Exhibit_A_-_Technical_Requirements.pdf

Exhibit A SPRBL1-18-R-0051 Page 1 of 17 Issue: 23 March 2018

TECHNICAL REQUIREMENTS

AN/PVS-14 Battery Compartment

NSN 5855-01-523-4058

Exhibit A SPRBL1-18-R-0051 Page 2 of 17

Exhibit A SPRBL1-18-R-0051 Page 3 of 17

TABLE OF CONTENTS

APPLICABLE DOCUMENTS

CONFIGURATION BASELINE

An Engineering Change Proposal (ECP) describes the changes to be made to the CI/CSCI and all associated Government documents and data that are affected by the proposed engineering change. ECP should be prepared in accordance with EIA-649-1, Section 3.3.1, and DI-SESS-80639

A Request For Variance (RFV) is a specific written authorization to depart from a particular requirement(s) of an item’s approved configuration documentation for a specific number of units or a specified period of time, either as an advance request or after the fact. The contractor shall identify the impact of the RFV on performance, operational readiness and logistics support of the affected CIs. The Government may require consideration for any RFV. RFV should be prepared in accordance with EIA-649-1, Section 3.3.2, and DI-

SESS-80640

A Notice of Revision (NOR) shows the detailed changes that must be made to technical documentation, except specifications, following approval of an ECP. A NOR shall be submitted for each document affected by an ECP. NOR should be prepared in accordance with EIA-649-1, Section 3.3.4, and DI-SESS-80642

PACKAGING

Wood Packing Material

Military Packaging

SPECIALIZED TESTING

CONTRACT DATA REQUIREMENT LIST (CDRL) DD 1423-1

CDRL List

Individual CDRLs

Test/Inspection Report

DI-NDTI-80809B

Exhibit A SPRBL1-18-R-0051 Page 4 of 17

APPLICABLE DOCUMENTS

Military and Federal Standards MIL-STD-129R Military Marking for Shipment and Storage MIL-STD-2073-1E Standard Practice for Military Packaging

Military and Federal Specifications

MIL-PRF-49324 Performance Specification, Monocular Night Vision Device, AN/PVS-14

Other Documents

Commercial Documents ISPM Number 15 Regulation of Wood Packaging in International Trade ANSI/ISO/ASQ(E) Q9001-2015 American National Standard, Quality Management Systems

Requirements EIA-649-1 Configuration Management Requirements For Defense Contracts IPC J-STD-001 Requirements for Soldered Electrical and Electronic Assemblies

Security Documents

CONFIGURATION BASELINE

The applicable Configuration Baselines (CB), for the listed Configuration Item (CI) and/or Computer Software Configuration Item (CSCI), are as listed in the table below.

NSN Nomenclature Part Numbers/Drawings 5855-01-523-4058 Battery Compartment A3297309

The Contractor shall establish a Configuration Management Program in accordance with EIA-649-1.

No changes or departures from the CB are acceptable except for changes or departures which are submitted in accordance with EIA-649-1, CDRL A001, CDRL B001, and CDRL C001, and are approved by the Government Configuration Manager (C Mgr.) or Configuration Management Officer (CMO) and which are made applicable to the contract by the PCO.

Exhibit A SPRBL1-18-R-0051 Page 5 of 17

An Engineering Change Proposal (ECP) describes the changes to be made to the CI/CSCI and all associated Government documents and data that are affected by the proposed engineering change. ECP should be prepared in accordance with EIA-649-1, Section 3.3.1, and DI-SESS-80639.

A Request For Variance (RFV) is a specific written authorization to depart from a particular requirement(s) of an item’s approved configuration documentation for a specific number of units or a specified period of time, either as an advance request or after the fact. The contractor shall identify the impact of the RFV on performance, operational readiness and logistics support of the affected CIs. The Government may require consideration for any RFV. RFV should be prepared in accordance with EIA-649-1, Section 3.3.2, and DI-

SESS-80640.

A Notice of Revision (NOR) shows the detailed changes that must be made to technical documentation, except specifications, following approval of an ECP. A NOR shall be submitted for each document affected by an ECP. NOR should be prepared in accordance with EIA-649-1, Section 3.3.4, and DI-SESS-80642.

Exhibit A SPRBL1-18-R-0051 Page 6 of 17

PACKAGING

Wood Packing Material

Wood packing material includes pallets. See DLA Technical and Quality Assurance Requirement RP001: DLA Packaging Requirements for Procurement.

