W56HZV-21-R-0068_0004.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. Contract ID Code Page Of

2. Amendment/Modification No.

3. Effective Date

4. Requisition/Purchase Req No.

5. Project No. (If applicable)

6. Issued By Code 7. Administered By (If other than Item 6) Code

8. Name And Address Of Contractor (No., Street, City, County, State and Zip Code)

9A. Amendment Of Solicitation No.

9B. Dated (See Item 11)

10A. Modification Of Contract/Order No.

10B. Dated (See Item 13) Code Facility Code

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended, is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing items 8 and 15, and returning ____________ copies of the amendments: (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. Accounting And Appropriation Data (If required)

13. THIS ITEM ONLY APPLIES TO MODIFICATIONS OF CONTRACTS/ORDERS

It Modifies The Contract/Order No. As Described In Item 14.

A. This Change Order is Issued Pursuant To: The Changes Set Forth In Item 14 Are Made In

The Contract/Order No. In Item 10A.

B. The Above Numbered Contract/Order Is Modified To Reflect The Administrative Changes (such as changes in paying office, appropriation data, etc.) Set

Forth In Item 14, Pursuant To The Authority of FAR 43.103(b).

C. This Supplemental Agreement Is Entered Into Pursuant To Authority Of:

D. Other (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return _______________ copies to the Issuing Office.

14. Description Of Amendment/Modification (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Except as provided herein, all terms and conditions of the document referenced in item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. Name And Title Of Signer (Type or print)

16A. Name And Title Of Contracting Officer (Type or print)

15B. Contractor/Offeror 15C. Date Signed 16B. United States Of America 16C. Date Signed

By (Signature of person authorized to sign) (Signature of Contracting Officer)

NSN 7540-01-152-8070

PREVIOUS EDITIONS UNUSABLE

30-105-02 STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

SEE SCHEDULE

X

Firm Fixed Price

0004 2021MAR04

W56HZV

ACC-DTA

6501 E. 11 MILE RD.

DETROIT ARSENAL, MI 48397-5000

KATHY KESSLER

EMAIL: KATHY.A.KESSLER.CIV@MAIL.MIL

W56HZV-21-R-0068

2021MAR02

X

X

/SIGNED/

2 signed

SEE SECOND PAGE FOR DESCRIPTION

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CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION A - SUPPLEMENTAL INFORMATION

Buyer Name: KATHY KESSLER

Buyer Office Symbol/Telephone Number: CCTA-APS-A/(586)282-7228

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

Amendment 0004

Amendment 0004 on solicitation W56HZV21R0068 is to do the following:

1. Correct Section E.4 FIRST ARTICLE TEST. First article packaging sample quantity is being changed from 30 unit pack containers to 3 unit pack containers. This is marked with *.

2. Add CDRLS A001 - A005 in Section B, Supplies and Services and add CDLS in Section J, List of Attachments, Exhibit A, CDRLS.

*** END OF NARRATIVE A0004 ***

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W56HZV-21-R-0068

PIIN/SIIN

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

1001 CONTRACT DATA REQUIREMENTS LIST (CDRL) ______________________________________

EXHIBIT A - All CDRLS are found in Section J, List of

Attachments

(End of narrative A001)

A001 A001 - ENGINEERING CHANGE PROPOSAL (ECP) 1 LO $ ** NSP ** ________________________________________ __________________

SERVICE REQUESTED: ECP

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 AS REQUIRED

A002 A002 - REQUEST FOR VARIANCE (RFV) 1 LO $ ** NSP ** _________________________________ __________________

SERVICE REQUESTED: RFV

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 AS REQUIRED

A003 A003- NOTICE OF REVISION (NOR) 1 LO $ ** NSP ** ______________________________ __________________

SERVICE REQUESTED: NOR

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 AS REQUIRED

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A004 A004 - PRODUCTION LOT ACCEPTANCE TEST REPORT 1 LO $ ** NSP ** ____________________________________________ __________________

SERVICE REQUESTED: TEST/INSPECTION REPORTS

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Destination

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 AS REQUIRED

A005 A005 - CERTIFICATE OF COMPLIANC (COC) 1 LO $ ** NSP ** _____________________________________ __________________

SERVICE REQUESTED: COC

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Destination

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 AS REQUIRED

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SECTION E - INSPECTION AND ACCEPTANCE

@E.1 INSPECTION AND ACCEPTANCE POINTS: ORIGIN _____________________________________________

The Government's inspection and acceptance of the supplies offered under this contract/purchase order shall take place at ORIGIN.

