H. TRADOC FORM 928-R-E Material Approval Submittal.pdf

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Attached to
Ft. Bliss Kitchenette Remodeling - BLDG 2447
Solicitation number
W911RX26BA006
Issued by

About this file

This is a TRADOC Form 928-R-E, Material Approval Submittal form used for federal contracting under TRADOC Regulation 715-3. The form is a template designed for contractors to submit materials for government approval in accordance with contract specifications. Materials are defined broadly to include articles, supplies, raw materials, equipment, parts, components, and end items to be incorporated into contracted work.

Contractors must submit the form in four copies, signed, with clearly identified and tabbed attachments that include shop drawings, equipment data, manufacturer's literature and certificates, and material samples. Submissions must be numbered consecutively by contract and clearly reference the relevant specification sections, paragraph numbers, and drawing numbers. The form requires contractor certification that materials comply with all contract specifications and includes government approval sections for the contracting officer and other designated personnel to approve, disapprove, or recommend resubmission. Resubmissions must reference the previous submission number and date along with a new submission number. The form is not valid without the contracting officer's signature, and disapproved items must be resubmitted within a timeframe specified by the government.

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MATERIAL APPROVAL SUBMITTAL

(TRADOC Reg 715-3)

TRADOC FORM 928-R-E, Jan 02 8½ x 11

TO: (Contracting Officer) FROM: (Contractor)

CONTRACT NUMBER SUBMISSION NUMBER SUBMITTAL

NEW RESUBMITTAL

ITEM

NO.

SPECIFICATION SECTION/

PARA NO./DRAWING NO.

AP-

PROVED

DATE

BY COMPLETING THIS FORM, THE UNDERSIGNED CONTRACTOR CERTIFIES THAT

THE MATERIAL COMPLIES WITH ALL SPECIFICATIONS OF SUBJECT CONTRACT.

DATE

PREVIOUS SUBMISSION NUMBER PROJECT NUMBER

TO BE COMPLETED BY CONTRACTOR FOR GOVERNMENT USE ONLY

DISAP-

PROVED

SEE

REVERSE

INITIAL

DESCRIPTION OF MATERIAL

(Include Type, Model Number, Catalog Number, Mfg., etc.)

TYPE OR PRINT NAME AND TITLE SIGNATURE

FOR GOVERNMENT USE ONLY

DATE TYPE OR PRINT NAME AND GRADE SIGNATURE

DATE TYPE OR PRINT NAME AND GRADE SIGNATURE

DATE TYPE OR PRINT NAME AND GRADE SIGNATURE

TO:

For Evaluation and Action.

TO:

TO: (Contractor)

Recommend Approval Disapproval as Indicated Above and Subject to Any Applicable Comments on the Reverse

Approved Disapproved as Indicated Above and Subject to Any Applicable Comments on the Reverse Side. Request Resubmittal on Disapproved

Items Within ________________ Days of Date Shown Below.

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COMMENTS

(Number to correspond with applicable Item Number on reverse)

INSTRUCTIONS TO CONTRACTORS

1. The term "material" is defined as articles, supplies, raw materials, equipment, parts, components, and end items that are to be incorporated into the work required by the contract.

2. This form is to be used by contractors for submitting Shop Drawings, Equipment Data, Manufacturer's Literature and Certificates and Sample of Materials to the Government for approval in accordance with the provisions of this contract. Unless otherwise specified, it is to be prepared in 4 copies, signed, and provided to the contracting officer with appropriate attachments.

3. Item(s) to be approved will be clearly tabbed or identified. Data pertaining to item(s) to be approved will be clearly identified or tabbed, particularly where documents are voluminous, in order to properly evaluate the materials or articles to be incorporated in the work. Each attachment will be numbered to correspond with the item number shown on the face of this form.

4. Requests submitted shall be numbered consecutively, by contract, in the space entitled "Submission No." This number, in addition to the Contract No., will be used to identify each Material Approval Submittal. Resubmissions will be indicated in the appropriate block and the insertion of previous submission number and date in addition to a new submission number. A single submission should be used for all work of a section of the specifications, but in NO instance should the submission include work for more than one (1) contract. Submittals requiring priority handling will be submitted by separate submittal using the form and so marked across the face of the form.

5. This material Approval Submittal is not valid unless it is signed by the contracting officer. This approval is required as called for by the contracting officer under the terms of this contract.

