be accomplished with the corresponding material and wm not be accomplished prior to shipment of material.

15. TOTAL 0 1

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

CERTIFICATE OF COMPLIANCE WELD REPAIR CERTIFICATE OF COMPLIANCE

4. AUTHORITY (Dato Jlc,;iur,;Jlon Do..,ment No.)

I

5. CONTRACT REFERENCE 6, REQUIRING OFFICE

DI-MISC-81356A PER CONTRACT PURCHASING ACTIVITY

7. CO 250 REQ 9, 01ST STATEMENT 10. l'RliOUENCY 12. DATE OF FIRST SUBMISSION

DD REQU RED ASREQ SEE BLOCK 16 14. DISTRIBUTION

a. ADDRESSEE b.COPIES

8.APPCOOE

D

11. AS OF DATE 13. DATE OF SllBSEOUENT

N/A N/A SUBM SS!OM O<aft Final N/A

Reg Repro

16. REMARKS N4523A 0 1 0

Block 9; Distribution Statement D. Distribution authorized to DoD and Do□ contractors only.

Administration and operations only, effective 6/9/2021. Other U.S. requests shall be referred to

COMNAVSEASYSCOM.

Block 10 • Submit Weld Repair Certificate of Compliance when No Weld Repairs were required. Stating the fact that No Weld Repairs were required.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow f'/VAWF) a-Business Suite. Acceptance/Rejection of Certification/Data Report lctocumentalion will be accomplished with the corresponding material and wrll not be accomplished prior to shipment of material.

Document no.: 03630180

15. TOTAL 0 1 0

G. PREPARED BY

I

H. DATE

'· APPROVED BY J.DATE

r7 /S/ Helland, David A 6/9/2021 SI.Gilger, Frank R 6/9/20

DD FORM 1423-2, AUG 96 PREVIOUS EDITION MAY BE USED. Page_1_of_1_ V Page

17. PRICEGRIJIJ'

19. ESIUATED

'ltmURJi

17. PRICEGRIJIJ'

19. ESTNATED

'ltmURJi

0015AB B

AB01

Form Approved CONTRACT DATA REQUIREMENTS LIST

Tho public reporting burden !or this collection ol lnlorm atlon 11 estimated to average 220 hours per re■pon1e, Including the lime !or reviewing lnstruclion•. toarchlng ulsUng data sources. gathering ■nd maintaining the data needed, and completing and revJewlng the colleetlon of lnrormallon. Send c0mmenlI regarding thl1 burden estimate or any other upecl or this colloctlon or Information, Including suggullans rar reducing tho b urden. ta tho Department of Oolenn, Executive Se rvice■ Directorate 10704-01881. Respondent■ should be eware that notwithstanding any other provision or law, no peraan 1hIII be 1ubjoct to any penalty !or railing la comply with a callocllan al lnlarmetlon II It doe• not display a currently va11d 0MB control number . Proue da not rotum your farm ta the above orv■nlullon. Send completed farm to the Government lasulng Contracting Officer tar tho Canlracl/PR No. U1tod In Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C.CATEGORY

TDP TM ___ _ OTHER_MISC __ _

D, SYSTEMIITEM

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

E. CONTRACT/PR NO.

CERTIFICATION/DATA REPORT

4, AUTHORITY (Data Acqulsll/an Dacumenl No} 5. CONTRACT REFERENCE

DI-MISC-80678 PER CONTRACT

F. CONTRACTOR

3. SUBTITLE

WELDING PERSONNEL QU

REPORT

7. DO 250 REQ 9 DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION 14.

DD ASREQ

8 APP CODE

N/A D

11. AS OF DATE

N/A

16 REMARKS

'Block 4 - Tailored to allow vendor to provide only 10.2.2.

15DAC

13, CATE OF SUBSEQUENT

SUBMISSION

N/A

Block 9 - Distribution Statement D. Distribution authorized to DoD and DoD contra dministration and operations only, effective 6/9/2021. Other U.S. requests shall

OMNAVSEASYSCOM.

