FA825022Q0641_______0001.pdf

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

J

2. AMENDMENT/MODIFICATION NO.

FA8250-22-Q-0641-0001

3. EFFECTIVE DATE

14 APR 2022

4. REQUISITION/PURCHASE REQ. NO.

FD20202200641

5. PROJECT NO (If applicable)

FA825022Q0641

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: Catherine Kobayashi/AFSC catherine.kobayashi@us.af.mil Phone: (801) 726- 7562

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.

FA825022Q0641

9B. DATED (SEE ITEM 11)

24-MAR-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

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-0641-0001

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

The purpose of this amendment is to add A001, A002, and A003 to DATA Clin 0002 (CAVAF).

SUPPLIES OR SERVICES AND PRICES/COSTS

In accordance with the attached CAV AF Reporting Requirements (see the document listed in Section J), the Contractor shall include a DD1348-1 when assets are shipped. DCMA Quality Assurance Representatives (QARs) will not approve or sign the DD1348-1, but will ensure a DD1348-1 is included with each returned asset. If a DD1348-1 is not included with each returned asset, DCMA will not sign the receiving report (DD250).

ACO Authority and Responsibilities:

1. All applicable contract admin functions as outlined in FAR 42.302(a) and DFARS 242.302(a)

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

3. The ACO or the ACO's delegated authority shall indicate inspection and acceptance in Wide Area Work Flow (WAWF) for CLIN 0001.

4. Deobligate excess funds if asset is determined to be Beyond Economic Repair (BER).

5. The government is authorized to withhold a portion of the total contract price pursuant to clause ‘Technical Data – Withholding of Payment (MAR 2000)’ DFARS 252.2277030 should the contractor fail to deliver data as required by the CDRL of this requirement.

NOTE:

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 shall supply disposition/condemnation instructions to the contractor. The contractor shall provide technical data on BER assets, including pictures of the repairable asset.

INFORMATIONAL CLIN

NSN: 6625013433026MZ

Item No.

J066 Maint & Repair of Eq/Instruments & Lab Equipment Applicability: None ;

Repair

NSN: 6625013433026MZ

Item No.

0001AA

Firm Fixed Price Quantity U/I Unit Price Amount

9 EA

CLIN ACRN ACRN Total

0001AA AA

NSN: 6625-01-343-3026 MZ

Repair

NSN: 6625013433026MZ

FREQUENCY STANDARD

Provides stable 5 MHz output various electronic components Manufacturer Part Number 13499 218-0057-030 13499 218-0057-031 50218 813-102-10 55761 813-102-10 55761 M-3000 55761 M-3051 Priority: R

Inspection: Origin Acceptance: Origin 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 W25G1W ORIGIN

Type / Ship To PACRN Mark For A W25G1W PAB Account A Type / Ship To Quantity (U/I) *ARO After Receipt of

Carcass Req No / Pri

Required Delivery

A W25G1W 9 EA *90 Days

Proposed Delivery

A W25G1W 9 EA

DATA CLIN

Commercial Asset Visibility Air Force (CAV) Item No.

Not Separately Priced Quantity U/I Unit Price

1 EA NSP

Data IAW DD Form 1423 CAV AF A001, A002, A003 Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required

DATA CLIN

Commercial Asset Visibility Air Force (CAV) Quality Assurance: Standard Inspection

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

+ CNOTE DESTINATION

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

1423-1.

Req No / Pri

Required Delivery

+ CNOTE 1 EA *1 Calendar Days

Proposed Delivery

+ CNOTE 1 EA

The prices of not-separately-priced DATA are included in the price of the individual Repair CLIN 0001AA.

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.

IAW 1423-1

DATA CLIN

Repairable Item Inspection Report Item No.

Not Separately Priced Quantity U/I Unit Price

2 EA NSP

Data IAW DD Form 1423-1 B001 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

Repairable Item Inspection Report

A FY2073 DESTINATION

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

1423-1 Req No / Pri

Required Delivery

A FY2073 2 EA *7 Calendar Days

Proposed Delivery

A FY2073 2 EA

The prices of not-separately-priced DATA are included in the price of the individual Repair CLIN 0001AA.

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.

IAW Form 1423-1

Counterfeit Prevention Plan Item No.

Not Separately Priced Quantity U/I Unit Price

2 EA NSP

Data IAW DD Form 1423-1 C001 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 DD Form

1423-1 Req No / Pri

Required Delivery

A FY2073 2 EA *30 Calendar Days

Proposed Delivery

A FY2073 2 EA

The prices of not-separately-priced DATA are included in the price of the individual Repair CLIN 0001AA.

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

IAW DD Form 1423-1

ENGINEERING CHANGE PROPOSAL (ECP)

Item No.

Not Separately Priced Quantity U/I Unit Price

2 EA NSP

Data IAW DD Form 1423-1 Data Item No. D001 Engineering Change Proposal (ESP) 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 Contractor shall deliver all applicable ECOs within 14 days after the completion of test, tear-down

Req No / Pri

Required Delivery

A FY2073 2 EA *14 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 0001AA.

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: + CNOTE

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 CA 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 W25G1W

W1A8 DLA DIST-TOBYANNA

GIBBS AND FIFTH STREETS

WAREHOUSE 6 BAY 4

TOBYHANNA PA 18466-5059

TOBYHANNA PA 18466-5059 42 18466-5059

USA

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

AWARD NUMBER:

IAW Form 1423-1

CONTRACT CLAUSES

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AA 97 X4930 .FC04 64 2 47 GH 8M745C 01K010 00000 UJEPAY 503000 F03000 $0.00

PSR: K28116 FSR: 001884 DSR: 137137 CIN: F2DCCW2074A1010000AA

ACRN TOTAL $ 0.00

LIST OF DOCUMENTS, EXHIBITS OR ATTACHMENTS

Form Number Description/File Name Date Number of Pages

CDRL