ATTACHMENTS_2_thru_9.pdf

FIRST ARTICLE REQUIREMENTS 1. DATE

21 JUN 2018(AFMCI 64-110, AFMCI 23-102 and FAR Part 9, Sub Part 9.3)(Additional Instructions on Page 3)

2. PR / MIPR NUMBER 3. CAGE / REFERENCE NUMBER

12464 / B54E0034-2

4. NSN

6130005007100FX

5. FIRST ARTICLE QUANTITY

THE FIRST ARTICLE IS 2 UNIT(S) OF LOT / ITEM Each

AND WILL BE: X PART OF PRODUCTION QUANTITY IN ADDITION TO PRODUCTION QUANTITY

6. ARTICLES

WILL X WILL NOT SERVE AS A MANUFACTURING STANDARD

7. LONG LEAD TIME ITEMS

REQUIRED X NOT REQUIRED

(See FAR 52.209-3 OR -4, alternate II)

8. SPECIAL REQUIREMENT/PRODUCTION FACILITIES (See FAR 52.209-3 OR -4 Alternate I)

REQUIRED X NOT REQUIRED

"The First Article offered must be manufactured at the facilities in which that item is to be produced under the contract, or if the First Article is a component not manufactured by the contractor, such component must be manufactured at the facilities in which the component is to be produced for the contract. A certification to this effect must accompany each First Article which is offered."

9. TEST / INSPECTION REQUIREMENTS

A. X CONTRACTOR TESTING

GOVERNMENT TESTING

Performance or other characteristics which the First Articles must meet are

Design, material, marking and construction requirements to include: Visual and form-fit-function examination, as well as electrical requirements and workmanship.

B. The detailed technical requirements for First Article approval tests are contained in

B54E0034-2 Revision H, all associated E.O.'s. and all other documents referenced therein.

(Cite Spec and Para number)

C. X TEST PLAN REQUIRED

Number of days for government approval / disapproval 45 days.

D. Contractor's notification to ACO and

409 SCMS/GUEA/F-15 Avionics Engineering

(Requesting Activity) of test time and location due 30 days prior to start of testing.

E. X TEST REPORT REQUIRED

(1) Forwarded to

F-15 FAM / 409 SCMS/GUEA

First Article Test Unit

455 Byron St. RAFB GA. 31098-1887

Call Paul Ham 478-926-3238

(2) Government written notice of approval / disapproval due 45 days after receipt of contractor's report.

F. FIRST ARTICLE DELIVERY

(1) Due within 270 calendar days from date contract.

(2) Notify 15 calendar days prior to shipment.

(3) Delivered to government at

FB2060/Special Handling

First Article Test Unit

455 Byron St. RAFB GA. 31098-1887

Call Paul Ham 478-926-3238

(Set Forth Consignee and Address)

(4) Government written notice of approval / disapproval within 110 days after receipt of first article package.

G. Estimated cost of government testing / inspection evaluation.

$9,190.9200

Page 1 of 2AFMC IMT 260, 20020830, V-3 Version 2Generated by PRPS using Jasper Reports on 26 Nov 2018

FIRST ARTICLE REQUIREMENTS 1. DATE

21 JUN 2018(AFMCI 64-110, AFMCI 23-102 and FAR Part 9, Sub Part 9.3)(Additional Instructions on Page 3)

10. DISPOSITION OF FIRST ARTICLES

X Approved First Articles will be forwarded to

DLA Supply

(insert quantity) First Articles will be expended in testing. Residual components of disapproved First Articles will be returned to the contractor will be retained by pending disposition instructions from the contractor.

X First Articles will be installed on aircraft/equipment to determine proper fit/function. Approved article will remain on the aircraft/equipment and will not be forwarded to USAF Supply, but will be considered part of the contract quantity.

X Disapproved First Articles will be returned to the contractor

X will be retained by 802 MXSS/MXDTA pending disposition instructions from the contractor.

On purchase requests designated as direct shipments the following disposition will apply. (NOTE: Always applicable on Foreign Military Sales (FMS)).

a. Approved First Articles will be returned to the contractor for shipment with production item.

b. Disposition of disapproved First Articles will remain the same as marked above.

X Other Disposition:

See remarks section, Block 12

11. CONDITION(S) FOR WAIVER OF FIRST ARTICLE APPROVAL

a. X Offerors who have previously furnished production quantities of the same or similar article to the prime contractor for delivery to the X Government, DoD, Air Force.

b. X Offerors currently in production of the same or similar article for a X Government, DoD, Air Force contract and who have received First Article approval under the existing contract.

c. X Offerors who have previously furnished production quantities of the same or similar articles to the X Government, DoD, Air Force, provided articles thus furnished, have exhibited satisfactory performance in service in the opinion of the Air Force.

d. X Provided not more than 36 months have elapsed since completion of the contract.

e. First Article testing will not be waived.

f. X See Remarks in block 12 below.

