Attachment 17_MPO RFD Form.pdf
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- Solicitation number
- N00039-19-R-1000
About this file
This document is a request for deviation/waiver form related to a federal contract opportunity issued by the Naval Information Warfare Systems Command to support the Multiple Information Distribution Program Office.
The solicitation seeks proposals for multiple award contracts to provide production, systems engineering and integration services, and retrofits for various MIDS Joint Tactical Radio System terminal configurations. Production requirements include manufacturing and delivering CMN-4, TTNT and F-22 terminals as well as shop replaceable units that comprise the terminal line replaceable units. Systems engineering and integration services are required to provide technical support according to delivery orders issued under the contract. Retrofits include retrofitting and upgrading the MIDS JTRS terminal configurations and associated line replaceable units and shop replaceable units. The period of performance and award dates are not specified in the document.
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Text version
REQUEST FOR DEVIATION / WAIVER 1. DATE (YYMMDD)
2. PROCURING
ACTIVITY NO.
3. DODAAC
4. ORIGINATOR
a. TYPED NAME (First, Middle Initial, Last)
b. ADDRESS (Street, City, State, Zip Code)
5. (X one)
DEVIATION WAIVER
6. (X one) MINOR
MAJOR CRITICAL
7. DESIGNATION FOR DEVIATION / WAIVER 8. BASELINE AFFECTED
FUNC TIONAL
ALLOCATED
PRODUCT
9. OTHER SYS./CON-FIG.
ITEMS AFFECTED
YES NO
a. MODEL/TYPE
b. CAGE CODE
c. SYS. DESIG.
d. DEV/WAIVER NO.
10. TITLE OF DEVIATION / WAIVER
11. CONTRACT NO. AND LINE ITEM
12. PROCURING CONTRACTING OFFICER
a. NAME (First, Middle Initial, Last)
b. CODE c. TELEPHONE
13. CONFIGURATION ITEM NOMENCLATURE
14. CLASSIFICATION OF DEFECT
a. CD NO.
b. DEFECT NO. c. DEFECT CLASSIFICATION
MINOR MAJOR CRITICAL
15. NAME OF THE LOWEST PART / ASSEMBLY AFFECTED
16. PART NO. OR TYPE DESIGNATION
17. EFFECTIVITY
18. RECURRING DEVIATION / WAIVER
YES NO
19. EFFECT ON COST / PRICE
20. EFFECT ON DELIVERY SCHEDULE
21. EFFECT ON INTEGRATED LOGISTICS SUPPORT, INTERFACE OR SOFTWARE
22. DESCRIPTION OF DEVIATION / WAIVER
23. NEED FOR DEVIATION / WAIVER
24. CORRECTIVE ACTION TAKEN
25. SUBMITTING ACTIVITY
a. TYPED NAME (First, Middle Initial, Last)
b. TITLE
c. SIGNATURE
26. APPROVAL/DISAPPROVAL
a. RECOMMEND APPROVAL DISAPPROVAL
b. APPROVAL
APPROVED DISAPPROVED
c. GOVERNMENT ACTIVITY
d. TYPED NAME (First, Middle Initial, Last)
e. SIGNATURE
f. DATE (YYMMDD)
g. APPROVAL
APPROVED DISAPPROVED
h. GOVERNMENT ACTIVITY
i. TYPED NAME (First, Middle Initial, Last)
j. SIGNATURE
k. DATE (YYMMDD)
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