SPRDL117R0030-0004.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. Contract ID Code Page Of

2. Amendment/Modification No.

3. Effective Date

4. Requisition/Purchase Req No.

5. Project No. (If applicable)

6. Issued By Code 7. Administered By (If other than Item 6) Code

8. Name And Address Of Contractor (No., Street, City, County, State and Zip Code)

9A. Amendment Of Solicitation No.

9B. Dated (See Item 11)

10A. Modification Of Contract/Order No.

10B. Dated (See Item 13) Code Facility Code

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 amendments: (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 you 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 Appropriation Data (If required)

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

It Modifies The Contract/Order No. As Described In Item 14.

A. This Change Order is Issued Pursuant To: 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 data, 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.

14. Description Of Amendment/Modification (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

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.

15A. Name And Title Of Signer (Type or print)

16A. Name And Title Of Contracting Officer (Type or print)

15B. Contractor/Offeror 15C. Date Signed 16B. United States Of America 16C. Date Signed

By (Signature of person authorized to sign) (Signature of Contracting Officer)

NSN 7540-01-152-8070

PREVIOUS EDITIONS UNUSABLE

30-105-02 STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

SEE SCHEDULE

X

Firm Fixed Price

0004 2017MAR30

SPRDL1

DLA LAND WARREN

WARREN, MI 48397-5000

GRETCHEN PERRY

EMAIL: GRETCHEN.E.PERRY.CIV@MAIL.MIL

SPRDL1-17-R-0030

2017JAN30

X

X

/SIGNED/

2 signed

SEE SECOND PAGE FOR DESCRIPTION

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CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION A - SUPPLEMENTAL INFORMATION

Buyer Name: GRETCHEN PERRY

Buyer Office Symbol/Telephone Number: ZGA/(586)282-3216

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

The purpose of Amendment 0004 to Solicitation SPRDL1-17-R-0030 is to revise the Delivery Schedule, Section C Exceptions, Clause 52.211-

4501 Packaging Requirements (Special Packaging Instructions), Clause 52.246-4520 Production Lot Testing (Conformance Inspection -

Contractor), and the Contract Data Requirements List.

1. The CLIN 0001AA and 0001AB delivery schedules, and Clauses 52.242-4022 Delivery Schedule and 52.209-3 First Article Approval --

Contractor Testing are revised.

2. The Section C Exceptions, posted on FBO with the TDP, are revised.

3. Clause 52.211-4501 Packaging Requirements (Special Packaging Instructions), G. SUPPLEMENTAL INSTRUCTIONS: is revised as follows:

Current - See Section C for changes/updates to SPIs associated to this TDP.

Revised - See Section C Exceptions, posted on FBO with the TDP, for changes/updates to SPIs associated to this TDP.

4. Clause 52.246-4520 Production Lot Testing (Conformance Inspection - Contractor) (b) 1. is revised as follows:

Current - For PN's 5-1-3525, 5-19-916,5-19-1900-1, 5-19-159, and others all require PLT IAW their QAPs, drawings, outstanding notices of ________ revision (NORs) and specifications/standards. The list above is not all inclusive.

Revised - For PN's 5-1-3525, 5-19-916, 5-19-1900-1, 5-9-159, and others all require PLT IAW their QAPs, drawings, outstanding notices of _______ revision (NORs) and specifications/standards. The list above is not all inclusive.

5. The Exhibit A, Contract Data Requirements List is revised to add Quality Program Plan.

6. All other terms and conditions remain unchanged.

*** END OF NARRATIVE A0005 ***

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SPRDL1-17-R-0030 0004

PIIN/SIIN

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

0001 FILTER UNIT,GAS-PARTICULATE

NSN: 4240-00-964-9061

Mfr CAGE: 81361

Mfr Part Number: PL5-19-3051

0001AA PRODUCTION QUANTITY 190 EA $ $ ____________________________ ______________ __________________

COMMODITY NAME: FILTER UNIT,GAS-PARTICULATE

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: EH68E552EH PRON AMD: 02

AMS CD: SM2B1100000

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: 20150315

DATE: 17-JUN-2016

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING CLAUSE

UNIT PACK: 001

LEVEL PRESERVATION: Military

LEVEL PACKING: B

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Deliveries or Performance _________________________

