CDRL DD FORM 1423 W56HZV-22-Q-0026 Revised.pdf

DD FORM 1423

Send completed form to the Government Issuing Contracting Officer for the

Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.: 0013

B. EXHIBIT: A

C. CATEGORY: Other _X_

D. SYSTEM/ITEM: Wiring Harness

E. CONTRACT/PR NO.: TDB

F. CONTRACTOR: TBD

G: NSN: 6150-01-451-0294

1. DATA ITEM NO: A001

2. TITLE: TEST/INSPECTION REPORT

3. SUBTITLE: FIRST ARTICLE TEST REPORT (FATR) CONTRACTOR FACILITY

4. AUTHORITY: DI-NDTI-80809B

5. CONTRACT REFERENCE: Section, E.4, E.5, E.6, and SECTION J

6. REQUIRING OFFICE: N/A

7. DD250 REQ: SD

8. APP CODE: A

9. DIST. STATEMENT REQ: C

10. FREQUENCY: ASREQ

11. AS OF DATE: Date of Contract Award

12. DATE OF FIRST SUBMISSION: ASREQ

13. DATE OF SUBS. SUBMISSION: SUBSEQUENT SUBMISSION ONLY IF INITIAL FAT FAILS.

14. DISTRIBUTION:

A. ADDRESSEE:

DCMA ACO: TBD

Contracting Officer: lee.f.tappy.civ@army.mil

Contract Specialist: billie.l.bowmer2.civ@army.mil

B. COPIES: 3

DRAFT: 0

FINAL: 3

REG REPRO: 0

15. TOTAL COPIES: 3

16. REMARKS:

CONTRACTOR FORMAT IS ACCEPTABLE. FATR SHALL BE SUBMITTED ELECTRONICALLY

WITH THE ONLY ACCEPTABLE MEDIA FOR DELIVERY BEING MICROSOFT OFFICE

PRODUCTS (ONLY WORD, EXCEL, POWERPOINT, OR ACCESS), ADOBE PDF (PORTABLE

DOCUMENT FORMAT), OR HTML (HYPERTEXT MARKUP LANGUAGE

THE CONTRACTOR SHALL PROVIDE AT LEAST 20 CALENDAR DAYS ADVANCE NOTICE (IN

WRITING) OF THE SCHEDULED DATE, TIME, AND LOCATION OF START OF FAT, SO

THAT THE GOVERNMENT MAY WITNESS THE TESTS. THE PCO IS THE FAT APPROVER.

THE FAT REPORT IS DUE 10 DAYS AFTER THE FIRST ARTICLE TEST.

mailto:lee.f.tappy.civ@army.mil mailto:billie.l.bowmer2.civ@army.mil

THE GOVERNMENT WILL REVIEW THE FATR AND PROVIDE FEEDBACK TO THE CONTRACTOR

WITHIN 30 DAYS OF RECEIPT OF FATR.

17. PRICE GROUP:

18. ESTIMATED TOTAL PRICE:

G. PREPARED BY: Billie L. Bowmer

H: DATE: 01 April 2022

(THE FOLLOWING IS FOR INFORMATION ONLY AND DOES NOT NEED TO BE PASTED INTO

YOUR CONTRACT DOCUMENT)

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

FOR GOVERNMENT PERSONNEL

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.

FOR CONTRACTOR PERSONNEL

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.

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.

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.

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.

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.

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.