NSTXU SOW.pdf

PRINCETON PLASMA PHYSICS LABORATORY

P.O. BOX 451 PRINCETON, N.J. 08543

STATEMENT OF WORK

NSTXU Research Experiment Component Fit-up, Machine/Trim to Fit and Installation Services

NSTXU_1_SOW_127

Work Planning #: N/A Effective Date: 02/06/2025

Prepared By: Tom Jernigan

Document Admin: Donna Kaiser

Reviewed By Tom Jernigan, Preparer 02/05/2025

10:01:40 AM

Reviewed By Adolfo Amaya, Quality Assurance 02/06/2025

11:16:14 AM

Reviewed By Joy Fleming, ES&H 02/05/2025

18:38:21 PM

Reviewed By Robert A. Ellis, Chief Engineer 02/05/2025

09:55:23 AM

Reviewed By Steve Raftopoulos, Technical Authority 02/05/2025

14:04:57 PM

Approved By Leslie Hill, Project Manager 02/06/2025

13:22:15 PM

STATEMENT OF WORK

FOR

NSTXU RESEARCH EXPERIMENT COMPONENT FIT UP, MACHINE/TRIM TO FIT

AND

INSTALLATION SERVICES

CAT: A1

NSTXU_1_SOW_127

Revision 0

Reference Work Planning #: N/A

DATED February 3, 2025

PREPARED BY: Tom Jernigan, NSTX-U APM

REVIEWED BY: A. Amaya, Quality Assurance

REVIEWED BY: J. Fleming, ESH

REVIEWED BY: Bob Ellis, Chief Engineer

REVIEWED BY: S. Raftopoulos, Technical Infrastructure Group Head

APPROVED BY: Les Hill, Project Manager

PRINCETON PLASMA PHYSICS LABORATORY

P.O. BOX 451

PRINCETON, N.J. 08543

609-243-2000

RECORD OF CHANGES

Rev # Date Description of Changes

0 2/3/25 Initial Release

1.0 INTRODUCTION & SCOPE

1.1 Princeton Plasma Physics Laboratory (PPPL), on Princeton University’s Forrestal Campus in Plainsboro, N.J. PPPL is managed by Princeton University for the U.S. Department of Energy’s Office of Science, which is the largest single sponsor of basic research in the physical sciences in the United States. PPPL’s mission is the research and understanding of the physics of plasmas, and developing practical solutions for the creation of fusion energy.

1.2 In furtherance of its mission, PPPL requires Subcontractor on-site and shop services (hereinafter referred to as “Work”) to fit up, trim/machine and install research experiment components under a Basic Order Agreement (BOA) as further described below:

1.2.1 Component fit-up on PPPL’s Forrestal Campus

1.2.2 Trim/machine-to-fit adjustments at the Subcontractor’s shop

1.2.3 Component installation on PPPL’s research machines

1.2.4 Component transport to and from PPPL’ Forrestal Campus

1.3 Upon issuance of the BOA, the Subcontractor will be issued Job Orders which will specify the scope of Work, expected period of performance, and identify PPPL-provided materials if any. Technical Requirements for the Work will be prescribed in PPPL-provided design documents.

2.0 APPLICABLE DOCUMENTS

Additional documents, if applicable, will be identified in the Job Order.

3.0 APPLICABLE DRAWINGS

Drawings applicable to the Work will be referenced and provided in the scope of Work issued with the Job Order.

4.0 RESPONSIBILITIES

4.1 PRINCETON PLASMA PHYSICS LABORATORY

4.1.1 PPPL shall designate a technical contact, the Princeton Technical Representative (PTR) and a Quality Assurance (QA) contact at the time of the award of the BOA.

4.1.2 All communications on administrative matters shall be directed to the PPPL Procurement Representative.

4.1.3 All communications on technical matters related to the BOA and its Job Orders shall be directed to the assigned PTR or a technical contact the PTR designates shall be directed to the assigned PTR.

4.1.4 PPPL shall designate a technical contact and a QA contact at the time of the award of each Job Order.

4.1.5 Job Orders issued by PPPL will identify the quantity of parts required, drawing number, with part numbers, required materials, special processes, and the required delivery date.

4.2 SUBCONTRACTOR

4.2.1 The Subcontractor shall provide a single point of contact for any communication between PPPL and the Subcontractor.

