ATTACHMENTS_1thru8.pdf

ITEM DESCRIPTION

NSN

4820012919229GC

CAGE

73760

REFERENCE NUMBER

AV16B2067D-1

NOUN

VALVE,GATE

END ITEM TCTO NUMBER TO NUMBER

1H-60(H)G-4-3

CRITICALITY CODE

Y

DEMILITARIZATION CODE

B

SECURITY CODE

U

MDC

8H3

ES CODE

XD

REMARKS

Mosley, Bobby CNAME: 14 OCT 2011DATE:

FUEL SHUTOFF VALVE, ALLOWS FUEL FLOW IN EITHER DIRECTION DURING NORMAL OPERATION OR DURING REFUELING/DEFUELING OF FUEL TANKS OR HELICOPTER. VALVE CAN BE OPENED/CLOSED ELECTRICALLY

OR MANUALLY.

INITIATOR

NAME

JERRY.BROOKS2

ORGANIZATION / OFFICE SYMBOL

411 SCMS / GUEA

DSN PHONE

497-6953

COMMERCIAL PHONE

478-327-6953

ITEM DESCRIPTION DATA

LENGTH ( IN )

4.6400

WIDTH ( IN )

3.1500

HEIGHT ( IN )

5.2500

WEIGHT ( LB )

2.0000

OTHER DIMENSIONS

ITEM MATERIAL

STEEL AND TEFLON INSERT(SLEEVE) - NO CRITICAL CHARACTERISTICS

ITEM FUNCTION

FUEL SHUTOFF VALVE, ALLOWS FREE FLOW OR STOPPAGE OF FUEL DURING TRANSFER OR NORMAL OPERATION.

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

Page 1 of 1ITEM DESCRIPTION Version 1Generated by PRPS using Jasper Reports on 24 Jan 2019

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

4820012919230GC

VERSION NUMBER

NOUN

VALVE,GATE

INITIATOR

Jones, Joseph L

ORGANIZATION CODE / OFFICE SYMBOL

WR-ALC / GRUEC

COMMERCIAL PHONE

478-926-7500

DSN PHONE

468-7500

CAGE / REFERENCE NUMBER

73760 / AV16B2059D-1

78286 / 65307-03067-104

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

Lamb, Steven HNAME: 17 AUG 2012DATE:

Contrator shall mark the part per OEM technical data.

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: 4820012919230GC

MARKING GUIDANCE ENGINEERING DRAWING / ECP / ECO NUMBER

MARKING TYPE MARKING METHOD

DESCRIPTION / LOCATION

REMARKS

ATTACHMENT(S)

Page 1 of 1IUID Version 1Generated by PRPS using Jasper Reports on 24 Jan 2019

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

ITEM REQUIRING IUID MARKING

NSN

4820012919229GC

VERSION NUMBER

NOUN

VALVE,GATE

INITIATOR

Jones, Joseph L

ORGANIZATION CODE / OFFICE SYMBOL

WR-ALC / GRUEC

COMMERCIAL PHONE

478-926-7500

DSN PHONE

468-7500

CAGE / REFERENCE NUMBER

73760 / AV16B2067D-1

78286 / 65307-03065-104

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

Mayfield, Alex HNAME: 22 DEC 2011DATE:

Contractor determined marking IAW MIL-STD-130 is acceptable.

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: 4820012919229GC

MARKING GUIDANCE ENGINEERING DRAWING / ECP / ECO NUMBER

MARKING TYPE MARKING METHOD

DESCRIPTION / LOCATION

REMARKS

Page 1 of 1IUID Version 1Generated by PRPS using Jasper Reports on 24 Jan 2019

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

ITEM REQUIRING IUID MARKING

NSN

4820012919230GC

VERSION NUMBER

NOUN

VALVE,GATE

INITIATOR

Giddens, Coby F

ORGANIZATION CODE / OFFICE SYMBOL

AFLCMC / WIUE

COMMERCIAL PHONE

478-926-7255

DSN PHONE

468-7255

CAGE / REFERENCE NUMBER

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

Giddens, Coby FNAME: 05 NOV 2018DATE:

Marking shall be performed in accordance with the latest version of MIL-STD-130.

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: 4820012919230GC

MARKING GUIDANCE ENGINEERING DRAWING / ECP / ECO NUMBER

MARKING TYPE MARKING METHOD

DESCRIPTION / LOCATION

REMARKS

Page 1 of 1IUID Version 3Generated by PRPS using Jasper Reports on 24 Jan 2019

ENGINEERING DATA LIST

DATE:

23 OCT 2018

REVISION: 9 *HISTORY*

CAGE:

78286

PAGE:

NSN:

4820012919229GC

DATA TECH:

Connell, Wesley A

END ITEM:

H-60 HELICOPTER

ORGANIZATION/OFFICE SYMBOL:

429 SCMS GUMACB/

MANUFACTURER NAME:

SIKORSKY AIRCRAFT CORPORATION

REFERENCE NUMBER:

65307-03065-104

NOUN:

VALVE,GATE

LINE/

SUB CAGE

ENG DRAWING NUM/ ACCOMP

DOC NUM REV

NR

SHEETS

FURN

CODE

DIST

CODE NOUN REMARKS

L 78286 65307-03065 R S C VALVE SHUT OFF FUEL

SYSTEM FUSELAGE

Connell, Wesley A 23 OCT 2018

-104 CONFIGURATION.

SPECIFICATION CONTROL DRAWING.

NAME: DATE:

L 78286 65307-03064 (PL) E S D VALVE SHUT OFF FUEL

SYSTEM FUSELAGE

Connell, Wesley A 23 OCT 2018

PARTS LIST.

NAME: DATE:

L 78286 SS5100 AW S D HOLE SIZES

L 78286 SS9300 AR S D TORQUE, WRENCH AND

TIGHTENING

L 78286 SS9210 (NOT REQ) Connell, Wesley A 23 OCT 2018

INACTIVE- USE SS9209.

NAME: DATE:

L 78286 SS8798 U S D IDENTIFICATION MARKING OF

PART, METHODS FOR

L 78286 SS9999 (NOT REQ) Connell, Wesley A 23 OCT 2018

NOT REQUIRED.

NAME: DATE:

L 78286 SS9209 (NOT REQ) Connell, Wesley A 23 OCT 2018

INACTIVE - USE ASME Y14.5

C/O: SS9210.

NAME: DATE:

L 0U583 ASME Y14.5 O A DIMENSIONING AND

TOLERANCING

Connell, Wesley A 23 OCT 2018

USE IN LIEU OF SS9209.

NAME: DATE:

L 78286 SS9208 BR S D PRODUCT DEFINITION DESIGN

CRITERIA

Connell, Wesley A 23 OCT 2018

C/O: 65307-03065(PL).

NAME: DATE:

L 78286 SS8535 S C CORROSION PREVENTION

DURING MANUFACTURING,

STORAGE

L 78286 SS5202 S D ALUMINUM AND ALUMINUM

ALLOY SHEET, THICKNESS

TOLER

L 78286 SS5204 B S D THICKNESS TOLERANCES

STEEL, TITANIUM AND

MAGNESIUM

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:

Page 1 of 2EDL Version 9Generated by PRPS using Jasper Reports on 20 Nov 2018

23 OCT 2018

REVISION: 9 *HISTORY*

CAGE:

78286

PAGE:

NSN:

4820012919229GC

DATA TECH:

Connell, Wesley A

END ITEM:

H-60 HELICOPTER

ORGANIZATION/OFFICE SYMBOL:

429 SCMS GUMACB/

MANUFACTURER NAME:

SIKORSKY AIRCRAFT CORPORATION

REFERENCE NUMBER:

65307-03065-104

NOUN:

VALVE,GATE

LINE/

SUB CAGE

ENG DRAWING NUM/ ACCOMP

DOC NUM REV

NR

SHEETS

FURN

CODE

DIST

CODE NOUN REMARKS

L 98752 200415485 C S A GENERAL ENGINEERING

NOTES, ENGINEERING

Connell, Wesley A 23 OCT 2018

APPLICABLE NOTES ARE 1,3,4 & 12.

