Attachment_10_Data_Item_Form.doc

DATA ITEM TRANSMITTAL/ACCEPTANCE/REJECTION FORM

Contract No.: TBD

CLIN/ELIN: ____ ___/______ TITLE:______________________________

Block 14 Distribution:

Other:

Doc. Ref. No.:______________________________Date:______________________________

From:

To: Department of the Army, U.S. Army Contracting Command-Orlando 12211 Science Drive, Orlando FL 32826-3224 Orlando, FL 32826 ATTN: Glenda Torres

The above detailed CDRL item is forwarded for review and acceptance/ rejection. This item is due __________________The Government review period is _______days.

Signature:

Typed Name/Title: _________________________________

FIRST ENDORSEMENT: _________________________________ Date Received:____________

( ) Accepted.

( ) Accepted. Attached comments must be incorporated into the next scheduled submission for periodic submissions or within the period provided within the DD1423 for non-periodic submissions.

( ) Rejected, comments attached. Change pages ( ) are ( ) not sufficient for correction. Contractor is allowed ( ) 30 days or ( ) days to resubmit.

Signature:

Typed Name/Title: ____________________________________

Code: ____________ Date: _____________

VIA: PD:_____ Date:_____

VIA: CS:_____ Date:_____

SECOND ENDORSEMENT: ___________________________________

( ) Accepted.

( ) Accepted conditionally. Attached comments must be incorporated in the next scheduled submission for periodic submissions or within the period provided within the DD1423 for non-periodic submissions.

( ) Rejected, comments attached. Resubmit no later than ____________ Signature:

Typed Name/Title:______________________________ Date: ____________ Contracting Officer

CC w/Encl.:

CC w/o Encl.: