Att(3)_VIR_W03489.pdf

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Revision Date 7/21/16 1

NUWCDIVNPT TAHE FACILITY FAX 401.832.3937

NUWC, BLDG 6 NEWPORT, RI 02841 PHONE 401.832.3068

(REFER TO INSTRUCTIONS)

VENDOR INFORMATION REQUEST 1. VIR NO.:

2. SUPPLIER NAME AND ADDRESS

3. DATE

4. DATE DISPOSITION

REQUIRED

5. MATERIAL NOMENCLATURE

7. PART NUMBER

8. QUANTITY

9. SERIAL NUMBER

10. STATUS OF PART NOT STARTED IN-PROCESS COMPLETED

11. DESCRIPTION:

12. CAUSE OF NONCONFORMANCE:

13. RECOMMENDED CORRECTIVE ACTION:

14. RECOMMENDED DISPOSITION:

15. TECHNICAL JUSTIFICATION AND PURCHASER'S BENEFIT:

REPAIR COST:

REPLACEMENT COST:

16. DELIVERY IMPACT

IF DISAPPROVED, DELIVERY WILL BE: IF APPROVED, DELIVERY WILL BE:

THE VENDOR ACCEPTS FULL

RESPONSIBILITY FOR THE

CORRECTNESS OF INFORMATION

AFFECTING THE ABOVE PARTS

17. REPORTED BY:

SIGNATURE:

PHONE:

VENDOR: PLEASE DO NOT WRITE BELOW THIS LINE

18. QA POC 19. DATE VIR RECEIVED

20. DISPOSITION

APPROVED DISAPPROVED CONDITIONALLY APPROVED

NC# SOW# WO# W03489

BELOW SPACE IS FOR FINAL DISPOSITION AUTHORIZATION USE ONLY:

21. DISPOSITION RESULTS

RFD # YES NO

NAVSEA APPROVAL REQUIRED YES NO

RPR # YES NO

ISEA/TDA APPROVAL REQ’D YES NO

MINOR YES NO

MAJOR YES NO

COST IMPACT YES NO

SCHEDULE IMPACT YES NO

PART NUMBER IMPACT YES NO

APPROVALS

22. ENGINEERING DATE

23. QA DATE

24 TAHEF MANAGER DATE

25. ISEA or TDA DATE

26. DISPOSITION SENT TO SUPPLIER

BY PURCHASING:

DATE:

NOTICE TO SUPPLIER: THE DISPOSITION OUTLINED ABOVE IS APPLICABLE TO THE MATERIAL ON THIS VIR ONLY.

SHIPPING DOCUMENTS FOR THIS MATERIAL MUST REFERENCE THIS VIR.

6. WORK ORDER #

W03489

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Revision Date 7/21/16 2

NUWCDIVNPT TAHE FACILITY FAX 401.832.3937

NUWC, BLDG 6 NEWPORT, RI 02841 PHONE 401.832.3068

VENDOR INFORMATION REQUEST FORM INSTRUCTIONS

A PROPERLY APPROVED VENDOR INFORMATION REQUEST (VIR) IS REQUIRED TO RESOLVE

TECHNICAL QUESTIONS OR PROBLEMS INVOLVING TOWED ARRAY HANDLING EQUIPMENT

FACILITY WORK ORDERS.

TO FACILITATE THE PREPARATION OF THE FORM, A BRIEF DESCRIPTION APPEARS BELOW

INDICATING THE INFORMATION REQUIRED TO BE ENTERED IN THE APPROPRIATE BLOCK. IF

MULTIPLE PAGES ARE REQUIRED, LINK ADDITIONAL PAGES BY BLOCK NUMBER TO THE FIRST

PAGE.

BLOCK NO. ENTRY (BLOCKS 2-16 TO BE FILLED IN BY VENDOR)

(BLOCKS 1, 17-25 TO BE FILLED IN BY TAHE FACILITY)

1. REFER TO THIS NUMBER (PROVIDED BY THE TOWED ARRAY FACILITY) ON ANY INQUIRY.

RECORD THIS NUMBER ON THE PACKING LIST PRIOR TO SHIPPING.

