3469_A_Form16.pdf

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NSWC IHEODTD 4200

NSWC IHEODTD 4200/9 REV (AUG 2018)

Page of

PREVIOUS EDITION IS OBSOLETE

QUALITY ASSURANCE REQUIREMENTS FORM

AKA Contracts Form 16

INSPECTION

CERTIFICATIONS

IMPORTANT - A single copy of these certifications must accompany the parts upon delivery

- The container holding these documents must be legibly marked as such

- An additional copy of these certs must also be forwarded to the point of contact identified in this form.

REQUIRED CERTIFICATIONS TABLE for

TEST / INSPECTION

CERTIFICATES

Analysis † Compliance ‡ † requires inclusion clause IHEODTD 88 if any row is checked in this column. ‡ requires inclusion clause IHEODTD 89 if any row is checked in this column Note: Customer is to select the applicable Special Clause(s), as follows, and the selected clause(s) shall be incorporated into the solicitation / award document:

SPECIAL CLAUSES

When NAVSEA, Naval Surface Warfare Center Indian Head Explosive Ordnance Disposal Technology Division receipt inspects ordnance material and/or ordnance component parts, under this contract, for rockets, missiles and their related component parts; the sampling plan utilized shall be as outlined in the technical data package or as otherwise specified in other applicable controlling documentation. If the sampling plan is not specified within any applicable controlling documentation the sampling plan and the sampling size shall be as outlined by one of the following denoted below If deemed appropriate by the procuring activity the Other option may be employed.

a.

Requirements Generator Instruction

- Select one of the following and provide appropriate sampling values & codes. Final determination will be based on the product that is inspected Critical:

100% Major:

Minor:

Critical:

100% Major:

Minor:

Critical:

100% Major:

Minor:

Critical:

100% Major:

Minor:

In all cases, the acceptance number will be ZERO (0); the entire lot will be rejected for any defect unless specifically otherwise specified by the inspection type and code.

b..

c..

Notwithstanding the above, the NAVSEA, Naval Surface Warfare Center Indian Head Explosive Ordnance Disposal Technology Division may at its discretion, accept a defect on an approved waiver on a case-by-case basis.

a.

When the NAVSEA, Naval Surface Warfare Center Indian Head Explosive Ordnance Disposal Technology Division receipt inspects man-rated matériel, under this contract, for catapults, cartridge actuated devices, propellant actuated devices and their related component parts, the sampling plan utilized shall be as outlined in the applicable technical data package or as otherwise specified in other controlling documentation. If the sampling plan is not specified within any applicable controlling documentation the sampling plan and the sampling size shall be as outlined by one of the following denoted below:

Requirements Generator Instruction

- Select one of the following and provide appropriate sampling values & codes. Final determination will be based on the product that is inspected Critical:

100% Major:

Level II Minor:

Level I Critical:

Level V Major:

Level II, N < 200 Level III, N > 200 Minor:

Level I, N < 100 Level II, N > 100 b.

In all cases, the acceptance number will be ZERO (0); the lot will be rejected for any defect unless specifically otherwise specified by the inspection type and code.

c.

Notwithstanding the above, the NAVSEA, Naval Surface Warfare Center Indian Head Explosive Ordnance Disposal Technology Division may, at its discretion, accept a defect on an approved waiver on a case-by-case basis.

a.

A certificate of analysis/test showing that the material has been sampled and/or tested and found to be within the minimum requirements of the specification/drawing/contract shall be prepared. The certificate shall be maintained by the contractor for a minimum of one (1) year from the completion of the order/contract or forwarded to this activity; one (1) copy to accompany the shipment (in the packing list envelope) and one (1) copy mailed to arrive at time of receipt of the shipment (mark the certificate to the attention of the designated POC above).

b.

Each certificate must be traceable to the material covered by the certificate. The certificate shall state, above the signature of a legally authorized representative of the company the following: This certification concerns a matter within the jurisdiction of an agency of the United States and the making of a false, fictitious, or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code, Section 1001.

c.

Certificate for shipments of bulk chemicals shall state contract number, drawing or specification number, lot number, rail car number if shipped by rail or trailer number if by truck, and the date of shipment.

d.

