FA811920Q0001 P00001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE Page 1

2. AMENDMENT/MODIFICATION NO.

FA8119-20-Q-0001-0001

3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO.

FD20301902781

5. PROJECT NO (If applicable)

6. ISSUED BY CODE

DEPARTMENT OF THE AIR FORCE, AFSC PZABC

3001 STAFF DR STE 1AD2 99A

TINKER AFB OK 73145-3015

BUYER: Bryce Cornish/AFSC/PZABC bryce.cornish@us.af.mil Phone: (405) 734- 4565

7. ADMINISTERED BY (If other than item 6) CODEFA8119

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

CODE

X

9A. AMENDMENT OF SOLICITATION NO.

FA811920Q0001

9B. DATED (SEE ITEM 11)

6-JAN-2020

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended, is not extended. Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods. ( a ) By completing Items 8 and 15, and returning copies of the amendment; ( b ) By acknowledging receipt of this amendment on each copy of the offer submitted; or ( c ) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified. 6-MAR-2020 3:00 PM

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Amendment to extend the solicitation.

15A. NAME AND TITLE OF SIGNER (Type or print)

15B. CONTRACTOR/OFFEROR

BY ________________________________________________________

(Signature of person authorized to sign)

15C. DATE SIGNED

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16B. UNITED STATES OF AMERICA

BY ____________________________________________________

(Signature of Contracting Officer)

16C. DATE SIGNED

FACILITY CODE

NSN 7540-01-152-8070

PREVIOUS EDITION UNUSABLE

30-105 STANDARD FORM 30 (REV. 10-83)

PRESCRIBED BY GSA

FAR (48 CFR) 53.243

X

X X

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

FA8119-20-Q-0001-0001

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

Tear Down, Test and Evaluate Power Supply

Basic Year Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Converts 208, 3-Phase VAC, to regulated 400Hz power for blowers (Fans) Metal chassis with internal electronic components Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Buy American Act/Balance of Payments Program IUID Required: Yes

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 PAA SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 30 days

Proposed Delivery

A SW3211 4 EA

Repair

Basic Year Item No.

Firm Fixed Price

Repair

Basic Year Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 PAB SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 60 days

Proposed Delivery

A SW3211 4 EA

Over and Above

Basic Year Item No.

To Be Negotiated Quantity U/I Unit Price

1 LO TBN

Over and Above Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Over and Above

Basic Year

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ TBD ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ TBD LO TBD

Proposed Delivery

+ TBD LO

Data

Basic Year Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Data A001: Commercial Asset Visibility (CAV) ReportA002: Contract Depot Maintenance (CDM) ReportA003: Governmnet Property Inventory ReportA004: Report of Shipping (Item) and Packaging DiscrepancyA005: Test/Inspection ReportA006: Counterfeit Prevention Plan (CPP)A007: Production Surge Plan Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ CNOTE ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ CNOTE LO IAW CDRLs

Proposed Delivery

+ CNOTE LO

Tear Down, Test and Evaluate Power Supply Option Year I

Item No.

Tear Down, Test and Evaluate Power Supply Option Year I

Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Converts 208, 3-Phase VAC, to regulated 400Hz power for blowers (Fans) Metal chassis with internal electronic components Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Buy American Act/Balance of Payments Program IUID Required: Yes

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 AA SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 30 days

Proposed Delivery

A SW3211 4 EA

Repair Option Year I

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF

Repair Option Year I

Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Buy American Act/Balance of Payments Program Latest Cost Amount: $15,490.43

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 AB SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 60 days

Proposed Delivery

A SW3211 4 EA

Over and Above Option Year I

Item No.

To Be Negotiated Quantity U/I Unit Price

1 LO TBN

Over and Above Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ TBD ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ TBD LO TBD

Proposed Delivery

+ TBD LO

Data Option Year I

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Data A001: Commercial Asset Visibility (CAV) ReportA002: Contract Depot Maintenance (CDM) ReportA003: Governmnet Property Inventory ReportA004: Report of Shipping (Item) and Packaging DiscrepancyA005: Test/Inspection ReportA006: Counterfeit Prevention Plan (CPP)A007: Production Surge Plan Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ CNOTE ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ CNOTE LO IAW CDRLs

Proposed Delivery

+ CNOTE LO

Tear Down, Test and Evaluate Power Supply Option Year II

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Converts 208, 3-Phase VAC, to regulated 400Hz power for blowers (Fans) Metal chassis with internal electronic components Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Tear Down, Test and Evaluate Power Supply Option Year II

Buy American Act/Balance of Payments Program IUID Required: Yes

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 AA SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 30 days

Proposed Delivery

A SW3211 4 EA

Repair Option Year II

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Buy American Act/Balance of Payments Program Latest Cost Amount: $15,490.43

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 AB SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 60 days

Proposed

Repair Option Year II

A SW3211 4 EA

Over and Above Option Year II

Item No.

To Be Negotiated Quantity U/I Unit Price

1 LO TBN

Over and Above Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ TBD ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ TBD LO TBD

Proposed Delivery

+ TBD LO

Data Option Year II

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Data A001: Commercial Asset Visibility (CAV) ReportA002: Contract Depot Maintenance (CDM) ReportA003: Governmnet Property Inventory ReportA004: Report of Shipping (Item) and Packaging DiscrepancyA005: Test/Inspection ReportA006: Counterfeit Prevention Plan (CPP)A007: Production Surge Plan Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Data Option Year II

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ CNOTE ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ CNOTE LO IAW CDRLs

Proposed Delivery

+ CNOTE LO

Tear Down, Test and Evaluate Power Supply Option Year III

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Converts 208, 3-Phase VAC, to regulated 400Hz power for blowers (Fans) Metal chassis with internal electronic components Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Buy American Act/Balance of Payments Program IUID Required: Yes

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 AA SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 30 days

Proposed

A SW3211 4 EA

Repair Option Year III

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Buy American Act/Balance of Payments Program Latest Cost Amount: $15,490.43

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 AB SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 60 days

Proposed Delivery

A SW3211 4 EA

Over and Above Option Year III

Item No.

To Be Negotiated Quantity U/I Unit Price

1 LO TBN

Over and Above Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Over and Above Option Year III

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ TBD ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ TBD LO TBD

Proposed Delivery

+ TBD LO

Data Option Year III

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Data A001: Commercial Asset Visibility (CAV) ReportA002: Contract Depot Maintenance (CDM) ReportA003: Governmnet Property Inventory ReportA004: Report of Shipping (Item) and Packaging DiscrepancyA005: Test/Inspection ReportA006: Counterfeit Prevention Plan (CPP)A007: Production Surge Plan Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ CNOTE ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ CNOTE LO IAW CDRLs

Proposed Delivery

+ CNOTE LO

Tear Down, Test and Evaluate Power Supply Option Year IV

Item No.

Tear Down, Test and Evaluate Power Supply Option Year IV

Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Converts 208, 3-Phase VAC, to regulated 400Hz power for blowers (Fans) Metal chassis with internal electronic components Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Buy American Act/Balance of Payments Program IUID Required: Yes

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 AA SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 30 days

Proposed Delivery

A SW3211 4 EA

Repair Option Year IV

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price

4 EA

NSN: 6130-01-528-9874 IM

POWER SUPPLY

Manufacturer Part Number

0XWR4 04015000-10

Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: WAWF

Repair Option Year IV

Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below. (if more than one, check the appropriate standard.)

Title Number Date Tailoring

AS9100 9100

Buy American Act/Balance of Payments Program Latest Cost Amount: $15,490.43

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3211 ORIGIN

Type / Ship To PACRN Mark For A SW3211 AB SW3211 Account 9 Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

A SW3211 4 EA 1 every 60 days

Proposed Delivery

A SW3211 4 EA

Over and Above Option Year IV

Item No.

To Be Negotiated Quantity U/I Unit Price

1 LO TBN

Over and Above Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ TBD ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ TBD LO TBD

Proposed

+ TBD LO

Data Option Year IV

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Data A001: Commercial Asset Visibility (CAV) ReportA002: Contract Depot Maintenance (CDM) ReportA003: Governmnet Property Inventory ReportA004: Report of Shipping (Item) and Packaging DiscrepancyA005: Test/Inspection ReportA006: Counterfeit Prevention Plan (CPP)A007: Production Surge Plan Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ CNOTE ORIGIN

Type / Ship To Quantity (U/I) Req No / Pri

Required Delivery

+ CNOTE LO IAW CDRLs

Proposed

+ CNOTE LO

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: + CNOTE

MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)

AWARD NUMBER:

TYPE/CODE: + TBD

MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)

AWARD NUMBER:

TYPE/CODE: A SW3211

DLA DISTRIBUTION DEPOT OKLAHOMA

3301 F AVE CEN REC BLDG 506 DR 22

TINKER AFB OK 73145-8000

TINKER AFB OK 73145-8000

TINKER AFB OK 73145-8000

USA

MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)

AWARD NUMBER: