762 (0712).pdf

CONTRACT REPAIR SCREENING ANALYSIS WORKSHEET

PART I (To be completed by PMS Seller)

1. FORM INITIATION DATE

08 NOV 2021

2. FORM PRIORITY

3. NSN

5985015370712FD

4. PART NUMBER

654M2252-1

5. PART NUMBER CAGE CODE

81755

6. NOUN

ANTENNA SUBASSEMBLY

7. ANNUAL REPAIR

QUANTITY

8. LATEST REPAIR COST

$12,750.0000

9. ANNUAL REPAIR

BUDGET VALUE

$25,500.00

10. FORECAST UNIT

PRICE

$12,750.0000

11. ERRC

T

12. WEAPON SYSTEM

MUTES

13. END ITEM APPLICATION

AN/MST/T1A

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

COBHAM EXETER INC. 30 AUG 202166544 FA825021P0072

COBHAM EXETER INC. 16 JUN 201166544 FA825011M0207

COBHAM EXETER INC. 25 JUN 200966544 FA825009M0165

15. PMS SELLER NAME CODE OFFICE SYMBOL PHONE COMPLETION DATE

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 X YES (annotate required data and availability on RDL) 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 X REQUIRED REQUIRED BUT NOT AVAILABLE

SPECIAL FACILITIES ARE NOT REQUIRED X REQUIRED

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

20. EQUIPMENT SPECIALIST NAME

Mickey, Richard J

CODE OFFICE SYMBOL

415 SCMS / GUMAA

PHONE

801-777-7551

COMPLETION DATE

14 APR 2022

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

21. REQUESTED ENGINEERING DATA

LISTED AND ANNOTATED ON RDL 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

R1 / C

29. RMC / RMSC EXPIRATION DATE

06 APR 2027

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

31. APPROVED / POTENTIAL SOURCES

CAGE

CODE DATE APPROVED

Cobham Exeter Inc 66544 06 APR 2022

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CONTRACT REPAIR SCREENING ANALYSIS WORKSHEET

32. ENGINEER NAME

Kincaid, James

CODE

N/A

OFFICE SYMBOL

415 SCMS / GUEA

PHONE

404-425-2433

COMPLETION DATE

18 APR 2022

PART V (Miscellaneous, if needed)

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

Page 2 of 2AFMC FORM 762, 20060201, V1 Version 4Generated by PRPS using Jasper Reports on 20 Apr 2022