Exhibit G - CDRL XM111.pdf

PDF 3 MB Posted

Attached to
Grenade Consolidation - Presolicitation Notice
Solicitation number
W52P1J-19-R-0032
Issued by

About this file

This document provides notice of a future consolidated federal contract solicitation. The Army Contracting Command - Rock Island intends to issue a Request for Proposal to consolidate requirements for several grenade and grenade fuze items. The solicitation will result in multiple award, firm-fixed price IDIQ contracts with a total potential value of $1 billion over five ordering periods and a period of performance of five years. Eligible contractors are those registered with the U.S./Canada Joint Certification Office and able to access the technical data packages, which are classified as Distribution D limited. The response date listed is for archive purposes only, with the actual due date to be specified in the forthcoming solicitation to be issued on or around June 1, 2020 via beta.SAM.gov.

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Other files

File Type Posted
Attachment 0001 - Price Evaluation Matrix - Rev 2.xlsx XLSX spreadsheet
W52P1J19R0032-0006.pdf PDF
W52P1J19R0032-0005.pdf PDF
W52P1J19R0032-0004.pdf PDF
Attachment 0001 - Price Evaluation Matrix - Rev 1.xlsx XLSX spreadsheet
W52P1J19R0032-0003.pdf PDF
Attachment 0030 - 900-20 Inert Molding Powder.pdf PDF
W52P1J19R0032-0002.pdf PDF
Attachment 0009 -SMALL_BUSINESS_PARTICIPATION.pdf PDF
Attachment 0025 - TDPL M208.pdf PDF
W52P1J19R0032-0001.pdf PDF
Attachment 0023 - TDPL M201 Mod 3.pdf PDF
Attachment 0024 - TDPL_M201A1.pdf PDF
Attachment 0019 - R20G2005_CushionDisk_Drawing.pdf PDF
Attachment 0020 - R19K2020_mortar_ammo_packaging_adhesive.pdf PDF
Exhibit F - CDRL M208.pdf PDF
Attachment 0018 - R20G2002_M208_COAI_reference_Pull_Requirement.pdf PDF
W52P1J19R0032.pdf PDF
Attachment 0024 - TDPL_M201A1.pdf PDF
Attachment 0010 Hazardous_Material_Label M67 XM111.pdf PDF
Attachment 0021 - R19G5001_M213_CushionDisk_SpecUpdate_Final (003).pdf PDF
Attachment 0005 OPSEC SOW.pdf PDF
Attachment 0025 - TDPL M208.pdf PDF
Attachment 0016 - R19G2003 XM112 POHG Spec Release.pdf PDF
Exhibit B - CDRL M228.pdf PDF
Attachment 0003 ASSIST Instructions.pdf PDF
Attachment 0026 - TDPL M67.pdf PDF
Attachment 0002 Guidance on Documentation of CDRL.pdf PDF
Attachment 0019 - R20G2005_CushionDisk_Drawing.pdf PDF
Exhibit A - CDRL M67.pdf PDF
Exhibit C - CDRL M213.pdf PDF
Attachment 0001 Price Evaluation Matrix.xlsx XLSX spreadsheet
Exhibit E - CDRL M201A1 Mod 3.pdf PDF
Attachment 0007 - Government Furnished Property.pdf PDF
Attachment 0014 Hazardous_Material_Label M208.pdf PDF
Attachment 0023 - TDPL M201 Mod 3.pdf PDF
Attachment 0012 Hazardous_Material_Label M213.pdf PDF
Exhibit D - CDRL M201A1.pdf PDF
Attachment 0028 - TDPL M213 W_Clip.pdf PDF
Attachment 0029 - TDPL M111.pdf PDF
Attachment 0004 SECURITY STATEMENT OF WORK Reference Document Jan 2020.pdf PDF
Attachment 0020 - R19K2020_mortar_ammo_packaging_adhesive.pdf PDF
Attachment 0009 -SMALL_BUSINESS_PARTICIPATION.pdf PDF
Attachment 0006 OPSEC SAMPLE AQUISITION PLAN.pdf PDF
Attachment 0027 - TDPL M228.pdf PDF
Attachment 0013 Hazardous_Material_Label M201A1_ M201A1 Mod 3.pdf PDF
Attachment 0017 - R20G2008_Dichromating_Req.pdf PDF
Attachment 0008 Disclosure of Lobbying Activities.pdf PDF
Attachment 0022 - TDPL_ M112.pdf PDF
Attachment 0011 Hazardous_Material_Label M228.pdf PDF
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Text version

