1.2 W SOUTHCOM Offer Submission Package.docx

OFFER SUBMISSION PACKAGE (OSP)

INTO-PLANE / PURCHASE PROGRAM

1.2 W SOUTHCOM (OVERSEAS) -SOLICITATION SPE607-23-R-0204

PERIOD OF PERFORMANCE: 1 OCT 2025 THROUGH 30 SEP 2028

CLOSING DATE AND TIME: September 12, 2025 @ 3:00 PM FORT BELVOIR, VA- EASTERN STANDARD TIME (EST). Late Offers: Any offers received after September 12, 2025@ 3:00 PM will be considered “LATE” and may be excluded from the competition. Submit your offers well ahead of the closing date and time.

OSP CHECKLIST

1) STANDARD FORM 1449: Signature and date in ink or digitally in Blocks 30a, b and c. include your company name, address, telephone, and fax, “DUNS” and “CAGE code” number in Block 17a.

2) OFFEROR PRICE BREAKDOWN SHEET: For each item number/ICAO code. Sign and date in ink or digital signature.

3) CERTIFICATE OF ANALYSIS OR CERTIFICATE OF QUALITY: Offerors shall submit a Certificate of Analysis (COA) or Certificate of Quality (COQ) from a supplier verifying that the fuel meets Government’s specifications for fuel type in Solicitation (C16.64-4 for JP8), per Factor 1: Technical Acceptability of FAR 52.212-2(a).

4) COMMITMENT LETTER (Reference template letter attached to solicitation)

5) SAM ACCOUNT: Completed or updated by Solicitation closing date: sam.gov/

By submitting your OSP, you agree to the terms and conditions of the entire Solicitation, and any Amendments, unless clearly stated herein.

INSTRUCTIONS TO OFFERORS

(PLEASE READ THE FOLLOWING CAREFULLY)

1. Only one CAGE code may be listed on an OSP. Offerors with more than one CAGE code MUST complete a separate OSP and Offer Price Breakdown Sheet for each company’s CAGE Code for every location that is offered on. DLA Energy will not accept an OSP with multiple CAGE Codes.

2. The Offer Submission Package must be returned to this office as your proposal based on the OSP checklist.

NOTE:

i. X Standard Form 1449 (SF1449) - Sign and date in ink or digitally in Blocks 30a, b and c. Include your company name, address, telephone, and fax, DUNS and CAGE numbers in Block 17a.

ii. X Offer Price Breakdown Sheet must be expressed in U.S. Dollars per gallon and to the 6th decimal. (Example: $0.000000) place for the Product being solicited. (Jet Petroleum 8 )

3. Offerors MUST update and complete registration in the System for Award Management (SAM) database by the solicitation closing date. The Website to obtain details and instructions is: https://sam.gov/SAM.

4. Evaluation Criteria: Proposals will be evaluated pursuant to FAR 52.212-2 – Evaluation – Commercial Items. Proposals will be evaluated based on a lowest price technically acceptable (LPTA) source selection process. The Contracting Officer will evaluate proposals in accordance with the FAR 15.101-2 Lowest Price Technically Acceptable source selection process. DLA Energy will make award(s) to the technically acceptable proposal with the lowest evaluated price for the requirements as solicited for the particular airport. In order to be considered for award, an Offeror must meet or exceed technical acceptability standards. Offers will be evaluated and contracts awarded by airport location. An offer for an airport location will be evaluated independently from all other airport locations for a contract award. An Offeror who fails to offer on all products solicited at an airport location in Section B for an airport location will be ineligible for award for that location.

5. Offerors must provide a Supplier Invoice with the Price Paid for fuel or government posting per location effective on The BASE REFERENCE DATE of 26 August 2025 (Invoice dated: 1 August 2025 – 31 August 2025.)

6. Offerors shall submit a Certificate of Analysis (COA) or Certificate of Quality (COQ) for each line item offered verifying that the fuel meets Government’s specifications for the fuel type in Solicitation (C16.64-4 for JP8). Offeror(s) must annotate each item number/ICAO code on the COAs and COQs. Offerors who are not the Refueler or Fixed- Based Operator are also required to submit a Commitment Letter from the FBO with its initial proposal. The Offeror must be able to demonstrate that the Offeror has secured arrangements that will enable it to support orders for the product specified, in accordance with the requirement schedule, and consistent with the delivery requirements and all other terms and conditions in the solicitation. Such commitment letters should be submitted with the Offeror’s initial proposal. COA and COQ must be in English. Reference sample Commitment Letter in the attachments. If the Offeror fails to submit a Certificate of Analysis or Certificate of Quality and Commitment Letter from the Fixed-Based Operator (FBO) with its proposal, the offer may be considered nonresponsive.

