6894_Dats_Follow_On_-_PWS_updated_11_Jun_19.docx

PERFORMANCE-BASED WORK STATEMENT (PWS)

For

Maintenance and Repair of

Digital Analog Test Stations (DATS)

Revised 11 June 2019

TABLE OF CONTENTS

1 Description of Services 3

2 Basic Services 3

3 Services Summary 6

4 Government Furnished Property 8

5 General Information 9

6 Appendicies 14

1. Description of Services

1.1. The contractor shall be responsible to provide technical assistance, repair, and maintenance for the Westest 2000/DATS P/N 9000301-1 Digital Analog Test Stations (DATS) (Appendix B) located at Hill Air Force Base (HAFB) and at the Contractor’s facility. There are twenty-one (21) government-owned DATS within HAFB and two (2) at the contractor’s facility. The contractor shall provide on-call technical support, on-site maintenance, and repair. The contractor shall ensure the test stations are restored to full functionality with verification testing and Government approval in order for the repairs to be accepted. The contractor shall provide all management, tools, supplies, equipment, and labor necessary for required services.

2. Basic Services

2.1 On-Call Technical Support

2.1.1. The Government Technical Point of Contact (GTPOC) will notify the contractor by phone or e-mail and initiate a Maintenance and Repair Request Form (MRRF) or Software Maintenance and Repair Request Form (SMRRF) (Appendix E and F) when DATS support is required.

2.1.2. The contractor shall have up to one business day in which to respond back to the Government’s MRRF and/or SMRF.

2.1.3. The contractor shall provide technical support via phone or email to assist the government in diagnosing and repairing the test stations as a first response.

2.1.4. If more than technical assistance is required, the contractor shall coordinate a time that is acceptable to the Government to be on-site for repair.

2.2. On-Site Repair and Maintenance Support

2.2.1. Once a MRRF/SMRRF is received, the contractor shall attempt to resolve the problem utilizing telephone support. If the issue cannot be resolved via telephone support the contractor shall respond to the site of the test stand in need of repair within the timeframe specified in the table below. The contractor shall have the test stand operational within the time frames depicted in the table.

Response Time

If the contractor receives the government notification on a Thursday or Friday afternoon, the government will notify the contractor when to be on-site due to down fridays and federal holidays. If the time frame listed above is such that the contractor should be on-site on a federal holiday, the contractor shall be on-site the next working day after the federal holiday.

Completion Time

Extensions may be granted by the GTPOC on a case-by-case basis.

2.2.2. The government may choose to deliver a defective station item to the contractor’s facility for repair if time constraints exist.

2.2.3. The contractor shall repair DATS In Accordance With (IAW) the recommended solutions using government approved process and procedures. The contractor shall have approval of the GTPOC prior to any repairs.

2.2.4. The contractor shall implement test station and test program software enhancements requested by the GTPOC or alternate.

2.2.5. The contractor shall document issues found, the ultimate solutions, repairs completed, and preventive measures recommended on the completed MRRF/SMRRF. (CDRL A001)

2.2.6. The Government will provide a final acceptance after repairs are completed, certifying the stations are fully operational.

2.2.6.1. The GTPOC or alternate will conduct a functional check of the test stand. This functional check shall be performed after maintenance or repairs to the test stand are completed and work will not be considered complete until this time.

2.3. Parts and Materials

2.3.1. The contractor shall procure additional DATS spare equipment, ancillary equipment and piece parts requested by the GTPOC or alternate. The contractor shall be responsible for the integrity of all government-owned parts and equipment for the duration of the contract.

2.3.2. At the end of the contract, the contractor shall return all additional DATS spare equipment, ancillary equipment, and piece parts back to the government. All parts/materials removed from the test station shall remain the property of the government. The contractor shall provide the government with estimated delivery or follow-up status.

2.3.3. The contractor shall be responsible to maintain spare equipment (Appendix D) for the government and shall provide a detailed inventory list with serial numbers for each spare piece of equipment. The inventory list is due by the tenth calander day of each month. (CDRL A002)

2.4. Financial

2.4.1. The government shall not be charged for any costs against this contract that are not authorized via a government approved MRRF and SMRRF. The contractor, at a minimum, shall do the following:

2.4.1.1. Protect the government from overrunning the financial allocations on the MRRF and SMRRF. If it appears that the anticipated repair costs for an item will exceed the remaining funds, the contractor shall immediately stop work on that item and notify GTPOC or COR.

2.4.1.2. The contractor shall provide the GTPOC and COR with a quarterly accounting of the funds and labor effort used in relation to this contract. The report shall include the MRRF and SMRRF task identifier and its parts and materials cost as well as the remaining funds on the contract line item. This quarterly accounting may be in contractor format. (CDRL A003)

CDRLs

3. SERVICES SUMMARY Comment by RANDALL THOMAS: CO - Determine monthly vs quarterly CDRL billing – CO will discuss with Contractor

The Contractor shall report ALL contractor labor hours (including sub-Contractor labor hours) required for performance of services provided under this contract via a secure data collection site. The Contractor is required to completely fill in all required data fields at http://www.ecmra.mil.

4. Government Furnished Property (GFP)

4.1. The government will provide a document in solicitation and when an award is made to indicate all GFP. The document will be a Non-Serialized Items List by NSN and Quantity.

4.2. The government will provide, without cost, the Government Furnished Property (GFP) listed and this PWS in support of the DATS at Hill AFB. The Government retains title to all GFP. The Government will provide disposition instructions for all GFP. The Government will maintain the GFP records for Government reporting requirements. Comment by LITTLE, WILLIE E JR CIV USAF AFMC OL_H/PZIMA: Earlier in the doc., you state that the KTR is responsible for maintaining a GFP list. Para. 2.3.3

Para. 2.3.3 and 4.2 are different issues.

4.3. The contractor shall conform to the provisions of Air Force Instruction (AFI) 31-101 (entirety), The Air Force Installation Security Program and Installation Security Program, for safeguarding all GFP. The contractor shall ensure all GFP is secured at the close of each workday. GFP shall only be used as needed for the performance of this contract.

4.4. The contractor is responsible for all costs related to making the property available for use, such as payment of all transportation, installation or rehabilitation costs.

4.5. GFP Identification Labels. The contractor shall clearly label (without damaging) GFP to distinguish it from contractor furnished property in accordance with the contract terms and conditions and this PWS.

4.6. Annual Joint GFP Inventory. The contractor shall assist the Government with the annual joint GFP inventory of the items listed in Appendix B and the Government will maintain the GFP records for Government reporting requirements.

4.7. Loss, Damage, Destruction, or Theft (LDDT) of GFP. The contractor’s liability for GFP shall begin when the contractor receives the GFP. The contractor shall remain liable for this GFP until returned to the Government.

4.8. At contract completion, termination, or when the GFP is no longer needed during the performance of this contract, the contractor is responsible for returning all GFP to the Government within five business days at the destination specified in the contract, FOB destination, unless directed otherwise in writing by the CO.

5. GENERAL INFORMATION

5.1. SECURITY

5.1.1. The contractor shall complete a "Request for Identification Credential (AFMC Form 496)" for each employee requiring access to Hill AFB. The requests shall be submitted to the GTPOC or COR for signature then to OO-ALC/OMD Security for processing. Comment by LITTLE, WILLIE E JR CIV USAF AFMC OL_H/PZIMA: What is this? Comment by CWALINSKI, JEANNIE NH-03 USAF AFMC OO-ALC/OBCA: It’s a form for CAC DBiDs used for security

5.1.2. The Contractor shall be escorted at all times when at Hill AFB.

5.2. PHYSICAL SECURITY

5.2.1. The Contractor shall be responsible for safeguarding all government furnished property provided. At the close of each work period, government facilities, property, and materials shall be secured.

5.2.2. Records

5.2.2.1. The Contractor shall be responsible for creating, maintaining, and disposing of only those government required records that are specifically cited in this PWS or required by the provisions of a mandatory directive listed in (List applicable Appendice), Applicable Publications and Forms. If requested by the Government, the Contractor shall provide the original record or a reproducible copy of any such record within five working days of receipt of the request.

5.3. VOLUNTEER PROTECTION PROGRAM (VPP)

5.3.1. Hill AFB, along with the entire Air Force, has adopted the VPP as recognized by Occupation Safety Health Association (OSHA). Consequently, VPP impacts all “applicable contractors” operating on Air Force Installations. It is the contractor’s responsibility to ensure its employees and managers have a comprehensive understanding of VPP as well as full compliance with OSHA requirements. Detailed information on VPP is available on the OSHA website (http://www.osha.gov/dcsp/vpp/index.html). Contractors, whether regularly involved in routine site operations or engaged in temporary projects such as construction or repair, must follow the safety and health rules of the installation or VPP site.

5.3.2. VPP requirements apply to contractors whose employees work more than 1,000 hours per quarter. The contractor shall flow down these requirements to all subcontractors who qualify as applicable contractors under this contract.

5.3.3. Contractors are required to provide their Total Case Incident Rate/Days Away Restricted or Transferred (TCIR/DART) rate by 15 January of each year to the COR for submission as part of the installation's annual OSHA VPP self-evaluation report. (CDRL A004)

5.4. SAFETY PLAN

5.4.1. The contractor shall implement a safety program that ensures protection of Government personnel and property. (See Appendix C)

5.4.2. As part of the Safety Program the contractor shall comply with Appendix C of this PWS.

5.4.3. In the event of an accident/mishap, the contractor shall take reasonable and prudent action to establish control of the accident/mishap scene, prevent further damage to persons or property, and preserve evidence. A written or email copy of the mishap/incident notification shall be sent within three calendar days to the Government Representative, who will forward it to 309 MXW safety. (CDRL A005)

5.5. HOURS OF OPERATION

5.5.1. The contractor shall have access to perform services during normal working, typically 6:00AM – 7:30 PM local time Monday through Friday. The contractor may work, with prior approval of the Contracting Officer and GTPOC or alternates, extended hours to ensure timely completion of work at no additional cost to the government

5.5.2. Unless otherwise required by the Government, the contractor shall not have access to Government facilities on the following federal holidays: New Year’s Day, Martin Luther King’s Birthday, President’s Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans’ Day, Thanksgiving Day, and Christmas Day.

5.5.2.1. If the holiday falls on Sunday, it is observed on Monday. If the holiday falls on Saturday, it is observed on Friday.

5.6. EVIRONMENTAL

5.6.1. The with Laws and Regulations. The contractor shall be knowledgeable of and comply with all applicable Interstate, Federal, State, and Local laws, regulations, and requirements regarding environmental protection. In the event environmental laws/regulations change during the term of this contract, the contractor is required to comply as such laws come into effect. If there is an increase or decrease in cost as a result of the change, the contractor shall inform the CO pursuant to notice requirements and negotiate a modification to the contract.

5.6.2. Compliance with Laws and Regulations. The contractor shall be knowledgeable of and comply with all applicable Interstate, Federal, State, and Local laws, regulations, and requirements regarding environmental protection. In the event environmental laws/regulations change during the term of this contract, the contractor is required to comply as such laws come into effect. If there is an increase or decrease in cost as a result of the change, the contractor shall inform the CO pursuant to notice requirements and negotiate a modification to the contract.

