Broad Agency Announcement ITC IPAC Atch 5 Blank

Form Approved OMB No. 0704-0188
OMB Approval Expires 20221130

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

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 collection 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 Directorate (0704-0188). 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

C. CATEGORY:

D. SYSTEM/ITEM

1. DATA ITEM NO.

E. CONTRACT/PR NO.

2. TITLE OF DATA ITEM

8. APP CODE

9. DIST STATEMENT

REQUIRED

F. CONTRACTOR

17. PRICE GROUP

3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.)

7. DD 250 REQ

5. CONTRACT REFERENCE

18. ESTIMATED

TOTAL PRICE

6. REQUIRING OFFICE

10. FREQUENCY

12. DATE OF FIRST SUBMISSION

11. AS OF DATE

13. DATE OF SUBSEQUENT

SUBMISSION

14.

DISTRIBUTION

b. COPIES

a. ADDRESSEE

Final

Draft

Reg

Repro

16. REMARKS

15. TOTAL

G. PREPARED BY

DD FORM 1423-1, FEB 2001

H. DATE

I. APPROVED BY

PREVIOUS EDITION MAY BE USED.

J. DATE

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Adobe Professional 8.0

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

A. CONTRACT LINE ITEM NO.

B. EXHIBIT

C. CATEGORY:

D. SYSTEM/ITEM

E. CONTRACT/PR NO.

F. CONTRACTOR

16. REMARKS (Continued)

DD FORM 1423-1, FEB 2001

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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.

FOR THE CONTRACTOR