7. All proposals must be received before 3:00 p.m. Ft. Belvoir, Virginia time, September 12, 2025. Any proposals received after 3:00 p.m. Ft. Belvoir, Virginia time, September 12, 2025, will be considered “late.” Offerors assume all risk for any delay in the transmission of their proposals. Refer to FAR 52.212-2(f). Faxed proposals are not authorized. Please e-mail your proposal to:jamika.forde@dla.mil. Please ensure that your proposal (SF1449) assigned per FAR 52.212-1. Late proposals will be processed in accordance with FAR 15.208 – Submission, Modification, Revision, and Withdrawal of Proposals. When submitting a proposal via e-mail, please ensure it is sent within enough time in order for it to be processed through the server. The maximum file size per email is 10 MB (IAW L2.11-4).

8. Exceptions to the specifications, terms, and conditions of this solicitation may be pursuant to the Provision M72 EVALUATION OF OFFERS (EXCEPTIONS/DEVIATIONS) (DLA ENERGY APR1997). Indicate any exceptions and the extent to which your offer differs from the solicitation requirements on company letter signed by an authorized representative of the company attached with your offer.

9. Offerors must agree to honor prices their proposal for 180 calendar days from the date of RFP closing date. The Offeror’s proposal in response to the solicitation may be incorporated into the resultant contract in whole or in part at the time of award.

10 .The Government has the right to evaluate all proposals in accordance with FAR Part 15.305(a) and establish the competitive range without discussions. Based on the ratings of each proposal against all evaluation criteria, the Contracting Officer will establish a competitive range comprised of all of the most highly rated proposals, unless the range is further reduced for purposes of efficiency. In the case where the Contracting Officer has determined that the number of most highly rated proposals will be too many to conduct efficient competition, the Contracting Officer may limit the number of proposals in the competitive range to the greatest number that will permit an efficient competition among the most highly rated proposals. The Contracting Officer will provide a written notice of competitive range decision to unsuccessful Offerors in accordance with FAR Part 15.503(a).

11. Offerors are reminded of the following language in the C16.64-4 specification for JP8: “Additives in accordance with MIL-DTL-83133K dated July 18, 2018 and as modified below are required for deliveries of JP8 at the skin of the aircraft. . .. (2)(i) The fuel shall contain 0.04 to 0.15 percent by volume FSII.”

12. Primary Solicitation Point of Contact: For clarification, explanation, and additional information, please contact Jamika Forde at 571-767-6959; email: jamika.forde@dla.mil

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

1.

REQUISITION NUMBER

7013620514

2. CONTRACT NO.

7. FOR SOLICITATION INFORMATION CALL:

3.

AWARD/EFFECTIVE DATE

a. NAME

Jamika Forde 23D 4.

ORDER NUMBER

5. SOLICITATION NUMBER SPE607-23-R-0204

b. TELEPHONE NUMBER (No Collect calls)

Phone: DSN392-767-69 6.

SOLICITATION ISSUE DATE

2025 SEP 5

OFFER DUE DATE/ LOCAL TIME

2025 SEPTEMBER 12

3:00 PM

8. ISSUED BY CODE

SPE607

9.

THIS ACQUISITION IS UNRESTRICTED OR

SET ASIDE: % FOR:

DLA ENERGY INTOPLANE

8725 JOHN J. KINGMAN ROAD

SMALL BUSINESS

HUBZONE SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED SMALL BUSINESS PROGRAM

FORT BELVOIR VA 22060 USA

SERVICE-DISABLED VETERAN-OWNED SMALL BUSINESS

EDWOSB 8 (A)

NAICS: 324110 SIZE STANDARD:

10. DELIVERYFOR FOB DESTINA-

TION UNLESS BLOCK IS MARKED

SEE SCHEDULE

15. DELIVER TO

11.

