Defense Security Service

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Overview

Cover Page
Table of Contents
General Instructions
Definitions
Reporting Level
1a
1b
2
3a
3b
3c
3d
3e
3f
3g
4a
4b
5
6
7
8
9a
9b
10
11
12
13
14

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Sheet 1: Cover Page

Next Page

OMB Control Number: 0694-0119

Expiration Date:

DEFENSE INDUSTRIAL BASE ASSESSMENT:
Critical Facilities Survey

SCOPE OF ASSESSMENT

The U.S. Department of Commerce, Bureau of Industry and Security (BIS), Office of Technology Evaluation (OTE), in coordination with the U.S. Department of Defense (DOD), Defense Security Service (DSS) is conducting a survey and assessment of organizations responsible for the research, design, engineering, development, manufacture, test, and integration of defense and high-technology products, components, and related services. The resulting data will provide a baseline understanding of the structure and interdependencies of organizations that participate in DOD acquisition programs and their associated supply chains. This survey will cover all operations at respondents' locations, including but not limited to the DSS-cleared areas. This effort will also assist DSS in its mission to provide security oversight and education on behalf of the DOD and other U.S. Government departments and agencies.

RESPONSE TO THIS SURVEY IS REQUIRED BY LAW

A response to this survey is required by law (50 U.S.C. App. Sec. 2155). Failure to respond can result in a maximum fine of $10,000, imprisonment of up to one year, or both. Information furnished herewith is deemed confidential and will not be published or disclosed except in accordance with Section 705 of the Defense Production Act of 1950, as amended (50 U.S.C App. Sec. 2155). Section 705 prohibits the publication or disclosure of this information unless the President determines that its withholding is contrary to the national defense. Information will not be shared with any non-government entity, other than in aggregate form. The information will be protected pursuant to the appropriate exemptions from disclosure under the Freedom of Information Act (FOIA), should it be the subject of a FOIA request.

Notwithstanding any other provision of law, no person is required to respond to nor shall a person be subject to a penalty for failure to comply with a collection of information subject to the requirements of the Paperwork Reduction Act unless that collection of information displays a currently valid OMB Control Number.

BURDEN ESTIMATE AND REQUEST FOR COMMENT

Public reporting burden for this collection of information is estimated to average 10 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 to BIS Information Collection Officer, Room 6883, Bureau of Industry and Security, U.S. Department of Commerce, Washington, D.C. 20230, and to the Office of Management and Budget, Paperwork Reduction Project (OMB Control No. 0694-0119), Washington, D.C. 20503.

BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 2: Table of Contents

Previous Page							Next Page
TABLE OF CONTENTS
I	General Instructions
II	Definitions
III	Reporting Level / Multiple Facility Instructions
1	Location and Organization Information
2	Mergers, Acquisitions, Divestitures, and Joint Ventures
3	Products and Services				Important Note: The drop-down menus in several later sections are based on your responses in Section 3. In order for all menus to work properly, you must complete these sections in order.
4	U.S. Government Support
5	Critical Suppliers
6	Employment
7	Sales
8	Customers
9	Security Procedures
10	Classified Contract Information
11	Research and Development
12	Financial Information
13	Organizational Challenges and Outreach Information
14	Certification
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 3: General Instructions

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Section I: GENERAL INSTRUCTIONS
A.	Your organization is required to complete this survey using an Excel template, which can be downloaded from the U.S. Department of Commerce, Census Bureau website: https://respond.census.gov/criticalfacility/download. For your convenience, a PDF version of the survey is available to aid your internal data collection. DO NOT submit the PDF version of your organization’s response to BIS.
B.	This survey has been distributed on a CAGE/facility basis, but should be completed at the location level. A location includes but is not limited to the DSS cleared area. A major goal of this assessment is to benchmark the operations, practices, and interdependencies of locations that contain DSS cleared facilities. For the purpose of this survey, a location is a single contiguous site. Locations may--and often will--contain multiple facilities.
C.	Respond to every question. Surveys that are not fully completed will be returned for completion. Use the comment boxes to provide any information to supplement responses provided in the survey form. Make sure to record a complete answer in the cell provided, even if the cell does not appear to expand to fit all the information. DO NOT COPY AND PASTE RESPONSES WITHIN THIS SURVEY. Survey inputs should be completed manually, by typing in responses or by use of a drop-down menu. The use of copy and paste can corrupt the survey template. If your survey response is corrupted as a result of copy and paste responses, a new survey will be sent to you for immediate completion.
D.	Do not disclose any classified information in this survey form.
E.	Estimates are often acceptable (and in some sections encouraged), but in sections that do not explicitly allow estimates you must contact BIS survey support staff before including estimates.
F.	Questions related to this Excel survey should be directed to: [email protected]. (E-mail is the preferred method of contact). You may also speak with a member of BIS survey support staff by calling (202) 482-7808.
G.	After completing, reviewing, and certifying the Excel survey, submit the survey via our Census Bureau web portal:
	https://respond.census.gov/criticalfacility
	Do not submit the survey via email.
H.	For questions related to the overall scope of this Defense Industrial Base assessment, contact: Brad Botwin, Director, Industrial Studies Office of Technology Evaluation, Room 1093 U.S. Department of Commerce 1401 Constitution Avenue, NW Washington, DC 20230 To contact Mr. Botwin, please call (202) 482-7808. DO NOT submit completed surveys to Mr. Botwin's postal or personal e-mail address; all surveys must be submitted electronically via our Census Bureau web portal:
	https://respond.census.gov/criticalfacility
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 4: Definitions

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Section II: Definitions
Term	Definition
Applied Research	Systematic study to gain knowledge or understanding necessary to determine the means by which a recognized and specific need may be met. This activity includes work leading to the production of useful materials, devices, and systems or methods, including design, development, and improvement of prototypes and new processes.
Authorizing Official	Executive officer of the organization or business unit or other individual who has the authority to execute this survey on behalf of the organization.
Basic Research	Systematic, scientific study directed toward greater knowledge or understanding of the fundamental aspects of phenomena and of observable facts.
Classified Contract	Any contract that requires access to classified U.S. Government information. Not to be confused with a contract whose existence may be classified, i.e. a Special Access Program.
Cleared Facility/Cleared CAGE	A facility possessing a facility clearance (FCL) under the National Industrial Security Program (NISP).
Commercial and Government Entity (CAGE) Code	Commercial and Government Entity (CAGE) Code identifies companies doing or wishing to do business with the U.S. Federal Government. The code is used to support mechanized government systems and provides a standardized method of identifying a given facility at a specific location. Find CAGE codes at https://cage.dla.mil/search/.
Commercially Sensitive Information (CSI)	Privileged or proprietary information which, if compromised through alteration, corruption, loss, misuse, or unauthorized disclosure, could cause serious harm to the information's owners.
Customer	An entity to which an organization directly delivers the product or service that the facility produces. A customer may be another company or another facility owned by the same parent organization. The customer may be the end user for the item but often will be an intermediate link in the supply chain, adding additional value before transferring the item to yet another customer.
Cyber Security	The body of technologies, processes, and practices designed to protect networks, computers, programs, and data from attack, damage, or unauthorized access.
Data Universal Numbering System (DUNS)	A nine-digit numbering system that uniquely identifies an individual business. Find DUNS numbers at http://fedgov.dnb.com/webform.
Facility	For the purpose of this survey, a facility is an area within an organization defined by a single CAGE code. An organization's physical location may contain multiple facilities.
Full Time Equivalent (FTE) Employees	Employees who work for 40 hours in a normal work week. Convert part-time employees into "full time equivalents" by taking their work hours as a fraction of 40 hours.
Location	For the purpose of this survey, a location is a single contiguous site. Locations may--and often will--contain multiple facilities. Additionally, all off-site activities associated with a location should be reported as part of that location. For instance, employees who work at a client site should be considered as part of their employing location.
North American Industry Classification System (NAICS) Code	North American Industry Classification System (NAICS) codes identify the category of product(s) or service(s) provided by an organization. Find NAICS codes at http://www.census.gov/epcd/www/naics.html
Product/Process Development	Conceptualization and development of a product prior to the production of the product for customers.
Service	An intangible product (contrasted to a good, which is a tangible product). Services typically cannot be stored or transported, are instantly perishable, and come into existence at the time they are bought and consumed.
Single Source	An organization that is designated as the only accepted source for the supply of parts, components, materials, or services, even though other sources with equivalent technical know-how and production capability may exist.
Sole Source	An organization that is the only source for the supply of parts, components, materials, or services. No alternative U.S. or non-U.S. based suppliers exist other than the current supplier.
Supplier	An entity from which your organization obtains inputs. A supplier may be another firm with which you have a contractual relationship, or it may be another facility owned by the same parent organization. The inputs may be goods or services.
United States	The "United States" or "U.S." includes the 50 states, Puerto Rico, the District of Columbia, the island of Guam, the Trust Territories, and the U.S. Virgin Islands.
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 5: Reporting Level

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Section III: Reporting Level
This survey is intended to cover all operations at a single location, including but not limited to the DSS cleared area. Your answers to this survey should address all operations at this location. Contact survey support staff with any questions.
A.	Does your organization have more than one DSS-cleared facility (CAGE)? If yes, contact survey support staff immediately to ensure consistent reporting.
B.	Identify all CAGE codes covered by this location's response:
		DSS Cleared CAGE(s) at location		All Other CAGEs at location, if applicable
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 6: 1a

