N00383-21-Q-R210.pdf

CHECKED

BOX CONFIRMING ORDER-DO NOT DUPLICATE

APPLIES ORDER FOR SUPPLIES OR SERVICES

REQUEST FOR QUOTATION NO. N00383-21-Q-R210

RETURN COPY(IES) OF THIS QUOTE BY

(THIS IS NOT AN ORDER SEE DD FORM 1155R)

PAGE 1 OF

5.CERTIFIED FOR NATIONAL

DEFENSE UNDER 15 CFR 700

DO1.CONTRACT/PURCHASE ORDER

NO.

2.DELIVERY ORDER NO. 3.DATE OF

ORDER

4.REQUISITION PURCH REQUEST NO

TBD TBD N0038321PR0R210

6.ISSUED BY CODE N00383 7.ADMINISTERED BY(IF OTHER THAN 6) CODE TBD 8.DELIVERY

NAVSUP Weapon Systems Support-Philadelphia Buyer: Ray Kent N731.35 700 Robbins Avenue, Philadelphia PA 19111 Phone: (215) 697-2557 Raymond.kent1@navy.mil

TBD FOB

DEST

OTHER(See

Schedule If Other)

ORIGIN

9.CONTRACTOR/QUOTE

CODE

03538 FACILITY

CODE

10.DELIVERY TO FOB POINT

ON OR BEFORE:

11.CHECK IF

BUSINESS IS

SMALL

SMALL/

DISADV.

WOMAN

OWNED

NAME

AND

ADDRESS

LOCKHEED MARTIN CORPORATION 497

ELECTRONICS PKWY BLDG EP-5 STOCKROOM

SYRACUSE, NY 13221

POC: MAKAWAN PAMORNSUT

EMAIL:

MAKAWAN.PAMORNSUT@LMCO.COM

12.DISCOUNT TERMS

13.MAIL INVOICES TO

(SEE BLOCK 15)

14.SHIP TO

CODE

15.PAYMENT WILL BE MADE BY

CODE

TBD

MARK ALL

PACKAGES AND

PAPERS WITH

CONTRACT AND

ORDER NUMBER

SEE ORDER SCHEDULE OR BOA

CONSIGNMENT INSTRUCTIONS

TBD

16.TYPE OF ORDER This delivery order is subject to instructions contained on this side of form only and is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract. NEGOTIATION EXCEPTION 10 U.S.C. 230- ) DELIVERY

PURCHASE Reference your furnish the following on terms specified herein, including, for U.S. purchases, General Provision or Purchase Order on DD Form 1155r(EXCEPT CLAUSE NO. 12 APPLIES ONLY IF THIS BOX IS CHECKED, AND NO 14 IF THIS BOX IS CHECKED):

special provisions : and delivery as indicated. This purchase is authority of 10 U.S.C.(a)(3) or as specified in the schedule if within the U.S., its possessions or Puerto Rico, if otherwise under 2304(a)(6).

If checked, Additional General Provisions apply, Supplier shall sign “Acceptance” on DD Form 1155r and return copies.

17. ACCOUNTING AND APPROPRIATION DATA-ACCOUNTING CLASSIFICATION (REV.7-65) TAC

ITEM APPROPRIATION

SYMBOL AND

SUBHEAD

OBJECT

CLASS

BUREAU

CONT NO.

SUB

ALLOT

AUTH’N

ACC’TG

ACT’Y

TRANS

TYPE

PROPERTY

ACT’G ACT’Y

COUNTRY COST CODE AMOUNT

18.ITEM NO 19.SCHEDULE OF SUPPLIES/SERVICES

(SEE ATTACHED SCHEDULE)

20.QUANTITY

ORDERED/

ACCEPTED

21.

UNIT

22.

UNIT PRICE

23.

AMOUNT

FMS CASE- JA-P-RJJ

Please furnish Quotations to the issuing office on or before close of business:

09 SEP 2021

SURVEILLANCE

CRITICALITY

DESIGNATOR

A B C X

GOVERNMENT INSPECTION AND ACCEPTANCE SHALL BE

AT:

FOB DoD ADMINISTRATIVE USE ONLY

Contractor’s Plant PRIORITY 03

TRANSPORTATION PRIORITY 08

BY: DCMA

If quantity accepted by the Government is same as quantity ordered, indicate by check mark.

If different, enter actual quantity accepted below quantity ordered and encircle.

24.UNITED STATES OF AMERICA 25.TOTAL TBD

BY: 29.DIFFERENCES

CONTRACTING/ORDERING OFFICER

26.QUANTITY IN COLUMN 20 HAS BEEN

INSPECTED RECEIVED ACCEPTED AND CONFORMS

TO THE CONTRACT EXCEPT

AS NOTED

27.SHIP.NO 28.D.O.VOUCHER NO. 30.

INITIALS

PARTIAL

FINAL

32.PAID BY 33.AMT VERIFIED CORRECT FOR

DATE SIGNATURE OF AUTHORIZED GOVERNMENT

REP

31.PAYMENT 34.CHECK NUMBER

36.I CERTIFY THE ACCOUNT IS CORRECT AND PROPER FOR

PAYMENT

COMPLETE

PARTIAL

FINAL 35.BILL OF LADING NO.

DATE SIGNATURE AND TITLE OF CERTIFYING

OFFICER

37.RECEIVED AT 38.RECEIVED BY (Print) 38.DATE

RECEIVED

(YY/MM/DD)

40.TOTAL

CONTAINERS

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

DDFORM 1155 JUN 94 NAVICP-P 4270/65(NAVICP/P OVERPRINT)(3/00)

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGES

NAME OF OFFEROR OR CONTRACTOR

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

CLIN NSN/PART NUMBER and NOMENCLATURE

SubCLIN MILSTRIP(TR)/Serial Number

NSN:

Part Number:

Nomenclature:

Serial Number: EA

Serial Number: EA

NSN:

Part Number:

Nomenclature:

Serial Number: EA

NSN:

Part Number:

Nomenclature:

Serial Number: EA

NSN:

Part Number:

Nomenclature:

Serial Number: EA

NSN:

Part Number:

Nomenclature:

Serial Number: EA

Serial Number: EA

Serial Number: EA

TOTAL

NSN 7540-01-152-8067 OPTIONAL FORM 336(4-86)

Sponsered by GSA FAR (48 CFR) 53.110

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGES

NAME OF OFFEROR OR CONTRACTOR

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

CLIN NSN/PART NUMBER and NOMENCLATURE

SubCLIN MILSTRIP(TR)/Serial Number

FMS Case:

Ship To:

Mark For:

SUPPAD:

TRANSPORTATION SCHEDULE INSTRUCTIONS:

In accordance attached packaging sheet

REPLACEMENT COST/STANDARD PRICE:

REPLACEMENT COST/STANDARD PRICE:

REPLACEMENT COST/STANDARD PRICE:

REPLACEMENT COST/STANDARD PRICE:

REPLACEMENT COST/STANDARD PRICE:

NSN 7540-01-152-8067 OPTIONAL FORM 336(4-86)

Sponsered by GSA FAR (48 CFR) 53.110

ALL terms and conditions of N00383-17-G-BR01 will apply to this order.

NO FAST PAY.

DO NOT INDUCT TO CAV.

THE CONTRACTOR IS REQUIRED TO SHIP BY TRACEABLE MEANS.

PLEASE SEND A COMPLETED COPY OF THE DD250 TO NAVSUP WSS CODES M0213 AND M85242.

GOVERNMENT SOURCE INSPECTION IS REQUIRED.

CONTACT DCMC TRANSPORTATION OFFICER FOR SHIPPING INSTRUCTIONS.

PACKAGING AND MARKING SHALL BE IN ACCORDANCE WITH BEST STANDARD COMMERCIAL PACKAGING FOR OVERSEAS SHIPMENT. IF AN ITEM IS FOUND TO BE EITHER BEYOND ECONOMICAL REPAIR (BER) OR BEYOND REPAIR (BR), THE CONTRACTOR SHALL NOTIFY THE DEFENSE CONTRACT MANAGEMENT AGENCY (DCMA) QUALITY ASSURANCE REPRESENTATIVE (QAR) FOR VERIFICATION OF THE ITEM'S CONDITION. THE QAR WILL PROVIDE THEIR ASSESSMENT OF THE ITEM'S CONDITION ALONG WITH ANY OTHER PERTINENT INFORMATION TO THE DCMA ADMINISTRATIVE CONTRACTING OFFICER (ACO). THE ACO WILL ROUTE THE INFORMATION TO THE NAVSUP WSS PROCUREMENT CONTRACTING OFFICER (PCO). THE CONTRACTOR SHALL NOT SCRAP OR CANNIBALIZE THE ITEM UNTIL WRITTEN AUTHORIZATION IS PROVIDED BY THE NAVSUP WSS PCO.