Trans0031.pdf

TRANSPORTATION DATA FOR SOLICITATIONS

COMMODITY: See Continuation

PURCHASE INSTRUMENT NUMBER:

FD20201801350-00

DATE INITIATED:

08 MAY 2018

STOCK NUMBER: See Continuation

X ORIGIN DESTINATION OTHER DATA / FIRST ARTICLE F.O.B. DESTINATION(Specify)

F.O.B. TERMS RECOMMENDED AS BEST SUITED FOR THIS PROCUREMENT

TRANSPORTATION PROVISIONS / CLAUSES FAR CITATION

F.O.B. Origin 52.247-29 Freight Classification Description 52.247-53 Evidence of Shipment FMS 352.225-U037U Contact DCMA Transportation Contact DCMA Transportation on ALL "DCMA Administered" contracts prior to shipment for shipping instructions using the DCMA Shipment Instruction Request (SIR) eTool System, at http://www.dcma.mil <http://www.dcma.mil/> for ALL FOB:

Origin, Foreign Military Sales (FMS), and FOB: Destination OCONUS/Export movements to obtain the appropriate DOD regulatory clearances, shipping documentation and instructions from your cognizant DCMA Transportation Office. If you are new to DCMA, and do not already have a SIR eTool account, you will first need to request an account via DCMA External Web Access Management (EWAM) application which can be accessed at http://www.dcma.mil. If you need additional assistance, email DCMA Transportation Group at: Transportation.Division@dcma.mil. Do not move any freight to a water or aerial port prior to contacting DCMA or it will become frustrated. Failure to contact the responsible DCMA may result in vendor incurring additional expenditures.

Vendor Transportation Instructions

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 SEN000 503000 F03000 FSR: 047076 PSR: 296435

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 6150015558904WF

Purchase Instrument Line Item Number: 0001

Ship to (DoDAAC / MAPAC): DPK002

Mark For: DPKG00

Ship To (Address):

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number: DPKG5481015283

Supplemental Address: DA2SAF

FMS Case: SAF

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

OTHER TRANSPORTATION DATA:

TACRN:

AAB

Page 1 of 2DD FORM 1653 Version 2Generated by PRPS using Jasper Reports on 10 May 2018

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 SEN000 503000 F03000 FSR: 047076 PSR: 296435

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 6150DTG180708WF

Purchase Instrument Line Item Number: 0002

Ship to (DoDAAC / MAPAC): FB2029

Mark For: DELIVER COUNTERFEIT PREVENTION PLAN NLT 30 DAYS

FROM CONTRACT AWARD.

Ship To (Address): OO ALC DDHU CNTRL RCV

5851 F AVE BLDG 849W

HILL AFB UT 84056-5713

84056 - 5713 usa

WPOD:

APOD:

BBP / CCP:

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

CP 385 519 8898

Ship To (Remarks): MARK FOR: SCMS/GUMAA 6070 GUM LANE, BLDG

1213, HILL AFB, UT 84056-5826

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

OTHER TRANSPORTATION DATA:

NAME

Pate, Robert T

ORGANIZATION / OFFICE

SYMBOL

406 SCMS / GULAA

COMMERCIAL / DSN

PHONE

478-926-2771 / 468-2771

SIGNATURE

//SIGNED//Pate, Robert T

DATE

08 MAY 2018

Page 2 of 2DD FORM 1653 Version 2Generated by PRPS using Jasper Reports on 10 May 2018

PURCHASE INSTRUMENT NUMBER:

FD20201801375-00

DATE INITIATED:

25 APR 2018

STOCK NUMBER: See Continuation

X ORIGIN DESTINATION OTHER DATA / FIRST ARTICLE F.O.B. DESTINATION(Specify)

F.O.B. TERMS RECOMMENDED AS BEST SUITED FOR THIS PROCUREMENT

TRANSPORTATION PROVISIONS / CLAUSES FAR CITATION

F.O.B. Origin 52.247-29 Freight Classification Description 52.247-53 Contact DCMA Transportation Contact DCMA Transportation on ALL "DCMA Administered" contracts prior to shipment for shipping instructions using the DCMA Shipment Instruction Request (SIR) eTool System, at http://www.dcma.mil <http://www.dcma.mil/> for ALL FOB:

