20Q0334 Exhibit A.pdf
PDF 212 KB Posted
- Attached to
- Manufacture Weld Qual Membranes for PNS
- Solicitation number
- N3904020Q0334
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Other files
| File | Type | Posted |
|---|---|---|
| 20Q0334 Attachment 3 - Drawing 149D1555 UNCLASS.pdf | ||
| 20Q0334 RFQ Request for Quote Sheet 200920.doc | DOC document | |
| 20Q0334 Exhibit B.pdf | ||
| 20Q0334 Attachment 2.pdf | ||
| 20Q0334 Attachment 1.pdf |
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PRINTED (DATE CREATED) PAGE _______
EXHIBIT A
(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)
CONTRACT DATA REQUIREMENTS LIST
SYSTEM/ITEM; WELD MEMBRANE PC 12 CATEGORY ____________
ITEM NO CONTRACTOR
01 SEQ NO A001
02 DATA DESC CERTIFICATE OF COMPLIANCE
03 SUBTITLE
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.1
06 TECH OFFICE 2370.1
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
15 TOTAL __
16 REMARKS
SEQ. NO. A001
PREPARED BY ________________________________________________ DATE__________________ APPROVED BY ________________________________________________ DATE__________________
DD FORM 1423
CONTRACT N3904020Q0334 __________________ 1/5
(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)
CONTRACT DATA REQUIREMENTS LIST
SYSTEM/ITEM; WELD MEMBRANE PC12 CATEGORY ____________
ITEM NO CONTRACTOR
01 SEQ NO A002
02 DATA DESC CHEMICAL CERTIFICATION
03 SUBTITLE BASE MATERIAL
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.2
06 TECH OFFICE 2370.1
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
15 TOTAL __
16 REMARKS
SEQ. NO. A002
PREPARED BY ________________________________________________ DATE__________________ APPROVED BY ________________________________________________ DATE__________________
CONTRACT N3904020Q0334 __________________ 2/5
(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)
CONTRACT DATA REQUIREMENTS LIST
SYSTEM/ITEM; WELD MEMBRANE PC12 CATEGORY ____________
ITEM NO CONTRACTOR
01 SEQ NO A003
02 DATA DESC MECHANICAL CERTIFICATION
03 SUBTITLE BASE MATERIAL
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.3
06 TECH OFFICE ______
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
15 TOTAL __
16 REMARKS
SEQ. NO. A003
PREPARED BY ________________________________________________ DATE__________________ APPROVED BY ________________________________________________ DATE__________________
CONTRACT __N3904020Q0334 3/5
(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)
CONTRACT DATA REQUIREMENTS LIST
SYSTEM/ITEM; WELD MEMBRANE PC12 CATEGORY ____________
ITEM NO CONTRACTOR
01 SEQ NO A004
02 DATA DESC LIQUID PENETRANT CERTIFICATION
03 SUBTITLE
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.4
06 TECH OFFICE 2370.1
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
15 TOTAL __
16 REMARKS
SEQ. NO. A004
PREPARED BY ________________________________________________ DATE__________________ APPROVED BY ________________________________________________ DATE__________________
DD FORM 1423
CONTRACT N3904020Q0334__
4/5
(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)
CONTRACT DATA REQUIREMENTS LIST
SYSTEM/ITEM; WELD MEMBRANE PC12 CATEGORY ____________
ITEM NO CONTRACTOR
01 SEQ NO A005
02 DATA DESC DIMENTIONAL VERIFICATION
03 SUBTITLE
04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A
05 CONTRACT REF PARA. C.6.5
06 TECH OFFICE 2370.1
07 DD 250 REQ DD
08 APP CODE
09 IAC INPUT
10 FREQUENCY O-TIME
11 AS OF DATE
12 DATE 1ST SUBM WITH MATERIAL
13 DATE SUB SUBM
14 DISTRIBUTION 410 __/ 0 VIA MAIL (N0 DD 250 REQD)
15 TOTAL __
16 REMARKS
SEQ. NO. A005
PREPARED BY ________________________________________________ DATE__________________ APPROVED BY ________________________________________________ DATE__________________
CONTRACT N3904020Q0334 __________________ 5/5
Attachment 1 to EXHIBIT A
ITEM __0003 (Data for Item 0001)______________________ (DATE FOR ITEM) _________________
REQUIRED CERTIFICATION
A. CERTIFICATION SHALL BE SUPPLIED WITH EACH SHIPMENT OF MATERIAL.
CERTIFICATION (CERTIFICATE OF COMPLIANCE) SHALL BE SUPPLIED AS OUTLINED IN
PARAGRAPH B. THE VENDOR IS LIABLE FOR CONDUCTING ALL TESTS, ANALYSES,
INSPECTIONS, AND EXAMINATIONS, ETC., AS SPECIFIED BY THE CONTRACT AND
SPECIFICATIONS WHETHER CERTIFICATIONS ARE REQUIRED OR NOT.
CERTIFICATE OF COMPLIANCE (PROVIDE THE FOLLOWING VERBATIM STATEMENT OR
COMPLETE THE OPTIONAL FORM AT THE END OF THIS PART)
"I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH
ALL CONTRACT REQUIREMENTS".
B. CERTIFICATION SHALL BE SUPPLIED PER THE FOLLOWING INSTRUCTIONS:
1. THE CERTIFICATION OF COMPLIANCE SHALL CONTAIN THE SIGNATURE AND TITLE OF
THE VENDOR OFFICIAL DESIGNATED RESPONSIBLE FOR QUALITY ASSURANCE.
2. THE MATERIAL IDENTIFICATION (E.G. LOT, BATCH, PART #, ETC.) SHALL BE INCLUDED
ON THE CERTIFICATE OF COMPLIANCE.
CONTRACT N3904020Q0334___
CONTRACT/SOLICITATION ___N3904020Q0334________________________________________________
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MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)
CONTRACT NO. ______________ ORDER NO. ________________ ITEM NO. __0001____________ NATIONAL/LOCAL STOCK NO. NSN/LSN ____________________________________________________ MANUFACTURER’S PART NO. _____________________________________________________________ MANUFACTURER’S SERIAL NO. ___________________________________________________________ DRAWING AND PIECE NO. _________________________________________________________________
MANUFACTURER’S LOT/HEAT NOS. AS MARKED ON THE MATERIAL _________________________
ALL INSPECTIONS AND TEST REPORTS REQUIRED BY ATTACHMENT I TO EXHIBIT A (DD FORM
1423) FOR TRACEABILITY TO EACH CONTRACT ITEM MUST ACCOMPANY THIS SIGNED
STATEMENT:
THE INSPECTION AND TEST REPORTS (AS APPLICABLE) PROVIDED REPRESENT THE ACTUAL
ATTRIBUTES OF THE ITEMS FURNISHED ON THIS CONTRACT AND INDICATE FULL
COMPLIANCE WITH ALL CONTRACT REQUIREMENTS. I ATTEST ALL ITEMS FURNISHED ON
THIS CONTRACT ARE IN FULL COMPLIANCE WITH ALL CONTRACT REQUIREMENTS.
SIGNATURE ___________________________________________________ DATE _______________
QUALITY ASSURANCE OFFICIAL
CONTRACT __N3904020Q0334
Attachment 1 to EXHIBIT A
CERTIFICATE OF COMPLIANCE
COMPANY NAME
2/2
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