FA8524-14-R-00254-0001.pdf

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

2. AMENDMENT/MODIFICATION NO.

FA8524-14-R-00254-0001

3. EFFECTIVE DATE

25 MAR 2014

4. REQUISITION/PURCHASE REQ. NO.

FD20601400254

5. PROJECT NO (If applicable)

6. ISSUED BY CODE

C-5/SOF-RW, AFSC/PZAAA

235 BYRON ST STE 19A

BLDG 300 CML PHN 478 926 0174

ROBINS AFB GA 31098-1670

BUYER: Erin C. Rowe/AFSC/PZAAA Erin.Rowe@robins.af.mil Phone: (478) 926- 0167 Fax: (478) 926-0154 No Collect Calls

7. ADMINISTERED BY (If other than item 6) CODEFA8524

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

CODE

X

9A. AMENDMENT OF SOLICITATION NO.

FA852414R00254

9B. DATED (SEE ITEM 11)

21-MAR-2014

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

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.

Amendment/Modification FA8524-14-R-00254-0001

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

A. The purpose of this amendment is to add the Part Number (4B97509-101A) to CLINs 0001, 1001, 2001, 3001, and 4001 as shown in the schedule below.

B. All other terms and conditions of the Solcitation remain unchanged.

Request for Proposal FA8524-14-R-00254-0001

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

BASIC ORDERING PERIOD: The Basic Ordering Period is applicable to orders placed on the date of the basic contract award through twelve (12) months thereafter.

BASIC ORDERING PERIOD

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

18 EA

CLIN ACRN ACRN Total

0001 AA

NSN: 5945-00-856-1787 UC

RELAY, ARMATURE

Electrical Mechanical Switch Manufacturer Part Number 98897 4B97509-101A Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Applicability: C-5B ; C-5A ;

Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAA FLB RIC D4S

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

Order or Reparable Assets, Whichever is Later

_ Req No / Pri

Required Delivery

A SW3119 18 EA *180 Calendar Days

Proposed Delivery

A SW3119 18 EA

ORDERING PERIOD I: Applicable to orders placed during the twelve (12) month period immediately following the Basic Ordering Period.

ORDERING PERIOD I

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

8 EA

CLIN ACRN ACRN Total

1001 AA

NSN: 5945-00-856-1787 UC

RELAY, ARMATURE

Electrical Mechanical Switch Manufacturer Part Number 98897 4B97509-101A Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Applicability: C-5B ; C-5A ;

Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAB FLB RIC D4S

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

Order or Reparable Assets, Whichever is Later

_ Req No / Pri

Required Delivery

A SW3119 8 EA *180 Calendar Days

Proposed Delivery

A SW3119 8 EA

ORDERING PERIOD II: Applicable to orders placed during the twelve (12) month period immediately following Ordering Period I.

ORDERING PERIOD II

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

ORDERING PERIOD II

8 EA

CLIN ACRN ACRN Total

2001 AA

NSN: 5945-00-856-1787 UC

RELAY, ARMATURE

Electrical Mechanical Switch Manufacturer Part Number 98897 4B97509-101A Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Applicability: C-5B ; C-5A ;

Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAC FLB RIC D4S

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

Order or Reparable Assets, Whichever is Later

_ Req No / Pri

Required Delivery

A SW3119 8 EA *180 Calendar Days

Proposed Delivery

A SW3119 8 EA

ORDERING PERIOD III: Applicable to orders placed during the twelve (12) month period immediately following Ordering Period II.

ORDERING PERIOD III

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

8 EA

CLIN ACRN ACRN Total

3001 AA

NSN: 5945-00-856-1787 UC

RELAY, ARMATURE

Electrical Mechanical Switch

ORDERING PERIOD III

Manufacturer Part Number 98897 4B97509-101A Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Applicability: C-5B ; C-5A ;

Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAD FLB RIC D4S

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

Order or Reparable Assets, Whichever is Later

_ Req No / Pri

Required Delivery

A SW3119 8 EA *180 Calendar Days

Proposed Delivery

A SW3119 8 EA

ORDERING PERIOD IV: Applicable to orders placed during the twelve (12) month period immediately following Ordering Period III.

ORDERING PERIOD IV

Item No.

Firm Fixed Price Best Estimated Qty

U/I Unit Price Amount

8 EA

CLIN ACRN ACRN Total

4001 AA

NSN: 5945-00-856-1787 UC

RELAY, ARMATURE

Electrical Mechanical Switch Manufacturer Part Number 98897 4B97509-101A Priority: R ROUTINE

Limitations of Liability: Other Than High Value Item

ORDERING PERIOD IV

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Applicability: C-5B ; C-5A ;

Buy American Act/Balance of Payments Program

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3119 ORIGIN

Type / Ship To PACRN Mark For

A SW3119 PAE FLB RIC D4S

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

Order or Reparable Assets, Whichever is Later

_ Req No / Pri

Required Delivery

A SW3119 8 EA *180 Calendar Days

Proposed Delivery

A SW3119 8 EA

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: A SW3119

DLA DISTRIBUTION WARNER ROBINS

455 BYRON STREET BLDG 376

ROBINS AFB GA 31098-1887

UNITED STATES

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

AWARD NUMBER: