1301121773-0001.pdf

Code

Purchase Request

Type of Action

ELECTRONIC FORM PR-001, AUG 95

KO Notes

See Attached for KO Notes

Issuing Office

Suggested Contract/Agreement Information

Contract/Agreement Number:

Suggested Preference Program

Ship To

No Pref erence / Not Listed

No CORs Defined

Suggested Contracting Officer’s Representative(s)

See Line Item Detail for Proposed Individual CLIN Contract Types

Suggested Type of Contract

Contract Data

Suggested Supply Source

Suggested Vendor(s)

Comments New Order

1. Rev ised basic, lines 1-2. To increase v aluation price due to rev ised quote and Amendment 0001 to add a line f or non-recurring e ngineering (NRE). Line 1 - Valuation price has increased f rom $9,900.00 by $400.00 to $10,300.00. Line 2 -

Line Item Summary

Total Cost $61,250.00

Total Funding $61,250.00 See Attached Page(s) for Line Item Detail

See Line Item Detail for "Ship To" Addresses

Requesting Office

Small Purchase Competed Contract Non-competed Contract Manufacturer Sole Source Delivery Order Task Order

Grants/Coops Agreement

Sealed Bid FSS/GSA Schedule Commercial

NIB / NISH / FPI

X

Delivery Order

Modif ication

Association

Description

New Order

1. Rev ised basic, lines 1-2.

Requisition Date

22-Feb-2024

Purchase Request Number

1301121773-0001

DPAS Priority Rating Priority

Tel: Fax:

Fax:Tel:

Contract Data (cont'd) REFERENCE NO. OF DOCUMENT BEING CONTINUED New Order

1. Revised basic, lines 1-2. / 1301121773-0001

PAGE

KO Notes

New Order

1. Rev ised basic, lines 1-2. To increase v aluation price due to rev ised quote and Amendment 0001 to add a line f or non-recurring e ngineering (NRE). Line 1 - Valuation price has increased f rom $9,900.00 by $400.00 to $10,300.00. Line 2 - Valuation price has increased f rom $200.00 by $50.00 to $250.00. Amendment 0001, line 3 - To add a line f or NRE in the amount of $9,500.00. PMT# N00421-24-

SIMACQ-4K0000T-0266.

6. Contract Specialist POC: Douglas Owen, 240-587-9405, douglas.a.owen.civ @us.nav y .mil

***END***

New Order

1. Procurement of 19" 1U Rack mountable computers f or the Adv anced Carrier Landing and Nav igation Sy stem (ACLNS). PMT# N00421-24-SI

MACQ-4K0000T-0266.

2. Requesting Activ ity FPOC: Rhuta Sheth, 562-335-6291, rhuta.a.sheth.civ @us.nav y .mil

3. Requesting Activ ity TPOC: Dillon Mandley , 301-752-8948, dillon.p.mandley .civ @us.nav y .mil, ATPOC: Shelly Hammett, 301-995-6504, michelle.l.hammett.civ @us.nav y .mil

4. Contracting Activ ity FPOC: TBD

5. Contracting Activ ity TPOC: TBD

6. Contract Specialist POC: Rick Paskoski, 301-342-5544, rick.a.paskoski.civ @us.nav y .mil

7. Non Sev erable

8. Planning PR: No

9. 1517 Authority Transf er: N/A

10. NAVAIR Specif ic Inf ormation 10b. Contracting Fee Document: N/A 10c. WAWF Inf o: Shelly Hammett, 301-995-6504, michelle.l.hammett.civ @us.nav y .mil 10d. DMS Attachment: Yes 10e. JA#: N/A 10f . Contractor Work Plan (CWP): N/A 10m. IT approv al/Clinger Cohen Act Compliance: N/A

***END***

Delivery / Task Order

ELECTRONIC FORM PR-001 (cont'd), AUG 95

Additional Data Additional Point of Contact (POC) Information

Property Officer Information

Security Clearance Required

Phone:

Fax:

Phone:

Fax:

X Unclassif ied

Confidential

Secret

Top Secret

J/A Number: Proposal Due:

Date:Execution Method:

Project Number:

Subtype Codes:

1301121773-0001

Section Supplies or Services and Price

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 5 Each $10,300.00 $51,500.00

RACK MOUNTABLE COMPUTER, 19" 1U

FFP

Revised Basic - Pre award amendment to increase the valuation price due to revised quote from $9,900.00 by $400.00 to $10,300.00 1. 19" 1U Rack mountable computer IAW attached SOW. P/N: 262-7143-00 2. APPN: , SUBHEAD: , PE:

N/A - NISE 3. Funding Doc: NISE 4. Funds Expire for Obligation: 09/30/24 5.

