MMS Aviation Project Information / Evaluation Form

Phone (740) 622-6848 fax (740) 622-8277

scheduling@mmsaviation.org
www.mmsaviation.org

PO BOX 1118
COSHOCTON OH 43812-6118

I. General Information Address Phone

Owner South America Mission

_______________________________ 1021 Maxwell Mill Road STE B
____________________________________________ 803 802 8580
________________

User SAMAIR Bolivia

_______________________________ KM7 airport Santa Cruz, Bolivia
____________________________________________ 591-3-353-4436
________________

Greg Dahl
Contact Person _________________________ gregdahl@gmail.com
____________________________________________ 591-7-213-3908
________________

II. Aircraft Description

N#- 442KB
_________ Aircraft #1 Engine #2 Engine #1 Prop #2 Prop
Make _________
Angel _________
Lycoming _________
Lycoming _________
Hartzell _________
Hartzell

Model 44
_________ _________
IO540M1C5 _________
IO540M1C5 _________ _________

S/N _________ _________

L28172-48A _________
L28171-48A _________ _________

Time S.O.H. _________ _________

About 300 _________
About 300 _________
About 300 _________
About 300

Total Time _________

About 300 _________
About 300 _________
About 300 _________
About 300 _________
About 300

List STC’s and other modifications:

None

III. Aircraft Use - Please describe where and how this aircraft is used:
Missionary service. Santa Cruz, Bolivia

VI. Work Requested:

1 or 2 engine overhauls for years accumulated. Both prop overhauls. Export C of A

V. Time Factor - When is aircraft available, and when must it be completed?

Available to be flown to MMS in late March. Will be ready to receive plane as early has late-July. Would like it to be done by the
end of August if possible. There is no absolute deadline but September is a slow time that will work well for us to ferry the plane.

VI. Terms

Our terms are cash in advance for parts, outside work, etc. based on our estimate at the onset. Balance is to be paid in full at delivery of
project. Mileage, freight, postage, outside work, all materials,supplies, phone calls, special manuals and other expenses directly related to
your project will be your expense. We will provide shop labor, services and facilities at no charge. MMS reserves the right to furnish all
parts. Charges for parts are as follows: Items will be invoiced at the MMS cost plus 20% (our discounts on most parts and materials are
from 20% - 40%) By prior arrangement and at the discretion of MMS, parts may be furnished by the owner.

Y
Are these terms acceptable to you? _________ (Y/N)

VII. Y
Doctrinal Agreement - Can you subscribe to every point of our doctrinal statement?_________ (Y/N)

Signed _______________________________________________ Date __________