Any demurrage accrued as a result of detaining commercial carriers because of nonreceipt of the certificate shall be the responsibility of the Contractor.

e.

Failure to provide certification at the time of shipment may result in material being rejected and returned at the contractor's expense.

a.

A certification of material shall be provided by the Contractor, one (1) copy to accompany the shipment (in the packing list envelope) and (l) copy mailed to arrive at time of receipt of the shipment. Mark the certificate to the attention of the designated POC above.

b.

The certificate shall state compliance of material with drawing specification and contract/order requirements. The certificate shall as a minimum state the company name, contract/order number, drawing or specification number, and date. The certificate shall state, above the signature of a legally authorized representative of the company, the following: This certification concerns a matter within the jurisdiction of an agency of the United States and making a false, fictitious, or fraudulent certification may render the maker subject to prosecution under Title 18, United States Code 1001.

c.

Failure to provide certification at the time of shipment may result in material being rejected and returned at the contractor's expense.

NAVSEA HQ CLAUSES to be incorporated The calibration of measuring and testing equipment shall, as a minimum, adhere to the requirements of ANSI/NCSL Z540.3-2006

NOTES (HQ E 2-0003)

- This text may be used in supplementing ANSI / ISO / ASQ 9001-2015 Quality Management Systems.

- Quality Management System Requirements (HQ E-2-0015) must also be cited when this item is used

- Applicable when product/service is non-commercial and Government is the prime purchaser.

Applicable whenever ANSI/ISO/ASQ 9001-2015 standard or other non-DoD quality systems is invoked in the contract.

The contractor shall maintain and use quality cost data as a management element of the quality program. The specific quality cost data to be maintained and used will be determined by the contractor. These data shall, on request, be identified and made available for “on site” review by the Government representative.

NOTES (HQ E 2-0004)

- This text may be used in supplementing ANSI/ISO/ASQ 9001-2015 Quality Management Systems.

- Quality Management System Requirements (HQ E-2-0015) must also be cited when this item is used.

- Applicable when the Government considers that cost related to implementation of the quality program provides an effective metric in the management of the program.

Applicable whenever ANSI/ISO/ASQ 9001-2015 standard or other non-DoD quality systems is invoked in the contract.

Inspection and test records shall, as a minimum, indicate the nature of the observations, number of observations made, and the number and type of deficiencies found. Data included in inspection and test records shall be complete and accurate, and shall be used for trend analysis and to assess corrective action and effectiveness.

NOTES (HQ E 2-0008)

- This text may be used in supplementing ANSI / ISO / ASQ 9001-2015 Quality Management Systems.

- Quality Management System Requirements (HQ E-2-0015) must also be cited when this item is used

- Applicable when product/service is critical or production is complex, requiring explicit records of inspection and test

Applicable whenever ANSI/ISO/ASQ 9001-2015 standard or other non-DoD quality systems is invoked in the contract.

The contractor’s software quality program shall be an integral part of the overall Quality Assurance Program. Software quality program controls shall be applicable to all project software that is developed, maintained, or modified within the following categories:

a. All deliverable software

b. All deliverable software that is included as part of deliverable hardware or firmware.

c. Non deliverable software (commercially available or user-developed) used for development, fabrication, testing, or acceptance of deliverable software or hardware (includes automated fabrication, test, and inspection/acceptance equipment software and software design, test, and inspection tools).

d. Commercially available, reusable, or Government software designated as part of a deliverable item.

NOTES (HQ E 2-0014)

- This text may be used in supplementing ANSI/ISO/ASQ 9001-2015 Quality Management Systems.

- Quality Management System Requirements (HQ E-2-0015) must also be cited when this item is used.

- Applicable when software is the deliverable product/service or is an integral element of the deliverable product/service.

Applicable whenever ANSI/ISO/ASQ 9001-2015 standard or other non-DoD quality systems is invoked in the contract.

The Contractor shall provide and maintain a quality management system that, as a minimum, adheres to the requirements of ANSI/ISO/ASQ 9001-2015 Quality Management Systems and supplemental requirements imposed by this contract. The quality management system procedures, planning, and all other documentation and data that comprise the quality management system shall be made available to the Government for review. Existing quality documents that meet the requirements of this contract may continue to be used. The Government may perform necessary requirements inspections, verifications and evaluations to ascertain conformance to requirements and the adequacy of the implementing procedures. The Contractor shall require of subcontractors a quality management system achieving control of the quality of the services and/or supplies provided. The Government reserves the right to disapprove the quality management system or portions thereof when it fails to meet the contractual requirements.

NOTES (HQ E 2-0015)

- When used cite ANSI/ISO/ASQ 9001-2015 in paragraph (b) of FAR 52.246-11, HIGHER LEVEL CONTRACT REQUIREMENT. If another non-DoD quality system is used, insert the appropriate system title. (See below FAR 52.246-11 HIGHER LEVEL CONTRACT REQUIREMENT paragraph (b)).

- In implementing ANSI/ISO/ASQ 9001-2015, it may be desirable to include topics not thoroughly addressed in 9001-2015. Listed below is the title of standardized text, included elsewhere in Section E, for areas where such supplementation is desired for a given contract. Use is not mandatory and paragraphs should be selected to work in conjunction with other contract quality requirements. In accordance with current policy guidance, supplementation should be limited to those areas listed below.

- CALIBRATION SYSTEM REQUIREMENTS (HQ E-2-0003)

- COST QUALITY DATA (HQ E-2-0004)

- INSPECTION AND TEST RECORDS (HQ E-2-0008)

- QUALITY IN SOFTWARE DEVELOPMENT AND PRODUCTION (HQ E-2-0014)

- USE OF CONTRACTOR’S INSPECTION EQUIPMENT (HQ E-2-0017)

Add reference to a Data Item Description of a program specific quality management system plan, if deemed necessary (see DoD 5010.12-L, Acquisition Management System and Data Requirements Control List).

Applicable whenever ANSI/ISO/ASQ 9001-2015 standard or other non-DoD quality systems is invoked in the contract.

The contractor’s gages, and measuring and testing devices shall be made available for use by the Government when required to determine conformance with contract requirements. If conditions warrant, the contractor’s personnel shall be made available for operations of such devices and for verification of their accuracy and condition.

NOTES (HQ E 2-0017)

- This text may be used in supplementing ANSI / ISO / ASQ 9001-2015 Quality Management Systems.

- Quality Management System Requirements (HQ E-2-0015) must also be cited when this item is used

- Applicable when the contract involves the use of unique, costly, or large/immobile test equipment such that it would be impractical for Government personnel to use separate equipment in the performance of verification activities..

Applicable whenever ANSI/ISO/ASQ 9001-2015 standard or other non-DoD quality systems is invoked in the contract.

Higher-Level Contract Quality Requirement (Dec 2014)

(a) The The Contractor shall comply with the higher-level quality standard(s) listed below.

Title Number Date Tailoring [Contracting Officer insert the title, number, date, and tailoring (if any) of the higher-level quality standards.]

(b) The Contractor shall include applicable requirements of the higher-level quality standard(s) listed in paragraph (a) of this clause and the requirement to flow down such standards, as applicable, to lower-tier subcontracts, in --

(1) Any subcontract for critical and complex items (see 46.203(b) and (c)); or

(2) When the technical requirements of a subcontract require --

(i) Control of such things as design, work operations, in-process control, testing, and inspection; or

(ii) Attention to such factors as organization, planning, work instruction, documentation control, and advanced metrology.

AUG 2018

degas.legal@navy.mil 04/24/2017

DEGAS LEGAL

NSWC IHEODTD 4200/9 QUALITY ASSURANCE REQUIREMENTS FORM

08/14/2018 One Copy of these certs must be forwarded to : Amanda Robson / amanda.robson@navy.mil General Arrangement, Peripheral Initiator Press Tooling, 5.73 Inch Die Set: Lower Ram Head V1 3469 [01] A IAW DWG (Sheet 2/3, Zone A-7) IAW DWG (Sheet 2/3, Zone A-7) - Test on lip adjacent to Note 4 stamp (Sheet 2/3, Zone A-6) IAW DWG (Sheet 2/3, Zone A-7) IAW DWG Note 3 IAW DWG (Sheet 2/3) 100% 100%