Attachment_0061_-_Identification_and_Assertion_of_Restrictions.xlsx

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Attachment 0061 IDENTIFICATION AND ASSERTION OF RESTRICTIONS

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UNCLASSIFIED

Attachment 0061 - Identification and Assertion of Restrictions on the Government's Use, Release, or Disclosure of Technical Data and Computer Software

26 July 2017

Distribution Statement A – Approved for Public Release; distribution unlimited (*Distribution Statement A only applies when form is not filled in. ) Once filled in the following Distribution statement applies: DISTRIBUTION B: The Product Manager Applique and Large Unmanned Ground Systems (PdM ALUGS), authorizes secondary distribution, release, and dissemination to the extent permitted by this distribution statement without additional approvals or authorizations. Secondary distribution authorized to U.S. Government agencies only (proprietary information, 04 May 2017). Other requests for this document shall be referred to the PdM ALUGS, 1414 W. Perimeter Rd., Selfridge ANGB, 48015.
UNCLASSIFIED

Instructions

UNCLASSIFIED
W56HZV-15-R-0156
Attachment 0061-

Identification and Assertion of Restrictions on the Government's Use, Release, or Disclosure of Technical Data and Computer Software

Instructions for completing this attachment

Technical Data and Computer Software to be Furnished With Restrictions*
For technical data (other than computer software documentation) pertaining to items, components, or processes developed at private expense, identify both the deliverable technical data and each such item, component, or process. For computer software or computer software documentation identify the computer software or documentation.
BOM Level: The offeror shall identify the level of the Indentured BOM corresponding to the technical data and computer software
Hardware or Computer Software: The offeror shall identify if the item is hardware or computer software. If computer software, the offeror must identify if it is object code/executable software or source code. If both, enter under two separate item ID's and on two separate rows.
Drawing Number: The offeror shall enter the drawing number for the technical data. For example: “12345678”.
Item Description: The offeror shall enter a description of the technical data or computer software which conveys the usage, function, and location of the item. For example, in the case of a pressure relief valve, a description would be "Pressure relief safety valve mounted to the pneumatic system air tanks.”
CDRL Number: The offeror shall identify the CDRL number that the technical data is being delivered under. For example: "CDRL_A024" .
Basis of Assertion**
Generally, development at private expense, either exclusively or partially, is the only basis for asserting restrictions. For technical data, other than computer software documentation, development refers to development of the item, component, or process to which the data pertain. The Government's rights in computer software documentation generally may not be restricted. For computer software, development refers to the software. Indicate whether development was accomplished exclusively or partially at private expense. If development was not accomplished at private expense, or for computer software documentation, enter the specific basis for asserting restrictions.
Asserted Rights Category***
Enter asserted rights category (e.g., government purpose license rights from a prior contract, rights in SBIR data generated under another contract, limited, restricted, or government purpose rights under this or a prior contract, or specially negotiated licenses).
Name of Person Asserting Restrictions****
Corporation, individual, or other person, as appropriate.
*****Enter “none” when all technical data or computer software will be submitted without restrictions.
Note: For each Item identified on the offeror's assertion of restrictions, the text entered in the Asserted Rights Category shall reflect the offeror's final proposal regarding data rights. For example see Item ID "2" in the tab titled "SAMPLE" (within this spreadsheet) - the item was developed exclusively at private expense and the offeror's final proposal regarding data rights is Government purpose rights.

Signature: As Attachment_0061 is an Assertion of Restrictions listing, it shall be dated and signed by an official authorized to contractually obligate the Offeror IAW DFARS 252.227-7017. The signature line can be found at the bottom of the tab titled "Hardware and Computer Software".

Distribution Statement A – Approved for Public Release; distribution unlimited (*Distribution Statement A only applies when form is not filled in. ) Once filled in the following Distribution statement applies: DISTRIBUTION B: The Product Manager Applique and Large Unmanned Ground Systems (PdM ALUGS), authorizes secondary distribution, release, and dissemination to the extent permitted by this distribution statement without additional approvals or authorizations. Secondary distribution authorized to U.S. Government agencies only (proprietary information, 04 May 2017). Other requests for this document shall be referred to the PdM ALUGS, 1414 W. Perimeter Rd., Selfridge ANGB, 48015.
UNCLASSIFIED

Hardware and Computer Software

UNCLASSIFIED
W56HZV-15-R-0156
Attachment 0061 - Identification and Assertion of Restrictions on the Government's Use, Release, or Disclosure of Technical Data and Computer Software

Technical Data and Computer Software to be Furnished With Restrictions* Contractor Format TDP and Computer Software with the level of data rights guaranteed to the Government by law

For the Contractor Format TDP and Computer Software required under Performance Work Statement section C.5.11, C.8.3.1, C.21.5.11, and C.21.8.3.1 the Offeror asserts for itself, or the persons identified below, that the following assertions will apply: Gov't Format TDP and Computer Software Option, with Greater Rights (if proposed)

If the Government Format TDP and Computer Software Option as described under Statement of Work Section C.24 is exercised, the Offeror asserts for itself, or the persons identified below, that the following assertions will apply:

Identification of ItemIdentification of Data
Item IDBOM LevelHardware or Computer SoftwareDrawing NumberItem DescriptionCDRL NumberBasis for Assertion**Asserted Rights Category***Name of Person Asserting Restrictions****Basis for Assertion**Asserted Rights Category***Name of Person Asserting Restrictions****
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Date:
Printed Name and Title

Signature

(End of identification)

UNCLASSIFIED

File: &F Page &P of &N

SAMPLE

UNCLASSIFIED
W56HZV-15-R-0156
Attachment 0061 -

Identification and Assertion of Restrictions on the Government's Use, Release, or Disclosure of Technical Data and Computer Software

Technical Data and Computer Software to be Furnished With Restrictions*Basis for Assertion**Asserted Rights Category***Name of Person Asserting Restrictions****
Identification of ItemIdentification of Data
Item IDBOM LevelHardware or Computer SoftwareDrawing NumberItem DescriptionCDRL Number
1Hardware12345678Weldment, Ramp, Front: Front Ramp weldment without mounting hardware or top coatA023Developed exclusively at private expenseLimited rightsUSA Defense LLC
2Hardware34567890Weldment, Ramp, Rear: Rear Ramp weldment without mounting hardware or top coatA024Developed exclusively at private expenseGovernment purpose rightsUSA Defense LLC
3Hardware12367845Transmission mounting bracket, FrontA024Developed partially at private expenseGovernment purpose license rights from a prior contractUSA Defense LLC
4Software11111111Source Code, Non-commercial Computer Software, C4I/CEN Enclave, Computer XXA122Developed partially at private expenseGovernment purpose rightsUSA Defense LLC
5Software22222222Executable Code, Non-commercial Computer Software, C4I/CEN Enclave, Computer XXA115Developed partially at private expenseGovernment purpose rightsUSA Defense LLC
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Printed Name and Title

Signature

(End of identification) (End of identification) (End of identification)

UNCLASSIFIED

File: &F Page &P of &N

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