G. PREPARED BY

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

Designed using Perform Pro, WHS/DIOR, Aug 96

A001

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A002

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A003

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER _________________________

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, AUG 96 (EG) Page ____ of ____ Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

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

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

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

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

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, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

(1 Data Item)

Form Approved OMB No. 0704-

Public reporting burden for this collection of information is estimated to average 220 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 the Contract/PR No.

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

TDP TM OTHER

E. CONTRACT / PR NO.

4I9A09O6M2

F. CONTRACTOR D. SYSTEM/ITEM

Grenade, Hand, Offensive, MK3 Series w/Fuze

1. DATA ITEM NO.

A016

2. TITLE OF DATA ITEM

REQUEST FOR VARIANCE (RFV)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Documentation No.)

DI-SESS-80640D

5. CONTRACT REFERENCE

SECTION C SOW

6. REQUIRING OFFICE

FCDD-ACE-SP

7. DD 250 REQ.

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF

SUBSEQUENT

SUBMISSION

ASREQ

Draft Final

Reg Repro

16. REMARKS:

DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (i.e., MICROSOFT OFFICE OR PORTABLE DOCUMENT FORMAT (pdf)).

*DISTRIBUTION STATEMENT WILL BE ASSIGNED AND IMPLEMENTED BY

THE DOD CONFIGURATION CONTROL AUTHORITY. THE PREFERRED

METHOD FOR SUBMITTAL IS DD FORM 1694 LOCATED AT http:// www.dtic.mil/whs/directives/infomgt/forms/. SUBMIT ELECTRONICALLY TO usarmy.pica.rdecom-ardec.mbx.ecp-document@mail.mil; COPY FURNISH

THIS SUBMITTAL TO THE GOVERNMENT CONTRACTING OFFICE.

ACO 0 1 0

PCO 0 1 0

15. TOTAL 0 2 0

H. DATE

3/17/2020

I. APPROVED BY J. DATE

DD FORM 1423-1 FEB 2001 PREVIOUS EDITIONS MAY BE USED. Page 1 of 7 Pages

K. Mosher for SDMO, FCDD-ACE-SP

(1 Data Item)

Form Approved OMB No. 0704-

Public reporting burden for this collection of information is estimated to average 220 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 the Contract/PR No.

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

TDP TM OTHER

E. CONTRACT / PR NO.

4I9A09O6M2

F. CONTRACTOR D. SYSTEM/ITEM

1. DATA ITEM NO.

A017

2. TITLE OF DATA ITEM

ENGINEERING CHANGE PROPOSAL (ECP)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Documentation No.)

DI-SESS-80639D

5. CONTRACT REFERENCE

SECTION C SOW

6. REQUIRING OFFICE

FCDD-ACE-SP

7. DD 250 REQ.

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF

SUBSEQUENT

SUBMISSION

ASREQ

Draft Final

Reg Repro

16. REMARKS:

DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (i.e., MICROSOFT OFFICE OR PORTABLE DOCUMENT FORMAT (pdf)).

*DISTRIBUTION STATEMENT WILL BE ASSIGNED AND IMPLEMENTED BY

THE DOD CONFIGURATION CONTROL AUTHORITY. THE PREFERRED

METHOD FOR SUBMITTAL IS DD FORM 1692 LOCATED AT http:// www.dtic.mil/whs/directives/infomgt/forms/. SUBMIT ELECTRONICALLY TO usarmy.pica.rdecom-ardec.mbx.ecp-document@mail.mil; COPY FURNISH THIS

SUBMITTAL TO THE GOVERNMENT CONTRACTING OFFICE.

