W56HZV22R0143-0001.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

0001 2023APR18

W56HZV

ACC-DTA

6501 E. 11 MILE RD.

DETROIT ARSENAL, MI 48397-5000

KATLYN M. MARCK

EMAIL: KATLYN.M.MARCK.CIV@ARMY.MIL

W56HZV-22-R-0143

2023MAR14

X

X 2023MAY15 04:00pm

/SIGNED/

2 signed

SEE SECOND PAGE FOR DESCRIPTION

1 12

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: KATLYN M. MARCK

Buyer Office Symbol/Telephone Number: CCTA-APS-B/(571)588-9178

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

Amendment 0001 to Solicitation W56HZV-22-R-0143

1. The purpose of amendment 0001 to solicitation W56HZV-22-R-0143 is to provide clarification on a paint color in a drawing and add

First Article Test and Report requirements.

2. Important Update to Drawing # 12350824: Note #1.5.1.1 - The Topcoat CARC paint system color for this item shall be Exterior color 383

Green (chip 34094 per ASM-STD-595) only.

3. The following deletions, additions, and revisions were made to the solicitation to reflect the addition of the First Article Test and

Report:

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS:

Added:

CLIN 0014, ELIN A002 First Article Test Report

CLIN 0015 First Article Test

SECTION E - INSPECTION AND ACCEPTANCE

Deleted:

E.01 Initial Product Inspection (IPI)

Added:

E.02 Notice Regarding First Article Test Sample

E.03 Inspection and Acceptance (First Article Approval)

E.04 Notice Regarding First Article

SECTION F - DELIVERIES OR PERFORMANCE:

Revised:

FAR 52.211-8 TIME OF DELIVERY

SECTION J LIST OF ATTACHMENTS

Revised:

Exhibit A - Contract Data Requirements List DD Form 1423 to add A002 - First Article Test Report

Added:

Attachment 0001 First Article Waiver Worksheet

SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS

Added:

L.04 PROVISION FOR WAIVER OF REQUIRED FIRST ARTICLE APPROVAL

4. As a result of the drawing clarification, and these revisions, the solicitation closing date is extended to 15 May 2023.

5. Interested Offerors must submit a new price proposal as the requirements have changed. Proposals should be submitted via email to the

Contract Specialist (katlyn.m.marck.civ@army.mil) and cc the corresponding Contracting Officer (valencia.d.lane.civ@army.mil) with the subject header: Proposal Submission - W56HZV-22-R-0143 (company name). Once a proposal is received, the Contract Specialist/Contracting

Officer will reply with the respective Offeror stating receipt of proposal submission.

6. Except as specifically provided in this amendment, all other terms and conditions remain unchanged and in full force and effect.

*** END OF NARRATIVE A0003 ***

2 12

W56HZV-22-R-0143

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

0014 BASIC CLIN FOR ELIN - CDRL __________________________

The below ELINs are associated with the Data Item

Numbers on exhibit A - Contract Data Requirements

List (CDRL) DD Form 1423, in Section J List of

Attachments.

(End of narrative A001)

A001 TEST PROCEDURE-PHOSPHATE COATING $ ** NSP ** $ ** NSP ** ________________________________ ______________ __________________

COMMODITY NAME: PRE-PRODUCTION PROCEDURE

Packaging and Marking _____________________

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

See guidance in exhibit A - Contract Data

Requirements List - DD FORM 1423, in Section J - List of Attachments.

(End of narrative F001)

A002 FIRST ARTICLE TEST REPORT (FATR) $ ** NSP ** $ ** NSP ** ________________________________ ______________ __________________

COMMODITY NAME: TEST/INSPECTION REPORT

CLIN CONTRACT TYPE:

Firm Fixed Price

Packaging and Marking _____________________

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Deliveries or Performance _________________________

FOB POINT:

SHIP TO:

(W56HZV) XU W4GG HQ US ARMY TACOM

6501 EAST 11 MILE ROAD

ARMY CONTRACTING COMMAND WARREN

3 12

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

DETROIT ARSENAL,MI,48397-5000

See guidance in exhibit A - Contract Data

Requirements List - DD FORM 1423, in Section J - List of Attachments.

