Atch_6_-_Statement_of_Intent-AMC_Form_207.pdf

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Synopsis Federal contract opportunity
Solicitation number
HTC711-14-R-C002
Issued by
Department of Defense United States Transportation Command

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Atch 6 - Statement of Intent-AMC Form 207

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CARRIER NAME

a. Key Management Personnel (Please attach a brief resume)

AMC Form 207, 20110104 FOR OFFICIAL USE ONLY (When filled in) PAGE 1 OF 6 PAGES

DOD STATEMENT OF INTENT

(To Provide Airlift Services to the Department of Defense)

OMB NUMBER: 0701-0137

SECTION I. GENERAL INFORMATION

The general purpose of this form is to assist Headquarters Air Mobility Command (HQ AMC) in the overall evaluation of commercial airlift procured by the Department of Defense (DOD). This document is intended to aid in the evaluation of air carrier acceptability for airlift contracts and agreements. This document is not designed to be all inclusive, but rather to serve as a tool to be used by DOD inspection and safety activities in the early phases of the procurement process. We recognize that the breadth of information provided will vary according to the complexity of the proposed operations and size of carrier.

SECTION II. MANAGEMENT

NAME TITLE PHONE, FAX, OR EMAIL DATE OF EMPLOYMENT

comply with a collection of information if it does not display a currently valid OMB control number.

The public reporting burden for this collection of information is estimated to an average 20 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services (WHS), Directorate for Information Operations and Reports (DIOR), (0701-0137), 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302. Respondents should be aware that notwithstanding any other provisions of law, no person shall be subject to any penalty for failing to comply with a

NOTE

HQ AMC/A3B, 402 Scott Drive, Unit 3A1, Scott AFB IL 62225-5302.completed form to

: Do not return your form to the above address. Return

ADDRESS DATE COMPLETED

EXPIRES: 20140930

audited, personnel performing audits, and audit frequency.

b. Briefly describe company's internal audit program or other method capable of identifying in-house deficiencies, including operational and maintenance areas

(Attach sample documentation to track accomplishment and discrepancy followup.)

c. Briefly describe company's flight safety program, to include safety points of contact and lines of communication.

SECTION III. FLIGHT OPERATIONS: (Use an "A" if presently approved, "S" if you are seeking approval.)

Part 135

Part 121

Part 133

Domestic carrier operations

Flag carrier operations

Supplemental carrier operations

Long-range international operations

Short-range international operations

Passengers only

Passengers and cargo

Cargo only

Aerial surveillances or photography

Aeromedical services

General Services Administration city pairs

HAZMAT authorization

On-demand air taxi services

Category II instrument approach and landing operations

Category III instrument approach and landing operations

Single pilot-in-command operations

Individually ticketed DOD passengers

Whole planeload DOD charter flights

Continued Next Page

FOR OFFICIAL USE ONLY (When filled in)

(Check)

Asia

Central and South America the DOD? Were these hours flown under your current certificate?

TYPE OF TRAINING

SECTION VII. PRIMARY AIRCREW TRAINING FACILITIES AND VENDORS

a. Number and types of aircraft you operate and are presently on your operations specifications.

AMC Form 207, 20110104 PAGE 2 OF 6 PAGES

c. Provide performance data on aircraft offered for DOD service. Include basic aircraft operating weight, maximum ramp weight, maximum payload weight, fuel burn rates, range, etc. For fixed-wing aircraft capable of transporting at least 75% of their maximum payload weight a minimum of 1500 NMs, submit the data on the HQ AMC Form 82 (MS Excel Version) and HQ AMC Form 83 (MS Excel Version) available at http://www.amc.af.mil/library/businesscustomers.asp; also provide a certified flight plan conforming to the requirements specified in paragraph 4.e. of the "Instructions for HQ AMC Forms 82 and 83". (Attach to the Statement of Intent.)

SECTION IV. AIRCRAFT DATA.

No (If"Yes", how high can the pallets be built to fit in your aircraft?)

(If you fly large cargo aircraft, can they accommodate the 463L pallet (88 inches by 108 inches)

Yes

MAKE, MODEL, SERIES PAYLOAD: CARGO (PAX) / RANGE OWNER NUMBER OF AIRCRAFT TYPE

b. Number and types of aircraft you would like to operate for the DOD ( specifications, and available for DOD inspection at the time of airlift capability survey. For AMC Contracts, see solicitation for further clarification.)