Offeror must specify below the exact name, address, and CAGE of the facility where supplies to be furnished under this contract/purchase order will be available for inspection/acceptance.

INSPECTION POINT: __________________________________________

(Name) (CAGE)

(Address) (City) (State) (Zip)

ACCEPTANCE POINT: __________________________________________

(Name) (CAGE)

(Address) (City) (State) (Zip)

E.2. REWORK AND REPAIR OF NONCONFORMING MATERIAL_________________________________________________

(a) Rework and Repair are defined as follows:

(1) Rework - The reprocessing of nonconforming material to make it conform completely to the drawings, specifications or contract requirements.

(2) Repair - The reprocessing of nonconforming material in accordance with approved written procedures and operations to reduce, but not completely eliminate, the nonconformance. The purpose of repair is to bring nonconforming material into a usable condition. Repair is distinguished from rework in that the item after repair still does not completely conform to all of the applicable drawings, specifications or contract requirements.

(b) Rework procedures along with the associated inspection procedures shall be documented by the Contractor and submitted to the

Government Quality Assurance Representative (QAR) for review prior to implementation. Rework procedures are subject to the QAR's disapproval.

(c) Repair procedures shall be documented by the Contractor and submitted on a Request for Deviation/Waiver, to the Contracting Officer for review and written approval prior to implementation.

(d) Whenever the Contractor submits a repair or rework procedure for Government review, the submission shall also include a description of the cause for the nonconformances and a description of the action taken or to be taken to prevent recurrence.

(e) The rework or repair procedure shall also contain a provision for re-inspection which will take precedence over the Technical Data

Package requirements and shall, in addition, provide the Government assurance that the reworked or repaired items have met reprocessing requirements.

E.3. USE OF MIL-STD 1916_________________________

a. The Government will not accept lots whose samples submitted for acceptance contain non-conformances unless appropriately documented and approved by the contracting officer. The contractor shall use MIL-STD 1916, DOD Preferred Methods of Acceptance of Product. The

Verification Level (VL) shall be VL II for major characteristics and VL 1 for minor characteristics.

b. MIL-STD HDBK-1916 provides guidance on the use of MIL-STD 1916. This handbook is not contractually binding.

E.4. FIRST ARTICAL TEST (FAT)_____________________________

The First Article sample shall consist of, (DWG: 5-77-3543), 100 each SIMULATOR, CHEMICAL AGENT DETECTOR: TRAINING, M256A2 manufactured using the same methods, materials, equipment, and processes as will be used during regular production. The First Article sample shall contain no more than one lot of each component, material, and reagent identified in MIL-DTL-1.3. The samples shall be tested-inspected in accordance with MIL-DTL-32578, paragraph s 4.2, 4.2.2, table II and associated drawings, and specifications.

In MIL-DTL-32578, the first article sample items shall be examined in accordance with the classification of characteristics in 4.3.5 and inspected for compliance with all of the requirements of the applicable drawings (3.2).

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The FAT is seperated into 6 different parts. Each part shall be quoted on CLIN 0001AA.

PART 1. First article sample items shall then be inspected by test and examination in accordance (4.4.7 - 4.4.9) and examined for defects. Certificate of Conformance (COC) shall be required for materials.

PART 3. Ampoule leakage test

PART 4. Potassium Carbonate Ampoule, High temperature stability test

PART 5. Cholinesterase Activity test

*Note: Each test is potentially destructive.*

PART 6: Packaging of FIrst Article: The Packaged First Article shall consist of 3 unit pack containers and their Contents, shall consist of *three (3) empty unit pack barrier bags, and meet all the requirements of SPI P5-77-3543 and all applicable specifications. ________

As determined by the Government, the samples shall be subject to any or all of the tests and inspections listed on the associated drawings, specifications and SPI.

The FAT report shall be reviewed by the Government QAR before submission to the Contracting Officer.

E.5. DESTRUCTIVE TESTING________________________

(a) All costs for destructive testing by the Contractor and items destroyed by the Government are considered as being included in the contract unit price.

(b) Where destructive testing of items or components thereof is required by contract or specification, the number of items or components required to be destructively tested, whether destructively tested or not, shall be in addition to the quantity to be delivered to the Government as set forth in the Contract Schedule.

(c) All pieces of the complete First Article shall be considered as destructively tested items unless specifically exempted by other provisions of this contract.

(d) The Contractor shall not reuse any components from items used in a destructive test during First Article, lot acceptance or in process testing, unless specifically authorized by the Contracting Officer.

(e) The Government reserves the right to take title to all or any items or components described above. The Government may take title to all or any items or components upon notice to the Contractor. The items or components of items to which the Government takes title shall be shipped in accordance with the Contracting Officer's instructions. Those items and components to which the Government does not obtain title shall be rendered inoperable and disposed of as scrap by the Contractor.

E.6. FIRST ARTICLE TESTING (CONTRACTOR) UTILIZATION OF ECBC LAB (TSA)______________________________________________________________________

(a) CLIN 0011-0015 - has a requirement for First Article Testing (CLIN 0001AA).

(b) The elements of First Article Testing (FAT) that can be performed by the Research Development & Engineering Command (RDECOM)

Chemical & Biological Center (C&B Center, Design Engineering & Test Facility (DE&TF) Rock Island. Contact the lab by email:

usarmy.ria.ecbc.mail.testfacility@mail.mil.

Prices are valid for 180 days after contract award. These prices shall be included in the total FAT price proposed.

(c) These elements may not be all inclusive of the FAT Requirements as stated in the solicitation. It is the successful offeror's responsibility to ensure that all FAT Requirements are met.

(d) It is not a requirement of this solicitation to utilize the ECBC Rock Island Lab, but an option available to all interested offerors.

(e) If it is determined that the C&B Center DE&TF, Rock Island, will be utilized for conducting any of the above testing, it is the successful contractors responsibility to contact the Chief, DE&TF to establish a Test Service Agreement (TSA) for necessary C&B center support. See contact information below.

Point of Contact for the ECBC Rock Island Lab is below:

Chief, DE&TF branch

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RDECOM-C&B

Building 62

1 Rock Island Arsenal

Rock Island, IL 61299-7390 usarmy.ria.ecbc.mail.testfacility@mail.mil

(f) The TSA will not be part of the resultant contract, but an independent agreement between the contractor and C&B Center Rock Island.

Payment to C&B center will be the responsibility of the successful offeror.

(g) It is in the contractors best interest to contact the C&B Center DE&TF as soon after contract award as possible to start the TSA process. Delay in contract performance due to failure to contact the lab and make arrangements in a timely manner is not an excusable delay. A copy of the TSA Customer's Guide is provided as an attachment to help expedite the TSA process. Please coordinate with the

C&B Center Rock Island regarding Electronic Funds Transfer (EFT) payments.

(h) Contractor shall annotate below whether the ECBC Lab will be utilized for this requirement.

____ The C&B Center Lab will be utilized for this requirement.

____ The C&B Center Lab will not be utilized for this requirement.

E.8 SUPPLEMENTAL REQUIREMENTS TO FIRST ARTICLE APPROVAL (CONTRACTOR TESTING)______________________________________________________________________________

(a) In accordance with the requirements under FAR clause 52.209-3, found in Amendment 0001, Section I of this document, the first article approval item(s) shall be examined and tested as required by the item specification(s), Quality Assurance Provisions (QAPs) and all drawings listed in the Technical Data Package.

(b) The first article shall be representative of items to be manufactured using the same processes and procedures and at the same facility as contract production. All parts and materials, including packaging and packing, shall be obtained from the same source of supply as will be used during regular production. All components, subassemblies, and assemblies in the first article sample shall have been produced by the Contractor (including subcontractors) using the technical data package applicable to this procurement.

(c) The first article shall be inspected and tested by the contractor for all requirements of the drawing(s), the QAPs, and specification(s) referenced thereon, except for:

(1) Inspections and tests contained in material specifications provided that the required inspection and tests have been performed previously and certificates of conformance are submitted with the First Article Test Report.

(2) Inspections and tests for Military Standard (MS) components and parts provided that inspection and tests have been performed previously and certifications for the components and parts are submitted with the First Article Test Report.

(3) Corrosion resistance tests over 10 days in length provided that a test specimen or sample representing the same process has successfully passed the same test within 30 days prior to processing the first article, and results of the tests are submitted with the First Article Test Report.

(4) Life cycle tests over 10 days in length provided that the same or similar items manufactured using the same processes have successfully passed the same test within 1 year prior to processing the first article and results of the tests are submitted with the First Article Test Report.

