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
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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Text version
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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