Attachment_0014-1_DD_Form_1692_ECP(pg1).pdf
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- Expeditionary Shelter Protection System (ESPS)
- Solicitation number
- W911QY-16-R-0003
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Attachment 0014-1_DD Form 1692_ECP(pg1)
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16. DOCUMENTS AFFECTED (Continue on back if necessary)
ENGINEERING CHANGE PROPOSAL
(ECP)
15. ALL LOWER OR HIGHER
ITEMS AFFECTED
f. REVISED
DOCUMENT
ATTACHEDa. CAGE
22. CONTRACT
23. CONTRACTING OFFICER
25. BELOW TO BE COMPLETED BY THE APPROVING ACTIVITY
24. ORIGINATOR
10. NEED FOR CHANGE:
17. BASELINE AFFECTED:
11. MODEL/TYPE DESIGNATION
(e.g., M16) :
5. CLASS OF ECP:
14.a. OTHER EXTERNAL SYSTEM AFFECTED?
3. ECP NUMBER:
1. DATE PREPARED
(DD-MMM-YYYY) OMB No.
0704-0188
4. TITLE OF CHANGE:
c. E-MAIL:b. TELEPHONE:a. NAME:
a. NOMENCLATURE: b. PART NO.: c. NSN:
12. SYSTEM/CONFIGURATION ITEM NOMENCLATURE
(e.g., Rifle):
19. EFFECTIVITY (Lot No., Serial No., Date): 20. EFFECT ON DELIVERY SCHEDULE:
9. DESCRIPTION OF CHANGE:
c. DATE SIGNED (DD-MMM-YYYY): d. SIGNATURE:
2. PROCURING ACTIVITY NO. (PAN):
Functional
Yes No
b. ADDRESS (Street, City, State, Zip Code):
b. DOCUMENT NO.
d.
CURRENT
REVISION
e.
NOR
NO.
b. NAME and TITLE:
a. RECOMMENDATIONS:
The public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, Alexandria, VA 22350-3100 (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 COMPLETED FORM TO THIS ADDRESS. RETURN COMPLETED FORM TO THE GOVERNMENT ISSUING CONTRACTING OFFICER FOR THE CONTRACT/PROCURING ACTIVITY NUMBER LISTED IN ITEM 2 OF THIS FORM.
Major Minor Administrative
6. PRIORITY:
E - Emergency U - Urgent R - Routine
7. ECP TYPE:
P - Preliminary F - Formal
8. JUSTIFICATION CODE:
O - Operational or Product Improvement P - Production Stoppage
B - Interface C - Compatibility D - Correction of Deficiency L - Logistics Support
R - Cost Reduction S - Safety V - Value Engineering
13. AFFECTED ITEM NOMENCLATURE
(e.g., Bracket):
b. IF BLOCK 14.a. IS YES, LIST OTHER SYSTEMS OR CONFIGURATION ITEMS AFFECTED:
c. NOMENCLATURE
Allocated Product
18. IN PRODUCTION:
Yes No
21.a. RECOMMEND RETROFIT TO EXISTING ASSETS? Yes No
b. IF BLOCK 21.a. IS YES, DESCRIBE RETROFIT
REQUIREMENTS:
a. CONTRACTOR: b. CONTRACT NO./LINE ITEM:
a. NAME (Submitter):
d. E-MAIL:
c. TELEPHONE:
Approval Disapproval Approval with Modification
c. DATE SIGNED (DD-MMM-YYYY): d. SIGNATURE: b. NAME and TITLE:
26.a. DISPOSITION (Configuration Change Authority) Approved Disapproved Approved with Modification
b. DATE NEW REVISION(S) RELEASED: c. SIGNATURE:a. NAME and TITLE:
27. TO BE COMPLETED BY THE ACTIVITY ACCOMPLISHING REVISION UPON NEW REVISION RELEASE
DD FORM 1692, MAR 2013 Adobe Designer 9.0
DISTRIBUTION STATEMENT:
PREVIOUS EDITION IS OBSOLETE.
e. ECP ORIGINATOR
CAGE CODE:
f. SUBMITTING ACTIVITY: h. NAME AND TITLE (Authorizing Official):g. AUTHORIZED SIGNATURE:
Yes Noc. COST IMPACT FROM ECP?
d. IF 21.c. IS YES, DESCRIBE:
DD Form 1692, Engineering Change Proposal Page 1, March 2013
WHS/ESD/IMD
16. DOCUMENTS AFFECTED
(Continue on back if necessary)
ENGINEERING CHANGE PROPOSAL
(ECP)
15. ALL LOWER OR HIGHER
ITEMS AFFECTED
f. REVISED
DOCUMENT
ATTACHED
a. CAGE
22. CONTRACT
23. CONTRACTING OFFICER
25. BELOW TO BE COMPLETED BY THE APPROVING ACTIVITY
24. ORIGINATOR
10. NEED FOR CHANGE:
17. BASELINE AFFECTED:
11. MODEL/TYPE DESIGNATION
(e.g., M16)
5. CLASS OF ECP:
14.a. OTHER EXTERNAL SYSTEM AFFECTED?
3. ECP NUMBER:
1. DATE PREPARED
(DD-MMM-YYYY)
OMB No.
0704-0188
4. TITLE OF CHANGE:
c. E-MAIL:
b. TELEPHONE:
a. NAME
a. NOMENCLATURE:
b. PART NO.:
c. NSN:
12. SYSTEM/CONFIGURATION ITEM NOMENCLATURE
(e.g., Rifle)
19. EFFECTIVITY
(Lot No., Serial No., Date)
20. EFFECT ON DELIVERY SCHEDULE:
9. DESCRIPTION OF CHANGE:
c. DATE SIGNED
(DD-MMM-YYYY)
: d. SIGNATURE:
2. PROCURING ACTIVITY NO. (PAN):
Functional Yes No
b. ADDRESS (Street, City, State, Zip Code)
b. DOCUMENT NO.
d.
