B01 - Attachment 0006 W53W9L230100RU CMTR MJU77B PISTON 1172022.pdf

CERTIFIED MATERIAL TEST REPORT / CERTIFICATE OF ANALYSIS

For those material(s) identified below, a Certificate of Analysis (C of A) test report shall be provided to the government at time of delivery to CAAA (Crane Army Ammunition Activity). The test results contained on the Certificate of Analysis report(s) shall be adequate to determine compliance with all applicable requirements of the material specification(s) listed below. Availability of the Certificate of Analysis may be in addition to other Purchase requirements and does not reduce or prejudice the Government’s right to inspect supplies under other provisions of this contract.

The test report(s) shall contain the following:

a. Name and address of Manufacturer and Supplier when *applicable.

(*If not manufactured by the Supplier.)

b. Purchase order number.

c. Identification of material by specification, revision, amendment and dates, together with type, grade, size etc. number.

d. Quantity of material.

e. Material testing results shall address drawing specifications.

Component / Item: Piston.

Drawing: 3976AS108 Rev. C Made from Material: Polyethylene ASTM D4976

PE0210A29900 KB012 UA320

Use 100% Virgin Material.

No Reground Allowed.

Note: The Piston shall be identifiable / traceable to the individual mold cavity.

Note: The Piston shall be identified with a traceable lot number at time of

Delivery.

Note: Item(s) cannot be accepted without documentation to support the required material was used to produce.

f. Quantity tested, sample size, and specimen type as applicable.

g. Date, signature, and title of the authorized representative of the contractor that is attesting to the accuracy of test report content.

Component: Piston.

Requirements for: MJU-77/B Program.

07 Nov. 2022.