PR_FD20202300248.pdf
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PURCHASE REQUEST
(Central Procurement and Research Development Test and Evaluation)
PROC ACTY
FA8250
TYPE PR
PRIORITY
R
DATE
02 DEC 2022
SDN
F2DCCW2353A102
PURCHASE REQUEST NUMBER
FD20202300248
AMENDMENT NO.
IM
Z
MGR DES
AL
MMAC
ZR
LIFE SUPPORT
YES X NO
ASI
YES X NO
PURPOSE
The purpose of this PR is to obtain contractual FY 2023 repair services for the CRC program.
REMARKS
NAME: Underwood, Ashley L ORG/OFFICE SYMBOL: 415 SCMS / GUMAB COMM/DSN PHONE: 801-777-6185 / 777-6185 DATE: 05 DEC 2022
The Requirement is not an inherently government function. Repair effort is deemed performance based. Critical Safety Item (CSI) does not apply to this PI.
ITEM NO.
DESCRIPTION
5895013093076ZR
AMC/AMSC RMC/RMSC
R1 / C
QUANTITY
UNIT
EA
EST UNIT PRICE
$1,000.00
EST TOTAL PRICE
$4,000.00
DESCRIPTION
BUY AUTHORITY: FY23 Repair Requirements NOUN: INDICATOR,AZIMUTH-R REQ CATEGORY: REPAIR / TEAR DOWN TEST & EVALUATION CAGE / REFERENCE NUMBER: 0DBW2 / U-15341-0-MIL ERRC: T REQUISITION NUMBER: REQ PRIORITY: REQ PROJECT CODE: INCOMING MIPR NUMBER:
INCOMING MIPR LINE ITEM: I&S NSN/ORDER OF USE:
CONTRACT NUMBER: CLIN:
CONTRACT
NEGOTIATED
QUANTITY
CONTRACT QUANTITY
POSITIVE VARIANCE
PERCENTAGE
CONTRACT QUANTITY
NEGATIVE VARIANCE
PERCENTAGE
PRICING
ARRANGEMENT
CONTRACT
NEGOTIATED UNIT
COST
CONTRACT
REMAINING QUANTITY
DELIVERY SCHEDULE
DELIVERY NUMBER: 1 TYPE: Event SHIP TO (DODAAC): SUPPLEMENTAL ADDRESS:
REQUIRED DELIVERY (DATE / EVENT / OTHER):
Deliver 4 unit(s) 30 Days After Receipt of Carcass . Early delivery is acceptable
MARK FOR:
SHIP TO (CUSTOMER):
SHIP TO (REMARKS): At Plant
LINE ITEM REMARKS
BEST EST QTY: ITEM MGR QTY: MISSION ESSENTIAL QTY:
MINIMUM QTY: MEDIUM QTY: MAXIMUM QTY:
NOT SEPARATELY PRICED: TO BE DETERMINED:
VIQ(-) PERCENT: VIQ(+) PERCENT:
GFP: YES GFM: NO GFE: NO ITEM MARKING CODE:
OPTIONS
OPTION NUMBER: TYPE: BEST ESTIMATED QUANTITY:ESTIMATED UNIT COST:
TOTAL OPTION COST:
ALD: AA FUNDING RECOMMENDATION: Initiate and Commit DOLLAR BREAKOUT: $4,000.00
STANDARD AIR FORCE ACCOUNTING CLASSIFICATION (SAFAC)
97X4930.FC04 643 47GH 8M407L 01K010 00000 UJENUA 503000 F03000 ALD:AA FSR: 001884 PSR: K31225 DSR: 215935 CIN: F2DCCW2353A1020000AA
001884
FSR PSR
K31225
DSR
215935
CIN: OTHER STATION FUNDS
Page 1 of 7AFMC FORM 36 Generated by PRPS using Jasper Reports on 21 Dec 2022
PROC ACTY
FA8250
TYPE PR
PRIORITY
R
DATE
02 DEC 2022
SDN
F2DCCW2353A102
PURCHASE REQUEST NUMBER
FD20202300248
AMENDMENT NO.
ITEM NO.
