A01_-_DD1423.doc

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CONTRACT DATA REQUIREMENTS LIST

(1 Data Item) Form Approved

OMB No. 0704-0188

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 collecton 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 and Communications Directorate (0704-1088). 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

A

C. CATEGORY:

TDP_____ TM ______ OTHER: MGMT

D. SYSTEM/ITEM

Geometry Editing, Mending, Development and Engineering Analysis of Ground Systems

E. CONTRACT/PR NO.

PR# 0010716456/W911QX-16-T-0021

F. CONTRACTOR

To Be Provided at Contract Award

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

STATUS REPORT

3. SUBTITLE

STATUS REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-MGMT-80368A

5. CONTRACT REFERENCE

PWS C.5.1

6. REQUIRING OFFICE

RDRL-SLB-G

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

MONTHLY

12. DATE OF FIRST SUBMISSION

NLT 30 DAYS ACA

14.

DISTRIBUTION

8. APP CODE

N/A

11. AS OF DATE

N/A

13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16

16. REMARKS

BLK 4: IN ADDITION TO PAPER COPIES, EACH REPORT SHALL BE DELIVERED ELECTRONICALLY IN A MEDIA SELECTED BY THE GOVERNMENT AT THE TIME OF DELIVERY. SOME MEDIA TYPES WHICH CAN BE ACCEPTED INCLUDE: FTP (FILE TRANSFER PROTOCOL), CD-ROM AND DVD-ROM, EMAIL IS ACCEPTABLE.

BLK 13: SUBSEQUENT SUBMISSIONS SHALL BE MADE NLT THE 10TH DAY OF THE MONTH FOLLOWING THE PERIOD OF PERFORMANCE REPORTING ON.

G. PREPARED BY

To Be Provided at Contract Award

H. DATE

16 June 2015

I. APPROVED BY

Fatimata Diallo

J. DATE

11/26/2015

DD FORM 1423-1, FEB 2001

PREVIOUS EDITION MAY BE USED.

Page 1 of Pages 3

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item) Form Approved

OMB No. 0704-0188

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 collecton 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 and Communications Directorate (0704-1088). 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

A

C. CATEGORY:

TDP_____ TM ______ OTHER: MISC

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

To Be Provided at Contract Award

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

TECHNICAL PRODUCTS/ANALYSIS RESULTS

3. SUBTITLE

Technical Reports

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80711A

5. CONTRACT REFERENCE

PWS C.8.3

6. REQUIRING OFFICE

RDRL-SLB-G

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ASREQ

12. DATE OF FIRST SUBMISSION

ASREQ

14.

8. APP CODE

N/A

11. AS OF DATE

SEE BLK 16

13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16

16. REMARKS

BLK 4: IN ADDITION TO PAPER COPIES, EACH REPORT SHALL BE DELIVERED ELECTRONICALLY IN A MEDIA SELECTED BY THE GOVERNMENT AT THE TIME OF DELIVERY. SOME MEDIA TYPES WHICH CAN BE ACCEPTED INCLUDE: FTP (FILE TRANSFER PROTOCOL), CD-ROM AND DVD-ROM, EMAIL IS ACCEPTABLE

BLK 11,12 AND 13: The Contractor shall provide written (e.g., reports and papers) and oral (e.g., briefings and presentations) technical products as requested or scheduled by the COR. DATA SHALL BE SUBMITTED AS REQUIRED PER THE APPROPRIATE TASK ASSIGNMENT.

G. PREPARED BY

To Be Provided at Contract Award

H. DATE

16 June 2015

I. APPROVED BY

Fatimata Diallo

J. DATE

Page 2 of Pages 3

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item) Form Approved

OMB No. 0704-0188

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 collecton 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 and Communications Directorate (0704-1088). 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

A

C. CATEGORY:

TDP_____ TM ______ OTHER: MISC

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

To Be Provided at Contract Award

1. DATA ITEM NO.

A003

2. TITLE OF DATA ITEM

SCIENTIFIC AND TECHNICAL REPORTS

3. SUBTITLE

FINAL REPORT

4. AUTHORITY (Data Acquisition Document No.)

DI-MISC-80711A

5. CONTRACT REFERENCE

PWS C.8.4

6. REQUIRING OFFICE

RDRL-SLB-G

7. DD 250 REQ

LT

9. DIST STATEMENT

REQUIRED

D

10. FREQUENCY

ONR/R

12. DATE OF FIRST SUBMISSION

SEE BLK 16

14.

8. APP CODE

N/A

11. AS OF DATE

SEE BLK 16

13. DATE OF SUBSEQUENT

SUBMISSION SEE BLK 16

16. REMARKS

BLK 4: CONTRACTOR FORMAT IS ACCEPTABLE. IN ADDITION TO PAPER COPIES, EACH REPORT SHALL BE DELIVERED ELECTRONICALLY IN A MEDIA SELECTED BY THE GOVERNMENT AT THE TIME OF DELIVERY. SOME MEDIA TYPES WHICH CAN BE ACCEPTED INCLUDE: FTP (FILE TRANSFER PROTOCOL), CD-ROM AND DVD-ROM.

BLK 11,12 AND 13: The final report shall document all of the project objectives, all work performed during the project, and the results obtained. A first draft of the final report shall be due 30 calendar days following the scheduled expiration of the contract. Requested changes or comments shall be provided to the contractor 15 calendar days following submission of the first draft . A final copy is due 15 calendar days to the COR following receipt of requested changes and comments.

G. PREPARED BY

To Be Provided at Contract Award

H. DATE

16 June 2015

I. APPROVED BY

Fatimata Diallo

J. DATE

Page 3 of Pages 3

EXHIBIT A – ATTACHMENT 1

ARMY RESEARCH LABORATORY

Report Title Goes Here

Any Subtitles Go Here

By Some Author and Another Author

Month XXXX

Prepared by

Whatever Technology Corporation

0000 Research Drive

Anywhere, ST 20006-1000

Under contract

W911QX-XX-C-XXXX

DISTRIBUTION STATEMENT GOES HERE

EXHIBIT A – ATTACHMENT 2

The findings in this report are not to be construed as an official Department of the Army position unless so designated by other authorized documents.

Citation of manufacturer's or trade names does not constitute an official endorsement or approval of the use thereof.

DESTRUCTION NOTICE: For classified documents, follow the procedures in DoD 5220.22-M, National Industrial Security Program Operating Manual, Chapter 5, Section 7. For unclassified, limited documents, destroy by any method that will prevent disclosure of contents or reconstruction of the document.