2. ENTER YOUR FULL MAILING ADDRESS, INCLUDING THE NAME OF ANYONE TO WHOM THE

RETURNED VIR SHOULD BE SENT.

3. THE DATE THE ENTRIES ARE BEING MADE.

4. GIVE DATE A REPLY TO THE VIR IS REQUIRED BY IN ORDER TO AVOID DELAY OF DELIVERY.

5. A GENERAL DESCRIPTION OF THE PART NAME THAT APPEARS ON THE PURCHASE ORDER.

6. WORK ORDER #

7. PART NUMBER

8. QUANTITY OF PIECES AFFECTED BY VIR (NOT QUANTITY ORDERED).

9. SERIAL NUMBER OF PIECE AFFECTED, WHERE APPLICABLE.

10. CHECK APPROPRIATE PART STATUS BLOCK.

11. DESCRIBE THE SPECIFIC PROBLEM/QUESTION/PROPOSED CHANGE, OR NONCONFORMANCE

IN DETAIL

INDICATE WHAT, IF ANYTHING, HAS BEEN VIOLATED

WHEN PROPOSING A MATERIAL SUBSTITUTION, INCLUDE A FULL DESCRIPTION OF THE

SUBSTITUTE MATERIAL (I.E.: ALLOY, CLASS, CONDITION OR TEMPER, SPECIFICATION,

ETC.). ATTACH A COPY OF THE TEST REPORT FOR THE MATERIAL IF AVAILABLE OR WITH

THE SHIPMENT OF THE COMPLETED HARDWARE.

WHEN REPORTING A NONCONFORMANCE INVOLVING THE HEAT TREATMENT OF

MATERIAL, A COPY OF THE APPLICABLE HEAT TREATMENT PROCEDURE USED SHOULD

BE ATTACHED.

WHEN REPORTING CHEMICAL AND MECHANICAL NONCONFORMANCE, ATTACH A COPY

OF THE TEST REPORT APPLICABLE LISTING BOTH CHEMICAL AND MECHANICAL TEST

RESULTS OF THE MATERIAL.

USE A CONTINUATION OR SKETCH SHEET IF THIS SPACE IS INADEQUATE TO SHOW A

SKETCH OR TO FULLY DESCRIBE THE PROBLEM.

12. INCLUDE THE CAUSE OF THE NONCONFORMANCE

13. INDICATE THE RECOMMENDED CORRECTIVE ACTION

14. INDICATE THE RECOMMENDED DISPOSITION

15. INCLUDE THE TECHNICAL JUSTIFICATION FOR ACCEPTING PERMANENT NONCONFORMANCE

BY INDICATING THE EFFECT OF THE DEVIATION ON THE FORM, FIT OR FUNCTION OF THE

MATERIAL, PART OR COMPONENT. IF UNABLE TO PROVIDE TECHNICAL JUSTIFICATION, SO

STATE. ALSO PROVIDE RATIONALE FOR PERCEIVED BENEFIT TO PURCHASER. FOR OUTSIDE

SERVICES INCLUDE REPAIR VS REPLACEMENT COST.

16. INDICATE THE DELIVERY IMPACT IF ACCEPTANCE OF THE REQUEST IS NOT GRANTED.

17. GIVE NAME OF PERSON TO CONTACT IN CASE OF ANY QUESTIONS REGARDING VIR.

18. FAX VIR to (401) 832-3937, to the attention of the Quality Assurance Department. QA Point Of Contact phone number is (401) 832-3068.

19. ENTER DATE VIR RECEIVED FROM VENDOR.

20. ENGINEERING, QA, AND MANAGEMENT ENTER REQUIRED INFORMATION.

21. ENGINEERING, QA, AND MANAGEMENT MARK EACH BLOCK AS APPLICABLE.

22– 25. APPROVALS AS REQUIRED.

26. PURCHASING: SIGN AND DATE WHEN COMPLETED VIR IS SENT TO SUPPLIER.