Block 10 - Submit Personnel Qualifications unless proof of prior acceplan ctivity prior lo performance of any welding.

Block 12 - Allow 45 Days from dale of entry in WAWF for certificati n ace erformance of any welding.

Block 14 - Certification/Data Report documentation shall be orkflow (YVAWF) e-Business Suite. Upon submission in WA

1. DATA ITEM ND.

15, TOTAL

3. SUBTITLE

Rog Ropro

WELDING PERSONNEL QUALIFICATIONS

PRIOR ACCEPTANCE

7. DD 250 REQ

DD

B. APP CODE

NIA

12. DATE OF FIRST SUBMISSION

07DAC

13. DA TE OF SUBSEQUENT

SUBMISSION

NIA

t D. Distribution authorized to DoD and DoD contractors only.

6. REQUIRING OFFICE

PURCHASING ACTIVITY

14. DISTRIBUTION

a. ADDRESSEE

Draft

N4523A 0

b. COPIES final

Reg Repro

1 0 s only, effective 6/9/2021. Other U.S. requests shall be referred to t---------1t----+---+----1 roof of p ior acceptance by a NAVSEA Activity shall be submitted in lieu of lifrcations Report prior to performance of any welding.

Days from date of entry in WAWF for certification acceptance prior to welding.

tlon/Data Report documentation shall be attached in the Wjde Area ·ness Suite. Upon submission fn WAWF send email notifications to:

.mll

Document number: 03630180

15. TOTAL 0 0

17. PRICEGROU'

19 ESTNATBl lOTA..m:E

1'- ESTNA1Bl lOTA..m:E

0015AC C

AC01

Form Approved CONTRACT DATA REQUIREMENTS LIST

The public reporting burden for 1h11 collecUon of Information ii utlm■led to average 220 hourt per r01pon1e, Including the lime for reviewing Instructions, searching existing data source■, gathering and maintaining the data ne eded, and complellng aM reviewing the collection of Information. Send comments regarding this burden estimate or any other ■sp•ct of 1h11 collection of •nform■tlon, including 1ugge1Uon1 for reducing the burden. 10 11,e Department of Defense, Executive Services Directorate (070.,0188). Rnpondenls should be aware that notwithstanding any other provision ol law. no person shall be subject to any penalty for lalllng to comply with a collection ol lnformallon If It does not display a currently valid 0MB conlrol number Ploase do not return your fonm to the above o,vanlutlon. Send completed lonm to the Government l11ulng Contracting Officer for the Contract/PR No. listed In Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TOP TM __ _ OTHER_MISC __ _

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

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

WELDING PROCEDURE QUALIFICATION TEST REPORT

4, AUTHORITY (01/1 Acquisllion Document No.)

7. 00 2S0 REQ

DD

8. APP CODE

NIA

16, REMARKS

D1-MISC-80876

9. DIST STATEMENT

REQUIRED

D

5. CONTRACT REFERENCE

10. FREQUENCY

ASREQ

11, AS OF DATE

NIA

PER CONTRACT

12 DATE OF FIRST SUBMISSION

15DAC

13. DA TE OF SU El SEQUENT

SUBMISSION

SEE B�K 16

lock 9 - Distribution Statement D. Distribution authorized lo DoD and DoD contractors dministralion and operations only, effective 6/9/2021. Other U.S. requests shall be

OMNAVSEASYSCOM.

lock 10 - Submit Welding Procedure Qualification Test Report unless proof cceptance by NAVSEA Activity.

lock 12 -Allow 45 Days from date of entry in WAWF for certification a erfonnance of any welding.

lock 14 - Certification/Data Report documentation shall be a orkflow (YVAWF) e-Business Suite. Upon submission in W wf rou .f .rnll

14.