Expected Delivery Date: 04/05/24 6. Non-Severable 7. IT Determination - N/A - Exempt due to embedded in weapons system or replica of one for lab use and does not contain an operating system or any software that has an Enterprise License Agreement (ELA).Shipping Address: NAWCAD-WOLF, RECEIVING OFFICER

BLDG 8115, 17598 WEBSTER FIELD ROAD, ST INIGOES MD 20684 ATTN:

Dillion Mandley, TW16100 FOB: Destination

NSN: 7B201023002323

PURCHASE REQUEST NUMBER: 1301121773-0001

PSC CD: 7B20

NET AMT $51,500.00

CIN: 130112177300001

$51,500.00

0002 1 Lite $250.00 $250.00 Shipping

FFP

Revised Basic - Pre award amendment to increase the valuation price due to revised quote from $200.00 by $50.00 to $250.00 1. Shipping IAW attached SOW.

P/N: N/A 2. APPN: , SUBHEAD: , PE: N/A - NISE 3. Funding Doc: NISE 4.

Funds Expire for Obligation: 09/30/24 5. Expected Delivery Date: 04/05/24 6.

Non-Severable 7. IT Determination - N/A - Exempt due to embedded in weapons system or replica of one for lab use and does not contain an operating system or any software that has an Enterprise License Agreement (ELA).Shipping Address:

NAWCAD-WOLF, RECEIVING OFFICER BLDG 8115, 17598 WEBSTER

FIELD ROAD, ST INIGOES MD 20684 ATTN: Dillion Mandley, TW16100 FOB: Destination

PSC CD: V112

NET AMT $250.00

CIN: 130112177300002

$250.00

0003 1 Lite $9,500.00 $9,500.00

NRE

FFP

Amendment 0001 - To add a line for NRE due to revised quote. 1. Non-recurring engineering (NRE) IAW attached SOW. P/N: N/A 2. APPN: , SUBHEAD: , PE:

N/A - NISE 3. Funding Doc: NISE 4. WCD: 09/30/24 5. POP Funding Date:

02/19/24 - 04/05/24 6. Expected Delivery Date: 04/05/24 7. Non-Severable 8. IT Determination - N/A - Exempt due to embedded in weapons system or replica of one for lab use and does not contain an operating system or any software that has an Enterprise License Agreement (ELA).Shipping Address: NAWCAD-WOLF, RECEIVING OFFICER BLDG 8115, 17598 WEBSTER FIELD ROAD, ST

INIGOES MD 20684 ATTN: Dillion Mandley, TW16100 FOB: Destination

PSC CD: 9999

NET AMT $9,500.00

CIN: 130112177300003

$9,500.00

Section Inspection and Acceptance

INSPECTION AND ACCEPTANCE

Supplies/services will be inspected/accepted at:

CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

0001 N/A N/A N/A Government 0002 N/A N/A N/A Government 0003 N/A N/A N/A Government

Section Deliveries and Performance

DELIVERIES AND PERFORMANCE

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

0001 05-APR-2024 5 N/A

FOB: Destination

0002 05-APR-2024 1 N/A

0003 POP 19-FEB-2024 TO

05-APR-2024

N/A N/A

Section Contract Administration Data

CONTRACT ADMINISTRATION DATA

97X4930 NH2A 220 77777 0 050120 2F 000000

COST CODE: A00007874603

AMOUNT: $250.00

97X4930 NH2A 260 77777 0 050120 2F 000000

COST CODE: A00007874603

AMOUNT: $61,000.00

ACRN CLIN/SLIN CIN AMOUNT

0001 130112177300001 $51,500.00 0002 130112177300002 $250.00 0003 130112177300003 $9,500.00