DESCRIPTION
5895013093076ZR
AMC/AMSC RMC/RMSC
R1 / C
QUANTITY
UNIT
EA
EST UNIT PRICE
$0.00
EST TOTAL PRICE
$0.00
DESCRIPTION
BUY AUTHORITY: FY23 Repair Requirement, Minor Repair NOUN: INDICATOR,AZIMUTH-R REQ CATEGORY: REPAIR / REPAIR CAGE / REFERENCE NUMBER: 0DBW2 / U-15341-0-MIL ERRC: T REQUISITION NUMBER: REQ PRIORITY: REQ PROJECT CODE: INCOMING MIPR NUMBER: INCOMING
MIPR LINE ITEM: I&S NSN/ORDER OF USE:
CONTRACT NUMBER: CLIN:
CONTRACT
NEGOTIATED
QUANTITY
CONTRACT QUANTITY
POSITIVE VARIANCE
PERCENTAGE
CONTRACT QUANTITY
NEGATIVE VARIANCE
PERCENTAGE
PRICING
ARRANGEMENT
CONTRACT
NEGOTIATED UNIT
COST
CONTRACT
REMAINING QUANTITY
DELIVERY SCHEDULE
DELIVERY NUMBER: 1 TYPE: Event SHIP TO (DODAAC): SW3215 SUPPLEMENTAL ADDRESS:
REQUIRED DELIVERY (DATE / EVENT / OTHER):
Deliver 4 unit(s) 60 Days After Completion of Study . Early delivery is acceptable
MARK FOR: Account A
SHIP TO (CUSTOMER): DLA DISTRIBUTION BARSTOW
CENTRAL RECEIVING WHSE 7
REC OFFICER 760 577 6442
BARSTOW CA 92311-5014, CA
92311-5014
USA
SHIP TO (REMARKS):
LINE ITEM REMARKS
BEST EST QTY: ITEM MGR QTY: MISSION ESSENTIAL QTY:
MINIMUM QTY: MEDIUM QTY: MAXIMUM QTY:
NOT SEPARATELY PRICED: TO BE DETERMINED: X
VIQ(-) PERCENT: VIQ(+) PERCENT:
GFP: YES GFM: NO GFE: NO ITEM MARKING CODE:
OPTIONS
OPTION NUMBER: TYPE: BEST ESTIMATED QUANTITY:ESTIMATED UNIT COST:
TOTAL OPTION COST:
ALD: AA FUNDING RECOMMENDATION: Initiate and Commit DOLLAR BREAKOUT: $0.00
STANDARD AIR FORCE ACCOUNTING CLASSIFICATION (SAFAC)
97X4930.FC04 643 47GH 8M407L 01K010 00000 UJENUA 503000 F03000 ALD:AA FSR: 001884 PSR: K31225 DSR: 215935 CIN: F2DCCW2353A1020000AA
001884
FSR PSR
K31225
DSR
215935
CIN: OTHER STATION FUNDS
ITEM NO.
DESCRIPTION
5895013093076ZR
AMC/AMSC RMC/RMSC
R1 / C
QUANTITY
UNIT
EA
EST UNIT PRICE
$8,088.00
EST TOTAL PRICE
$32,352.00
DESCRIPTION
BUY AUTHORITY: FY23 Repair Requirement, Major Repair NOUN: INDICATOR,AZIMUTH-R REQ CATEGORY: REPAIR / REPAIR CAGE / REFERENCE NUMBER: 0DBW2 / U-15341-0-MIL ERRC: T REQUISITION NUMBER: REQ PRIORITY: REQ PROJECT CODE: INCOMING MIPR NUMBER: INCOMING
MIPR LINE ITEM: I&S NSN/ORDER OF USE:
CONTRACT NUMBER: CLIN:
CONTRACT
NEGOTIATED
QUANTITY
CONTRACT QUANTITY
POSITIVE VARIANCE
PERCENTAGE
CONTRACT QUANTITY
NEGATIVE VARIANCE
PERCENTAGE
PRICING
ARRANGEMENT
CONTRACT
NEGOTIATED UNIT
COST
CONTRACT
REMAINING QUANTITY
Page 2 of 7AFMC FORM 36 Generated by PRPS using Jasper Reports on 21 Dec 2022
PROC ACTY
FA8250
TYPE PR
PRIORITY
R
DATE
02 DEC 2022
SDN
F2DCCW2353A102
PURCHASE REQUEST NUMBER
FD20202300248
AMENDMENT NO.
DELIVERY SCHEDULE
DELIVERY NUMBER: 1 TYPE: Event SHIP TO (DODAAC): SW3215 SUPPLEMENTAL ADDRESS:
REQUIRED DELIVERY (DATE / EVENT / OTHER):
Deliver 4 unit(s) 120 Days After Completion of Study . Early delivery is acceptable
MARK FOR: Account A
SHIP TO (CUSTOMER): DLA DISTRIBUTION BARSTOW
CENTRAL RECEIVING WHSE 7
REC OFFICER 760 577 6442
BARSTOW CA 92311-5014, CA
92311-5014
USA
SHIP TO (REMARKS):
LINE ITEM REMARKS
BEST EST QTY: ITEM MGR QTY: MISSION ESSENTIAL QTY:
MINIMUM QTY: MEDIUM QTY: MAXIMUM QTY:
NOT SEPARATELY PRICED: TO BE DETERMINED:
VIQ(-) PERCENT: VIQ(+) PERCENT:
GFP: YES GFM: NO GFE: NO ITEM MARKING CODE:
OPTIONS
OPTION NUMBER: TYPE: BEST ESTIMATED QUANTITY:ESTIMATED UNIT COST:
TOTAL OPTION COST:
ALD: AA FUNDING RECOMMENDATION: Initiate and Commit DOLLAR BREAKOUT: $32,352.00
STANDARD AIR FORCE ACCOUNTING CLASSIFICATION (SAFAC)
97X4930.FC04 643 47GH 8M407L 01K010 00000 UJENUA 503000 F03000 ALD:AA FSR: 001884 PSR: K31225 DSR: 215935 CIN: F2DCCW2353A1020000AA
001884
FSR PSR
K31225
DSR
215935
CIN: OTHER STATION FUNDS
ITEM NO.
DESCRIPTION
6110DTG23016E
AMC/AMSC RMC/RMSC QUANTITY
UNIT
EA
EST UNIT PRICE
$0.00
EST TOTAL PRICE
$0.00
DESCRIPTION
BUY AUTHORITY: IAW DD Form 1423 PSEUDO NSN REFERENCE: 6110DTG130534 RELATED NSNs:
DESCRIPTION: IAW DD Form 1423-1 Data Item No. A001, AOO2, AOO3. REQ CATEGORY: OTHER / DATA CAGE / REFERENCE NUMBER: / ERRC:
REQUISITION NUMBER: REQ PRIORITY: REQ PROJECT CODE: INCOMING MIPR NUMBER: INCOMING MIPR LINE ITEM:
CONTRACT NUMBER: CLIN:
CONTRACT
NEGOTIATED
QUANTITY
CONTRACT QUANTITY
POSITIVE VARIANCE
PERCENTAGE
CONTRACT QUANTITY
NEGATIVE VARIANCE
PERCENTAGE
PRICING
ARRANGEMENT
CONTRACT
NEGOTIATED UNIT
COST
CONTRACT
REMAINING QUANTITY
DELIVERY SCHEDULE
DELIVERY NUMBER: 1 TYPE: Other SHIP TO (DODAAC): FB2029 SUPPLEMENTAL ADDRESS:
REQUIRED DELIVERY (DATE / EVENT / OTHER):
Deliver 1 unit(s) IAW DD Form 1423-1. . Early delivery is acceptable
MARK FOR:
SHIP TO (CUSTOMER): FB2029 OO ALC DDHU CNTRL RCV
CP 385 519 8898
5851 F AVE BLDG 849W
HILL AFB UT 84056, UT
84056-4056
Page 3 of 7AFMC FORM 36 Generated by PRPS using Jasper Reports on 21 Dec 2022
PROC ACTY
FA8250
TYPE PR
PRIORITY
R
DATE
02 DEC 2022
SDN
F2DCCW2353A102
PURCHASE REQUEST NUMBER
FD20202300248
AMENDMENT NO.
USA
SHIP TO (REMARKS): IAW DD Form 1423-1.