15. TOTAL

1. DATA ITEM NO. 2. TITL OF DATA ITEM J. SUEITITt.E

Final

Rog Repra

WELDING PROCEDURE QUALIFICATION TEST

REPORT PRIOR ACCEPTANCE

7. DD 250 REO

DD

8. APP CODE

N/A

6.REMARKS

12. DATE OF FIRST SUBMISSION

07DAC

13. DATE OF SUBSEQUENT

SUBMISSION

NIA

ent D. Distribution authorized to DoD and DoD contractors only.

6. REQUIRING OFFICE

PURCHASING ACTIVITY

D ISTRIEIUTION

a. ADDRESSEE

Draft

N4523A 0 b COPIES

Final

Reg Repra

1 0 r lions onl;y, effective 6/9/2021. Other U.S. requests shall be referred to 1--------1�--t----+----1 of of prior acceptance by a NAVSEA Activity shall be submitted in lieu of <fre Qualification Test Report prior to performance of any welding.

5 Days from date of entry in WAWF for certification acceptance prior to y test.

lion/Data Report documentation shall be attached in the Wide Area

· ·te. Upon submission in WAWF send email notificat'ions to.

Document number: 03630180

15. TOTAL

17. PRICE GROlP

19. ESlNATBl 1IJrlURJl

17. PRICE GROlP

19. ES'INATBl 1IJrlURJl

D0015AD

AD01

(1 Data Item) 0MB 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 thus burden estimate or any other aspect of this collection o f 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 lssuina Contractina Officer for the ContractJPR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TOP TM OlliER

MISC

D. SYSTEMIITEM E. CONTRACT/PR NO. F. CONTRACTOR

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

CERTIFICATION/DATA REPORT MILESTONE/SCHEDULE

4. AUTHORITY (Dllta Acquisition Document No.) 5, CONTRACT REFERENCE &. REQUIRING OFFICE

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7 DD 250 REO 9 DISTSTATEMENT 10 FREQUENCY 12 DATE OF FIRST SUBMISSION 14 DISTRIBUTION

REQUIRED PSNS &IMF CODE 700

DD ONE/R SEE BLOCK 16 b. COPIES 0-2-0

8.APP CODE

D

11 AS OF DATE 13. DATE OF SUBSEQUENT a ADDRESSEE DRAFT FINAL

SUBMISSION

N/A N/A N/A Reg Repr

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.4, 10.3, 10.3.1-Provlde actual values JAW procurement specification. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 6/1/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 • Certlflcatlon/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) e•Buslness Suite.

Upon submission in WAWF send email notifications to:

PSNS.WAWFQACertlflcations.FCM@navy.ml!. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document No.:03630180 15 Total 0 1 0

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

/s/ Helland, David A 6/9/2021 Isl Gilger, Frank R 6/9/2021

11. EITIMATUJ

T01'Al ,-,tr;l!

DD FORM 1423-1, JUN 90 (EG) Page of

VLF

0015AE E

AE01

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Form Approved

0MB 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 thus burden estimate or any other aspect of this collection o f 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 Reducti reject (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form t e Government lssuin Contractin Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B, EXHIBIT C. CATEGORY:

TOP

D. SYSTEMIITEM E. CONTRACT/PR NO.

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

SAFETY DATA SHEET (SOS) REPORT

4. AUTHORITY (Data Acqul5/tlon Document No.} 5. CONTRACT REFERENCE

7. DD250REO

DD

8.APP CODE

N/A

16. REMARKS

DI-SAFT-82112

9. DIST STATEMENT 10, FREQUENCY

REQUIRED

ONE/R

D 11. AS OF DATE

NIA

PER CONTRACT

Block 9: Distribution Statement D. Distribution authorized to DoD an Administration and operations only, effective 6/9/2021. OI U.S. reque to COMNAVSEASYSCOM.

Block 12 • Allow 45 Days from date of entry in W performance of any test.

