A001 - Traceablility Documentation.pdf

DLA LAND AND MARITIME FORM 918 (AUG 2017) Page 1 of 3 PDF(DLA L&M)

TRACEABILITY/TEST DOCUMENTATION COVER SHEET

PART I - TO BE COMPLETED BY THE SUPPLIER

1. TYPE OF DOCUMENTATION ATTACHED/SUBMITTED

Traceability Documentation

Test Report

2. DATE

3. SUBMITTED

BY

a. Name

b. E-mail

c. Phone No.

4. SUPPLIER a. Company b. CAGE

c. Address

5. ITEM a. Contract No. b. CLIN

c. Qty d. Item Name/Description

e. FSC f. NIIN g. Part No.

h. Part Manufacturer i. Mfr CAGE

j. Date Code(s)

6. AWARD INFORMATION -- TRACEABILITY/TEST DOCUMENTATION REQUIREMENTS IN ACCORDANCE WITH DFARS 252.246-7008 & DLAD PROCUREMENT NOTE M01 APPROVED SUPPLIERS for FSC 5961 Semiconductors and FSC 5962 Electronic Microcircuits

The Supplier listed in block 4 of this form offered, and was awarded the contract listed in block 5a of this form as a: (Check Box That Applies)

Approved Source Manufacturer Specified in the Solicitation/Contract Item Description (Original Component Manufacturer (OCM), Original Equipment Manufacturer (OEM))

Required Documentation of Traceability: Completed DLA L&M Form 918. If the bare item markings on the parts being provided do not match the CAGE and part number specified in the item description in the contract, the supplier must provide documentation certifying that the parts containing the alternate markings are the "exact product" as the item represented by the CAGE and part number specified in the in the contract item description.

Approved Source on the Applicable Qualified Products List (QPL)/Qualified Manufacturers List (QML) Required Documentation of Traceability: Completed DLA L&M Form 918. Also requires a Certificate of Conformance and

Traceability (CoC/T), which must include information and documentation required by the applicable military specification for the QPL/QML product.

Refer to DLA Technical and Quality Requirement RQ007.

Authorized Distributor of the OCM/OEM or QPL/QML Approved Source Required Documentation of Traceability: Evidence of a contractual arrangement with or the express written authority of the manufacturer or current design activity to buy, stock, sell or distribute the part and an unbroken chain of traceability documentation through authorized distributors (if applicable), back to the approved source/manufacturer specified in the solicitation/contract.

Supplier/Distributor on the Qualified Supplier List of Distributors (QSLD) for FSC 5961/5962 Required Documentation of Traceability: Evidence of unbroken chain of traceability documentation, through trusted providers, back to an approved manufacturer specified in the solicitation/contract item description. Refer to the QSLD-5961/5962 document.

QPL/QML items require a Certificate of Conformance and Traceability (CoC/T), which must include information and documentation required by the applicable military specification for the QPL/QML product. Refer to DLA Technical and Quality Requirement RQ007.

Supplier/Distributor on the Qualified Testing Suppliers List (QTSL) for FSC 5961/5962 Required Documentation of Testing: Complete test report including summary of test results, electrical testing read and record data, device photos, etc. Traceability documentation to the source of parts provided for testing. Refer to DLAD Procurement Note M01.

PART II - TO BE COMPLETED BY DLA

REVIEWER Name

Date

DLA LAND AND MARITIME FORM 918 (AUG 2017) Page 2 of 3 PDF(DLA L&M)

TRACEABILITY/TEST DOCUMENTATION COVER SHEET

INSTRUCTIONS

Part I

Block 1 - TYPE OF DOCUMENTATION ATTACHED/SUBMITTED: Block 6 - AWARD INFORMATION -- TRACEABILITY / TEST Indicate the type of documentation being submitted. "Test Report" DOCUMENTATION REQUIREMENTS refers to a complete test report in accordance with the SAE AS6081 Indicate the category of trusted supplier for which the supplier listed guidelines required by the Criteria and Provisions for Qualified in Block 4 of this form has offered, and was awarded the contract Testing Suppliers List (QTSL-5961/5961). listed in Block 5a of this form. The categories of trusted suppliers are--