(5) Onetime qualification tests, which are defined as a one-time on the drawing(s), provided that the same or similar item manufactured using the same processes has successfully passed the tests, and results of the test are on file at the contractor's facility and certifications are submitted with the First Article Test Report.

(d) Those inspections which are of a destructive nature shall be performed upon additional sample parts selected from the same lot(s) or batch(es) from which the first article was selected.

(e) A First Article Test Report shall be compiled by the contractor documenting the results of all inspections and tests (including supplier's and vendor's inspection records and certifications, when applicable). The First Article Test Report shall include actual inspection and test results to include all measurements, recorded test data, and certifications (if applicable) keyed to each drawing, specification and QAP requirement and identified by each individual QAP characteristic, drawing/specification characteristic and unlisted characteristic. Evidence of the QAR's verification will be provided. One copy of the First Article Test Report will be copy furnished to the contracting officer.

(f) Notwithstanding the provisions for waiver of first article, an additional first article sample or portion thereof, may be ordered by the Contracting Officer in writing when (i) a major change is made to the technical data, (ii) whenever there is a lapse in production for a period in excess of 90 days, or (iii) whenever a change occurs in place of performance, manufacturing process, material

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used, drawing, specification or source of supply. When conditions (i), (ii), or (iii) above occurs, the Contractor shall notify the

Contracting Officer so that a determination can be made concerning the need for the additional first article sample or portion thereof, and instructions provided concerning the submission, inspection, and notification of results. Costs of the additional first article testing resulting from any of the causes listed herein that were instituted by the contractor and not due to changes directed by the

Government shall be borne by the Contractor.

E.8. PRODUCTION LOT TESTING (CONFORMANCE INSPECTION - Contractor)__________________________________________________________________

(a)The Contractor shall conduct production lot testing (PLT) for each production lot to be tendered to the Government for acceptance.

(b) The samples shall be selected, examined, and tested in accordance with MIL-STD 1916

(c) The samples shall be randomly selected from the entire lot by, or in the presence of, the Government Quality Assurance

Representative (QAR). The Contractor shall notify the QAR in writing at least five (5) workdays in advance, when the lot is ready for sample selection. The Contractor shall inspect production lots for conformance to the contracts requirements prior to selecting PLT samples. Unless otherwise authorized by the Contracting Officer, test samples shall not be submitted pursuant to this provision where the Contractor has determined that the lot does not conform to all contract requirements.

(d) Within 5 days of completing PLT on any given lot, the Contractor shall deliver to the Government a report that documents whether production lots conform to PLT requirements. The PLT report shall verify whether all required inspections and tests have been completed successfully. The report shall be submitted to the Government in accordance with CDRL in Section J.

(e) Within 10 workdays after receipt of the PLT report by the government, the government will notify the Contractor in writing whether the specific lot has been approved, conditionally approved, or rejected. The Contractor shall maintain PLT report(s) for a period of two years after contract expiration, during which time they shall be available for Government review.

(f) If the PLT sample fails to meet any contractual requirement, the lot from which the test samples were drawn shall be rejected by the

Government. In that event, the Contractor shall take immediate corrective action at no increase in the contract price, and shall submit an additional PLT sample (from the reworked lot or from a new lot) for inspection. Corrective action shall apply to all items including, if applicable, basic items, repair parts, and in-process or final assembly items produced or in production since the last successful production lot test.

(g) PLT samples not consumed or destroyed in testing may be delivered as part of the production quantities due under the contract.

E.9. ALTERNATIVES TO LOT ACCEPTANCE SAMPLING (INCLUDING STATISTICAL PROCESS CONTROL (SPC))___________________________________________________________________________________________

(a) Offerors are encouraged to propose a defect prevention strategy in lieu of lot acceptance inspection and testing requirements cited in the technical data package. The Government recognizes that industry has developed numerous prevention based strategies which result in reduced process variation and promote continuous process improvement initiatives. Use of alternatives to lot acceptance sampling can provide offerors the latitude of implementing prevention based programs that are suitable to their particular mode of operation.

Offerors are encouraged to submit their alternative proposals prior to award. Although the Government will entertain post award requests, there is no guarantee such requests will be accepted.

(b) Requests to use alternatives to lot acceptance sampling shall be provided to the Contracting Officer for review and approval or disapproval. Such requests shall include:

(1) Identification of the specific inspections and tests to be reduced or eliminated.

(2) A description of your prevention based program. This should include such topics as a training program and the performance of audits.

