FA821221Q0011_0001.pdf

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

J

2. AMENDMENT/MODIFICATION NO.

FA8212-21-Q-0011-0001

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

FD20202100102

5. PROJECT NO (If applicable)

6. ISSUED BY CODE

DEPARTMENT OF THE AIR FORCE, DIRECTORATE OF CONTRACTING

AFSC PZABA

6050 GUM LANE BLDG 1215

HILL AIR FORCE BASE UT 84056-5825

BUYER: Chandell Noorlander/AFSC chandell.noorlander@us.af.mil Phone: (801) 586- 0820

7. ADMINISTERED BY (If other than item 6) CODEFA8212

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

CODE

X

9A. AMENDMENT OF SOLICITATION NO.

FA821221Q0011

9B. DATED (SEE ITEM 11)

5-APR-2021

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. 15-MAY-2021 5:00 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 1 copies to the issuing office.

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

ROUTINE

A8B

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.

FA8212-21-Q-0011-0001

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

Purpose of this amendment is to extend the solicitation closing date:

From: 5 May 2021 To: 15 May 2021

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

Item No.

NSN: 1560-01-094-4532 FJ

DOOR, AIRCRAFT

DOOR, AIRCRAFT | STA 481.0 TO 524.3 | A-10 | C/O 1 COVER, 1 PLATE, 12 PLUGS, RIVETS AND SEALANT A/R Manufacturer Part Number 26512 160D215009-37 Applicability: None ;

Buy American Act/Balance of Payments Program

Bid A - First Article Required Item No.

0001AA

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

CLIN ACRN ACRN Total

0001AA AA

Data Report Data data line for FA Priority: R

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ CNOTE ORIGIN

Type / Ship To Quantity (U/I) IAW DD1423 Req No / Pri

Required Delivery

+ CNOTE 1 LO IAW DD1423

Proposed Delivery

+ CNOTE 1 LO

IAW DD1423

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: 1560-01-094-4532 FJ

First Article

DOOR, AIRCRAFT

Door Assembly Access to a-10 Fuel Tank.

Formed Aluminum sheetmetal, sealer and rivits.

Manufacturer Part Number 26512 160D215009-37

79RG9 160D215009-37

98747 160D215009-37 Priority: R

Inspection: Origin Acceptance: Origin Quality Assurance: Standard Inspection Applicability: None ;

Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ CNOTE ORIGIN

Type / Ship To PACRN Mark For

+ CNOTE PAB

Type / Ship To Quantity (U/I) IAW FA activity form

Req No / Pri

Required Delivery

+ CNOTE 1 EA IAW FA activity form

Proposed Delivery

+ CNOTE 1 EA

IAW FA activity form 260

Bid A - First Article Required Item No.

0001AC

Firm Fixed Price

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

7 EA

CLIN ACRN ACRN Total

0001AC AA

NSN: 1560-01-094-4532 FJ

Production Article

DOOR, AIRCRAFT

Door Assembly Access to a-10 Fuel Tank.

Formed Aluminum sheetmetal, sealer and rivits.

Manufacturer Part Number 26512 160D215009-37

79RG9 160D215009-37

98747 160D215009-37 Priority: R

Inspection: Origin Acceptance: Origin Quality Assurance: Standard Inspection Applicability: None ;

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 PAC 09 account Type / Ship To Quantity (U/I) On or Before Req No / Pri

Required Delivery

A SW3210 7 EA 1 JUN 2022

Proposed Delivery

A SW3210 7 EA

Bid B - First Article NOT Required Item No.

0001AD

Firm Fixed Price Quantity U/I Unit Price Amount

8 EA

CLIN ACRN ACRN Total

0001AD AA

NSN: 1560-01-094-4532 FJ

Production Article

DOOR, AIRCRAFT

Door Assembly Access to a-10 Fuel Tank.

Formed Aluminum sheetmetal, sealer and rivits.

Bid B - First Article NOT Required Manufacturer Part Number 26512 160D215009-37

79RG9 160D215009-37

98747 160D215009-37 Priority: R

Inspection: Origin Acceptance: Origin Quality Assurance: Standard Inspection Applicability: None ;

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 PAD 09 account Type / Ship To Quantity (U/I) On or Before Req No / Pri

Required Delivery

A SW3210 8 EA 1 JUN 2022

Proposed Delivery

A SW3210 8 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

CML 385 519 8898

HILL AFB UT 84056-5734

HILL AFB UT 84056-5734 49 84056-5734

USA

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

AWARD NUMBER:

IAW FA activity form 260

PART I - THE SCHEDULE

SECTION E

INSPECTION AND ACCEPTANCE