NAME: DATE:

STANDARD ENGINEERING TEXT

Connell, Wesley A 23 OCT 2018

For General Engineering Notes, see document number 200415485.

Spares Configuration: Per Drawing.

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.

Page 2 of 2EDL Version 9Generated by PRPS using Jasper Reports on 20 Nov 2018

23 OCT 2018

REVISION: 3 *HISTORY*

CAGE:

78286

PAGE:

NSN:

4820012919230GC

DATA TECH:

Connell, Wesley A

END ITEM:

H-60 HELICOPTER

ORGANIZATION/OFFICE SYMBOL:

429 SCMS GUMACB/

MANUFACTURER NAME:

SIKORSKY AIRCRAFT CORPORATION

REFERENCE NUMBER:

65307-03067-104

NOUN:

VALVE,GATE

LINE/

SUB CAGE

ENG DRAWING NUM/ ACCOMP

DOC NUM REV

NR

SHEETS

FURN

CODE

DIST

CODE NOUN REMARKS

L 78286 65307-03067 P S C VALVE SHUT-OFF FUEL

SYSTEM FUSELAGE

Connell, Wesley A 23 OCT 2018

-104 CONFIGURATION.

SPECIFICATION CONTROL DRAWING.

NAME: DATE:

L 78286 65307-03067 (PL) E S C VALVE SHUT-OFF FUEL

SYSTEM FUSELAGE

Connell, Wesley A 23 OCT 2018

PARTS LIST.

NAME: DATE:

L 78286 SS5100 AW S D HOLE SIZES

L 78286 SS9300 AR S D TORQUE, WRENCH AND

TIGHTENING

L 78286 SS9210 (NOT REQ) Connell, Wesley A 23 OCT 2018

INACTIVE- USE SS9209.

NAME: DATE:

L 78286 SS8798 U S D IDENTIFICATION MARKING OF

PART, METHODS FOR

L 78286 SS9999 (NOT REQ) Connell, Wesley A 23 OCT 2018

NOT REQUIRED.

NAME: DATE:

L 78286 SS9209 (NOT REQ) Connell, Wesley A 23 OCT 2018

INACTIVE - USE ASME Y14.5

C/O: SS9210.

NAME: DATE:

L 0U583 ASME Y14.5 O A DIMENSIONING AND

TOLERANCING

Connell, Wesley A 23 OCT 2018

USE IN LIEU OF SS9209.

NAME: DATE:

L 78286 SS9208 BR S D PRODUCT DEFINITION DESIGN

CRITERIA

Connell, Wesley A 23 OCT 2018

C/O: 65307-03065(PL).

NAME: DATE:

L 78286 SS8535 S C CORROSION PREVENTION

DURING MANUFACTURING,

STORAGE

L 78286 SS5202 S D ALUMINUM AND ALUMINUM

ALLOY SHEET, THICKNESS

TOLER

L 78286 SS5204 B S D THICKNESS TOLERANCES

STEEL, TITANIUM AND

MAGNESIUM

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.

Page 1 of 2EDL Version 3Generated by PRPS using Jasper Reports on 20 Nov 2018

23 OCT 2018

REVISION: 3 *HISTORY*

CAGE:

78286

PAGE:

NSN:

4820012919230GC

DATA TECH:

Connell, Wesley A

END ITEM:

H-60 HELICOPTER

ORGANIZATION/OFFICE SYMBOL:

429 SCMS GUMACB/

MANUFACTURER NAME:

SIKORSKY AIRCRAFT CORPORATION

REFERENCE NUMBER:

65307-03067-104

NOUN:

VALVE,GATE

LINE/

SUB CAGE

ENG DRAWING NUM/ ACCOMP

DOC NUM REV

NR

SHEETS

FURN

CODE

DIST

CODE NOUN REMARKS

L 98752 200415485 C S A GENERAL ENGINEERING

NOTES, ENGINEERING

Connell, Wesley A 23 OCT 2018

APPLICABLE NOTES ARE 1,3,4 & 12.