(End of narrative F001)

0015 FIRST ARTICLE TEST (FAT) $ ** NSP ** $ ** NSP ** ________________________ ______________ __________________

COMMODITY NAME: FIRST ARTICLE TEST (FAT)

A FIRST ARTICLE TEST (FAT) AND REPORT (FATR) ARE

REQUIRED IN ACCORDANCE WITH THE FAR CLAUSE 52.209-3

ENTITLED "FIRST ARTICLE APPROVAL-- CONTRACTOR

TESTING".

The Contractor may request for a FAT Waiver with the

ATTACHMENT 0001 "FAT WAIVER WORKSHEET". The waiver must be submitted with the proposal in accordance with Section L, narrative L.04 PROVISION FOR WAIVER

OF REQUIRED FIRST ARTICLE APPROVAL.

Additional information on the FAT and FATR can be found in Section E, narratives E.02 NOTICE REGARDING

FIRST ARTICLE TEST SAMPLE, E.03 INSPECTION AND

ACCEPTANCE (FIRST ARTICLE APPROVAL), and E.04 NOTICE

REGARDING FIRST ARTICLE.

NOTE TO OFFEROR:

Please fill in the dollar amount you have

INCLUDED in Production CLIN 0011 to cover the cost of performing FAT and writing the FATR:

WE ARE REQUESTING OFFERORS TO FILL IN THE DOLLAR

AMOUNT IN THE PARAGRAPH ABOVE

SO WE WILL KNOW HOW MUCH TO SUBTRACT

FROM THE PRODUCTION CLIN IF THE FAT WAIVER IS

APPROVED.

(End of narrative A001)

Packaging and Marking _____________________

Deliveries or Performance _________________________

FOB POINT:

4 12

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION E - INSPECTION AND ACCEPTANCE

E.01 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.02 NOTICE REGARDING FIRST ARTICLE TEST SAMPLE

(a) The approved first article items, as described elsewhere in this contract, consist of a quantity of -1- that will be consumed or destroyed in testing. Any items consumed or destroyed in testing shall not be delivered as part of the contractually required quantity as set forth in the schedule. The cost of any items that are consumed or destroyed shall be included in the overall offer or contract price. A quantity of -2- that successfully passes all specified tests, less the destructive tests, if any, -3- serve as a manufacturing standard for the remainder of the contract.

(b) A manufacturing standard is an item, which conforms to all technical performance requirements. A manufacturing standard will serve as 1) an aid in identifying configuration changes not controlled by the contractual design. 2) an aid in identifying any process changes, or 3) the approved workmanship sample, when required, unless alternate samples are submitted for specific characteristics by the Contractor and approved by the Government.

(c) The manufacturing standard will only be used to supplement contractual acceptance/rejection criteria for those process characteristics that require approved workmanship samples. For other characteristics, if configuration or process changes are identified in production units, the contractor will notify the contracting officer for disposition. Manufacturing items that serve as a manufacturing standard may be delivered as part of the contractual quantity with the last shipment made under this contract provided it meets all contractual requirements existing at time of delivery.

E.03 INSPECTION AND ACCEPTANCE (FIRST ARTICLE APPROVAL)

In addition to inspection requirements specified in applicable drawings and/or specifications, the following provisions shall apply to this contract:

(a) FIRST ARTICLE APPROVAL-CONTRACTOR TESTING: First Article Approval-Contractor Testing shall be performed in accordance with -1-

(b) The First Article Test Report (FATR) shall be compiled by the contractor to the contractor's own format. The FATR shall document the results of all inspections and tests (including supplier's and vendor's inspection records and certifications, when applicable).

