ATTACHMENT TECHNICAL SPEC AND CERT.docx

CONTRACT __________________

PRINTED 28 JULY 2021 PAGE _______

ATTACHMENT 1 TO EXHIBIT A (DD FORM 1423)

REQ DOC NO. - 1204E040 ATTACHMENT _________

CONTINUATION SHEET CONTRACT NO. - _______________ PAGE ___ OF ___

NAME OF OFFER OR/CONTRACTOR

______________________________________________________________________________ITEM # SUPPLIES/SERVICES QTY U/I

TAPE, INSULATION, ELECTRICAL 1000 RL

FOR PNSY USE ONLY (LL-R00-3353,)

C. DESCRIPTION/SPECIFICATIONS

C.1 TAPE, INSULATION, ELECTRICAL, HIGH TEMPERATURE, GLASS FIBER, PRESSURE SENSITIVE SILICONE ADHESIVE ON ONE SIDE, 3 INCHES WIDE X 0.007-0.010 INCHES THICK X 108 FEET LONG, PER MIL-I-19166C.

C.2 PER QPL 19166-QDS, THE ELECTRICAL TAPE REQUIRES THE VENDOR TO BE ON THE “QUALIFIED PRODUCTS LIST” FOR VENDORS. SEE ATTATCHED.

C.3 TAPE SHALL MEET TABLE II SHIP PRODUCT LIMITS OF MIL-STD-2041E, FOR MERCURY, ANTIMONY, BISMUT, CADMIUM, LEAD, TIM, ZINC, BROMIDES, CHOLORIDES, FLOURIDES, SULFUR AND PHOSPHOURUS. TEST SHALL BE ACCOMPLISHED IN ACCORDANCE WITH MIL-STD-2041E.

C.3.1 TEST RESULTS (REPORTS) SHALL BE PROVIDED WITH MATERIAL.

C.4 DATA REQUIREMENTS PER EXHIBIT A (DD-1423) & ATTACHMENT #1.

C.4.1 CERTIFICATION OF COMPLIANCE; MIL-STD-2041E; EXHIBIT A SEQUENCE A001.

C.4.2 CERTIFICATE OF REQUIRED TEST; TABLE II PER MIL-STD-2041E; EXHIBIT A SEQUENCE A002.

D. PRESERVATION/PACKAGING/PACKING

D.1 EACH ITEM OR ITEM PACKAGE TO BE PER MIL-I-19166C LEVEL C

D.2 EACH ITEM OR ITEM PACKAGE TO CONTAIN MIL-STD-129 (L/R) TYPE I SHELF LIFE MARKINGS FOR CURE DATE/MANUFACTURE DATE (AS APPLICABLE) AND EXPIRATION DATE BASED UPON A SHELF LIFE OF 18 MONTHS. ITEMS SHALL ALSO BE SUPPLIED WITH AT LEAST 85 PERCENT OF THEIR SHELF LIFE REMAINING AT TIME OF SHIPMENT BASED UPON THE ACTUAL CURE DATE/MANUFACTURE DATE AND EXPIRATION DATE MARKINGS.

(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)

CONTRACT DATA REQUIREMENTS LIST

SEQ. NO. A002

CONTRACT __________________

PRINTED 28 JULY 2021 PAGE _______

EXHIBIT A

(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)

CONTRACT DATA REQUIREMENTS LIST

SEQ. NO. A002

SOLICITATION ________________________________________________________________

ITEM ___________________________________________ (DATE FOR ITEM) ___________________

REQUIRED CERTIFICATION

A. CERTIFICATION SHALL BE SUPPLIED WITH EACH SHIPMENT OF MATERIAL. CERTIFICATION (CERTIFICATE OF COMPLIANCE) SHALL BE SUPPLIED AS OUTLINED IN PARAGRAPH B. THE VENDOR IS LIABLE FOR CONDUCTING ALL TESTS, ANALYSES, INSPECTIONS, AND EXAMINATIONS, ETC., AS SPECIFIED BY THE CONTRACT AND SPECIFICATIONS WHETHER CERTIFICATIONS ARE REQUIRED OR NOT.

CERTIFICATE OF COMPLIANCE (PROVIDE THE FOLLOWING VERBATIM STATEMENT OR COMPLETE THE OPTIONAL FORM AT THE END OF THIS PART)

"I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH ALL CONTRACT REQUIREMENTS".

B. CERTIFICATION SHALL BE SUPPLIED PER THE FOLLOWING INSTRUCTIONS:

1. THE CERTIFICATION OF COMPLIANCE SHALL CONTAIN THE SIGNATURE AND TITLE OF THE VENDOR OFFICIAL DESIGNATED RESPONSIBLE FOR QUALITY ASSURANCE.

2. THE MATERIAL IDENTIFICATION (E.G. LOT, BATCH, PART #, ETC.) SHALL BE INCLUDED ON THE CERTIFICATE OF COMPLIANCE.

CERTIFICATE OF COMPLIANCE

COMPANY NAME

MATERIL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)

CONTRACT NO. ______________ ORDER NO. ________________ ITEM NO. ____________________ NATIONAL/LOCAL STOCK NO. NSN/LSN ____________________________________________________ MANUFACTURER’S PART NO. _____________________________________________________________ MANUFACTURER’S SERIAL NO. ___________________________________________________________ DRAWING AND PIECE NO. _________________________________________________________________

MANUFACTURER’S LOT/HEAT NOS. AS MARKED ON THE MATERIAL _________________________

ALL INSPECTIONS AND TEST REPORTS REQUIRED BY ATTACHMENT I TO EXHIBIT A (DD FORM 1423) FOR TRACEABILITY TO EACH CONTRACT ITEM MUST ACCOMPANY THIS SIGNED STATEMENT:

THE INSPECTION AND TEST REPORTS (AS APPLICABLE) PROVIDED REPRESENT THE ACTUAL ATTRIBUTES OF THE ITEMS FURNISHED ON THIS CONTRACT AND INDICATE FULL COMPLIANCE WITH ALL CONTRACT REQUIREMENTS. I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH ALL CONTRACT REQUIREMENTS.