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Contract Data Requirements List

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CONTRACT DATA REQUIREMENTS LIST

Form Approved

OMB No. 0704-0188

(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 Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. 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 address. 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:

X001, X002

D.

SYSTEM/ITEM

A001

Colibrium (formerly GE)

2. TITLE OF DATA

ITEM

3. SUBTITLE

Service/Work Request Report

4. AUTHORITY

(Data

Acquisition Document No.)

7. DD 250 REQ

9. DIST STATEMENT

REQUIRED

GMT-81893
DI-M

NO

8. APP CODE

N/A

OTHER MGMT

TM

E. CONTRACT/PR NO. N000421- F. CONTRACTOR

GE M2
1. DATA ITEM NO.

TDP

6. REQUIRING OFFICE

SOW Para 3.0

AM IPT

10. FREQUENCY

ASREQ

11. AS OF DATE

A

See BLK 16

5. CONTRACT REFERENCE

CA

12. DATE OF FIRST SUBMISSION 14.

DISTRIBUTION

b. COPIES

See BLK 16

13. DATE OF SUBSEQUENT

SUBMISSION

ASREQ

16. REMARKS

BLK 3:
Annual Inspections, Hardware/Software Maintenance and
Updates
BLK 12:
Provide after each maintenance inspection detailing work accomplished and identifying any parts replaced.
BLK 14:
Unclassified deliveries shall be in electronic Format
compatible with MS Office products. Email to the following addresses for initial submission and initial revisions only: PM: Theodore Gronda, [email protected]
PA: Tamera Mebane, [email protected]
Log: Fernando Zuniga, [email protected]
ENG: John Ullman, [email protected]

Final

a. ADDRESSEE

See Blk 16

Draft

Reg

Repro

15. TOTAL

PREPARED BY:

H. DATE

09/14/2026

I. APPROVED BY

J. DATE

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

DD FORM 1423-1, AUG 96 (EG)

Pages Aug 96

PREVIOUS EDITION MAY BE USED.

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