Attachment 1 - Statement of Work - 70Z03826QH0000107.pdf

ATTACHMENT 1 - STATEMENT OF WORK (SOW) – 70Z03826QH0000107

FOR OVERHAUL

1.0 GENERAL

1.1 BACKGROUND

The U.S. Coast Guard (USCG) Aviation Logistics Center (ALC) requires overhaul services for the applicable Part Numbers (P/N), National Stock Numbers (NSN), and quantity estimates as specified on the Schedule of Supplies/Services (Schedule). The Contractor shall be required to overhaul components to be returned to USCG in a ready for issue (RFI) condition.

The Long-Range Surveillance Product Line Division (LRS) supports the HC-130J aircraft by providing logistics, inventory management, and sustainment support for USCG aviation assets utilized by Air Stations geographically located in and outside the continental United States. As part of this responsibility, LRS is responsible for the ongoing support and maintenance of components used on the aircraft.

This purchase order will provide an acquisition vehicle for the USCG to maintain an inventory of RFI components to supply depot level maintenance and the field units. It will continue to enhance the USCG’s ability to perform congressionally mandated missions including search and rescue, law enforcement, international ice patrol, marine environmental protection, and marine resource conservation. With such a demanding operational tempo, aircraft condition and availability are essential to mission success.

1.2 SCOPE

Subject to the Government’s need and availability of funds, the components listed in the Schedule will be furnished to the Contractor for overhaul at the prices established at award. All overhaul actions shall be accomplished In Accordance With (IAW) the Original Equipment Manufacturer (OEM) specifications, or the applicable technical directive, or alternate standard approved in writing by USCG LRS Contracting Officer.

Components furnished hereunder shall be returned by the Contractor in an airworthy condition and in all respects suitable for installation on the HC-130J aircraft. Certification and documentation requirements apply.

Overhaul shall be performed using the following:

1. Component test jigs listed in Table 1 which have been approved in writing by the United States Air Force (USAF), or

2. Alternate component test jigs which have been approved in writing by the aircraft OEM Lockheed Martin, or

3. Alternate component test jigs which have been approved in writing by the component OEM Tactair Fluid Controls, Inc.

The contractor shall furnish written approval that their test jig meets one or more of the above criteria. Failure to provide verifiable proof will result in removal of the proposal from further consideration. The USCG will reject any component overhauled using a test jig that does not meet these specific requirements.

Statement of Work -- Overhaul

Table 1: Components and Related Information

Component Description NSN OEM Part

Number Jig Part

Numbers

Elevator Booster Assembly 1680-01-472-5564 70236 374461-11 339814-TCR

Firm-fixed pricing for overhauls is fully burdened. The Contractor shall provide all parts, labor, and materials necessary to restore these components to Ready-for-Issue (RFI) condition. The incorporation of Service Bulletins (SB) or repairs for unusual damage will be negotiated separately at a later date.

The technical requirements outlined in the SOW represent the minimum acceptable standards of performance.

They are not intended to be exhaustive or to supersede the procedures specified in the manufacturer’s drawings, manuals, specifications, and service bulletins. The Contractor must have access to all applicable technical documents necessary to perform teardown, inspection, rework or replacement, assembly, and testing of all items identified in the schedule.

The contractor is required to perform a complete overhaul of each component, not limited to the installation of overhaul kits specified in applicable technical documents. During teardown and inspection, the contractor must identify and correct any additional deficiencies discovered. The firm-fixed price shall cover:

Installation and replacement of parts specified in technical directives and Attachments 1.

Removal of any foreign matter or corrosion

Rectification of all deficiencies identified during the overhaul process

1.3 APPLICABLE DOCUMENTS

1.3.1 Technical Directives

The following documents provide technical directives, specifications, standards, or guidelines that must be complied with in order to meet the requirements of this purchase order: Either the OEM Component Maintenance Manual (CMM) or Air Force Technical Order (AFTO) may be used to accomplish overhaul actions.

Original Equipment Manufacturer’s Commercial Maintenance Manuals, (CMM), latest version.

Manufactures Cage Code: 70236

Technical Order:

Other:

Table 2: Technical Specifications

Component Description

NSN OEM Part Number Technical Data

Elevator Booster 1680-01-472-5564 70236 374461-11 Original Equipment

Manufacturer (OEM), (70236), Specifications.