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Section 1a: Location Information
A.	Provide the following information for your location (see definitions).
	Location Name
	Organization Name
	Street Address
	City
	State
	Zip Code
	Website
	Phone Number
	Is this the only location your organization currently operates?
B.	Does your organization have a parent company?					If Yes, provide the following information on your parent organization(s):
				Parent Organization 1			Parent Organization 2
	Organization Name
	Street Address
	City
	State/Province
	Country
	Postal Code/Zip Code
	Primary CAGE Code
C.	Is your organization publicly traded or privately held?					If your organization is publicly traded, identify its stock ticker symbol.
D.	Are any of the areas in your location that are authorized to store classified information or to perform on a classified contract shared and/or operated by another organization? If yes, provide the information below.
	Other Organization Name				Purpose of Shared Area
E.	Point of Contact regarding this survey:
	Name			Title	Phone Number		E-mail Address		State
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 7: 1b

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Section 1b: Location Information (Cont.)
A.	Select the option that most closely describes your location's primary business, and indicate any "Additional Business Lines" that are applicable below.
	Academic institution
	Distribution/brokerage/reseller/retail
	Holding company
	Inspection and quality control
	Information technology (software, hardware, installation)
	Integration (product, systems integration)
	Maintenance/aftermarket/repair/refurbishing services
	Manufacturing (including assembly)
	Manufacturing systems development and management
	Material finishing (machining, coating, plating, heat treating, etc.)
	Material preparation (casting, forming, molding, forging, etc.)
	Product and design engineering (tooling, new processes, etc.)
	Professional services (legal, accounting, consulting, etc.)
	Raw materials provider
	Research and development
	Testing/evaluation/validation
	Other			(specify here)
B.	Please provide the following identification codes, as applicable, for your location. *Find your location's North American Industry Classification System (NAICS) codes at http://www.census.gov/epcd/www/naics.html.
	Data Universal Numbering System (DUNS) Code(s)				NAICS (6-digit) Code(s)*
	Find DUNS numbers at:				Find NAICS codes at:
	http://fedgov.dnb.com/webform				http://www.census.gov/epcd/www/naics.html
C.	Does your organization qualify as any of the following types of business?						If Yes, indicate which types:
		A small business enterprise (as defined by the Small Business Administration)
		8(a) Firm (as defined by the Small Business Administration)
		A historically underutilized business zone (HUBZone)
		A minority-owned business
		A woman-owned business
		A veteran-owned or service-disabled veteran owned business
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 8: 2

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Section 2: Mergers, Acquisitions, Divestitures, and Joint Ventures
A.	Mergers, Acquisitions, Divestitures
	How many mergers, acquisitions, and divestitures has your organization been involved in over the past 10 years?
	Identify your organization's ten most recent mergers, acquisitions, and divestitures, if applicable.
	Organization Name			Type of Activity	Country	Year	Primary Objective				Explain
	1.
	2.
	3.
	4.
	5.
	6.
	7.
	8.
	9.
	10.
B.	Joint Ventures
	How many joint ventures does your organization currently participate in?
	Identify your organization's current joint venture relationships, including public/private R&D partnerships, if applicable. Be sure to provide a description of the joint venture's purpose (e.g. patent licensing, co-production, product integration, after-market support, etc.):
	Organization/Entity Name			Country		Year Initiated	Primary Purpose of Relationship				Explain
	1.
	2.
	3.
	4.
	5.
	6.
	7.
	8.
	9.
	10.
	11.
	12.
	13.
	14.
	15.
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 9: 3a

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Section 3: Products and Services
In Section 3 you will be asked to identify the products and services your location manufactures, distributes, researches, and/or provides. For the purpose of this survey, products and services have been divided into 25 general categories, as detailed below. Identify each general category in which your location has capabilities. In the next five pages you will select the individual type of products or services within these categories in which your location participates. The list below contains links that can move you to a particular product and/or service segment. After completing this page you may skip to the sections with the products/services that pertain to your location, but be sure to review all segments to ensure you do not omit any required information.
Part	Product and Service Category						Participation
A	Raw Materials (Ores, Alloys, Chemicals, etc.)
B	Electronics (Circuits, Processors, Diodes, etc.)
C	Manufacturing Equipment and Processes (Machinery, Lathes, etc.)
D	Lasers
E	Directed Energy
F	Optics (Optics, Coatings, Lenses, etc.)
G	Acoustic Sensors (Sonar, other acoustic sensors, etc.)
H	Positioning, Navigation, and Timing (Gyroscopes, Accelerometers, GPS, etc.)
I	Radars
J	Signature Control (Materials, Chemicals, and Processes for Signature Control)
K	Aeronautic Systems (Aircraft, Airframes, Structural Components, etc.)
L	Space Systems (Launch Vehicles, Satellites, Rocket Motors, Survivability Systems, etc.)
M	Marine Systems (Ships, Landing Vessels, Submarines, etc.)
N	Ground Vehicle Systems (Vehicles, Tanks, Unmanned Ground Systems, etc.)
O	Armaments, Explosives, and Survivability (Munitions, Armor, Missiles, Launchers, etc.)
P	Energy Systems & Energetics (Engines, Catapults, Batteries, Propellants, etc.)
Q	Nuclear (Reactors, Design, Protection, Detection, Storage, etc.)
R	Biological (Biological research, Biological Agent Detection/Destruction/Readiness, etc.)
S	Chemical (Chemical research, Chemical Agent Detection/Destruction/Readiness, etc.)
T	Emerging Technology (Nanotechnology, Synthetic Biology, Quantum Systems, Cognitive Neuroscience, etc.)
U	Agricultural (Agricultural Machinery and Technology)
V	Medical (MRI machinery, X-Radiation Machinery, Disease Research, Medicinal Distribution Technology, etc.)
W	Command, Control, Communication, and Computer (C4)
X	Software
Y	Services and Other Products (Services and products not included above)
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 10: 3b

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	Section 3b: Product and Service List
	For each area in which your location provides a product or service (including R&D), indicate the type of participation, whether your location performs R&D, and provide a description of the products or services. Then, identify the expected end usage of your product/service, and whether the product/service is subject to U.S. export control regulations. Finally, state whether the product/service has supported a classified contract within the past three years. While many specific product/service areas are listed, not every possible product and service has been included. If the product or service your location provides is not listed, use the "other" listing within the relevant category.
	Do not disclose any classified information in this survey form.
	A: Raw Materials
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	A1 - Ores
	A2 - Rare earth minerals
	A3 - Alloys
	A4 - Chemicals
	A5 - Fiber-based materials
	A6 - Other raw materials
	B: Electronics
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	B1 - Integrated circuits
	B2 - Application specific integrated circuits (ASICs)
	B3 - Radiation hardened integrated circuits
	B4 - Field programmable gate arrays (FPGAs)
	B5 - Programmable memory
	B6 - Optical filters
	B7 - Micro-sensors
	B8 - Vacuum tubes
	B9 - Capacitors
	B10 - Microprocessors
	B11 - Microcontrollers
	B12 - Digital signal processors
	B13 - Diodes
	B14 - Wafers (any molecular composition)
	B15 - Circuit boards
	B16 - Flexible circuit boards
	B17 - Other electronic products
	C: Manufacturing Equipment and Processes
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	C1 - Additive manufacturing (3D printing)
	C2 - Computer Numerical Control (CNC) machines
	C3 - Lathes, grinding machines, planers, shapers
	C4 - Die press lines
	C5 - Robot work cells
	C6 - Bearings
	C7 - Transmission equipment (gears, pulleys, sprockets, belts, torque converters, etc.)
	C8 - Welding, soldering, and brazing equipment
	C9 - Other manufacturing equipment
	Comments:
	BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 11: 3c

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	Section 3c: Product and Service List
	For each area in which your location provides a product or service (including R&D), indicate the type of participation, whether your location performs R&D, and provide a description of the products or services. Then, identify the expected end usage of your product/service, and whether the product/service is subject to U.S. export control regulations. Finally, state whether the product/service has supported a classified contract within the past three years. While many specific product/service areas are listed, not every possible product and service has been included. If the product or service your location provides is not listed, use the "other" listing within the relevant category.
	Do not disclose any classified information in this survey form.
	D: Lasers
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	D1 - Gas lasers
	D2 - Solid state lasers
	D3 - Chemical lasers
	D4 - Excimer lasers
	D5 - Fiber lasers
	D6 - Photonic crystal lasers
	D7 - Semiconductor lasers
	D8 - Dye lasers
	D9 - Free electron lasers
	D10 - Bio lasers
	D11 - Other laser products
	E: Directed Energy
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	E1 - Directed electromagnetic radiation (not lasers)
	E2 - Directed particles with mass
	E3 - Directed sound
	E4 - Other directed energy products
	F: Optics
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	F1 - Optics
	F2 - Fiber optics
	F3 - Polarization
	F4 - Reflective coatings
	F5 - Refractive coatings
	F6 - Lenses
	F7 - Other optics products
	G: Acoustic Sensors
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	G1 - Active sonar
	G2 - Passive sonar
	G3 - Sonobouys
	G4 - Commercial off-the-shelf sonar equipment
	G5 - Other acoustic sensor products
	H: Positioning, Navigation, and Timing
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	H1 - Inertial measuring units
	H2 - Gyroscopes
	H3 - Global Positioning Systems
	H4 - Atomic clocks
	H5 - Accelerometers
	H6 - Other positioning, navigation, or timing products
	I: Radars
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	I1 - Mechanically steered radars
	I2 - Electronically steered radars
	I3 - Phase adaptive radars
	I4 - Pulse radars
	I5 - Continuous wave radars
	I6 - Other radar products
	J: Signature Control
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	J1 - Compounds or materials engineered to reduce or eliminate a signature
	J2 - Chemical compositions of signature control compounds
	J3 - Processes used to apply signature control compounds
	J4 - Other signature control products
	Comments:
	BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 12: 3d

