QA_016220446_11_26_2014.pdf

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

5821016220446HL

Rambo, Lindsay K 478-222-0978

Slaughter, Jill M 478-926-9337

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

X NO

NEW SOURCE

X 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

Frauenglass, Marian B

WR-ALC / GRUEC

478-327-6960/497-6960 25 MAR 2014

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