AFForm9ReqforPurchase_F2DCDE1063A101_000.pdf

PDF 137 KB Posted

Attached to
UWARS Battery Federal contract opportunity
Solicitation number
FA8213-21-R-3019
Issued by
Department of the Air Force Materiel Command Lifecycle Management Center Hill Air Force Base

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Text version

FOR OFFICIAL USE ONLY

ALD

HEADER:

Page 1 of 3 BASIC

F2DCDE1063A101

HILL AFB, UT 12/28/2020

AFLCMC/EBHK 1377

AFLCMC/EBHJ

FD20202150082

AFLCMC/EBHJ

AFLCMC/EBHJ See Below Line Items 09/30/2022

AA

THE PURPOSE OF THIS PR IS TO PROCURE UWARS BATTERY KITS FOR USAF CAD/PAD

REQUIREMENTS, BPAC 355105. PLEASE INCLUDE 80 EACH FOR NASA T38. COMBINE WITH FMS

PR FD20202150083.

GPP DOES NOT APPLY

ROUTE THROUGH TRANSPORTATION

0.00 EA $0.0000 $0.00

$189,850.00

FD20202150082CADPAD

POST TO GAFS

5713011 H81 LCHN 355105 4E27A1 63681 78070F 503000 F03000 ALD:AA FSR: 086990 PSR: B94327 DSR: 255635 CIN:

F2DCDE1063A1010000AA $189,850.00 $189,850.00

Debited against CCaR# 7081175 355105 - Common Egress $189,850.00

PAGE 2 TOTAL: $189,850.00

Lisa S. Stettler, CIV, Program Item Analyst, (801) 777-

03-MAR-2021

// SIGNED //

801-777-5694

03-MAR-2021 Scott Kunzler, CIV, Budget Analyst , (801) 775-2660 // SIGNED //

04-Mar-2021 22:51:48.000000000 +00:00

Shelley Merritt Civilian, Funds Certifier, (801) 777-0786 Digitally signed by Shelley.Merritt.Civilian.1473485148

I certify these funds are available

FOR OFFICIAL USE ONLY

PR NUMBER: FD2020-21-50082

PROC ACTY: FA8213, TYPE PR: 11 PRIORITY: R

IM: W MGR DES: ZE TYPE REQ: 2 MMAC: ES

Type PR: 11 Priority: R IM: W Mgr Des: ZEQ Type Reqmt: 2 MMAC: ES PROC ACTY: FA8213

This requirement is included in the approved program (PA/BA) for fiscal year 2021.

Document Number: F2DCDE1063A101 BASIC Page 2 of 3

ITEM

NO.

a

DESCRIPTION

b (Federal stock number, nomenclature, specification and/or drawing No., etc.)

QTY

c

UNIT

d

ESTIMATED

UNIT

PRICE

e

ESTIMATED

UNIT

PRICE

f

AA

NSN: 1377-01-571-5244ES P/N 1914-031-02 CAGE 99251

alt NSN: 1377-01-652-5022ES P/N 01-0-012 ORE CAGE 3AX04

NOUN: UWARS BATTERY KIT DODIC: JN18 ERRC: N

TLI: I IMQ: 3797 CC: LA AUTH: FY21 RDM COMP

AMC/AMSC 2R REQ/DES: R

DESCRIPTION: LITHIUM COIN BATTERY, SCREENED FOR PROPER VOLTAGE AND INTERNAL

IMPEDENCE. PROVIDES POWER FOR UNIVERSAL WATER ACTIVATION RELEASE SYSTEM

(UWARS)

DELIVERY SCHEDULE: SEP 2022

SHIP TO: FV2172

MARK FOR: 09 ACCOUNT

EST UNIT COST: $50.00

TOTAL LINE ITEM COST: $189,850.00

3,797.00 EA $50.0000 $189,850.00

ALD

AMC: 2 AMSC: R REQ/DES: R Del Sched: 30 SEP 2022 Ship To: FV2172 Mark For: 09 ACCOUNT

AA

DATA IAW DD1423-1 EXHIBIT A ATTACHED

A001 AMMUNITION DATA CARD (ADC)

A002 ENGINEERING CHANGE PROPOSAL (ECP)

A003 NOTICE OF REVISION (NOR)

A004 REQUEST FOR VARIANCE (RFV)

A005 TEST/INSPECTION REPORT

A006 FAILURE SUMMARY & ANALYSIS REPORT

TLI: 6 CC: MA

REQ/DES: R DELIVERY SCHEDULE IAW DD1423

SHIP TO: IAW DD1423

NSP

1.00 LO $0.0000 $0.00

ALD

REQ/DES: R Del Sched: IAW DD1423 Ship To: IAWDD1423

AF Form 9: Req For Purchase Continuation Sheet PREVIOUS EDITION OBSOLETE CCaR Generated Form

Continuation Sheet - Accounting Classification(s) Document Number: F2DCDE1063A101 BASIC

Accounting Classification Previous Total This Amendment Document Total

5713011 H81 LCHN 355105 4E27A1 63681 78070F 503000 F03000 ALD:AA

FSR: 086990 PSR: B94327 DSR: 255635 CIN: F2DCDE1063A1010000AA

$0.00 $189,850.00 $189,850.00

$189,850.00Amendment Total Change Amount:

Document Number: F2DCDE1063A101 BASIC PREVIOUS EDITION OBSOLETE CCaR Generated Form

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