Contract Data Requirements List A001 - Reports

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 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

E. CONTRACT/PR NO.

MGMT

F. CONTRACTOR

Forklift Maintenance
1. DATA ITEM NO.

A001

3. SUBTITLE

REPORT

Service, Safety, and Testing Reports

4. AUTHORITY (Data Acquisition Document No.)

5. CONTRACT REFERENCE

DI-NDTI-80809B*

7. DD 250 REQ

DD

8. APP CODE

N/A

17. PRICE GROUP

2. TITLE OF DATA ITEM

9. DIST STATEMENT

REQUIRED

D*

10. FREQUENCY

12. DATE OF FIRST SUBMISSION

ASGEN

NSWCPD C/107

14.

DISTRIBUTION

ASGEN*

13. DATE OF SUBSEQUENT

SUBMISSION

11. AS OF DATE

b. COPIES

a. ADDRESSEE

ASGEN

ASGEN

18. ESTIMATED

TOTAL PRICE

6. REQUIRING OFFICE

SOW para 4.0

16. REMARKS

C/107 TPOC

Final

Draft

Reg

Repro

BLK 4: Report shall be submitted in Contractor format.
BLK 9: Distribution Statement D. Distribution authorized to U.S. Department of Defense and U.S. DoD contractors only for administrative and operational use, 15 June 2018. Other requests for this document shall be referred to Commander, Naval Surface Warfare Center, Philadelphia Division, 5001 South Broad Street, Building 4, Philadelphia, PA 19112.
BLK 12: Report shall be submitted to NSWCPD NLT 2 days after completion of service. BLK 14: TPOCs - [email protected]; [email protected]

15. TOTAL

G. PREPARED BY

H. DATE

Mike Nolan
Digitally signed by

NOLAN.MICHAEL.D.1393545069 NOLAN.MICHAEL.D.1393545069

Date: 2026.08.28 13:51:05 -04'00'

DD FORM 1423-1, FEB 2001

08/28/2026

I. APPROVED BY

Michael D. Nolan

NOLAN.MICHAEL.D.13935

45069

PREVIOUS EDITION MAY BE USED.

J. DATE

Digitally signed by

NOLAN.MICHAEL.D.1393545069