NOTE TO BUYER: UNDER CONDITIONS A AND C ABOVE, THE COGNIZANT ENGINEERING ACTIVITY WILL DECIDE WHETHER OR NOT THE ITEM HAS EXHIBITED SATISFACTORY PERFORMANCE IN SERVICE AND PREPARE AND RETAIN SUPPORTING DOCUMENTATION TO FULLY JUSTIFY THIS DECISION. THE BUYER MUST SOLICIT DUAL PRICES (That is, both with and without requirement for first article approval) AND MUST FURNISH THE COGNIZANT ENGINEERING ACTIVITY WITH THE FOLLOWING INFORMATION ON THE PREVIOUSLY SUPPLIED ARTICLE:

A. PROCURING OFFICE B. CONTRACT NUMBER C. DATE OF CONTRACT D. SPECIFICATION NUMBER AND REVISION

12. REMARKS

Cheatham, Anthony MNAME: 02 JUL 2018DATE:

9. In addition to the required Contractor testing, Government Fit Verification Testing will be completed on subject part J72B0003-1 to verify the Contractor can correctly interpret the technical data package.

9.C. Test Plan Required: The Contractor must include the Test Procedures that will be used to perform First Article testing. The test procedures must include a listing of the test equipment used.

9.D. The 409th SCMS/GUEA F-15 Avionics Group reserves the right to witness contractor acceptance testing as well as complete a site survey of manufacturing and testing facilities.

9.E. Test Report Required: The Test Report may be delivered with the First Articles.

9.G. Estimated cost of government testing/inspection evaluation: The cost will be charged to the funds that DLA has MIPR'd to WR-ALC for First Article Testing.

10. Untested and approved First Articles will be forward to DLA supply.

11. First Articles are required from any vendor who has not successfully manufactured and delivered their product or a product considered to be similar by the Engineering Support Activity (ESA) to the Government within the last 36 months per the conditions and exceptions noted above. Furthermore, if any Product Quality Deficiency Reports have been filed against a manufacturer within the same 36 month window, First Articles are required.

13. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR APPROVING TEST

(Name, Organization, Phone)

Cheatham, Anthony M

409 SCMS / GU E A B

478-926-1792

468-1792

14. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR CONDUCTING

TEST (Name, Organization, Phone)

Page 2 of 2AFMC IMT 260, 20020830, V-3 Version 2Generated by PRPS using Jasper Reports on 26 Nov 2018

ITEM DESCRIPTION

NSN

6130005007100FX

CAGE

08748

REFERENCE NUMBER

4-031-05

NOUN

POWER SUPPLY

END ITEM TCTO NUMBER TO NUMBER

5N29-8-4

CRITICALITY CODE

X

DEMILITARIZATION CODE

B

SECURITY CODE

U

MDC

UAH

ES CODE

R7

REMARKS

INITIATOR

NAME

PETER.J.SISINNI

ORGANIZATION / OFFICE SYMBOL

409 SCMS / GUMCA

DSN PHONE

472-8726

COMMERCIAL PHONE

478-472-8726

ITEM DESCRIPTION DATA

LENGTH ( IN )

6.0000

WIDTH ( IN )

4.0000

HEIGHT ( IN )

3.5000

WEIGHT ( LB )

5.0000

OTHER DIMENSIONS

ITEM MATERIAL

Phenolic block, rubber, plastic, electronic circuit board material and electronic components.

ITEM FUNCTION

This is a power supply for the function of the AVQ-20 HUD. Provides regulated voltage for circuit operations.

SAFETY CRITICAL SCREW

THREADED COMPONENT

ESD CEMS SENSITIVE DATA

STATEMENT OF HELIUM CONTENT (%) 0 PRECIOUS METAL INDICATOR CODE

GFM REQUIRED GFE REQUIRED GFP REQUIRED

JEWEL BEARING JEWEL BEARING RELATED

LEGACY ITEM DESCRIPTION

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ITEM UNIQUE IDENTIFICATION (IUID) CHECKLIST

I. IUID DETAILS: DFARS 252.211.7003

SECTION (c) (1) (i) APPLIES TO THE FOLLOWING:

ITEM REQUIRING IUID MARKING

NSN

6130005007100FX

VERSION NUMBER

NOUN

POWER SUPPLY

INITIATOR

Cheatham, Anthony M

ORGANIZATION CODE / OFFICE SYMBOL

409 SCMS / GUEAB

COMMERCIAL PHONE

478-926-1792

DSN PHONE

468-1792

CAGE / REFERENCE NUMBER

08748 / 4-031-05 12464 / B54E0034-2 50218 / 4-031-05 76301 / B54E0034-2

MARKING IS TO BE PERFORMED IN ACCORDANCE WITH THE LATEST VERSION OF MIL-STD-130

MARKING GUIDANCE

Contractor Determined Location and Method

ENGINEERING DRAWING / ECP / ECO NUMBER

MARKING TYPE MARKING METHOD

DESCRIPTION / LOCATION

REMARKS

ATTACHMENT(S)

II. EMBEDDED ITEMS

SECTION (c) (1) (iii) APPLIES TO THE FOLLOWING:

NSN NOUN

CAGE / REFERENCE NUMBER

ITEM IS AN EMBEDDED ITEM FOR NSN / PSEUDO NSN: 6130005007100FX

MARKING GUIDANCE ENGINEERING DRAWING / ECP / ECO NUMBER

MARKING TYPE MARKING METHOD

DESCRIPTION / LOCATION

REMARKS

ATTACHMENT(S)

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ENGINEERING DATA LIST

DATE:

29 AUG 2018

REVISION: 2 *HISTORY*

CAGE:

76301

PAGE:

NSN:

6130005007100FX

DATA TECH:

McCranie, Raymond E

END ITEM:

F-15 Aircraft

ORGANIZATION/OFFICE SYMBOL:

429 SCMS GUMACA/

MANUFACTURER NAME:

BOEING COMPANY, THE

REFERENCE NUMBER:

B54E0034-2

NOUN:

POWER SUPPLY

LINE/

SUB CAGE

ENG DRAWING NUM/ ACCOMP

DOC NUM REV

NR

SHEETS

FURN

CODE

DIST

CODE NOUN REMARKS

L 12464 B54E0034 & ACCs H S C Power Supply, High Voltage McCranie, Raymond E 29 AUG 2018

/ -2 Power Supply, High Voltage ACC#s 1EO and 2014C0002-R.

"Preferred Parts List(PPL) MAC A0195 called out in drawing B54E0034 is not available.

Refer to parts selection criteria, sheet 15, Section 3.3.1.2.1."

NAME: DATE:

L 98752 200415485 C S A General Engineering Notes McCranie, Raymond E 29 AUG 2018

/ General Engineering Notes. See Notes: 1, 3, 4, and 12.

NAME: DATE:

STANDARD ENGINEERING TEXT

McCranie, Raymond E 29 AUG 2018

For General Engineering Document Notes, see document number 200415485.

Spares Configuration: Per blueprint.

"Preferred Parts List(PPL) MAC A0195 called out in drawing B54E0034 is not available. Refer to parts selection criteria, sheet 15, Section 3.3.1.2.1."

NAME: DATE:

C - CLASSIFIED DOCUMENT.

S - FURNISHED WITH SOLICITATION.

M - STABLE BASE DRAWING REQUIRED; FURNISHED WITH

CONTRACT AWARD.

X - DATA SUPPLIED (NOT IN JEDMICS).

R - FURNISHED BY PCO UPON REQUEST.

P - PARTIAL DOCUMENT FURNISHED.

V - VENDOR DRAWING; (NOT PROVIDED).

G - GOV'T DOCUMENT.

O - OTHERS, CONTRACTOR MUST ACQUIRE.

A- DATA NOT AVAILABLE.

FURNISHED METHOD CODE LEGEND:

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RECOMMENDED QUALITY ASSURANCE PROVISIONS

AND SPECIAL INSPECTION REQUIREMENTS

1. PR / MIPR NUMBER

2. NATIONAL STOCK NUMBER

6130005007100FX

3. POINT OF INSPECTION

SOURCE DESTINATION

X

SEE DFARS 246.402

4. POINT OF ACCEPTANCE

SOURCE DESTINATION

X

5. ITEM MANAGER / PHONE

Scott, Ryan A / 478-926-4654

6. EQUIPMENT SPEC / PHONE

Sisinni, Peter J / 478-222-8726

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 X NEW SOURCE

PREVIOUS SOURCEX NO

AFMC PARTICIPATION

RECOMMENDED

10. CODES

A. I&A

B. CQR

G

11. SIGNATURE OF TECHNICAL AUTHORITY

Cheatham, Anthony M

ORGANIZATION / SYMBOL

409 SCMS / GUEAB

PHONE

478-926-1792 / 468-1792

DATE

31 MAY 2018

Page 1 of 1AFMC FORM 807, 20060111, V1 Version 2Generated by PRPS using Jasper Reports on 26 Nov 2018