LINE ITEM REMARKS
BEST EST QTY: ITEM MGR QTY: MISSION ESSENTIAL QTY:
MINIMUM QTY: MEDIUM QTY: MAXIMUM QTY:
NOT SEPARATELY PRICED: X TO BE DETERMINED:
VIQ(-) PERCENT: VIQ(+) PERCENT:
GFP: NO GFM: NO GFE: NO ITEM MARKING CODE:
OPTIONS
OPTION NUMBER: TYPE: BEST ESTIMATED QUANTITY:ESTIMATED UNIT COST:
TOTAL OPTION COST:
ALD: AA FUNDING RECOMMENDATION: Initiate and Commit DOLLAR BREAKOUT: $0.00
STANDARD AIR FORCE ACCOUNTING CLASSIFICATION (SAFAC)
97X4930.FC04 643 47GH 8M407L 01K010 00000 UJENUA 503000 F03000 ALD:AA FSR: 001884 PSR: K31225 DSR: 215935 CIN: F2DCCW2353A1020000AA
001884
FSR PSR
K31225
DSR
215935
CIN: OTHER STATION FUNDS
ITEM NO.
DESCRIPTION
6110DTG23016F
AMC/AMSC RMC/RMSC QUANTITY
UNIT
EA
EST UNIT PRICE
$0.00
EST TOTAL PRICE
$0.00
DESCRIPTION
BUY AUTHORITY: IAW DD Form 1423 RIIR PSEUDO NSN REFERENCE: 6110DTG130535 RELATED NSNs:
DESCRIPTION: IAW DD Form 1423 Data Item No. B001 RIIR REQ CATEGORY: OTHER / DATA CAGE / REFERENCE NUMBER: / ERRC: REQUISITION NUMBER: REQ PRIORITY: REQ PROJECT CODE: INCOMING MIPR NUMBER: INCOMING MIPR LINE ITEM:
CONTRACT NUMBER: CLIN:
CONTRACT
NEGOTIATED
QUANTITY
CONTRACT QUANTITY
POSITIVE VARIANCE
PERCENTAGE
CONTRACT QUANTITY
NEGATIVE VARIANCE
PERCENTAGE
PRICING
ARRANGEMENT
CONTRACT
NEGOTIATED UNIT
COST
CONTRACT
REMAINING QUANTITY
DELIVERY SCHEDULE
DELIVERY NUMBER: 1 TYPE: Other SHIP TO (DODAAC): FY2073 SUPPLEMENTAL ADDRESS:
REQUIRED DELIVERY (DATE / EVENT / OTHER):
Deliver 3 unit(s) Contractor shall deliver the Reparable Item Inspection Report within 7 days after the completion of each repair. . Early delivery is acceptable
MARK FOR:
SHIP TO (CUSTOMER): FY2073 OO ALC 502 CBSS GBMAA
CP 801 586 1368
6012 FIR AVE BLDG 1239 RM 2
HILL AFB UT 84056, UT
84056-4056
USA
SHIP TO (REMARKS):
Page 4 of 7AFMC FORM 36 Generated by PRPS using Jasper Reports on 21 Dec 2022
PROC ACTY
FA8250
TYPE PR
PRIORITY
R
DATE
02 DEC 2022
SDN
F2DCCW2353A102
PURCHASE REQUEST NUMBER
FD20202300248
AMENDMENT NO.
LINE ITEM REMARKS
BEST EST QTY: ITEM MGR QTY: MISSION ESSENTIAL QTY:
MINIMUM QTY: MEDIUM QTY: MAXIMUM QTY:
NOT SEPARATELY PRICED: X TO BE DETERMINED:
VIQ(-) PERCENT: VIQ(+) PERCENT:
GFP: NO GFM: NO GFE: NO ITEM MARKING CODE:
OPTIONS
OPTION NUMBER: TYPE: BEST ESTIMATED QUANTITY:ESTIMATED UNIT COST:
TOTAL OPTION COST:
ALD: AA FUNDING RECOMMENDATION: Initiate and Commit DOLLAR BREAKOUT: $0.00
STANDARD AIR FORCE ACCOUNTING CLASSIFICATION (SAFAC)
97X4930.FC04 643 47GH 8M407L 01K010 00000 UJENUA 503000 F03000 ALD:AA FSR: 001884 PSR: K31225 DSR: 215935 CIN: F2DCCW2353A1020000AA
001884
FSR PSR
K31225
DSR
215935
CIN: OTHER STATION FUNDS
ITEM NO.
DESCRIPTION
6110DTG230170
AMC/AMSC RMC/RMSC QUANTITY
UNIT
EA
EST UNIT PRICE
$0.00
EST TOTAL PRICE
$0.00
DESCRIPTION
BUY AUTHORITY: IAW DD Form 1423 PSEUDO NSN REFERENCE: 6110DTG130534 RELATED NSNs:
DESCRIPTION: IAW DD Form 1423 Data Item No. C001 Contractor's Counterfeit Prevention Plan REQ CATEGORY: OTHER / DATA CAGE / REFERENCE NUMBER:
/ ERRC: REQUISITION NUMBER: REQ PRIORITY: REQ PROJECT CODE: INCOMING MIPR NUMBER: INCOMING MIPR LINE ITEM:
CONTRACT NUMBER: CLIN:
CONTRACT
NEGOTIATED
QUANTITY
CONTRACT QUANTITY
POSITIVE VARIANCE
PERCENTAGE
CONTRACT QUANTITY
NEGATIVE VARIANCE
PERCENTAGE
PRICING
ARRANGEMENT
CONTRACT
NEGOTIATED UNIT
COST
CONTRACT
REMAINING QUANTITY
DELIVERY SCHEDULE
DELIVERY NUMBER: 1 TYPE: Other SHIP TO (DODAAC): FY2073 SUPPLEMENTAL ADDRESS:
REQUIRED DELIVERY (DATE / EVENT / OTHER):
Deliver 3 unit(s) Contractor shall deliver the Counterfeit Prevention Plan within 30 days of contract award. . Early delivery is acceptable
MARK FOR:
SHIP TO (CUSTOMER): FY2073 OO ALC 502 CBSS GBMAA
CP 801 586 1368
6012 FIR AVE BLDG 1239 RM 2
HILL AFB UT 84056, UT
84056-4056
USA
SHIP TO (REMARKS):
LINE ITEM REMARKS
BEST EST QTY: ITEM MGR QTY: MISSION ESSENTIAL QTY:
MINIMUM QTY: MEDIUM QTY: MAXIMUM QTY:
NOT SEPARATELY PRICED: X TO BE DETERMINED:
VIQ(-) PERCENT: VIQ(+) PERCENT:
GFP: NO GFM: NO GFE: NO ITEM MARKING CODE:
Page 5 of 7AFMC FORM 36 Generated by PRPS using Jasper Reports on 21 Dec 2022
PROC ACTY
FA8250
TYPE PR
PRIORITY
R
DATE
02 DEC 2022
SDN
F2DCCW2353A102
PURCHASE REQUEST NUMBER
FD20202300248
AMENDMENT NO.
OPTIONS
OPTION NUMBER: TYPE: BEST ESTIMATED QUANTITY:ESTIMATED UNIT COST:
TOTAL OPTION COST:
ALD: AA FUNDING RECOMMENDATION: Initiate and Commit DOLLAR BREAKOUT: $0.00
STANDARD AIR FORCE ACCOUNTING CLASSIFICATION (SAFAC)
97X4930.FC04 643 47GH 8M407L 01K010 00000 UJENUA 503000 F03000 ALD:AA FSR: 001884 PSR: K31225 DSR: 215935 CIN: F2DCCW2353A1020000AA
001884
FSR PSR
K31225
DSR
215935
CIN: OTHER STATION FUNDS
ITEM NO.