1.3.2 Availability of Documents

The Contractor must have access to the most current editions of all applicable documents and manuals necessary for the repair of these components. The USCG does not maintain or release the technical directive documents required for these components. To be deemed technically acceptable, the Contractor must demonstrate availability of the required technical data by submitting the cover sheet of the relevant documents and manuals referenced above. Contractors must have access to the most current editions of all applicable documents and manuals.

1.3.3 Source of Component Maintenance Manuals

The contact below is provided for information about obtaining the technical directives:

406 SCMS/GUEE

Tinker AFB, Oklahoma 73145-3029

1.3.4 U.S. Federal Specifications and Standards

U.S Government specifications, standards, and handbooks are available from the Standardization Document Order Desk, 700 Robbins Avenue, Building 4D, Philadelphia PA 19111-5094. Other Government activities, contractors, and other private concerns must procure copies from the American Society for Testing and Materials, 100 Barr Harbor Dr., West Conshohocken PA 19428-2959.

2.0 SPECIFIC REQUIREMENTS/TASKS

2.1 The contractor shall implement a reliability improvement program and maintain certification for a quality management system compliant with SAE International Standard AS9100 (preferred), ISO 9001:2008, or an equivalent quality management standard. The certification must be current and maintained throughout the contract period.

2.2 All work shall be performed in accordance with the technical documents specified in section 1.3, with the latest revision applied unless otherwise noted in this contract. The Contractor must have access to all necessary maintenance, repair manuals, and performance/test/acceptance criteria and data to ensure that equipment is repaired, calibrated, and operating in accordance with the technical document specifications.

If a manual revision is released that alters or modifies the repair specifications and impacts the cost of repairs, the Contractor shall immediately cease work and notify the Government in writing within fifteen

(15) calendar days. The Contractor shall provide an updated firm-fixed price proposal reflecting how the revision affects the work being performed.

2.3 The Contractor shall provide all necessary parts, material, labor, tooling, test equipment, and facilities to evaluate and overhaul the components listed in the Schedule for the USCG HC-130J fleet as necessary to conform with the requirements of this SOW at the firm-fixed-pricing established in the contract schedule.

2.4 Reporting Requirements

2.4.1 Receipt of Components

Upon receipt of components, the Contractor shall notify the Contracting Officer in writing and provide the following information: (1) the date the component(s) were received at the Contractor’s facility, or point of departure for foreign Contractors; and (2) confirmation of the part numbers and serial numbers, including any discrepancies between the received items and those listed on the purchase order (part numbers and serial numbers must match those specified on the purchase order). Notification may be sent to the administrative contract specialist assigned at the time of award. Failure to acknowledge receipt of the components as specified in the schedule of services may result in the Government presuming that the components were received at the Contractor’s facility within seven (7) days of the purchase order date.

2.4.2 Monthly Status Report

The Contractor shall submit a monthly status report to the Contracting Officer via the Contract Specialist not later than the 10th calendar day of each month. The report shall contain the following information for each component issued for overhaul: the P/N and S/N, contract number, date received at Contractor’s facility, date inducted for overhaul, current status of work in process to include any issues or parts delays, projected completion date, and date shipped to USCG when complete.

2.5 Corrosion

The Contractor shall perform a visual and technical inspection IAW the current applicable technical documents and correct all additional deficiencies found. This shall include replacement of broken parts and the removal of any foreign matter or corrosion. USCG aircraft operate primarily in a saltwater environment and are subject to corrosion. Corrosion found on components is expected to be repaired under this contract. Note: The existence of corrosion does NOT support a determination for Unusual Damage. See paragraph titled Unusual Damage

2.5.1 During inspection and functional testing, the presence of corrosion in any component or subcomponent shall warrant a more thorough disassembly and inspection. If corrosion is detected, disassembly shall be performed only to the extent necessary to remove the corrosion or replace the affected part(s). Corroded parts shall be replaced unless removal of corrosion does not compromise the efficiency or safe operation of the part. Corrosion removal and treatment of affected areas shall be conducted in accordance with technical directive specifications and Federal Aviation Administration (FAA) Advisory Circular AC 43-4B, dated September 11, 2018, "Corrosion Control for Aircraft."