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	Section 3d: Product and Service List
	For each area in which your location provides a product or service (including R&D), indicate the type of participation, whether your location performs R&D, and provide a description of the products or services. Then, identify the expected end usage of your product/service, and whether the product/service is subject to U.S. export control regulations. Finally, state whether the product/service has supported a classified contract within the past three years. While many specific product/service areas are listed, not every possible product and service has been included. If the product or service your location provides is not listed, use the "other" listing within the relevant category.
	Do not disclose any classified information in this survey form.
	K: Aeronautic Systems
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	K1 - Fixed wing combat aircraft
	K2 - Other fixed wing aircraft, including cargo and transport
	K3 - Rotary wing aircraft (including helicopters)
	K4 - Unmanned aerial vehicles and drones
	K5 - Airframes and structural components (including rotor blades, landing gear, hydraulics, etc.)
	K6 - Other aeronautic system products
	L: Space Systems
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	L1 - Space launch vehicles
	L2 - Satellites and satellite buses
	L3 - Space survivability systems and equipment
	L4 - Solid rocket motors and related equipment
	L5 - Liquid rocket motors and related equipment
	L6 - Other space system products
	M: Marine Systems
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	M1 - Combat ships and landing vessels
	M2 - Transport vessels
	M3 - Cargo and tanker vessels
	M4 - Submarines
	M5 - Other marine system products
	N: Ground Vehicle Systems
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	N1 - Light armored vehicles & designs
	N2 - Medium tactical vehicles & designs
	N3 - M1 Abrams variations of heavy tanks & designs
	N4 - Transport vehicles & designs
	N5 - Wheeled or tracked vehicles not specified above
	N6 - Unmanned ground systems
	N7 - Other ground system products
	O: Armaments, Explosives, and Survivability
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	O1 - Conventional small arms (5.56mm to .50 cal)
	O2 - Automatic and semi-automatic weapons
	O3 - Mortar rounds
	O4 - Artillery rounds
	O5 - Rockets (endo and exoatmospheric)
	O6 - Missiles
	O7 - Hypervelocity weapons
	O8 - Launchers (missile, torpedo, rocket, etc.)
	O9 - Underwater explosives (mines, torpedos, etc.)
	O10 - Fire control systems and components
	O11 - Body armor
	O12 - Other armor
	O13 - Other armaments, explosives, or survivability products
	Comments:
	BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 13: 3e

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	Section 3e: Product and Service List
	For each area in which your location provides a product or service (including R&D), indicate the type of participation, whether your location performs R&D, and provide a description of the products or services. Then, identify the expected end usage of your product/service, and whether the product/service is subject to U.S. export control regulations. Finally, state whether the product/service has supported a classified contract within the past three years. While many specific product/service areas are listed, not every possible product and service has been included. If the product or service your location provides is not listed, use the "other" listing within the relevant category.
	Do not disclose any classified information in this survey form.
	P: Energy Systems & Energetics
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	P1 - Gas turbine engines
	P2 - Rocket engines
	P3 - Generators
	P4 - Combustion engines
	P5 - Turbo fan engines
	P6 - Catapults
	P7 - Batteries
	P8 - Propellants
	P9 - Other energy systems products
	Q: Nuclear
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	Q1 - Nuclear reactors
	Q2 - Nuclear weapon design and capabilities
	Q3 - Nuclear weapon destruction and demilitarization technology
	Q4 - Protective clothing
	Q5 - Radiation detective devices (e.g. Geiger counters)
	Q6 - Radioactive material storage
	Q7 - Nuclear disaster response equipment
	Q8 - Other nuclear products
	R: Biological
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	R1 - DNA research
	R2 - RNA research
	R3 - Biological or physiological research
	R4 - Biological weapons destruction and demilitarization technology
	R5 - Biological agent detection equipment
	R6 - Biological disaster response equipment
	R7 - Other biological products
	S: Chemical
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	S1 - Chemical research
	S2 - Chemical weapons destruction and demilitarization technology
	S3 - Chemical agent detection equipment
	S4 - Chemical disaster response equipment
	S5 - Other chemical products
	T: Emerging Technology
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	T1 - Nanotechnology
	T2 - Synthetic biology
	T3 - Energetic materials
	T4 - Quantum systems
	T5 - Computational modeling of human behavior
	T6 - Cognitive neuroscience
	T7 - Other emerging technology products
	U: Agricultural
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	U1 - Soil cultivation machinery
	U2 - Planting machinery
	U3 - Irrigation machinery
	U4 - Produce sorters
	U5 - Harvesting technology
	U6 - Other agricultural products
	V: Medical
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	V1 - Electron microscopes
	V2 - Sonograms
	V3 - Magnetic Resonance Image (MRI) machines
	V4 - X-radiation machines
	V5 - Medicine distribution technology
	V6 - Disease and vector research
	V7 - Other medical products
	Comments:
	BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 14: 3f

	Previous Page	Table of Contents					Next Page
	Section 3f: Product and Service List
	For each area in which your location provides a product or service (including R&D), indicate the type of participation, whether your location performs R&D, and provide a description of the products or services. Then, identify the expected end usage of your product/service, and whether the product/service is subject to U.S. export control regulations. Finally, state whether the product/service has supported a classified contract within the past three years. While many specific product/service areas are listed, not every possible product and service has been included. If the product or service your location provides is not listed, use the "other" listing within the relevant category.
	Do not disclose any classified information in this survey form.
	W: Command, Control, Communication, and Computer (C4)
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	W1 - Common data links
	W2 - Monitors
	W3 - Printers
	W4 - Telecommunication devices (phones, cell phones, radios, radio mounts)
	W5 - Commercial off-the-shelf equipment used for C4
	W6 - Computers and CPUs
	W7 - Antennas
	W8 - Beyond the line of sight C2
	W9 - Line of sight C2
	W10 - Other C4 products and IT equipment
	X: Software
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	X1 - Computer aided design (CAD) software
	X2 - Modeling and simulation software
	X3 - Artificial intelligence software
	X4 - Swarm software
	X5 - Microelectronic design software
	X6 - System development kits (SDK)
	X7 - Software algorithms
	X8 - Correlation software
	X9 - Database
	X10 - Computer language software
	X11 - Operating systems
	X12 - Finance and accounting software
	X13 - Other software products
	Y: Services and Other Products
		Participation Type	Conduct R&D?	Product/Service Description	Primary End Use	Export Controlled?	Associated with a Classified Program (DD-254 Contract)?
0	Y1 - Analytic services
	Y2 - Canine training
	Y3 - Construction
	Y4 - Consulting services
	Y5 - Delivery and freight services
	Y6 - Education and training services
	Y7 - Engineering
	Y8 - Financial and banking services
	Y9 - General contracting
	Y10 - Graphic arts, video, digital production
	Y11 - Information technology services
	Y12 - Internet service provision
	Y13 - Janitorial services
	Y14 - Legal services
	Y15 - Logistical services
	Y16 - Marketing services
	Y17 - Medical services
	Y18 - Professional services
	Y19 - Property management
	Y20 - Security and protection services
	Y21 - Staffing services
	Y22 - Telecommunication services
	Y23 - Translation services
	Y24 - Transportation services
	Y25 - Other services
	Y26 - Products not listed
	Comments:
	BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 15: 3g

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Section 3g: Primary Product/Service
Select your location's primary product or service, based on total sales.
Is your location's viability dependent on this product or service?
Explain:
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 16: 4a

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Section 4a: Support of U.S. Government (USG) Agencies
Indicate all USG departments and agencies your location has supported, directly or indirectly, in the past three years. Estimate the percentage of your location's total sales that supported each agency over the past three years. Percentages will only sum to 100% if all of your location's sales are to USG agencies.
A.	Agency Name		Type of Support	Estimated Percent of Your Location's Total Sales Attributable to USG Agency
	U.S. Navy
	U.S. Army
	U.S. Air Force
	U.S. Marine Corps
	DOD Defense Advanced Research Projects Agency (DARPA)
	DOD Missile Defense Agency (MDA)
	Department of Homeland Security (DHS)
	National Aeronautics and Space Administration (NASA)
	U.S. Intelligence Community (such as CIA, NGA, NRO, NSA, DNI, etc.)
	Department of Energy (DOE)
	Department of State
	Other Agency	(Select from list)
	Other Agency	(Select from list)
	Other Agency	(Select from list)
	Other Agency	(Select from list)
	Other Agency	(Select from list)
	Other Agency	(Select from list)
	Other Agency	(Select from list)
	Other Agency	(Select from list)
	Other Agency	(Select from list)
	Other Agency	(Select from list)
	Unlisted Agency	(Write-in)
	Unlisted Agency	(Write-in)
	Unlisted Agency	(Write-in)
B.	Does your facility engage in Diminishing Manufacturing Sources & Materials Shortages (DMSMS) or obsolescence activities?			DMSMS: the loss or impending loss of manufacturers or suppliers of items that may cause material shortages which endanger a weapon system's or equipment's development, production, or post-production support capability.
	If yes, who is the point of contact for DMSMS/obsolescence at your location?
	Name	Title	Phone	Email
	If yes, estimate how much (in thousands of dollars) your location spent in each of the last three years on finding, managing, and/or resolving DMSMS/obsolescence problems on DOD systems or projects, including parts, components, materials, and software:
	Record $ in Thousands, e.g. $12,000.00 = survey input of $12		DMSMS comments/ explanations:
	2013
	2014
	2015
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 17: 4b

