FA821321R3045_______0001.pdf

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

J

2. AMENDMENT/MODIFICATION NO.

FA8213‐21‐R‐3045‐0001

3. EFFECTIVE DATE

29 JUN 2021

4. REQUISITION/PURCHASE REQ. NO.

FD20202151265

5. PROJECT NO (If applicable)

6. ISSUED BY CODE

DEPARTMENT OF THE AIR FORCE, DIRECTORATE OF CONTRACTING

AFLCMC EBHK

6072 FIR AVENUE BLDG 1233

HILL AIR FORCE BASE UT 84056‐5820

BUYER: Elizabeth Dykes/AFLCMC elizabeth.dykes@us.af.mil

7. ADMINISTERED BY (If other than item 6) CODEFA8213

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

CODE

X

9A. AMENDMENT OF SOLICITATION NO.

FA821321R3045

9B. DATED (SEE ITEM 11)

29‐JUN‐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. 29‐JUL‐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.

EXPEDITED DELIVERY AT NO ADDITIONAL COST TO THE GOVERNMENT IS AUTHORIZED.

Sole source to: Nammo Talley.; cage code 12116

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.

FA8213‐21‐R‐3045‐0001

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

The purpose of this amendment is to correct the no later date that offers will be received.

From June 29th, 2021

To July 29th, 2021.

All other terms, conditions, and attachments shall remain the same.

PART I ‐ THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

DCMA and DFAS are required to withhold payment IAW DFAR 252.227‐7030 until CDRL A001, A002 & A003 have been delivered and/or approved by Hill AFB.

EXPLOSIVE ROTARY ACTUATOR

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

60 EA

CLIN ACRN ACRN Total

0001 AA

NSN: 1377‐00‐891‐6310 ES

ACTUATOR,EXPLOSIVE,ROTARY

EXPLOSIVE ROTARY ACTUATOR When gas pressure enters the inlet port of the actuator, the shear pin shears and the firing pin is propelledagainst the primer of the cartridge. As the cartridge fires, gas pressure is created.

Manufacturer Part Number 12116 1000‐34 Priority: R ROUTINE.

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required 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

ISO 9001:2015

Applicability: None ;

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

Serial Number Required

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

C FV2172 ORIGIN

Type / Ship To PACRN Mark For

C FV2172 09 ACCOUNT

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

Required Delivery

EXPLOSIVE ROTARY ACTUATOR

C FV2172 60 EA *12 Months Non‐MilStrip

Proposed Delivery

C FV2172 60 EA

Physical Item Markings IAW CAD/PAD Item Marking Instructions version 1.5 01 May 2019

SPI Number: F00‐407‐9649

Transportation Chargeable To: F8UT

EXPLOSIVE ROTARY ACTUATOR

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

35 EA

CLIN ACRN ACRN Total

0002 AB

NSN: 1377‐01‐049‐7586 ES

T‐38 EXPLOSIVE ROTARY ACTUATOR

EXPLOSIVE ROTARY ACTUATOR When gas pressure enters the inlet port of the actuator, the shear pin shears and thefiring pin is propelled against the primer of the cartridge. As the cartridge fires, gas pressure is created.

DODIC : SP97

Manufacturer Part Number 12116 1000‐54 Priority: R ROUTINE.

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required 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

ISO 9001:2015

Applicability: None ;

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

Serial Number Required

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

C FV2172 ORIGIN

EXPLOSIVE ROTARY ACTUATOR

Type / Ship To PACRN Mark For

C FV2172 09 ACCOUNT

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

Required Delivery

C FV2172 35 EA *12 Months Non‐MilStrip

Proposed Delivery

C FV2172 35 EA

Physical Item Markings IAW CAD/PAD Item Marking Instructions version 1.5 dated 01 May 2019

Applicable SPI Number: F00‐407‐9649

Transportation Chargeable To: F8UT

Data

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

DATA

DATA IAW DD1423‐1 EXHIBIT A ATTACHED.

