FA825022Q0261_0001.pdf

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

J

2. AMENDMENT/MODIFICATION NO.

FA8250-22-Q-0261-0001

3. EFFECTIVE DATE

13 JAN 2022

4. REQUISITION/PURCHASE REQ. NO.

FD20202200261

5. PROJECT NO (If applicable)

FD20202200261

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: Nataly Pringle/AFSC nataly.pringle.1@us.af.mil Phone: (801) 777- 6355

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.

FA825022Q0261

9B. DATED (SEE ITEM 11)

13-JAN-2022

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 1 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.

FA8250-22-Q-0261-0001

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

This amendment is to add the Repair qualification Requirements (RQR) and restrict the solicitation to qualified small businesses for NSN 5955010976223FD, NAICS Code:

811219. This RFQ is now a small business set-aside.

ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

ACO AUTHORITY AND RESPONSIBLITIES:

1) All applicable contract admin functions as outlined in FAR 42.302(a) and DFARS

242.302(a)

2) Definitize order if it does not require supplemental funding.

3) Extend the delivery schedule as required and take consideration if deemed necessary.

4) Upon completion of review of cost information and negotiations, if required, the ACO shall issue definitization modification and approve all invoices for payment.

5) Deobligate excess funds after confirming all required assets have generated and contractor's final invoices are approved.

6) Initiate order close out when actions required in paragraph 4) are completed.

7) ACO is to verify Commercial Asset Visibility Air Force (CAVAF) inputs have been made before authorizing payment on the contract. Inputs can be verified by emailing 415SCMS.PMS.Contract@us.af.mil

8) ACO is authorized to take consideration from the contractor for failure to comply with CAVAF inputs.

NOTE: In the event funds on the order are insufficient based on the contractor's proposal and the judgment of the ACO, the ACO will document what is a fair and reasonable price, and provide the pricing documentation to the PCO for action. The PCO will then address funding and supplemental agreement when approved, and will direct the contractor for commencement of work.

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

INFORMATIONAL CLIN

NSN: 5955010976223FD

Item No.

J059 Grid Pulsed Cavity Oscillator

Informational line item for TT&E and Repair.

Applicability: None ;

Test, Teardown, and Evaluation (TT&E)

NSN: 5955010976223FD

Item No.

0001AA

Firm Fixed Price Quantity U/I Unit Price Amount

8 EA

CLIN ACRN ACRN Total

0001AA AA

NSN: 5955-01-097-6223 FD

OSCILLATING GROUP

Oscillator Oscillating Group Manufacturer Part Number

2503H-1

654VE4851-3

PC-2000A-1

PC2000A

Priority: R

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

IUID Required: Yes

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ TBD ORIGIN

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 8 EA *30 Days

Proposed Delivery

+ TBD 8 EA

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

The ACO is authorized to negotiate and definitize CLIN 0001AB via modification. Work shall not begin under CLIN 0001AB until notice to proceed is provided from DCMA in the form of a definitization modification.

REPAIR

NSN: 5955010976223FD

Item No.

0001AB

Not to Exceed Price

REPAIR

NSN: 5955010976223FD

Quantity U/I Unit Price Not to Exceed Price

8 EA

CLIN ACRN ACRN Total

0001AB AA

NSN: 5955-01-097-6223 FD

OSCILLATING GROUP

Manufacturer Part Number

2503H-1

654VE4851-3

PC-2000A-1

PC2000A

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Applicability: None ;

IUID Required: Yes

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3215 ORIGIN

Type / Ship To PACRN Mark For A SW3215 PAC Account A Type / Ship To Quantity (U/I) *ARO After Completion of Study Req No / Pri

Required Delivery

A SW3215 8 EA *60 Days

Proposed Delivery

A SW3215 8 EA

The NTE price on CLIN 0001AB is used for purposes of funding the purchase order. The NTE price does not obligate the contractor to make repairs at the NTE price, if the contractors quoted repair price to the ACO is higher. The NTE price is established so that any repair price submitted to the ACO, that is over the NTE, will require action by the PCO prior to commencement of repair effort under CLIN 0001AB.

The not‐to‐exceed price quoted on CLIN 0001AB represents the maximum extent of work needed to restore the item to serviceable, like‐new condition (worst-case scenario). All other repair scenarios requiring fewer resources than the max‐extent will definitize lower than the NTE price.

