CLIN_0005_Attachments.pdf

REQ DOC NO. - 8313V047 ATTACHMENT AMD

CONTINUATION SHEET CONTRACT NO. - PAGE

OF

NAME OF OFFER OR/CONTRACTOR

ITEM # SUPPLIES/SERVICES QTY U/I

SHIELD BOLT 24 EA

C. DESCRIPTION/SPECIFICATIONS.

C.1. PIECE 5 OF FINAL CLOSURE COVER, STAINLESS STEEL, XY SHIELD

(RF-6600, LIN 0006) MANUFACTURED IAW PNS 2370B0000155 REV

ORG. SEE ATTACHMETS FOR ADDITIONAL REQUIREMENTS AND

INFORMATION.

C.2. PNSY RESERVES THE RIGHT TO INSPECT THE BOLTS AT AN

APPROXIMATE HALF WAY POINT OF CONSTRUCTION.

C.2.1. CONTRACTOR SHALL NOTIFY PNSY WITH PROJECTED WORK

SCHEDULE. HALFWAY POINT OF CONSTRUCTION SHALL BE

DETERMINED BY THE CONTRACTOR AND PNSY AFTER

AWARD OF CONTRACT.

C.3. NAVSEA HQ C-2-0023 MERCURY CONTROL

D. PRESERVATION/PACKAGING/PACKING.

D.1. D4 PREPARATION FOR DELIVERY (COMMERCIALLY PACKAGED).

E. INSPECTION AND ACCEPTANCE.

E.1. HQ E-1-0003, INSPECTION & ACCEPTANCE OF F.O.B. DESTINATION

DELIVERIES.

E.2. FAR 52.246-2 INSPECTION OF SUPPLIES. FIXED PRICE

E.3. FAR 52.212-4 CONTRACT TERMS & CONDITONS (COMMERCIAL)

e e

CONTRACT ----------

PRINTED 11/30/2018 PAGE

EXHIBIT A

(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)

CONTRACT DATA REQUIREMENTS LIST

SYSTEM/ITEM SHIELD CAP CATEGORY

ASSEMBLY

ITEM NO 001 CONTRACTOR

01 SEQ NO A001

02 DATA DESC CERTIFICATE OF COMPLIANCE

03 SUBTITLE

04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A

05 CONTRACT PARA C.7.1

REF

06 TECH OFFICE 2370.1

07 DD 250 REQ DD

08 APP CODE

09 IAC INPUT

10 FREQUENCY 0-TIME

11 AS OF DATE

12 DATE1ST WITH MATERIAL

SUBM

13 DATE SUB

SUBM

14 DISTRIBUTION 410/2370 1/ 0 VIA MAIL (NO DD 250 REQD)

15 TOTAL 1

16 REMARKS

SEQ. NO. A001

PREPARED BY DATE

APPROVED BY DATE

DD FORM 1423

CONTRACT ----------

PRINTED 11/30/2018 PAGE

EXHIBIT A

(ADP DD FORM 1423 (MECHANIZED EQUIVALENT) PER DAR CLAUSE 16-815)

CONTRACT DATA REQUIREMENTS LIST

SYSTEM/ITEM SHIELD CAP

ASSEMBLY

CATEGORY

ITEM NO 002 CONTRACTOR

01 SEQ NO

02 DATA DESC

03 SUBTITLE

04 DID NUMBER

05 CONTRACT REF

06 TECH OFFICE

07 DD 250 REQ

08 APP CODE

09 IAC INPUT

10 FREQUENCY

11 AS OF DATE

12 DATE 1ST SUBM

13 DATE SUB SUBM

14 DISTRIBUTION

15 TOTAL

16 REMARKS

PREPARED BY

APPROVED BY

A002

LIQUID PENETRANT CERTIFICATION

PER ATTACHMENT 1 TO EXHIBIT A

PARA. C.7.2

2370.1

DD

0-TIME

WITH MATERIAL

410 1/

0 VIA MAIL (NO DD 250 REQD)

SEQ. NO. A002

DATE

DATE

CO,RACT • -------- -

PRINTED 11/30/2018 PAGE

ATIACHMENT 1 TO EXHIBIT A (DD FORM 1423)