PACKAGING REQUIREMENTS

PURCHASE INSTRUMENT NUMBER: FD20601900060-00 VERSION: 1

MIL-STD 129 REVISION: R MIL-STD 2073-1 REVISION: E

THE FOLLOWING STATEMENT IS IN COMPLIANCE WITH THE UNITED NATIONS-IMPLEMENTED RESTRICTIONS ON WOOD PACKAGING MATERIAL (WPM). THIS REQUIREMENT IS SPECIFICALLY CONCERNED WITH INVASIVE SPECIES SUCH AS THE PINEWOOD NEMATODE. WPM IS DEFINED AS WOOD PALLETS, SKIDS, LOAD BOARDS, PALLET COLLARS, WOODEN BOXES, REELS, DUNNAGE, CRATES, FRAMES, AND CLEATS. THE STATEMENT BELOW CITES THE REQUIREMENTS IN DETAIL AND COVERS LUMBER FOR BUILDING CONTAINERS AND PALLETS USED FOR DELIVERIES RESULTING IN SHIPMENTS WORLDWIDE (DIRECT, OR THROUGH AIR LOGISTICS CENTERS (ALC), CONTAINER CONSOLIDATION POINTS (CCP), OR OTHER BASES). WOODEN LUMBER, WOODEN

PALLET AND PACKAGING/CONTAINER STATEMENT:

ALL WOODEN LUMBER, WOODEN PALLET'S, AND WOODEN CONTAINERS PRODUCED ENTIRELY OR IN PART OF WOOD PACKING MATERIAL (WPM) SHALL BE CONSTRUCTED FROM DEBARKED WOOD IN ADDITION TO THE APPLICATION OF HEAT-TREATED (HT) MATERIAL (HT TO 56 DEGREES CENTIGRADE OR 133 DEGREES FAHRENHEIT FOR 30 MINUTES). CERTIFICATION/MARKING IS REQUIRED BY AN ACCREDITED AGENCY RECOGNIZED BY THE AMERICAN LUMBER STANDARDS COMMITTEE (ALSC). FOR REFERENCE DOCUMENTATION, SEE LATEST REVISION OF "INTERNATIONAL STANDARDS FOR PHYTOSANITARY MEASURES" (ISPM)NO.15), "REGULATION OF WOOD PACKAGING MATERIAL IN INTERNATIONAL TRADE."

PACRN: PACKAGING REQUIREMENT: PRESERVATION LEVEL: PACKAGING LEVEL: SPI: SPI REV: SPI DATE:

AAA MIL Long Line Packaging MIL B

ITEM(S):

6130005007100FX

CODED DATA:

QUP ICQ

PRES

METH CD

PRES

MTL

WRAP

MTL

CUSH

DUNN CT

UNIT

CONT

INT

CONT UCL

SPEC

MKG

UNIT PACK

WEIGHT

UNIT PACK

LENGTH

UNIT PACK

WIDTH

UNIT PACK

DEPTH

UNIT PACK

CUBE OPI

1 000 GX 1 00 K3 NB A NR 00 B 17 4.10 8.3 8.3 12.5 0.498 M

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

When shipping containers are received that meet the requirements of the AFMC Form 158 and are suitable for return shipment of serviceable assets, they shall be reclaimed, stored and protected for reuse. Unserviceable containers shall be disposed of and replaced with new containers by the contractor that meet the requirements of the AFMC Form 158.

SUPPLEMENTAL PACKAGING INSTRUCTION TEXT:

VENDOR PACKAGING INSTRUCTIONS:

Military Packaging and Marking Items shall be packaged in accordance with MIL-STD-2073-1, Standard Practice for Military Packaging. Shipping and storage markings shall be in accordance with MIL-STD-129, Standard Practice for Military Marking.

Shipping Container Marking Shipping containers shall be marked meeting the following criteria: (a) MIL-STD-129, Standard Practice for Military Marking. (b) Bar code format shall conform to bar code symbology Format 3 of 9, Code 39 as specified in MIL- STD-129. (c.) Additional marking and/or bar coding requirements exceeding those of MIL-STD-129 (e.g., unit serial numbers, original equipment manufacturers (OEM) name, or OEM model number, as specified on the AFMC Form 158.