Aircraft must be approved by the FAA FSDO, on your operations

MAKE, MODEL, SERIES PAYLOAD: CARGO (PAX) / RANGE OWNER NUMBER OF AIRCRAFT TYPE

SECTION III. FLIGHT OPERATIONS: (Continued)

Scheduled military channel operations

Operations into areas of magnetic unreliability

Extended Range Operations with Twin-Engined Airplanes

North Pacific Operations (NOPAC)

(ETOPS)

Central Pacific Operations (CEPAC)

North Atlantic Operations (NAT)

Operations with autopilot in lieu of second-in-command

Block seat sales to the DOD

Civil Reserve Air Fleet Stage I Stage II Stage III

a. Will the service you anticipate performing for the DOD require any additional aircrew training events or programs? If so, briefly explain.

SECTION VI. CREW MEMBERS (Excluding management)

SECTION V. GEOGRAPHIC AND CLIMATOLOGICAL DATA (Check the geographic area of operations/climates in which you intend to operate for the DOD)

Extended Overwater

North Atlantic

North Pacific

Continental US

Europe, Africa, and Middle East

Alaska Tropical

Desert

Arctic

Mountainous of continuous service. Attach additional documentation as required.)

(If yes, please provide documentation to show 12 months

SERVICE/ROUTE TYPE AIRCRAFT OPERATION

NUMBER MONTHS OF ROUTE

OF FLIGHTS PER MONTH

APPROXIMATE NUMBER

b. For international routes, how many hours of international operations have you flown during the preceding 12 months over routes similar to the service sought by

QUALIFICATION TOTAL NUMBER QUALIFIED

INTERNATIONALLY NUMBER WITH MILITARY

RESERVE/NATIONAL GUARD

CAPTAINS

FIRST OFFICERS

SECOND OFFICERS

FLIGHT ATTENDANTS

LOCATION VENDOR

Other:

YES NO

YES NO

a. Have you performed service continuously for the past 12 months along a comparable route structure?

FOR OFFICIAL USE ONLY (When filled in) AMC Form 207, 20110104

d. Describe your training program for: (1) Mechanic indoctrination to company policies and procedures, (2) Aircraft Systems, (3) List all initial and recurrent training,

(4) Training for any contract personnel, (5) Inspector initial/recurrent training.

b. Location and description of maintenance facilities, including line stations. Include company-owned and/or major contracted maintenance.

QUALIFICATION TOTAL NUMBER FULL-TIME

NUMBER

PART-TIME

NUMBER

A & P

RII / IA

OTHER

SECTION VIII. MAINTENANCE

TYPE OF SERVICE LOCATION VENDOR

a. Primary aircraft overhaul / engine maintenance vendors

c. Describe your documented quality assurance programs: (1) Internal audits. (2) Vendor audits. (3) Mechanical performance monitoring. (4) Tool/test equipment calibration tracking. NOTE: Please include copies of your internal/vendor audit schedules.

e. Describe your reliability program.

f. Type of maintenance programs.

g. Are you an FBO/repair station? If so, please describe authorization. If you use contracted fuel, please describe your fuel vendor audit process.

h. Describe your off-line fuel quality assurance inspection/documantation procedures. Where are these published?

PAGE 3 OF 6 PAGES

i. Will the service you anticipate performing for the DOD require an expansion of your aircraft maintenance capability? If so, briefly explain.

b. Number of spare engines.

a. Please provide financial statements, including balance sheets, income statements, and statements of change in financial position (or statement of cash flow) from DOD business, indicate amount and procuring activity.

the last two fiscal years and year-to-date information. What was the amount of your total revenues for your most recent fiscal year end? If any of that revenue was

b. Are there any bankruptcies, mergers, divestitures, or acquisitions planned?

c. Within the past 10 years, has the company ever declared bankruptcy? If so, briefly explain.

You may be asked to provide financial statements

d. If your company is privately owned, please give names and percentage of ownership. If owned by another privately held company, please detail its ownership.

(i.e., balance sheet, profit and loss) of the company owner (s) at a later date.

SECTION X. FINANCIAL: Failure to provide the requested financial information could result in the company not being approved as a DOD carrier.

SECTION IX. SUPPLY

PAGE 4 OF 6 PAGES

k. Describe your recordkeeping programs (e.g. computerized, manual, etc.)

j. Describe your maintenance and company manuals revision and tracking processes (e.g., computerized, manual, combination computerized/manual, etc).

e. Is there any significant litigation against your company which could affect its overall financial or operational health?

a. Number and types of line items. Please describe receiving, inspection and shelf life monitoring programs.

c. Do you carry fly-away kits? (If so, list type of items - pumps, tires, brakes, etc.)

FOR OFFICIAL USE ONLY (When filled in) AMC Form 207, 20110104 PAGE 5 OF 6 PAGES

c. Please list any other air transportation contracts you have with the Federal Government.

d. Please provide, as reference, a list of your principal commercial customers, especially those using the services you propose providing to the DOD.

e. Provide the total number of departures for the last four calendar years, by certificate type.

SECTION XII. FAA SAFETY REGULATION

a. When did you receive your operating certificate? What is your certificate number?

b. Has the operating certificate ever been suspended or revoked? If so, explain.

AGENCY TELEPHONE CONTRACT TYPE SERVICE

FIRM'S NAME ADDRESS PHONE CONTACT

YEAR PART 121 OTHER OPERATIONS TOTAL DEPARTURES135

SECTION XI. PAST PERFORMANCE

briefly explain circumstances.

a. Within the past 5 years, have any key company personnel been arrested, indicted, convicted, or had an FAA license suspended, surrendered, or revoked? If so,

b. Within the past 5 years, have you ever defaulted on a contract with the Federal Government? If so, please provide a brief explanation and point of contact.

f. Do you anticipate operating for the DOD as a joint venture with other carriers?

c. Are all of the authorizations in your "Ops Spec" active? If some have been inactive for more than 12 months, please explain.

f. Do you have any open Enforcement Investigation Reports (EIR) with the FAA? If so, briefly explain their nature and your company's position.

PAGE 6 OF 6 PAGES

g. Will the operations you plan on performing for the DOD require any changes to your FAA operating specifications?

e. List all aircraft accidents as defined by NTSB 830 in the last four years. Include date, location, type of aircraft, type of operation (i.e., Part 121, Part 135, Part 91), number of fatalities, and extent of damage.

ADDITIONAL COMMENTS: (Comments you wish to make about your company or its health.)

AVIONICS

d. What is the address of your FAA certificate holding office and the names and telephone numbers of your principal aviation safety inspectors?