4.2.2 The Subcontractor shall provide all labor, materials, equipment, and supervision services necessary to complete the proposed work in accordance with this Statement of Work, the referenced codes and standards, and the project requirements.

4.2.3 The Subcontractor is responsible to verify and confirm the scope of work within this Statement of Work and referenced documents. All questions regarding the scope of work shall be received by PPPL prior to Subcontractor’s submittal of proposal.

4.2.4 Periodic status meetings between the Subcontractor and PPPL representatives may be identified in the resultant Job Order issued to the Subcontractor under the provisions of the BOA. Meeting minutes delineating all action items shall be kept by the Subcontractor and distributed to all attendees.

4.2.5 The Subcontractor shall notify and obtain PPPL written approval for any Work to be performed by lower-tier Subcontractors.

4.2.6 Subcontractor agrees to employ in the performance of Work only qualified personnel.

5.0 REQUIREMENTS

5.1 SHOP LOCATION

Subcontractor shop shall be located within 50 mile driving distance of PPPL Forrestal Campus.

5.2 PERFORMANCE REQUIREMENTS

Performance requirements, if applicable, will be provided in the Job Order issued to the Subcontractor under the provisions of the BOA.

5.3 EQUIPMENT DEFINITION

Not applicable

5.4 GENERAL DESIGN FEATURES

Design Features, if applicable to the Work, will be identified in the Job Order.

5.5 MATERIALS

5.5.1 PPPL-PROVIDED MATERIALS

PPPL-Provided Materials to be utilized in the Work will be identified in Job Order.

5.5.2 SUBCONTRACTOR-PROVIDED MATERIALS

Required Subcontractor-Provided Materials to be utilized in the Work will be identified in the Job Order.

5.5.3 ELECTROMAGNETIC INTERFERENCE AND SUSCEPTIBILITY

Electromagnetic Interference and Susceptibility requirements, if applicable to the Work, will be identified in with the Job Order.

5.5.4 IDENTIFICATION AND MARKING

Identification and Marking requirements, if applicable to the Work, will be identified in the Job Order.

5.5.5 WORKMANSHIP

Completed Work shall conform to the requirements specified in the Job Order. Work shall be performed by appropriately-skilled personnel in a workmanlike manner in using best industry practices. Work shall be completed to generally accepted machining standards with finished parts deburred, clean, and free of sharp edges.

5.5.6 SUBCONTRACTOR EQUIPMENT USE

Not applicable

6.0 TEST & INSPECTION REQUIREMENTS

6.1 PERFORMANCE TESTS

Performance Requirements, if applicable to the Work, will be provided in the Job Order.

6.2 ACCEPTANCE TESTS

Acceptance Tests, if applicable to the Work, will be provided in the Job Order.

6.3 SUPPLIER HOLD POINTS

Hold Points, if applicable to the Work, will be provided in the Job Order.

7.0 QUALIFICATIONS

7.1 Subcontractor shall use trained and qualified personnel and qualified written procedures in accordance with specified requirements for the performance of certain special processes, including but not limited to, soldering, brazing, welding, plating, heat treatment, nondestructive examination, etc. Copies of special process procedures and qualifications shall be available for review by PPPL and submitted to PPPL for acceptance if requested.

7.2 Heat treating services, if offered, shall be accredited by National Aerospace and Defense Contractors Accreditation Program (NADCAP)/Aerospace Materials Specification (AMS) 275).

7.3 Certifications of Personnel qualified to perform specific work such as welding, brazing, etc. shall be provided. Qualification documentation will need to be approved by PPPL prior to starting the Work.

Note: Job Orders may be issued which require the Subcontractor to perform Work on the PPPL site to collaborate with PPPL Engineers and Technicians to determine the optimum manufacturability or sequence for final assembly and installation of the fabricated components. Additionally, PPPL may request the Subcontractor to supply fabricated components which will field fit-up prior to final delivery of the components. In such cases, the Subcontractor will be required to comply with Section 8.0 herein.

