PART I - TO BE COMPLETED BY THE SUPPLIER

TRACEABILITY/TEST DOCUMENTATION COVER SHEET

 3. SUBMITTED 

 BY

 1. TYPE OF DOCUMENTATION ATTACHED/SUBMITTED 

Traceability Documentation 

Test Report

a. Name

 c. Phone No.

 2. DATE

 b. E-mail

 4. SUPPLIER a. Company b. CAGE

 c. Address

 5. ITEM a. Contract No. b. CLIN

 d. Item Name/Description

 e. FSC f. NIIN g. Part No.

 c. Qty

 h. Part Manufacturer i. Mfr CAGE

 6. AWARD INFORMATION -- TRACEABILITY/TEST DOCUMENTATION REQUIREMENTS IN ACCORDANCE WITH DFARS 252.246-7008 & 

 DLAD PROCUREMENT NOTE M01 APPROVED SUPPLIERS for FSC 5961 Semiconductors and FSC 5962 Electronic Microcircuits

 The Supplier listed in block 4 of this form offered, and was awarded the contract listed in block 5a of this form as a: (Check Box That Applies)

Approved Source Manufacturer Specified in the Solicitation/Contract Item Description (Original Component 

Manufacturer (OCM), Original Equipment Manufacturer (OEM)) 

 Required Documentation of Traceability: Completed DLA L&M Form 918. If the bare item markings on the parts being provided do not 

 match the CAGE and part number specified in the item description in the contract, the supplier must provide documentation certifying that 

 the parts containing the alternate markings are the "exact product" as the item represented by the CAGE and part number specified in the 

 in the contract item description. 

Authorized Distributor of the OCM/OEM or QPL/QML Approved Source 

 Required Documentation of Traceability: Evidence of a contractual arrangement with or the express written authority of the 

 manufacturer or current design activity to buy, stock, sell or distribute the part and an unbroken chain of traceability documentation through 

 authorized distributors (if applicable), back to the approved source/manufacturer specified in the solicitation/contract. 

Supplier/Distributor on the Qualified Supplier List of Distributors (QSLD) for FSC 5961/5962 

 Required Documentation of Traceability: Evidence of unbroken chain of traceability documentation, through trusted providers, 

 back to an approved manufacturer specified in the solicitation/contract item description. Refer to the QSLD-5961/5962 document. 

 QPL/QML items require a Certificate of Conformance and Traceability (CoC/T), which must include information and documentation required 

 by the applicable military specification for the QPL/QML product. Refer to DLA Technical and Quality Requirement RQ007. 

Supplier/Distributor on the Qualified Testing Suppliers List (QTSL) for FSC 5961/5962 

 Required Documentation of Testing: Complete test report including summary of test results, electrical testing read and record data,

 device photos, etc. Traceability documentation to the source of parts provided for testing. Refer to DLAD Procurement Note M01.

 PART II - TO BE COMPLETED BY DLA 

 REVIEWER Name Date

 j. Date Code(s)

Approved Source on the Applicable Qualified Products List (QPL)/Qualified Manufacturers List (QML) 

 Required Documentation of Traceability: Completed DLA L&M Form 918. Also requires a Certificate of Conformance and

 Traceability (CoC/T), which must include information and documentation required by the applicable military specification for the QPL/QML product. 

 Refer to DLA Technical and Quality Requirement RQ007. 

 DLA LAND AND MARITIME FORM 918 (AUG 2017) Page 1 of 2 PDF(DLA L&M)
 DLA LAND AND MARITIME FORM 918 (AUG 2017) Page 2 of 2 PDF(DLA L&M)

TRACEABILITY/TEST DOCUMENTATION COVER SHEET

INSTRUCTIONS

NOTE: The Contracting Officer reserves the right to, at any time, request additional documentation of traceability or test 

report. The Contractor must maintain and be prepared to provide traceability/test documentation in accordance with the 

clauses within the awarded contract listed in Block 5a of this form. 

