A004 - AT Level 1 Training.docx

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item) Form Approved

OMB NO. 0704-D188

Public reporting burden for this collection of information is estimated to average 440 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. listed in Block E.

A. Contract Line Item No.

B. Exhibit:

F C. Category:

TDP |_| TM |_| OTHER |_|

D. System/Item:

Stryker Family of Vehicles

E. Contract/Pr No.

W56HZV-18-R-0048

F. Contractor:

General Dynamics Land Systems

1. Data Item No.:

A004

2. Title of Data Item:

Antiterrorism Level 1 Training Report

3. Subtitle:

Certificate of Compliance

17. Price Group:

4. Authority (Data Acquisition Document No.):

DI-MISC-81356A

5. Contract Reference:

C.1.7

6. Requiring Office:

SFAE-GCS

18. Estimated Total Price:

7. DD 250 Req:

N/A

9. Dist. Statement Required:

N/A

10. Frequency:

Annually

12. Date of First Submission:

See block 16

14. Distribution

8. APP Code:

N/A

11. As of Date:

13. Date of Subsequent Submission:

Annually

a. Addressee:

b. Copies:

16. Remarks:

Block 4 Tailored: Omit g, h, and i from the Certificate of Compliance

Block 12/13: The contractor shall use Government provided training for all contractor personnel supporting the contract who are operating on a DoD controlled installation, facility, or area. AT Level 1 training shall be accomplished NLT 45 days after the contract award date and within 30 calendar days of new employees commencing performance with the results reported to the COR NLT 60 calendar days after contract award. The first and supplemental submissions shall be a letter certifying that the contractor has completed AT Level 1 training along with all certificates of completion.

G. Prepared By:

Diane Mitchell H. Date:

19 April 2018 I. Approved By:

Diane Mitchell

J. Date:

19 April 2018

DD Form 1423-1, JUN 90 (EF) PREVIOUS EDITIONS ARE OBSOLETE Page 1 of 1 Pages