Previous Page			Table of Contents					Next Page
Section 4b: Participation in USG Programs
A.	Estimate the total number of USG programs your location has directly or indirectly supported in the past three years (including those not listed below):
B.	From the list of select U.S. Government programs provided below, identify each program your location has directly or indirectly supported in the past three years. Then, select the top five product/services your location provides for each program supported. The product/service drop-down list is based on your responses to Section 3. If your product or service does not appear in the drop-down, ensure that you have indicated in Section 3 that your location provides the product or service. If you participate in a USG program that is not listed below, you may enter it manually at the bottom of this page (entries 211-230). In these cases, identify the relevant agency in the 'U.S. Government Agency' column and then identify the program name in the 'Program Name' column. If you would like to list more programs than space allows, contact survey support staff at [email protected] for instructions.
	If your location does not support any of the listed U.S. Government programs, indicate this in the box to the right:
	Note: For your convenience, you may utilize the built-in filters to isolate particular U.S. Government agencies or programs from the list (press the down facing arrow in the top right corner of the relevant column below).
	USG Program Identification Do not disclose any classified information in this survey form.
	U.S. Government Agency	Program Name	Participation	Product/Service List Area (from Survey Section 3b-3f) Supporting USG Programs
				1	2	3	4	5
1	Air Force	Advanced Extremely High Frequency Satellite (AEHF)
2	Air Force	Advanced Pilot Trainer (APT)
3	Air Force	AIM-120 Advanced Medium Range Air-to-Air Missile (AMRAAM)
4	Air Force	Air and Space Operations Center-Weapon System Increment 10.2 (AOC-WS Inc 10.2)
5	Air Force	Air Force Integrated Personnel and Pay System (AF IPPS)
6	Air Force	Air Force Intercontinental Ballistic Missile Fuze Modernization (ICBM Fuze Mod)
7	Air Force	Airborne Warning and Control System Block 40/45 Upgrade (AWACS Blk 40/45 Upgrade)
8	Air Force	B-2 Defensive Management System Modernization (B-2 DMS Mod)
9	Air Force	B-2 Extremely High Frequency SATCOM and Computer Increment 1 (B-2 EHF Inc 1)
10	Air Force	B61 Mod 12 Life Extension Program Tailkit Assembly (B61 Mod 12 LEP TKA)
11	Air Force	Base Information Transport Infrastructure Wired (BITI Wired)
12	Air Force	Business Systems Modernization - Energy (BSM-E)
13	Air Force	C-130J Hercules Transport Aircraft (C-130J)
14	Air Force	C-27J (C-27J)
15	Air Force	C-5 Reliability Enhancement and Re-engining Program (C-5 RERP)
16	Air Force	Combat Identification/Identification Friend or Foe (CID/IFF)
17	Air Force	Combat Rescue Helicopter (CRH)
18	Air Force	Defense Enterprise Accounting and Management System-Increment 1 (DEAMS Inc 1)
19	Air Force	Deliberate and Crisis Action Planning and Execution Segments Increment 2A (DCAPES Inc 2A)
20	Air Force	Deliberate and Crisis Action Planning and Execution Segments Increment 2B (DCAPES Inc 2B)
21	Air Force	Enhanced Polar System (EPS)
22	Air Force	Evolved Expendable Launch Vehicle (EELV)
23	Air Force	F-15 Eagle Passive Active Warning Survivability System (F-15 EPAWSS)
24	Air Force	F-22 Increment 3.2B Modernization (F-22 Inc 3.2B Mod)
25	Air Force	Family of Advanced Beyond Line-of-Sight - Terminals (FAB-T)
26	Air Force	Global Broadcast Service (GBS)
27	Air Force	Global Positioning System III (GPS III)
28	Air Force	Ground Based Strategic Deterrent (GBSD)
29	Air Force	Hard Target Munition (HTM)
30	Air Force	HC/MC-130 Recapitalization Aircraft (HC/MC-130 Recap)
31	Air Force	Integrated Strategic Planning and Analysis Network Increment 4 (ISPAN Inc 4)
32	Air Force	Joint Air-to-Surface Standoff Missile (JASSM)
33	Air Force	Joint Direct Attack Munition (JDAM)
34	Air Force	Joint Space Operations Center (JSpOC) Mission System Increment 2 (JMS Inc 2)
35	Air Force	KC-46A Tanker Modernization (KC-46A)
36	Air Force	Long Range Stand Off Weapon (LRSO)
37	Air Force	Military Global Positioning System (GPS) User Equipment (MGUE Inc 1)
38	Air Force	Military Global Positioning System (GPS) User Equipment Increment 2 (MGUE Inc 2)
39	Air Force	Mission Planning System Increment 4 (MPS Inc 4)
40	Air Force	MQ-9 Reaper Unmanned Aircraft System (MQ-9 Reaper)
41	Air Force	Next Generation Long Range Strike (NGLRS) (NGLRS)
42	Air Force	Next Generation Operational Control System (OCX)
43	Air Force	North Atlantic Treaty Organization Alliance Ground Surveillance (NATO AGS)
44	Air Force	Nuclear Detonation Detection System (NDS)
45	Air Force	Presidential Aircraft Recapitalization (PAR)
46	Air Force	Protected Satellite Communication Services (PSCS)
47	Air Force	RQ-4A/B Global Hawk Unmanned Aircraft System (RQ-4A/B Global Hawk)
48	Air Force	Small Diameter Bomb Increment II (SDB II)
49	Air Force	Space Based Infrared System Follow-On (SBIRS Follow-On)
50	Air Force	Space Based Infrared System High (SBIRS High)
51	Air Force	Space Fence Ground-Based Radar System Increment 1 (Space Fence Inc 1)
52	Air Force	Three-Dimensional Expeditionary Long-Range Radar (3DELRR)
53	Air Force	Weather Satellite Follow-on (WSF)
54	Air Force	Wideband Global SATCOM (WGS)
55	Army	AH-64E Apache New Build (AH-64E New Build)
56	Army	AH-64E Apache Remanufacture (AH-64E Remanufacture)
57	Army	Airborne & Maritime/Fixed Station Joint Tactical Radio System (AMF JTRS)
58	Army	Armored Multi-Purpose Vehicle (AMPV)
59	Army	Biometrics Enabling Capability Increment 1 (BEC Inc 1)
60	Army	CH-47F Improved Cargo Helicopter (CH-47F)
61	Army	Common Infrared Countermeasure (CIRCM)
62	Army	Distributed Common Ground System - Army Increment 2 (DCGS-A Inc 2)
63	Army	Distributed Common Ground System-Army Increment 1 (DCGS-A Inc 1)
64	Army	Excalibur Precision 155mm Projectiles (Excalibur)
65	Army	Global Combat Support System - Army Increment 2 (GCSS-A Inc 2)
66	Army	Global Combat Support System - Army Increment 1 (GCSS-A Inc 1)
67	Army	Guided Multiple Launch Rocket System/Guided Multiple Launch Rocket System Alternative Warhead (GMLRS/GMLRS AW)
68	Army	Improved Turbine Engine Program (ITEP)
69	Army	Indirect Fire Protection Capability Increment 2 - Intercept (IFPC Inc 2 - I)
70	Army	Integrated Air and Missile Defense (IAMD)
71	Army	Integrated Personnel and Pay System-Army Increment 1 (IPPS-A Inc 1)
72	Army	Integrated Personnel and Pay System-Army Increment 2 (IPPS-A Inc 2)
73	Army	Joint Air-to-Ground Missile (JAGM)
74	Army	Joint Personnel Identification Version 2 (JPI V2)
75	Army	Joint Tactical Networks (JTN)
76	Army	Joint Tactical Radio System Handheld, Manpack, and Small Form Fit Radios (JTRS HMS)
77	Army	Logistics Modernization Program Increment 2 (LMP Inc 2)
78	Army	Long Range Precision Fires (LRPF)
79	Army	Mid-Tier Networking Vehicular Radio (MNVR)
80	Army	MQ-1C Gray Eagle Unmanned Aircraft System (MQ-1C Gray Eagle)
81	Army	NETT WARRIOR (NETT WARRIOR)
82	Army	Non-Standard Rotary Wing Aircraft (NSRWA)
83	Army	Paladin Integrated Management (PIM)
84	Army	Patriot Advanced Capability-3 Missile Segment Enhancement (PAC-3 MSE)
85	Army	Patriot/Medium Extended Air Defense System Combined Aggregate Program (Patriot/MEADS CAP)
86	Army	RQ-7B Shadow Tactical Unmanned Aircraft System (RQ-7B Shadow)
87	Army	Tactical Mission Command (TMC)
88	Army	UH-60M Black Hawk Helicopter (UH-60M Black Hawk)
89	Army	Warfighter Information Network-Tactical Increment 2 (WIN-T Inc 2)
90	Army	Warfighter Information Network-Tactical Increment 3 (WIN-T Inc 3)
91	DOD	Advanced Anticonvulsant Systems (CBDP-MEDSYS - AAS)
92	DOD	Analytical Laboratory System (CBDP-GUARD - ALS)
93	DOD	Anthrax Vaccine Adsorbed (CBDP-MEDSYS - AVA)
94	DOD	Ballistic Missile Defense System (BMDS)
95	DOD	Ballistic Missile Technical Collection (BMTC)
96	DOD	Bioscavenger I (CBDP-MEDSYS - pBSCAV)
97	DOD	Bioscavenger Increment II (CBDP-MEDSYS - BSCAV II)
98	DOD	CBDP-GUARD-CALS (CBDP-GUARD - CALS)
99	DOD	Chemical and Biological Protective Shelter (CBPS) (CBDP-CP - CBPS)
100	DOD	Chemical Biological Defense Small Project Acquisition (CBDP-GUARD - CSPA)
101	DOD	Chemical Demilitarization-Assembled Chemical Weapons Alternatives (Chem Demil-ACWA)
102	DOD	Collectively Protected Field Hospital (CBDP-CP - CPFH)
103	DOD	Defense Agencies Initiative Increment 2 (DAI Inc 2)
104	DOD	Department of Defense Healthcare Management System Modernization (DHMSM)
105	DOD	F-35 Joint Strike Fighter Aircraft (F-35)
106	DOD	Global Combat Support System - Joint Increment 8 (GCSS-J Inc 8)
107	DOD	Global Combat Support System - Joint Increment 7 (GCSS-J Inc 7)
108	DOD	Human Remains Decontamination System (CBDP-DECON - HRDS)
109	DOD	Improved Nerve Agent Identification and Diagnositc System (CBDP-MEDSYS - INATS)
110	DOD	Installation Protection Program (CBDP-GUARD - IPP)
111	DOD	integrated Electronic Health Record Increment 1 (iEHR Inc 1)
112	DOD	Joint Aerial Layer Network (JALN)
113	DOD	Joint Biological Agent Identification and Diagnostic System (CBDP-MEDSYS - JBAIDS)
114	DOD	Joint Biological Point Detection System (JBPDS) (CBDP-BD - JBPDS)
115	DOD	Joint Biological Standoff Detection System Increment 1 (CBDP-BD - JBSDS Inc 1)
116	DOD	Joint Biological Standoff Detection System Increment 2 (CBDP-BD - JBSDS Inc 2)
117	DOD	Joint Biological Tactical Detection System Increment 1 (CBDP-BD - JBTDS Inc 1)
118	DOD	Joint Chemical Agent Detector Increment 2 (CBDP-CA - JCAD Inc 2)
119	DOD	Joint Chemical Agent Detector M4/M4E1 (CBDP-CA - JCAD M4/M4E1)
120	DOD	Joint Chemical, Biological and Radiological Agent Water Monitor (CBDP-CA - JCBRAWM)
121	DOD	Joint Command and Control Capability Area (Joint C2)
122	DOD	Joint Effects Model (CBDP-IS - JEM)
123	DOD	Joint Expenditionary Collective Protection (CBDP-CP - JECP)
124	DOD	Joint Light Tactical Vehicle (JLTV)
125	DOD	Joint Material Decontamination System (CBDP-DECON - JMDS)
126	DOD	Joint Operations Effects Federation (CBDP-IS - JOEF)
127	DOD	Joint Protective Aircrew Ensemble (CBDP-IP - JPACE )
128	DOD	Joint Service Aircrew Mask Apache (CBDP-IP - JSAM Apache)
129	DOD	Joint Service Aircrew Mask Fixed Wing (CBDP-IP - JSAM FW)
130	DOD	Joint Service Aircrew Mask Rotary Wing (CBDP-IP - JSAM RW)
131	DOD	Joint Service General Purpose Mask (JSGPM) (CBDP-IP - JSGPM)
132	DOD	Joint Service Lightweight Integrated Suit Technology - AFS/IFS (CBDP-IP - JSLIST AFS/IFS)
133	DOD	Joint Service Lightweight Integrated Suit Technology - JB2GU FR (CBDP-IP - JSLIST JB2GU FR)
134	DOD	Joint Service Lightweight Integrated Suit Technology - JB2GU nFR (CBDP-IP - JSLIST JB2GUnFR)
135	DOD	Joint Service Lightweight Integrated Suit Technology - JC3 (CBDP-IP - JSLIST JC3)
136	DOD	Joint Service Lightweight Integrated Suit Technology - SUITS (CBDP-IP - JSLIST SUITS)
137	DOD	Joint Service Lightweight Standoff Chemical Agent Detector (CBDP-CA - JSLSCAD)
138	DOD	Joint Service NBC Reconnaissance System (CBDP-CA - JNBCRS)
139	DOD	Joint Service Personnel Decon System (CBDP-DECON - JSPDS)
140	DOD	Joint Service Transportable Decon System (CBDP-DECON - JSTDS - SS)
141	DOD	Joint Warning and Reporting Network (CBDP-IS - JWARN)
142	DOD	Key Management Infrastructure Increment 2 (KMI Inc 2)
143	DOD	M93/M93A1/M93A1P1 Fox NBC Reconnaissance Vehicle (CBDP-CA - FOX)
144	DOD	Medical Radiation Countermeasures (CBDP-MEDSYS - MRADC)
145	DOD	Nuclear, Biological, Chemical Reconnaissance Vehicle (CBDP-CA - NBCRV)
146	DOD	Plague Vaccine (CBDP-MEDSYS - Plague )
147	DOD	Product Director, Test Equipment, Stragety and Support (CBDP-CA - PD-TESS)
148	DOD	Public Key Infrastructure Increment 2 (PKI Inc 2)
149	DOD	Recombinant Botulinum Vaccine (CBDP-MEDSYS - rBV A/B)
150	DOD	Shipboard Collective Protection System Backfit (CBDP-CP - CPS BKFT)
151	DOD	Smallpox Vaccine System (CBDP-MEDSYS - Smallpox)
152	DOD	Teleport Generation 3 (Teleport Gen 3)
153	DOD	Theater Medical Information Program-Joint Increment 2 (TMIP-J Inc 2)
154	DOD	Unified Command Suite (CBDP-GUARD - UCS)
155	DOE	B61 Mod 12 Life Extension Program (B61-12 LEP)
156	DOE	W76 Mod 1 Life Extension Program (W76-1 LEP)
157	DOE	W78/88 Mod 1 Life Extension Program (W78/88-1 LEP)
158	DOE	W88 Alteration 370 (W88 ALT 370)
159	Navy	AGM-88E Advanced Anti-Radiation Guided Missile (AGM-88E AARGM)
160	Navy	AIM-9X Block II Sidewinder (AIM-9X Blk II)
161	Navy	Air and Missile Defense Radar (AMDR)
162	Navy	Amphibious Combat Vehicle (ACV)
163	Navy	Amphibious Ship Replacement (LX(R))
164	Navy	CH-53K Heavy Lift Replacement Helicopter (CH-53K)
165	Navy	Common Aviation Command and Control System Increment 1 (CAC2S Inc 1)
166	Navy	Consolidated Afloat Network Enterprise Services (CANES)
167	Navy	Cooperative Engagement Capability (CEC)
168	Navy	CVN 78 Gerald R. Ford Class Nuclear Aircraft Carrier (CVN 78)
169	Navy	DDG 1000 Zumwalt Class Destroyer (DDG 1000)
170	Navy	DDG 51 Arleigh Burke Class Guided Missile Destroyer (DDG 51)
171	Navy	Dept of the Navy-Large Aircraft-Infrared Counter Measures (DoN-LAIRCM)
172	Navy	Distributed Common Ground System-Navy Increment 1 (DCGS-N Inc 1)
173	Navy	Distributed Common Ground System-Navy Increment 2 (DCGS-N Inc 2)
174	Navy	E-2D Advanced Hawkeye Aircraft (E-2D AHE)
175	Navy	EA-18G Growler Aircraft (EA-18G)
176	Navy	Global Combat Support System-Marine Corps Logistics Chain Management Increment 1 (GCSS-MC LCM Inc 1)
177	Navy	Global Command and Control System-Maritime Increment 2 (GCCS-M Inc 2)
178	Navy	Ground/Air Task Oriented Radar (G/ATOR)
179	Navy	H-1 Upgrades (4BW/4BN) (H-1 Upgrades)
180	Navy	Integrated Defensive Electronic Countermeasures (IDECM)
181	Navy	Joint and Allied Threat Awareness System (JATAS)
182	Navy	Joint Precision Approach and Landing System Increment 1A (JPALS Inc 1A)
183	Navy	Joint Standoff Weapon - Baseline Variant and Unitary Warhead Variant (JSOW)
184	Navy	KC-130J Transport Aircraft (KC-130J)
185	Navy	LHA 6 America Class Amphibious Assault Ship (LHA 6)
186	Navy	Littoral Combat Ship (LCS)
187	Navy	Littoral Combat Ship Mission Modules (LCS MM)
188	Navy	LPD 17 San Antonio Class Amphibious Transport Dock (LPD 17)
189	Navy	MH-60R Multi-Mission Helicopter (MH-60R)
190	Navy	Mobile Landing Platform (MLP)
191	Navy	Mobile User Objective System (MUOS)
192	Navy	MQ-4C Triton Unmanned Aircraft System (MQ-4C Triton)
193	Navy	MQ-8 Fire Scout Unmanned Aircraft System (MQ-8 Fire Scout)
194	Navy	Multifunctional Information Distribution System (MIDS)
195	Navy	Navy Multiband Terminal (NMT)
196	Navy	Next Generation Enterprise Network Increment 1 (NGEN Inc 1)
197	Navy	Next Generation Jammer (NGJ)
198	Navy	Offensive Anti-Surface Warfare (OASuW)
199	Navy	Ohio Class Submarine Replacement (Ohio Replacement)
200	Navy	P-8A Poseidon Multi-Mission Maritime Aircraft (P-8A)
201	Navy	Remote Minehunting System (RMS)
202	Navy	Ship to Shore Connector Amphibious Craft (SSC)
203	Navy	SSN 774 Virginia Class Submarine (SSN 774)
204	Navy	Standard Missile-6 (SM-6)
205	Navy	Tactical Tomahawk RGM-109E/UGM-109E Missile (TACTOM)
206	Navy	T-AO(X) Fleet Replenishment Oiler (T-AO(X))
207	Navy	Trident II (D-5) Sea-Launched Ballistic Missile UGM 133A (Trident II Missile)
208	Navy	Unmanned Carrier Launched Airborne Surveillance & Strike (UCLASS)
209	Navy	V-22 Osprey Joint Services Advanced Vertical Lift Aircraft (V-22)
210	Navy	VH-92A Presidential Helicopter (VH-92A)
	Do not disclose any classified information in this survey form.
211	(Identify Agency)	(Write-In Program Here)
212	(Identify Agency)	(Write-In Program Here)
213	(Identify Agency)	(Write-In Program Here)
214	(Identify Agency)	(Write-In Program Here)
215	(Identify Agency)	(Write-In Program Here)
216	(Identify Agency)	(Write-In Program Here)
217	(Identify Agency)	(Write-In Program Here)
218	(Identify Agency)	(Write-In Program Here)
219	(Identify Agency)	(Write-In Program Here)
220	(Identify Agency)	(Write-In Program Here)
221	(Identify Agency)	(Write-In Program Here)
222	(Identify Agency)	(Write-In Program Here)
223	(Identify Agency)	(Write-In Program Here)
224	(Identify Agency)	(Write-In Program Here)
225	(Identify Agency)	(Write-In Program Here)
226	(Identify Agency)	(Write-In Program Here)
227	(Identify Agency)	(Write-In Program Here)
228	(Identify Agency)	(Write-In Program Here)
229	(Identify Agency)	(Write-In Program Here)
230	(Identify Agency)	(Write-In Program Here)
	Do not disclose any classified information in this survey form.
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Section 5: Suppliers

