FA825019Q1367_______0001.pdf

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

J

2. AMENDMENT/MODIFICATION NO.

FA8250-19-Q-1367-0001

3. EFFECTIVE DATE

4. REQUISITION/PURCHASE REQ. NO.

FD20201901367

5. PROJECT NO (If applicable)

6. ISSUED BY CODE

DEPARTMENT OF THE AIR FORCE, DIRECTORATE OF CONTRACTING

AFSC PZAAA1

6050 GUM LANE BLDG 1215

HILL AIR FORCE BASE UT 84056-5825

BUYER: Bruce Christensen/AFSC bruce.christensen.3@us.af.mil Phone: (801) 777- 6660 No Collect Calls

7. ADMINISTERED BY (If other than item 6) CODEFA8250

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

CODE

X

9A. AMENDMENT OF SOLICITATION NO.

FA825019Q1367

9B. DATED (SEE ITEM 11)

25-JUN-2019

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 copies to the issuing office.

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

ROUTINE

Requirement restricted to qualified source(s). All non-qualified vendors that submit a proposal in support of this requirement must comply with qualification requirements found in clause 52.209-1, and the source qualification statement attached hereto, in order to be considered for award. Award shall not be delayed to qualify new sources.

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.

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

To attach the Performance Work Specifications document (PWS_FD20201901367).

ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

Upon completion of CLIN 0001AA a detailed repair quote shall be forwarded to the AFSC PCO.

Work shall not begin under CLIN 0001AB until notice to proceed is provided from the PCO in the form of a definitization modification.

NOTE:

In the case of a Beyond Economical Repair (BER) determination, the contractor shall request disposition instructions and/or condemnation approvals from the cognizant USAF Program Manager, customer, or PCO.

INFORMATION CLIN

NSN: 6110-01-481-1994 FD

Item No.

J061 Maint & Repair of Eq/Power Distribution Equipment Applicability: None ;

TEARDOWN, TEST, and EVALUATION (TT&E) CLIN

NSN: 6110-01-481-1994 FD

Item No.

0001AA

Firm Fixed Price Quantity U/I Unit Price Amount

1 EA

CLIN ACRN ACRN Total

0001AA AA

NSN: 6110-01-481-1994 FD

DISTRIBUTION BOX

Responsible for generating the high voltage required for the operation of the radiation source within the transmitter.

Various metals Manufacturer Part Number 66948 A26367-000 8M906 A26367-000 Priority: R

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

TEARDOWN, TEST, and EVALUATION (TT&E) CLIN

NSN: 6110-01-481-1994 FD

IUID Required: Yes Physical Item Markings:

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ TBD DESTINATION

Type / Ship To PACRN Mark For

+ TBD PAC

Type / Ship To Quantity (U/I) *ARO After Receipt of

Carcass Req No / Pri

Required Delivery

+ TBD 1 EA *30 Days

Proposed Delivery

+ TBD 1 EA

AT PLANT

REPAIR CLIN

NSN: 6110-01-481-1994 FD

Item No.

0001AB

Not to Exceed Quantity U/I Unit Price Not to Exceed Price

1 EA

CLIN ACRN ACRN Total

0001AB AA

NSN: 6110-01-481-1994 FD

DISTRIBUTION BOX

Responsible for generating the high voltage required for the operation of the radiation source within the transmitter.

Various metals Manufacturer Part Number 66948 A26367-000 8M906 A26367-000 Priority: R

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

IUID Required: Yes Physical Item Markings:

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3210 DESTINATION

REPAIR CLIN

NSN: 6110-01-481-1994 FD

Type / Ship To PACRN Mark For A SW3210 PAC Account A Type / Ship To Quantity (U/I) *ARO Definization

Modification and Notification to Proceed

Req No / Pri

Required Delivery

A SW3210 1 EA *90 Calendar Days

Proposed Delivery

A SW3210 1 EA

DATA CLIN

Commercial Asset Visibility Air Force (CAVAF) Reporting Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Data IAW DD Form 1423. Data Item No.A001,A002 & A003 CAVAF CDRL.

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A FB2029 DESTINATION

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

Required Delivery

A FB2029 1 LO *24 Hours

Proposed Delivery

A FB2029 1 LO

DATA which is 'Not Separately Priced' (NSP). The price of NSP DATA are included in the price of the individual Repair CLINs 0001AA and 0001AB. Failure to comply with contract data requirements may result in the withholding of payment on the aforementioned CLINs. This allows the government to withhold payment on the repairs if the contractor does not deliver the required data. The data is also important, and it is a material requirement of the contract. The contract is not finished until the data is delivered.

IAW DD Form 1423

DATA CLIN

Repairable Item Inspection Report (RIIR) Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Data IAW DD Form 1423 Data Item No.B0001 Repair Item Inspection Report.

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

C FY2073 DESTINATION

Type / Ship To Quantity (U/I) *ARO Completed

Study Req No / Pri

Required Delivery

C FY2073 1 LO *7 Calendar Days

Proposed Delivery

C FY2073 1 LO

DATA which is 'Not Separately Priced' (NSP). The price of NSP DATA are included in the price of the individual Repair CLINs 0001AA and 0001AB. Failure to comply with contract data requirements may result in the withholding of payment on the aforementioned CLINs. This allows the government to withhold payment on the repairs if the contractor does not deliver the required data. The data is also important, and it is a material requirement of the contract. The contract is

IAW attached DD Form 1423

DATA CLIN

Counterfeit Prevention Plan (CPP) Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

DATA CLIN

Counterfeit Prevention Plan (CPP) Data

CPP CDRL IAW FORM 1423 C0001

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

C FY2073 DESTINATION

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

Required Delivery

C FY2073 1 LO *30 Calendar Days

Proposed Delivery

C FY2073 1 LO

DATA which is 'Not Separately Priced' (NSP). The price of NSP DATA are included in the price of the individual Repair CLINs 0001AA and 0001AB. Failure to comply with contract data requirements may result in the withholding of payment on the aforementioned CLINs. This allows the government to withhold payment on the repairs if the contractor does not deliver the required data. The data is also important, and it is a material requirement of the contract. The contract is

IAW FORM 1423-1

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: + TBD

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

AWARD NUMBER:

TYPE/CODE: A FB2029

DDHU HILL FACILITY

CENTRAL RECEIVING BLDG 849W

5851 F AVE

HILL AIR FORCE BASE UT 84056-5713

UNITED STATES

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 AIR FORCE BASE UT 84056-5734

UNITED STATES

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

AWARD NUMBER:

TYPE/CODE: C FY2073

415 SCMS GUMA

6012 FIR AVE BLDG 1239 ROOM2

HILL AIR FORCE BASE UT 84056-5820

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 G

CONTRACT ADMINISTRATION DATA

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AA 97 X4930 .FC04 64 9 47 GH 8M816L 01K010 00000 UJENTD 503000 F03000 $0.00

PSR: K18563 FSR: 001884 DSR: 204518 CIN: F2DCCW9169B103 PR: FD20201901367

ACRN TOTAL $ 0.00

PART III - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACHMENTS

SECTION J

LIST OF ATTACHMENTS

Form Number Description/File Name Date Number of Pages ATTACHMENT 12 PWS_FD20201901367.pdf 11JUN2019 10