8.0 ENVIRONMENT, SAFETY, AND HEALTH (ON-SITE FITUP AND INSTALLATION SERVICES)

8.1 All work shall comply with PPPL ESHD 5008. The manual is available on the internet at:

http://www.pppl.gov/eshis/ESHD_MANUAL/sm.html

8.2 Subcontractor shall prepare a written Integrated Safety Management (ISM) Plan (construction project safety and health plan) that implements the requirements noted and will obtain approval of the plan by the PPPL PTR prior to commencement of any work covered by the Plan. In the Plan, the Subcontractor must designate the individual(s) responsible for its on-site implementation, specify qualifications for those individuals, and provide a list of those project activities for which subsequent job hazard analyses are to be performed. The level of detail within the ISM Plan should be commensurate with the size, complexity, and risk level of the construction project.

8.3 The Subcontractor must comply with:

8.3.1 The specific PPPL documents, requirements, permits and courses listed in this

Statement of Work, and

8.3.2 All applicable Federal, State, and local laws, regulations and requirements whether or not they are specifically listed in the Statement of Work or subcontract.

8.4 All work shall be in accordance with all OSHA, DOE and PPPL requirements. Care shall be taken to protect personnel, employees and surroundings.

8.5 PPPL will prepare a Job Hazard Analyses (JHA) in accordance with PPPL procedure ESH- 004 prior to commencement of all onsite work. The JHAs will identify foreseeable hazards and protective measures and address further hazards revealed by supplemental information provided by the PTR.

8.6 The Subcontractor shall ensure workers are aware of foreseeable hazards and the protective measures as defined by JHAs and require that workers acknowledge being so informed.

8.7 The Subcontractor shall ensure that workers not following safe work practices are subject to Subcontractor’s disciplinary process.

8.8 The Subcontractor shall maintain a designated representative onsite during all work activities that is knowledgeable of the associated hazards and has the authority to act on behalf of the Subcontractor.

http://www.pppl.gov/eshis/ESHD_MANUAL/sm.html

8.9 The Subcontractor shall provide all Personnel Protective (PPE) for its employees or lower tier subcontractors.

8.10 The Subcontractor shall instruct workers to report to the Subcontractor’s designated representative hazards not previously identified or evaluated. If immediate corrective action is not possible or the hazards fall outside the project scope, the Subcontractor must immediately notify the affected workers as well as notify the PPPL PTR of the hazard. The Subcontractor or the designated representative must stop work in the affected area until appropriate protective measures are established.

8.11 Safety Data Sheets for all paints adhesives, chemicals, stains and solvents furnished by the Subcontractor shall be provided to the PTR prior to the start of work.

8.12 All requirements of this Statement of Work apply to all sub-tier contractors.

8.13 Subcontractor must have their employees trained and provide PPPL with their qualification prior to performing this work. PPPL ES&H training courses that are more specific to the Subcontractor's laboratory work scope may also be required. If PPPL determines that training of Subcontractor employees is inadequate, PPPL reserves the right to require Subcontractor to obtain certified training.

8.14 PPPL-Specific Training

8.14.1 PPPL-Specific Training for onsite Work will be specified in the Job Order.

9.0 QUALITY ASSURANCE REQUIREMENTS

9.1 Inspection / Surveillance / Audit by PPPL

Authorized representatives of PPPL and the U. S. Government shall have the right at all reasonable times to visit the Subcontractor's premises and those of Subcontractor's suppliers during the performance of the procurement for the purposes of inspection, surveillance, audit and/or obtaining any required information as may be necessary to assure that items or services are being furnished in accordance with specified requirements. Such visits shall be coordinated with the Subcontractor's personnel to minimize interference with the normal operations of said premises. The Subcontractor shall make available records and documentation necessary for this function and shall provide all reasonable facilities and assistance for the safety and convenience of PPPL and/or U. S. Government representatives in the performance of their duties. PPPL and the U. S. Government recognize the Subcontractor's right to withhold information concerning proprietary processes. The Subcontractor agrees to insert the paragraph above in each lower-tier procurement issued hereunder.

9.2 Subcontractor's Responsibility for Conformance

PPPL's review and/or approval of Subcontractor's documents nor PPPL's inspection of Subcontractor's items or services shall not relieve the Subcontractor of responsibility for full compliance with requirements of the purchase order/contract. The Subcontractor is responsible for assuring that all requirements and restrictions are imposed on any sub-tier suppliers.

9.3 Changes to PPPL Approved Documents

Revisions or changes by the Subcontractor to documents approved by PPPL shall be reviewed and approved by PPPL prior to use.

