EXHIBITS_A-D.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 the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Please DO NOT RETURN your form to either of these address. 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 TBD

TDP _________________ TM __________________ OTHER _____________________

D. SYSTEM/ITEM

Trident Submarine Brows (Qty: 3), Project #877-834

E. CONTRACT/PR NO. F. CONTRACTOR

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

TEST/INSPECTION REPORT

3. SUBTITLE

Pad Eyes Certification & NDT Report

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80809B

5. CONTRACT REFERENCE

Per Contract

6. REQUIRING OFFICE

PSNS & IMF, Bangor – C830E

7. DD 250 REQ

NO

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

SEE BLOCK 16

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16

14. DISTRIBUTION

See Block 16

b. COPIES

8. APP CODE

N/A

N/R 11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

A. ADDRESSEE Final

N/A Draft Reg Repr

16. REMARKS

Block 3 - The Trident Submarine Brows (Qty: 3) Lifting Pad Eyes Certification and Non- Destructive (NDT) report shall be in the Contractor’s format, but shall include all required items included in content section (paragraph 2.2) on page two of this document.

Block 9 - Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 3/7/2019. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Personnel Qualifications and Test Procedures, when ordered on separate contract line item, shall be submitted and approved before testing unless otherwise specified in contract.

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

Blocks 10 & 12 & 14 - The Contractor shall provide three copies (one per brow), Lifting Pad Eye Certification and Non-Destructive (NDT) report (for each brow’s pad eyes), NLT than after completion of the Trident Submarine Brows (Qty: 3), but prior to final acceptance.

Lifting Pad Eyes Certification and Non-Destructive (NDT) Report - Concurrent with delivery of the equipment, the contractor shall provide a signed, written certification of compliance to the lifting pad and NDT testing requirements as outlined in the specification (paragraph 3.6). The Lifting Pad Certification statement shall include that all lifting pads have been designed in accordance with design criteria and that each lifting pad has successfully passed a 200-210% load test.

The NDT report shall show the results of the magnetic particle or liquid penetrant examination of each load bearing weld and lifting pad (following the load test).

Failure to provide this certification and NDT report could result in rejection of this equipment, because of failure to comply with the terms of the contract acceptance.

See Block 16 N68438 3

TOTAL 3

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

Carl Jaeckel 7 March 2019 Carl Jaeckel 7 March 2019

DD Form 1423-1, FEB 2001 previous edition may be used. Page 1 of 2 Pages

Trident Submarine Brows (Qty: 3), Project #877-834

17. PRICE

18. ESTIM

TOTAL

0004AA A

A001

EXHIBITS A - D

DATA ITEM DESCRIPTION

Title: Lifting Pad Eyes Documentation Number: TBD Approval date: TBD AMSC Number: TBD Limitation: N/A DTIC Applicable: N/A GIDEP Applicable: N/A Office of Primary Responsibility: PSNS & IMF, Bangor Site, Code 300E Applicable Forms: N/A

1 Use/relationship. The Lifting Pad Eyes Certification and Non-Destructive (NDT) report shall demonstrate that the contractor has performed, completed and successfully passed the Load Test of Lifting Pads and Non-Destructive (NDT) Tests of Load Bearing Welds (of each lifting pad eye) as outlined in the specification, for the Trident Submarine Brows (Qty: 3)

2 Requirements:

2.1 Format. The Lifting Pad Eyes Certification and Non-Destructive (NDT) report shall be presented in the contractor’s format.

2.2 Content. The Lifting Pad Certification and Non-Destructive (NDT) Report shall include a signed, written certification of compliance to the lifting pad and NDT testing requirements as outlined in the specification. The Lifting Pad Certification statement shall include that all lifting pads have been designed in accordance with design criteria and that each lifting pad has successfully passed a 200- 210% load test. The NDT report shall show the results of the magnetic particle or liquid penetrant examination of each load bearing weld and lifting pad (following the load test). Failure to provide this certification and NDT report could result in rejection of this equipment, because of failure to comply with the terms of the contract.

2.3 Media requirement. Each reports shall be a “hard” copy, and shall be clearly legible and on 8-1/2 x 11 inch plain bond paper. The type of report shall be identified in the subject heading of each report.

3 End of TBD

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 the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Please DO NOT RETURN your form to either of these address. 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

TDP TM OTHER NDTI

D. SYSTEM/ITEM

Trident Submarine Brows (Qty: 3), Project #877-

E. CONTRACT/PR NO. F. CONTRACTOR

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

TEST PLAN REPORT

3. SUBTITLE

BROW TESTING RESULTS

4. AUTHORITY (Data Acquisition Document No.)

DI-NDTI-80566A

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D*

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16*

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

A. ADDRESSEE Final

N/A Draft Reg Repr o 16. REMARKS

Block 9 - Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 5/29/2019. 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.WAWFQACertifications.FCM@navy.mil. Acceptance/Rejection of Certification/Data Report documentation will be accomplished with the corresponding material and will not be accomplished prior to shipment of material.

