FA820615R010150003.pdf

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

J

2. AMENDMENT/MODIFICATION NO.

FA8206-15-R-01015-0003

3. EFFECTIVE DATE

4. REQUISITION/PURCHASE REQ. NO.

FD20201600013

5. PROJECT NO (If applicable)

6. ISSUED BY CODE

DEPARTMENT OF THE AIR FORCE, DIRECTORATE OF CONTRACTING

AFSC PZAAA2

6050 GUM LANE BLDG 1215

HILL AIR FORCE BASE UT 84056-5825

BUYER: Francene Bielik/AFSC francene.bielik@us.af.mil Phone: (801) 777- 9301 No Collect Calls

7. ADMINISTERED BY (If other than item 6) CODEFA8206

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

CODE

X

9A. AMENDMENT OF SOLICITATION NO.

FA820615R01015

9B. DATED (SEE ITEM 11)

10-NOV-2015

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.

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 1 copies to the issuing office.

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

ROUTINE

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.

Amendment/Modification FA8206-15-R-01015-0003

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

The purpose of this Amendment is to:

1. Change the Delivery Date for CLIN 0001AC

From: 240 days

To: 300 days

All other Terms and Conditions remain unchanged by this Amendment.

Request for Proposal FA8206-15-R-01015-0003

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

Item No.

CLIN ACRN ACRN Total

0001 AA

NSN: 1135-01-251-9017 NP

HIGH IMPACT TRANSDUCER

High Impulse Transducer cable senses vehicle impact and generates a trigger signal for contact fuzing in the RV configuration.

Item consists of twisted-pair shielded and coiled cabling with two connectors which are soldered and/or encapsulated.

Manufacturer Part Number

07571 SD351P5

79272 47A528109P5 Priority: R IUID Required: Yes Buy American Act/Balance of Payments Program Physical Item Markings:

Bid A - First Article Required Item No.

0001AA

Firm Fixed Price Quantity U/I Unit Price Amount 1 LO Not Separately Priced Not Separately Priced

CLIN ACRN ACRN Total

0001AA AA

DATA IAW DD 1423-1

Exhibit A Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: IAW 1423-1 Buy American Act/Balance of Payments Program Type / Ship To Quantity (U/I) *ARO ARO IAW DD

1423-1 _ Req No / Pri

Required Delivery

Bid A - First Article Required + CNOTE 1 LO *235 Calendar Days

Proposed Delivery

+ CNOTE 1 LO

FIRST ARTICLE

Bid A - First Article Required Item No.

0001AB

Firm Fixed Price Quantity U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

0001AB AA

NSN: 1135-01-251-9017 NP

FIRST ARTICLE

FIRST ARTICLE - SAME AS BASIC LINE ITEM ABOVE

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: IAW DD 1423-1 Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3210 DESTINATION

Type / Ship To PACRN Mark For A SW3210 First article submitted for inspection and testing. DO NOT

POST

Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri

Required Delivery

A SW3210 1 EA *220 Calendar Days

Proposed Delivery

A SW3210 1 EA

FIT CHECK TO BE PERFORMED BY LM AT CRL FACILITY.

Container and shipping vouchers shall be conspicuously marked with large red lettering as follows: FIRST

ARTICLE, DO NOT PLACE IN AIR FORCE SUPPLY.

FIRST ARTICLE

Bid A - First Article Required Item No.

0001AC

Firm Fixed Price

FIRST ARTICLE

Bid A - First Article Required Quantity U/I Unit Price Amount

149 EA

CLIN ACRN ACRN Total

0001AC AA

NSN: 1135-01-251-9017 NP

PRODUCTION ARTICLE

PRODUCTION ARTICLE - SAME AS BASIC LINE ITEM ABOVE

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3210 ORIGIN

Type / Ship To PACRN Mark For A SW3210 Acct 09 Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri

Required Delivery

A SW3210 149 EA *300 Calendar Days

Proposed

A SW3210 149 EA

FIRST ARTICLE

Bid B - First Article NOT Required Item No.

0001AD

Firm Fixed Price Quantity U/I Unit Price Amount

150 EA

CLIN ACRN ACRN Total

0001AD AA

NSN: 1135-01-251-9017 NP

PRODUCTION ARTICLE

PRODUCTION ARTICLE - SAME AS BASIC LINE ITEM ABOVE

Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Buy American Act/Balance of Payments Program

FIRST ARTICLE

Bid B - First Article NOT Required

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3210 ORIGIN

Type / Ship To PACRN Mark For A SW3210 Acct 09 Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri

Required Delivery

A SW3210 150 EA *120 Calendar Days

Proposed

A SW3210 150 EA

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: A SW3210

DLA DISTRIBUTION DEPOT HILL

7537 WARDLEIGH RD BLDG 849W

HILL AFB UT 84056-5734

HILL AFB UT 84056-5734

HILL AFB UT 84056-5734

USA

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

AWARD NUMBER:

IAW DD Form 1423-1

PART I - THE SCHEDULE

SECTION G

CONTRACT ADMINISTRATION DATA

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AA 57 43020 . 15 5 47 NK 25133G 3G6BFX 63685 11213F 503000 F03000 $0.00

PSR: 682426 FSR: 030260

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

ACRN TOTAL $ 0.00