 

 

 

Block 6 - AWARD INFORMATION -- TRACEABILITY / TEST 

 DOCUMENTATION REQUIREMENTS 

Indicate the category of trusted supplier for which the supplier listed 

in Block 4 of this form has offered, and was awarded the contract 

listed in Block 5a of this form. The categories of trusted suppliers are-- 

 

 Approved Manufacturer Specified in the Solicitation/ 

 Contract Item Description --

 The source identified by name, CAGE, and part number listed in 

 the purchase item description in Section B of the award. This 

 category of supplier shall only be selected if the entity in Block 

 4 of the form is-- 

 1) the original manufacturer of the part 

 2) the original component manufacturer 

 3) the original equipment manufacturer 

 4) manufacturer specified in the solicitation/contract item 

 description 

 5) the part Design Control Activity, which is defined as the 

 entity having responsibility for the design of a given part and 

 for the preparation and currency of engineering drawings and 

 other technical data (TD) for that part. 

 

 Authorized Distributor of the Approved Manufacturer 

 Specified in the Solicitation/Contract Item Description -- 

 A supplier who has a contractual arrangement or the express 

 written authority with 1-5 above to buy, stock, re-package, sell, and 

 distribute the item specified in the solicitation/contract. 

 

 Supplier/Distributor on the Qualified Supplier List of 

 Distributors (QSLD) for FSC 5961/5962 -- 

 A distributor listed or determined qualified for listing on the 

 DLA Land and Maritime Qualified Supplier List of Distributors 

 (QSLD) for FSC 5961/5962. 

 

 Supplier/Distributor on the Qualified Testing Suppliers List 

 (QTSL) for FSC 5961/5962 -- 

 A distributor listed or determined qualified for listing on the 

 DLA Land and Maritime Qualified Testing Suppliers List (QTSL) 

 for FSC 5961 and 5962. 

 

 

 

 

 

 

Part II 

 

The DLA Land and Maritime contract administrator conducting the documentation review will enter his/her name and date to 

acknowledge the receipt of the form and accompanying traceability/test report. The entry of the reviewer's name and date does not 

signify a determination by the Government that the DLA L&M Form 918 and accompanying traceability documentation/test report is 

acceptable. Notification of acceptance will be provided by Contracting Officer letter. 

 

 

 

 

 

 

 

 

Part I 

 

Block 1 - TYPE OF DOCUMENTATION ATTACHED/SUBMITTED: 

Indicate the type of documentation being submitted. "Test Report" 

refers to a complete test report in accordance with the SAE AS6081 

guidelines required by the Criteria and Provisions for Qualified 

Testing Suppliers List (QTSL-5961/5961).

 

Block 2 - DATE: Enter the date the Supplier filled out the form.

 

Block 3 - SUBMITTED BY: Enter the name, E-mail address, and 

phone number of the person submitting the form. The person listed 

in Block 3a must be an individual who has the authority to bind the 

Contractor.

 

Block 4 - SUPPLIER: Enter the company name, Commercial and 

Government Entity (CAGE) code, and address of the entity to which 

the contract/purchase order was awarded. 

 

Block 5 - ITEM 

 a. Contract No.: Enter the Contract/Purchase Order/Agreement 

Number and, if applicable, the Delivery Order/Call Number of the 

order for which the item(s) are being provided.

 b. CLIN: Enter the Contract Line Item Number (CLIN) representing 

the item(s) being provided. 

 c. QTY: Enter the quantity of item(s) being provided.

 d. Item Name/Description: Enter the Item Description (item 

name) as it appears in the contract.

 e. FSC: Enter the Federal Supply Class (FSC) code. The FSC is the 

first four digits of the 13-digit National Stock Number (NSN).

 f. NIIN: Enter the National Item Identification Number (NIIN). The 

NIIN is the last nine digits of the 13-digit NSN. 

 g. Part No., h. Part Manufacturer, i. Mfr CAGE: Enter the 

manufacturer's part number, the part manufacturer, and the 

manufacturer's CAGE code for the item(s) being provided. The part 

manufacturer, CAGE, and part number entered shall be the same as 

what is in the product item description in the contract. 

 j. Date Code(s): Enter the manufacturing date codes for the parts 

being provided. The standard date code is four (4) numbers 

representing the year and week in that year the part was 

manufactured. Note: Some date codes will contain prefix and/or 

suffix pertaining to certain manufacturers.