3 - POM_CONST_Submittals.pdf
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- W91QF4-25-B-0001
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The document is a TRADOC (Training and Doctrine Command) Material Approval Submittal form, designated as TRADOC Form 928-R from November 1991. This form is designed for contractors to certify material compliance with contract specifications and to obtain government approval for submitted materials. The form provides spaces for contractors to detail specific items, including type, model number, catalog number, and manufacturer information, and allows government personnel to approve, disapprove, or request additional information about the submitted materials. Multiple review levels are included, with checkboxes for approval status and spaces for signatures from various reviewing officials.
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[ ] NEW [ ] RESUBMIT
ITEM SPECIFICATION SECJ AP- DISAP- SEE INITIAL
No PARA. NO./DWG. NO. PROVED PROVED REVERSE
TYPE OR PRINT NAME TITLE
TYPE OR PRINT NAME AND GRADE
TYPE OR PRINT NAME AND GRADE
TYPE OR PRINT NAME AND GRADE
TRADOC FORM 928-R, Nov 91
TO:
[ ] Approved [ ] Disapprove as indicated Above and Subject to Any Applicable Comments on the Reverse Side. Request Resubmittal on Disapproved.
items Within _______________ Days of Date Shown Below.
DATE SIGNATURE
TO:
DATE SIGNATURE
Recommend [ ] Approval [ ] Disapproval as indicated Above and Subject to Any Applicable Comments on the Reverse
TO:
FOR GOVERNMENT USE ONLY
For Evaluation and Action
DATE SIGNATURE
MATERIAL APPROVAL SUBMITTAL
TRADOC Reg 715-3
BY COMPLETEING THIS FORM, THE UNDERSIGNED CONTRACTOR CERTIFIES THAT
THE MATERIAL COMPLIES WITH ALL SPECIFICATIONS OF SUBJECT CONTRACT.
DATE
PREVIOUS SUBMISSION NUMBER PROJECT NUMBER
SUBMITTALSUBMISSION NUMBER
DESCRIPTION OF MATERIAL
DATE SIGNATURE
TO: (Contracting Officer) FROM: (Contractor)
TO BE COMPLETED BY CONTRACTOR FOR GOVERNMENT USE ONLY
(Include Type, Model Number, Catalog Number, Mfg., etc.)
CONTRACT NUMBER
(for Digital Signature)
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