3427116_SMW_REPORT.pdf
PDF 116 KB Posted
- Attached to
- F100 Circuit Card Assembly
- Solicitation number
- FD20302500228
About this file
This Surplus Materiel Worksheet is a detailed evaluation document for a specific electronic circuit board component (Part Number 1002169-2, NSN 5998015391742NZ) used in the F100-PW-220/220E/229 engine application. The document indicates the potential availability of surplus material to fulfill government needs, with a comprehensive evaluation process outlined to assess the acceptability of the surplus item across multiple criteria including prior government ownership, inspection, testing, and verifiable dimensions.
The worksheet specifies strict acceptance requirements, including that the part must be in an original unopened package with correct labeling, show no evidence of corrosion, and have undamaged packaging. The evaluation was completed on 07 APR 2022 by an engineer from AFLCMC/LPSEA, with the original request dated 04 FEB 2022. The surplus material is associated with a broader federal contract opportunity (Solicitation Number FD20302500228) for an Air Force spares purchase of 62 Circuit Card Assembly units, with delivery expected by 31 Dec 2025 and a quantity range of 16-93 units.
View the file
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Text version
SURPLUS MATERIEL WORKSHEET
DATE
04 FEB 2022
I. REQUEST FOR EVALUATION
NSN
5998015391742NZ
PART NUMBER
1002169-2
CAGE
73030
APPLICATION
F100-PW-220/220E/229
IMS
Nichols, Harry E
OFFICE SYMBOL
421 SCMS / GUMAD
PHONE
405-736-2239
SURPLUS MATERIEL MAY BE AVAILABLE TO FULFILL THE GOVERNMENT'S NEEDS FOR THIS ITEM. AS A RESULT, AN EVALUATION MUST BE PERFORMED
IAW AFMC FAR SUPPLEMENT PART 5352.
THE EVALUATION ON THIS ITEM INDICATES SURPLUS MATERIEL WILL BE CONSIDERED IN THE FOLLOWING TYPES / CATEGORIES
II. EVALUATION CRITERIA (For types/categories deemed acceptable)
ACCEPT-
ABLE (Y/N)
P/N AND
MFG
VERIFI-
CATION
PRIOR
GOV'T
OWNER-
SHIP
100% END
ITEM
INSPECT
TEST AND
VERIFI-
CATION
VERIFI-
ABLE
DIMEN-
SIONS
LOCATION
INSPEC-
TION
TESTING
INITIAL
ACCEPT-
ABILITY
ITEMS
OVERHAUL
AND
CERTIFI-
CATION
OTHER
(Explain in Remarks)
Y X X X
N
N
N
N
N
N
N
G O V T
S U R P L U S
NEW/UNUSED
NEW/RECONDITIONED
NEW/MODIFIED
USED/OVERHAULED
C O M M L
S U R P L U S
NEW/UNUSED
NEW/RECONDITIONED
NEW/MODIFIED
USED/OVERHAULED
SURPLUS EVALUATION CRITERIA (If Section 11a. indicates surplus materiel may be considered). (Fill in blanks as appropriate)
PART NUMBER VERIFICATION 73030(AFMCFARS 5352.211-9011) MFG 1002169-2P/N
PRIOR GOVERNMENT OWNERSHIP (AFMCFARS 5352.211-9015)
100% END ITEM INSPECTION (AFMCFARS 5352.211-9017)
TEST AND VERIFICATION (AFMCFARS 5352.211-9013) TECH ORDER NUMBER
VERIFIABLE DIMENSION (AFMCFARS 5352.211-9012) DESIGN ACTIVITY
DRAWING NUMBER
LOCATION OF INSPECTION TESTING (AFMCFARS 5352.211-9015)
INITIAL ACCEPTABILITY ITEMS (AFMCFARS 5352.211-9014) A QUANTITY OF ITEMS WILL BE TESTED FOR INITIAL ACCEPTANCE
6J3-4-117-2
TEST WILL BE CONDUCTED USING THE FOLLOWING CRITERIA (and location of testing)
OVERHAUL AND CERTIFICATION (AFMCFARS 5352.211-9010)
N/A
OTHER SPECIAL REQUIREMENTS (Explain)
Sanor, Dacota RNAME: 07 APR 2022DATE:
Surplus Offerors shall complete and return the "Required Information for Surplus Material Evaluation" form, attached, in accordance with FAR 11.302(b).
The Contracting Officer shall obtain approval/ disapproval from the Cognizant Engineer based on the completed form returned by the surplus offeror prior to accepting or rejecting the surplus offer.
REMARKS
JUSTIFICATION FOR UNACCEPTABLE SURPLUS MATERIEL
Surplus items that do not conform to all of the above requirements, including those in the REMARKS section, are not acceptable. Misrepresentation of any item by the offeror shall be cause for rejection and return of all items to the offeror at no cost to the government.
-The part shall be in the original unopened package, labeled with the correct part number and NSN.
-Misrepresentation of any item by the surplus vendor shall be cause for rejection.
-Damage to packaging shall be cause for rejection as these parts are susceptible to corrosion.
-Any evidence of corrosion shall be cause for rejection of part.
-Rejected parts will be returned to the vendor at no cost to the government
Page 1 of 2AFMC FORM 813, 20000323 (IMT-V1) Version 6Generated by PRPS using Jasper Reports on 15 Apr 2025
SURPLUS MATERIEL WORKSHEET
DATE
04 FEB 2022
EVALUATOR
Sanor, Dacota R
OFFICE SYMBOL
AFLCMC / LPSEA
PHONE
405-734-4526 / 884-4526
COMPLETE DATE
07 APR 2022
SIGNATURE
//SIGNED// Sanor, Dacota R
USER TYPE
Engineer
SIGNATURE DATE
07 APR 2022
Page 2 of 2AFMC FORM 813, 20000323 (IMT-V1) Version 6Generated by PRPS using Jasper Reports on 15 Apr 2025
File details come from the government source that posted it. Updated .