R-0013_Attachments.pdf

RECOMMENDED QUALITY ASSURANCE PROVISIONS

AND SPECIAL INSPECTION REQUIREMENTS

1. PR / MIPR NUMBER

2. NATIONAL STOCK NUMBER

1680012133841UC

3. POINT OF INSPECTION

SOURCE DESTINATION

X

SEE DFARS 246.402

4. POINT OF ACCEPTANCE

SOURCE DESTINATION

X

5. ITEM MANAGER / PHONE

Roberts, Teresa C / 478-926-6856

6. EQUIPMENT SPEC / PHONE

Griffis, Wayne A / 478-926-6731

7. CONTRACT QUALITY REQUIREMENTS/SPECIAL INSPECTION REQUIREMENTS

CERTIFICATE OF CONFORMANCE

FAR 52.246-15

CONTRACT RESPONSIBILITY

FOR INSPECTION

FAR 52.246-1

STANDARD INSPECTION

FAR 52.246-2,-3,-4,-5 OR -6

AS APPLICABLE TO CONTRACT

X HIGHER LEVEL CONTRACT QUALITY REQUIREMENTS

ISO 9001:2000

COMMERCIAL ITEM INSPECTION

FAR 52.212-4

OTHER (Describe in Block 8)

8. REMARKS

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 AF FARS 5323)

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

Nanez, Doug A

ORGANIZATION / SYMBOL

AFLCMC / WLSEAB

PHONE

478-926-4836 / 468-4836

DATE

11 AUG 2016

Page 1 of 1AFMC FORM 807, 20060111, V1 Version 1Generated by PRPS using Jasper Reports on 03 Mar 2017

RECOMMENDED QUALITY ASSURANCE PROVISIONS

AND SPECIAL INSPECTION REQUIREMENTS

1. PR / MIPR NUMBER

2. NATIONAL STOCK NUMBER

1680012133842UC

3. POINT OF INSPECTION

SOURCE DESTINATION

X

SEE DFARS 246.402

4. POINT OF ACCEPTANCE

SOURCE DESTINATION

X

5. ITEM MANAGER / PHONE

Roberts, Teresa C / 478-926-6856

6. EQUIPMENT SPEC / PHONE

Wayne, Griffis A / 478-926-6731

7. CONTRACT QUALITY REQUIREMENTS/SPECIAL INSPECTION REQUIREMENTS

CERTIFICATE OF CONFORMANCE

FAR 52.246-15

CONTRACT RESPONSIBILITY

FOR INSPECTION

FAR 52.246-1

STANDARD INSPECTION

FAR 52.246-2,-3,-4,-5 OR -6

AS APPLICABLE TO CONTRACT

X HIGHER LEVEL CONTRACT QUALITY REQUIREMENTS

ISO 9001:2000

COMMERCIAL ITEM INSPECTION

FAR 52.212-4

OTHER (Describe in Block 8)

8. REMARKS

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 AF FARS 5323)

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

Nanez, Doug A

ORGANIZATION / SYMBOL

AFLCMC / WLSEAB

PHONE

478-926-4836 / 468-4836

DATE

11 AUG 2016

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TRANSPORTATION DATA FOR SOLICITATIONS

COMMODITY: See Continuation

PURCHASE INSTRUMENT NUMBER:

FD20601700878-00

DATE INITIATED:

23 FEB 2017

STOCK NUMBER: See Continuation

X ORIGIN DESTINATION OTHER DATA / FIRST ARTICLE F.O.B. DESTINATION(Specify)

F.O.B. TERMS RECOMMENDED AS BEST SUITED FOR THIS PROCUREMENT

TRANSPORTATION PROVISIONS / CLAUSES FAR CITATION

F.O.B. Origin 52.247-29 Freight Classification Description 52.247-53

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 97X4930.FC04 647 47GR 15410Z 01N000 00000 000DLA 503000 HQ0104 FSR: 013408 PSR: K11705

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA:

Additional Funding Information:

ZERO DOLLAR

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 1680012133841UC

Purchase Instrument Line Item Number: 0003

Ship to (DoDAAC / MAPAC): SW3119

Mark For: RIC FLB

Ship To (Address): DLA DISTRIBUTION WARNER ROBINS

ROBINS A F B GA 31098-1887

31098 - 1887

USA

WPOD:

APOD:

BBP / CCP: SW3119

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

455 BYRON STREET BLDG 376

Ship To (Remarks): SW3119

NSN / Pseudo NSN: 1680012133842UC

Purchase Instrument Line Item Number: 0004

Ship to (DoDAAC / MAPAC): SW3119

Mark For: RIC FLB

Ship To (Address): DLA DISTRIBUTION WARNER ROBINS

ROBINS A F B GA 31098-1887

31098 - 1887

USA

WPOD:

APOD:

BBP / CCP: SW3119

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

455 BYRON STREET BLDG 376

Ship To (Remarks): SW3119

EVALUATION OF PORT BID OR PROPOSAL:

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SOLICITATION DATA NOTES:

ZERO DOLLAR

OTHER TRANSPORTATION DATA:

TACRN:

AAB

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 97X4930.FC04 647 47GR 15410Z 01N000 00000 000DLA 503000 HQ0104 FSR: 013408 PSR: K11705

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA:

Additional Funding Information:

ZERO DOLLAR

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 1680012133841UC

Purchase Instrument Line Item Number: 0001

Ship to (DoDAAC / MAPAC): FD2060

Mark For: FIRST ARTICLE TESTING (FAT) DO NOT POST

Ship To (Address): FD2060 DDWG ER DLA CENTRAL RCVG

455 BYRON ST

ROBINS AFB GA 31098

31098 - 1098

USA

WPOD:

APOD:

BBP / CCP:

RIC: 3

Requisition Number:

Supplemental Address:

FMS Case:

CP 478 926 3638

Ship To (Remarks):

NSN / Pseudo NSN: 1680012133842UC

Purchase Instrument Line Item Number: 0002

Ship to (DoDAAC / MAPAC): FD2060

Mark For: FIRST ARTICLE TESTING (FAT) DO NOT POST

Ship To (Address): FD2060 DDWG ER DLA CENTRAL RCVG

455 BYRON ST

ROBINS AFB GA 31098

31098 - 1098

USA

WPOD:

APOD:

BBP / CCP:

RIC: 3

Requisition Number:

Supplemental Address:

FMS Case:

CP 478 926 3638

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

ZERO DOLLAR

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OTHER TRANSPORTATION DATA:

NAME

Pate, Robert T

ORGANIZATION / OFFICE

SYMBOL

406 SCMS / GULAA

COMMERCIAL / DSN

PHONE

478-926-2771 / 468-2771

SIGNATURE

//SIGNED//Pate, Robert T

DATE

23 FEB 2017

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