ORGANIZATION / OFFICE SYMBOL:

406 SCMS / GULAA

PACKAGING SPECIALIST:

Kerr, Jason B

PHONE NUMBER:

478-327-6316 / 497-6316

SIGNATURE:

//SIGNED//Kerr, Jason B

DATE:

18276 - 03 OCT 2018

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TRANSPORTATION DATA FOR SOLICITATIONS

COMMODITY: See Continuation

PURCHASE INSTRUMENT NUMBER:

FD20601900060-00

DATE INITIATED:

15 NOV 2018

STOCK NUMBER: See Continuation

X ORIGIN DESTINATION OTHER X 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 Contact DCMA Transportation Contact DCMA Transportation on ALL "DCMA Administered" contracts prior to shipment for shipping instructions using the DCMA Shipment Instruction Request (SIR) eTool System, at http://www.dcma.mil <http://www.dcma.mil/> for ALL FOB:

Origin, Foreign Military Sales (FMS), and FOB: Destination OCONUS/Export movements to obtain the appropriate DOD regulatory clearances, shipping documentation and instructions from your cognizant DCMA Transportation Office. If you are new to DCMA, and do not already have a SIR eTool account, you will first need to request an account via DCMA External Web Access Management (EWAM) application which can be accessed at http://www.dcma.mil. If you need additional assistance, email DCMA Transportation Group at: Transportation.Division@dcma.mil. Do not move any freight to a water or aerial port prior to contacting DCMA or it will become frustrated. Failure to contact the responsible DCMA may result in vendor incurring additional expenditures.

Vendor Transportation Instructions

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 97X4930.FC04 649 47GR 15328Z 01N000 00000 000DLA 503000 F03000 FSR: 013408 PSR: K19359

First Destination Transportation Account Code: FRS6

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA:

Additional Funding Information:

ZERO DOLLAR

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 6130005007100FX

Purchase Instrument Line Item Number: 0001

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:

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

455 BYRON STREET BLDG 376

Ship To (Remarks):

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NSN / Pseudo NSN: 6130005007100FX

Purchase Instrument Line Item Number: 0002

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:

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

455 BYRON STREET BLDG 376

Ship To (Remarks):

NSN / Pseudo NSN: 6130DTL19000C

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:

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

455 BYRON STREET BLDG 376

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

OTHER TRANSPORTATION DATA:

TACRN:

AAB

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 97X4930.FC04 649 47GR 15328Z 01N000 00000 000DLA 503000 F03000 FSR: 013408 PSR: K19359

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA:

Additional Funding Information:

FOB DESTINATION/DATA

ITEM / SHIP TO(s):

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NSN / Pseudo NSN: 6130DTL19000D

Purchase Instrument Line Item Number: 0004

Ship to (DoDAAC / MAPAC):

Mark For: IAW DD Form 1423

Ship To (Address):

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number:

Supplemental Address:

FMS Case:

Ship To (Remarks): IAW DD Form 1423. This is for data only.

NSN / Pseudo NSN: 6130DTL19000F

Purchase Instrument Line Item Number: 0005

Ship to (DoDAAC / MAPAC):

Mark For: IAW DD Form 1423

Ship To (Address):

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number:

Supplemental Address:

FMS Case:

Ship To (Remarks): IAW DD Form 1423. This line is for data only

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

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

15 NOV 2018

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Page of Pages

G. PREPARED BY

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, FEB 2001

A. CONTRACT LINE ITEM NO. B. EXHIBIT

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

X

High Voltage Power Supply FD2060-19-00060

0003 Counterfeit Prevention Plan

DI-MGMT-81832 409 SCMS/GUMCA

LT

A D

See Blk 16

See Blk 16

See Blk 16 see Block 16 Program Manager 1 1

Block 7: The Government will accept the receiving report through WAWF.

Contractor shall submit the receiving report upon final submission to DODAAC FA8538, attention ronald.miller.49@us.af.mil (PM) to account for data previously submitted by letters of transmittal. Government will approve/disapprove within 30 business days of receipt.

Blocks 10-13: Date of first submission shall be within 30 days of contract award.

The Government shall provide approval/comments/corrections thirty days after receipt of document. The contractor then has thirty days to correct and resubmit the document. The Counterfeit Prevention Plan shall be updated as counterfeiting methods evolve to include new indicators as well as new prevention processes needed.

Block 14: Submit digital copy in a Microsoft Office ® compatible format.

See Block 16 for e-mail address

10-03-02

Control Number

JONES.DAVID.

