813_SMW.pdf
PDF 110 KB Posted
- Solicitation number
- SPRWA1-26-R-0033
- Issued by
-
Defense Logistics Agency Aviation
About this file
This is an AFMC Form 813 Surplus Materiel Worksheet dated 09 JUN 2026 for evaluating the availability and acceptability of surplus government materials to fulfill procurement needs.
The worksheet concerns part number 212-076-006-5 (NSN 4810-00-007-3455GA) manufactured by cage code 97499, intended for application in Bell UH-1N Helicopters. The evaluation was requested by Stephen R. Graves, an engineer with AFLCMC/WIHEZ office. The evaluation criteria indicate that surplus materiel may be considered for both government surplus items in new/unused condition and commercial surplus items in new/unused condition. Acceptance requires part number and manufacturer verification, 100% end item inspection, and test and verification. Specific testing criteria mandate that each item be inspected for overall new condition and examined for evidence of corrosion or deterioration of gaskets and seals. The remarks section notes that the design activity is Bell and PTI is the manufacturer to Bell specification; PTI adds "-SM" to part number 48088820-105 as an internal designator that does not affect form, fit, or function. The evaluation was completed on 09 JUN 2026 with justification for unacceptable surplus materiel being that products do not comply with Bell specification/QPL or items are not in new/unused condition.
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Other files
| File | Type | Posted |
|---|---|---|
| SPRWA1-26-R-0033.pdf | ||
| IUID.pdf | ||
| DDFORM1653.pdf | ||
| AFMC158.pdf |
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Text version
SURPLUS MATERIEL WORKSHEET
DATE
09 JUN 2026
I. REQUEST FOR EVALUATION
NSN
4810000073455GA
PART NUMBER
212-076-006-5
CAGE
97499
APPLICATION
Bell UH-1N Helicopter
IMS
Graves, Stephen R
OFFICE SYMBOL
AFLCMC / WIHEZ
PHONE
478-222-1727
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
N
N
N
Y X X
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 97499(AFMCFARS 5352.211-9011) MFG 212-076-006-5P/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
Each item shall be inspected for overall new condition and examined for any evidence of corrosion or deterioration of gaskets and seals.
TEST WILL BE CONDUCTED USING THE FOLLOWING CRITERIA (and location of testing)
OVERHAUL AND CERTIFICATION (AFMCFARS 5352.211-9010)
NA
OTHER SPECIAL REQUIREMENTS (Explain)
Graves, Stephen RNAME: 09 JUN 2026DATE:
Each item shall be inspected for overall new condition and examined for any evidence of corrosion or deterioration of gaskets and seals. NSN 4810-00-007-3455 Bell is the design activity PTI is the manufacturer to the Bell specification. Per Bell e-mail, PTI adds -SM to the PN 48088820-105 as an internal designator that does not affect form, fit or function.
REMARKS
JUSTIFICATION FOR UNACCEPTABLE SURPLUS MATERIEL
Product does not comply with Bell specification/QPL or items not in New/Unused condition.
EVALUATOR
Graves, Stephen R
OFFICE SYMBOL
AFLCMC / WIHEZ
PHONE
478-222-1727 / 472-1727
COMPLETE DATE
09 JUN 2026
SIGNATURE
//SIGNED// Graves, Stephen R
USER TYPE
Engineer
SIGNATURE DATE
09 JUN 2026
Page 1 of 1AFMC FORM 813, 20000323 (IMT-V1) Version 8Generated by PRPS using Jasper Reports on 11 Jun 2026
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