Attachment 0003 - Request for Use of Prohibited Material - W56HZV-21-R-0037.pdf
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- Attached to
- M1300 Heavy Equipment Transporter System (HETS) Tractor Modification (MOD) B Solicitation
- Solicitation number
- W56HZV-21-R-0037
About this file
This document is a request form for a defense contractor to seek approval to use prohibited materials in fulfilling a federal contract for modification of heavy equipment transport vehicles.
The form requests information on the prohibited materials for which a waiver is sought, including descriptions of parts and processes where the materials would be used. It also asks the contractor to explain any health hazards posed and personal protective equipment needed, identify alternative materials considered, provide technical justification for using the prohibited materials, and describe program risks of denial as well as plans to substitute alternatives later. The U.S. Army would evaluate the request and provide recommendations, with final approval contingent on agreement from chief engineers and program directors.
The related federal contract opportunity is a sole-source solicitation from the U.S. Army to Oshkosh Defense for modification of 174 M1300 Heavy Equipment Transporter System tractor vehicles. The work includes procuring modification kits, installing them on government equipment, and reconfiguring the vehicles to required standards.
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Attachment 0003
W56HZV-21-R-0037
Request for Use of Prohibited Material
Distribution Statement A – Approved for Public Release; distribution unlimited
(*Distribution Statement A only applies when form is not filled in. Once filled check the [Program] Security Class Guide for proper distribution statement/markings)
UNCLASSIFIED
Attachment 0003, W56HZV-21-R-0037 – Request for Use of Prohibited Material
1. General Information Requesting Company Date of Request Point of Contact
Prohibited material for which waiver is requested
2. Explanation of Use Instructions: Provide a description of the parts/processes where the prohibited material will be used. Identify all components/parts which will contain the prohibited materials upon vehicle delivery including quantities of these parts. Indicate the specific variant and/or trailer the components/parts are on. Identify whether or not the material will be required for operation or maintenance (including during vehicle rebuild). A separate spreadsheet may be attached listing the specific parts/processes, if needed.
3. Health Hazard Instructions: Provide an explanation of any health hazards associated with the use or presence of the prohibited material. Include likely routes of exposure to both the operator and the maintainer. Identify if any personal protective equipment (PPE) that would be required as a result of using this material. Include the type of PPE and under what circumstances it would be required (manufacturing, operation, maintenance, etc.).
4. Analysis of Alternatives Instructions: Identify all alternative which were considered for the prohibited material. If the alternative is only for specific applications, identify what type of parts it is a potential alternative for.
5. Technical Justification
Instructions: Provide technical justification for the use of prohibited material. Explain why it is necessary and why it cannot be eliminated. Note cost, schedule, and use of non-developmental items (NDI) are not technical justifications.
6. Program Risk Instructions: Describe the program risk(s) (cost, schedule, and performance) associated with denial of this request by the Government.
7. Get Well Plan Instructions: Identify which parts where an alternative may be integrated at a later date.
Provide a get well plan explaining how this will be accomplished. Also, indicate which parts you will not be able to eliminate and provide a brief explanation.
The following Sections will be filled in by the Government
8. Environmental Safety and Occupational Health Representative Evaluation/ Recommendation
Instructions: Government ESOH Representative to provide evaluation of the above information and a recommendation to the Product Director/Project Manager regarding approval/disapproval of the prohibited material request.
ESOH Representative Date
9. Concurrence
I concur that use of {prohibited material} as described in this form under the {Contractor Name} Contract –{Contract Number} is acceptable and justified:
Chief/Lead Engineer
Product Director
10. Approval Upon the basis of the findings above, I hereby determine that use of {prohibited material} as identified in Section 2 of this form for the {Contractor Name} Contract {Contract Number} is acceptable and justified.
Project Manager
File details come from the government source that posted it. Updated .