DISCOUNT TERMS

CODE

13a. THIS CONTRACT IS A RATED ORDER UNDER DPAS (15 CFR 700)

16. ADMINISTERED BY

13b. RATING

14. METHOD OF SOLICITATION

RFQ IFB RFP

CODE

SEE SCHEDULE

17a. CONTRACTOR/ CODE OFFEROR

FACILITY CODE

18a. PAYMENT WILL BE MADE BY CODE

TELEPHONE NO.

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK

OFFER

BELOW IS CHECKED

SEE ADDENDUM

1.

ITEM NO.

2.

SCHEDULE OF SUPPLIES/SERVICES

3.

QUANTITY

4. UNIT

5.

UNIT PRICE

6.

AMOUNT

See Schedule

1.2W SOUTHCOM consist of various commercial Airports as follows:

MPPA – PANAMA PACIFICO INTERNATIONAL AIRPORT (BALBOA), PANAMA

PERIOD OF PERFORMANCE: 01 OCT 2025 - 30 SEPT 2028

(Use Reverse and/or Attach Additional Sheets as Necessary)

7. ACCOUNTING AND APPROPRIATION DATA

8. TOTAL AWARD AMOUNT (For Govt. Use Only)

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

29. AWARD OF CONTRACT: REF. OFFER

DATED . YOUR OFFER ON SOLICITATION (BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (Type or Print) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or Print) 31c. DATE SIGNED

ARE NOT ATTACHED ARE NOT ATTACHED

AUTHORIZED FOR LOCAL REPRODUCTION PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

Offerors, who submit an offer under Solicitation SPE607-23-R-0204 with any Amendments, for all locations, must complete all Certifications and Representations below. Full text for all Certifications and Representations are found in Solicitation SPE607-23-R-0204. Those Certifications and Representations available in SAM shall be completed in SAM; those not available in SAM shall be completed below.

FAR CLAUSES, DFARS CLAUSES AND DLA ENERGY CONTRACT TEXTS:

1. B15.01, SUPPLIES AND ESTIMATED QUANTITIES TO BE FURNISHED (INTO-PLANE) (DLA ENERGY(DEC 2018)

2. G9.07-5 ELECTRONIC TRANSFER OF FUNDS PAYMENTS –RESERVE WIRE

TRANSFERSYSTEM (DLA ENERGY JAN 2012) – Provide account details if Offeror is using a Non United States Bank

3. FAR 52.203-2 CERTIFICATE OF INDEPENDENT PRICE DETERMINATION (APR 1985)

4. FAR 52.203-11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCECERTAIN FEDERAL TRANSACTIONS (SEP 2007)

5. FAR 52.203-18 PROHIBITION ON CONTRACTING WITH ENTITIES THAT REQUIRE CERTAININTERNALCONFIDENTIALITY AGREEMENTS OR STATEMENTS— REPRESENTATION (JAN 2017)

6. FAR 52.204-16 COMMERCIAL AND GOVERNMENT ENTITY CODE REPORTING (AUG 2020)

7. FAR 52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (AUG 2020)

8. FAR 52.204-20 PREDECESSOR OF OFFEROR (AUG 2020)

9. FAR 52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS-REPRESENTATION (NOV 2015)

10. FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (AUG 2020)

11. FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

12. FAR 52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY OR AFELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

13. FAR 52.212-3 OFFEROR REPRESENTATIONS AND COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (FEB 2024)

14. FAR 52.222-25 AFFIRMATIVE ACTION COMPLIANCE (APR 1984)

15. FAR 52.222-56 CERTIFICATION REGARDING TRAFFICKING IN PERSONS COMPLIANCE PLAN (OCT 2020)

16. FAR 52.229-11 TAX ON CERTAIN FOREIGN PROCUREMENTS – NOTICE AND REPRESENTATION (JUNE 2020)

17. DFARS 252.204-7016 COVERED DEFENSE TELECOMMUNICATIONS EQUIPMENT OR SERVICES – REPRESENTATION (DEC 2019)

SPE607-23-R-0204

18. DFARS 252.204-7017 PROHIBITION ON THE ACQUISITION OF COVERED DEFENSE TELECOMMUNICATIONS EQUIPMENT OR SERVICES – REPRESENTATION (MAY 2021)

19. DFARS 252.209-7002 DISCLOSURE OF OWNERSHIP OR CONTROL BY A FOREIGN GOVERNMENT (DEC 2022)

20. DFARS 252.225-7020 TRADE AGREEMENTS CERTIFICATE—BASIC (NOV 2014)

21. DFARS 252.247-7022 REPRESENTATION OF EXTENT OF TRANSPORTATION BY SEA (JUN

2019)

22. K15 RELEASE OF UNIT PRICES (DLA ENERGY MAR 2009)

23. K33.01 AUTHORIZE NEGOTIATORS (DLA ENERGY APR 2007)

24. K150 WIDE AREA WORKFLOW (DLA ENERGY MAY 2014)

The Offeror has completed the Certifications and Representations 1 through 24 above for the Solicitation SPE607-23-R-0204.

Print Name of Authorized Official: _ Signature of Authorized Official: Date:

OFFER PRICE BREAKDOWN SHEET (OVERSEAS version) Jet Petroleum 8 (JP8)

AIRPORT NAME AND ICAO CODE:

(Identify the airport and its ICAO code found in the solicitation schedule)

VENDOR CAGE CODE: LARGE OR SMALL BUSINESS: CLIN NUMBER: STATE/ COUNTRY:

EST QUANTITY GALLONS:

IF THE INCUMBENT, STATE YOUR CONTRACT NUMBER #: REFERENCE DATE: 26 August 2025

Jet Petroleum 8 (JP8):

($ USD Currency)

into-plane, into-truck, rapid refuel)

TOTAL UNIT PRICE (Sum of A and B) $ C.

PUBLICATION/REFERENCE SELECTED FOR MARKET PRICE ADJUSTMENT

PLATTS : OTHER :

Prices will change on [ ] Monday [ ] Tuesday [ ] Weekly [ ] Monthly[ ] Other

** NOTE Call Out Fees and hours are not evaluated items; however, in the event that 24-hour service is not available and the Government is unable to provide advance notification of after-hour delivery requirements, into-plane fuel may be procured from another source.

Per Hour or Per Occurrence (Included)

Hours of Operations [ ] 24 hours per day, 7 days per week (preferred) OR [ ] Other (Specify hours/call- out, and phone number for call-outs):

Circle One Call-Out/Overtime Fee and Advance Notice: Holidays Included: YES or NO

Are you the REFUELER for this offer under this location? (Please check one) YES or NO

**** (Commitment letter must match the name and Address of the Refueler/FBO information below. COA or COQ must be in English)

Refueler (FBO) Point of Contact Name:

Full Physical Address (Country & State):

Person at Facility Phone Number:

Refinery Source Name:

Physical Address:

Phone Number:

K33.01 Authorized Negotiators (Reference: DLA Energy APR 2007)

Name & Title: Email &Phone:

Name & Title: Email &Phone:

FAR 52.209-2 PROHIBITION ON CONTRACTING WITH INVERTED DOMESTIC CORPORATIONS- REPRESENTATION (NOV 2015)

(C) REPRESENTATION. THE OFFEROR REPRESENTS THAT-

(1) IT □ IS, □ IS NOT AN INVERTED DOMESTIC CORPORATION; AND

(2) IT □ IS, □ IS NOT A SUBSIDIARY OF AN INVERTED DOMESTIC CORPORATION.

(END OF PROVISION)

FAR 52.209-5 CERTIFICATION REGARDING RESPONSIBILITY MATTERS (AUG 2020)

(A) (1) THE OFFEROR CERTIFIES, TO THE BEST OF ITS KNOWLEDGE AND BELIEF, THAT—

(I) THE OFFEROR AND/OR ANY OF ITS PRINCIPALS–

(A) ARE □ ARE NOT □ PRESENTLY DEBARRED, SUSPENDED, PROPOSED FOR DEBARMENT, OR DECLARED INELIGIBLE FOR THE AWARD OF CONTRACTS BY ANY FEDERAL AGENCY;

(B) HAVE □ HAVE NOT □, WITHIN A THREE-YEAR PERIOD PRECEDING THIS OFFER, BEEN CONVICTED OF OR HAD A CIVIL JUDGMENT RENDERED AGAINST THEM FOR: COMMISSION OF FRAUD OR A CRIMINAL OFFENSE IN CONNECTION WITH OBTAINING, ATTEMPTING TO OBTAIN, OR PERFORMING A PUBLIC (FEDERAL, STATE, OR LOCAL) CONTRACT OR SUBCONTRACT; VIOLATION OF FEDERAL OR STATE ANTITRUST STATUTES RELATING TO THE SUBMISSION OF OFFERS; OR COMMISSION OF EMBEZZLEMENT, THEFT, FORGERY, BRIBERY, FALSIFICATION OR DESTRUCTION OF RECORDS, MAKING FALSE STATEMENTS, TAX EVASION, VIOLATING FEDERAL CRIMINAL TAX LAWS, OR RECEIVING STOLEN PROPERTY (IF OFFEROR CHECKS "HAVE", THE OFFEROR SHALL ALSO SEE 52.209-7, IF INCLUDED IN THIS SOLICITATION);

(C) ARE □ ARE NOT □ PRESENTLY INDICTED FOR, OR OTHERWISE CRIMINALLY OR CIVILLY CHARGED BY A GOVERNMENTAL ENTITY WITH, COMMISSION OF ANY OF THE OFFENSES ENUMERATED IN PARAGRAPH (A)(1)(I)(B) OF THIS PROVISION;

(D) HAVE □, HAVE NOT □, WITHIN A THREE-YEAR PERIOD PRECEDING THIS OFFER, BEEN NOTIFIED OF ANY DELINQUENT FEDERAL TAXES IN AN AMOUNT THAT EXCEEDS THE THRESHOLD AT 9.104-5(A)(2) FOR WHICH THE LIABILITY REMAINS UNSATISFIED.

FAR 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

(B) THE OFFEROR □ HAS □ DOES NOT HAVE CURRENT ACTIVE FEDERAL CONTRACTS AND GRANTS WITH TOTAL VALUE GREATER THAN $10,000,000.

SPE607-23-R-0204

DFARS 252.225-7020 TRADE AGREEMENTS CERTIFICATE—BASIC (NOV 2014)

(B) CERTIFICATION AND IDENTIFICATION OF COUNTRY OF ORIGIN.

(1) FOR ALL LINE ITEMS SUBJECT TO THE TRADE AGREEMENTS—BASIC CLAUSE OF THIS SOLICITATION, THE OFFEROR CERTIFIES THAT EACH END PRODUCT TO BE DELIVERED UNDER THIS CONTRACT, EXCEPT THOSE LISTED IN PARAGRAPH (C)(2) OF THIS PROVISION, IS A U.S.-MADE, QUALIFYING COUNTRY, OR DESIGNATED COUNTRY END PRODUCT.

(2) THE FOLLOWING SUPPLIES ARE OTHER NON-DESIGNATED COUNTRY END PRODUCTS: (LINE ITEM NUMBER) (COUNTRY OF ORIGIN)

FAR 52.209-11 REPRESENTATION BY CORPORATIONS REGARDING DELINQUENT TAX LIABILITY OR A FELONY CONVICTION UNDER ANY FEDERAL LAW (FEB 2016)

(b) The Offeror represents that–

(1) It is □ is not □ a corporation that has any unpaid Federal tax liability that has been assessed, for which all judicial and administrative remedies have been exhausted or have lapsed, and that is not being paid in a timely manner pursuant to an agreement with the authority responsible for collecting the tax liability; and

(2) It is □ is not □ a corporation that was convicted of a felony criminal violation under a Federal law within the preceding 24 months.

(End of provision)

DFARS 252.209-7002 DISCLOSURE OF OWNERSHIP OR CONTROL BY A FOREIGN GOVERNMENT (DEC 2022)

(a) Definitions.As used in this provision—

(1) “Effectively owned or controlled” means that a foreign government or any entity controlled by a foreign government has the power, either directly or indirectly, whether exercised or exercisable, to control the election, appointment, or tenure of the Offeror’s officers or a majority of the Offeror’s board of directors by any means, e.g., ownership, contract, or operation of law (or equivalent power for unincorporated organizations).

(2) “Entity controlled by a foreign government”—

(i) Means—

(A) Any domestic or foreign organization or corporation that is effectively owned or controlled by a foreign government; or

(B) Any individual acting on behalf of a foreign government.

(ii) Does not include an organization or corporation that is owned, but is not controlled, either directly or indirectly, by a foreign government if the ownership of that organization or corporation by that foreign government was effective before October 23, 1992.