2.6 Replacement Parts

Replacement parts shall be in new condition and traceable to the OEM. If new parts are no longer available, replacement parts classified as “serviceable” or “repaired” and meeting the requirements of the applicable technical documents may be used, subject to authorization by the Contracting Officer. For each component, the Contractor shall provide a copy of the work order listing all replacement parts utilized. The Contractor shall retain certification documentation for all replacement parts for inspection by the Government for a minimum of twenty-four (24) months after delivery.

Unless otherwise directed in writing, defective parts removed from components shall be rendered unusable for their intended purpose and disposed of at the Contractor’s facility in accordance with standard parts disposal procedures.

In addition to the parts that must be replaced per the Technical Documents, the USCG mandates all parts listed in Attachment 1 shall be replaced at overhaul regardless of condition.

The contractor may submit a quote for over and above costs for damaged major components that are not identified for replacement by the Technical Documents or USCG mandates. Such components shall be inspected, repair costs determined, and authorization to proceed obtained from the Contracting Officer prior to commencement of work. Once notified of a possible exclusion, the Contracting Officer will make a written determination within thirty (30) days as to exclusion validity. The Contracting Officer may approve the quote, decline the quote and have the item returned as-is, or consider the item BER.

Replacement parts shall be documented as traceable to the OEM as specified by the applicable technical documents. Only OEM replacement parts as authorized by the applicable technical documents are authorized for use in this situation. Note that photographic evidence may be required to support the contractor’s determination.

2.7 In all cases inspection, overhaul, and test procedures must meet or exceed technical document specifications.

Components delivered to the Government shall be certified to be airworthy and ready for field level (USCG Air Station) installation on a USCG aircraft, including final paint.

2.8 The Contractor shall remove the unserviceable tag DD Form 1577-2 from the overhauled component upon completion of overhaul.

2.9 Service Bulletins (SB) or Other Modifications

Upon receiving a written notice of a SB or other modification by either the Government or OEM, the Contractor shall submit within thirty (30) calendar days a firm-fixed priced proposal of an incremental charge to be assessed each time the SB or change is incorporated in a component. The proposal shall contain a breakdown of material and labor cost based upon the firm-fixed labor rates and material factors. The incremental charge agreed to for incorporation of a SB shall apply only to those components into which the Contractor incorporates a required SB, not those into which the SB has been previously incorporated. Upon agreement of the incremental charge and issuance of a contract modification to reflect this change, the SB shall be incorporated into each subsequent component received at the Contractor’s facility if said SB has not already been incorporated. When SB incorporation changes the component’s part number, the new part numbers will be added to the contract. The Contractor shall update the components’ data plate, if applicable, to denote the new part number and/or modification number.

2.10 Obsolete Parts or Processes

The Contractor shall use new parts meeting the requirements of the specified technical documents, specifications and drawings. In the event certain parts or processes become obsolete the Contractor shall, within fifteen (15) calendar days after receipt of the assembly or component, notify the Contracting Officer and submit 1) rationale and verification of any obsolete part or process, and 2) a written estimate of the effort required to make the repair.

Such estimates shall include nomenclature, part number, cost and quantity of replacement parts, and total labor hours. The Contractor shall verify cost of parts with invoices or catalogs. The Contractor’s delivery obligation for the component(s) identified shall be suspended as of the date of the notice to the Contracting Officer. The Contracting Officer will, within thirty (30) calendar days of receipt of the Contractor’s written estimate, make a written determination as to the disposition of the component. After receipt of the Contracting Officer’s disposition instruction, the Contractor shall have sixty (60) calendar days for delivery.

3.0 OTHER APPLICABLE CONDITIONS

3.1 Place of Performance

The primary place of performance will be the Contractor’s facilities or other USCG approved location, if applicable.

3.2 Turn-around Time/Delivery Schedule

The desired turn-around time for overhaul is sixty (60) days after receipt of material (ARM) at the contractor’s facility. Turn-around time is defined as beginning at the time of receipt of component at the Contractor’s facility and ending at the time of delivery to ALC Elizabeth City, NC.

The USCG desires early deliveries therefore early shipments are encouraged as long as no additional costs are incurred by the USCG. All requests for time extensions shall be submitted to the Contracting Officer in writing and shall include substantiation of the need for such time extension(s) IAW FAR 52.212-4 (f) excusable delays.