Origin, Foreign Military Sales (FMS), and FOB: Destination OCONUS/Export movements to obtain the appropriate DOD regulatory clearances, shipping documentation and instructions from your cognizant DCMA Transportation Office. If you are new to DCMA, and do not already have a SIR eTool account, you will first need to request an account via DCMA External Web Access Management (EWAM) application which can be accessed at http://www.dcma.mil. If you need additional assistance, email DCMA Transportation Group at: Transportation.Division@dcma.mil. Do not move any freight to a water or aerial port prior to contacting DCMA or it will become frustrated. Failure to contact the responsible DCMA may result in vendor incurring additional expenditures.

Vendor Transportation Instructions

IAW Basic Contract 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 SEN000 503000 F03000 FSR: 047076 PSR: 412473

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 6150015559771WF

Purchase Instrument Line Item Number: 0001

Ship to (DoDAAC / MAPAC): DPK002

Mark For: DPKG00

Ship To (Address):

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number: DPKG5481015289

Supplemental Address: DA2SAF

FMS Case: SAF

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

OTHER TRANSPORTATION DATA:

NAME

Carter, Glenn A

ORGANIZATION / OFFICE

SYMBOL

406 SCMS / GULAA

COMMERCIAL / DSN

PHONE

478-327-7399 / 497-7399

SIGNATURE

//SIGNED//Carter, Glenn A

DATE

25 APR 2018

Page 1 of 1DD FORM 1653 Version 1Generated by PRPS using Jasper Reports on 03 May 2018

PURCHASE INSTRUMENT NUMBER:

FD20201801379-00

DATE INITIATED:

08 MAY 2018

STOCK NUMBER: See Continuation

X ORIGIN DESTINATION OTHER DATA / FIRST ARTICLE F.O.B. DESTINATION(Specify)

F.O.B. TERMS RECOMMENDED AS BEST SUITED FOR THIS PROCUREMENT

TRANSPORTATION PROVISIONS / CLAUSES FAR CITATION

F.O.B. Origin 52.247-29 F.O.B. Origin - Prepaid Freight Shipment(s) shall be made with freight transportation costs prepaid by the Contractor, who shall verify with the freight shipment company that rates for this/these shipment(s) are equal to or lower than those used for U.S. Government shipments. If rates are not equal to or lower than those for Government shipments, contact the Contracting Officer for additional instructions. Shipping charges are to be shown as a separate item on the payment invoice. If the charges are $100 or more, a copy of the freight charges invoice must be attached to the payment invoice. Failure to properly annotate the invoice and provide a copy of the carrier's bill may result in those costs being disallowed.

Vendor Transportation Instructions

Freight Classification Description 52.247-53 Evidence of Shipment FMS 352.225-U037U Contact DCMA Transportation Contact DCMA Transportation on ALL "DCMA Administered" contracts prior to shipment for shipping instructions using the DCMA Shipment Instruction Request (SIR) eTool System, at http://www.dcma.mil <http://www.dcma.mil/> for ALL FOB:

Origin, Foreign Military Sales (FMS), and FOB: Destination OCONUS/Export movements to obtain the appropriate DOD regulatory clearances, shipping documentation and instructions from your cognizant DCMA Transportation Office. If you are new to DCMA, and do not already have a SIR eTool account, you will first need to request an account via DCMA External Web Access Management (EWAM) application which can be accessed at http://www.dcma.mil. If you need additional assistance, email DCMA Transportation Group at: Transportation.Division@dcma.mil. Do not move any freight to a water or aerial port prior to contacting DCMA or it will become frustrated. Failure to contact the responsible DCMA may result in vendor incurring additional expenditures.

Vendor Transportation Instructions

IAW BASIC CONTRACT FD20201801379-00

Note to Contractor: Contact CTO if problems arise. Ship Door-to-Door commercial express carrier service for movement of MICAP and project codes (TP-1 and TP-2/RDD 777): 122, 123, 700, 780 (With restrictions), 879, 880, 9FF, 9FV, 9FX, 9GF, 9GJ, 9GV, 9GS, 9GD, Surge and 720.

