QAIRQMT_REPORT 6234FD.pdf

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Repair Services for the MUTES Program
Solicitation number
FA825026Q0011
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This is an AFMC Form 807, Recommended Quality Assurance Provisions and Special Inspection Requirements, documenting quality and inspection standards for a motor control component procurement.

The item being procured is a control motor (Part Number DPM56DF4-K7710, National Stock Number 6105013256234FD) that requires inspection at the contractor's source facility and acceptance at the source, as the destination facility (RTS-SPO) lacks proper test equipment and repacking of the item would be necessary if packaging were disturbed. Standard inspection per FAR 52.246-2 is specified as necessary to verify the item meets critical technical and performance requirements. A quality pre-award survey is recommended for this new source acquisition using AFMC participation. The technical authority determined the requirement does not mandate the use of Class I ozone depleting substances. The item manager is Christina McGinnis (801-895-1226) and the equipment specification contact is Jason L. Francom (801-586-2884). The Technical Authority signature is dated 01 JUL 2024, with the form generated on 08 May 2026.

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RECOMMENDED QUALITY ASSURANCE PROVISIONS

AND SPECIAL INSPECTION REQUIREMENTS

1. PR / MIPR NUMBER

2. NATIONAL STOCK NUMBER

6105013256234FD

3. POINT OF INSPECTION

SOURCE DESTINATION

X

SEE DFARS 246.402

4. POINT OF ACCEPTANCE

SOURCE DESTINATION

X

5. ITEM MANAGER / PHONE

Christina, Mcginnis / 801-895-1226

6. EQUIPMENT SPEC / PHONE

Francom, Jason L / 801-586-2884

7. CONTRACT QUALITY REQUIREMENTS/SPECIAL INSPECTION REQUIREMENTS

CERTIFICATE OF CONFORMANCE

FAR 52.246-15

CONTRACT RESPONSIBILITY FOR INSPECTION

FAR 52.246-15

X STANDARD INSPECTION

FAR 52.246-2,-3,-4,-5 OR -6 AS APPLICABLE TO CONTRACT

HIGHER LEVEL CONTRACT QUALITY REQUIREMENTS FAR 52.246-11

COMMERCIAL ITEM INSPECTION

FAR 52.212-4

OTHER (Describe in Block 8)

8. REMARKS

Masters, Bobby KNAME: 28 OCT 2019DATE:

Part Number: DPM56DF4-K7710 Noun: MOTOR,CONTROL

ESD: No

SPI: Yes, F000003XE7 "In accordance with FAR 46.2 Contract Quality Requirements, it has been determined by the Technical Authority that the item to be procured under this acquisition must meet critical technical/performance requirements and therefore inspection at the contractor's facility, per FAR 52.246-2 Standard Inspection, is necessary."

Block 3. This item meets all three criteria for inspection at the Source.

Block 4. This item meets the criteria for acceptance at the Source.

Note: It is not feasible to inspect/accept these items at the destination. The RTS-SPO does not have the proper test equipment at this location, if the packaging of this item is disturbed/opened in any way, these items will have to be re-packed.

8a. OZONE DEPLETING SUBSTANCES (ODS)

X STATEMENT

"I HAVE REVIEWED THE REQUIREMENT, INCLUDING AVAILABLE TECHNICAL DOCUMENTATION, AND BELIEVE THAT IT DOES NOT REQUIRE THE CONTRACTOR USE CLASS I OZONE DEPLETING SUBSTANCES (ODS) IDENTIFIED IN AIR FORCE POLICY, NOR IS IT WRITTEN SO THAT IT CAN

ONLY BE MET BY THE USE OF A CLASS I ODS."

WAIVER (SEE DAFFARS 5323.8)

NOTE: Quality provisions as annotated hereon will not be downgraded without Technical Authority coordination. The Technical Authority must be notified if award selection is made to a new source using Acquisition Method Code (AMC) 3, 4, or 5.

9. QUALITY PRE-AWARD SURVEY

X YES X NEW SOURCE

PREVIOUS SOURCENO

X AFMC PARTICIPATION

RECOMMENDED

10. CODES

A. I&A

B. CQR

C

11. SIGNATURE OF TECHNICAL AUTHORITY

Francom, Jason L

ORGANIZATION / SYMBOL

415 SCMS / GUMAA

PHONE

801-586-2174 / 586-2174

DATE

01 JUL 2024

Page 1 of 1Prescribed by: AFMCI20-102 Version 3Generated by PRPS using Jasper Reports on 08 May 2026

AFMC FORM 807, 20230130 PREVIOUS EDITION IS OBSOLETE

File details come from the government source that posted it. Updated .