Attachment_3_-_USAF_TPS_Individual_Evaluation_Checklist_HU16.pdf

ATTACHMENT 3

FA9302-19-D-0005

AFTC TECHNICAL EVALUATION CHECKLIST

AIRCRAFT EVAL: HU-16

TAIL#:

OFFEROR:

EVALUATOR:

DATE:

Examination Areas Y/N N/A Notes Aircraft Airworthiness Certificate is available and verified valid with Registry at FAA.gov

For Experimental category, Operating Limitations are included with Airworthiness Certificate

Aircraft is registered to an appropriate party, and registration is current.

Aircraft maintenance logs & inspections are current as required for category Standard = Annual & 100-hour Experimental = FAA Approved MX Plan

All modifications on aircraft are signed by an FAA inspector or Designated Engineering Representative (DER)?

A visual examination was conducted of the aircraft exterior. Discrepancies identified are listed in the “Notes” column.

aircraft engine(s), including prop(s) and rotor(s) as applicable. Discrepancies identified are in the “Notes” column.

aircraft cockpit and other interior spaces.

Discrepancies identified are in the “Notes” column.

Additional Comments/Notes:

A visual examination of the aircraft was performed and aircraft forms were reviewed. The aircraft is maintained under current Federal Aviation Regulations and it appears suitable for government use in the desired mission.

USAF TPS QE Program Manager

ATTACHMENT 3

FA9302-19-D-0005

PILOT EVALUATION: HU-16

Evaluator Pilot:

Contractor Pilot:

Tail:

Location:

Date:

Evaluation Events Req’d Proficiency Score Mission Brief 3 Ground Operations 3 Takeoff 3 Departure 3 Basic Acft Control 3 Touch-and-Go (land) 3 Touch-and-Go (water) 3 Water Taxi 3 In-flight instruction 2 Communication 3 Situational Awareness/Airmanship

EP knowledge 3

The grading scales is: 1 – Unable, 2 – Partially Proficient, 3 – Competent, 4 – Highly Proficient

Mission Overview:

Overall assessment:

Recommend for USAF TPS QE program Yes/No.

Name of Evaluator Signature/Date