CURRENT
REVISION
e.
NOR
NO.
b. NAME and TITLE:
a. RECOMMENDATIONS:
The public reporting burden for this collection of information is estimated to average 2 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing the burden, to Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 4800 Mark Center Drive, Alexandria, VA 22350-3100 (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 COMPLETED FORM TO THIS ADDRESS. RETURN COMPLETED FORM TO THE GOVERNMENT ISSUING CONTRACTING OFFICER FOR THE CONTRACT/PROCURING ACTIVITY NUMBER LISTED IN ITEM 2 OF THIS FORM.
Major Minor Administrative
6. PRIORITY:
E - Emergency U - Urgent R - Routine
7. ECP TYPE:
P - Preliminary F - Formal
8. JUSTIFICATION CODE:
O - Operational or Product Improvement P - Production Stoppage B - Interface C - Compatibility D - Correction of Deficiency L - Logistics Support R - Cost Reduction S - Safety V - Value Engineering
13. AFFECTED ITEM NOMENCLATURE
(e.g., Bracket)
b. IF BLOCK 14.a. IS YES, LIST OTHER SYSTEMS OR CONFIGURATION ITEMS AFFECTED:
c. NOMENCLATURE Allocated Product
18. IN PRODUCTION:
Yes No 21.a. RECOMMEND RETROFIT TO
EXISTING ASSETS?
Yes No
b. IF BLOCK 21.a. IS YES, DESCRIBE RETROFIT
REQUIREMENTS:
a. CONTRACTOR:
b. CONTRACT NO./LINE ITEM:
a. NAME (Submitter)
d. E-MAIL:
c. TELEPHONE:
Approval Disapproval Approval with Modification
c. DATE SIGNED
(DD-MMM-YYYY)
: d. SIGNATURE:
b. NAME and TITLE:
26.a. DISPOSITION (Configuration Change Authority) Approved Disapproved Approved with Modification
b. DATE NEW REVISION(S) RELEASED: c. SIGNATURE:
a. NAME and TITLE:
27. TO BE COMPLETED BY THE ACTIVITY ACCOMPLISHING REVISION UPON NEW REVISION RELEASE
DD FORM 1692, MAR 2013
Adobe Designer 9.0
DISTRIBUTION STATEMENT:
PREVIOUS EDITION IS OBSOLETE.
e. ECP ORIGINATOR
CAGE CODE:
f. SUBMITTING ACTIVITY:
h. NAME AND TITLE (Authorizing Official)
g. AUTHORIZED SIGNATURE:
Yes No
c. COST IMPACT FROM ECP?
d. IF 21.c. IS YES, DESCRIBE:
| 1. Date prepared (2 digit day-3 letter month-4 digit year).: |
| 2. Procuring Activity Number (PAN).: |
| 3. Engineering Change Proposal (ECP) number.: |
| 4. Title of change.: |
| 26a. Disposition (Configuration change authority). (To be completed by the approving activity). X first box if approved, second if disapproved, third if approved with modification.: |
| 9. Description of change.: |
| 10. Need for change.: |
| 11. Model/type designation (e.g., M-16).: |
| 12. System/configuration item nomenclature (e.g., rifle).: |
| 13. Affected item nomenclature (e.g., bracket).: |
| b. If yes, list other systems or configuration items affected.: |
| 15. All lower or higher items affected. a. Nomenclature.: |
| b. Part number.: |
| c. NSN.: |
| 16. Documents affected. a. CAGE code, line 1.: |
| b. Document number.: |
| c. Nomenclature.: |
| d. Current revision.: |
| e. Notice of Revision number.: |
| f. Revised document attached.: |
| a. CAGE code, line 2.: |
| b. Document number.: |
| c. Nomenclature.: |
| d. Current revision.: |
| e. Notice of Revision number.: |
| f. Revised document attached.: |
| b. Document number.: |
| a. CAGE code, line 3.: |
| c. Nomenclature.: |
| d. Current revision.: |
| e. Notice of Revision number.: |
| f. Revised document attached.: |
| a. CAGE code, line 4.: |
| b. Document number.: |
| c. Nomenclature.: |
| d. Current revision.: |
| e. Notice of Revision number.: |
| f. Revised document attached.: |
| a. CAGE code, line 5.: |
| b. Document number.: |
| c. Nomenclature.: |
| d. Current revision.: |
| e. Notice of Revision number.: |
| f. Revised document attached.: |
| 19. Effectivity (lot number, serial number, date).: |
| 20. Effect on delivery schedule.: |
| b. If yes, describe retrofit requirements.: |
| d. If yes, describe.: |
| 22. Contract information. a. Contractor.: |
| b. Contract number and line item.: |
| 23. Contracting officer. a. Name (first, middle initial, last).: |
| b. Telephone number.: |
| c. E-mail address.: |
| 24. Originator. a. Name (first, middle initial, last).: |
| c. Address (include zip code).: |
| c. Telephone number.: |
| d. E-mail address.: |
| e. ECP originator CAGE code.: |
| f. Submitting activity.: |
| g. Authorized signature.: |
| h. Name and title of authorizing official.: |
| b. Name and title.: |
| c. Signature.: |
| d. Date signed (2 digit day-3 letter month-4 digit year).: |
| b. Name and title.: |
| c. Signature.: |
| d. Date signed (2 digit day-3 letter month-4 digit year).: |
| 27. To be completed by the activity accomplishing revision upon new revision release. a. Name and title.: |
| b. Signature.: |
| c. Date signed (2 digit day-3 letter month-4 digit year).: |
| Distribution statement.: |
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