FA852621Q0016_______0001.pdf

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

J

2. AMENDMENT/MODIFICATION NO.

FA8526-21-Q-0016-0001

3. EFFECTIVE DATE

4. REQUISITION/PURCHASE REQ. NO.

MULTIPLE

5. PROJECT NO (If applicable)

6. ISSUED BY CODE

GLOBEMASTER (C-17), AFLCMC/WLMK

235 BYRON ST STE 19A

BLDG 300 CML PHN 478 327 7137

ROBINS AFB GA 31098-1670

BUYER: Kizmet Y. Hall/WLMK kizmet.hall@us.af.mil Phone: (478) 222- 3352 Fax: (000) 000-0000 No Collect Calls

7. ADMINISTERED BY (If other than item 6) CODEFA8526

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

CODE

X

9A. AMENDMENT OF SOLICITATION NO.

FA852621Q0016

9B. DATED (SEE ITEM 11)

1-MAR-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. 6-JUN-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

This is a competitive 100% Total Small Business set-aside.

PRs include: FD2060-21-30049 & FD2060-21-30111.

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

A. The purpose of this amendment is to reclassify the set-aside from 100% Service Disabled Veterans Owned Small Business (SDVOSB) to 100% Small Business Set-Aside.

B. The date specfied for receipt of offers is extended to June 06, 2021.

C. All other terms and conditions remain unchanged.

SUPPLIES OR SERVICES AND PRICES/COSTS

ELECTRONIC RESPONSES ARE AUTHORIZED (MAR 2003)

(IAW FAR 13.003(f))

In accordance with FAR 13.003(f), electronic commerce method to receive proposals, modifications, and revisions is permitted and preferred. Buyer and Contracting Officer's email addresses for submissions are listed on the front page of this document.

Fill – In Below:

Note: An option is considered to have been exercised at the time the Government deposits written notification to the Contractor via mail or other electronic means of notification. In the event of overlapping deliveries due to exercise of option, the Contractor shall not be required to deliver more than _3__ EA (or applicable qty/unit and item number or Noun) in any 30 day period.

Offeror Note: For First Article Waiver Information see “First Article Applicability and/or Conditions for Waiver”. Bid A is for offerors who are required to produce the First Article; Bid B is for offerors who are exempt from production of "First Article”.

Note 1 to Contractors: Determination of Responsiveness - In order to be determined responsive and have your proposal accepted, interested contractors must submit their proposals using the attached C-17 PSE Solicitation Template, carefully adhering to the CONTRACTOR INSTRUCTIONS in the first tab of the spreadsheet. Offerors must ensure they annotate the proposed labor hours and rates for each applicable line item, carefully following the examples and guidance within each tab. Failure to submit your proposal in accordance with the guidance in this template could render your proposal being ineligible for award.

Note 2 to Contractors: Representations & Certifications - In addition to ensuring your proposals are submitted in accordance with the PSE Solicitation Template, contractors MUST also ensure they fully complete all representations and certifications listed in the Representations, Instructions and Evaluations section in the back pages of this document. Failure to properly and fully annotate the certifications and representations requested in this solicitation package could result in an interested offeror being determined non-responsive and, therefore, ineligible for award.

Note 3 to Contractors: Access to TDP - The technical data Package (TDP) associated with this requirement contains data proprietary to The Boeing Company. In order to receive access to the TDP, interested offerors must complete and sign the attached non-disclosure agreement (NDA) which must be emailed to the PCO and Buyer. Upon receipt of the NDA, the PCO or Buyer will email a link providing access to the TDP via the DODSafe website.

Bid A - First Article Required

Item No.

NSN: 4920-01-530-0158 BA

First Article/Production Break Out Box-Pitot Static

Manufacturer Part Number 88277 17G573809-1

Bid A - First Article Required

First Article Item No.

0001AA

Firm Fixed Price Quantity U/I Unit Price Amount

1 EA

FA

FIRST ARTICLE/PRODUCTION

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standard certification is preferred. Contractor QA shall meet highest standardunder which they qualify.

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A FE5612 DESTINATION

Class I ODS Substance Application/Use Quantity

NONE

None Type / Ship To PACRN Mark For

A FE5612 PAA

Type / Ship To Quantity (U/I) *ARO APPROVAL OF

FATP

_ Req No / Pri

Required Delivery

A FE5612 1 EA *265 Calendar Days FE561290810169 / PRI: R

Proposed Delivery

A FE5612 1 EA

Bid A - First Article Required

Data in Support of CLIN 0001AA Item No.

DATA

Data in Support of First Article CLIN 0001AA Exhibit: A

Bid A - First Article Required

Test Plan Item No.

0002AA

Firm Fixed Price Quantity U/I Unit Price Amount

1 LO

FATP

First Article Test Plan In accordance with CDRL A001

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Exhibit: A Quality Assurance: Standard Inspection Type / Ship To PACRN Mark For I FA8526 AFLCMC/WLE, C-17 PSE Engineering Type / Ship To Quantity (U/I) *ARO Contract _ Req No / Pri

Required Delivery

I FA8526 1 LO *60 Calendar Days

Proposed Delivery

I FA8526 1 LO

Bid A - First Article Required

Test Report Item No.

0002AB

Firm Fixed Price Quantity U/I Unit Price Amount

1 LO

FATR

First Article Test Report In accordance with CDRL A002

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Exhibit: A Quality Assurance: Standard Inspection Type / Ship To PACRN Mark For I FA8526 AFLCMC/WLE, C-17 PSE Engineering Type / Ship To Quantity (U/I) *ARO Approval of

First Article _ Req No / Pri

Required Delivery

Bid A - First Article Required

Test Report I FA8526 1 LO *60 Calendar Days

Proposed Delivery

I FA8526 1 LO

Item Unique Identification Item No.

Not Separately Priced Quantity U/I Unit Price

LO NSP

DATA

Item Unique Identification In accordance with CDRL A003 Exhibit: A

Bid B - First Article NOT Required

Production (No First Article Required) Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

3 EA

NSN: 4920-01-530-0158

FIRST ARTICLE/PRODUCTION BREAKOUT BOX - PITOT STATIC

NSN: 4920-01-530-0158

Manufacturer Part Number

17G573809-1

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standardcertification is preferred. Contractor QA shall meet highest standard under which they qualify.

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A FE5612 DESTINATION

A FE6520 DESTINATION

Type / Ship To PACRN Mark For

A FE6520 PAA

A FE5612 PAA

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

Bid B - First Article NOT Required

Production (No First Article Required) A FE6520 2 EA *120 Calendar Days FE6520082690026 / PRI: R

A FE5612 1 EA *120 Calendar Days FE561290810169 / PRI: R

Proposed Delivery

A FE6520 2 EA

A FE5612 1 EA

Tech Manual

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

1 LO

DATA

Tech Manual In accordance CDRL A004 Exhibit: A

NOTE: The Technical Manual is not required and need not be proposed to if the contractor will be providing the suggested source’s support equipment to satisfy this contract. If any other equipment besides the suggested source’s equipment will be developed/delivered, then the Technical Manual is required and should be proposed to. However, contractors planning to purchase the suggested source and sell it to the Government as a pass-through must obtain permission from the PCO beforehand. It is the Government’s preference to avoid the need for pass-through charges.

Option I can be exercised from time to time, at any time, within a period of 365 days after award or after approval of First Article, whichever is later, not to exceed a quantity of 3 each. Multiple option periods may be exercised simultaneously. An option is determined to have been exercised when transmitted electronically email. Sub-line items may be established at the time of option exercise.

Option I

Item No.

Firm Fixed Price From Quantity U/I To Quantity U/I Unit Price

1 EA 3 EA

NSN: 4920-01-530-0158

BREAKOUT BOX - PITOT STATIC

Manufacturer Part Number 88277 17G573809-1

Limitations of Liability: Other Than High Value Item

Option I

Inspection: Origin Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standard certification is preferred. Contractor QA shall meet highest standard under which they qualify.

Type / Ship To PACRN Mark For

+ TBD AB

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

Option _ Req No / Pri

Required Delivery

+ TBD 1 EA

*100 Calendar Days

Proposed Delivery

+ TBD 1 EA

Accelerated delivery is acceptable.

Option II can be exercised from time to time, at any time, within a period of 730 days after award or after approval of First Article, whichever is later, not to exceed a quantity of 3 each. Multiple option periods may be exercised simultaneously. An option is determined to have been exercised when transmitted electronically email. Sub-line items may be established at the time of option exercise.

