__________________________________________________________________________________________________________

                                    PERFORMANCE REQUIREMENTS SUMMARY
__________________________________________________________________________________________________________
              |           |                      |  MAXIMUM ALLOWABLE   |              | PROPORTION OF
   REQUIRED   | PARAGRAPH |       STANDARD       | DEGREE OF DEVIATION  |  METHOD OF   | REQUIRED SERVICE
   SERVICE    |  NUMBER   |                      | FROM REQMT. (AQL)    | SURVEILLANCE | TO TOTAL CONTRACT
______________|___________|______________________|______________________|______________|_____PRICE________
              |           |                      |                      |              |
0010BF Perform| C.5.28    |Accomplish per        | 10% Lot is number of |   Random     |     $______
preventive    | C.5.28.3  |procedure IAW schedule| days per month. All  |  Sampling    |
maintenance   |           |and Section C.        | defects cured within |              |
on ice        |           |                      | ______.              |              |
machines.     |           |                      |                      |              |
              |           |                      |                      |              |
0010BG Perform| C.5.28    |Accomplish per        | 10% Lot is number of |   Random     |     $______
preventive    | C.5.28.5  |procedure IAW schedule| requests per month.  |  Sampling    |
on freezer    |           |and Section C.        | All defects cured    |              |
chests and    |           |                      | within ______.       |              |
walk-ins.     |           |                      |                      |              |
              |           |                      |                      |              |
0010BH Perform| C.5.28    |Accomplish per        | 10% Lot is number of |   Random     |     $______
preventive    | C.5.28.7  |procedure IAW schedule| requests per month.  |  Sampling    |  
maintenance on|           |and Section C.        | All defects cured    |              |
air cleaning  |           |                      | within ______.       |              |
devices.      |           |                      |                      |              |
              |           |                      |                      |              |
0010BI Perform| C.5.28    |Accomplish per        | 10% Lot is number of |   Random     |     $______
preventive    | C.5.28.8  |procedure IAW schedule| requests per month.  |  Sampling    | 
maintenance on|           |and Section C.        | All defects cured    |              |
evaporative   |           |                      | within ______.       |              |
cooling for   |           |                      |                      |              |
drip-type and |           |                      |                      |              |
rotary drum   |           |                      |                      |              |
coolers.      |           |                      |                      |              |
              |           |                      |                      |              |
0010BJ Perform| C._._     |Accomplish per        | 4%  Lot is number of |   Random     |     $______
emergency     |           |procedure IAW schedule| requests per month.  |  Sampling    |              
response and  |           |and Section C.        | All defects cured    |              |
repair.       |           |                      | within ______.       |              |
              |           |                      |                      |              |
              |           |                      |                      |              | 
______________|___________|______________________|______________________|______________|__________________

     Reference, DA Pamphlet 715-15 Form 5473-R













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