QAIRQMT_REPORT.pdf

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Injector Assembly
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SPRTA126R0428
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This is an Air Force Quality Assurance Provisions and Special Inspection Requirements form (AFMC Form 807) dated November 6, 2024, for National Stock Number 2915015503637NZ. The document designates inspection at the source and acceptance at the source per DFARS 246.402. The item manager is Tommy J. Sneed (405-734-5446) and the equipment specialist is Ronald P. Van Velsor (405-734-5811), with the technical authority organization being AFLCMC/LPSBE.

The procurement requires Higher Level Contract Quality Requirements under FAR 52.246-11 with ISO 9001:2000 certification compliance. The item is classified as a Critical Safety Item with criticality code 'F', indicating heightened quality assurance measures. The form confirms that a previous source will be utilized, eliminating the need for a pre-award quality survey. The inspection and acceptance codes are designated as I&A Code 1 and CQR Code G. A statement confirming that the requirement does not necessitate use of Class I Ozone Depleting Substances has been executed. Quality provisions are established on a no-downgrade basis without Technical Authority coordination, and any future award to a new source using specific Acquisition Method Codes must include Technical Authority notification.

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RECOMMENDED QUALITY ASSURANCE PROVISIONS

AND SPECIAL INSPECTION REQUIREMENTS

1. PR / MIPR NUMBER

2. NATIONAL STOCK NUMBER

2915015503637NZ

3. POINT OF INSPECTION

SOURCE DESTINATION

X

SEE DFARS 246.402

4. POINT OF ACCEPTANCE

SOURCE DESTINATION

X

5. ITEM MANAGER / PHONE

Sneed, Tommy J / 405-734-5446

6. EQUIPMENT SPEC / PHONE

Van Velsor, Ronald P / 405-734-5811

7. CONTRACT QUALITY REQUIREMENTS/SPECIAL INSPECTION REQUIREMENTS

CERTIFICATE OF CONFORMANCE

FAR 52.246-15

CONTRACT RESPONSIBILITY FOR INSPECTION

FAR 52.246-15

STANDARD INSPECTION

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

X HIGHER LEVEL CONTRACT QUALITY REQUIREMENTS FAR 52.246-11

ISO 9001:2000

COMMERCIAL ITEM INSPECTION

FAR 52.212-4

OTHER (Describe in Block 8)

8. REMARKS

Van Velsor, Ronald PNAME: 06 NOV 2024DATE:

This part is a Critical Safety Item, crit code 'F'

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

YES NEW SOURCE

X PREVIOUS SOURCEX NO

AFMC PARTICIPATION

RECOMMENDED

10. CODES

A. I&A

B. CQR

G

11. SIGNATURE OF TECHNICAL AUTHORITY

Van Velsor, Ronald P

ORGANIZATION / SYMBOL

AFLCMC / LPSBE

PHONE

405-734-5811 / 884-5811

DATE

06 NOV 2024

Page 1 of 1Prescribed by: AFMCI20-102 Version 7Generated by PRPS using Jasper Reports on 30 Jul 2025

AFMC FORM 807, 20230130 PREVIOUS EDITION IS OBSOLETE

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