Blocks 10 & 12 & 14 - The Contractor shall provide three copies (one per brow). Brow Testing Report, NLT than after completion of the Trident Submarine Brows (Qty: 3), but prior to final acceptance.

Brow Testing Report - Concurrent with delivery of the equipment, the contractor shall provide a signed, written certification of compliance to the brow load testing requirements as outlined in this specification (paragraph 3.5).

N68438 0 3 0

TOTAL 0 3 0

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

Carl Jaeckel 5/29/2019 Carl Jaeckel 5/29/2019

Project: Trident Submarine Brows (Qty: 3), Project #877-834

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

0004AB B

B001

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 the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Please DO NOT RETURN your form to either of these address. 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

TDP TM OTHER SESS

D. SYSTEM/ITEM

Trident Submarine Brows (Qty: 3), Project #877-

E. CONTRACT/PR NO. F. CONTRACTOR

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

WARRANTY PERFORMANCE REPORT

3. SUBTITLE

WARRANTY DOCUMENTATION

4. AUTHORITY (Data Acquisition Document No.)

DI-SESS-81639A

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D*

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16*

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

A. ADDRESSEE Final

N/A Draft Reg Repr o 16. REMARKS

Block 9: Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 5/29/2019. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 4 - Tailored to allow vendor to provide only 3.1.1 (a, c, d, e), 3.1.2 (a, b, c, d, e, f, g, h, j, k, l, m).

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

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

Blocks 10 & 12 & 14 - The Contractor shall provide three copies (one per brow), of the warranty statement, NLT than after completion of the Trident Submarine Brows (Qty: 3), but prior to final acceptance.

The warranty shall be for a period of 1 year (from the date of acceptance)

N68438 0 3 0

TOTAL 0 3 0

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

Carl Jaeckel 5/29/2019 Carl S Jaeckel 5/29/2019

Project: Trident Submarine Brows (Qty: 3), Project #877-834

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

0004AC C

C001

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 the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0704-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Please DO NOT RETURN your form to either of these address. 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

TDP ______________ TM ____________ OTHER TMSS

____________________________________D. SYSTEM/ITEM

Project: Trident Submarine Brows (Qty: 3), Project #877-834

E. CONTRACT/PR NO. F. CONTRACTOR

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

COMMERCIAL OFF-THE-SHELF (COTS) MANUALS

AND ASSOCIATED SUPPLEMENTAL DATA

3. SUBTITLE

BROW DATA REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-TMSS-80257C

5. CONTRACT REFERENCE

PER CONTRACT

6. REQUIRING OFFICE

PURCHASING ACTIVITY

7. DD 250 REQ

DD

9. DIST STATEMENT

REQUIRED

D*

10. FREQUENCY

ONE/R

12. DATE OF FIRST

SUBMISSION

SEE BLOCK 16*

14. DISTRIBUTION

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

A. ADDRESSEE

Final

N/A Draft Reg Repr o

16. REMARKS

Block 9 - Distribution Statement D. Distribution authorized to DoD and DoD contractors only. Administration and operations only, effective 5/29/2019. Other U.S. requests shall be referred to COMNAVSEASYSCOM.

Block 12 - Certification/Data Report documentation shall be attached to the Invoice/Receiving Report located in Wide Area Workflow (WAWF) e-Business Suite:

Invoice, Receipt, Acceptance, and Property Transfer (iRAPT).

Upon submission in iRAPT send email notifications to:

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

Blocks 10 & 12 & 14 - The Contractor shall provide three copies (one per brow). Brow Data Report report, NLT than after completion of the Trident Submarine Brows (Qty: 3), but prior to final acceptance.

Brow Data Report – Concurrent with delivery of the equipment, the contract shall provide data regarding the brow, including recommended maintenance tasks (i.e.

for the “cam lock” system), materials type components (i.e. type of bolts), and actual weight, lift points and center of gravity of the brow. The vendor shall provide a “no asbestos used” statement, certifying that all products/materials (i.e. gaskets, etc.) used in the components of the equipment does not contain asbestos, as outlined in paragraph 3.2.2.

N68438 0 3 0

TOTAL 0 3 0

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

Carl S Jaeckel 5/29/2019 Carl S Jaeckel 5/29/2019

DD Form 1423-1, FEB 2001 Previous edition may be used. Page 1 of 1 Pages

Project: Trident Submarine Brows (Qty: 3), Project #877-834

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

0004AD D

D001

3 End of TBD