-6601.pdf

CONTRACT REPAIR SCREENING ANALYSIS WORKSHEET

PART I (To be completed by PMS Seller)

1. FORM INITIATION DATE

08 JUL 2016

2. FORM PRIORITY

3. NSN

6220012636601FW

4. PART NUMBER

710410-3

5. PART NUMBER CAGE CODE

19623

6. NOUN

CONTROL,ELECTRIC LI

7. ANNUAL REPAIR

QUANTITY

8. LATEST REPAIR COST

$7,000.0000

9. ANNUAL REPAIR

BUDGET VALUE

$7,000.00

10. FORECAST UNIT

PRICE

$94,260.0000

11. ERRC

T

12. WEAPON SYSTEM

B-2

13. END ITEM APPLICATION

B-2

14. HISTORY

DOES ORGANIC REPAIR OR DMISA REPAIR CAPABILITY CURRENTLY EXIST? X NO YES (if yes, specify SOR)

HAS THE ITEM PREVIOUSLY BEEN CONTRACT REPAIRED?

IF YES, COMPLETE TABLE BELOW FOR LAST 5 YEARS (not to exceed last 3 contracts)

NO X YES

SOURCE NAME CAGE CONTRACT NUMBER AWARD DATE

GE AVIATION SYSTEMS LLC 12 DEC 201119623 FA811912D00030001

GE Aviation 18 NOV 201119623 FA8119-12-D-0003

15. PMS SELLER NAME

Maddox, Lee H

CODE

NKV

OFFICE SYMBOL

422 SCMS / GUME

PHONE

405-582-5322

COMPLETION DATE

08 JUL 2016

PART II (To be completed by Equipment Specialist)

16. TECHNICAL ORDERS REQUIRED X NO YES (annotate required data and availability on RDL) UNKNOWN

17. OTHER SPECIFICATIONS / SPECIAL REPAIR CRITERIA REQUIRED NO YES (annotate required data and availability on RDL) X UNKNOWN

18. X THE DATA LISTED IN RDL COMPLETED SPECIFIES THE REPAIR REQUIREMENTS OR

ADDITIONAL DATA IS REQUIRED (Coordinate with the engineer and screening office to determine information required. Document in Block 33)

19. SPECIAL TOOL / SPECIAL TEST EQUIPMENT IS NOT REQUIRED REQUIRED X REQUIRED BUT NOT AVAILABLE

SPECIAL FACILITIES ARE X NOT REQUIRED REQUIRED

GOVERNMENT FURNISHED MATERIAL IS NOT REQUIRED X REQUIRED REQUIRED BUT NOT AVAILABLE

20. EQUIPMENT SPECIALIST NAME

Standlee, Rodney

CODE

NG

OFFICE SYMBOL

422 SCMS / GUME

PHONE

405-582-5311

COMPLETION DATE

22 JUL 2016

PART III (To be completed by Screening Technician if applicable)

21. REQUESTED ENGINEERING DATA

LISTED AND ANNOTATED ON RDL X NO DATA

22. SCREENING TECHNICIAN REMARKS

23. SCREENING TECHNICIAN NAME CODE OFFICE SYMBOL PHONE COMPLETION DATE

PART IV (To be completed by the Engineer)

24. CRITICAL SAFETY ITEM

X NO YES

25. CAN THIS ITEM BE COMMERCIALLY

OVERHAULED / REPAIRED (FAR Part 12)

X NO YES

26. PRECONTRACT QUALIFICATION

REQUIRED

X NO YES (JQR/QR, SQS, Waiver)

27. RDL REQUIRED FOR

SOLICITATION

NO X YES

28. RMC / RMSC CODE

R3 / D

29. RMC / RMSC EXPIRATION DATE

11 MAR 2021

30. REASON FOR OTHER THAN G CODE AND ACTION TO REMEDY

Factory Test Equipment Required, P/N: CTP710400-3 is not available in the CITIS drawing database. Factory Test Equipment is required for repair of the item..

Email dated 03/21/2016 was sent to GE Aviation, Cage 19623 to request repair data. No further action will be taken until response is received.

31. APPROVED / POTENTIAL SOURCES

CAGE

CODE DATE APPROVED

Extant Aerospace 22830 22 JUL 2016

32. ENGINEER NAME

Elden, Mark E

CODE

N/A

OFFICE SYMBOL

422 SCMS / GUEAB

PHONE

405-582-5340

COMPLETION DATE

22 JUL 2016

Page 1 of 2AFMC FORM 762, 20060201, V1 Version 5Generated by PRPS using Jasper Reports on 11 Jan 2022

CONTRACT REPAIR SCREENING ANALYSIS WORKSHEET

PART V (Miscellaneous, if needed)

33. REMARKS (Remarks require Functional Responsibility / Name / Office Symbol / Phone)

USER TYPE: Equipment Specialist NAME: Standlee, Rodney DATE: 22 JUL 2016

ORG / OFFICE SYMBOL: 422 SCMS / GUME COMMERCIAL PHONE: 405-582-5311 DSN PHONE: 852-5311

See Appendix B for GFE listing. Additional special tools/test equipment is required but not available.

USER TYPE: Engineer NAME: DAO, Lan T DATE: 11 MAR 2016

ORG / OFFICE SYMBOL: 422 SCMS / GUEAB COMMERCIAL PHONE: 405-736-4267 DSN PHONE: 336-4267

The following is required: Government Source Inspection (GSI), Configuration Control (Class I and Class II Change approval), and in-plant DCMC contract administration.

USER TYPE: Equipment Specialist NAME: Tenbrook, Ivan L DATE: 02 FEB 2016

ORG / OFFICE SYMBOL: 422 SCMS / GUME COMMERCIAL PHONE: 405-734-8342 DSN PHONE: 884-8342

8A10-4-14-2 Dist. E. only

Page 2 of 2AFMC FORM 762, 20060201, V1 Version 5Generated by PRPS using Jasper Reports on 11 Jan 2022