SYSTEM/ITEM SHIELD CAP CATEGORY

ASSEMBLY

ITEM NO 003 CONTRACTOR

01 SEQ NO A003

02 DATA DESC LOAD TEST CERTIFICATION

03 SUBTITLE

04 DID NUMBER PER ATTACHMENT 1 TO EXHIBIT A

05 CONTRACT REF PARA. C.7.3

06 TECH OFFICE 2370.1

07 DD 250 REQ DD

08 APP CODE

09 IAC INPUT

10 FREQUENCY 0-TIME

11 AS OF DATE

12 DATE 1ST SUBM WITH MATERIAL

13 DATE SUB SUBM

14 DISTRIBUTION 410 1/ 0 VIA MAIL (NO DD 250 REQD)

15 TOTAL 1

16 REMARKS

SEQ. NO. A003

PREPARED BY DATE

eel-RA CT •

PRINTED 11/30/2018

ATTACHMENT 1 TO EXHIBIT A (OD FORM 1423)

SYSTEM/ITEM SHIELD CAP

ASSEMBLY

CATEGORY

ITEM NO 004 CONTRACTOR

SEQ NO

DATA DESC

SUBTITLE

DID NUMBER

CONTRACT REF

TECH OFFICE

DD 250 REQ

APP CODE

IAC INPUT

FREQUENCY

AS OF DATE

DATE 1ST SUBM

DATE SUB SUBM

A004

VISUAL TEST CERTIFICATION (IF APPLICABLE)

PER ATTACHMENT 1 TO EXHIBIT A

PARA. C.7.4

2370.1

DD

0-TIME

WITH MATERIAL

PAGE

14 DISTRIBUTION 410 1/

0 VIA MAIL (NO DD 250 REQD)

15 TOTAL

16 REMARKS

SEQ. NO. A004

PREPARED BY DATE

CO,RACT • PRINTED 11/30/2018 PAGE

CONTRACT/SOLICITATION - -------- -

ITEM (DAT A FOR ITEM

REQUIRED CERTIFICATION

A. CERTIFICATION SHALL BE SUPPLIED WITH EACH SHIPMENT OF MATERIAL.

CERTIFICATION (CERTIFICATE OF COMPLIANCE) SHALL BE SUPPLIED AS OUTLINED IN

PARAGRAPH B. THE VENDOR IS LIABLE FOR CONDUCTING ALL TESTS, ANALYSES,

INSPECTIONS, AND EXAMINATIONS, ETC., AS SPECIFIED BY THE CONTRACT AND

SPECIFICATIONS WHETHER CERTIFICATIONS ARE REQUIRED OR NOT.

CERTIFICATE OF COMPLIANCE (PROVIDE THE FOLLOWING VERBATIM STATEMENT OR

COMPLETE THE OPTIONAL FORM AT THE END OF THIS PART):

"I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH

ALL CONTRACT REQUIREMENTS. THE INSPECTION AND TEST REPORTS PROVIDED

REPRESENT THE ACTUAL ATTRIBUTES OF THE ITEMS FURISHED ON THIS CONTRACT AND

INDICATE FULL COMPLIANCE WITH ALL APPLICABLE SPECIFICATION AND CONTRACT

REQUIREMENTS."

B. CERTIFICATION SHALL BE SUPPLIED PER THE FOLLOWING INSTRUCTIONS:

1. THE CERTIFICATION OF COMPLIANCE SHALL CONTAIN THE SIGNATURE AND TITLE OF

THE VENDOR OFFICIAL DESIGN A TED RESPONSIBLE FOR QUALITY ASSURANCE.

2. THE MATERIAL IDENTIFICATION (E.G. LOT, BATCH, PART#, ETC.) SHALL BE INCLUDED

ON THE CERTIFICATE OF COMPLIANCE AND ASSOCIATED TEST CERTIFICATIONS.

eel-RA CT • ---------

PRINTED 11/30/2018 PAGE

CERTIFICATE OF COMPLIANCE

COMPANY NAME

MATERIAL IDENTIFICATION (COMPLETE APPLICABLE ITEMS)

CONTRACT NO.