The FATR shall include actual inspections and test results to include all measurements, recorded test data, and certifications (if applicable) keyed to each drawing, specification and Quality Assurance Provision (QAP) requirement and identified by each individual QAP characteristic, drawing/specification characteristic and unlisted characteristic. The FATR shall contain sufficient narrative content, technical data, illustrations or photographic evidence, and an objective determination by the contractor to allow the designated

Government representative to determine that the First Article Test was successfully completed.

5 12

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

E.04 NOTICE REGARDING FIRST ARTICLE

(a) 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 one year, or (iii) whenever a change occurs in place of performance, manufacturing process, material used, drawing, specification or source of supply.

(b) When any of the conditions 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 can be provided concerning the submission, inspection, and notification of results.

(c) Costs of any additional testing and inspection resulting from conditions specified above shall be borne by the Contractor, unless the change was directed by the Government. Further, any production delays caused by additional testing and inspection will not be the basis for an excusable delay as defined in the default clause of this contract. Such delays shall not form the basis for adjustment in contract price or delivery schedule.

*** END OF NARRATIVE E0001 ***

6 12

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION F - DELIVERIES OR PERFORMANCE

Status Regulatory Cite Title Date Status Regulatory Cite Title Date _______ _______________ ______________________________________________________________________ ____________ _______ _______________ ______________________________________________________________________ ____________

F-1 CHANGED 52.211-8 TIME OF DELIVERY JUN/1997

(a) The Government requires delivery to be made according to the following schedule:

REQUIRED DELIVERY SCHEDULE WITH FIRST ARTICLE TEST (FAT):

ITEM NO. QUANTITY WITHIN DAYS AFTER DATE OF CONTRACT

0011 First Ordering Year Estimated 570 EA 360 Days After Delivery Order Issuance, and First Article Test and Report

Approval at a rate of 95 EA per month

0012 Second Ordering Year Estimated 254 EA 270 Days After Delivery Order Issuance, at a rate of 95 EA per month

0013 Third Ordering Year Estimated 254 EA 270 Days After Delivery Order Issuance, at a rate of 95 EA per month

0015 / 0014 A002(FAT/R) 1 EA 270 Days After Delivery Order Issuance

REQUIRED DELIVERY SCHEDULE IF THERE IS NO FIRST ARTICLE TEST (FAT), OR IF FAT IS WAIVED:

ITEM NO. QUANTITY WITHIN DAYS AFTER DATE OF CONTRACT

0011 First Ordering Year Estimated 570 EA 270 Days After Delivery Order Issuance, at a rate of 95 EA per month

0012 Second Ordering Year Estimated 254 EA 270 Days After Delivery Order Issuance, at a rate of 95 EA per month

0013 Third Ordering Year Estimated 254 EA 270 Days After Delivery Order Issuance, at a rate of 95 EA per month

The Government will evaluate equally, as regards time of delivery, offers that propose delivery of each quantity within the applicable delivery period specified above. Offers that propose delivery that will not clearly fall within the applicable required delivery period specified above, will be considered nonresponsive and rejected. The Government reserves the right to award under either the required delivery schedule or the proposed delivery schedule, when an offeror offers an earlier delivery schedule than required above. If the offeror proposes no other delivery schedule, the required delivery schedule above will apply.

OFFERORS PROPOSED DELIVERY SCHEDULE

ITEM NO. QUANTITY WITHIN DAYS

AFTER DATE OF

CONTRACT

(b) Attention is directed to the Contract Award provision of the solicitation that provides that a written award or acceptance of offer mailed, or otherwise furnished to the successful offeror, results in a binding contract. The Government will mail or otherwise furnish

7 12

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

to the offeror an award or notice of award not later than the day award is dated. Therefore, the offeror should compute the time available for performance beginning with the actual date of award, rather than the date the written notice of award is received from the

Contracting Officer through the ordinary mails. However, the Government will evaluate an offer that proposes delivery based on the

Contractors date of receipt of the contract or notice of award by adding

(1) five calendar days for delivery of the award through the ordinary mails, or

(2) one working day if the solicitation states that the contract or notice of award will be transmitted electronically. (The term working day excludes weekends and U.S. Federal holidays.) If, as so computed, the offered delivery date is later than the required delivery date, the offer will be considered nonresponsive and rejected.

(End of Clause)

8 12

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION I - CONTRACT CLAUSES

Status Regulatory Cite Title Date Status Regulatory Cite Title Date _______ _______________ ______________________________________________________________________ ____________ _______ _______________ ______________________________________________________________________ ____________

I-1 CHANGED 52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS SUBCONTRACTORS(MAR MAR/2023

2023)

I-2 CHANGED 52.244-6 SUBCONTRACTS FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES(MAR MAR/2023

2023)

I-3 CHANGED 252.227-7013 RIGHTS IN TECHNICAL DATA?OTHER THAN COMMERCIAL PRODUCTS AND MAR/2023

COMMERCIAL SERVICES (MAR 2023

I-4 CHANGED 252.227-7014 RIGHTS IN NONCOMMERCIAL COMPUTER SOFTWARE AND NONCOMMERCIAL COMPUTER MAR/2023

SOFTWARE DOCUMENTATION(MAR 2023)

I-5 CHANGED 252.227-7015 TECHNICAL DATA?COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAR 2023) MAR/2023

I-6 CHANGED 252.227-7025 LIMITATIONS ON THE USE OR DISCLOSURE OF GOVERNMENT-FURNISHED JAN/2023

INFORMATION MARKED WITH RESTRICTIVE LEGENDS (JAN 2023)

9 12

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

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 REQUIREMENTS LIST - DD FORM 1423 002 DATA

Attachment 0001 FAT WAIVER WORKSHEET 01-SEP-2015 003 EMAIL

10 12

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION L - INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS

L.01 OFFERS DELIVERED BY THIRD PARTY EXPRESS SERVICES (NON-US POSTAL SERVICE MAIL)

(a) Unless specifically authorized elsewhere in this solicitation, paper offers will not be accepted. Preference for offers is to be submitted in response to solicitations via SAM.gov. Alternatively offers may be mailed following these procedures.

(b) Offers, including disks or other electronic media, shall be addressed to:

U.S. Army Contracting Command - Warren

Bid Room, Bldg 231, Mail Stop 303

6501 East 11 Mile Road

Warren, MI 48397-5000

(c) Offers shall not be addressed to an individual buyer. All offers must be addressed to the Offer Receipt Office at the above address.

(d) The external delivery envelope or wrapper must be marked with the solicitation number and the date and time of the solicitation closing. Each envelope should contain only one offer.

(e) Offerors must ensure that the commercial carrier they use has a tracking system that can provide documentation of the date and time of delivery to the Government.

L.02 HQ-AMC LEVEL PROTEST PROCEDURES

Complete AMC Protest Procedures can be found at: http://www.amc.army.mil/Connect/Legal-Resources/

An agency protest may be filed with either the contracting officer or to HQAMC but not both following the procedures listed on the website above.

L.03 NOTICE OF REQUIREMENT TO SUBMIT CERTIFIED COST OR PRICING DATA AFTER PRICE AGREEMENT

In accordance with DFARS 252.215-7010, if the offeror is not granted an exception from the requirement to submit certified cost or pricing data, the offeror must submit a Certificate of Current Cost or Pricing Data as soon as practicable after price agreement but before contract award. In order to reduce delays, the Contracting Officer requests the Certificate of Cost or Pricing Data be submitted no later than five (5) business days after price agreement.

L.04 PROVISION FOR WAIVER OF REQUIRED FIRST ARTICLE APPROVAL

(a) The requirement entitled FIRST ARTICLE APPROVAL (52.209-3 or 52.209-4) in Section E of this solicitation may be waived by the

Government, provided that the offeror meets the conditions outlined below.