Block 12 • Certification/Data Report docu Workflow (WAWF) e-Business Suite. U PSNS.WAWFQACertifications.FCM

Document No.: 03630180

TM OTHER

SAFT

F. CONTRACTOR

3. SUBfflLE

N4523A

15. Total

G. PREPARED BY

Isl Helland, David A

H.DATE

61912021

I. APPROVED BY

Isl Gilger, Frank R

b. COPIES

DRAFT FIN"L

Reg R•pn, 0 1 0

0 0

17,P'IICICI!

CIRou;, 1LtB1'1M&ffO To.TAI.�

(1 Data Item) 0MB 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 thus burden estimate or any other aspect of this collection of information, Including suggestions for reducing this burden, lo 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 (0704-01 BB), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses.

Send completed form to the Government lssuinq ContractinQ Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B, EXHIBIT C. CATEGORY:

TOP ™ OTHEl'I

Ml$(:

D. SYSTEMIITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO, 2. TITLE OF DATA ITEM 3. suemLE

CERTIFICATION/DATA REPORT

REQUEST FOR SERIAL NUMBER

ASSIGNMENT

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

DI-CMAN-81211 PER CONTRACT PURCHASING ACTIVITY

7 DD250REO 9. DIST STATEMENT 10 FREQUENCY 12 DATE OF FIRST SUBMISSION 14, 0:-STRIBUTION

REQUIRED PSNS &IMF CODE 700

DD ONE/R SEE BLOCK 16 b. COPIES 0.2-0

B.APPCODE D 11. AS OF DATE 13. DATE OF SUBSEQUENT a ADDRESSEE DRAFT FINAL

SUBMISSION

NIA N/A N/A Rog Res,,

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 7.1, 10.1, 10.2 (b), 10.2 (c), 10.2(d),

10.3. Ensure certs provided are traceable to material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and o perations only, effective 6/1/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached In the Wide Area Workflow (WAWF) e-Business Suite.

Upon submission In WAWF send email notifications to:

PSNS.WAWFQACertiflcatlons.FCM@navy.mil. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accompllshed prior to shipment of material.

Document No.:03630180

15. Total 0 1 0

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

/sl Helland, David A 61912021 Isl Gilger, Frank R 61912021

11.UTIIU,TUJ

DD FORM 1423-1, JUN 90 (EG) Page of fiLF

G

AG01

0015AG

{1 Data Item) 0MB 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 thus burden estimate or any other aspect of this collection o f 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 the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY:

TOP TM OTHER

MISC

D. SYSTEMIITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TlnE OFDATAITEM 3, SUBTITLE

CERTIFICATION/DATA REPORT WEIGHT CERTIFICATION

4. AUTHORITY (Dala Acquisition Document No.} 5. CONTRACT REFERENCE &. REQUIRING OFFICE

DI-MISC-80678 PER CONTRACT PURCHASING ACTIVITY

7 00250 REQ 9. DIST STATEMENT 10 FREQUENCY 12 DATE OF FIRST SUBMISSION 14. DISTRIBUTION

REQUIRED

DD ONE/R SEE BLOCK 16 b. COPIES

8 APP CODE D 11 AS OF DATE 13 DATE OF SUBSEQUENT a. ADDRESSEE DRAFT FIN,\L

SUBMISSION

N/A NIA N/A Aog Repr D

16. REMARKS N4523A 0 1 0

Block 4: Tailored to allow the vendor to only provide: 10.1, 10.2, 10.2.1, 10.3, 10.3.1-Provide actual values IAW procurement specification. Ensure certs provided are traceable lo material via unique markings, 10.5.

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only.

Administration and operations only, effective 6/9/2021. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached in the Wide Area Workflow (WAWF) a-Business Suite. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Document No.: 03630180

15. Total 0 1 0

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

/s/ Helland, David A 6/9/2021 ts/ Gilger, Frank R 6/9/2021

DD FORM 1423-1, JUN 90 {EG) Page of Pages

11.un,u,ng TDT.U.PltlCt

VLF

0015AH

AH01

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