NAME: DATE:

STANDARD ENGINEERING TEXT

Connell, Wesley A 23 OCT 2018

For General Engineering Notes, see document number 200415485.

Spares Configuration: Per Drawing.

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.

Page 2 of 2EDL Version 3Generated by PRPS using Jasper Reports on 20 Nov 2018

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

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, Executive Services Directorate (0704-0188).

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 organization. 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 C. CATEGORY

TDP X TM OTHER

D. SYSTEM / ITEM

4820012919229GC/4820012919230GC

E. CONTRACT / PR NO.

FD20601900124

F. CONTRACTOR

1. DATA ITEM NO.

A001

2. TITLE OF DATA ITEM

First Article Qualification Test Plan and Procedures

3. SUBTITLE

4820-01-291-9229GC

4. AUTHORITY

DI-NDTI-80809B

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

FD20601900124

6. REQUIRING OFFICE

WIU

7. DD 250 REQ

N/A

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

ONE/P

11. AS OF DATE

2018212

12. DATE OF FIRST

SUBMISSION

2018212

13. DATE OF SUBSEQUENT

SUBMISSION

N/A

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

COORDINATORS:

Attn: Traci Polk DLA Central Receiving/DDWG-ER Special Handling: FA UNIT-

DO NOT POST

455 Byron St, Bldg 376 Robins AFB, GA 31098-1887

1 1 1

1 1 115. TOTAL

G. PREPARED BY

Bryant, Juan L

411 SCMS / GUBAA

478-327-9381

H. DATE

16 NOV 2018

I. APPROVED BY

//DIGITALLY SIGNED//

BASS.STEVIE.RIDDLE.1384905206

411 SCMS / GULAB 478-926-2227 / 468-2227

J. DATE

16 NOV 2018

Page 1 of 2DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 20 Nov 2018

PREVIOUS EDITION MAY BE USED.

CONTRACT DATA REQUIREMENTS LIST Form Approved OMB No. 0704-0188(1 Data Item)

A. CONTRACT LINE ITEM NO. B. EXHIBIT C. CATEGORY

TDP X TM OTHER

D. SYSTEM / ITEM

4820012919229GC/4820012919230GC

E. CONTRACT / PR NO.

FD20601900124

F. CONTRACTOR

1. DATA ITEM NO.

A002

2. TITLE OF DATA ITEM

First Article Qualification Test Plan and Procedures

3. SUBTITLE

4820-01-291-9230

4. AUTHORITY

DI-NDTI-80809B

(Data Acquisition Document No.) 5. CONTRACT REFERENCE

FD20601900124

6. REQUIRING OFFICE

WIU

7. DD 250 REQ

N/A

8. APP CODE

A

9. DIST STATEMENT

REQUIRED

N/A

10. FREQUENCY

ONE/P

11. AS OF DATE

2018212

12. DATE OF FIRST

SUBMISSION

2018212

13. DATE OF SUBSEQUENT

SUBMISSION

N/A

a. ADDRESSEE

Draft Final

ReproReg

b. COPIES

14. DISTRIBUTION

16. REMARKS

COORDINATORS:

Attn: Traci Polk DLA Central Receiving/DDWG-ER Special Handling: FA UNIT-

DO NOT POST

455 Byron St, Bldg 376 Robins AFB, GA 31098-1887

1 1 1

1 1 115. TOTAL

G. PREPARED BY

Bryant, Juan L

411 SCMS / GUBAA

478-327-9381

H. DATE

16 NOV 2018

I. APPROVED BY

//DIGITALLY SIGNED//

BASS.STEVIE.RIDDLE.1384905206

411 SCMS / GULAB 478-926-2227 / 468-2227

J. DATE

16 NOV 2018

Page 2 of 2DD FORM 1423-1, FEB 2001 Version 1Generated by PRPS using Jasper Reports on 20 Nov 2018

PREVIOUS EDITION MAY BE USED.