DOC SUPPL

REL CD MILSTRIP ADDR SIG CD MARK FOR TP CD ______ ________ ______ ______ ________ _____

001 W56HZV6106V641 W22PVJ J 2

DEL REL CD QUANTITY DAYS AFTER AWARD __________ ______________ ________________

001 70 0420

002 70 0450

003 50 0470

FOB POINT: Destination

SHIP TO:

(W22PVJ) XU W0L7 BLUE GRASS ARMY DEPOT

BLUE GRASS ARMY DEPOT

431 BATTLEFIELD MEMORIAL HIGHWAY

RICHMOND,KY,40475-5070

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A First Article Test Report is required in accordance with the Clause entitiled "First Article Approval --

Contractor Testing", FAR 52.209-3.

The price for First Article testing in the total amount of $_______________ is included in the total amount for CLIN 0001AA.

After submission of the First Article Test report, the Government will have 30 days to approve or disapprove.

(End of narrative B001)

0001AB FIRST ARTICLE TEST 1 EA $ ** NSP ** $ ** NSP ** __________________ ______________ __________________

COMMODITY NAME: FILTER UNIT, GAS-PARTICULATE

Packaging and Marking _____________________

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Destination

Deliveries or Performance _________________________

DOC SUPPL

REL CD MILSTRIP ADDR SIG CD MARK FOR TP CD ______ ________ ______ ______ ________ _____

001 3

DEL REL CD QUANTITY DAYS AFTER AWARD __________ ______________ ________________

001 1 0270

FOB POINT: Destination

SHIP TO:

(Y00006) SEE FIRST ARTICLE TEST CLAUSE

FOR DISTRIBUTION

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0002 FILTER UNIT, GAS-PARTICULATE

NSN: 4240-00-964-9061

Mfr CAGE: 81361

Mfr Part Number: PL5-19-3051

OPTION QUANTITY, PURSUANT TO THE CLAUSE ENTITLED

"SEPARATELY PRICED OPTION FOR INCREASED QUANTITY".

The quantity stated for the option CLIN does NOT form a part of the basic contractual quantity. Part or all of it may, however, be added to the contract by exercise of the option clause, at the discretion of the Government.

The failure of the offeror to insert a unit price applicable to the option quantity shall mean that the offeror will supply the option, if exercised by the

Government, at the basic contract unit price, and the offer will be evaluated for award accordingly.

(End of narrative B001)

0002AA UNEXERCISED OPTION QUANTITY 380 EA $ $ _____________________________ ______________ __________________

COMMODITY NAME: FILTER UNIT, GAS-PARTICULATE

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: 20150315

DATE: 17-JUN-2016

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING CLAUSE

UNIT PACK: 001

LEVEL PRESERVATION: Military

LEVEL PACKING: B

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Deliveries or Performance _________________________

DOC SUPPL

REL CD MILSTRIP ADDR SIG CD MARK FOR TP CD ______ ________ ______ ______ ________ _____

DEL REL CD QUANTITY DAYS AFTER AWARD __________ ______________ ________________

001 70 0150

002 70 0180

003 70 0210

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

004 70 0240

005 70 0270

006 30 0300

FOB POINT: Destination

SHIP TO:

(Y00000) SHIPPING INSTRUCTIONS FOR CONSIGNEE

(SHIP-TO) WILL BE FURNISHED PRIOR

TO THE SCHEDULED DELIVERY DATE FOR

ITEMS REQUIRED UNDER THIS

REQUISITION.

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SECTION D - PACKAGING AND MARKING

Status Regulatory Cite Title Date Status Regulatory Cite Title Date _______ _______________ ______________________________________________________________________ ____________ _______ _______________ ______________________________________________________________________ ____________

D-1 CHANGED 52.211-4501 PACKAGING REQUIREMENTS (SPECIAL PACKAGING INSTRUCTIONS) DEC/2007

TACOM (RI)

A. Military preservation, packing, and marking for the item identified above shall be accomplished in accordance with the specific requirements identified below, all the applicable requirements of, MIL-STD-2073-1, Revision D, Date 15 Dec 99 including Notice 1, dated