If nonperformance is not covered by an excusable delay, the Contractor and the Contracting Officer shall negotiate the consideration for the approval of the extended delivery date at which time a modification to the purchase order will be issued to reflect the consideration and the extension. The Contractor may also propose a staggered delivery schedule based on plant capability for large quantity purchase orders.

3.2.1 Delivery – Dock to dock. The government has no preference in freight forwarders; the contractor’s delivery obligation shall remain unchanged.

3.3 Warranty

The Contractor shall provide a 12-month warranty against defects in workmanship and materials. The warranty period shall begin on the date the component is delivered to USCG.

3.4 Environmental requirements

All parts must be thoroughly cleaned IAW applicable technical documents, to ensure they are as free as practicable of all hazardous dust to include hexavalent chromium, cadmium, lead, etc., prior to being returned to ALC. ALC may take random samples of parts to ensure they are free as practicable of all hazards. Information on these hazards can be found in Occupational Safety and Health Standards 1910-1025 (lead), 1910.1026 (Hexavalent Chromium) and 1910-1027 (Cadmium).

3.5 Unusual Damage

The USCG intends that all components specified in the Schedule will be overhauled at the firm-fixed prices established in the contract. Occasionally, components may be received in a condition that falls outside the scope of the applicable technical documents and may be classified as Unusually Damaged. To be classified as Unusually Damaged, a component must be received for routine repair and, upon evaluation, exhibit one or more of the following conditions:

Obvious misuse Cannibalization Crash damage

Note: Only components meeting one or more of the above criteria may be considered as Unusually Damaged.

All other components shall be overhauled IAW the firm-fixed prices established at award.

3.7.1 Unusual Damage Report Requirements

When a component is processed for Unusual Damage Evaluation, the Contractor shall, within thirty (30) calendar days of receipt of the component, submit an inspection condition report, photographs if requested, and price proposal for the additional work. The price proposal shall contain the purchase order number, line item number, NSN, P/N, S/N, nomenclature and pricing for all materials and labor needed to return the component to RFI condition. The hourly labor rate will be charged at the firm-fixed hourly labor rate contained in the Schedule. The Contractor’s delivery obligation shall stop from the date of notification that a component has been determined to be a candidate for Unusual Damage evaluation. The delivery obligation will be specified in a purchase order modification and will apply only to those items specifically addressed by the modification.

The Contractor is obligated to deliver all other components not individually addressed by the modification under the original delivery date specified on the purchase order.

The proposal shall not include the work involved in the teardown and inspection already performed, as this is covered by the firm-fixed price specified in the Schedule.

Within thirty (30) calendar days, the Contracting Officer will either initiate negotiations for a firm-fixed price with the Contractor or deny authorization for the overhaul based on information in the report and any other information which may be available. Upon mutual agreement as to price and delivery, a purchase order modification will be issued to require the additional work at the agreed upon terms. If the additional work is not desired, the Contracting Officer shall provide the Contractor with disposition instructions for the un-overhauled component. In the event an item is returned to the USCG in a disassembled condition, the Contractor shall be entitled only to compensation for the Evaluation Fee.

3.7.2 Cannibalized Components

Firm-fixed prices in the Schedule for overhaul shall not include assemblies and components which have been cannibalized for repairable parts. These components shall be evaluated at the firm-fixed price specified in the Schedule for Inspection/No Fault Found. In the event any of the components listed in the Schedule are received in a condition that represents cannibalization, immediate notification to the Contracting Officer is required.

This notification shall include a detailed description of the noted deficiencies and shall reference the purchase order number, line-item number, NSN, P/N, and S/N, and is subject to the discretion of the Contracting Officer.

3.7.3 Beyond Economical Repair

In the event an entire component is determined BER, the Contractor shall provide written notification to the Contracting Officer. In this notification, the Contractor shall list the purchase order number, line item number, NSN, P/N, and S/N, with a brief description supporting the determination. The Contracting Officer shall provide disposition instructions via modification to the purchase order. The USCG will make all final BER determinations. The Contractor shall be entitled to compensation for teardown and evaluation at the firm-fixed price established for “Evaluation Fee” in the Schedule.

