UpdatedCDRL840924Feb16.pdf

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Aircraft and Airframe Structural Components
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SPRWA1-16-R-0037
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Contract Data Requirements List

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CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

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 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 C. CATEGORY

TDP TM OTHER X

D. SYSTEM / ITEM

TANK, FUEL, AIRCRAFT/1560013918409GC

E. CONTRACT / PR NO.

FD20601600021

F. CONTRACTOR

ROBERTSON AVIATION LLC

1. DATA ITEM NO.

a001

2. TITLE OF DATA ITEM

First Article Test Report

3. SUBTITLE

Fuel Tank / NSN 1560013918409GC / PN HM-020-008

4. AUTHORITY

DI-NDTI-80809B

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

FD20601600021

6. REQUIRING OFFICE

AFLMC/WIUEC

7. DD 250 REQ

N/A

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

ONE/P

11. AS OF DATE

20151022

12. DATE OF FIRST

SUBMISSION

SEE BLK 16

13. DATE OF SUBSEQUENT

SUBMISSION

N/A

SEE REMARKS

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

McAllister, Lisha ANAME: 27 OCT 2015DATE:

First Article test report due upon delivery of First Article.

Engineer: Daniel Hodges AFMC Form 260 First Article Requirements

COORDINATORS:

5.

0 1 0

0 1 0

G. PREPARED BY

McAllister, Lisha A

411 SCMS / GULA

478-926-6333

H. DATE

27 OCT 2015

I. APPROVED BY

//DIGITALLY SIGNED//

BRACK.NEIL.M.1073866681

411 SCMS / GULD 478-926-2227 / 468-2227

J. DATE

27 OCT 2015

Page 1 of 1DD FORM 1423-1, FEB 2001 Version 3Generated by PRPS using Jasper Reports on 19 Feb 2016

PREVIOUS EDITION MAY BE USED.

1229940879C Typewritten Text

1229940879C Typewritten Text

BLOCK 14 DISTRIBUTION

DLA Central Receiving/DDWG-ER ATTN: Traci Polk, SOF-PR FA Manager Special Handling, First Article Unit 455 Byron St, Bldg 376 Robins AFB GA 31098-1887

ATTN: FIRST ARTICLE - DO NOT POST

1229940879C Typewritten Text

1229940879C Typewritten Text

1229940879C Typewritten Text

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