AFMCForm807.pdf

AFMC Form 807, 20060111, V1 Page 1 of Generated By PRPS Using Oracle Reports Version 1 1

4810013353160EW

Graham, Mara 478-926-6023

Beatty, John C 478-926-7584

1. PR/MIPR NUMBER

2. NATIONAL STOCK NUMBER

5. ITEM MANAGER/PHONE

6. EQUIPMENT SPEC/PHONE

RECOMMENDED QUALITY ASSURANCE PROVISIONS

AND SPECIAL INSPECTION REQUIREMENTS

3. POINT OF INSPECTION

SOURCE DESTINATION

4. POINT OF ACCEPTANCE

SOURCE DESTINATION

X X

SEE DFARS 246.402

7. CONTRACT QUALITY REQUIREMENTS/SPECIAL INSPECTION REQUIREMENTS

CERTIFICATE OF CONFORMANCE

FAR 52.246-15

CONTRACT RESPONSIBILITY

FOR INSPECTION

FAR 52.246-1

STANDARD INSPECTION

FAR 52.246-2,-3,-4,-5 OR -6

AS APPLICABLE TO CONTRACT

HIGHER LEVEL CONTRACT QUALITY REQUIREMENTS

X

COMMERCIAL ITEM INSPECTION

FAR 52.212-4

OTHER (Describe in Block 8)

NOTE: Quality provisions as annotated hereon will not be downgraded without Technical Authority coordination. The Technical Authority must be notified if award selection is made to a new source using Acquisition Method Code (AMC) 3, 4, or 5.

9. QUALITY PRE-AWARD SURVEY

YES

NO

NEW SOURCE

PREVIOUS SOURCE

AFMC PARTICIPATION

RECOMMENDED

10. CODES

A. I&A

B. CQR

G

11. SIGNATURE OF TECHNICAL AUTHORITY

ORGANIZATION/SYMBOL

PHONE DATE

8a. OZONE DEPLETING SUBSTANCES (ODS)

X STATEMENT

"I HAVE REVIEWED THE REQUIREMENT, INCLUDING AVAILABLE TECHNICAL DOCUMENTATION, AND BELIEVE THAT IT DOES NOT REQUIRE THE CONTRACTOR USE CLASS I OZONE DEPLETING SUBSTANCES (ODS) IDENTIFIED IN AIR FORCE POLICY, NOR IS IT WRITTEN SO THAT IT CAN ONLY BE MET BY THE USE OF A CLASS I ODS."

WAIVER (SEE AF FARS 5323)

8. REMARKS

NAME DATESmith, YaHang C 08 JUL 2013 ALQ-155 Flow Protect Valve (p/n: 029-001716-001)

Smith, YaHang C

408 SCMS / GUEA

478-222-4667/472-4667 08 JUL 2013

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