3.__CDRLs.pdf

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

UH1N Helicopter

E. CONTRACT / PR NO.

FD20601800115

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

Item Unique Identification (IUID) Marking Plan

3. SUBTITLE

IUID Validation and Verification Report

4. AUTHORITY

DI-MGMT-81803

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.3.2

6. REQUIRING OFFICE

411 SCMS/GUBAA

7. DD 250 REQ

LT

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

B

10. FREQUENCY

ONE/R

11. AS OF DATE

See Blk 16

12. DATE OF FIRST

SUBMISSION

See Blk 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Blk 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Bryant, Juan LNAME: 11 DEC 2017DATE:

Block 9: Submit to U.S. Government ONLY.

Block 12: Submit written report within 30 days after contract award.

Block 14 a.

Engineer: johnny.mangum@us.af.mil PM: Rodney.mathis@us.af.mil

Purvis, Stephanie MNAME: 10 FEB 2017DATE:

CURRENT VERSION 1

Barzgari, Mohammad JNAME: 27 JAN 2017DATE:

Block 7: DCMA Quality Assurance Representative(QAR) will be responsible for acceptance at source.

Block 10-13: The contractor shall submit a complete IUID Marking Plan within one month after contract award. The Government will review and determine acceptance or rejection and notify contractor within 10 business days of receipt.

If rejected the contractor shall have 10 business days to correct any error and return a corrected IUID Marking Plan to the Government for review.

Block 14: The contractor shall send email notification to the Program Manager:

Yve.Mutchler@us.af.mil or the Program Engineer: Mohammad.Barzgari@us.af.mil.

Block 14: Contract Data Requirements List (CDRL) POC information:

ATTN:

Mohammad (Mike) Barzgari, Program Engineer, 410 SCMS/GUEA, 235 Byron Street, Suite 19A;

Robins AFB, GA 31098-1813;

Phone: DSN 497-2880, Commercial: 478-327-2880 E-mail: Mohammad.Barzgari@us.af.mil.

COORDINATORS:

carol.emanuel@us.af.mil , johnny.mangum@us.af.mil , juan.bryant@us.af.mil

1 1 0

1 1 015. TOTAL

G. PREPARED BY

Bryant, Juan L

411 SCMS / GUBAA

478-327-9381

H. DATE

30 AUG 2018

I. APPROVED BY

//DIGITALLY SIGNED//

STEWART.TODD.RICHARD.1071073277

411 SCMS / GULB 478-926-3258 / 468-3258

J. DATE

30 AUG 2018

Page 1 of 3DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 30 Aug 2018

PREVIOUS EDITION MAY BE USED.

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

TDP TM OTHER X

D. SYSTEM / ITEM

UH1N Helicopter

E. CONTRACT / PR NO.

FD20601800115

F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

Item Unique Identification (IUID) Marking Activity, Validation, and Verification Report

3. SUBTITLE

IUID Validation and Verification Report

4. AUTHORITY

DI-MGMT-81804

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PWS Para 4.3.4

6. REQUIRING OFFICE

411 SCMS/GUBAA

7. DD 250 REQ

LT

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

B

10. FREQUENCY

ONE/R

11. AS OF DATE

See Blk 16

12. DATE OF FIRST

SUBMISSION

See Blk 16

13. DATE OF SUBSEQUENT

SUBMISSION

See Blk 16

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Bryant, Juan LNAME: 11 DEC 2017DATE:

Block 9: Submit to U.S. Government ONLY.

Block 12: Submit written report within 30 days after contract award.

Block 14 a.

Engineer: johnny.mangum@us.af.mil PM: Rodney.mathis@us.af.mil

Holland, Kimberly ANAME: 17 NOV 2016DATE:

BLK 4: Contractor format is acceptable. 100% of the units shall be inspected, evaluated and added to the Activity and Verification Report.

BLK 7: Contractor shall submit each report with a letter of transmittal. The last report shall summarize all reports and shall be submitted on DD Form 250 for payment.

BLK 9: Distribution authorized to U.S. Government agencies and their contractors (Administrative or Operational Use 03May2013). Other requests shall be referred to jonathan.pitt@us.af.mil

BLK 10, 11, 12 and 13: The first report shall be submitted within 10 days after the first three full months after contract award. Reporting shall continue on a quarterly basis to be received no later than the 10th day of the quarter following the end of the report period. Quarterly reports shall be submitted by e-mail.

COORDINATORS:

carol.emanuel@us.af.mil , johnny.mangum@us.af.mil , juan.bryant@us.af.mil

1 1 0

1 1 015. TOTAL

G. PREPARED BY

Bryant, Juan L

411 SCMS / GUBAA

478-327-9381

H. DATE

30 AUG 2018

I. APPROVED BY

//DIGITALLY SIGNED//

STEWART.TODD.RICHARD.1071073277

411 SCMS / GULB 478-926-3258 / 468-3258

J. DATE

30 AUG 2018

Page 2 of 3DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 30 Aug 2018

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

TDP X TM OTHER

D. SYSTEM / ITEM

UH1N Helicopter

E. CONTRACT / PR NO.

FD20601800115

F. CONTRACTOR

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

First Article Test Plan

3. SUBTITLE

N/A

4. AUTHORITY

DI-NDTI-81307A/T

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PR# FD206018115 (03)

6. REQUIRING OFFICE

AFLCMC/WIUEC

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

11. AS OF DATE

N/A

12. DATE OF FIRST

SUBMISSION

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Bryant, Juan LNAME: 10 AUG 2018DATE:

NAME: Carol Emanuel IAW DI-NDTI-81307A/T and AFMC 260 Submission Date: 30 days prior to testing

COORDINATORS:

carol.emanuel@us.af.mil , johnny.mangum@us.af.mil , juan.bryant@us.af.mil

1 1 0

1 1 015. TOTAL

G. PREPARED BY

Bryant, Juan L

411 SCMS / GUBAA

478-327-9381

H. DATE

30 AUG 2018

I. APPROVED BY

//DIGITALLY SIGNED//

STEWART.TODD.RICHARD.1071073277

411 SCMS / GULB 478-926-3258 / 468-3258

J. DATE

30 AUG 2018

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

TDP X TM OTHER

D. SYSTEM / ITEM

UH1N Helicopter

E. CONTRACT / PR NO.

FD20601800115

F. CONTRACTOR

1. DATA ITEM NO.

A004

2. TITLE OF DATA ITEM

Test/Inspection Report

3. SUBTITLE

First Article Test Report

4. AUTHORITY

DI-NDTI-80809B/T

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

PR# FD20601800115-03 / AFMC 260

6. REQUIRING OFFICE

AFLCMC/WIUEC

7. DD 250 REQ

LT

8. APP CODE

N/A

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

11. AS OF DATE

N/A

12. DATE OF FIRST

SUBMISSION

N/A

13. DATE OF SUBSEQUENT

SUBMISSION

N/A

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

Bryant, Juan LNAME: 10 AUG 2018DATE:

NAME: Carol Emanuel - Engineer IAW DI-NDTI-80809B/T and AFMC 260 Submission Date: 30 days after completion of study.

COORDINATORS:

carol.emanuel@us.af.mil , johnny.mangum@us.af.mil , juan.bryant@us.af.mil

1 1 0

1 1 015. TOTAL

G. PREPARED BY

Bryant, Juan L

411 SCMS / GUBAA

478-327-9381

H. DATE

30 AUG 2018

I. APPROVED BY

//DIGITALLY SIGNED//

STEWART.TODD.RICHARD.1071073277

411 SCMS / GULB 478-926-3258 / 468-3258

J. DATE

30 AUG 2018

Page 3 of 3DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 30 Aug 2018