Option II

Item No.

Firm Fixed Price From Quantity U/I To Quantity U/I Unit Price

1 EA 3 EA

NSN: 4920-01-530-0158

BREAKOUT BOX - PITOT STATIC

Manufacturer Part Number 88277 17G573809-1

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standard certification is preferred. Contractor QA shall meet highest standard under which they qualify.

Type / Ship To PACRN Mark For

+ TBD AC

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

Option _ Req No / Pri

Option II

+ TBD 1 EA

*100 Calendar Days

Proposed Delivery

+ TBD 1 EA

Option III can be exercised from time to time, at any time, within a period of 1,095 days after award or after approval of First Article, whichever is later, not to exceed a quantity of 3 each. Multiple option periods may be exercised simultaneously. An option is determined to have been exercised when transmitted electronically email. Sub-line items may be established at the time of option exercise.

Option III

Item No.

Firm Fixed Price From Quantity U/I To Quantity U/I Unit Price

1 EA 3 EA

NSN: 4920-01-530-0158

BREAKOUT BOX - PITOT STATIC

Manufacturer Part Number 88277 17G573809-1

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: The latest revision of ISO 9001, AS9100, NATO AQAP 2070 or equivalent quality management standard certification is preferred. Contractor QA shall meet highest standard under which they qualify.

Type / Ship To PACRN Mark For

+ TBD AD

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

Option _ Req No / Pri

Required Delivery

+ TBD 1 EA

*100 Calendar Days

Proposed Delivery

+ TBD 1 EA

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 FE5612

FE5612 86 LRS LGRDD

BLDG 2127 CP 011 49 637 147 2303

TMO RAMSTEIN FLUGPLATZ

66877 RAMSTEIN

MIESENBACH DE

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

AWARD NUMBER:

TYPE/CODE: A FE6520

FE6520 176 LRS LGRT

CP 907 552 3767

8515 SAVILLE AVE

JOINT BASE ELMENDORF-RICHARDSON AK 99506-2959

USA

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

AWARD NUMBER:

TYPE/CODE: I FA8526

GLOBEMASTER (C-17)

AFLCMC/WLME

235 BYRON ST STE 19A

BLDG 300 CML PHN 478 327 7137

ROBINS AFB GA 31098-1670

UNITED STATES

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

AWARD NUMBER:

SDT: FXHA, FXGA, F8HA, F8GA

SDT: FXHA, FXGA, F8HA, F8GA

CONTRACT CLAUSES

252.211-7008 USE OF GOVERNMENT-ASSIGNED SERIAL NUMBERS (SEP 2010)

(IAW DFARS 211.274-6(c), DFARS 212.301(f)(xv))

252.227-7025 LIMITATIONS ON THE USE OR DISCLOSURE OF GOVERNMENT-FURNISHED

INFORMATION MARKED WITH RESTRICTIVE LEGENDS (MAY 2013)

(IAW DFARS 227.7103-6(c), DFARS 227.7104(f)(1), DFARS 227.7203-6(d))

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AA 57 13840 . 58 1 41 65 XXF638 010000 57833 54121F 503000 F03000 $0.00

CSN: PSEREP PSR: 064292 FSR: 370789

REFERENCE:

AA F3QCGR1067A105

PR: FD2060-21-30110

ACRN TOTAL $ 0.00

52.246-11 HIGHER-LEVEL CONTRACT QUALITY REQUIREMENT (DEC 2014)

(IAW FAR 46.311, DFARS 246.202-4(1))

(a) The Contractor shall comply with the higher-level quality standard(s) listed below. [If more than one standard is listed, the offeror shall indicate its selection by checking the appropriate block.]*

Title Number Date Tailoring *See Individual Line Item Schedule

LIST OF DOCUMENTS, EXHIBITS OR ATTACHMENTS

Form Number Description/File Name Date Number of Pages 1423 CDRLs.pdf

First Article Test/Inspection/Plan

07JAN2021 2

1423 IUID.pdf Marking Plan

29APR2020 2

1423 TechManual.pdf Equipment Technical Manual(sanitized)

29APR2020 2

EDL.pdf 04FEB2021 1

NDA.docx 1

1653 Transportation.pdf 25FEB2021 3

158 Packaging.pdf 2

EXCEL C17-PSE Solicitation Template.xlsx UNDATED 4