N.1229899402

Digitally signed by

JONES.DAVID.N.122989

Date: 2018.10.03 11:00:54 -04'00'

DMO Signature

03 Oct 2018

1 0 Date

MILLER.RONALD.K

.1126404766

Digitally signed by

MILLER.RONALD.K.1126404766

Date: 2018.10.03 07:39:18 -04'00'

10/03/2018

RINGLEY.JONATH

AN.R.1264500881

Digitally signed by

RINGLEY.JONATHAN.R.126450088

Date: 2018.10.03 12:58:45 -04'00'

3 Oct 2018

1 6

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

16. REMARKS (Continued)

C. CATEGORY:

TDP ________ TM _______ OTHER

DD FORM 1423-1, FEB 2001 Page of Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

X

High Voltage Power Supply FD2060-19-00060

2 6

Page of Pages

G. PREPARED BY

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

16. REMARKS

C. CATEGORY:

TDP ________ TM _______ OTHER

Form Approved OMB No. 0704-0188

15. TOTAL

PREVIOUS EDITION MAY BE USED.DD FORM 1423-1, FEB 2001

A. CONTRACT LINE ITEM NO. B. EXHIBIT

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

1. DATA ITEM NO. 2. TITLE OF DATA ITEM 3. SUBTITLE

4. AUTHORITY (Data Acquisition Document No.) 5. CONTRACT REFERENCE 6. REQUIRING OFFICE

7. DD 250 REQ

8. APP CODE

9. DIST STATEMENT

REQUIRED

10. FREQUENCY

11. AS OF DATE

12. DATE OF FIRST SUBMISSION

13. DATE OF SUBSEQUENT

SUBMISSION

14. DISTRIBUTION

a. ADDRESSEE

b. COPIES

Draft Final

Reg Repro

17. PRICE GROUP

18. ESTIMATED

TOTAL PRICE

H. DATE J. DATEI. APPROVED BY

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports (0701-0188), 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 22202-4302. Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please DO NOT RETURN your form to the above address. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

X

High Voltage Power Supply FD2060-19-00060

0004 Item Unique Identification (IUID) Marking Activity Report

DI-MGMT-81804A 409 SCMS/GUMCA

LT

A D

See Blk 16

See Blk 16

See Blk 16 see Block 16 Program Manager 1 1

Block 7: The Government will accept the receiving report through WAWF.

Contractor shall submit the receiving report upon final submission to DODAAC FA8538, attention ronald.miller.49@us.af.mil (PM) to account for data previously submitted by letters of transmittal. Government will approved/disapprove within 30 business days of receipt.

Blocks 8, 10-13: Date of first submission shall be 90 days ARO. Subsequent deliveries shall be quarterly thereafter by the 10th business day. The Government shall provide approval/comments/corrections 30 business days after receipt of document. The contractor then has 30 business days to correct and resubmit the document.

Block 14: Submit digital copy in a Microsoft Office ® compatible format.

See Block 16 for e-mail address

Control Number

JONES.DAVID.

N.1229899402

Digitally signed by

JONES.DAVID.N.122989

Date: 2018.10.17 14:15:26 -04'00'

DMO Signature

17 Oct 2018

1 0 Date

MILLER.RONALD.K

.1126404766

Digitally signed by

MILLER.RONALD.K.1126404766

Date: 2018.10.03 08:22:52 -04'00'

10/03/2018

RINGLEY.JONATH

AN.R.1264500881

Digitally signed by

RINGLEY.JONATHAN.R.126450088

Date: 2018.10.18 09:11:34 -04'00'

10/18/2018

3 6

CONTRACT DATA REQUIREMENTS LIST

(1 Data Item)

16. REMARKS (Continued)

C. CATEGORY:

TDP ________ TM _______ OTHER

DD FORM 1423-1, FEB 2001 Page of Pages

A. CONTRACT LINE ITEM NO. B. EXHIBIT

D. SYSTEM/ITEM E. CONTRACT/PR NO. F. CONTRACTOR

X

High Voltage Power Supply FD2060-19-00060

4 6

CONTRACT DATA REQUIREMENTS LIST Form Approved CMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 220 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to Department of Defense, Washington Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington, VA 222202-2302, and to the Office of Management and Budget, Paperwork Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either of these addresses. Send completed form to the Government Issuing Contracting Officer for the Contract. PR No. listed in Block E.