Military Packaging DS7029 and/or DS7033 Preservation, Packing and Marking Instructions

DS7029 - DS7033 LEGEND

Qty Quantity Prot Req Protection Required PKG-REF Packaging Reference (Military/Federal Specification or Standard) SPI Special Packaging Instruction LPK Level of Packing QUP Quantity per Unit Pack ICQ Intermediate Container Quantity Pkg Reqmt Codes Packaging Requirement Codes when PKG-REF cites MIL-STD-2073 The below codes are for special markings:

PC Project Code WG Warranty/Guarantee SL Shelf Life BC Bar Code FMS Foreign Military Sales

Exhibit A SPRBL1-18-R-0051 Page 7 of 17

DS7029 - DS7033

NSN Prot Req PKG-REF or SPI LPK QUP ICQ Special Markings

Pkg J. J J J J J J J J J Reqmt I. II. III. IV. V. VI. VII. VII.a IX X Codes (MP) (CD) (PM) (WM) (CD) (CT) (UC) (IC) (PK) (SM) 5855-01-523-4058 Military MIL-STD-2073-1E B 001 - 10 1 00 DA NA B D4 BC

Exhibit A SPRBL1-18-R-0051 Page 8 of 17

SPECIALIZED TESTING

The Contractor shall perform Quality Conformance Inspection IAW QAP A3297309 and the Technical Data Package.

The contractor shall prepare and submit a Quality Validation Plan in accordance with CDRL D001. In addition to the information required by DI-NDTI-81307A, this submission shall contain:

a. The delineation and allocation of tests to be performed on each of the First Article units and the order of such tests.

b. The delineation and allocation of tests to be performed as Conformance Inspection on subsequent production lots, to include the order of tests and the sampling plan.

c. Step-by-step test procedures for each test and the data sheets to be employed to document the results of testing.

d. Identification of required test facilities, equipment and personnel.

e. Test milestones schedules and the contractor's test readiness posture.

f. A table which cross references the paragraph number of the specification requirement (including a brief description of the requirement) and the associated paragraph number of the Quality Validation Plan.

A FAT Report shall be prepared and submitted in accordance with FAR 52.209-3 and CDRL E001. The FAT Report shall be complete, accurate, and readable and shall provide sufficient data to determine that the hardware item meets all the requirements delineated in the contract. The report will include the following:

1) General Data.

a. Contractor's name and address.

b. Contract number.

c. Nomenclature, type number and (if assigned) stock number of item represented by the First Article.

d. Name and address of plant where First Article was fabricated and assembled.

e. Place and date of performance of tests.

f. Identification (including date) of applicable equipment specifications and associated amendments.

g. Sample size or quantity submitted for test or inspection.

Exhibit A SPRBL1-18-R-0051 Page 9 of 17

2) Cross Reference. A table which cross-references the paragraph numbers of the specification, the test procedures, and data sheet entry.

3) Test Results. Complete test results showing actual or quantitative observations and all required calculations.

‘GO/NOGO’ data is allowable (under certain circumstances) only with prior Government approval. Allowable tolerances for each parameter shall be presented. Test data should also include the date that the test was performed, name and signature of tester, name and signature of the Government verifier/witness and serial number of the equipment. Test results shall cite detailed qualitative and quantitative data results such as test categories, test conditions, test methods employed, and types of inspection and test equipment used during the test or inspection.

4) FAT Failures. FAT failures shall list all requirements not complied with during FAT. If none, this should be explicitly stated. For each requirement not met, a corrective action to remove the noncompliance will be proposed. This corrective action must include retest or other verification that the corrective action does remedy the problem/failure. The corrective action will address changes in design or manufacturing process which will preclude this deficiency in subsequent production units. Verified corrective action must be implemented prior to contractor entering into production.

5) FAT/Production Discrepancies. Any Government approved difference between the parts, materials and processes used to manufacture FAT samples and production units shall be documented in the FAT report.

The contractor shall report each conformance test failure verbally to the Government Quality Assurance Representative (QAR) and the Technical Activity (see Block 16 of DD Form 1423 for CDRL F001) within one working day. Within fifteen working days of failure occurrence, the contractor shall submit a written failure report through the cognizant QAR to the Technical Activity as required by CDRL F001. In addition to the information required by DI-RELI-81315, the report shall include:

a) Contractor's name, address and applicable contract number.

b) Number of units in sample and number of failed units subjected to test.

c) Root cause of failure.

d) Environmental re-inspection plan to validate the corrective action, consisting of all applicable environmental test and examinations. The plan shall include identification of previous functional, environmental and reliability tests, if any, invalidated by the corrective action changes and recommendations of those tests which should be repeated to prove the corrective action.

e) Proposed disposition of items in the inspection lot at time of failure of any and all inspections during environmental test and of items manufactured under the same conditions and which the Government considers subject to the same failure mechanism.