TRADOC FORM 928-R-E, Nov 91 8½ x 11

TO Contracting Officer: MICC-Fort Bliss
FROM Contractor: Company Name
DATE: MM/DD/YYYY
CONTRACT NUMBER: W911SG-XX-X-XXXX
SUBMISSION NUMBER: 00X
NEW: Off
RESUBMITTAL: Off
ITEM NORow1:
SPECIFICATION SECTION PARA NODRAWING NORow1:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow1:
AP PROVEDRow1:
DISAP PROVEDRow1:
SEE REVERSERow1:
INITIALRow1:
ITEM NORow2:
SPECIFICATION SECTION PARA NODRAWING NORow2:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow2:
AP PROVEDRow2:
DISAP PROVEDRow2:
SEE REVERSERow2:
INITIALRow2:
ITEM NORow3:
SPECIFICATION SECTION PARA NODRAWING NORow3:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow3:
AP PROVEDRow3:
DISAP PROVEDRow3:
SEE REVERSERow3:
INITIALRow3:
ITEM NORow4:
SPECIFICATION SECTION PARA NODRAWING NORow4:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow4:
AP PROVEDRow4:
DISAP PROVEDRow4:
SEE REVERSERow4:
INITIALRow4:
ITEM NORow5:
SPECIFICATION SECTION PARA NODRAWING NORow5:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow5:
AP PROVEDRow5:
DISAP PROVEDRow5:
SEE REVERSERow5:
INITIALRow5:
ITEM NORow6:
SPECIFICATION SECTION PARA NODRAWING NORow6:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow6:
AP PROVEDRow6:
DISAP PROVEDRow6:
SEE REVERSERow6:
INITIALRow6:
ITEM NORow7:
SPECIFICATION SECTION PARA NODRAWING NORow7:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow7:
AP PROVEDRow7:
DISAP PROVEDRow7:
SEE REVERSERow7:
INITIALRow7:
ITEM NORow8:
SPECIFICATION SECTION PARA NODRAWING NORow8:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow8:
AP PROVEDRow8:
DISAP PROVEDRow8:
SEE REVERSERow8:
INITIALRow8:
ITEM NORow9:
SPECIFICATION SECTION PARA NODRAWING NORow9:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow9:
AP PROVEDRow9:
DISAP PROVEDRow9:
SEE REVERSERow9:
INITIALRow9:
ITEM NORow10:
SPECIFICATION SECTION PARA NODRAWING NORow10:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow10:
AP PROVEDRow10:
DISAP PROVEDRow10:
SEE REVERSERow10:
INITIALRow10:
ITEM NORow11:
SPECIFICATION SECTION PARA NODRAWING NORow11:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow11:
AP PROVEDRow11:
DISAP PROVEDRow11:
SEE REVERSERow11:
INITIALRow11:
ITEM NORow12:
SPECIFICATION SECTION PARA NODRAWING NORow12:
DESCRIPTION OF MATERIAL Include Type Model Number Catalog Number Mfg etcRow12:
AP PROVEDRow12:
DISAP PROVEDRow12:
SEE REVERSERow12:
INITIALRow12:
DATE_2:
TYPE OR PRINT NAME AND TITLE:
TO:
For Evaluation and Action:
DATE_3:
TYPE OR PRINT NAME AND GRADE:
TO_2:
Approval: Off
Disapproval as Indicated Above and Subject to Any Applicable Comments on the Reverse: Off
DATE_4:
TYPE OR PRINT NAME AND GRADE_2:
TO Contractor:
Approved: Off
Disapproved as Indicated Above and Subject to Any Applicable Comments on the Reverse Side Request Resubmittal on Disapproved: Off
Items Within:
DATE_5:
TYPE OR PRINT NAME AND GRADE_3:
COMMENTS Number to correspond with applicable Item Number on reverseRow1:
COMMENTS Number to correspond with applicable Item Number on reverseRow2:
COMMENTS Number to correspond with applicable Item Number on reverseRow3:
COMMENTS Number to correspond with applicable Item Number on reverseRow4:
COMMENTS Number to correspond with applicable Item Number on reverseRow5:
COMMENTS Number to correspond with applicable Item Number on reverseRow6:
COMMENTS Number to correspond with applicable Item Number on reverseRow7:
COMMENTS Number to correspond with applicable Item Number on reverseRow8:
COMMENTS Number to correspond with applicable Item Number on reverseRow9:
COMMENTS Number to correspond with applicable Item Number on reverseRow10:
COMMENTS Number to correspond with applicable Item Number on reverseRow11:
COMMENTS Number to correspond with applicable Item Number on reverseRow12:
COMMENTS Number to correspond with applicable Item Number on reverseRow13:
COMMENTS Number to correspond with applicable Item Number on reverseRow14:
COMMENTS Number to correspond with applicable Item Number on reverseRow15:
COMMENTS Number to correspond with applicable Item Number on reverseRow16:
COMMENTS Number to correspond with applicable Item Number on reverseRow17:
PREVIOUS SUBMISSION NUMBER:
PROJECT NUMBER:

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