(3) A description of the tools used to monitor and control the specific processes being evaluated. This should include such topics as criteria for determining out of control conditions and procedures to be used when an out of control condition is detected.

(4) The results of a process performance study, and if available, the results of a process capability study.

(5) For SPC data to be used as an alternative to lot acceptance sampling, the following conditions shall be met:

(i) The process is in a state of statistical control using SPC control chart methods.

(ii) Variable data: for Critical characteristics a CPK =/> 2.00 (or equivalent capability) is achieved; for Major characteristics a CPK =/> 1.33 (or equivalent capability) is achieved.

(iii) Attribute data: for Critical Characteristics a process average of 100% of the product conforming to the

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specification; for Major Characteristics a process average of 99.9937% of the product conforming to the specification.

(c) Proposals offered after award. The Contracting Officer is responsible for accepting or rejecting the alternate lot acceptance procedure submitted by the contractor. The contractor may submit an alternate lot acceptance procedure at any time during the performance of this contract. The Contracting Officer is responsible for accepting or rejecting the alternate procedure within 30 days of receipt. If the Government needs more time to evaluate the alternate procedure, the Contracting Officer shall notify the contractor in writing, giving the reasons and the anticipated decision date. The contractor may withdraw its proposal at any time prior to its incorporation by contract modification. Because offerors may withdraw their proposal at any time, the Contracting Officer's failure to timely accept or reject the proposal shall not constitute grounds for claim against the Government. Any proposed and accepted procedure must be incorporated by contract modification. If the alternate procedure is not accepted, the Contracting Officer shall provide the contractor with written notification, explaining the reasons for rejection.

(d) Any equitable adjustment resulting from approval of an alternate lot acceptance procedure described in paragraph (c) above will be handled in accordance with the Changes clause of this contract.

(e) Until notification is received, the contractor is required to perform under this contract in accordance with the requirements herein, including lot acceptance inspection and testing.

E.10 REQUIRED CONFORMANCE INSPECTION_____________________________________

In addition to other inspection and acceptance terms of this contract, the Contractor is required to perform Conformance inspection of the following listed Production Supply Items IAW MIL-DTL-32578, paragraphs 4.3 and 4.3.5:

i. 4.3.5 (a) Sampler Sub-Assembly Part number: 5-77-2916

ii. 4.3.5 (b) Sampler Assembly Part Number: 5-77-2917

iii. 4.3.5 (c) Sampler Assembly, Bagged Part Number: 5-77-2915

iv. 4.3.5 (d) Bag Part Number 5-77-2910

v. 4.3.5 (e) Direction Card Part Number 5-77-3548

vi. 4.3.5 (f) Training Kit Instruction Card Part Number 5-77-3549

vii. 4.3.5 (g) Simulator, Chemical Agent Detector: Training, M256A2 PN: 5-77-3543

viii. 4.3.5(h) Training Disc Part Number: 5-77-3555

The Contractor shall provide the Conformance inspection Report to the Government's Quality Assurance Representative, or other designated representative, prior to Government acceptance of any lot. A separate PLAT Report is required for each production lot, and for each listed Production Supply Item. The Conformance inspection Report shall comply with MIL-HDBK-831. The PLAT Report: A copy of all vendor

Certificates of Conformance (COC) shall be included in the Conformance inspection Report. All test and inspection results shall be fully documented. In the event of critical or major defect being detected during final acceptance inspection, a detailed root cause analysis and corrective action plan, to include implementation milestones, if applicable, shall be attached to the Conformance inspection Report. Unless otherwise specified in the classification of characteristics, the sampling and acceptance criteria for critical characteristics shall be in accordance with the Critical characteristics paragraph of MIL-STD-1916.

* quantity changed on amendment 0004 from 30 to 3.

*** END OF NARRATIVE E0001 ***

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SECTION J - LIST OF ATTACHMENTS

List of Number List of Number

Addenda Title Date of Pages Transmitted By Addenda Title Date of Pages Transmitted By________________ ____________________________________________________________ _______________ ____________ _______________________________ ____________________________________________________________ _______________ ____________ _______________

Exhibit A CONTRACT DATA REQUIREMENT LIST (CDRL) 03-FEB-2020 004 DATA

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MOD/AMD

ATT/EXH ID

PAGE

Exhibit A

CONTRACT DATA REQUIREMENTS LIST

DD FORM 1423 (MECHANIZED)

CATEGORY: MISC SYSTEM/ITEM: SIMULATOR, CHEMICAL AGENT DETECTOR

TO CONTRACT/PR: EH0C0321EH

NSN: 6665-01-663-5355

1. SEQUENCE NUMBER 14. DRFT/REG/REPRO

2. TITLE OF DATA ITEM DISTRIBUTION COPIES

3. SUBTITLE

4. DATA ITEM NUMBER

5. CONTRACT REFERENCE

6. TECHNICAL OFFICE 7. DD 250 8. APP CODE 9. DIST STATEMENT REQUIRED

10. FREQUENCY 11. AS OF DATE

12. DATE OF 1ST SUBMISSION 13. DATE OF SUBSEQUENT SUBMISSION

15. TOTAL 16. REMARKS

1. A001 14.

SEE ADDRESS CODE / /

2. ENGINEERING CHANGE PROPOSAL (ECP) DISTRIBUTION

ATTACHED**

3.

4. DI-SESS-80639

5. SECTION C

6. FCDD-CBE-M 7. LT 8. N/A 9. *

10. ASREQ 11. N/A 15. TOTAL 0/ 0 / 0

12. ASREQ 13. ASREQ

16. REMARKS

DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (e.g., MICROSOFT OFFICE OR PORTABLE DOCUMENT FORMAT (pdf)). *DISTRIBUTION STATEMENT

WILL BE ASSIGNED AND IMPLEMENTED BY THE DOD CONFIGURATION MANAGER. **SUBMIT ELECTRONICALLY TO USARMY.RIA.CCDC-CBC.MBX.CMACTION@MAIL.MIL.

ELECTRONIC FILES SHALL BE LESS THAN 7MB. THE PREFERRED METHOD IS THE DD FORM 1692 WHICH IS LOCATED AT http://www.dtic.mil/whs/directives/infomgt/forms/ . CONTRACTOR FORMAT

ALTERNATIVE TO THE DD FORM IS ACCEPTABLE PROVIDED THE NECESSARY DATA

ELEMENTS ARE PROVIDED.

1. A002 14.

SEE ADDRESS CODE / /

2.) DISTRIBUTION

ATTACHED**

3.

4. DI-SESS-80640

5. SECTION C

6. FCDD-CBE-M 7. LT 8. N/A 9. *

10. ASREQ 11. N/A 15. TOTAL 0 / 0 / 0

12. ASREQ 13. ASREQ

16. REMARKS

DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (e.g., MICROSOFT OFFICE OR PORTABLE DOCUMENT FORMAT (pdf)). *DISTRIBUTION STATEMENT

WILL BE ASSIGNED AND IMPLEMENTED BY THE DOD CONFIGURATION MANAGER. **SUBMIT ELECTRONICALLY TO USARMY.RIA.CCDC-CBC.MBX.CMACTION@MAIL.MIL.

ELECTRONIC FILES SHALL BE LESS THAN 7MB. THE PREFERRED METHOD IS THE DD FORM 1694 WHICH IS LOCATED AT

ATT/EXH ID

PAGE

Exhibit A http://www.dtic.mil/whs/directives/infomgt/forms/ . CONTRACTOR FORMAT

ALTERNATIVE TO THE DD FORM IS ACCEPTABLE PROVIDED THE NECESSARY DATA

ELEMENTS ARE PROVIDED.

1. A003 14.

SEE ADDRESS CODE / /

2. NOTICE OF REVISION (NOR) DISTRIBUTION

ATTACHED**

3.

4. DI-SESS-80642

5. SECTION C

6. FCDD-CBE-M 7. LT 8. N/A 9. *

10. ASREQ 11. N/A 15. TOTAL 0 / 0 / 0

12. ASREQ 13. ASREQ

16. REMARKS

DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (e.g., MICROSOFT OFFICE OR PORTABLE DOCUMENT FORMAT (pdf)). *DISTRIBUTION STATEMENT

WILL BE ASSIGNED AND IMPLEMENTED BY THE DOD CONFIGURATION MANAGER. **SUBMIT ELECTRONICALLY TO USARMY.RIA.CCDC-CBC.MBX.CMACTION@MAIL.MIL.

ELECTRONIC FILES SHALL BE LESS THAN 7MB. THE PREFERRED METHOD IS THE DD FORM 1695 WHICH IS LOCATED AT http://www.dtic.mil/whs/directives/infomgt/forms/ . CONTRACTOR FORMAT

ALTERNATIVE TO THE DD FORM IS ACCEPTABLE PROVIDED THE NECESSARY DATA

ELEMENTS ARE PROVIDED.