The contractor shall implement the proposed corrective action on all units in the lot, select new samples and conduct environmental re-tests and other required re-testing in accordance with the retest plan in the Governement approved Failure Analysis and Corrective Action Report. Results of the environmental re-tests shall be submitted in accordance with DI-NDTI-80809B as implemented by CDRL G001.

Exhibit A SPRBL1-18-R-0051 Page 10 of 17

Final acceptance and shipment approval will be withheld until results of the environmental retests substantiate that the corrective action was effective, as authorized by the PCO.

CONTRACT DATA REQUIREMENT LIST (CDRL) DD 1423-1

CDRL List

CDRL

Data Line No. DID Identification Title

A001 DI-SESS- 80639 Engineering Change Proposal B001 DI-SESS- 80640 Request for Variance C001 DI-SESS- 80642 Notice of Revision D001 DI-NDTI- 81307A First Article Qualification Test Plan – Quality Validation Plan E001 DI-NDTI- 80809B Test/Inspection Report – First Article Test Report F001 DI-RELI- 81315 Failure Analysis and Corrective Action Report G001 DI-NDTI- 80809B Test/Inspection Report – Environmental Retest

Individual CDRLs

List of CDRLs begin on the next page.

Exhibit A SPRBL1-18-R-0051 Page 11 of 17

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

Original 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, 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 Contract/PR No. listed in Block E.

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

A001 TDP X TM OTHER

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

Battery Compartment

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

GROUP

Engineering Change Proposal

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

TOTAL PRICE

DI-SESS-80639 AMSEL-LCE-INV

INSERT

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

IN

LT

ASREQ SEE ITEM 16

b. COPIES

SECT. B

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

Draft Final

SEE ITEM 16

Reg Repro

16. REMARKS:

The contractor shall prepare and submit Engineering Change Proposal in accordance with EIA-649-1 and this DID when a change to a contractual baseline document is deemed necessary.

The Government will have 30 days to review, accept, and/or comment on the draft submission. The contractor shall incorporate changes into the electronic deliverable within 30 days after receipt of Government comments. The Government will have 30 days to review, accept, and/or comment on the final submission.

Data shall be submitted and exchanged electronically in Microsoft Office suite of applications (MS Word, Excel, Power Point, Access, and Project). Alternate formats may be allowed subject to Government review and approval.

E-mail notification is required with any electronic submission.

AMSEL-LCE-INV

RDER-PRA-CA

QAR

PCO

ACO

15. TOTAL 0 5 0

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

Timothy Langan

RDER-PRA-CA

Electronics Engineer

Angel Acevedo

RDER-PRA-CA

Branch Chief

Exhibit A SPRBL1-18-R-0051 Page 12 of 17

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, 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 Contract/PR No. listed in Block E.

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

B001 TDP X TM OTHER

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

Battery Compartment

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

Request For Variance

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

DI-SESS-80640 AMSEL-LCE-INV

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

SUBMISSION

a. ADDRESSEE

16. REMARKS: The contractor shall prepare and submit Request For Variance in accordance with EIA-649-1 and this DID when a departure from a contractual baseline document is deemed necessary.

The Government will have 30 days to review, accept, and/or comment on the draft submission. The contractor shall incorporate changes into the electronic deliverable within 30 days after receipt of Government comments. The Government will have 30 days to review, accept, and/or comment on the final submission.

Data shall be submitted and exchanged electronically in Microsoft Office suite of applications (MS Word, Excel, Power Point, Access, and Project). Alternate formats may be allowed subject to Government review and approval.

E-mail notification is required with any electronic submission.

AMSEL-LCE-INV

RDER-PRA-CA

QAR

Timothy Langan

RDER-PRA-CA

Electronics Engineer

Angel Acevedo

Exhibit A SPRBL1-18-R-0051 Page 13 of 17

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, 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 Contract/PR No. listed in Block E.

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

C001 TDP X TM OTHER

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

Battery Compartment

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

Notice of Revision

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

DI-SESS-80642 AMSEL-LCE-INV

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

SUBMISSION

a. ADDRESSEE

16. REMARKS: The contractor shall prepare and submit Notice of Revision in accordance with EIA-649-1 and this DID when a change to a contractual baseline document is deemed necessary.

The Government will have 30 days to review, accept, and/or comment on the draft submission. The contractor shall incorporate changes into the electronic deliverable within 30 days after receipt of Government comments. The Government will have 30 days to review, accept, and/or comment on the final submission.