9.4 Subcontractor Quality Assurance Program

The Subcontractor shall establish and maintain an effective Quality Assurance Program to assure that the Subcontractor's Work meets the required level of quality and is performed in accordance with contractual requirements.

• Subcontractor's quality assurance function shall be organized to have sufficient authority and independence to identify quality problems, verify conformance of supplied items or services to specified requirements and obtain satisfactory resolution of conflicts involving quality.

• Subcontractor shall perform planned, periodic audits of the various aspects of its QA Program by persons not directly responsible for the area being audited.

Written reports of these audits shall be available to PPPL.

• The Subcontractor’s Quality program will be evaluated for Subcontractor qualification prior to award of the BOA.

9.5 Submittal of Quality Assurance Plan for this procurement

Subcontractor shall submit within 10 working days of award and prior to start of manufacture, unless another time period has been agreed to, a plan describing the specific quality assurance and quality control procedures and practices to meet the requirements of this particular subcontract/purchase order, for PPPL review and approval.

9.6 Submittal of Manufacturing/ Inspection/Test (MIT) Plan

When a Job Order requires an MIT Plan, the Subcontractor shall submit the Plan within 10 working days after receipt of the Job Order for PPPL approval prior to start of Work.

The plan shall identify parts; show their integrated flow into end items; identify critical manufacturing operations; and show inspections and the characteristics/dimensions to be inspected. The Plan may include flow chart(s), Process Sheets, Shop Travelers, and inspection sheets, etc. PPPL may designate selected operations as mandatory "witness" points based on the MIT Plan. Subcontractor shall provide PPPL with notice five working days in advance of such witness points. Revisions or changes to the approved MIT shall be reviewed and approved by PPPL prior to use.

9.7 Process and Sequence

The Subcontractor shall maintain a system to define the sequence and document the performance of manufacturing, inspection, installation, and test activities. These shall provide for signoff and date by designated inspection personnel at specified process, inspection, and test points and shall be traceable to the items.

9.8 Document Traceability and Records

The Subcontractor shall maintain a system of documentation whereby the results of required operations, inspections, examinations, and tests is systematically compiled, indexed and stored. Such objective evidence may include "travelers"; and material test, certification, inspection, examination, test and discrepancy reports; which shall be complete, legible, signed, and dated and shall be traceable to subject items.

9.9 Inspection and Test Control

Inspections and tests shall be performed in accordance with written procedures referencing criteria for acceptance or rejection. Adequate records shall be maintained and available for PPPL's review.

9.10 Submittal of Acceptance Test Procedures (ATPs) For PPPL Approval

When a Job Order requires Acceptance Test Procedures (ATPs), the procedures including pass/fail criteria, required to demonstrate conformance to PPPL's requirements shall be submitted to PPPL for review and approval prior to use of such procedures.

9.11 Performance and Documentation of Inspections & Tests

Each item to be delivered to PPPL shall be inspected and tested by the Subcontractor to verify that they meet PPPL's requirements. All produced parts must be inspected and tested unless an alternate plan is agreed upon with PPPL in writing. Results shall be documented and reported to PPPL. Any exceptions to PPPL requirements must be approved by PPPL in writing.

The inspection/test report(s) shall indicate the results of all tests and compliance with all drawing notes. Actual values for all drawing dimensions, including Basic, but excluding Reference, must be reported. Either a drawing copy or an inspection report may be used as the report, but the drawing zone and actual measured values must be clearly indicated. Regardless of format, the report must be dated and signed.

9.12 Equipment/Material Identification and Status

Material and equipment identification shall be maintained throughout processing and be traceable to the records. Status of acceptability shall be readily discernible through the Subcontractor's use of tags, stamps, serial numbers or other positive means.

9.13 First Article Inspection Qualification

When a Job Order requires first article inspection, Subcontractor shall provide for inspection/test of a first article to provide objective evidence of the conformance of the item, documentation, and process to PPPL requirements. First article inspection will be a mandatory witness point. After acceptance of first article, the remaining units required by the purchase order shall be produced using the same design, materials, processes, methods, and tooling that were used to manufacture the approved first article. Any changes must have prior approval from PPPL.

9.14 Document Review, Approval and Control

The Subcontractor shall implement a system for review and approval of design documents (drawings, specifications, etc.), prior to issuance for use, and for approval and incorporation of changes in a formal and orderly manner. The system shall control obsolete documents to prevent inadvertent use. The system shall also control PPPL-furnished design documents, shall ensure that any models are in sync with the applicable drawings, and that obsolete information is not used.