5.6.3. Notification of Environmental Spills. If the contractor spills or releases any substance contained in 40 CFR 302, including hazardous materials, into the environment, the contractor or its agent shall immediately call 911. If the call is made from an on base phone it will go directly to Hill AFB dispatch. If using a cell phone it will go off base, ask the 911 dispatcher to be transferred to Hill AFB. The liability for the spill or release of such substances rests solely with the contractor and its agent.

5.7. MANPOWER REPORTING

5.7.1. The Contractor shall report ALL Contractor labor hours (including sub-Contractor labor hours) required for performance of services provided under this contract via a secure data collection site. The Contractor is required to completely fill in all required data fields at http://www.ecmra.mil.

5.7.2. Reporting inputs will be for the labor executed during the period of performance for each Government fiscal year (FY), which runs 1 October through 30 September. While inputs may be reported any time during the FY, all data shall be reported no later than 31 October* of each calendar year. Contractors may direct questions to the CMRA help desk.

5.7.3. Uses and Safeguarding of Information: Information from the secure web site is considered to be proprietary in nature when the contract number and Contractor identity are associated with the direct labor hours and direct labor dollars. At no time will any data be released to the public with the Contractor name and contract number associated with the data. User Manuals: Data for Air Force service requirements must be input at the Air Force CMRA link. However, user manuals for Government personnel and Contractors are available at the Army CMRA link at http://www.ecmra.mil. (CDRL A006)

5.8. QUALITY CONTROL

The contractor shall establish a complete Quality Control Program (QCP) to ensure the requirements of this contract are provided as specified. The contractor's quality management program shall comply with the minimum quality management systems elements specified in the American National Standards Institute (ANSI), American Standards Organization (ASO), and International Standard Organization (ISO) family of standards. The report shall be submitted. within ten (10) business days of awarded contract. (CDRL A007)

5.8.1. Quality Assurance

5.8.1.1. The Contracting Officer Representative is the authorized government representative(s) who will perform assessments of the contractor’s performance. Subsequent to contract award, the identity of the COR(s), with a letter defining duties and authority will be promptly furnished to the contractor.

5.8.1.2. The The Contracting Officer Representative is the authorized government representative(s) who will perform assessments of the contractor’s performance. Subsequent to contract award, the identity of the COR(s), with a letter defining duties and authority will be promptly furnished to the contractor.

5.8.1.3. Any matter concerning a change to the scope, prices, terms or conditions of this contract shall be referred to the CO.

5.8.1.4. The services to be performed by the contractor during the period of this contract are at all times and places subject to review by the CO or authorized representative(s).

5.8.1.5. The Government will periodically evaluate the contractor’s performance by appointing a representative(s) to monitor performance to ensure services are received. The Government representative will evaluate the contractor’s performance through inspections and receipt of complaints from base personnel.

5.8.1.6. The government may inspect each task as completed or increase the number of quality control inspections if deemed appropriate because of repeated failures discovered during quality control inspections or because of repeated customer complaints.

5.9. GOVERNMENT OBSERVATION

5.9.1. Government personnel, other than COs and Contracting Officer Representative(CORs), may from timetotime, with CO coordination, observe Contractor operations. However, these personnel may not interfere with Contractor performance.

5.10. TRAINING

5.10.1. Contractor employees shall be familiar with and trained in the use and repair of the DATS along with its support equipment, computer, and software necessary to understand the DATS total scope of operation.

5.11. FOREIGN OBJECT DAMAGE (FOD) AND TOOL CONTROL

5.11.1. The contractor shall follow the applicable guidance in AFI 21-101 and HQ AFMC, Hill AFB, and 309 MXW supplements to the AFI 21-101 concerning base tool (chapter 10 section B), and FOD control policies (chapter 14, and sub paragraphs designated as 41), daily. . Cloth rags are considered tools and will follow the same regulations and procedures as tools.

5.11.2. If tools, rags, and/or equipment are lost, the contractor will report the loss to the GTPOC/COR no later than two hours after discovery. If tools are lost or not accounted for, then the contractor shall implement the lost tool procedures of AFMC supplement to AFI 21-101, chapter 10, section B.