ACO 0 1 0

PCO 0 1 0

15. TOTAL 0 2 0

H. DATE

3/17/2020

I. APPROVED BY J. DATE

DD FORM 1423-1 FEB 2001 PREVIOUS EDITIONS MAY BE USED. Page 2 of 7 Pages

DD FORM 1423-1 FEB 2001 PREVIOUS EDITIONS MAY BE USED. Page 3 of 7 Pages

(1 Data Item)

Form Approved OMB No. 0704-

Public reporting burden for this collection of information is estimated to average 220 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 the Contract/PR No.

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

TDP TM OTHER

E. CONTRACT / PR NO.

4I9A09O6M2

F. CONTRACTOR D. SYSTEM/ITEM

1. DATA ITEM NO.

A018

2. TITLE OF DATA ITEM

NOTICE OF REVISION (NOR)

3. SUBTITLE

4. AUTHORITY (Data Acquisition Documentation No.)

DI-SESS-80642D

5. CONTRACT REFERENCE

SECTION C SOW

6. REQUIRING OFFICE

FCDD-ACE-SP

7. DD 250 REQ.

LT

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF

SUBSEQUENT

SUBMISSION

ASREQ

Draft Final

Reg Repro

16. REMARKS:

DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (i.e., MICROSOFT OFFICE OR PORTABLE DOCUMENT FORMAT (pdf)).

*DISTRIBUTION STATEMENT WILL BE ASSIGNED AND IMPLEMENTED BY

THE DOD CONFIGURATION CONTROL AUTHORITY. THE PREFERRED

METHOD FOR SUBMITTAL IS DD FORM 1695 LOCATED AT http:// www.dtic.mil/whs/directives/infomgt/forms/. SUBMIT ELECTRONICALLY TO usarmy.pica.rdecom-ardec.mbx.ecp-document@mail.mil; COPY FURNISH THIS

SUBMITTAL TO THE GOVERNMENT CONTRACTING OFFICE.

ACO 0 1 0

PCO 0 1 0

15. TOTAL 0 2 0

H. DATE

3/17/2020

I. APPROVED BY J. DATE

DD FORM 1423-1 FEB 2001 PREVIOUS EDITIONS MAY BE USED. Page 4 of 7 Pages

(1 Data Item)

Form Approved OMB No. 0704-

Public reporting burden for this collection of information is estimated to average 220 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 the Contract/PR No.

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

TDP TM OTHER

E. CONTRACT / PR NO.

4I9A09O6M2

F. CONTRACTOR D. SYSTEM/ITEM

1. DATA ITEM NO.

A019

2. TITLE OF DATA ITEM

Operations Security (OPSEC) Plan

3. SUBTITLE

4. AUTHORITY (Data Acquisition Documentation No.)

DI-MGMT-80934C

5. CONTRACT REFERENCE

OPSEC SOW

6. REQUIRING OFFICE

AMSJM-FP/G2

7. DD 250 REQ.

XX

9. DIST

STATEMENT

REQUIRED

D

10. FREQUENCY

ONE/R

12. DATE OF FIRST SUBMISSION

ASREQ

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

8. APP CODE

A

11. AS OF DATE

ASREQ

13. DATE OF

SUBSEQUENT

SUBMISSION

ASREQ

Draft Final

Reg Repro

16. REMARKS:

DELETE REFERENCE 'APPLYING OPSEC TO U.S. GOVERNMENT

CONTRACTS'. REPLACE WITH REFERENCE 'SAMPLE ACQUISITIONS

OPSEC PLAN'. 10 CALENDAR DAYS REQUIRED FOR GOVERNMENT

REVIEW AND APPROVAL. *30 CALENDAR DAYS AFTER THE

CONTRACTING OFFICER PROVIDES THE LIST OF KNOWN CRITICAL

INFORMATION (CI)/THREAT INFORMATION. ** RESUBMIT 10

CALENDAR DAYS AFTER GOVERNMENT REVIEW. SUBMIT

ELECTRONICALLY TO usarmy.ria.jmc.mbx.OPSEC-FD@mail.mil.

JMC OPSEC 0 1 0

PCO 0 1 0

15. TOTAL 0 2 0

H. DATE

3/17/2020

I. APPROVED BY J. DATE

1. DATA ITEM NO.

17. PRICE

GROUP

A020

18. ESTIMATED

TOTAL PRICE

XX

8. APP CODE

0 1 0

Page: 5 of 7DD Form 1423-1, FEB 2001 Previous editions may be used.