10 May 02 and the Special Packaging Instruction (SPI) contained in the TDP.

PRESERVATION: MILITARY

LEVEL OF PACKING: B

QUANTITY PER UNIT PACKAGE: 001

SPI NUMBER PPL5-19-3051, Dated30 APR 15, REV B

B. Unitization: Shipments of identical items going to the same destination shall be palletized if they have a total cubic displacement of 50 cubic feet or more unless skids or other forklift handling features are included on the containers. Pallet loads must be stable, and to the greatest extent possible, provide a level top for ease of stacking. A palletized load shall be of a size to allow for placement of two loads high and wide in a conveyance. The weight capacity of the pallet must be adequate for the load. The pallet shall be a 40 x 48 inch, 4-way entry pallet although variations may be permitted as dictated by the characteristics of the items being unitized. The load shall be contained in a manner that will permit safe handling during shipment and storage.

C. Marking: In addition to any special markings called out on the SPI;

C.1. All unit packages, intermediate packs, exterior shipping containers, and, as applicable, unitized loads shall be marked in accordance with MIL-STD-129, Revision R including bar coding and a MSL label. The contractor is responsible for application of special markings as discussed in the Military Standard regardless of whether specified in the contract or not. Special markings include, but are not limited to, Shelf-life markings, structural markings, and transportation special handling markings. The marking of pilferable and sensitive materiel will not identify the nature of the materiel. Passive RFID tagging is required in all contracts that contain DFARS clause 252.211-7006. Contractors must check the solicitation and/or contract for this clause. For details and most recent information, see http://www.acq.osd.mil/log/rfid/index.htm for the current DoD Suppliers Passive RFID Information Guide and Supplier Implementation

Plan. If the item has Unique Item Identifier (UII) markings then the concatenated UII needs to be 2D bar coded and applied on the unit package, intermediate and exterior containers, and the palletized unit load.

D. Heat Treatment and Marking of Wood Packaging Materials: All non-manufactured wood used in packaging shall be heat treated to a core temperature of 56 degrees Celsius for a minimum of 30 minutes. The box/pallet manufacturer and the manufacturer of wood used as inner packaging shall be affiliated with an inspection agency accredited by the board of review of the American Lumber Standard Committee. The box/pallet manufacturer and the manufacturer of wood used as inner packaging shall ensure tractability to the original source of heat treatment. Each box/pallet shall be marked to show the conformance to the International Plant Protection Convention Standard.

Boxes/pallets and any wood used as inner packaging made of non-manufactured wood shall be heat-treated. The quality mark shall be placed on both ends of the outer packaging, between the end cleats or end battens; on two sides of the pallet. Foreign manufacturers shall have the heat treatment of non-manufactured wood products verified in accordance with their National Plant Protection Organizations compliance program. In addition, wood used as dunnage for blocking and bracing, to include ISO containers, shall be ordered with ALSC certified marking for dunnage or the markings may be applied locally at two foot intervals.

E. This SPI has been validated and the method of preservation/packing has proven successful in meeting the needs of the military distribution system, including indeterminate storage and shipment throughout the world. Special instructions and/or tailoring of the

SPI is detailed in the Supplemental Instructions below. A prototype package is required to validate the sizes and fit requirements of the SPI. Minor dimensional and size changes are acceptable provided contractor provides the PCO and ACO with notification 60 days prior to delivery. Any design changes or changes in the method of preservation that provide a cost savings without degrading the method of preservation or packing or affecting the serviceability of the item will be considered and responded to within 10 days of submission to

PCO and ACO. Government reserves the right to require testing to validate alternate industrial preservation methods, materials, alternate blocking, bracing, cushioning, and packing.

F. Hazardous Materials (as applicable):

F.1..Hazardous Materials is defined as a substance, or waste which has been determined by the Secretary of Transportation to be capable of posing an unreasonable risk to health, safety, and property when transported in commerce and which has been so designated. (This includes all items listed as hazardous in Titles 29, 40 and 49 CFR and other applicable modal regulations effective at the time of shipment.)

F.2. Unless otherwise specified, packaging and marking for hazardous material shall comply with the requirements for the mode of transport and the applicable performance packaging contained in the following documents:

--International Air Transport Association (IATA) Dangerous Goods Regulations

--International Maritime Dangerous Goods Code (IMDG)

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--Code of Federal Regulations (CFR) Title 29, Title 40 and Title 49

--Joint Service Regulation AFJMAN24-204/TM38-250/NAVSUPPUB 505/MCO

P4030.19/DLAM 4145.3 (for military air shipments).

