L-4 Delivery Order N0002424F22AX.docx

DOCX document 36 KB Posted

Attached to
40' Patrol Boats (40 PB) with Draft RFP
Solicitation number
N0002423R2275
Issued by

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N0002424F22AX

Page of

ORDER FOR SUPPLIES OR SERVICES

1. CONTRACT/PURCH. ORDER/ AGREEMENT NO.

2. DELIVERY ORDER/ CALL NO.

3.

DATE OF ORDER/CALL 4. REQ./ PURCH. REQUEST NO.

( YYYYMMMDD)

5. PRIORITYDO-A3

6. ISSUED BY CODE

NAVAL SEA SYSTEMS COMMAND (HQ) 1333 ISAAC HULL AVE SE

WASHINGTON NAVY YARD DC 20376-2060

N00024 7.

ADMINISTERED BY (if other than 6)

SEE ITEM 6

CODE

8. ( X

)DELIVERY FOB

DESTINATION OTHER

(See Schedule if other)

9. CONT RACT OR

NAME AND

ADDRESS

FACILITY

10. DELIVER TO FOB POINT BY (Date)

SEE SCHEDULE

12. DISCOUNT TERMS

11. MARK IF BUSINESS IS SMALL

SMALL

DISADVANTAGED

WOMEN-OWNED

14. SHIP TO

13. MAIL INVOICES TO THE ADDRESS IN BLOCK

See Item 15

15. PAYMENT WILL BE MADE BY CODE

Naval Support Fleet Logistic Center, Cheatham Annex (NAVSUPFLC CAX) Warehouse 11, C Street Williamsburg, VA 23187

MARK ALL PACKAGES AND

PAPERS WITH IDENTIFIC ATIO N NUMBERS IN

BLO CKS 1 AND 2.

16.

TYPE OF ORDER

DELIVERY/ X

CALL

PURCHASE

This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract.

Reference your quote dated Furnish the following on terms specified herein. REF:

ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS

AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME.

NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE

If this box is marked, supplier must sign Acceptance and return the following number of copies:

17. ACCOUNTING AND APPROPRIATION DATA/ LOCAL USE

DATE SIGNED

18. ITEM NO.

19. SCHEDULE OF SUPPLIES/ SERVICES

20. QUANTITY ORDERED/ ACCEPT ED*

21. UNIT

22. UNIT PRICE

23. AMOUNT

* If quantity accepted by the Government is same as

SEE SCHEDULE

24. UNITED STATES OF AMERICA TEL:

25. TOTAL

quantity ordered, indicate by X. If different, enter actual EMAIL:

26.

quantity accepted below quantity ordered and encircle.

27a. QUANTITY IN COLUMN 20 HAS BEEN

BY:

CONTRACTING / ORDERING OFFICER

DIFFERENCES

INSPECTED

RECEIVED

ACCEPTED, AND CONFORMS TO THE

CONTRACT EXCEPT AS NOTED

b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE c. DATE d. PRINTED NAME AND TITLE OF AUTHORIZED

GOVERNMENT REPRESENTATIVE

e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

28. SHIP NO.

29. DO VOUCHER NO. 30.

INITIALS

f. TELEPHONE NUMBER

g. E-MAIL ADDRESS

PARTIAL FINAL

32.

PAID BY

33.

AMOUNT VERIFIED CORRECT FOR

36. I certify this account is correct and proper for payment.

31. PAYMENT

34.

CHECK NUMBER

a. DATE

( YYYYMMMDD)

b.

SIGNATURE AND TITLE OF CERTIFYING OFFICER

COMPLETE PARTIAL FINAL

35. BILL OF LADING NO.

37. RECEIVED AT

38.

RECEIVED BY

39.

DATE RECEIVED

( YYYYMMMDD)

40.

TOTAL CONTAINERS

41.

S/R ACCOUNT NO. 42. S/R VOUCHER NO.

DD Form 1155, DEC 2001 PREVIOUS EDITION IS OBSOLETE.

Section B - Supplies or Services and Prices

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

CLIN Number 0001

1
Each

40PB Flight 2 Boat

FFP

The contractor shall construct the 40’ Patrol Boat Flight 2 (40PB Flt 2) Boat in accordance with Section C and the 40PB Flt 2 Specification, Attachment J-1.

FOB: Destination

PSC CD: 1940

NET AMT

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

CLIN Number 0002

1
Each

Removable Well Deck Kickstand

The contractor shall deliver the removable portion of the Well Deck Kickstand with the boat(s) in accordance with Section C and Attachment J-1.

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

CLIN Number 0003

1
Each

40 PB Shipping - Williamsburg, VA

In accordance with Section C.

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

CLIN Number 0004

1
Each

Shipping: Long Term Machinery Presv.

In accordance with Section C.

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

CLIN Number 0005

1
Each

Pre-Delivery Inspection and Trial (PDIT)

In accordance with Section C and in accordance with Attachment J-1.

FOB: Origin (Shipping Point)

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

CLIN Number 0006

1
Each

OEM Craft Familiarization – Norfolk, VA

In accordance with Section C.

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

CLIN Number 0009

1
Each

OEM Mn Prop Dies Eng Trng - Norfolk, VA

In accordance with Section C.

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

CLIN Number 0012

1
Each

OEM Waterjet Systems Trng – Norfolk, VA

In accordance with Section C.

ITEM NO
SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT

CLIN Number 0015

1
Each

40PB Flt 2 Non Recurring Design INTEG

Functional and Transitional Design Data in accordance with Section C and Attachment J-1.

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