A. Contract Line Item No.

B. Exhibit A

C. Category

OTHER - TEST PLANS AND TEST REPORTS

D. System/Item E. Contract/PR NO. F. Contractor

1. Data Item No.

2. Title of Data Item:

First Article Qualification Test Plan and Procedures

3. Subtitle:

4. Authority (Data Acquisition Document No.)

DI-NDTI-81307A

5. Contract Reference 6. Requiring Office

409 SCMS/GUEA

7. DD 250 Req

DD

9. Dist Statement Required 10. Frequency

ONE / R

12. Date of First Submission

SEE BLK 16

14. Distribution

8. APP Code A

F 11. As of Date

SEE BLK 16

13. Date of Subsequent Submission

SEE BLK 16

a. Addressee b. Copies

Draft Final

Reg Repro

16. REMARKS SEE BLK 16 1 1 0

BLK 2. FIRST ARTICLE TEST PLAN MUST DESCRIBE WHAT REQUIREMENTS ARE TO BE TESTED

AND HOW THE TESTS ARE TO BE PERFORMED. FIRST ARTICLE TESTS MUST CONFORM TO

REQUIREMENTS IDENTIFIED IN THE ASSOCIATED AFMC FORM 260. THE TEST PLAN MUST INCLUDE

A LIST OF THE TEST EQUIPMENT USED DURING TESTING.

BLK 4. CONTRACTOR FORMAT IS ACCEPTABLE.

BLK 9. DISTRIBUTION CODE F: FURTHER DISSEMINATION ONLY AS DIRECTED BY 409 SCMS/GUEA

OR HIGHER DOD AUTHORITY.

BLK 8, 11 – 13. FIRST SUBMISSION IS DUE 60 CALENDAR DAYS AFTER CONTRACT AWARD.

409 SCMS/GUEA APPROVAL WITHIN 45 CALENDAR DAYS AFTER RECEIPT. RESUBMITTAL WITH

REVISIONS WITHIN 30 CALENDAR DAYS OF ORIGINAL SUBMISSION.

BLK 14.SUBMIT FIRST ARTICLE TEST PLAN TO 409 SCMS/GUEA (ATTENTION F-15 FIRST ARTICLE MANAGER), 235 BYRON STREET, SUITE19A, ROBINS AFB, GA., 31098-1670. ALTERNATELY, THE

TEST PLAN MAY BE EMAILED TO: 782CBSG.F15.FAT@US.AF.MIL

15. TOTAL 1 1 0

1. Data Item No.

A002

2. Title of Data Item:

TEST / INSPECTION REPORT

3. Subtitle:

4. Authority (Data Acquisition Document No.)

DI-NDTI-80809B

5. Contract Reference 6. Requiring Office

409 SCMS/GUEA

7. DD 250 Req

DD

9. Dist Statement Required 10. Frequency

ONE / R

12. Date of First Submission

SEE BLK 16

14. Distribution

8. APP Code A

F 11. As of Date

SEE BLK 16

13. Date of Subsequent Submission N/A

a. Addressee b. Copies

Draft Final

Reg Repro

16. REMARKS SEE BLK 16 1 1 0

BLK 4. CONTRACTOR FORMAT IS ACCEPTABLE.

BLK 9. DISTRIBUTION CODE F; FURTHER DISSEMINATION ONLY AS DIRECTED BY 409 SCMS/GUEA

OR HIGHER DOD AUTHORITY.

BLK 8, 11 – 13. FIRST SUBMISSION IS DUE 270 CALENDAR DAYS AFTER CONTRACT AWARD OR WITH

DELIVERY OF FIRST ARTICLE(S).

BLK 14.THE VENDOR HAS THE OPTION TO SUBMIT THE FIRST ARTICLE TEST REPORT WITH THE

FIRST ARTICLE TEST SAMPLES TO THE ADDRESS IDENTIFIED ON THE ASSOCIATED AFMC FORM

260, BLK 9.F.3. ELSE SUBMIT A SEPARATE FIRST ARTICLE TEST REPORT TO 409 SCMS/GUEA (ATTENTION F-15 FIRST ARTICLE MANAGER), 235 BYRON STREET, SUITE19A, ROBINS AFB, GA., 31098-1670. ALTERNATELY, THE TEST REPORT MAY BE EMAILED TO: 782CBSG.F15.FAT@US.AF.MIL

DMO CONTROL NUMBER DMO SIGNATURE DATE

15. TOTAL 1 1 0

G. PREPARED BY H. DATE I. APPROVED BY J. DATE

DD Form 1423-2, JUN 90 Previous editions are obsolete Page 5 of 6 Pages

F-15C/D/ AVQ-20 Head Up Display/ B54E0034-2 High Voltage Power Supply

09-06-76

20180906 06 Sep 2018

06 Sept 2018JONES.DAVID.N.12298 99402

Digitally signed by

JONES.DAVID.N.1229899402

Date: 2018.09.06 10:13:00 -04'00'