1. A004 14.

ACO 0 / 1 / 0

2. TEST/INSPECTION REPORTS THRU QAR 0 / 1 / 0

PCO 0 / 1 / 0

3. PRODUCTION LOT ACCEPTANCE TEST REPORT

(CONTRACTOR)

4. DI-NDTI-80809

5. SECTION E

6. FCDD-CBE-SQ 7. LT 8. ** 9. C

10. ASREQ* 11. N/A 15. TOTAL 0 / 3 / 0

12. ASREQ* 13. ASREQ

16. REMARKS

*THIS REPORT SHALL BE SUBMITTED AT THE COMPLETION OF A NEW PRODUCTION LOT.

REPORT SHALL BE SUBMITTED TO THE QUALITY ASSURANCE REPRESENTATIVE (QAR)

WHENEVER A NEW LOT OF MATERIAL HAS COMPLETED TESTING. PRIOR TO BEGINNING PRODUCTION, THE CONTRACTOR SHALL SUBMIT A QUALITY PLAN TO THE

QAR FOR REVIEW AND APPROVAL, ON HOW THEY WILL COMPLY WITH THE REQUIREMENTS OF THE PRODUCTION LOT TEST. ONCE THE QAR APPROVES THE

QUALITY PLAN FOR THE PRODUCTION LOT TESTING, THE APPROVED METHOD WILL BE USED THROUGHOUT THE LIFE OF THE CONTRACT TO VALIDATE COMPLIANCE

WITH THE CONTRACT CLAUSE. QAR WILL PROVIDE WRITTEN APPROVAL OF THE QA PLAN TO THE CONTRACTOR. **THE CONTRACTOR SHALL SUBMIT THE

PRODUCTION LOT TEST REPORT TO THE QAR ON ADD1222 OR COMPARABLE DOCUMENT FOR ACCEPTANCE WITHIN TEN DAYS OF COMPLETION OF THE TESTING.

THE QAR HAS 30 WORK DAYS AFTER RECEIPT TO REVIEW AND PROVIDE APPROVAL/DISAPPROVAL IN WRITING TO THE CONTRACTOR. APPROVAL OF THE

PRODUCTION LOT TEST REPORT SHALL BE APPROVAL OF THE LOT. WHEN THE REPORT FILES ARE TOO LARGE TO SEND OVER EMAIL, THE CONTRACTOR MAY SEND

THE REPORT THROUGH THE SAFE ACCESS FILE EXCHANGE (SAFE) APPLICATION (FILE SIZE UP TO 2GB). SEE

HTTPS://SAFE.AMRDEC.ARMY.MIL/SAFE/GUIDE.ASPX FOR MORE INFORMATION. TESTING SHALL BE PERFORMED IN ACCORDANCE WITH THE CONTRACT CLAUSE

FOR THIS REQUIREMENT.

1. A005 14.

QAR 0 / 1 / 0

2. CERTIFICATE OF COMPLIANCE PCO 0 / 1 / 0

ATT/EXH ID

PAGE

Exhibit A

(Blocks 3 thru 19 of Form 010) FCDD-CBE-SQ 0 / 1 / 0

3.

4. DI-MISC-81356A*

5. SECTION I**

6. FCDD-CBE-SQ (RI) 7. LT 8. N/A 9. N/A

10. ASREQ 11. N/A 15. TOTAL 0 / 3 / 0

12. ASREQ 13. ASREQ

16. REMARKS

*MODIFY DI-MISC-81356, 2.I TO READ: "A STATEMENT ON CONTRACTOR LETTERHEAD, CERTIFYING THAT ALL ITEMS FURNISHED ON THE CONTRACT ARE

IN FULL COMPLIANCE WITH THE TDP (INCLUDING REVISION OF THE DRAWING AND SPECIFICATION), ALL SPECIFICATIONS AND CONTRACT REQUIREMENTS.".

SUBMIT CERTIFICATE OF COMPLIANCE(S) WITH THE FIRST ARTICLE TEST REPORT. 2.G TO READ NSN (IF APPLICABLE) AND PART NUMBER. **FIRST

ARTICLE APPROVAL CONTRACTOR TESTING.

SUBMIT ELECTRONICALLY TO THE PCO.

DATE: 03 FEBRUARY 2020