3.7.4 Evaluation Fee

Evaluation fee will include teardown, test and inspection. Should the component be determined to be non-repairable, the Contractor shall immediately notify the Contracting Officer and await disposition instructions. A modification will be provided to the vendor for disposition of the property. In this instance, the Contractor will be entitled to the Evaluation Fee only and ALC will dispose of the property.

3.7.5 Inspection/No Fault Found

Components received which, when tested, indicate a “no fault found” situation shall be thoroughly inspected to ensure they meet current minimum functional performance and test specifications as designated by the applicable technical directives. S/N tracked items shall be documented on the Component Repair Record (CRR) as required in paragraph 6.2. The work shall be invoiced IAW, the applicable “Inspection/No Fault Found” charge indicated in the Schedule

4.0 RESERVED

5.0 PRODUCT QUALITY/AIRWORTHINESS

5.1 Ready for Issue

ALC considers components Ready for Installation (RFI) upon acceptance. Components determined to be Not Ready for Installation (NRFI) within the 12-month warranty period, upon aircraft installation, shall be returned to the Contractor under warranty. Deficiencies shall be described in a Product Quality Deficiency Report.

5.2 Product Quality Deficiency Report

Overhauled or modified components found to have deficiencies will be returned to the Contractor via a no-cost purchase order and accompanied by Standard Form “SF 368 Product Quality Deficiency Report” (PQDR). The Contractor shall report findings of their investigation to the Contracting Officer within thirty (30) calendar days after receipt of the PQDR and component. If the parties agree that the component’s deficiencies are not related to previous work, the Contractor’s report of findings shall include a detailed proposal that includes a breakdown of parts and labor necessary to return the component to an RFI status. The breakdown shall be IAW the fixed hourly labor rate established in the Schedule. The Contracting Officer will either initiate negotiations for the work or accept the Contractor’s proposal and issue a purchase order modification. The standard terms and conditions, specifically for delivery obligations, of the purchase order shall apply to items submitted via PQDR evaluation.

5.3 Airworthiness and Required Certification

Failure to comply with these requirements may result in refusal to accept and pay for services.

5.3.1 Airworthiness and Suitability

All aircraft parts ordered, serviced, modified, or overhauled shall be traceable to the OEM and certified airworthy and suitable for installation on USCG aircraft.

a. Airworthiness Certification is required for all parts provided under this purchase order. All components must be airworthy and suitable for installation on USCG aircraft. The Contractor shall supply a Federal Aviation Administration (FAA) 8130-3 Airworthiness Release Certificate or EASA Form-1 with each component that is tested, repaired, or overhauled.

b. Alternatively, the Contractor may request written authorization from the cognizant Contracting Officer to submit a Certificate of Conformance or an alternate document as proof of traceability, testing, repair, and/or overhaul. Use of a Certificate of Conformance must be approved in writing.

The Certificate of Conformance must, at a minimum, include all information required by the 8130-3, including airworthiness release details and relevant information in accordance with 14 CFR, Federal Aviation Regulation (FAR) 43.11 and/or 43.9. Replacement part certification documentation must be maintained by the Contractor for inspection for a minimum of twenty-four

(24) months after delivery of component to USCG.

c. All documentation must be attached and submitted in accordance with 48 CFR, Federal Acquisition Regulation (FAR) 52.246-15. The appropriate certificate must be signed and dated by an authorized official representing the approved repair station. A copy of the certificate must be included with the packaging slip and another copy with the invoice.

5.3.2 Contractor Facility Certifications

The Contractor shall be either the Original Equipment Manufacturer (OEM), an OEM Authorized Repair Center, or a Federal Aviation Administration (FAA) Certified 145 Repair Center deemed acceptable to the Coast Guard for the inspection and repair of components as specified in the attached schedule.

5.3.3 OEM Authorized Repair Center

To demonstrate OEM certification, the Contractor must submit official documentation issued directly by the OEM confirming that the Contractor is authorized to perform the services required under this contract. This documentation must explicitly reference the specific part numbers listed in the Schedule of Services and must be current as of the date of proposal submission. Generic letters of authorization or documentation not directly tied to the required services and part numbers will not be accepted.