CHEATHAM.ANTHO

NY.M.1104871018

Digitally signed by

CHEATHAM.ANTHONY.M.1104871018

Date: 2018.09.06 10:02:23 -04'00'

SEALY.TRACEE

.A.1229963011

Digitally signed by

SEALY.TRACEE.A.1229963011

Date: 2018.09.06 10:43:32 -04'00'

DD FORM 1423-1 (BACK), FEB 2001

Item 17. Specify appropriate price group from one of the following groups of effort in developing estimated prices for each data item listed on the DD Form 1423.

a. Group I. Definition - Data which is not otherwise essential to the contractor's performance of the primary contracted effort (production, development, testing, and administration) but which is required by DD Form 1423.

Estimated Price - Costs to be included under Group I are those applicable to preparing and assembling the data item in conformance with Government requirements, and the administration and other expenses related to reproducing and delivering such data items to the Government.

b. Group II. Definition - Data which is essential to the performance of the primary contracted effort but the contractor is required to perform additional work to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, or quality of the data item.

Estimated Price - Costs to be included under Group II are those incurred over and above the cost of the essential data item without conforming to Government requirements, and the administrative and other expenses related to reproducing and delivering such data item to the Government.

c. Group III. Definition - Data which the contractor must develop for his internal use in performance of the primary contracted effort and does not require any substantial change to conform to Government requirements with regard to depth of content, format, frequency of submittal, preparation, control, and quality of the data item.

Estimated Price - Costs to be included under Group III are the administrative and other expenses related to reproducing and delivering such data item to the Government.

d. Group IV. Definition - Data which is developed by the contractor as part of his normal operating procedures and his effort in supplying these data to the Government is minimal.

Estimated Price - Group IV items should normally be shown on the DD Form 1423 at no cost.

Item 18. For each data item, enter an amount equal to that portion of the total price which is estimated to be attributable to the production or development for the Government of that item of data. These estimated data prices shall be developed only from those costs which will be incurred as a direct result of the requirement to supply the data, over and above those costs which would otherwise be incurred in performance of the contract if no data were required. The estimated data prices shall not include any amount for rights in data. The Government's right to use the data shall be governed by the pertinent provisions of the contract.

INSTRUCTIONS FOR COMPLETING DD FORM 1423

(See DoD 5010.12-M for detailed instructions.)

Item A. Self-explanatory.

Item B. Self-explanatory.

Item C. Mark (X) appropriate category: TDP - Technical Data Package;

TM - Technical Manual; Other - other category of data, such as "Provisioning,""Configuration Management," etc.

Item D. Enter name of system/item being acquired that data will support.

Item E. Self-explanatory (to be filled in after contract award).

Item F. Self-explanatory (to be filled in after contract award).

Item G. Signature of preparer of CDRL.

Item H. Date CDRL was prepared.

Item I. Signature of CDRL approval authority.

Item J. Date CDRL was approved.

Item 1. See DoD FAR Supplement Subpart 4.71 for proper numbering.

Item 2. Enter title as it appears on data acquisition document cited in Item 4.

Item 3. Enter subtitle of data item for further definition of data item (optional entry).

Item 4. Enter Data Item Description (DID) number, military specification number, or military standard number listed in DoD 5010.12-L (AMSDL), or one-time DID number, that defines data content and format requirements.

Item 5. Enter reference to tasking in contract that generates requirement for the data item (e.g., Statement of Work paragraph number).

Item 6. Enter technical office responsible for ensuring adequacy of the data item.

Item 7. Specify requirement for inspection/acceptance of the data item by the Government.

Item 8. Specify requirement for approval of a draft before preparation of the final data item.

Item 9. For technical data, specify requirement for contractor to mark the appropriate distribution statement on the data (ref. DoDD 5230.24).

Item 10. Specify number of times data items are to be delivered.

Item 11. Specify as-of date of data item, when applicable.

Item 12. Specify when first submittal is required.

Item 13. Specify when subsequent submittals are required, when applicable.

Item 14. Enter addressees and number of draft/final copies to be delivered to each addressee. Explain reproducible copies in Item 16.

Item 15. Enter total number of draft/final copies to be delivered.

Item 16. Use for additional/clarifying information for Items 1 through 15.

Examples are: Tailoring of documents cited in Item 4; Clarification of submittal dates in Items 12 and 13; Explanation of reproducible copies in Item 14.; Desired medium for delivery of the data item.

FOR THE CONTRACTOR

FOR GOVERNMENT PERSONNEL