(1) Offerors who intend to request a waiver or partial waiver of the First Article Test must provide sufficient information in order for the Government to determine whether the request is to be approved. If the offeror intends to request a waiver, a First Article

Waiver Worksheet must be completed and submitted to the Government along with any supporting documentation. The worksheet can be found in Section J Attachments of this solicitation. The offerors request will not be considered if the worksheet and any supporting documentation is not submitted to the Government. The worksheet must be completed in its entirety. For those sections of the worksheet which do not apply, annotate with N/A (not applicable). To substantiate or clarify information provided by the offeror, the Government may request additional information. Incomplete worksheets can result in the waiver request being denied, Offerors should contact the

Contract Specialist listed on the face page of this solicitation for assistance in filling out the worksheet completely.

(2) Offerors should not assume that the FAT waiver request will be granted even if the completed worksheet and any supporting information is submitted to the Government.

11 12

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

(3) The worksheet and any additional supporting documentation is part of your quote/offer and must be submitted as part of the response to this solicitation on Company letterhead and signed by an agent of the Company.

(4) The offeror may request a waiver for only a portion of the First Article Test, such as a vibration test or a salt water spray test, or the test on a component or subassembly of the procured item.

(5) The offeror shall list specifically on the worksheet, by technical data package reference, that portion of the test requested to be waived. The references shall include but may not be limited to the following as applicable:

(i) Identification of the specification or standard along with the specific specification or standard paragraph(s)

(ii) Identification of the drawing with specific references to the drawing notes.

(iii) Identification of the Quality Assurance Provision (QAP), or Quality Assurance Requirement (QAR) or Supplemental Quality

Assurance Provision (SQAP) with specific references to the specific paragraph.

(6) Supporting documentation.

(i) The request for waiver must be accompanied by documentation in support of the request. The documentation may include information such as the following; (1) Copy of the Administrative Contracting Officers (ACOs) or Procuring Contracting Officers (PCO) letter approving a First Article Test report on a recent contract for the same or similar item. (2) Copy of a First Article Test report for the same or a similar item as that herein solicited. (3) Copy of an ACO or PCO letter approving a prior waiver request. (4) If the waiver request is based on similarity, a copy of the drawing/other appropriate technical requirements of the similar item.

(ii) If a copy of a First Article Test report is submitted in support of a request for waiver under this solicitation, the test report must have been approved and signed by an authorized representative of the Government.

(iii) The FAT report and all supporting documentation should be submitted by electronic media and should accompany the offerors proposal. If the FAT report and supporting documentation cannot be transmitted by electronic media, the offeror shall contact the PCO for further instruction.

(b) Note that if a waiver is granted to the successful offeror, an accelerated delivery schedule will apply. See Section F.

(c) Note: Cost considerations shall apply for approving a waiver or a portion thereof of a First Article Test.

*** END OF NARRATIVE L0001 ***

12 12

MOD/AMD

ATT/EXH ID

PAGE

Exhibit A

CONTRACT DATA REQUIREMENTS LIST

Form Approval OMB No. 0704-0188

Public reporting burden for this collection of information is estimated to average 440 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 22202-4302, and to the Office of Management and Budget, Paperwork

Reduction Project (0704-0188), Washington, DC 20503. Please DO NOT RETURN your form to either 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.: 0014

B. EXHIBIT: A

C. CATEGORY:

TDP _X__ TM ____ OTHER ___

D. SYSTEM/ITEM: Fan, Vaneaxial, NSN: 1005-01-114-2298

E. CONTRACT/PR NO.: TBD

F. CONTRACTOR: TBD

1. DATA ITEM NO.: A001

2. TITLE OF DATA ITEM: TEST PROCEDURE-PHOSPHATE COATING

3. SUBTITLE: PRE-PRODUCTION PROCEDURE

4. DATA ITEM NUMBER / AUTHORITY: DI-NDTI-80603

5. CONTRACT REFERENCE: TT-C-490, TYPE 1, PARAS 3.2.1, 3.2.2

6. TECHNICAL OFFICE / REQUIRING OFFICE: RDAR-MEE-W(R)

7. DD250 REQ: XX

8. APP CODE: A

9. DIST. STATEMENT: N/A

10. FREQUENCY: ONE/R

11. AS OF DATE: N/A

12. DATE OF FIRST SUB: 60DAC

13. DATE OF SUBS: N/A

14. DISTRIBUTION: THRU CONTRACTING OFFICER 0 / 1 / 0

15. TOTAL: 0 / 1 / 0

16. REMARKS: SUBMIT ELECTRONICALLY TO THE GOVERNMENT CONTRACT SPECIALIST.

BLOCK 8 CONT. - PRIOR TO PRODUCTION, APPROVAL THRU THE CONTRACTING OFFICER IS REQUIRED W/IN 90 DAYS AFTER CONTRACT AWARD. CONTRACTING

