Request for Information Attachment 1 SQS

SOURCE QUALIFICATION STATEMENT (SQS)

Introduction:
This document defines the Qualification Requirements (QR) and administrative criteria necessary to establish source approval for the item(s) listed in Section A from the approved sources listed in Table I of this document. There are three types of offers considered under this SQS: Manufacturing and Procurement, Procurement Only, and Repair, Overhaul, Maintenance and Modification (ROMM). 1. Manufacturing and Procurement: The offeror of the item possesses the required Technical Data Package (TDP), tooling, and manufacturing capabilities to produce and deliver a fully compliant, field-ready asset from raw materials and/or piece parts. 2. Procurement Only (Distributor / Supplier): The offeror operates as an authorized vendor/ distributor supplying the item from an approved manufacturing source. The offeror does not perform value-added manufacturing, assembly, or modification but must provide documentation verifying traceability from the approved Original Equipment Manufacturer (OEM). 3. Repair, Overhaul, Maintenance and Modification (ROMM): The offeror possesses the technical data, specialized tooling, and depot-level capabilities to restore a non-serviceable asset to its original operational performance standards and operational safety, suitability, and effectiveness (OSS&E) limits.

SECTION A: ITEM IDENTIFICATION

Stock Number (NSN):

Part Number:

1650-01-187-9395

205-076-056-107

Nomenclature:

ACTUATOR ASSEMBLY, FLIGHT CONTROL

Technical Order (If Applicable):
Note: Potential vendors will have to obtain access to the USAF Technical Order system- the Enhanced Technical Information Management System (ETIMs). This system is the source for the most up to date USAF TOs.
AMSC Code: C

AMSC Code: This part requires engineering source approval to ensure the integrity of the part. An alternative source must qualify according to procedures, as approved by Cognizant Engineering Authority: AFLCMC/WIHEZ

SECTION B: JUSTIFICATION FOR ESTABLISHING A QUALIFICATION REQUIREMENT

Note: Reference AFI20-106 Management of Aviation Critical Safety Items Aircraft Applicability: TH-1H
Item Description / Application:
Flight Control Actuator Assembly (P/N: 205-076-056-107) This actuator assembly (P/N 205-076-056-107) is utilized on the cyclic and collective controls. This actuator assembly provides hydraulic assisted cyclic input from the pilot to the main rotor through the swashplate and collective input through the collective levers and scissor hub. The likely failure mode would be a functional loss of hydraulic assist. In the