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 SEN000 503000 F03000 FSR: 047076 PSR: 296435

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 6150015559783WF

Purchase Instrument Line Item Number: 0001

Ship to (DoDAAC / MAPAC): DPK002

Mark For: DPKG00

Ship To (Address):

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number: DPKG5481015290

Supplemental Address: DA2SAF

FMS Case: SAF

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

FMS

OTHER TRANSPORTATION DATA:

Page 1 of 2DD FORM 1653 Version 2Generated by PRPS using Jasper Reports on 15 May 2018

NAME

Langford, Dorothy A

ORGANIZATION / OFFICE

SYMBOL

406 SCMS / GULAA

COMMERCIAL / DSN

PHONE

478-327-6593 / 497-6593

SIGNATURE

//SIGNED//Langford, Dorothy A

DATE

08 MAY 2018

Page 2 of 2DD FORM 1653 Version 2Generated by PRPS using Jasper Reports on 15 May 2018

PURCHASE INSTRUMENT NUMBER:

FD20201801380-00

DATE INITIATED:

26 APR 2018

STOCK NUMBER: See Continuation

X ORIGIN DESTINATION OTHER DATA / FIRST ARTICLE F.O.B. DESTINATION(Specify)

F.O.B. TERMS RECOMMENDED AS BEST SUITED FOR THIS PROCUREMENT

TRANSPORTATION PROVISIONS / CLAUSES FAR CITATION

F.O.B. Origin 52.247-29 F.O.B. Origin - Prepaid Freight Shipment(s) shall be made with freight transportation costs prepaid by the Contractor, who shall verify with the freight shipment company that rates for this/these shipment(s) are equal to or lower than those used for U.S. Government shipments. If rates are not equal to or lower than those for Government shipments, contact the Contracting Officer for additional instructions. Shipping charges are to be shown as a separate item on the payment invoice. If the charges are $100 or more, a copy of the freight charges invoice must be attached to the payment invoice. Failure to properly annotate the invoice and provide a copy of the carrier's bill may result in those costs being disallowed.

Vendor Transportation Instructions

Freight Classification Description 52.247-53 Contact DCMA Transportation Contact DCMA Transportation on ALL "DCMA Administered" contracts prior to shipment for shipping instructions using the DCMA Shipment Instruction Request (SIR) eTool System, at http://www.dcma.mil <http://www.dcma.mil/> for ALL FOB:

Origin, Foreign Military Sales (FMS), and FOB: Destination OCONUS/Export movements to obtain the appropriate DOD regulatory clearances, shipping documentation and instructions from your cognizant DCMA Transportation Office. If you are new to DCMA, and do not already have a SIR eTool account, you will first need to request an account via DCMA External Web Access Management (EWAM) application which can be accessed at http://www.dcma.mil. If you need additional assistance, email DCMA Transportation Group at: Transportation.Division@dcma.mil. Do not move any freight to a water or aerial port prior to contacting DCMA or it will become frustrated. Failure to contact the responsible DCMA may result in vendor incurring additional expenditures.

Vendor Transportation Instructions

IAW Basic Contract 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Note to Contractor: Contact CTO if problems arise. Ship Door-to-Door commercial express carrier service for movement of MICAP and project codes (TP-1 and TP-2/RDD 777): 122, 123, 700, 780 (With restrictions), 879, 880, 9FF, 9FV, 9FX, 9GF, 9GJ, 9GV, 9GS, 9GD, Surge and 720.

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 SEN000 503000 F03000 FSR: 047076 PSR: 412473

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 6150015559768WF

Purchase Instrument Line Item Number: 0001

Ship to (DoDAAC / MAPAC): DPK002

Mark For: DPKG00

Ship To (Address):

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number: DPKG5481015288

Supplemental Address: DA2SAF

FMS Case: SAF

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

Page 1 of 2DD FORM 1653 Version 1Generated by PRPS using Jasper Reports on 09 May 2018

Carter, Glenn A

ORGANIZATION / OFFICE

SYMBOL

406 SCMS / GULAA

COMMERCIAL / DSN

PHONE

478-327-7399 / 497-7399

SIGNATURE

//SIGNED//Carter, Glenn A

DATE

26 APR 2018

Page 2 of 2DD FORM 1653 Version 1Generated by PRPS using Jasper Reports on 09 May 2018

