MS 052 CMU Specs and Certs.pdf

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MATERIAL APPROVAL SUBMITTAL

(See Instructions on Reverse)

Form Approved OMB No 9000-0062

Expires May 31, 2005

Public reporting burden for this collection of information is estimated to average 20 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the Department of Defense, Washington Headquarters Services, Directorate for Information Operations and

Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302, and to the Office of Management and Budget, Paperwork Reduction Project OMB No 9000-0062, Washington DC 20503. Please DO NOT RETURN your form to either of these addresses. Send your completed form to: SAF/AQCP, 1060 Air Force Pentagon, Washington DC

TO: (Contracting Officer) FROM: (Contractor) DATE

CONTRACT NUMBER SUBMISSION NUMBER SUBMITTAL

PREVIOUS SUBMISSION NUMBER PROJECT NUMBER

TO BE COMPLETED BY CONTRACTOR FOR GOVERNMENT USE ONLY

ITEM

NO.

SPECIFICATION SECTION/

PARA NO./DRAWING NO.

DESCRIPTION OF MATERIAL

(Include Type, Model Number, Catalog Number, Mfg., etc.)

AP-

PROVED

DISAP-

PROVED

SEE

REVERSE

INITIAL

BY COMPLETING THIS FORM, THE UNDERSIGNED CONTRACTOR CERTIFIES THAT

THE MATERIAL COMPLIES WITH ALL SPECIFICATIONS OF SUBJECT CONTRACT.

DATE (YYYYMMDD) TYPE OR PRINT NAME AND GRADE SIGNATURE

FOR GOVERNMENT USE ONLY

TO: (Base Civil Engineering Officer)

For Evaluation and Action RNLT ________________ OR SOONER

TO: (AF Contracting Office)

RECOMMEND APPROVAL DISAPPROVAL AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE

TO: (Contractor)

APPROVED

DISAPROVED AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE SIDE. REQUEST

RESUBMITTAL ON DISAPPROVED ITEMS WITHIN ____ DAYS OF DATE SHOWN BELOW.

AF IMT 3000, 20030901, V1 PREVIOUS EDITION IS OBSOLETE.

New Resubmittal

1392454892C

Line

1515150249C

Oval

1515150249C

Line

COMMENTS

(Number to correspond with applicable Item Number on reverse)

INSTRUCTIONS TO CONTRACTORS

1. The term "material" is defined as articles, supplies, raw materials, equipment, parts, components, and end items that are to be incorporated into the work required by the contract.

2. This form is to be used by contractors for submitting Shop Drawings, Equipment Data, Manufacturer's Literature and Certificates and samples of Materials to the Government for approval in accordance with the provisions of this contract. Unless otherwise specified, it is to be prepared in 4 copies, signed, and provided to the contracting officer with appropriate attachments.

3. Item(s) to be approved will be clearly tabbed or identified. Data pertaining to item(s) to be approved will be clearly identified or tabbed, particularly where documents are voluminous, in order to properly evaluate the materials or articles to be incorporated in the work. Each attachment will be numbered to correspond with the item number shown on the face of this form.

4. Requests submitted shall be numbered consecutively, by contract, in the space entitled "Submission No.". This number, in addition to the Contract No., will be used to identify each Material Approval Submittal. Resubmissions will be indicated in the appropriate block and the insertion of previous submission number and data in addition to a new submission number. A single submission should be used for all work of a section of the specifications, but in NO instance should the submission include work for more than one (1) contract. Submittals requiring priority handling will be submitted by separate submittal using the form and so marked across the face of the form.

5. This Material Approval Submittal is not valid unless it is signed by the contracting officer. This approval is required as called for by the contracting officer under the terms of this contract.

AF IMT 3000, 20030901, V1 (REVERSE)

TO Contracting Officer: SrA Vitaliy Poprozhuk

FROM Contractor: FARR Builders LLC S. Gevers, San Antonio, TX 78210

DATE: 15 Aug. 2018

CONTRACT NUMBER: FA4661-15-D-0001

SUBMISSION NUMBER: 52

PREVIOUS SUBMISSION NUMBER: 51

PROJECT NUMBER: FNWZ 12-0053

ITEM NORow1: 1

SPECIFICATION SECTION PARA NODRAWING NORow1: Per Sow

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow1: CMU Product Data & Certifications:

INITIALRow1: PR

ITEM NORow2:

SPECIFICATION SECTION PARA NODRAWING NORow2:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow2: Batch Block Color Clarification Will Follow Later

INITIALRow2:

ITEM NORow3:

SPECIFICATION SECTION PARA NODRAWING NORow3:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow3:

INITIALRow3:

ITEM NORow4:

SPECIFICATION SECTION PARA NODRAWING NORow4:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow4:

INITIALRow4:

ITEM NORow5:

SPECIFICATION SECTION PARA NODRAWING NORow5:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow5: Sample Wall is Approved/Disapproved.

INITIALRow5:

ITEM NORow6:

SPECIFICATION SECTION PARA NODRAWING NORow6:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow6:

INITIALRow6:

ITEM NORow7:

SPECIFICATION SECTION PARA NODRAWING NORow7:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow7:

INITIALRow7:

ITEM NORow8:

SPECIFICATION SECTION PARA NODRAWING NORow8:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow8:

INITIALRow8:

ITEM NORow9:

SPECIFICATION SECTION PARA NODRAWING NORow9:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow9:

INITIALRow9:

ITEM NORow10:

SPECIFICATION SECTION PARA NODRAWING NORow10:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow10:

INITIALRow10:

ITEM NORow11:

SPECIFICATION SECTION PARA NODRAWING NORow11:

DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow11:

INITIALRow11:

DATE YYYYMMDD: 2018-08-15

TYPE OR PRINT NAME AND GRADE: Wayne Owens, Project Supt.

TO Base Civil Engineering Officer: 502 CE

RNLT:

DATE YYYYMMDD_2:

TYPE OR PRINT NAME AND GRADE_2:

TO AF Contracting Office:

DATE YYYYMMDD_3: 20180822

TYPE OR PRINT NAME AND GRADE_3: Patrick Rolan, GS-12

TO Contractor:

DATE YYYYMMDD_4: 20180904

TYPE OR PRINT NAME AND GRADE_4: Capt Hilary Ince

2018-08-22T14:07:56-0500

ROLAN.PATRICK.M.1515150249

2018-09-04T11:11:19-0500

INCE.HILARY.RAE.1368173785

Text5:

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Check Box3: Yes

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COMMENTS Number to correspond with applicable Item Number on reverseRow1: Please provide final mortar color name / mix as shown on mock up wall. i.e. how do I describe this mortar color on the next job?

cast stone sill color selection: Brownstone

Check Box39: Yes

Check Box50: Off