15. TOTAL

G. PREPARED BY

K. Mosher for SDMO, FCDD-ACE-SP

H. DATE

3/17/2020

I. APPROVED BY J. DATE

A N/A Reg Repro N/A

16. REMARKS

SUBMIT PROCEDURE FOR APPROVAL 60 DAYS PRIOR TO FIRST ARTICLE TEST OR PRODUCTION IF FIRST

ARTICLE IS NOT APPLICABLE. ALLOW 28 DAYS FOR APPROVAL/DISAPPROVAL THROUGH THE

CONTRACTING OFFICER. SUBMIT ELECTRONICALLY TO usarmy.ria.ardec.mbx.ri-corrosion-team@mail.mil and usarmy.ria.rdecom-ardec.mbx.ardec-pre-production-data@mail.mil. CONTRACTOR SHALL RESUBMIT WITH GOVERNMENT REVISIONS WITHIN 10 DAYS. FCDD-ACE-QP(R) SHALL PROVIDE PROCEDURE REVIEW RESPONSE BACK TO CONTRACTING OFFICER. COATED PANELS PER PARA 3.2.2 SHALL INCLUDE THREE WITH PHOSPHATE ONLY, THREE WITH PHOSPHATE AND PRIMER, AND THREE

WITH PHOSPHATE, PRIMER AND TOP COAT. A DD FORM 250 IS NOT REQUIRED FOR PHOSPHATE

COATING PROCEDURAL APPROVAL. CONTRACTOR FORMAT ACCEPTABLE. WRITTEN PROCEDURES

SHALL BE SUBMITTED USING A PC COMPATIBLE FORMAT (I.E. PDF, RICH TEXT FORMAT (RTF), OR WORD

FILE). THE PANELS SHALL BE MAILED TO THE FOLLOWING ADDRESS:

Combat Capabilities Development Command Armaments Center Attn: FCDD-ACE-QP/Mark Godlewski 1 Rock Island Arsenal Bldg. 62 2nd Floor, NW Wing Rock Island, IL 61299-7300

ARDEC

N/A

ONE/R ASREQ

a. ADDRESSEE

b. COPIES

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

Draft

Final

7. DD 250 REQ

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

4. AUTHORITY (Data Acquisition Document

No.)

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

DI-NDTI-80603A TT-C-490, TYPE 1, PARAS 3.2.1, 3.2.2 FCDD-ACE-QP

2. TITLE OF DATA ITEM

TEST PROCEDURE

3. SUBTITLE

PRE-PRODUCTION PROCEDURE --Phosphate Coating

TDP____________ TM____________ OTHER____________

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

4I9A09O6M2

F. CONTRACTOR

CONTRACT DATA REQUIREMENTS LIST

(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 the 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

Form Approved

OMB No. 0704-0188

10 0

1. DATA ITEM NO.

17. PRICE

GROUP

A021

18. ESTIMATED

TOTAL PRICE

LT

8. APP CODE

0 1 0

0 1 0

Page: 6 of 7DD Form 1423-1, FEB 2001 Previous editions may be used.

15. TOTAL

G. PREPARED BY

K. Mosher for SDMO FCDD-ACE-SP

H. DATE

3/17/2020

I. APPROVED BY J. DATE

RDAR-EIL-P

N/A N/A Reg Repro

ASREQ

16. REMARKS

30 DAYS PRIOR TO FIRST ARTICLE TEST. REPORT TITLE SHALL INCLUDE ITEM NAME AND MODEL

NUMBER OF THE AMMUNITION THAT GOES INTO THE PACKAGE. IF ITEM IS A COMPONENT OF

AMMUNITION, THE AMMUNITION SYSTEM THAT THE ITEM IS USED ON SHALL ALSO BE INCLUDED.

REPORT SHALL BE SUBMITTED ELECTRONICALLY VIA E-MAIL TO

YUEN.H.LAM.CIV@MAIL.MIL AND JOSEPH.W.HANSSEN.CIV@MAIL.MIL SAVED IN RICH TEXT

FORMAT (RTF), ASCII OR PDF FORMAT. SUBMIT EVERY TWO (2) YEARS.