5.11.3. Contractors tools, and/or equipment are lost, the contractor will report the loss to the GTPOC/COR no later than two hours after discovery. If tools are lost or not accounted for, then the contractor shall implement the lost tool procedures of AFMC supplement to AFI 21-101, chapter 10, section B.

5.12. PUBLICATIONS

5.12.1. Compliance with all publications (e.g. DATS Operation and Maintenance Manual - TO 51C3-1-131), regulations and operating instructions provided by the Government is required when:

5.12.1.1. They pertain to the procedures for materials expediting herein and where the Contractor is authorized by the performance-based statement of work to accomplish the work specified in the publication, regulation or operating instructions.

5.12.1.2. The publications prescribe USAF policies, use of materials, procedures and processes applicable to the work requirements.

5.12.1.3. The contractor is required to acquire and work on the latest version of the publication.

5.13. WARRANTY Comment by CWALINSKI, JEANNIE NH-03 USAF AFMC OO-ALC/OBCA: CO – Does the Warranty belong in the PWS, or is it provided thru a contract clause now.

CO will research the need for this

5.13.1. Warranty Requirments

5.13.1.1. Warranty shall be valid for a minimum of 90 days.

5.13.1.2. The warranty shall commence upon completion of work of the operational test system after maintenance has occurred.

5.13.1.3. The contractor shall provide a written warranty certificate, containing at a minimum, the following information.

5.13.1.3.1. Part number/serial number of the part(s)

5.13.1.3.2. Contract Number

5.13.1.3.3. Start date

5.13.1.3.4. End date

5.13.1.3.5. Contractor’s contact information

5.13.1.3.6. List of included systems, componenets, etc.

5.13.1.4. Unless otherwise agreed to by the Government, the Contractor shall at their own cost remedy all deficiencies under warranty within 25 days of identification.

6. APPENDICIES

APPENDIX A

ACRONYMS AND ABBREVIATIONS LIST

Acronym/Abbreviation Definition

APPENDIX B

EQUIPMENT LIST & LOCATIONS

*Serial Number 3 was not procured and thus is not listed in the list above.

APPENDIX C

SAFETY, FIRE PROTECTION AND HEALTH

SPECIFICATION

INDUSTRIAL SAFETY REQUIREMENTS

OGDEN AIR LOGISTICS COMPLEX

UNITED STATES AIR FORCE

HILL AIR FORCE BASE, UTAH 84056

WESTEST2000 Digital Analog TEST STATION (DATS)

21 Feb 2019

OO-ALC/SE

Control Number: TH190206

SECTION I - GENERAL REQUIREMENTS

A. Safety Program Requirements.

The contractor will implement a safety program that ensures protection of Government personnel and property. The program will consist of, as a minimum:

1. Mishap reporting, as defined in paragraph B1 below.

2. Routine and recurring surveillance to ensure the safety requirements of this contract are enforced.

3. Identification of segregated work site locations for operations that cannot be co-mingled with general industrial operations and the process for ACO approval of operations and changes at these specific sites.

4. All contractor personnel shall be trained and qualified to perform their duties safely.

5. The contractor shall include a clause in all subcontracts requiring the subcontractors to comply with the safety provisions of this contract, as applicable.

B. Mishap Notification

1. The contractor shall notify OO-ALC/SE (801-586-6038) or the Hill AFB Command Post (801-777-3007) after normal duty hours, and the designated Government Representative (GR), i.e., the ACO, PCO, or DCMA COR (Contracting Officer's Representative) within one (1) hour of all mishaps or incidents at or exceeding $2,000 (material + labor) in damage to DOD property entrusted by this contract, even if the government is wholly or partially reimbursed. This notification requirement shall also include physiological mishaps/incidents. A written or email copy of the mishap/incident notification shall be sent within three calendar days to the GR, who will forward it to OO-ALC/SE. For information not available at the time of initial notification, the contractor shall provide the remaining information no later than 20 calendar days after the mishap, unless extended by the ACO.