5.3.4 FAA Certified Facility

To demonstrate that the Contractor is properly certified by the FAA, the Contractor must submit their repair station certificate. If the Contractor holds a limited rating, the Contractor must also submit:

1. A capabilities list identifying the relevant part numbers specified on the schedule of services, in accordance with 14 CFR 145.215; and

2. A self-evaluation affirming that the repair station has all housing, facilities, equipment, material, technical data, processes, and trained personnel in place to perform work on the articles identified in the schedule of services, in accordance with 14 CFR 145.215. Upon request by the Contracting Officer, the Contractor may be required to submit a copy of the repair station manual and quality control manual.

5.3.5 Changes Affecting Contractor Certifications

If the Contractor’s certification status changes at any time during the period of performance (e.g., suspension of the FAA repair station certificate), the Contractor shall immediately notify the USCG. Such a change may be grounds for contract termination. The USCG will review the circumstances surrounding the change in certification status and make a final determination regarding contract continuation. The USCG reserves the right to permit the Contractor to continue work if it determines that all other requirements of the SOW can still be met.

5.3.6 Sub-Contractors

All potential Sub-contractors must meet one of the requirements specified in section 5, as applicable to the items listed in the Schedule. To be considered technically acceptable, the Contractor shall submit a comprehensive list of all Sub-contractors who may perform work on USCG articles. If no Sub-contractors will be utilized, the Contractor must provide a statement confirming this.

The Sub-contractor list must include the following information for each Sub-contractor: name, location, certification source (e.g., FAA, OEM, DoD, USCG), rating type (if applicable, e.g., NDI, Specialized Services), and a description of the services provided. Each Sub-contractor must provide documentation of the services rendered to the Contractor, either in the form of an FAA Form 8130 certification or an equivalent Airworthiness Certificate, clearly indicating that the work was performed in accordance with the relevant technical data.

The Contractor is required to inform the USCG in writing of any changes to the Sub-contractor list during the period of performance. Failure to properly notify the USCG of Sub-contractors performing work on USCG articles may result in contract termination.

5.3.7 Quality Assurance System

The Prime Contractor and all potential Sub- contractors shall be in possession of an FAA or OEM certification in the applicable category for the items listed in the Schedule. The Contractor shall maintain a Quality Assurance System, including test component calibration system requirements, and documentation of said requirements, sufficient to ensure that overhaul services conform to OEM or TO specifications and requirements of this contract.

6.0 ASSET COMPUTERIZED MAINTENANCE SYSTEM

6.1 Asset Computerized Maintenance System

Asset Computerized Maintenance System (ACMS) is the management information system used to schedule and record all USCG aircraft maintenance. The Contractor’s responsibility within ACMS shall include submission of the appropriate reports within five (5) working days of completion of work. Tracked components will be shipped to the Contractor with a SCHR and a blank CRR for each tracked component. USCG will provide the appropriate forms with each component as follows:

SCHR The document which contains the maintenance history of the serial numbered tracked component. It remains with its corresponding component until the component is reinstalled on an aircraft or annotated

“Scrapped”.

CRR Records the maintenance performed by the Contractor on a serial number tracked component. The Contractor may request that their in-house technical action report be accepted to fulfill the CRR requirement if it contains all of the information required on the USCG provided CRR (sample at Attachment 3). The Contracting Officer will provide a written determination in response to the request.

6.2 The Contractor is responsible for the following disposition of CRRs for each component overhauled or scrapped:

The original CRR shall be packed with the component at completion of overhaul for return to USCG.

Mail one completed copy to the following address within five (5) working days of completion of component overhaul.

USCG Aviation Logistics Center ACMS – Bldg. 63 1664 Weeksville Rd.

Elizabeth City, NC 27909-5001

6.3 The Contractor shall maintain a copy of each completed CRR for a period of one (1) year.

Attachment 1

Elevator Booster Assembly (P/N 374461) Replacement Parts List Part Number Nomenclature QTY

AN386-1- 14A PIN, THREADED TAPER 4

AN975-3 WASHER 4

MS21042-3 NUT 31

AN386-3- 16A PIN, THREADED TAPER 1

AN975-4 WASHER 1

MS21042-4 NUT 9

340942 WASHER 2

341339 SHAFT 1

341357-3 HOUSING 2

NAS516-1A LUBE FITTING 2

342741 NUT 2

NASS09-10 NUT 2

344886-4 SHIM 2

344886-7 SHIM 2

348465-4 PIN 4

348474-4 LINK 2

352562 NAME PLATE 1

MS20005-32 BOLT 2

MS20005-22 BOLT 2

MS20002- CS WASHER 4

MS20202KP21B BEARING 4

MS16625-1206 SNAP RING 2

LS4893-5 RETAINER 4

2752-054 NUT, BARREL 4

364577-1 PLATE 1

341403 CASE HYO FILTER 2

348654 NAME PLATE 2

348658 NAME PLATE 2

348657 NAME PLATE 4

364795-1

ARM, DAMPER, VISCOUS BOOST

VALVE

AN173H6A BOLT 2

AN502-10-4 SCREW 2

M83461/1-110 0- RING, BUNA N 2

M83461/1- 231 0- RING 2

Attachment 1 (Continued)

Part Number Nomenclature OTY

MB538FS160 BEARING 4

364578-1 WASHER 2

AN960-416L WASHER 5

MS20004-16 BOLT 6

MS20004-36 BOLT 8

C5788-16 NAMEPLATE 1

2752-048RET RETAINER 10

350981-1 ROD 1

346169 SHAFT 1

346170 SPACER 1

MS16625-1100 RETAINING RING 2

AN4H4A BOLT 4

AN4H7A BOLT 2

AN500A8-8 BOLT 2

AN960D416 WASHER 12

AN960D516 WASHER 2

AN960-D8 WASHER 2

MS16624-1018 RING 8

MS16625-1375 RETAINING RING 2

MS17826-4 NUT 10

MS17826-5 NUT 2

MS20202KP33B BEARING 2

MS24665-134 PIN, COTTER 8

MS28775-128 0- RING, BUNA N 4

C5803-17 NAME PLATE 1

C5791-30 PISTON RING SET 2

MS28774-224 RING, B/U, TEFLON 16

MS28775-224 0- RING, BUNA N 8

7214-FT-160-T RING SEAL SET 4

NAS1104-14D BOLT 2

NAS1104-16D BOLT 2

NAS1104-15D BOLT 1

NAS1104-17D BOLT 1

Attachment 1 (Continued)

Part Number Nomenclature QTY

NAS1103-6 BOLT 22

M73FS6323C SCREW 2

695228 FILTER ELEMENT 2

M83461/1- 113 O- RING, BUNA N 15

M83461/1- 114 O- RING, BUNA N 6

M83461/1- 222 O- RING 8

AN6235- 2A ELEMENT ASSY 2

LS4634-6 O- RING 4

LS4634-12 O- RING 2

AN960D10 WASHER 30

NAS623-3-8 SCREW 6

MS20002C4 WASHER 29

M8791/1- 222 RING, B/U 16

LS4634-8 O- RING 4

LS4634-3 O- RING 6

LS4634-4 O- RING 1

2752-048 BARREL NUT 14

M8791/1- 114 RING, BACK - UP 2

C5788-17 NAMEPLATE 1

C5787- 18 SLEEVE 2

C5787- 24 CAP 2

C5787- 25 COVER 2

C5787- 26 GUIDE 2

RS602- 10 INSERT 2

C5787- 41 BOLT 2

AN4-23A BOLT 8

AN960C416 WASHER 8

AN316- 4R NUT 2

NAS144DH-16 BOLT 8

NAS144DH-30 BOLT 8

MS28775-019 O- RING, BUNA N 10

MS28775-026 O- RING, BUNA N 4

MS28775-114 O- RING, BUNA N 2

MS28775-218 O- RING, BUNA N 2

MS28775-220 O- RING, BUNA-N 2

Attachment 2

CERTIFICATE OF CONFORMANCE IN ACCORDANCE WITH

FAR 52.246-15 (APR 1984)

“ I certify that on (Date), the

(’s Name) furnished supplies or services called for by Contract Number via (Carrier) on (Bill of Lading/Shipping Document) in accordance with all applicable requirements. I further certify that the supplies and services are of the quality specified and conform in all respects with the contract requirements, including specifications, drawings, preservation, packaging, marking requirements, and physical item identification (Part Number), are in the quantity shown in this or on the attached acceptable document.”

Date of Execution:

Signature:

Title:

Attachment 3

SAMPLE