PURCHASE INSTRUMENT NUMBER:

FD20201801346-00

DATE INITIATED:

19 APR 2018

STOCK NUMBER: See Continuation

X ORIGIN DESTINATION OTHER DATA / FIRST ARTICLE F.O.B. DESTINATION(Specify)

F.O.B. TERMS RECOMMENDED AS BEST SUITED FOR THIS PROCUREMENT

TRANSPORTATION PROVISIONS / CLAUSES FAR CITATION

F.O.B. Origin 52.247-29 F.O.B. Origin - Prepaid Freight Shipment(s) shall be made with freight transportation costs prepaid by the Contractor, who shall verify with the freight shipment company that rates for this/these shipment(s) are equal to or lower than those used for U.S. Government shipments. If rates are not equal to or lower than those for Government shipments, contact the Contracting Officer for additional instructions. Shipping charges are to be shown as a separate item on the payment invoice. If the charges are $100 or more, a copy of the freight charges invoice must be attached to the payment invoice. Failure to properly annotate the invoice and provide a copy of the carrier's bill may result in those costs being disallowed.

Vendor Transportation Instructions

Freight Classification Description 52.247-53 Contact DCMA Transportation Contact DCMA Transportation on ALL "DCMA Administered" contracts prior to shipment for shipping instructions using the DCMA Shipment Instruction Request (SIR) eTool System, at http://www.dcma.mil <http://www.dcma.mil/> for ALL FOB:

Origin, Foreign Military Sales (FMS), and FOB: Destination OCONUS/Export movements to obtain the appropriate DOD regulatory clearances, shipping documentation and instructions from your cognizant DCMA Transportation Office. If you are new to DCMA, and do not already have a SIR eTool account, you will first need to request an account via DCMA External Web Access Management (EWAM) application which can be accessed at http://www.dcma.mil. If you need additional assistance, email DCMA Transportation Group at: Transportation.Division@dcma.mil. Do not move any freight to a water or aerial port prior to contacting DCMA or it will become frustrated. Failure to contact the responsible DCMA may result in vendor incurring additional expenditures.

Vendor Transportation Instructions

IAW Basic Contract 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Note to Contractor: Contact CTO if problems arise. Ship Door-to-Door commercial express carrier service for movement of MICAP and project codes (TP-1 and TP-2/RDD 777): 122, 123, 700, 780 (With restrictions), 879, 880, 9FF, 9FV, 9FX, 9GF, 9GJ, 9GV, 9GS, 9GD, Surge and 720.

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 SEN000 503000 F03000 FSR: 047076 PSR: 412473

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 6150015558880WF

Purchase Instrument Line Item Number: 0001

Ship to (DoDAAC / MAPAC): DPK002

Mark For: DPKG00

Ship To (Address):

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number: DPKG5481015275

Supplemental Address: DA2SAF

FMS Case: SAF

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

Page 1 of 2DD FORM 1653 Version 1Generated by PRPS using Jasper Reports on 02 May 2018

Carter, Glenn A

ORGANIZATION / OFFICE

SYMBOL

406 SCMS / GULAA

COMMERCIAL / DSN

PHONE

478-327-7399 / 497-7399

SIGNATURE

//SIGNED//Carter, Glenn A

DATE

19 APR 2018

Page 2 of 2DD FORM 1653 Version 1Generated by PRPS using Jasper Reports on 02 May 2018

PURCHASE INSTRUMENT NUMBER:

FD20201801381-00

DATE INITIATED:

09 MAY 2018

STOCK NUMBER: See Continuation

X ORIGIN DESTINATION OTHER X DATA / FIRST ARTICLE F.O.B. DESTINATION(Specify)

F.O.B. TERMS RECOMMENDED AS BEST SUITED FOR THIS PROCUREMENT

TRANSPORTATION PROVISIONS / CLAUSES FAR CITATION

F.O.B. Origin 52.247-29 F.O.B. Origin - Prepaid Freight Shipment(s) shall be made with freight transportation costs prepaid by the Contractor, who shall verify with the freight shipment company that rates for this/these shipment(s) are equal to or lower than those used for U.S. Government shipments. If rates are not equal to or lower than those for Government shipments, contact the Contracting Officer for additional instructions. Shipping charges are to be shown as a separate item on the payment invoice. If the charges are $100 or more, a copy of the freight charges invoice must be attached to the payment invoice. Failure to properly annotate the invoice and provide a copy of the carrier's bill may result in those costs being disallowed.