Mishap notifications shall contain, as a minimum, the following information:

(a) Contract, Contract Number, Name and Title of Person(s) Reporting

(b) Date, Time and exact location of accident/incident

(c) Brief Narrative of accident/incident (Events leading to accident/incident)

(d) Cause of accident/incident, if known

(e) Estimated cost of accident/incident (material and labor to repair/replace)

(f) Nomenclature of equipment and personnel involved in accident/incident

(g) Corrective actions (taken or proposed)

(h) Other pertinent information

2. The contractor shall cooperate with any and all government mishap investigations. Additionally if requested by government personnel or designated government representative (GTPOC), i.e., the ACO, PCO, or DCMA COR (Contract Officers Representative), the contractor shall immediately secure the mishap scene/damaged property and impound pertinent maintenance and training records, until released by safety investigators.

3. The contractor shall provide copies of contractor data related to mishaps, such as contractor analyses, test reports, summaries of investigations, etc. as necessary to support the government investigation.

4. The contractor shall support and comply with the safety investigation and reporting requirements of AFI 91-204, Chapters 1 – 5.

C. General Safety Requirements:

Contractor personnel must receive Explosive Safety Awareness Training if their duties require entry into the Explosive Clear Zone. This training will be provided by the OO-ALC Safety Office. Contact Eric Covington at 586-0168.

A Risk Assessment will be required prior to any work being accomplished, if munitions will remain in the facility.

Compliance with OSHA and other applicable laws and regulations for the protection of contractor employees is exclusively the obligation of the contractor. Note: The government shall assume no liability or responsibility for the contractor's compliance or non-compliance with such requirements. The contractor shall furnish to each of his/her employees a place of employment, which is free from recognized hazards. The contractor shall brief his/her employees on the safety requirements of this contract and on hazards associated with prescribed tasks. The contractor is responsible for compliance with OSHA Public Law and the resultant standards identified within. In addition, the contractor is required to flow down the safety requirements/specification to all subcontractors. This applies to Federal Acquisition Regulation (FAR) 12 commercial acquisitions as well. This contract shall in no way require persons to work in surroundings or under working conditions which are unsafe or dangerous to their health. The contractor must coordinate and perform work so as not to impact the safety of government employees or cause damage to government property. This requires providing personnel with protective equipment and associated safety equipment as may be necessary. The contractor must also protect personnel from hazards generated by the work. If the contractor employs BILINGUAL speaking employees, they must post bilingual signs and have written procedures for specific tasks in applicable languages.

SECTION II – SPECIFIC REQUIREMENTS

PEDESTRIAN CROSSWALKS: All contractor personnel are required to use the closest crosswalk, or traffic controlled intersection when crossing the road. Pedestrians must look both ways to ensure the coast is clear before stepping out into the crosswalk. Pedestrians DO NOT have the right of way unless they are already in the crosswalk. Contractor vehicle operators have the same responsibilities as pedestrians, to share the road and mutually observe and yield to pedestrians.

MOTOR VEHICLES: Contractor shall comply with the standards in: DoD Directive 5525.4, Enforcement of State Traffic Laws on DoD Installations", Nov 2, 1981, Para 3-4; DODI 6055.4, DoD Traffic Safety Program, 20 Jul 99; AFI 91-207, USAF Traffic Safety Program, 22 May 07; and AFI 91-207 AFMC SUP1, The US Air Force Traffic Safety Program, 1 Oct 07. Each applies to all persons at any time on an Air Force Installation and includes all leased, owned, or privatized property including housing areas. In addition: AFI 13-213, Airfield Management, applies to all contractors, sub-contractors, vendors, commercial delivery companies, and all other private business vehicles who operate anywhere on Hill Air Force Base, including the airfield (to include the industrial areas and any buildings or hangars located upon the airfield) in support of their mission.