ITEM NO.

ORDER NO.

LOCALSTOCKNUMBER: ~------~

MANUFACTURER'S PART NUMBER -----

I ATTEST ALL ITEMS FURNISHED ON THIS CONTRACT ARE IN FULL COMPLIANCE WITH ALL

CONTRACT REQUIREMENTS. THE INSPECTION AND TEST REPORTS PROVIDED REPRESENT

THE ACTUAL ATTRIBUTES OF THE ITEMS FURISHED ON THIS CONTRACT AND INDICATE

FULL COMPLIANCE WITH ALL APPLICABLE SPECIFICATION AND CONTRACT

REQUIREMENTS.

SIGNATURE DATE ------------

QUALITY ASSURANCE OFFICIAL

c

B

A

4 3

1. MANUFACTURING REQUIREMENTS

1.1. WHERE MIL-SPECS, STANDARDS, TECHNICAL PUBLICATIONS ANOIDR REFERENCE

DRAWINGS ARE NOTED, THE LATEST REVISION SHALL BE IN EFFECT UNLESS OTHERWISE

SPECIFIED.

1.2. BREAK ALL SHARP EDGES TO A 1164" CHAMFER (OR SMALLER).

1.3. ALL SURFACES MUST HAVE A 125 RA FINISH (OR BETTER) UNLESS OTHERWISE SPECIFIED.

2. WELDING & NON..[)ESTRUCTIVE TESTING (NOT) REQUIREMENTS

2.1. NONE.

3. LOAD TEST & NON..[)ESTRUCTIVE TESTING (NOT) REQUIREMENTS

3.1. NONE.

4. CLEANLINESS REQUIREMENTS

4.1. ALL ACCESSIBLE SURFACES SHALL BE VISIBLY FREE OF CUTTING FLUID, TAPE RESIDUE, MACHINE CHIPS, GREASE, OL, FLUX. DIRT, GRIT, SCALE, RUST, SMEARED METAL OR

OTHER FOREIGN MATERIAL. THIN FILMS OF TIGHTLY ADHERENT RUST OR OXIDE ARE

ACCEPTABLE. IF EQUIPMENT COMPONENTS REQUIRE ASSEMBLY, ALL ACCESSIBLE

SURFACES SHOULD BE INSPECTED AND CLEANED AS NECESSARY PRIOR TO ASSEMBLY.

5. MARKING REQUIREMENTS

5.1. MARK PER MIL-ST0-792, TYPE I (VIBRATING TOOL), TYPE II (ELECTROCHEMICAL) OR TYPE

VII (ENGRAVING) THE FOLLOWING ON THE SPECIFIED SURFACES:

"RF~. LIN 0006"

5.1.1. USE - .25' TALL X - .12" WIDE CHARACTERS. DO NOT EXCEED .02" DEPTH.

8. DOCUMENTATION REQUIREMENTS "

6.1. NONE.

NIA

NEXT ASSY I USED ON

APPLICATION

4 3

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BOLT

PC# I DESCRIPTION

DECIMAL TOLERENCEI:

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X.XXX • s.0.005 XJOOOC • t a.oms ntAC110N8: t 1m

AMGl.£8: * 0.5"

UNl.ESS OTHERWISE SPECIFIED, OlfllENSIONS Mtf. IN INCHES.

DRAWING OIMtiNSIONAL & GEOMETRIC r(tl..EREHCES PER~y14.s..2008

THIRD ANGLE PROJECTION

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REVISION HISTORY

DESCRIPTION

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MATERIAL I QTY

APPROVAi/CONCURRENCE

I SIGNAn!RE lDATE

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DATE APPROVED

REMARKS

PORTSMOUTH NAVAL SHIPYARD

NUCLEAR FIEFUELING ENGINEERING DIVISION

CODE 2370 - KIT'fERY, ME c

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PORTSMOUTtf NAVAL SHIPYARD NUCLEAR REFUELl~G ENGINEERING DIVISION

CODE 2310 - KITTERY, ME

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