FIRST ARTICLE REQUIREMENTS 1. DATE

12 JUL 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

78286 / 65307-03065-104

4. NSN

4820012919229GC

5. FIRST ARTICLE QUANTITY

THE FIRST ARTICLE IS 1 UNIT(S) OF LOT / ITEM 1

AND WILL BE: PART OF PRODUCTION QUANTITY X 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

MATERIAL, DIMENSIONAL AND FINISH SPECIFICATIONS

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

Drawing 65307-03065-104 Cage 78286

(Cite Spec and Para number)

C. TEST PLAN REQUIRED

Number of days for government approval / disapproval days.

D. Contractor's notification to ACO and

TRACI.POLK@US.AF.MIL

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

E. X TEST REPORT REQUIRED

(1) Forwarded to

SEE REMARKS NOTE 1

(2) Government written notice of approval / disapproval due 30 days after receipt of contractor's report.

F. FIRST ARTICLE DELIVERY

(1) Due within calendar days from date contract.

(2) Notify calendar days prior to shipment.

(3) Delivered to government at

(Set Forth Consignee and Address)

(4) Government written notice of approval / disapproval within 30 days after receipt of first article package.

G. Estimated cost of government testing / inspection evaluation.

$1,730.0000

Page 1 of 2AFMC IMT 260, 20020830, V-3 Version 7Generated by PRPS using Jasper Reports on 24 Jan 2019

12 JUL 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

Approved First Articles will be forwarded to

X 1 (insert quantity) First Articles will be expended in testing. Residual components of disapproved First Articles

X will be returned to the contractor will be retained by pending disposition instructions from the contractor.

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

X will be returned to the contractor will be retained by 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.

Other Disposition:

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 Government, X DoD, Air Force.

b. X Offerors currently in production of the same or similar article for a Government, X 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 Government, X 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

Solomon, Ricky ANAME: 27 JUL 2018DATE:

Note 1: Ship First Article Test Report to:

Attn: Traci Polk DLA Central Receiving/DDWG-ER Special Handling: FA UNIT-DO NOT POST 455 Byron St, Bldg 376 Robins AFB, GA 31098-1887 Note 2: First article test report should include:

1. Certifications for all purchased hardware/material.

2. Dimensional check worksheet.

3. A copy of the latest calibration certifications for all measuring instruments used to perform the dimensional checks.

4. Certifications for any work not performed by the contractor, if applicable.

5. Job travelers. Job travelers should include process from s art to finish, even if the first article is requested without coatings.

6. Results of all testing requirements indicated on drawing.

Note 3: Waiver conditions apply only to production of same, and not similar, article.

13. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR APPROVING TEST

(Name, Organization, Phone)

Solomon, Ricky A.

AFLCMC/WIUEC

478-327-6965

497-6965

14. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR CONDUCTING

TEST (Name, Organization, Phone)

Page 2 of 2AFMC IMT 260, 20020830, V-3 Version 7Generated by PRPS using Jasper Reports on 24 Jan 2019

12 JUL 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

78286 / 65307-03067-104

4. NSN

4820012919230GC

5. FIRST ARTICLE QUANTITY

THE FIRST ARTICLE IS 1 UNIT(S) OF LOT / ITEM 1

AND WILL BE: PART OF PRODUCTION QUANTITY X 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

MATERIAL, DIMENSIONAL AND FINISH SPECIFICATIONS

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

Drawing 65307-03067 Cage 78286

(Cite Spec and Para number)

C. TEST PLAN REQUIRED

Number of days for government approval / disapproval days.

D. Contractor's notification to ACO and

TRACI.POLK@US.AF.MIL

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

E. X TEST REPORT REQUIRED

(1) Forwarded to

SEE REMARKS 1

(2) Government written notice of approval / disapproval due 30 days after receipt of contractor's report.

F. FIRST ARTICLE DELIVERY

(1) Due within calendar days from date contract.

(2) Notify calendar days prior to shipment.

(3) Delivered to government at

(Set Forth Consignee and Address)

(4) Government written notice of approval / disapproval within 30 days after receipt of first article package.

G. Estimated cost of government testing / inspection evaluation.

$1,730.0000

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12 JUL 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

Approved First Articles will be forwarded to

X 1 (insert quantity) First Articles will be expended in testing. Residual components of disapproved First Articles

X will be returned to the contractor will be retained by pending disposition instructions from the contractor.