Vendor Transportation Instructions

Freight Classification Description 52.247-53 Evidence of Shipment FMS 352.225-U037U Contact DCMA Transportation Contact DCMA Transportation on ALL "DCMA Administered" contracts prior to shipment for shipping instructions using the DCMA Shipment Instruction Request (SIR) eTool System, at http://www.dcma.mil <http://www.dcma.mil/> for ALL FOB:

Origin, Foreign Military Sales (FMS), and FOB: Destination OCONUS/Export movements to obtain the appropriate DOD regulatory clearances, shipping documentation and instructions from your cognizant DCMA Transportation Office. If you are new to DCMA, and do not already have a SIR eTool account, you will first need to request an account via DCMA External Web Access Management (EWAM) application which can be accessed at http://www.dcma.mil. If you need additional assistance, email DCMA Transportation Group at: Transportation.Division@dcma.mil. Do not move any freight to a water or aerial port prior to contacting DCMA or it will become frustrated. Failure to contact the responsible DCMA may result in vendor incurring additional expenditures.

Vendor Transportation Instructions

IAW Basic Contract 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Note to Contractor: Contact CTO if problems arise. Ship Door-to-Door commercial express carrier service for movement of MICAP and project codes (TP-1 and TP-2/RDD 777): 122, 123, 700, 780 (With restrictions), 879, 880, 9FF, 9FV, 9FX, 9GF, 9GJ, 9GV, 9GS, 9GD, Surge and 720.

TACRN:

AAA

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 SEN000 503000 F03000 FSR: 047076 PSR: 296435

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 6150015559784WF

Purchase Instrument Line Item Number: 0001

Ship to (DoDAAC / MAPAC): DPK002

Mark For: DPKG00

Ship To (Address):

WPOD:

APOD:

BBP / CCP:

RIC:

Requisition Number: DPKG5481015291

Supplemental Address: DA2SAF

FMS Case: SAF

Ship To (Remarks):

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

Page 1 of 2DD FORM 1653 Version 3Generated by PRPS using Jasper Reports on 16 May 2018

TACRN:

AAB

TRANSPORTATION FUNDS INFORMATION:

Purchase Instrument Line LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 SEN000 503000 F03000 FSR: 047076 PSR: 296435

First Destination Transportation Account Code:

Miscellaneous Obligation / Reimbursement Document:

Second Destination Transportation Account Code:

FMS LOA: 9711X8242.0002 4FX LCSH CSAFPK 000000 00000 S

Additional Funding Information:

ITEM / SHIP TO(s):

NSN / Pseudo NSN: 6150DTG1807C9WF

Purchase Instrument Line Item Number: 0002

Ship to (DoDAAC / MAPAC): FB2029

Mark For: FIRST ARTICLE TEST, DO NOT POST

Ship To (Address): OO ALC DDHU CNTRL RCV

5851 F AVE BLDG 849W

HILL AFB UT 84056-5713

84056 - 5713

USA

WPOD:

APOD:

BBP / CCP:

RIC: 1

Requisition Number:

Supplemental Address:

FMS Case:

CP 385 519 8898

Ship To (Remarks): 809 MXSS/MXDEB

BLDG 849

ATTN: NON ACCOUNTABLE BAY

HILL AFB, UT 84056-5713

EVALUATION OF PORT BID OR PROPOSAL:

SOLICITATION DATA NOTES:

OTHER TRANSPORTATION DATA:

NAME

Carter, Glenn A

ORGANIZATION / OFFICE

SYMBOL

406 SCMS / GULAA

COMMERCIAL / DSN

PHONE

478-327-7399 / 497-7399

SIGNATURE

//SIGNED//Carter, Glenn A

DATE

09 MAY 2018

Page 2 of 2DD FORM 1653 Version 3Generated by PRPS using Jasper Reports on 16 May 2018