HOUSEKEEPING: Housekeeping shall be conducted according to the requirements in OSHA Standard 29 CFR 1910.141. CLEAN AS YOU GO will be enforced.

Element/Requirement Referenced Benchmark

Facility Fire Protection NFPA 13, 70, & 72

NFPA 409/410

AFI 91-203 Chapters 6, 22

Handling, Storage and use of Flammable/ NFPA 30, 33

Hazardous Material Management AFI 32-7086 HAFBSUP 1

Storage and Materials Handling DoDI 4140.62

APPENDIX D

GOVERNMENT FURNISHED PROPERTY

All data contained within Appendix B is correct as of 23 April 2019. It is up to the contractor to verify all data.

TESTERS SHIPPED/RECEIVED

WTDA-003

Speakers

WTDA-043

VXI-MXI-2 User Manual & Software

WTDA-045

Microsoft Windows XP Prof. Office Software

WTDA-046

Microsoft Windows XP Prof. Software

WTDA-047

Paperport Deluxe Software

WTDA-054

WTDA-055

WTDA-056

WTDA-057

WTDA-060

Speakers

WTDA-071

Microsoft Windows XP office

WTDA-072

Microsoft Windows XP Proff. office

WTDA-073

Paperport Deluxe

SPARE EQUIPMENT

Government Furnished Equipment

Storage

Storage

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WesTest

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WesTest

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WesTest

WesTest

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WesTest

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USAF-079

USAF-080

USAF-081

WesTest

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WesTest

Storage

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WesTest

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Storage

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Storage

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Storage

Hill

Storage

Storage

Storage (re-conditioned)

Storage (re-conditioned)

WesTest

WesTest

WesTest

WesTest

WesTest

WesTest

WesTest

WesTest

WesTest

WesTest

WesTest

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Storage

Storage

Storage

Storage

ISSUED PARTS AND MRRF NUMBERS

Issued on MRRF 045

WesTest

WesTest

MRRF 101-13

APPENDIX E

MRRF

APPENDIX F

SMRF

WESTEST 2000/DATS SOFTWARE ORGANIZATION (516 MXDEC) MAINTENANCE AND REPAIR REQUEST FORM

Instructions: This form is to be used to request maintenance/repair, and technical assistance for any problems related to the WesTest 2000 DATS Automatic Test Systems (ATS) and Associated Equipment, Test Program Sets (TPSs) or any other problems related to the utilization of the equipment. This form is available via www.westest.com S/W Maintenance and Request for Repair Forms (SMRRFs) must be approved and submitted by OO-ALC/MXDAC.

Complete this form and e-mail it to the Engineering Manager, Mr. Dave Jensen at davej@westest.com along with a description of the problem including as much detail as required. Upon receipt of the SMRRF a tracking number will be assigned and will be given to the responsible engineer/technician to take appropriate action. The person reporting the problem will be notified of the anticipated resolution date. Additionally the current status and history of all SMRRFs will be available on the DATS Database which can be accessed via www.westest.com.

Projected Resolution:

Assigned To:

Actual Resolution:

WT SMRRF No:

Hill SMRRF File Name:

Problem Area: Tester |_| ITA |_| Support Equipment |_| Documentation |_|

2000/DATS |_| S/N

Other |_| Nomenclature: S/N

WORK STOPPAGE?: Effected Data:

Description of the Problem (include serial number):

Problem Resolution:

Asset/Exhibit Tracking Item Delivered to WesTest: Print Name: Date:

Signature: ________________________

Hrs Expended J/C: 6306 : Eng: Tech: Fab: Total:

Material Cost J/C: 6306 :

Date Task Completed:

OO-ALC/MXDAC: Print Name: ________________________

Signature: _________________________

Date: _____________ image1.jpeg image2.png