(3) “Foreign government” includes the state and the government of any country (other than the United States and its outlying areas) as well as any political subdivision, agency, or instrumentality thereof.

(4) “Proscribed information” means—

(i) Top Secret information;

(ii) Communications security (COMSEC) material, excluding controlled cryptographic items when unkeyed or utilized with unclassified keys;

(iii) Restricted Data as defined in the U.S. Atomic Energy Act of 1954, as amended;

(iv) Special Access Program (SAP) information; or

(v) Sensitive Compartmented Information (SCI).

(b) Prohibition on award. No contract under a national security program may be awarded to an entity controlled by a foreign government if that entity requires access to proscribed information to perform the contract, unless the Secretary of Defense or a designee has waived application of 10 U.S.C. 4874.

(c) Disclosure.The Offeror shall disclose any interest a foreign government has in the Offeror when that interest constitutes control by a foreign government as defined in this provision. If the Offeror is a subsidiary, it shall also disclose any reportable interest a foreign government has in any entity that owns or controls the subsidiary, including reportable interest concerning the Offeror’s immediate parent, intermediate parents, and the ultimate parent. Use separate paper as needed, and provide the information in the following format:

Offeror’s Point of Contact for Questions about Disclosure

(Name and Phone Number with Country Code, City Code and Area Code, as applicable)

Name and Address of Offeror

Name and Address of Entity Controlled by a Foreign Government

Description of Interest, Ownership Percentage, and Identification of Foreign Government

(End of provision)

G9.07-5 ELECTRONIC TRANSFER OF FUNDS PAYMENTS – FEDERAL RESERVE WIRE TRANSFER SYSTEM (DLA ENERGY JAN 2012)

(a) The Contractor shall supply the following information to the Contracting Officer no later than 5 days after contract award and before submission of the first request for payment. The bank designated as the receiving bank must be capable of receiving Federal wire transactions via either a SWIFT Code or an IBAN.

(b) Any change by the Contractor in the designation of the bank account to receive electronic transfer of funds in accordance with this contract textmust be received by the Contracting Officer no later than 30 days prior to the date the change is to become effective.

(c) The electronic transfer of funds does not constitute an assignment of such funds in any form or fashion.

COMPLETE THE FOLLOWING INFORMATION (TYPE WRITTEN OR CLEAR PRINTING)

RECIPIENT’S NAME: | | | | | | | | | | | | | | | | | | | | | | | | | | (DO NOT EXCEED 25 CHARACTERS)

ORIGINATOR ABA: 044036205 (DLA ENERGY fill-in)

CONTRACT NUMBER: (DLA ENERGY fill-in) RECIPIENT’S CAGE CODE:

[ ] CHECKING TYPE 22 [ ] SAVINGS TYPE 32

RECIPIENT’S DUNS NUMBER:

BENEFICIARY’S BANK NAME: | | | | | | | | | | | | | | | | | | | | | | | (DO NOT EXCEED 29 CHARACTERS)

BENEFICIARY’S BANK ACCOUNT NUMBER:

BENEFICIARY’S BANK SWIFT NUMBER: | | | | | | | | | | | | (EITHER 8 OR 11 CHARACTERS ONLY)

IBAN NUMBER:

BENEFICIARY’S BANK SORT CODE: | | | | | | | (FOR BANKS IN THE UNITED KINGDOM ONLY)

(6 CHARACTERS ONLY)

(d) CONTRACTOR’S DESIGNATED OFFICIAL SUBMITTING ELECTRONIC FUNDS TRANSFER INFORMATION.

NAME | | | | | | | | | | | | | | | | | | | | | | | | | | (DO NOT EXCEED 25 CHARACTERS)

TITLE | | | | | | | | | | | | | | | | | | | | | | | | | | (DO NOT EXCEED 25 CHARACTERS)

TELEPHONE NUMBER | | | | | | | | | | | | | | | | | | | | | | | | (DO NOT EXCEED 25 CHARACTERS)

SIGNATURE

control.

(e) Notwithstanding any other provision of the contract, the requirements of this contract text shall image3.png image4.png image5.png image6.png image7.png image8.png image9.png image10.png image11.png image12.png image13.png image14.png image15.png image16.png image17.png image18.png image19.png image1.png image2.png