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

X will be returned to the contractor will be retained by 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.

Other Disposition:

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 Government, X DoD, Air Force.

b. X Offerors currently in production of the same or similar article for a Government, X 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 Government, X 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

Solomon, Ricky ANAME: 27 JUL 2018DATE:

Note 1: Ship First Article Test Report to:

Attn: Traci Polk DLA Central Receiving/DDWG-ER Special Handling: FA UNIT-DO NOT POST 455 Byron St, Bldg 376 Robins AFB, GA 31098-1887 Note 2: First article test report should include:

1. Certifications for all purchased hardware/material.

2. Dimensional check worksheet.

3. A copy of the latest calibration certifications for all measuring instruments used to perform the dimensional checks.

4. Certifications for any work not performed by the contractor, if applicable.

5. Job travelers. Job travelers should include process from s art to finish, even if the first article is requested without coatings.

6. Results of all testing requirements indicated on drawing.

Note 3: Waiver conditions apply only to production of same, and not similar, article.

13. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR APPROVING TEST

(Name, Organization, Phone)

Solomon, Ricky A

AFLCMC/WIUEC

478-327-6965

497-6965

14. COGNIZANT ENG ORGANIZATION RESPONSIBLE FOR CONDUCTING

TEST (Name, Organization, Phone)

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RECOMMENDED QUALITY ASSURANCE PROVISIONS

AND SPECIAL INSPECTION REQUIREMENTS

1. PR / MIPR NUMBER

2. NATIONAL STOCK NUMBER

4820012919229GC

3. POINT OF INSPECTION

SOURCE DESTINATION

X

SEE DFARS 246.402

4. POINT OF ACCEPTANCE

SOURCE DESTINATION

X

5. ITEM MANAGER / PHONE

Peacock, Andrew A / 478-222-4981

6. EQUIPMENT SPEC / PHONE

Hartley, Kevin / 478-327-3895

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

HIGHER LEVEL CONTRACT QUALITY REQUIREMENTS

COMMERCIAL ITEM INSPECTION

FAR 52.212-4

X OTHER (Describe in Block 8)

8. REMARKS

Solomon, Ricky ANAME: 06 AUG 2018DATE:

Higher Level Contract Quality Requirements ISO 9001:2008

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

I

11. SIGNATURE OF TECHNICAL AUTHORITY

Solomon, Ricky A

ORGANIZATION / SYMBOL

AFLCMC / WIU

PHONE

478-327-6965 / 497-6965

DATE

06 AUG 2018

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RECOMMENDED QUALITY ASSURANCE PROVISIONS

AND SPECIAL INSPECTION REQUIREMENTS

1. PR / MIPR NUMBER

2. NATIONAL STOCK NUMBER

4820012919230GC

3. POINT OF INSPECTION

SOURCE DESTINATION

X

SEE DFARS 246.402

4. POINT OF ACCEPTANCE

SOURCE DESTINATION

X

5. ITEM MANAGER / PHONE

McAllister, Lisha A / 478-222-0524

6. EQUIPMENT SPEC / PHONE

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

HIGHER LEVEL CONTRACT QUALITY REQUIREMENTS

X 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

PREVIOUS SOURCEX NO

AFMC PARTICIPATION

RECOMMENDED

10. CODES

A. I&A

B. CQR

H

11. SIGNATURE OF TECHNICAL AUTHORITY

Mayfield, Alex H

ORGANIZATION / SYMBOL

580 ACSG / GFEAC

PHONE

478-327-6973 / 497-6973

DATE

21 DEC 2010

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PACKAGING REQUIREMENTS

PURCHASE INSTRUMENT NUMBER: FD20601900124-00 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 No Packaging Data Required

ITEM(S):

4820DTL18054CGC

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

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

SUPPLEMENTAL PACKAGING INSTRUCTION TEXT:

VENDOR PACKAGING INSTRUCTIONS:

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

AAB No Packaging Data Required

ITEM(S):

4820DTL18054EGC

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

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

SUPPLEMENTAL PACKAGING INSTRUCTION TEXT:

VENDOR PACKAGING INSTRUCTIONS:

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PACKAGING REQUIREMENTS

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

AAC MIL Long Line Packaging MIL B

ITEM(S):

4820012919229GC 4820012919230GC

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 41 1 00 EA NA A NR 00 B ZZ 6.30 12.5 12.5 14.5 1.311 M

ADDITIONAL PACKAGING AND CONTAINER MARKING REQUIREMENTS:

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:

Corbin, Cedric M

PHONE NUMBER:

478-327-6323 / 497-6323

SIGNATURE:

//SIGNED//Corbin, Cedric M

DATE:

18296 - 23 OCT 2018

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TRANSPORTATION DATA FOR SOLICITATIONS

COMMODITY: See Continuation

PURCHASE INSTRUMENT NUMBER:

FD20601900124-01

DATE INITIATED:

22 JAN 2019

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 F.O.B. Destination 52.247-34 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

IAW Basic Contract FD20601900124-01

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 97X4930.FC04 649 47GR 15U60V 01N000 00000 000000 503000 F03000 ESP: 7C FSR: 013408 PSR: K19324

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: 4820012919229GC

Purchase Instrument Line Item Number: 0001

Ship to (DoDAAC / MAPAC): SW3119

Mark For: Attention: Traci Polk

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): DO NOT POST TO SUPPLY Early Delivery acceptable at no additional cost to government.

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NSN / Pseudo NSN: 4820012919230GC

Purchase Instrument Line Item Number: 0002

Ship to (DoDAAC / MAPAC): SW3119

Mark For: Attention: Traci Polk

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): DO NOT POST TO SUPPLY Early Delivery acceptable at no additional cost to government.

NSN / Pseudo NSN: 4820012919229GC

Purchase Instrument Line Item Number: 0003

Ship to (DoDAAC / MAPAC): SW3119

Mark For: Attention: Traci Polk

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): DO NOT POST TO SUPPLY Early Delivery acceptable at no additional cost to government.

NSN / Pseudo NSN: 4820012919230GC

Purchase Instrument Line Item Number: 0004

Ship to (DoDAAC / MAPAC): SW3119

Mark For: Attention: Traci Polk

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): DO NOT POST TO SUPPLY Early Delivery acceptable at no additional cost to government.

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

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OTHER TRANSPORTATION DATA:

TACRN:

AAB

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 97X4930.FC04 649 47GR 15U60V 01N000 00000 000000 503000 F03000 ESP: 7C FSR: 013408 PSR: K19324

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA:

Additional Funding Information:

FOB Destination/Zero Dollar

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 4820DTL18054CGC

Purchase Instrument Line Item Number: 0005

Ship to (DoDAAC / MAPAC): FA8524

Mark For:

Ship To (Address): FA8524 AFSC PZAAA

235 BYRON ST BLDG 300 STE 19A

ROBINS AFB GA 31098-1670

31098 - 1670

USA

WPOD:

APOD:

BBP / CCP:

RIC: 0

Requisition Number:

Supplemental Address:

FMS Case:

CP 478 327 3661

Ship To (Remarks): Email data directly to Traci Polk at traci.polk@us.af.mil

NSN / Pseudo NSN: 4820DTL18054EGC

Purchase Instrument Line Item Number: 0006

Ship to (DoDAAC / MAPAC): FA8524

Mark For:

Ship To (Address): FA8524 AFSC PZAAA

235 BYRON ST BLDG 300 STE 19A

ROBINS AFB GA 31098-1670

31098 - 1670

USA

WPOD:

APOD:

BBP / CCP:

RIC: 0

Requisition Number:

Supplemental Address:

FMS Case:

CP 478 327 3661

Ship To (Remarks): Email data directly to Traci Polk at traci.polk@us.af.mil

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

OTHER TRANSPORTATION DATA:

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NAME

Little, Phillip D

ORGANIZATION / OFFICE

SYMBOL

406 SCMS / GULAA

COMMERCIAL / DSN

PHONE

478-327-6350 / 497-6350

SIGNATURE

//SIGNED//Little, Phillip D

DATE

22 JAN 2019

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