9.15 Acceptability of Purchased Items and Services (Procurement Control)

The Subcontractor shall verify conformance of purchased and PPPL-furnished items or services to drawing and specification requirements and shall provide objective evidence of such verifications to PPPL if requested.

9.16 Non-conformance & Corrective Actions and Notification

Non-conforming items or services shall be identified, and, where possible, segregated to prevent use. The Subcontractor shall document each nonconformance. The written approval of PPPL is required prior to the use of the nonconforming item or service. The Subcontractor's system shall provide not only for timely resolution of non-conformances but also for analysis of non-conformances to determine causes and to implement appropriate corrective actions (determination of cause and corrective action may be waived by PPPL for specific situations).

9.17 Measuring Equipment / Calibration

Acceptance inspections and tests shall be performed using properly calibrated measuring equipment. Calibration standards shall be traceable to the National Institute for Standards and Technology (NIST) or equivalent. Where such standards do not exist, the basis used for calibration shall be documented. Standards used for calibration shall not be used for shop inspections and shall be protected against damage or degradation.

9.18 Welding and Brazing

Unless otherwise specified, drawings issued with the Job Order:

• Welder(s) and welding procedure(s) shall be qualified to ASME B&PV Code Section IX or to AWS D1.1.

• Brazer(s) and brazing procedure(s) shall be qualified to ASME B&PV Code Section IX.

• Flame brazing procedures shall minimize the embrittlement of copper in copper-to-copper joint.

9.19 Submittal of Completed Release for Shipment Form

Subcontractor shall not ship without a "Product Quality Certification and Shipping Release" Form (Attachment 2) signed by PPPL's Representative. Subcontractor shall complete and sign the certification section, fax or email the form to PPPL’s Quality Assurance (QA) Representative, and hold shipment until PPPL signs and returns the form, authorizing shipment. A copy of the fully executed form shall accompany each full or partial shipment.

9.20 Submittal of Completed Process History (Documentation Package)

Subcontractor shall deliver, along with the completed item(s), one digital or two hard copies of the Process History, a compilation of documents, detailing the objective evidence of the acceptability of the Work performed. Some parts of the Process History, typically inspection and test reports, will be required with the Shipping Release request.

The Process History shall include as a minimum, the following:

• Subcontractor's Certificate of Compliance (CofC), signed by the Quality Manager, stating that the Work performed conforms in every respect to PPPL the physical configuration and functional inspection/test requirements and that personnel performing or interpreting the results of special processes (i.e., welding, soldering, electronic assembly, brazing, nondestructive examination, etc.) were properly trained and qualified. Subcontractor’s Quality Assurance (QA) Manager shall sign the CofC. Where the Subcontractor has used PPPL-furnished material, such certification shall also include the statement: "Material furnished by PPPL has been inspected by the Subcontractor and used by the Subcontractor as specified by PPPL with no unauthorized substitutions".

• When a Job Order requires Material Certification, the Subcontractor shall submit the manufacturer's Material Test Reports (MTR) showing actual relevant chemical, mechanical, and electrical properties of materials used and providing traceability to the actual material. Submitted MTRs must be linked to the specific part by referencing the parts list on the drawing. One copy is to be submitted to PPPL upon Subcontractor acceptance for use. Note: For specialty materials, typically non-metals, where test reports are not readily available from the manufacturer, their certificate of analysis or certificate of grade, as appropriate, may suffice, subject to PPPL concurrence.

• Signed and dated reports for all required inspections and tests.

• Copies of Non-Conformance Reports

9.21 Age/Shelf Life Storage Control and Records

Subcontractor shall maintain records that verify that materials with a specified limited shelf life shall have been stored in accordance with manufacturer's recommendations.

Materials shall possess at least 35% (or higher if specified elsewhere by PPPL) of the initial 100% shelf life at the time they are used in the respective manufacturing process.

9.22 PPPL Receiving / Inspection

PPPL will perform Receiving Inspection on items or services supplied by Subcontractor, using either a sampling plan or 100% inspection. Discrepant items or services will be rejected and returned to Subcontractor or reworked by PPPL.

9.23 High Strength Fasteners

Subcontractor shall provide high strength fasteners (tensile strength equal to or greater than 100 ksi) in accordance with the Fastener Quality Act. Fasteners shall exhibit grade marks and the manufacturer’s identification symbol (headstamp) as specified in the referenced Material Specification. Fasteners having a headmark shown on the suspect fastener list will not be accepted. Certified Material Test Reports (CMTR), showing actual material composition and physical properties and traceable to the actual fasteners, are required for each lot supplied. Results must be on the original letterhead of the entity performing the tests and not transferred to alternate letterhead. Where high strength fasteners are not required, it is recommended that they not be used. If used, the requirements above shall be implemented.

10.0 SHIPPING STORAGE AND HANDLING

Subcontractor shall control items during handling and shipping and while in storage to assure that materials and items are adequately protected from damage or deteriorations, with special attention to packaging for shipment to PPPL. Packaging, shipping and storage systems shall provide adequate marking or labeling to clearly and readily identify the items.

11.0 WARRANTY

Not applicable.

12.0 ATTACHMENTS

12.1 Attachment 1 – DOE Headmark List

12.2 Attachment 2 - Product Quality Certification and Shipping Release Form

13.0 DOCUMENTATION & DELIVERABLES

Required Documentation and Deliverables for individual Job Orders will be identified in the Job Order.

Deliverables List

PO / Subcontract / BOA / BPA #:

# Physical Deliverables Required When Deliverable Is Required

Deliverable Received

1 Not applicable - services Exceptions:

# Document Deliverables Required

When Deliverable Is Required

Deliverable format (paper, electronic etc.)

Storage Location for Deliverable

Deliverable Received

1 Integrated Safety Management Plan (See note preceding 8.0)

Prior to commencement of Work on the PPPL site Electronic Ops Center

2 Quality Assurance Plan (9.0) With 10 days of award Electronic Ops Center 3 Additional, Job Order-Specific document deliverables will be identified in the BOA Job Order

TBD TBD TBD N/A

Exceptions: None

Princeton Technical Representative/COG:

(Sign-off and provide to the Operations Center when job is completed and deliverables are dispositioned and placed/filed in Operations Center (or other Project, Department or Division designated file center)

Attachment 1

ANY BOLT ON THIS LIST SHOULD BE TREATED AS DEFECTIVE WITHOUT FURTHER

TESTING

PRINCETON UNIVERSITY PLASMA PHYSICS LABORATORY—PPPL

PRODUCT QUALITY CERTIFICATION & SHIPPING RELEASE

To be completed by supplier and submitted to PPPL with the Documentation package.

Shipment (full or partial) is not authorized until PPPL returns this form signed.

PPPL SUBCONTRACT/ ORDER # ITEM #(s) QUANTITY SHIPPED

ITEM DESCRIPTION

SUPPLIER REFERENCE # SHIPMENT #

Co m pl et ed b y Su pp lie r

SUPPLIER'S CERTIFICATION

This is to certify that the products and services identified herein have been produced under a controlled quality assurance program and are in conformance with the procurement requirements including applicable codes, standards and specifications as identified in the above-referenced documents unless noted below. Any supporting documentation will be retained in accordance with the procurement requirements.

SIGNED: _________________________________________ DATE: __________________________

TITLE: _________________________________ COMPANY: _______________________________

PPPL (AUTHORIZED REPRESENTATIVE) SHIPPING RELEASE

This is to certify that evidence supporting the above Supplier's Certification statement has been reviewed and no product/service nonconformances from procurement requirements have been identified unless noted below. This product/service is hereby released for shipment.

This section serves as the Quality Assurance release for the above described product for shipment. It does not constitute an acceptance thereof and does not relieve the Supplier, Manufacturer or Contractor of any and all responsibility or obligation imposed by the purchase contract. It does not waive any rights the Purchaser may have under the purchase contract, including the Purchaser's right to reject the above described material upon discovery of any deviations from requirements of the purchase contract, drawings and specifications.

NONCONFORMANCES FROM PROCUREMENT QUALITY REQUIREMENTS:

REMARKS/PRODUCT SERIAL NUMBERS:

Co m pl et ed , s ig ne d, a nd r et ur ne d by P

PP

L be fo re s hi pm en t

BY PPPL QA REPRESENTATIVE (OR DESIGNEE) DATE

Rev. 1 November 15, 2010