F.3. If the shipment originates from outside the continental United States, the shipment shall be prepared in accordance with the United

Nations Recommendations on the Transport of Dangerous Goods in a manner acceptable to the Competent Authority of the nation of origin and in accordance with regulations of all applicable carriers.

F.4. When applicable, a Product Material Safety Data Sheets (MSDS) is required to be included with every unit pack and intermediate container and shall be included with the packing list inside the sealed pouch attached to the outside of the package.

G. SUPPLEMENTAL INSTRUCTIONS: Place a red X and the words "Short Box" on the front of any boxes that has a short quantity, then place that box/boxes with the markings showing on the top front of the pallet load.

- See Section C Exceptions, posted on FBO with the TDP, for changes/updates to SPIs associated to this TDP.

(End of Clause)

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SECTION E - INSPECTION AND ACCEPTANCE

Status Regulatory Cite Title Date Status Regulatory Cite Title Date _______ _______________ ______________________________________________________________________ ____________ _______ _______________ ______________________________________________________________________ ____________

E-1 CHANGED 52.246-4520 PRODUCTION LOT TESTING (CONFORMANCE INSPECTION - CONTRACTOR) SEP/2012

(TACOM RI)

(a) The Contractor shall conduct production lot testing (PLT) for each production lot to be tendered to the Government for acceptance.

(b) The samples shall be selected, examined, and tested in accordance with:

1. For PN's 5-1-3525, 5-19-916, 5-19-1900-1, 5-9-159, and others all require PLT IAW their QAPs, drawings, outstanding notices of revision (NORs) and specifications/standards. The list above is not all inclusive.

(c) The samples shall be randomly selected from the entire lot by, or in the presence of, the Government Quality Assurance

Representative (QAR). The Contractor shall notify the QAR in writing at least five (5) business days in advance, when the lot is ready for sample selection. The Contractor shall inspect production lots for conformance to the contracts requirements prior to selecting PLT samples. Unless otherwise authorized by the Contracting Officer, test samples shall not be submitted pursuant to this provision where the Contractor has determined that the lot does not conform to all contract requirements.

(d) Within 10 business days of completing PLT on any given lot, the Contractor shall deliver to the Government a report that documents whether production lots conform to PLT requirements. The PLT report shall verify whether all required inspections and tests have been completed successfully. The report shall be submitted to the Government in accordance with CDRL in Section J.

(e) Within 30 business days after receipt of the PLT report by the government, the government will notify the Contractor in writing whether the specific lot has been approved, conditionally approved, or rejected. The Contractor shall maintain PLT report(s) for a period of two years after contract expiration, during which time they shall be available for Government review.

(f) If the PLT sample fails to meet any contractual requirement, the lot from which the test samples were drawn shall be rejected by the

Government. In that event, the Contractor shall take immediate corrective action at no increase in the contract price, and shall submit an additional PLT sample (from the reworked lot or from a new lot) for inspection. Corrective action shall apply to all items including, if applicable, basic items, repair parts, and in-process or final assembly items produced or in production since the last successful production lot test.

(g) PLT samples not consumed or destroyed in testing may be delivered as part of the production quantities due under the contract.

(End of clause)

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SECTION F - DELIVERIES OR PERFORMANCE

Status Regulatory Cite Title Date Status Regulatory Cite Title Date _______ _______________ ______________________________________________________________________ ____________ _______ _______________ ______________________________________________________________________ ____________

F-1 CHANGED 52.242-4022 DELIVERY SCHEDULE SEP/2008

(TACOM)

(a) Delivery under this contract must conform to the required schedule specified below, unless acceleration is acceptable.

(b) DEFINITIONS:

(1) DAYS means the number of days after the date of contract award when you must deliver the stated quantity (QTY) of supplies.

(2) DELIVERY is defined as follows:

FOB Origin - Contractor is required to deliver its shipment as provided in FAR 52.247-29(a)(1)-(4) by the time specified in the individual contract; or

FOB Destination - Contractor is required to deliver its shipment as provided in FAR 52.247-34(a)(1)-(2) by the time specified in the individual contract. The contractor must take into consideration the length of time necessary to deliver its shipment to the destination designated in the contract, to ensure that the item reaches its destination by the time reflected in the contract.