Block 2 - DATE: Enter the date the Supplier filled out the form. Approved Manufacturer Specified in the Solicitation/

Contract Item Description -- Block 3 - SUBMITTED BY: Enter the name, E-mail address, and The source identified by name, CAGE, and part number listed in phone number of the person submitting the form. The person listed the purchase item description in Section B of the award. This in Block 3a must be an individual who has the authority to bind the category of supplier shall only be selected if the entity in Block Contractor. 4 of the form is--

1) the original manufacturer of the part Block 4 - SUPPLIER: Enter the company name, Commercial and 2) the original component manufacturer Government Entity (CAGE) code, and address of the entity to which 3) the original equipment manufacturer the contract/purchase order was awarded. 4) manufacturer specified in the solicitation/contract item description Block 5 - ITEM 5) the part Design Control Activity, which is defined as the

a. Contract No.: Enter the Contract/Purchase Order/Agreement entity having responsibility for the design of a given part and Number and, if applicable, the Delivery Order/Call Number of the for the preparation and currency of engineering drawings and order for which the item(s) are being provided. other technical data (TD) for that part.

b. CLIN: Enter the Contract Line Item Number (CLIN) representing the item(s) being provided. Authorized Distributor of the Approved Manufacturer

c. QTY: Enter the quantity of item(s) being provided. Specified in the Solicitation/Contract Item Description --

d. Item Name/Description: Enter the Item Description (item A supplier who has a contractual arrangement or the express name) as it appears in the contract. written authority with 1-5 above to buy, stock, re-package, sell, and

e. FSC: Enter the Federal Supply Class (FSC) code. The FSC is the distribute the item specified in the solicitation/contract.

first four digits of the 13-digit National Stock Number (NSN).

f. NIIN: Enter the National Item Identification Number (NIIN). The Supplier/Distributor on the Qualified Supplier List of

NIIN is the last nine digits of the 13-digit NSN. Distributors (QSLD) for FSC 5961/5962 --

g. Part No., h. Part Manufacturer, i. Mfr CAGE: Enter the A distributor listed or determined qualified for listing on the manufacturer's part number, the part manufacturer, and the DLA Land and Maritime Qualified Supplier List of Distributors manufacturer's CAGE code for the item(s) being provided. The part (QSLD) for FSC 5961/5962.

manufacturer, CAGE, and part number entered shall be the same as what is in the product item description in the contract. Supplier/Distributor on the Qualified Testing Suppliers List

j. Date Code(s): Enter the manufacturing date codes for the parts (QTSL) for FSC 5961/5962 --being provided. The standard date code is four (4) numbers A distributor listed or determined qualified for listing on the representing the year and week in that year the part was DLA Land and Maritime Qualified Testing Suppliers List (QTSL) manufactured. Note: Some date codes will contain prefix and/or for FSC 5961 and 5962.

suffix pertaining to certain manufacturers.

Part II

The DLA Land and Maritime contract administrator conducting the documentation review will enter his/her name and date to acknowledge the receipt of the form and accompanying traceability/test report. The entry of the reviewer's name and date does not signify a determination by the Government that the DLA L&M Form 918 and accompanying traceability documentation/test report is acceptable. Notification of acceptance will be provided by Contracting Officer letter.

NOTE: The Contracting Officer reserves the right to, at any time, request additional documentation of traceability or test report. The Contractor must maintain and be prepared to provide traceability/test documentation in accordance with the clauses within the awarded contract listed in Block 5a of this form.

DLA LAND AND MARITIME FORM 918 (AUG 2017) Page 3 of 3 PDF(DLA L&M)