ARDEC PACKAGING

N/A

ASREQ ASREQ

a. ADDRESSEE

b. COPIES

11. AS OF DATE

13. DATE OF SUBSEQUENT SUBMISSION

Draft

Final

7. DD 250 REQ

9. DIST

STATEMENT

REQUIRED

10. FREQUENCY 12. DATE OF FIRST SUBMISSION

14. DISTRIBUTION

5. CONTRACT REFERENCE 6. REQUIRING OFFICE

4. AUTHORITY (Data Acquisition Document

No.)

DI-PACK-81059A SECTION D RDAR-EIL-TP (RI)

2. TITLE OF DATA ITEM

PERFORMANCE ORIENTED PACKAGING TEST REPORT

3. SUBTITLE

TDP____________ TM____________ OTHER____________

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

4I9A09O6M2

F. CONTRACTOR

CONTRACT DATA REQUIREMENTS LIST

(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 the 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

Form Approved

OMB No. 0704-0188

QA CDRL Distribution block - IPT members list Distribution with specific contact information will be provided at Post Award

PQM – Product Quality Manager

PCO – Procuring Contracting Officer

CS – Contract Specialist

QAR – Quality Assurance Representative

PO or PM – Project Officer or Project Manager

AQE – Army Quality Engineer

APO - Army Lead Engineer (Project Officer)

DA – Design Agent (NAVSEA)

PL – Project Lead (NAVAIR)

NQA – Navy Quality Assurance

ME – Material Engineer (NAVAIR)

PE – Program Engineer (Air Force)

AEA – Acquisition Engineering Agent (NAVSEA) GE – Gage Engineer

Production Manager, JMC - Production Manager, Joint Munitions Command

MCEA – Marine Corp Engineering Activity

CDM – Configuration/Data Management (NAVAIR)

WARP - Worldwide Ammunition-Data Repository Program

SAFE - Safe Access File Exchange

FOR GOVERNMENT PERSONNEL FOR THE CONTRACTOR

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package; TM -

Technical Manual; Other - other category of data, such as

"Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award). Item F. Self-explanatory (to be filled in after contract award). Item G. Signature of preparer of

CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the

Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15. Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items

12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data. These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required.

The estimated data prices shall not include any amount for rights in data. The

Government's right to use the data shall be governed by the pertinent provisions of the contract.

DD FORM 1423 (BACK)

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the

Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form

1423.

INSTRUCTIONS FOR COMPLETING DD FORM 1423

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form

1423.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the

Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD

Form 1423 at no cost.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the

Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

7Page 7 of

Distro List
Instructions
CDRL M67 T.pdf
POP_pennock.pdf
A001 - TDP (2018-01-29)
A002 - CICL (2018-01-16)
A003 - MSE (2018-01-16)
A004 - CCCP (2018-01-16)
A005 - Light Phosphate (2018-01-16)
A006 - Heavy Phosphate (2018-01-16)
A007 - QPP (2018-01-16)
A008 - FAT PLAN (2018-01-16)
A009 - SPC (2018-01-16)
A010 - PAITP (2018-01-16)
A011 - FATR (2018-01-29)
A012 - ADC (2018-01-29)
A013 - CPOA (2018-01-16)
A014 - NOR (2018-01-16)
A015 - FACAR (2018-01-16)
A016 - ECP (2018-01-16)
A017 - RFV (2018-01-29)
A018 - Loading Authorization and Descriptive Sheets (2018-01-29)
A019 - LATR (2018-01-11)
A020 - Notification of Critical (2018-01-29)
A021 - Critical Investigation and Restart (2018-01-16)
4A8A18QDM2_gfm.pdf
80438A
INSTRUCTIONS_for_adding.pdf
80603L
80934a
80639
80640
80642
81722
80043
81307
81315
80809B
81987spc
Instructions
spc_81987.pdf
81987_spc
number:
ADC CDRL #: A012
ADC Title: Ammunition Data Card (ADC)
ADC Subtitle: Data Input
ADC DID: DI-MISC-80043 (Current Revision)
ADC Contract Reference: Section: C, MIL-STD-1168
ADC DD250: XX
ADC Freq: ASREQ
ADC Submission: ASREQ
ADC second Sub: ASREQ
ADC Remarks: BLK 12: Sample ADC shall be submitted into the Munitions History Program (MHP) system and approved prior to First Article Testing (FAT) or initiation of production if FAT is not required. ADCs shall be prepared IAW MIL-STD-1168 by accessing the data repository system WARP on the Munitions History Program website at https://mhpwarp.redstone.army.mil/.