ADDRESS

OPERATIONS

AIRWORTHINESS

TELEPHONE

TELEPHONE

TELEPHONE

CARRIER NAME:
ADDRESS:
DATE COMPLETED:
NAMERow1:
TITLERow1:
PHONE FAX OR EMAILRow1:
DATE OF EMPLOYMENTRow1:
NAMERow2:
TITLERow2:
PHONE FAX OR EMAILRow2:
DATE OF EMPLOYMENTRow2:
NAMERow3:
TITLERow3:
PHONE FAX OR EMAILRow3:
DATE OF EMPLOYMENTRow3:
NAMERow4:
TITLERow4:
PHONE FAX OR EMAILRow4:
DATE OF EMPLOYMENTRow4:
NAMERow5:
TITLERow5:
PHONE FAX OR EMAILRow5:
DATE OF EMPLOYMENTRow5:
NAMERow6:
TITLERow6:
PHONE FAX OR EMAILRow6:
DATE OF EMPLOYMENTRow6:
audited personnel performing audits and audit frequency b Briefly describe company s internal audit program or other method capable of identifying inhouse deficiencies including operational and maintenance areas Attach sample documentation to track accomplishment and discrepancy followup:
c Briefly describe company s flight safety program to include safety points of contact and lines of communication:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow1:
Part 135:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow2:
Part 121:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow3:
Part 133:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow4:
Domestic carrier operations:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow5:
Flag carrier operations:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow6:
Supplemental carrier operations:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow7:
Longrange international operations:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow8:
Shortrange international operations:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow9:
Passengers only:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow10:
Passengers and cargo:
SECTION III FLIGHT OPERATIONS Use an A if presently approved S if you are seeking approvalRow11:
SECTION III FLIGHT OPERATIONS ContinuedRow1:
Scheduled military channel operations:
SECTION III FLIGHT OPERATIONS ContinuedRow2:
Operations into areas of magnetic unreliability:
SECTION III FLIGHT OPERATIONS ContinuedRow3:
Extended Range Operations with TwinEngined Airplanes ETOPS:
SECTION III FLIGHT OPERATIONS ContinuedRow4:
North Pacific Operations NOPAC:
SECTION III FLIGHT OPERATIONS ContinuedRow5:
Central Pacific Operations CEPAC:
SECTION III FLIGHT OPERATIONS ContinuedRow6:
North Atlantic Operations NAT:
SECTION III FLIGHT OPERATIONS ContinuedRow7:
Operations with autopilot in lieu of secondincommand:
Other:
If you fly large cargo aircraft can they accommodate the 463L pallet 88 inches by 108 inches:
MAKE MODEL SERIESRow1:
PAYLOAD CARGO PAX RANGERow1:
OWNERRow1:
NUMBER OF AIRCRAFT TYPERow1:
MAKE MODEL SERIESRow2:
PAYLOAD CARGO PAX RANGERow2:
OWNERRow2:
NUMBER OF AIRCRAFT TYPERow2:
MAKE MODEL SERIESRow3:
PAYLOAD CARGO PAX RANGERow3:
OWNERRow3:
NUMBER OF AIRCRAFT TYPERow3:
MAKE MODEL SERIESRow1_2:
PAYLOAD CARGO PAX RANGERow1_2:
OWNERRow1_2:
NUMBER OF AIRCRAFT TYPERow1_2:
MAKE MODEL SERIESRow2_2:
PAYLOAD CARGO PAX RANGERow2_2:
OWNERRow2_2:
NUMBER OF AIRCRAFT TYPERow2_2:
MAKE MODEL SERIESRow3_2:
PAYLOAD CARGO PAX RANGERow3_2:
OWNERRow3_2:
NUMBER OF AIRCRAFT TYPERow3_2:
MAKE MODEL SERIESRow4:
PAYLOAD CARGO PAX RANGERow4:
OWNERRow4:
NUMBER OF AIRCRAFT TYPERow4:
SERVICEROUTERow1:
TYPE AIRCRAFTRow1:
OPERATION NUMBER MONTHS OF ROUTERow1:
OF FLIGHTS PER MONTH APPROXIMATE NUMBERRow1:
SERVICEROUTERow2:
TYPE AIRCRAFTRow2:
OPERATION NUMBER MONTHS OF ROUTERow2:
OF FLIGHTS PER MONTH APPROXIMATE NUMBERRow2:
SERVICEROUTERow3:
TYPE AIRCRAFTRow3:
OPERATION NUMBER MONTHS OF ROUTERow3:
OF FLIGHTS PER MONTH APPROXIMATE NUMBERRow3:
SERVICEROUTERow4:
TYPE AIRCRAFTRow4:
OPERATION NUMBER MONTHS OF ROUTERow4:
OF FLIGHTS PER MONTH APPROXIMATE NUMBERRow4:
b For international routes how many hours of international operations have you flown during the preceding 12 months over routes similar to the service sought by:
TOTAL NUMBERCAPTAINS:
QUALIFIED INTERNATIONALLYCAPTAINS:
NUMBER WITH MILITARY RESERVENATIONAL GUARDCAPTAINS:
TOTAL NUMBERFIRST OFFICERS:
QUALIFIED INTERNATIONALLYFIRST OFFICERS:
NUMBER WITH MILITARY RESERVENATIONAL GUARDFIRST OFFICERS:
TOTAL NUMBERSECOND OFFICERS:
QUALIFIED INTERNATIONALLYSECOND OFFICERS:
NUMBER WITH MILITARY RESERVENATIONAL GUARDSECOND OFFICERS:
TOTAL NUMBERFLIGHT ATTENDANTS:
QUALIFIED INTERNATIONALLYFLIGHT ATTENDANTS:
NUMBER WITH MILITARY RESERVENATIONAL GUARDFLIGHT ATTENDANTS:
TYPE OF TRAININGRow1:
LOCATIONRow1:
VENDORRow1:
TYPE OF TRAININGRow2:
LOCATIONRow2:
VENDORRow2:
TYPE OF TRAININGRow3:
LOCATIONRow3:
VENDORRow3:
TYPE OF TRAININGRow4:
LOCATIONRow4:
VENDORRow4:
a Will the service you anticipate performing for the DOD require any additional aircrew training events or programs If so briefly explain:
TOTAL NUMBERA P:
FULLTIME NUMBERA P:
PARTTIME NUMBERA P:
TOTAL NUMBERRII IA:
FULLTIME NUMBERRII IA:
PARTTIME NUMBERRII IA:
TOTAL NUMBEROTHER:
FULLTIME NUMBEROTHER:
PARTTIME NUMBEROTHER:
TYPE OF SERVICERow1:
LOCATIONRow1_2:
VENDORRow1_2:
TYPE OF SERVICERow2:
LOCATIONRow2_2:
VENDORRow2_2:
TYPE OF SERVICERow3:
LOCATIONRow3_2:
VENDORRow3_2:
TYPE OF SERVICERow4:
LOCATIONRow4_2:
VENDORRow4_2:
b Location and description of maintenance facilities including line stations Include companyowned andor major contracted maintenance:
c Describe your documented quality assurance programs 1 Internal audits 2 Vendor audits 3 Mechanical performance monitoring 4 Tooltest equipment calibration tracking NOTE Please include copies of your internalvendor audit schedules:
d Describe your training program for 1 Mechanic indoctrination to company policies and procedures 2 Aircraft Systems 3 List all initial and recurrent training 4 Training for any contract personnel 5 Inspector initialrecurrent training:
e Describe your reliability program:
f Type of maintenance programs:
g Are you an FBOrepair station If so please describe authorization If you use contracted fuel please describe your fuel vendor audit process:
h Describe your offline fuel quality assurance inspectiondocumantation procedures Where are these published:
i Will the service you anticipate performing for the DOD require an expansion of your aircraft maintenance capability If so briefly explain:
j Describe your maintenance and company manuals revision and tracking processes eg computerized manual combination computerizedmanual etc:
k Describe your recordkeeping programs eg computerized manual etc:
a Number and types of line items Please describe receiving inspection and shelf life monitoring programs:
b Number of spare engines:
c Do you carry flyaway kits If so list type of items pumps tires brakes etc:
a Please provide financial statements including balance sheets income statements and statements of change in financial position or statement of cash flow from DOD business indicate amount and procuring activity the last two fiscal years and yeartodate information What was the amount of your total revenues for your most recent fiscal year end If any of that revenue was:
b Are there any bankruptcies mergers divestitures or acquisitions planned:
c Within the past 10 years has the company ever declared bankruptcy If so briefly explain:
You may be asked to provide financial statements d If your company is privately owned please give names and percentage of ownership If owned by another privately held company please detail its ownership ie balance sheet profit and loss of the company owners at a later date:
e Is there any significant litigation against your company which could affect its overall financial or operational health:
f Do you anticipate operating for the DOD as a joint venture with other carriers:
briefly explain circumstances a Within the past 5 years have any key company personnel been arrested indicted convicted or had an FAA license suspended surrendered or revoked If so:
b Within the past 5 years have you ever defaulted on a contract with the Federal Government If so please provide a brief explanation and point of contact:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow1:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow1_2:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow1_3:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow1_4:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow2:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow2_2:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow2_3:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow2_4:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow3:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow3_2:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow3_3:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow3_4:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow4:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow4_2:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow4_3:
AGENCY TELEPHONE CONTRACT TYPE SERVICERow4_4:
FIRMS NAMERow1:
ADDRESSRow1:
PHONERow1:
CONTACTRow1:
FIRMS NAMERow2:
ADDRESSRow2:
PHONERow2:
CONTACTRow2:
FIRMS NAMERow3:
ADDRESSRow3:
PHONERow3:
CONTACTRow3:
YEARRow1:
PART 121Row1:
135Row1:
OTHER OPERATIONSRow1:
TOTAL DEPARTURESRow1:
YEARRow2:
PART 121Row2:
135Row2:
OTHER OPERATIONSRow2:
TOTAL DEPARTURESRow2:
YEARRow3:
PART 121Row3:
135Row3:
OTHER OPERATIONSRow3:
TOTAL DEPARTURESRow3:
YEARRow4:
PART 121Row4:
135Row4:
OTHER OPERATIONSRow4:
TOTAL DEPARTURESRow4:
a When did you receive your operating certificate What is your certificate number:
b Has the operating certificate ever been suspended or revoked If so explain:
c Are all of the authorizations in your Ops Spec active If some have been inactive for more than 12 months please explain:
ADDRESS_2:
OPERATIONS:
TELEPHONE:
AIRWORTHINESS:
TELEPHONE_2:
AVIONICS:
TELEPHONE_3:
e List all aircraft accidents as defined by NTSB 830 in the last four years Include date location type of aircraft type of operation ie Part 121 Part 135 Part 91 number of fatalities and extent of damage:
f Do you have any open Enforcement Investigation Reports EIR with the FAA If so briefly explain their nature and your company s position:
g Will the operations you plan on performing for the DOD require any changes to your FAA operating specifications:
ADDITIONAL COMMENTS Comments you wish to make about your company or its health:
Check Box4: Off
Check Box5: Off
Check Box6: Off
Check Box7: Off
Check Box8: Off
Check Box9: Off
Check Box10: Off
Check Box11: Off
Check Box12: Off
Check Box13: Off
Check Box14: Off
Check Box15: Off
Check Box16: Off
Check Box17: Off
Check Box18: Off
Check Box19: Off
Check Box20: Off
Check Box21: Off
Check Box22: Off
Check Box23: Off
Check Box24: Off
Text1: SOLICITATION: HTC711-14-R-C002
Text2: ATTACHMENT 6

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