Data shall be submitted and exchanged electronically in Microsoft Office suite of applications (MS Word, Excel, Power Point, Access, and Project). Alternate formats may be allowed subject to Government review and approval.

E-mail notification is required with any electronic submission.

AMSEL-LCE-INV

RDER-PRA-CA

QAR

Timothy Langan

RDER-PRA-CA

Electronics Engineer

Angel Acevedo

Exhibit A SPRBL1-18-R-0051 Page 14 of 17

ONTRACT DATA REQUIREMENTS LIST

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, 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 Contract/PR No. listed in Block E.

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

D001 TDP TM OTHER NDTI

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

Battery Compartment

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

First Article Qualification Test Plan Quality Validation Plan

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

DI-NDTI-81307A AMSEL-LCE-INV

INSER

T

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

DD

ONE/P 30 DAC

SECT.

B

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE Draft

A

16. REMARKS: Submit draft via LT. Government requires 30 days for review/comments. Submit final within 30 days of receipt of Government comments, via DD 250.

Each draft and the final submissions shall be delivered in a format, compatible with Microsoft Office software delivered by e-mail.

Alternative delivery media may be discussed with the Contracting Officer prior to delivery. E-mail notification is required with any electronic submission.

AMSEL-LCE-INV

15. TOTAL 3 3 0

Timothy Langan

RDER-PRA-CA

Electronics Engineer

Angel Acevedo

Exhibit A SPRBL1-18-R-0051 Page 15 of 17

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, 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 Contract/PR No. listed in Block E.

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

E001 TDP TM OTHER NDTI

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

Battery Compartment

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

Test/Inspection Report

First Article Test Report

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

DI-NDTI-80809B

INSER

T

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION 14. DISTRIBUTION

DD

OTIME 90 DAC

SECT.

B

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

16. REMARKS: Submit report of First Article Test results via DD 250.

Government requires 14 days to provide comments/approval.

Submit revised report within 7 days after receipt of government comments. Government requires 7 days to provide comments/approval.

All deliveries shall be delivered in a format, compatible with Microsoft Office software delivered by e-mail. Alternative delivery media may be discussed with the Contracting Officer prior to delivery. E-mail notification is required with any electronic submission.

15. TOTAL 0 3 0

Timothy Langan

RDER-PRA-CA

Electronics Engineer

Angel Acevedo

Exhibit A SPRBL1-18-R-0051 Page 16 of 17

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, 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 Contract/PR No. listed in Block E.

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

F001 TDP TM OTHER SESS

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

Battery Compartment

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

GROUP

Failure Analysis and Corrective Action Report

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

DI-SESS-81315B AMSEL-LCE-INV

INSERT

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION IN

b. COPIES SECT. B

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

Reg

Repro

16. REMARKS: Data Item Description (DID) reference to MIL specs/stds is for guidance only.

Failure reports shall be submitted within 10 days of failure occurrence.

Technical Activity Representative is Timothy Langan.

Each draft and the final submissions shall be delivered in a format, compatible with Microsoft Office software delivered by e-mail.

Alternative delivery methods may be discussed and agreed upon with the Contracting Officer prior to delivery. E-mail notification is required with any electronic submission.

AMSEL-LCE-INV

RDER-PRA-CA

PCO

ACO

QAR

15. TOTAL 0 3 3

Timothy Langan

RDER-PRA-CA

Electronics Engineer

Angel Acevedo

Exhibit A SPRBL1-18-R-0051 Page 17 of 17

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, 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 Contract/PR No. listed in Block E.

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

G001 TDP TM OTHER NDTI

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

Battery Compartment

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

Test/ Inspection Report Environmental Retest

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

DI-NDTI-80809B AMSEL-LCE-I

INSERT

7. DD 250 REQ 9.DIST STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST

SUBMISSION

14. DISTRIBUTION IN

b. COPIES SECT. B

8. APP CODE N/A 11. AS OF DATE 13. DATE OF SUBSEQUENT

SUBMISSION

a. ADDRESSEE

Reg

Repro

16. REMARKS: Submit results of Environmental retest(s) NLT 15 days after completion of retest(s).

All deliveries shall be delivered in a format, compatible with Microsoft Office software delivered by e-mail.

Alternative delivery media may be discussed with the Contracting Officer prior to delivery.

E-mail notification is required with any electronic submission.

AMSEL-LCE-I

15. TOTAL 0 3 3

Timothy Langan

RDER-PRA-CA

Electronics Engineer

Angel Acevedo