DATA CLIN

CAVAF

Item No.

Not Separately Priced Quantity U/I Unit Price

1 EA NSP

Data IAW DD Form 1423 Data Item No. A001, AOO2, AND 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 IAW 1423-1 Req No / Pri

Required Delivery

A FB2029 1 EA *1 Calendar Days

Proposed Delivery

A FB2029 1 EA

IAW 1423-1

The prices of not-separately-priced DATA are included in the price of the individual Repair CLIN 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 a material requirement of the contract.

DCMA shall coordinate with CAVAF monitor to ensure requirements are met prior to Repair Invoice Acceptance. If CAVAF requirements are not met in accordance with the CDRL then payment may be withheld until CAVAF requirements are met. DCMA shall not provide acceptance until receipt of concurrence from CAVAF monitor.

DATA CLIN

Repairable Item Inspection Report (RIIR) Item No.

Not Separately Priced Quantity U/I Unit Price

DATA CLIN

Repairable Item Inspection Report (RIIR)

3 EA NSP

Data IAW DD Form 1423 Data Item No. B001 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.

A FY2073 DESTINATION

Type / Ship To Quantity (U/I) *ARO IAW 1423-1 Req No / Pri

Required Delivery

A FY2073 3 EA *7 Calendar Days

Proposed Delivery

A FY2073 3 EA

IAW DD Form 1423-1

The prices of not-separately-priced DATA are included in the price of the individual Repair CLIN 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 a material requirement of the contract.

Counterfeit Prevention Plan (CPP) Item No.

Not Separately Priced Quantity U/I Unit Price

2 EA NSP

Data IAW DD FORM 1423 Data Item No. C001 CPP CDRL Priority: R

Limitations of Liability: Other Than High Value Item

DATA CLIN

Counterfeit Prevention Plan (CPP)

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 FY2073 DESTINATION

Type / Ship To Quantity (U/I) *ARO IAW DD FORM

1423-1 Req No / Pri

Required Delivery

A FY2073 2 EA *30 Calendar Days

Proposed Delivery

A FY2073 2 EA

IAW DD Form 1423-1

The prices of not-separately-priced DATA are included in the price of the individual Repair CLIN 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

Engineerinig Change Proposal (ECP) Item No.

Not Separately Priced Quantity U/I Unit Price

3 EA NSP

Data IAW DD Form 1423 Data Item No. D001 Engineering Change Order 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.

DATA CLIN

Engineerinig Change Proposal (ECP)

A FY2073 DESTINATION

Type / Ship To Quantity (U/I) *ARO IAW DD 1423-1 Req No / Pri

Required Delivery

A FY2073 3 EA *14 Calendar Days

Proposed Delivery

A FY2073 3 EA

IAW DD Form 1423-1

The prices of not-separately-priced DATA are included in the price of the individual Repair CLIN 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

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 FY2073

FY2073 OO ALC 502 CBSS GBMAA

CP 801 586 1368

6012 FIR AVE BLDG 1239 RM 2

HILL AFB UT 84056 49 84056-4056

USA

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

AWARD NUMBER:

TYPE/CODE: A SW3215

DLA DISTRIBUTION BARSTOW

CENTRAL RECEIVING WHSE 7

REC OFFICER 760 577 6442

BARSTOW CA 92311-5014

BARSTOW CA 92311-5014 CA 92311-5014

USA

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

AA 97 X4930 FC04 64 2 47 GH 8M816L 01K010 00000 UJEZEK 503000 F03000 $0.00

PSR: K28028 FSR: 001884 DSR: 244965 CIN: F2DCCW1349A1030000AA

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 1 PWS 06JAN2022 10

Attachment 2 Item_Description 15DEC2021 1

Attachment 3 RDL 14FEB2018 1

Attachment 4 PKG 15DEC2021 3

Attachment 5 PKG_SOW 01MAR2021 4

Attachment 6 Transportation 15DEC2021 4

Attachment 7 CAVAF 01SEP2018 7

Attachment 8 CDRLs 14DEC2021 14

Attachment 9 Instructions 13JAN2022 2

Attachment 10 Evaluation 13JAN2022 2

Attachment 11 RQR 27FEB2018 3