Attachment_0017_Request_for_Use_of_Prohibited_Material.doc

Attachment 0017 – Request for Use of Prohibited Materials

Solicitation No.: W56HZV-22-R-0026 Attachment 0017 – Request for Use of Prohibited Materials

Solicitation No.: W56HZV-22-R-0026

Attachment 0017

Request for Use of Prohibited Materials

Solicitation No.: W56HZV-22-R-0026 Date: 29 March 2022

Distribution Statement A: Approved for public release; distribution is unlimited.

SECURITY NOTICE: Contractor responses to the data requirements below are likely to be at Controlled Unclassified Information Level (CUI) level.

All CUI responses should be marked with the following CUI Designation Indicator and Distribution Statement:

Controlled by: the name of the Offeror Company (not required if identified in the letterhead)

Controlled by: identification of the office creating the document

CUI Category(ies): CTI, EXPT

Distribution Statement: D

POC: name and phone number or email of POC

DISTRIBUTION STATEMENT D: Distribution authorized to the Department of Defense and U.S. DoD contractors only; Administrative or Operational Use; Export Control; date of determination is 18 February 2021. Other requests for this document shall be referred to the attention of the PM MCS Security Manager at: Program Executive Office Ground Combat Systems (PEO GCS), ATTN: SFAE-GCS-C, 6501 E. 11 Mile Road, Detroit Arsenal, MI 48397-5000.

WARNING - This document contains technical data whose export is restricted by the Arms Export Control Act (Title 22, U.S.C., Sec 2751, et seq.), or the Export Administration Act of 1979, (Title 50, U.S.C., App. 2401 et seq), as amended. Violations of these export laws are subject to severe criminal penalties. Disseminate IAW provisions of DoD Directive 5230.25.

DESTRUCTION NOTICE: Destroy by any method that will prevent disclosure of contents or reconstruction of the document.

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.