SMW_REPORT.pdf

SURPLUS MATERIEL WORKSHEET

DATE

07 FEB 2018

I. REQUEST FOR EVALUATION

NSN

6625015338403KR

PART NUMBER

FT0100-6

CAGE

91417

APPLICATION

ILS

IMS

Smithson, Ronald L

OFFICE SYMBOL

AFLCMC / WWZ

PHONE

405-739-7232

SURPLUS MATERIEL MAY BE AVAILABLE TO FULFILL THE GOVERNMENT'S NEEDS FOR THIS ITEM. AS A RESULT, AN EVALUATION MUST BE PERFORMED

IAW AFMC FAR SUPPLEMENT PART 5352.

THE EVALUATION ON THIS ITEM INDICATES SURPLUS MATERIEL WILL NOT BE CONSIDERED IN THE FOLLOWING TYPES / CATEGORIES

II. EVALUATION CRITERIA (For types/categories deemed acceptable)

ACCEPT-

ABLE (Y/N)

P/N AND

MFG

VERIFI-

CATION

PRIOR

GOV'T

OWNER-

SHIP

100% END

ITEM

INSPECT

TEST AND

VERIFI-

CATION

VERIFI-

ABLE

DIMEN-

SIONS

LOCATION

INSPEC-

TION

TESTING

INITIAL

ACCEPT-

ABILITY

ITEMS

OVERHAUL

AND

CERTIFI-

CATION

OTHER

(Explain in Remarks)

N

N

N

N

N

N

N

N

G O V T

S U R P L U S

NEW/UNUSED

NEW/RECONDITIONED

NEW/MODIFIED

USED/OVERHAULED

C O M M L

S U R P L U S

NEW/UNUSED

NEW/RECONDITIONED

NEW/MODIFIED

USED/OVERHAULED

SURPLUS EVALUATION CRITERIA (If Section 11a. indicates surplus materiel may be considered). (Fill in blanks as appropriate)

PART NUMBER VERIFICATION 91417(AFMCFARS 5352.211-9011) MFG FT0100-6P/N

PRIOR GOVERNMENT OWNERSHIP (AFMCFARS 5352.211-9015)

100% END ITEM INSPECTION (AFMCFARS 5352.211-9017)

TEST AND VERIFICATION (AFMCFARS 5352.211-9013) TECH ORDER NUMBER

VERIFIABLE DIMENSION (AFMCFARS 5352.211-9012) DESIGN ACTIVITY

DRAWING NUMBER

LOCATION OF INSPECTION TESTING (AFMCFARS 5352.211-9015)

INITIAL ACCEPTABILITY ITEMS (AFMCFARS 5352.211-9014) A QUANTITY OF ITEMS WILL BE TESTED FOR INITIAL ACCEPTANCE

TEST WILL BE CONDUCTED USING THE FOLLOWING CRITERIA (and location of testing)

OVERHAUL AND CERTIFICATION (AFMCFARS 5352.211-9010)

OTHER SPECIAL REQUIREMENTS (Explain)

Smithson, Ronald LNAME: 08 FEB 2018DATE:

ILS, There is NO Surplus and due to the nature and user of this test set there will not be usable serviceable assets.

REMARKS

JUSTIFICATION FOR UNACCEPTABLE SURPLUS MATERIEL

Due to the unique properties of the B-2 enterprise system test requirements this RSS tester must be new and unused

EVALUATOR

Schwarz, Robert M

OFFICE SYMBOL

AFLCMC / WWZE

PHONE

405-736-8681 / 336-8681

COMPLETE DATE

09 FEB 2018

SIGNATURE

//SIGNED// Schwarz, Robert M

USER TYPE

Engineer

SIGNATURE DATE

09 FEB 2018

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