DESCRIPTION
5998DTG230171
AMC/AMSC RMC/RMSC QUANTITY
UNIT
EA
EST UNIT PRICE
$0.00
EST TOTAL PRICE
$0.00
DESCRIPTION
BUY AUTHORITY: IAW DD Form 1423-1 PSEUDO NSN REFERENCE: 5998DTG21069E RELATED NSNs:
DESCRIPTION: IAW DD Form 1423-1 Data Item No. D001 Engineering Change Proposal REQ CATEGORY: OTHER / DATA CAGE / REFERENCE NUMBER: / ERRC: REQUISITION NUMBER: REQ PRIORITY: REQ PROJECT CODE: INCOMING MIPR NUMBER: INCOMING MIPR LINE ITEM:
CONTRACT NUMBER: CLIN:
CONTRACT
NEGOTIATED
QUANTITY
CONTRACT QUANTITY
POSITIVE VARIANCE
PERCENTAGE
CONTRACT QUANTITY
NEGATIVE VARIANCE
PERCENTAGE
PRICING
ARRANGEMENT
CONTRACT
NEGOTIATED UNIT
COST
CONTRACT
REMAINING QUANTITY
DELIVERY SCHEDULE
DELIVERY NUMBER: 1 TYPE: Other SHIP TO (DODAAC): FY2073 SUPPLEMENTAL ADDRESS:
REQUIRED DELIVERY (DATE / EVENT / OTHER):
Deliver 3 unit(s) In accordance with 1423 . Early delivery is acceptable
MARK FOR:
SHIP TO (CUSTOMER): FY2073 OO ALC 502 CBSS GBMAA
CP 801 586 1368
6012 FIR AVE BLDG 1239 RM 2
HILL AFB UT 84056, UT
84056-4056
USA
SHIP TO (REMARKS):
LINE ITEM REMARKS
BEST EST QTY: ITEM MGR QTY: MISSION ESSENTIAL QTY:
MINIMUM QTY: MEDIUM QTY: MAXIMUM QTY:
NOT SEPARATELY PRICED: X TO BE DETERMINED:
VIQ(-) PERCENT: VIQ(+) PERCENT:
GFP: NO GFM: NO GFE: NO ITEM MARKING CODE:
OPTIONS
OPTION NUMBER: TYPE: BEST ESTIMATED QUANTITY:ESTIMATED UNIT COST:
TOTAL OPTION COST:
Page 6 of 7AFMC FORM 36 Generated by PRPS using Jasper Reports on 21 Dec 2022
PROC ACTY
FA8250
TYPE PR
PRIORITY
R
DATE
02 DEC 2022
SDN
F2DCCW2353A102
PURCHASE REQUEST NUMBER
FD20202300248
AMENDMENT NO.
ALD: AA FUNDING RECOMMENDATION: Initiate and Commit DOLLAR BREAKOUT: $0.00
STANDARD AIR FORCE ACCOUNTING CLASSIFICATION (SAFAC)
97X4930.FC04 643 47GH 8M407L 01K010 00000 UJENUA 503000 F03000 ALD:AA FSR: 001884 PSR: K31225 DSR: 215935 CIN: F2DCCW2353A1020000AA
001884
FSR PSR
K31225
DSR
215935
CIN: OTHER STATION FUNDS
INCREASE DECREASE GRAND TOTAL
$36,352.00
PREPARED BY (Name, User Role/Type, Org/Office Symbol, Phone (Comm/DSN), Date Prepared)
Underwood, Ashley L Supply Planner 415 SCMS / GUMAB 801-777-6185 / 777-6185 05 DEC 2022
APPROVALS (Name, User Role/Type, Org/Office Symbol, Phone (Comm/DSN), Date Coordinated)
Jourdan, Larry W Resource Advisor 448 SCMW / FMR 801-775-4043 / 775-4043 19 DEC 2022
(Funds Coordinated: AA)
CERTIFYING OFFICIAL (Name, User Role/Type, Org/Office Symbol, Phone (Comm/DSN), Date Certified)
//DIGITALLY SIGNED IN ABSS// I certify that funds are available The certified source document(s) for this/these purchase request(s) resides in the Automated Business Service System (ABSS) database.
Gregory, Michelle Financial Management Specialist FMSuite 8017770113 21 DEC 2022
COMPLETE OFFICIAL (Name, User Role/Type, Org/Office Symbol, Phone (Comm/DSN), Date Completed)
//ELECTRONICALLY SIGNED//
Underwood, Ashley L Supply Planner 415 SCMS / GUMAB 801-644-8432 / 644-8432 21 DEC 2022
Page 7 of 7AFMC FORM 36 Generated by PRPS using Jasper Reports on 21 Dec 2022
File details come from the government source that posted it. Updated .