OFFICER WILL ROUTE INTERNALLY TO THE APPROVING OFFICE (FCDD-ACE-QP). CONTRACTING OFFICER SHALL PROVIDE PROCEDURE AND TEST REVIEW

RESPONSE BACK TO CONTRACTOR. COATED PANELS PER PARA 3.2.2 SHALL INCLUDE THREE WITH PHOSPHATE ONLY, THREE WITH PHOSPHATE AND PRIMER, AND

THREE WITH PHOSPHATE, PRIMER AND TOP COAT. THE PANELS SHALL BE MAILED TO THE FOLLOWING ADDRESS:

Combat Capabilities Development Command Armaments Center

Attn: FCDD-ACE-QP/Mark Godlewski

1 Rock Island Arsenal

Bldg. 62 2nd Floor, NW Wing

Rock Island, IL 61299-7300

A DD FORM 250 IS NOT REQUIRED FOR PHOSPHATE COATING PROCEDURE APPROVAL. CONTRACTOR FORMAT ACCEPTABLE.

1. DATA ITEM NO.: A002

2. TITLE OF DATA ITEM: FIRST ARTICLE TEST REPORT (FATR)

3. SUBTITLE: TEST/INSPECTION REPORT

4. DATA ITEM NUMBER / AUTHORITY: DI-NDTI-80809B

5. CONTRACT REFERENCE: SECTION C.6 and F.1

6. TECHNICAL OFFICE / REQUIRING OFFICE: RDAR-EIQ-P

7. DD250 REQ: Not required

8. APP CODE: A*

9. DIST. STATEMENT: D

10. FREQUENCY: ASREQ

11. AS OF DATE: SEE BLOCK 16

12. DATE OF FIRST SUB: SEE BLOCK 16

13. DATE OF SUBS: SEE BLOCK 16

MOD/AMD

ATT/EXH ID

PAGE

Exhibit A

14. DISTRIBUTION:

A. ADDRESSEE: Engineering, usarmy.pica.devcom-ac.mbx.qesa-qew-aie@army.mil, Quality Assurance, usarmy.ria.devcom-ac.mbx.rdar-qep@army.mil, and Kat Marck, Contract Specialist, katlyn.m.marck.civ@army.mil, and Valencia Lane, Contracting Officer, Valencia.d.lane.civ@army.mil

B. COPIES: 3

DRAFT:

FINAL: 3

15. TOTAL: 3

16. REMARKS: REQUIRED BY THE AUTHORITY IN BOX 4, PARA 10.2 AND ITS SUBPARAGRAPHS. CONTRACTOR FORMAT IS ACCEPTABLE.

The FATR 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. THE CONTRACTOR

SHALL PROVIDE TO THE PROCURING CONTRACTING OFFICER, QAR, AND RDAR-EIQ-P AT LEAST 15 CALENDAR DAYS ADVANCE NOTICE (IN WRITING) OF THE

SCHEDULED DATE, TIME AND LOCATION OF START OF FAT, SO THAT THE GOVERNMENT MAY WITNESS THE TESTS. THE GOVERNMENT WILL REVIEW THE FATR AND

PROVIDE FEEDBACK TO THE CONTRACTOR WITHIN 30 CALENDAR DAYS OF RECEIPT OF FATR.

BLOCK 13: SUBSEQUENT SUBMISSION ONLY IF INITIAL FAT FAILS.

11 APRIL 2023