Attachment 0007 DD1694 REQUEST FOR PROPOSAL.docx
DoD Form DOCX document 24 KB Posted
- Attached to
- 60mm (M204, M235, M236); 81mm (M218, M219, M220, M658); and 120mm (M234A1) Propelling Charges
- Solicitation number
- W519TC-24-R-0003
About this file
This document is a request for variance form used to request changes to federal contracts. The form collects information on the requested variance such as the priority level, whether it is pre- or post-production, the affected baseline, the system and item the variance applies to, classification of any defects, description of the variance need, corrective actions taken, and potential effects. It also requires contact information for the contracting officer, originator, and submitting activity. The approving activity must provide recommendations on and final disposition of the variance request.
The related federal contract opportunity is a solicitation from the Department of the Army Materiel Command Contracting Command at Rock Island Arsenal to provide 60mm, 81mm, and 120mm propelling charges.
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Text version
REQUEST FOR VARIANCE (RFV)
1. DATE PREPARED
(DD-MON-YYYY)
2. PROCURING ACTIVITY NO. (PAN):
OMB No. 0704-0188
3. RFV NUMBER:
The public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, Alexandria, VA 22350-3100 (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. PLEASE DO NOT RETURN YOUR COMPLETED FORM TO THIS ADDRESS. RETURN COMPLETED FORM TO THE GOVERNMENT ISSUING CONTRACTING OFFICER FOR THE CONTRACT/PROCURING ACTIVITY NUMBER LISTED IN ITEM 22 OF THIS FORM.
4. TITLE OF VARIANCE:
5. RFV PRIORITY:
|_| E-Emergency |_| U-Urgent |_| R-Routine
6. VARIANCE PRE OR POST-PRODUCTION:
|_| Pre-Production |_| Post-Production
7. BASELINE AFFECTED:
|_| Functional |_| Allocated |_| Product
8. SYSTEM
INFORMATION
a. MODEL/TYPE DESIGNATION
(ex. M16):
b. SYSTEM/CONFIG. ITEM NOMENCLATURE
(ex. Rifle):
c. END ITEM CAGE CODE:
9. AFFECTED ITEM NOMENCLATURE (ex.Bracket):
10. PART NUMBER(S) OF AFFECTED ITEM(S):
11.a. OTHER EXTERNAL SYSTEM AFFECTED?:
|_| Yes |_| No
b. IF BLOCK 11.a. IS YES, LIST OTHER SYSTEMS OR CONFIGURATION ITEMS AFFECTED:
12. CLASSIFICATION
OF DEFECT(S)
a. DEFECT CLASSIFICATION:
|_| Critical |_| Major |_| Minor
b. DEFECT NO.:
c. DOCUMENT DEFINING DEFECT CLASS:
13. DESCRIPTION OF VARIANCE:
14. NEED FOR VARIANCE:
15. CORRECTIVE ACTION TAKEN:
16. EFFECT ON PERFORMANCE, FUNCTION, RELIABILITY, DURABILITY, INTEGRATED LOGISTICS SUPPORT, INTERFACE OR SOFTWARE:
17. RECURRING VARIANCE?
|_| Yes |_| No
18. EFFECTIVITY (Quantity Affected, Lot Numbers Affected, Serial Numbers, Dates):
19. PER UNIT COST IMPACT:
20. TOTAL COST IMPACT:
21. EFFECT ON DELIVERY SCHEDULE IF REJECTED:
| 22. CONTRACT INFORMATION |
| a. CONTRACTOR: |
b. CONTRACT NO. AND LINE ITEM:
| 23. CONTRACTING OFFICER |
| a. NAME: |
b. TELEPHONE:
c. E-MAIL:
| 24. ORIGINATOR |
| a. NAME: |
| b. ADDRESS (Street, City, State, Zip Code): |
c. RFV ORIGINATOR CAGE CODE:
d. TELEPHONE:
e. E-MAIL:
25.a. SUBMITTING ACTIVITY:
b. NAME and TITLE:
c. AUTHORIZED SIGNATURE:
BELOW TO BE COMPLETED BY THE APPROVING ACTIVITY
26.a. RECOMMENDATIONS |_| Approval |_| Approval with Modification |_| Disapproval
b. NAME AND TITLE:
c. SIGNATURE:
d. DATE SIGNED
(DD-MON-YYYY):
27.a. DISPOSITION (Configuration Change Authority) |_| Approved |_| Approved with Modification |_| Disapproved
b. NAME AND TITLE:
c. SIGNATURE:
d. DATE SIGNED
(DD-MON-YYYY):
DD FORM 1694, AUG 2019 (US ARMY CCDC-Armament Center VERSION) Microsoft Office WORD
DISTRIBUTION STATEMENT:
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