N0010419RF011.U0001.pdf

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

2. AMENDMENT/MODIFICAITON NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicble)

7. ADMINISTERED BY (If other than Item 6) CODE

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

FACILITY CODE

9A. AMENDMENT OF SOLICIATION NO.

9B. DATED (SEE ITEM 11)

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 your 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 APPROPIRATION DATA (If required)

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

CHECK ONE 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 THE 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.

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.

15C. DATE SIGNED

15A. NAME AND TITLE OF SIGNER (Type or print)

16C. DATE SIGNED

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

14. DESCRIPTION OF AMENDMENT/MODIFICATION ( Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

PAGE OF PAGES

6. ISSUED BY CODE

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

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

NSN 7540-01-152-8070

Previous edition unusable

J 1 3

U0001 Feb 4, 2019 See Schedule

N00104

NAVSP Weapon Systems Support 5450 Carlisle Pike Attn: Code N743.32 Mechanicsburg, PA 17055-0788 Phone/E-mail: 717-605-4048 royce.hoffman@navy.mil

See Block 6

N0010419RF011

Jan 23, 2018

1) Section B - The quantities for CLINs 0001 and 0002 are increased as shown below.

2) Section F - The Required Delivery Schedules and Shipping information for the increased quantities are inserted as shown below.

3) All other terms and conditions remain unchanged.

N0010419RF011.U0001

Section F - Deliveries or Performance

SECTION B

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001AD CO2 Scrubber 1 EA Evaluate and Repair the following Government Furnished

Material in accordance with RI 5320-012-0728 Rev G

Serial Number: TSN 530TR34223

FOB: Origin

Inspection/Acceptance: S/S

NSN: 4Y 4460-01-444-9652

PURCHASE REQUEST NUMBER: N0010419YRA21

NET AMT

TAC:

ACRN:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0002AD CO2 Scrubber, Skid A 1 EA Evaluate and Repair the following Government Furnished

Material in accordance with RI 5320-012-0728 Rev G

Serial Number: TSN 317TR34089

FOB: Origin

Inspection/Acceptance: S/S

NSN: 4Y 4460-01-363-7481

PURCHASE REQUEST NUMBER: N0010419YRA22

NET AMT

TAC:

ACRN:

N0010419RF011.U0001

Section F

SECTION F02 – TIME OF DELIVERY

REQUIRED DELIVERY SCHEDULE

CLIN Quantity Delivery

0001AA 1EA 365DADO

0001AB 1EA 365DADO

0001AD 1EA 365DADO

0002AA 1EA 365DADO

0002AB 1EA 365DADO

0002AD 1EA 365DADO

SECTION F03 – PLACE OF DELIVERY FOB ORIGIN

Unless otherwise indicated in this contract, accelerated delivery is desirable and acceptable. The addresses for the activities designated to receive supplies are listed below:

LINE / SUBLINE ITEM

AND QTY SHIP TO: MARK FOR:

0001AA

0001AB

1EA

1EA

N68438 Receiving Officer, NAVIMFAC PACNORWEST BLDG. 7000, Finback Circle.

Silverdale, WA. 98315-7000

“A” CONDITION STOCK

0001AD

1EA N44466-

TRF Kings Bay

990 USS Thomas Jefferson Drive

Kings Bay, GA 31547

0002AA

0002AB

0002AD

1EA

1EA

1EA

N68438

Receiving Officer, NAVIMFAC PACNORWEST BLDG. 7000, Finback Circle.

Silverdale, WA. 98315-7000

NOTE: The above Mark For information is to be noted on the WAWF-RR for each applicable subline item.