SUPPLIER CHECKLIST FOR VIR (EXCLUDING WAIVERS)(Supplement for Form DAC 26-887)

Deviation: A Written authorization, granted prior to the manufacture of an item, to depart from a particular performance or design requirement of a contract, specification or referenced document for a specific number of units for a specific period of time.

Non-Deviation: Information and/or clarification of technical or contractual requirements.

1. VENDOR NAME, ADDRESS, TELEPHONE NUMBER

2. PART NUMBER/SPEC

3. PART NAME

4. DETAIL PART NUMBER (*)

5. DETAIL PART NAME (*)

6. SUPPLIER DRAWING/BLUEPRINT (*)

7. PURCHASE ORDER NUMBERS (*)

8. QUANTITY SUBMITTED AND AFFECTED (*)

9. STATE DRAWING/SPEC REQUIREMENT LOCATION

10. IDENTIFICATION NUMBER(S) FOR PART/MATERIAL, SERIAL, LOT, BATCH, HEAT OR ROLL (*)

11. ADDITIONAL INFORMATION TO SUPPORT VIR (*)

12. NOTE IF DAC FURNISHED MATERIAL OR TOOLING

Note: (*) = if applicable