For each type of input provided to your location by a key supplier: - First, in column 1, select the general category of the input supplied (Raw Materials, Electronics, Manufacturing Equipment, etc.). Then, select in column 2 the specific type of input and provide a description of the input in column 3. - Next, in columns 4-6, provide supplier information, and select in column 7 the primary product/service area (earlier specified in Section 3) in which your location uses the input. - Finally, indicate in columns 8-13 whether the supplier/input is critical for any reason. Note: Provision of supplier information is mandatory. Per Section 705(d) of the Defense Production Act, all data contained in this survey response remains business confidential and is exampt from Freedom of Information Act (FOIA) requests.

Input Details - Inputs to Your Products/Services

Supplier Information - Your Supplier

Input Utilization

Criticality

1: General Category Provided By Supplier

2: Input Area Provided By Supplier

3: Input Description

4: Supplier Name

5: Supplier State (if applicable)

6: Supplier Country

7: Primary Product/Service at Your Location in Which the Input is Utilized

8: Supports Multiple USG Programs

9: Single/Sole Supplier (see definitions)

10: Contributes Significantly to End Value

11: Long Lead Time

12: Obsolete Part

13: Other Critical Measure (if applicable)

ProductCats

Groups

group

Agroup

Bgroup

Cgroup

Dgroup

Egroup

Fgroup

Ggroup

Hgroup

Igroup

Jgroup

Kgroup

Lgroup

Mgroup

Ngroup

Ogroup

Pgroup

Qgroup

Rgroup

Sgroup

Tgroup

Ugroup

Vgroup

Wgroup

Xgroup

Ygroup

Example

P: Energy Systems & Energetics

P4 - Combustion engines

Truck engines

Sara's Engine Works

Alabama

United States

N1 - Light armored vehicles & designs

Yes

Neither

Yes

No

No

1.

(specify)

A: Raw Materials

Agroup

A1 - Ores

B1 - Integrated circuits

C1 - Additive manufacturing (3D printing)

D1 - Gas lasers

E1 - Directed electromagnetic radiation (not lasers)

F1 - Optics

G1 - Active sonar

H1 - Inertial measuring units

I1 - Mechanically steered radars

J1 - Compounds or materials engineered to reduce or eliminate a signature

K1 - Fixed wing combat aircraft

L1 - Space launch vehicles

M1 - Combat ships and landing vessels

N1 - Light armored vehicles & designs

O1 - Conventional small arms (5.56mm to .50 cal)

P1 - Gas turbine engines

Q1 - Nuclear reactors

R1 - DNA research

S1 - Chemical research

T1 - Nanotechnology

U1 - Soil cultivation machinery

V1 - Electron microscopes

W1 - Common data links

X1 - Computer aided design (CAD) software

Y1 - Analytic services

2.

(specify)

B: Electronics

Bgroup

A2 - Rare earth minerals

B2 - Application specific integrated circuits (ASICs)

C2 - Computer Numerical Control (CNC) machines

D2 - Solid state lasers

E2 - Directed particles with mass

F2 - Fiber optics

G2 - Passive sonar

H2 - Gyroscopes

I2 - Electronically steered radars

J2 - Chemical compositions of signature control compounds

K2 - Other fixed wing aircraft, including cargo and transport

L2 - Satellites and satellite buses

M2 - Transport vessels

N2 - Medium tactical vehicles & designs

O2 - Automatic and semi-automatic weapons

P2 - Rocket engines

Q2 - Nuclear weapon design and capabilities

R2 - RNA research

S2 - Chemical weapons destruction and demilitarization technology

T2 - Synthetic biology

U2 - Planting machinery

V2 - Sonograms

W2 - Monitors

X2 - Modeling and simulation software

Y2 - Canine training services

3.

(specify)

C: Manufacturing Equipment and Processes

Cgroup

A3 - Alloys

B3 - Radiation hardened integrated circuits

C3 - Lathes, grinding machines, planers, shapers

D3 - Chemical lasers

E3 - Directed sound

F3 - Polarization

G3 - Sonobouys

H3 - Global Positioning Systems

I3 - Phase adaptive radars

J3 - Processes used to apply signature control compounds

K3 - Rotary wing aircraft (including helicopters)

L3 - Space survivability systems and equipment

M3 - Cargo and tanker vessels

N3 - M1 Abrams variations of heavy tanks & designs

O3 - Mortar rounds

P3 - Generators

Q3 - Nuclear weapon destruction and demilitarization technology

R3 - Biological or physiological research

S3 - Chemical agent detection equipment

T3 - Energetic materials

U3 - Irrigation machinery

V3 - Magnetic Resonance Image (MRI) machines

W3 - Printers

X3 - Artificial intelligence software

Y3 - Construction

4.

(specify)

D: Lasers

Dgroup

A4 - Chemicals

B4 - Field programmable gate arrays (FPGAs)

C4 - Die press lines

D4 - Excimer lasers

E4 - Other directed energy products

F4 - Reflective coatings

G4 - Commercial off-the-shelf equipment used for sonar

H4 - Atomic clocks

I4 - Pulse radars

J4 - Other signature control products

K4 - Unmanned aerial vehicles and drones

L4 - Solid rocket motors and related equipment

M4 - Submarines

N4 - Transport vehicles & designs

O4 - Artillery rounds

P4 - Combustion engines

Q4 - Protective clothing

R4 - Biological weapons destruction and demilitarization technology

S4 - Chemical disaster response equipment

T4 - Quantum systems

U4 - Produce sorters

V4 - X-radiation machines

W4 - Telecommunication devices (phones, cell phones, radios, radio mounts)

X4 - Swarm software

Y4 - Consulting services

5.

(specify)

E: Directed Energy

Egroup

A5 - Fiber-based materials

B5 - Programmable memory

C5 - Robot work cells

D5 - Fiber lasers

F5 - Refractive coatings

G5 - Other sensor products

H5 - Accelerometers

I5 - Continuous wave radars

K5 - Airframes and structural components (including rotor blades, landing gear, hydraulics, etc.)

L5 - Liquid rocket motors and related equipment

M5 - Other marine systems

N5 - Wheeled or tracked vehicles not specified above

O5 - Rockets (endo and exoatmospheric)

P5 - Turbo fan engines

Q5 - Radiation detective devices (e.g. Geiger counters)

R5 - Biological agent detection equipment

S5 - Other chemical products

T5 - Computational modeling of human behavior

U5 - Harvesting technology

V5 - Medicine distribution technology

W5 - Commercial off-the-shelf equipment used for C4

X5 - Microelectronic design software

Y5 - Delivery and freight services

6.

