CRSAW_REPORT.pdf

CONTRACT REPAIR SCREENING ANALYSIS WORKSHEET

PART I (To be completed by PMS Seller)

1. FORM INITIATION DATE

09 DEC 2019

2. FORM PRIORITY

3. NSN

5998012915407KV

4. PART NUMBER

091060-301

5. PART NUMBER CAGE CODE

22915

6. NOUN

CIRCUIT CARD ASSEMB

7. ANNUAL REPAIR

QUANTITY

8. LATEST REPAIR COST

$5,000.0000

9. ANNUAL REPAIR

BUDGET VALUE

$100,000.00

10. FORECAST UNIT

PRICE

$5,000.0000

11. ERRC

T

12. WEAPON SYSTEM

A-10C

13. END ITEM APPLICATION

IEPU NSN 6610-01-611-3294

14. HISTORY

DOES ORGANIC REPAIR OR DMISA REPAIR CAPABILITY CURRENTLY EXIST? X NO YES (if yes, specify SOR)

HAS THE ITEM PREVIOUSLY BEEN CONTRACT REPAIRED?

IF YES, COMPLETE TABLE BELOW FOR LAST 5 YEARS (not to exceed last 3 contracts)

NO X YES

SOURCE NAME CAGE CONTRACT NUMBER AWARD DATE

NORTHROP GRUMMAN SYSTEMS CORPORATIO 28 SEP 20121LTU5 FA851712D00200001

NORTHROP GRUMMAN SUPPORT SERVICES C 22 JUL 200848306 FA851908C0004

15. PMS SELLER NAME

Gregory-Benz, Leigh A

CODE OFFICE SYMBOL

410 SCMS / GULB

PHONE

478-327-3318

COMPLETION DATE

11 FEB 2020

PART II (To be completed by Equipment Specialist)

16. TECHNICAL ORDERS REQUIRED X NO YES (annotate required data and availability on RDL) UNKNOWN

17. OTHER SPECIFICATIONS / SPECIAL REPAIR CRITERIA REQUIRED NO X YES (annotate required data and availability on RDL) UNKNOWN

18. THE DATA LISTED IN RDL COMPLETED SPECIFIES THE REPAIR REQUIREMENTS OR

X ADDITIONAL DATA IS REQUIRED (Coordinate with the engineer and screening office to determine information required. Document in Block 33)

19. SPECIAL TOOL / SPECIAL TEST EQUIPMENT IS NOT REQUIRED REQUIRED X REQUIRED BUT NOT AVAILABLE

SPECIAL FACILITIES ARE X NOT REQUIRED REQUIRED

GOVERNMENT FURNISHED MATERIAL IS X NOT REQUIRED REQUIRED REQUIRED BUT NOT AVAILABLE

20. EQUIPMENT SPECIALIST NAME

Green, Craig A

CODE OFFICE SYMBOL

410 SCMS / GULB

PHONE

478-222-8583

COMPLETION DATE

12 FEB 2020

PART III (To be completed by Screening Technician if applicable)

21. REQUESTED ENGINEERING DATA

LISTED AND ANNOTATED ON RDL NO DATA

22. SCREENING TECHNICIAN REMARKS

23. SCREENING TECHNICIAN NAME

Rohde, David K

CODE

N/A

OFFICE SYMBOL

429 SCMS / GUMACA

PHONE

478-222-3052

COMPLETION DATE

11 DEC 2019

PART IV (To be completed by the Engineer)

24. CRITICAL SAFETY ITEM

X NO YES

25. CAN THIS ITEM BE COMMERCIALLY

OVERHAULED / REPAIRED (FAR Part 12)

X NO YES

26. PRECONTRACT QUALIFICATION

REQUIRED

X NO YES (JQR/QR, SQS, Waiver)

27. RDL REQUIRED FOR

SOLICITATION

X NO YES

28. RMC / RMSC CODE

R3 / R

29. RMC / RMSC EXPIRATION DATE

13 FEB 2025

30. REASON FOR OTHER THAN G CODE AND ACTION TO REMEDY

The Government does not own the data or the rights to the data needed to contract repair of this part from additional sources. It has been determined to be uneconomical to buy the data or rights to the data. It is uneconomical to reverse engineer the part.

31. APPROVED / POTENTIAL SOURCES

CAGE

CODE DATE APPROVED

NORTHROP GRUMMAN CORP 22915 13 FEB 2020

32. ENGINEER NAME

Tobias, Mario A

CODE

N/A

OFFICE SYMBOL

410 SCMS / GUEA

PHONE

478-222-0023

COMPLETION DATE

13 FEB 2020

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CONTRACT REPAIR SCREENING ANALYSIS WORKSHEET

PART V (Miscellaneous, if needed)

33. REMARKS (Remarks require Functional Responsibility / Name / Office Symbol / Phone)

USER TYPE: Equipment Specialist NAME: Green, Craig A DATE: 10 DEC 2019

ORG / OFFICE SYMBOL: 410 SCMS / GULB COMMERCIAL PHONE: 478-222-8583 DSN PHONE: 472-8583

GOVERNMENT DOES NOT HAVE TEST PROCEDURES TO REPAIR CARRIER BOARD. TEST PROCEDURES ARE ONLY AVAILABLE THROUGH OEM.

USER TYPE: Equipment Specialist NAME: Green, Craig A DATE: 10 DEC 2019

ORG / OFFICE SYMBOL: 410 SCMS / GULB COMMERCIAL PHONE: 478-222-8583 DSN PHONE: 472-8583

ORGANIC REPAIR CANNOT BE PERFORMED DUE TO LACK OF TEST PROGRAM.

Page 2 of 2AFMC FORM 762, 20060201, V1 Version 11Generated by PRPS using Jasper Reports on 04 Jun 2020