ITEM TITLE

A001 AMMUNITION DATA CARD

A002 LOT ACCEPTANCE TEST PLAN

A003 TEST/INSPECTION REPORT

A004 FAILURE ANALYSIS AND CORRECTIVE ACTION REPORT

A006 ENGINEERING CHANGE PROPOSAL (ECP)

A007 NOTICE OF REVISION (NOR)

A008 REQUEST FOR VARIANCE (RFV)

Priority: R ROUTINE.

Data

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Data

DATA

DATA IAW DD1423‐1 EXHIBIT A ATTACHED.

ITEM TITLE

A005 REPORT OF RECEIPTS, INVENTORY, ADJUSTMENTS AND SHIPMENTS OF GOVERNMENT PROPERTY

CONTRACTOR POSSESSED MUNITIONS REPORT (CPM)

Priority: R ROUTINE.

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: C FV2172

649 MUNS MXW

6024 PINE LANE

BLDG 1377 BAY 2

HILL AIR FORCE BASE UT 84056‐5707

UNITED STATES

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

AWARD NUMBER:

PART I ‐ THE SCHEDULE

SECTION C

DESCRIPTION/SPECIFICATIONS/STATEMENT OF WORK

SPECIFICATIONS, STANDARDS AND DRAWINGS (MAY 1993)

(IAW FAR 11.201)

Specifications, standards or drawings (as applicable) are furnished/listed below or are listed in Section J herein. The contractor shall perform in accordance with those specifications and/or the attachments listed in Section J:

ITEM NR SPECIFICATIONS, STANDARDS AND/OR ATTACHMENTS

PART I ‐ THE SCHEDULE

SECTION F

DELIVERIES OR PERFORMANCE

52.247-29 F.O.B. ORIGIN (FEB 2006)

(IAW FAR 47.303-1(c))

52.247-34 F.O.B. DESTINATION (NOV 1991)

(IAW FAR 47.303-6(c))

52.247-61 F.O.B. ORIGIN-MINIMUM SIZE OF SHIPMENTS (APR 1984)

(IAW FAR 47.305-16(c))

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 13400 . 30 1 87 HI XX27JX 010000 56050 11113F 503000 F03000 $0.00

PSR: B44929 FSR: 084762 DSR: 033662 CIN: F2DCDE1144A1030000AA

AB 57 13400 . 30 1 87 HI XX27JW 010000 56050 84741F 503000 F03000 $0.00

PSR: B44922 FSR: 084762 DSR: 033597 CIN: CIN: F2DCDE1144A1030000AB

REFERENCE:

AA CIN: F2DCDE1144A1030000AA

FD20202151265

AB CIN: F2DCDE1144A1030000AB

FD20202151265

ACRN TOTAL $ 0.00

PART II ‐ CONTRACT CLAUSES

SECTION I

CONTRACT CLAUSES

252.209-7009 ORGANIZATIONAL CONFLICT OF INTEREST--MAJOR DEFENSE ACQUISITION

PROGRAM (MAY 2019)

(IAW DFARS 209.571-8(b))

52.215-14 INTEGRITY OF UNIT PRICES -- ALTERNATE I (OCT 1997)

(IAW FAR 15.408(f)(2))

252.227-7030 TECHNICAL DATA--WITHHOLDING OF PAYMENT (MAR 2000)

(IAW DFARS 227.7103-6(e)(2), DFARS 227.7104(e)(4))

(a) the Contracting Officer may until such data is accepted by the Government, withhold payment to the Contractor of ten percent (10%) of the total contract price or amount

PART IV ‐ REPRESENTATIONS AND INSTRUCTIONS

SECTION K

REPRESENTATIONS, CERTIFICATIONS, AND OTHER STATEMENTS

OF OFFERORS OR RESPONDENTS

52.225-20 PROHIBITION ON CONDUCTING RESTRICTED BUSINESS OPERATIONS IN

SUDAN--CERTIFICATION (AUG 2009)

(IAW FAR 25.1103(d))

PART IV ‐ REPRESENTATIONS AND INSTRUCTIONS

SECTION L

INSTRUCTIONS, CONDITIONS, AND NOTICES TO OFFERORS OR RESPONDENTS

PART IV ‐ REPRESENTATIONS AND INSTRUCTIONS

SECTION M

EVALUATION FACTORS FOR AWARD