(specify)

F: Optics

Fgroup

A6 - Other raw materials

B6 - Optical filters

C6 - Bearings

D6 - Photonic crystal lasers

F6 - Lenses

H6 - Other positioning, navigation, or timing products

I6 - Other radar products

K6 - Other aeronautic products

L6 - Other space system products

N6 - Unmanned ground systems

O6 - Missiles

P6 - Catapults

Q6 - Radioactive material storage

R6 - Biological disaster response equipment

T6 - Cognitive neuroscience

U6 - Other agricultural products

V6 - Disease and vector research

W6 - Computers and CPUs

X6 - System development kits (SDK)

Y6 - Education and training services

7.

(specify)

G: Acoustic Sensors

Ggroup

B7 - Micro-sensors

C7 - Transmission equipment (gears, pulleys, sprockets, belts, torque converters, etc.)

D7 - Semiconductor lasers

F7 - Other optics products

N7 - Other ground system products

O7 - Hypervelocity weapons

P7 - Batteries

Q7 - Nuclear disaster response equipment

R7 - Other biological products

T7 - Other emerging technology

V7 - Other medical products

W7 - Antennas

X7 - Software algorithms

Y7 - Engineering services

8.

(specify)

H: Positioning, Navigation, and Timing

Hgroup

B8 - Vacuum tubes

C8 - Welding, soldering, and brazing equipment

D8 - Dye lasers

O8 - Launchers (missile, torpedo, rocket, etc.)

P8 - Propellants

Q8 - Other nuclear products

W8 - Beyond the line of sight C2

X8 - Correlation software

Y8 - Financial and banking services

9.

(specify)

I: Radars

Igroup

B9 - Capacitors

C9 - Other manufacturing equipment

D9 - Free electron lasers

O9 - Underwater explosives (mines, torpedos, etc.)

P9 - Other energy systems products

W9 - Line of sight C2

X9 - Database

Y9 - General contracting

10.

(specify)

J: Signature Control

Jgroup

B10 - Microprocessors

D10 - Bio lasers

O10 - Fire control systems and components

W10 - Other C4 products

X10 - Computer language software

Y10 - Graphic arts, video, digital production services

11.

(specify)

K: Aeronautic Systems

Kgroup

B11 - Microcontrollers

D11 - Other laser products

O11 - Body armor

X11 - Operating systems

Y11 - Information technology services

12.

(specify)

L: Space Systems

Lgroup

B12 - Digital signal processors

O12 - Other armor

X12 - Finance and accounting software

Y12 - Internet service provision

13.

(specify)

M: Marine Systems

Mgroup

B13 - Diodes

O13 - Other armaments, explosives, or survivability products

X13 - Other software products

Y13 - Janitorial services

14.

(specify)

N: Ground Systems

Ngroup

B14 - Wafers (any molecular composition)

Y14 - Legal services

15.

(specify)

O: Armaments and Survivability

Ogroup

B15 - Circuit boards

Y15 - Logistical services

16.

(specify)

P: Energy Systems & Energetics

Pgroup

B16 - Flexible circuit boards

Y16 - Marketing services

17.

(specify)

Q: Nuclear

Qgroup

B17 - Other electronic products

Y17 - Medical services

18.

(specify)

R: Biological

Rgroup

Y18 - Professional Services

19.

(specify)

S: Chemical

Sgroup

Y19 - Property management services

20.

(specify)

T: Emerging Technology

Tgroup

Y20 - Security and protection services

21.

(specify)

U: Agricultural

Ugroup

Y21 - Staffing services

22.

(specify)

V: Medical

Vgroup

Y22 - Telecommunication services

23.

(specify)

W: Command, Control, Communication, and Computer

Wgroup

Y23 - Translation services

24.

(specify)

X: Software

Xgroup

Y24 - Transportation services

25.

(specify)

Y: Services and Other Products

Ygroup

Y25 - Other services

Comments:

Y26 - Products not listed

BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 19: 6

Previous Page		Table of Contents				Next Page
Section 6: Employment
Record the total number of full time equivalent (FTE) employees and contractors employed by this location for the past three years. This may include employees who work off-site but report to this location.
A.				2013	2014	2015
	FTE Employees
	FTE Contractors
B.	How many non-U.S. citizens work at your location?
	If yes, identify the number of each type of non-U.S. citizen worker currently employed at your location.
		H-1B	H-2B	F-1	Green Card	Other
	FTE Employees
	FTE Contractors
	List each country (other than the U.S.) from which your location has non-U.S. citizen workers (employees or contractors), and identify the number of each type of visa or green card holder associated with each country.
	Country	H-1B	H-2B	F-1	Green Card	Other
C.	Provide the number of FTE employees and contractors employed by this location that hold active security clearances at the following levels:			Top Secret	Secret	Confidential
D.	Does your location have difficulty hiring and/or retaining any parts of its workforce? If yes, identify which occupations and explain your selection.
	Occupation		Difficulty	Explanation
	Engineers, Scientists, and R&D Staff
	Information Technology Professionals
	Production Line Workers
	Testing Operators and Quality Control Technicians
	Other	(specify here)
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 20: 7

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Section 7: Sales

Provide your location's total sales information for the past three years to U.S. and non-U.S. customers. If location level data is not available, contact survey support staff at [email protected] before entering higher level data. In Part B, indicate your location's total sales for defense-related purposes (including commercial and government sales). In Part C, indicate your location's total sales from classified contracts. In Part D, indicate your location's total sales to all governments. Note: "U.S." means U.S. domestic sales; "Non-U.S." means export sales from U.S. locations.

Source of Sales Data:

Reporting Schedule:

Record in $ Thousands, e.g. $12,000.00 = survey input $12

2013

2014

2015*

Data Confirmation

U.S.

Non-U.S.

U.S.

Non-U.S.

U.S.

Non-U.S.

Total Listed 2015 Sales

A.

Total Sales, all Customers (in $)

None

Lines B-D need not sum to 100%. Estimates are acceptable. Ensure you complete lines B-D for all years with sales. Do not disclose any classified information in this survey form.

B.

Total Defense-Related Sales (as a % of A)

C.

Total Sales from Classified Contracts (as a % of A)

D.

Total Sales from all Government Contracts (as a % of A)

* Furnish full year estimates for 2015 if data is unavailable.

Comments:

BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 21: 8

Previous Page		Table of Contents		Next Page
Section 8: Top Customers
Identify your location's top U.S. and non-U.S. direct customers by sales for the past three years. A direct customer is the immediate entity to which you sell your products/services. Customers can include other business units/divisions within your parent organization. Indicate the type of customer and their location.
Location's Top U.S.-Based Customers
	Estimated total number of U.S.-based customers in past three years:
Customer Name		Type of Customer	Customer City	Customer State
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Location's Top Non-U.S.-Based Customers
	Estimated total number of non-U.S.-based customers in past three years:
Customer Name		Type of Customer	Customer City	Customer Country
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 22: 9a

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Section 9a: Physical and Cyber Security Procedures

A.

In the event of a suspected/confirmed security incident at your location, do you know what authorities to contact?

Indicate which organizations your location would notify in response to a suspected/confirmed security incident by briefly describing the type of incident(s) for which you would contact the organization.

Defense Security Service (DSS)

Government-Industry Data Exchange Program (GIDEP)

Defense Logistics Agency (DLA)

National Aeronautics & Space Administration (NASA)

Defense-Related Investigative Services (e.g. DCIS, NCIS, etc.)

National Security Agency (NSA)

Department of Commerce, Bureau of Industry and Security (BIS)

Nuclear Regulatory Commission (NRC)

Department of Energy (DOE)

Secret Service Electronic Crimes Task Force

Department of Homeland Security (DHS)

State & Local Authorities

Department of Justice (DOJ)

US-CERT

Federal Bureau of Investigation (FBI)

None at All

Federal Communications Commission (FCC)

Other

(specify here)

Federal Trade Commission (FTC)

Other

(specify here)

B.

State the number of security incidents your location has recorded in each year:

Year

Physical Incidents

Cyber Incidents

2013

2014

2015

C.

Indicate which of the following security measures are in place at this location:

Physical Security

Cyber Security

After hours inspections of cleared areas

Account Monitoring and Control

Inventory of Authorized/Unauthorized Software

CCTV monitoring

Application Software Security

Limitation/Control of Network Ports and Services

Control of facility points of entry

Boundary Defense

Maintenance, Monitoring, & Analysis of Audit Logs

Intrusion alarms

Continuous Vulnerability Assessment

Malware Defenses

Perimeter barriers around facility

Controlled Access Based on Need to Know

Penetration Tests and Red Team Exercises

Personnel physical access cards

Controlled Use of Administrative Privileges

Secure Configurations on Hardware

Physical separation of cleared areas

Data Protection

Secure Configurations of Network Devices

Security guards

Data Recovery Capability

Secure Network Engineering

Other

(specify here)

Incident Response and Management

Security Skills Assessments and Training

Other

(specify here)

Inventory of Authorized/Unauthorized Devices

Wireless Access Control

Other

(specify here)

Other

(specify here)

Other

(specify here)

D.

Is this location familiar with the National Institute of Standards and Technology's (NIST) Cyber Security Framework? (http://www.nist.gov/cyberframework/):

Does this location employ any of the NIST Cyber Security Framework's recommended controls?

Provide any explanations of the controls your location has in place or feedback you may have on potential improvements, clarifications, or other changes:

Comments:

BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 23: 9b

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Section 9b: Physical and Cyber Security Procedures (Cont.)

A.

Is this location a possessing (has access to on-site classified information) or non-possessing (employees only access classified information off-site) facility? ALL LOCATIONS (possessing and non-possessing) should complete this section, based on their on-site systems.

Estimate your location's spending on physical and cyber security, in thousands of dollars. Note: Location level data is strongly preferred. If you do not keep this information at a location level, provide data at the next highest level available.

Record $ in Thousands, e.g. $12,000.00 = survey input of $12

Source of Security Expenditure Data:

Reporting Schedule:

2013

2014

2015*

Data Confirmation

1

Physical Security

Total 2015 Security Expenditures

2

Cyber Security

None

* Furnish full year estimates for 2015.

B.

Provide the following information on remote network access:

1

Are employees and/or contractors able to access this facility's internal networks remotely?

Explain:

2

Are any other organizations/companies able to access this facility's internal networks remotely?

Explain:

C.

Provide the following information on data storage and sharing:

1

Does your location or parent organization operate its own data center in the U.S.?

If yes, how many?

2

Does your location or parent organization operate its own data center outside the U.S.?

If yes, how many?

3

Does your location use a U.S.-based cloud service or external data storage provider?

4

Does your location use a non-U.S.-based cloud service or external data storage provider?

5

Estimate the percentage of your location's Commercially Sensitive Information that is stored with cloud services or external data storage providers:

6

Does your location share Commercially Sensitive Information with non-U.S. organizations in order to support business operations? This might include the sharing of customer information, proprietary designs, R&D information, production data, etc.

If yes, identify both the types of CSI shared and the countries of the organizations it is shared with:

D.

Provide the following information on cyber threats (to all systems, both classified and unclassified):

1

Is your location able to detect the theft of, or unauthorized access to, Commercially Sensitive Information by cyber means?

If yes, has your location investigated the source of any such theft or unauthorized access in the past three years?

Explain:

2

Is your location able to detect an Advanced Persistent Threat (APT)?

If yes, estimate how many APTs your location has encountered in the past three years:

3

Identify any impacts or actions resulting from malicious cyber activity at your location in the past three years:

Impacts Experienced

Actions Undertaken

IT downtime

Revised approach to international partnerships

Costs from damage assessment/remediation

Significant change in R&D strategy

Loss of sales/Business interruption

Exit from foreign markets or market segments

Exfiltration of Commercially Sensitive Information

Exit from product or business line

Damage to IT infrastructure

Major new investment in cyber security

Damage to company production capabilities or systems

Other

(specify here)

Theft of software and/or source code

Other

(specify here)

Comments:

BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 24: 10

Previous Page				Table of Contents				Next Page
Section 10: Classified Contract Information
Provide the following information on your classified contracts:
Do not disclose any classified information in this survey form.
A.	Number of classified prime contracts awarded to this location in the past three years
	Number of classified subcontracts awarded to this location in the past three years
	Number of classified subcontracts this location awarded to contractors in the past three years
	Number of classified foreign contracts awarded to this location in the past three years
B.	How many contracts with active DD-254s does this location manage/administer:
C.	Identify the top ten contracts with active DD-254s your location manages, in descending order of total contract award dollars. Do not disclose any classified information in this survey form. If any of the requested information is classified, enter "Classified" in the corresponding field.
		Contract ID Number	CAGE Associated with Contract	USG Customer	USG Program	Product/Service 1	Product/Service 2	Product/Service 3
	1
	2
	3
	4
	5
	6
	7
	8
	9
	10
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 25: 11

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Section 11: Research & Development
A.	Does your location conduct research and development (R&D)?				If no, proceed to Section 12.
In Question B, record your location's total R&D dollar expenditures and type of R&D expenditure for the previous three years. In Question C, identify your location's R&D funding sources, by percent of total R&D dollars sourced. Note: Location level data is strongly preferred. If you do not keep this information at a location level, provide data at the next highest level available.
			Source of R&D data:
			Reporting Schedule:
B.				Record $ in Thousands, e.g. $12,000.00 = survey input of $12
				2013	2014	2015*
	1	Total R&D Expenditures						Data Confirmation
	2	Basic Research (as a percent of B1)						Total 2015 R&D Expenditures
	3	Applied Research (as a percent of B1)						None
	4	Product/Process Development (as a percent of B1)
	5	Total of 2 - 4 (must equal 100%)		0%	0%	0%
C.				Record $ in Thousands, e.g. $12,000.00 = survey input of $12
				2013	2014	2015*
	1	Total R&D Funding Sources
	2	Internal/Self-Funded/IRAD (as a percent of C1)
	3	Total Federal Government (as a percent of C1)
	4	Total State and Local Government (as a percent of C1)
	5	Universities - Public and Private (as a percent of C1)
	6	U.S. Industry, Venture Capital, Non-Profit (as a percent of C1)
	7	Non-U.S. Investors (as a percent of C1)
	8	Other	(specify here)
	9	Total of 2 - 8 (must equal 100%)		0%	0%	0%
* Furnish full year estimates for 2015 if data is unavailable.
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 26: 12

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Section 12: Financials
Provide the following financial line items for your location for the last three years below. Note: Location level data is strongly preferred. If you do not keep this information at a location level, provide data at the next highest level available.
Source of Income Statement Items:
Reporting Schedule:
Income Statement (Select Line Items)			Record $ in Thousands, e.g. $12,000.00 = survey input of $12
			2013	2014	2015*
A.	Net Sales (and other revenue)						Data Confirmation
B.	Cost of Goods Sold						2015 Net Sales
C.	Total Operating Income (Loss)						None
D.	Earnings Before Interest and Taxes
E.	Net Income
Source of Balance Sheet Items:
Reporting Schedule:
Balance Sheet (Select Line Items)			Record $ in Thousands, e.g. $12,000.00 = survey input of $12
			2013	2014	2015*
A.	Cash
B.	Inventories
C.	Total Current Assets
D.	Total Assets
E.	Total Current Liabilities
F.	Total Liabilities
G.	Retained Earnings
H.	Total Owner's Equity
* Furnish full year estimates for 2015 if data is unavailable.
Note: Total Assets must equal Total Liabilities plus Total Owner's Equity
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 27: 13

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Section 13: Challenges and Outreach
A.	Identify the issues that have impacted your location in the past three years. In column A, select YES/NO from the dropdown menu. In column B, rank your top five issues (one being the most important) by selecting numbers one through five, using each rank exactly once. In column C, provide an explanation for the relevant issues.
	Type of Issue			A	B	C
				-Yes/No-	Rank Top 5	Explanation of Issue:
	Aging equipment, facilities, or infrastructure
	Aging workforce
	Counterfeit parts
	Cyber security
	Domestic competition
	Environmental regulations/remediation
	Export controls/ITAR & EAR
	Foreign competition
	Government acquisition process
	Government purchasing volatility
	Government regulatory burden
	Healthcare
	Input availability
	Intellectual property/patent infringement
	Labor availability/costs
	Obsolescence
	Pension costs
	Proximity to customers
	Proximity to suppliers
	Qualifications/certifications
	Quality of inputs
	R&D costs
	Reduction in USG demand
	Taxes
	Worker/skills retention
	Other	(specify here)
B.	There are many federal and state government programs and services available to assist your organization to better compete in the global marketplace. If your organization would like more information regarding these government programs, select the specific areas of interest below. The Commerce Department will follow-up with your organization regarding your selections.
	Continuous Improvement/ Lean Manufacturing			Market Expansion/Business Growth
	Cyber Security			Product Design
	Design for Assembly			Prototyping
	Design for Manufacturability			Quality Management and Control
	Energy and Environmentally Conscious Manufacturing			Small Business Innovation Research (SBIR) and Small Business Technology Transfer (STTR) contracts
	Export Assistance			Supply Chain Optimization
	Export Licensing (ITAR/EAR)			Technology Acceleration
	Government Procurement Guidelines			Vendor/Material Sourcing
Comments:
BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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Sheet 28: 14

xx

0%

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xx

Section 14: Certification

xx

The undersigned certifies that the information herein supplied in response to this questionnaire is complete and correct to the best of his/her knowledge. It is a criminal offense to willfully make a false statement or representation to any department or agency of the United States Government as to any matter within its jurisdiction (18 U.S.C.A. 1001 (1984 & SUPP. 1197)) Once this survey is complete, first save it to your computer, and then submit the document via the Census Bureau portal linked here:

Verification Metrics

https://respond.census.gov/criticalfacility

Location Name

Organization Name

Sales/Net Sales

No Net Sales

Organization's Internet Address

Revenue per Employee

No Employees

Name of Authorizing Official

Income Progression

Income Reasonable

Title of Authorizing Official

Cash/Current Assets

Cash/Current Assets Reasonable

E-mail Address

Current/Total Assets

Current/Total Assets Reasonable

Phone Number and Extension

Current/Total Liabilities

Current/Total Liabilities Reasonable

Date Certified

R&D Sources

R&D Funding = R&D Expenditure

In the box below, provide any additional comments or any other information you wish to include regarding this survey assessment.

Cyber, Physical Expenditures

No physical or cyber security expenditures listed

xx

How many hours did it take to complete this survey?

Completion Estimate

0%

BUSINESS CONFIDENTIAL - Per Section 705(d) of the Defense Production Act

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