Af Form 3000 (Sep 91) Material Approval Submittal

Form Approved

MATERIAL APPROVAL SUBMITTAL

OMB No 9000-0062

(See Instructions on Reverse)

Expires Apr 30, 1993

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TO: (Contracting Officer)

FROM: (Contractor)

DATE

CONTRACT NUMBER

SUBMISSION NUMBER

SUBMITTAL

NEW

RESUBMITTAL

PREVIOUS SUBMISSION NUMBER

PROJECT NUMBER

TO BE COMPLETED BY CONTRACTOR

FOR GOVERNMENT USE ONLY

ITEM

SPECIFICATION SECTION/

DESCRIPTION OF MATERIAL

AP-

DISAP-

SEE

INITIAL

NO.

PARA NO./DRAWING NO.

(Include Type, Model Number, Catalog Number, Mfg., etc.)

PROVED

PROVED

REVERSE

BY COMPLETING THIS FORM, THE UNDERSIGNED CONTRACTOR CERTIFIES THAT

THE MATERIAL COMPLIES WITH ALL SPECIFICATIONS OF SUBJECT CONTRACT.

DATE

TYPE OR PRINT NAME AND TITLE

SIGNATURE

FOR GOVERNMENT USE ONLY

TO: (Base Civil Engineering Officer)

For Evaluation and Action

DATE

TYPE OR PRINT NAME AND GRADE

SIGNATURE

TO: (AF Contracting Office)

RECOMMEND

APPROVAL

DISAPPROVAL AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE

DATE

TYPE OR PRINT NAME AND GRADE

SIGNATURE

TO: (Contractor)

DISAPROVED AS INDICATED ABOVE AND SUBJECT TO ANY APPLICABLE COMMENTS ON THE REVERSE SIDE. REQUEST

APPROVED

RESUBMITTAL ON DISAPPROVED ITEMS WITHIN

DAYS OF DATE SHOWN BELOW.

DATE

TYPE OR PRINT NAME AND GRADE

SIGNATURE

AF FORM 3000, SEP 91 (EF)

PREVIOUS EDITION IS OBSOLETE.