BLK 10/13: An ADC shall be submitted with each lot.

Hard copy ADC provided with lot shipments shall be generated from the WARP and signed/dated by the Government Agency Responsible for Acceptance (GARA).

When ballistic test are required, one hard copy ADC generated from the WARP and signed/dated by the GARA shall be sent to the Proving Ground with sample shipment, plus an additional signed/dated, hard copy provided to the Proving Ground by mail.

If the critical characteristic requirement is in the contract, the critical characteristic information fields in WARP for the ADC shall be completed for each lot.

TDP:
A0(CDRL#):
Exhibit:
TM:
E CONTRACTPR NO:
F CONTRACTOR:
17:
18:
H DATE:
Draft15 TOTAL: 0
Repro15 TOTAL: 0
J DATE:
PCCI OTHER: MGMT
PCCI CONTRACTPR NO:
PCCI CDRL #: A008
PCCI TITLE OF DATA ITEM: Management Plan
PCCI SUBTITLE: PROCESS CONTROL PLAN (PCP)
PCCI Authority: DI-MGMT-80004 (Current Revision)
PCCI CONTRACT REFERENCE: Section: E
PCCI DD 250: LT
PCCI FREQUENCY: ONE/R
PCCI DATE OF FIRST SUBMISSION: 90DAC
PCCI AS OF DATE: N/A
PCCI DATE OF SUBSEQUENT SUBMISSION: ASREQ
PCCI Remarks: BLK 12: The Contractor shall submit initial PCP no later than 90 calendar days after contract award. The Government will respond within 30 calendar days of initial submission. If further revisions are necessary, the Contractor shall have 15 calendar days to generate them and the Government shall have 15 calendar days to review and respond to them. The PCP shall be approved prior to the First Article or start of production if a First Article is not required. Disposition of the PCCI submission will be provided through the Procuring Contracting Officer.

BLK 13: If Contractor revises a previously Government accepted PCP, the revised PCP must be submitted to the Government for acceptance before it is released for use. The Government will respond within 15 working days.

BLK 14: Submit electronically via email or SAFE https://safe.amrdec.army.mil/safe/Welcome.aspx.

Specific email addresses for the distribution list will be provided after contract award.

A PCCI Review Guide is available to assist Contractors on the ARDEC Public Website (http://www.ardec.army.mil/organizations/QESA/) in the application of the PCCI Clause. The PCCI Review Guide's content, in its entirety, is provided solely for REFERENCE and GUIDANCE PURPOSES ONLY- it is not, nor is it intended to be, contractually binding. Accordingly, the information contained within the PCCI Review Guide is expressly not, nor shall it be construed to be, incorporated either directly or by reference into the terms of the PCCI clause itself nor into the terms and conditions of any underlying contract which contains the PCCI clause.

MSE OTHER: QCIC
MSE CDRL #: A009
MSE TITLE OF DATA ITEM: Measurement System Evaluation (MSE) – Measurement and Inspection Equipment System Design Documentation for Acce
MSE SUBTITLE: Measurement System Evaluation/Acceptance Inspection Equipment (MSE/AIE)
MSE Authority: DI-QCIC-81960 (Current Revision)
MSE CONTRACT REFERENCE: Section: E
MSE DD 250: DD
MSE FREQUENCY: ONE/R
MSE DATE OF FIRST SUBMISSION: 120DAC
MSE DATE OF SUBSEQUENT SUBMISSION: ASREQ
CCCP OTHER: MGMT
CCCP CDRL #:
CCCP TITLE OF DATA ITEM: Critical Characteristics Control Plan (CCCP)
CCCP SUBTITLE: N/A
CCCP CONTRACT REFERENCE: Section: E
CCCP DD 250: LT
CCCP FREQUENCY: ANNLY
CCCP DATE OF FIRST SUBMISSION: 120DAC

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