(c) The Government requires delivery to be made according to the following schedule:

(1) GOVERNMENT REQUIRED DELIVERY SCHEDULE WITH FIRST ARTICLE TEST (FAT)

ITEM NO. QTY WITHIN DAYS AFTER DATE OF CONTRACT AWARD

0001AA 70 each 420 days after award

0001AA 70 each 450 days after award

0001AA 50 each 470 days after award

0001AB 1 each 270 days after award

0002AA 70 each 150 days after option exercise

0002AA 70 each 180 days after option exercise

0002AA 70 each 210 days after option exercise

0002AA 70 each 240 days after option exercise

0002AA 70 each 270 days after option exercise

0002AA 30 each 300 days after option exercise

(2) GOVERNMENT REQUIRED DELIVERY SCHEDULE IF THERE IS NO FIRST ARTICLE TEST (FAT), OR IF FAT IS WAIVED

ITEM NO. QTY WITHIN DAYS AFTER DATE OF CONTRACT AWARD

0001AA 70 each 150 days after award

0001AA 70 each 180 days after award

0001AA 50 each 210 days after award

0002AA 70 each 150 days after option exercise

0002AA 70 each 180 days after option exercise

0002AA 70 each 210 days after option exercise

0002AA 70 each 240 days after option exercise

0002AA 70 each 270 days after option exercise

0002AA 30 each 300 days after option exercise

(d) Accelerated delivery schedule IS acceptable. __

(e) If an accelerated delivery schedule is not acceptable, the required delivery schedule above will apply. If it is acceptable, you may propose an accelerated delivery schedule at no additional cost; fill in the appropriate information here:

(1) OFFERORS PROPOSED ACCELERATED DELIVERY SCHEDULE WITH FIRST ARTICLE TEST (FAT)

ITEM NO. QTY WITHIN DAYS AFTER DATE OF CONTRACT AWARD

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(2) OFFERORS PROPOSED ACCELERATED DELIVERY SCHEDULE WITHOUT FIRST ARTICLE TEST (FAT), or IF FAT IS WAIVED

ITEM NO. QTY WITHIN DAYS AFTER DATE OF CONTRACT AWARD

[End of Clause]

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SECTION I - CONTRACT CLAUSES

Status Regulatory Cite Title Date Status Regulatory Cite Title Date _______ _______________ ______________________________________________________________________ ____________ _______ _______________ ______________________________________________________________________ ____________

I-1 CHANGED 52.209-3 FIRST ARTICLE APPROVAL -- CONTRACTOR TESTING (SEP 1989) -- ALTERNATE SEP/1989

I (JAN 1997) AND ALTERNATE II (SEP 1989)

(a) The contractor shall conduct a First Article Test (FAT) on PL5-19-3051, Filter Unit, Gas-Particulate, 20 CFM, M13A1 for those items

(assemblies, components, and subcomponents) listed on the TDPL for PL5-19-3051 which will not be supplied as government furnished material. FAT shall consist of inspections and testing for all items in accordance with (IAW) their QAPs, drawings, outstanding notices of revision (NORs) and specifications/standards. The contractor is responsible for all inspections and testing regardless of who conducts the actual testing. A portion of the FAT must be done at a government certified facility which does not need to be repeated by the contractor.

A COC is required for all materials for the subcomponents requiring inspection or being tested. COCs must be submitted IAW the contract

CDRL and DID DI-MISC-81356A.

The following government furnished material do not require FAT or PLT: M3 heater (part number (PN) 5-19-1782), Precleaner, (PN 5-19-

2353), and M18A1 gas filter (PN 5-19-2300).

The quantities required for the FAT will be three (3) each for every item except for the following items listed below requiring testing for a different quantity based on their applicable specification:

1. For the Hose Assembly (PN 5-19-1893, 5-19-1893-20, and 5-19-1893-30) only one set of hoses and coupling halves, as listed below, need to be tested.

a. Twenty (20) Hoses, Air Duct, Air Breathing (PN 5-19-916) shall be inspected and tested to all the requirements of the drawing and

PARA 4.2 of Specification MIL-DTL-14506J.

b. Twenty two (22) coupling halves (PN C5-19-1900-1) shall be inspected and tested to all the requirements of the drawing and paragraph 4.2 of MIL-DTL-51073E w/ amendment 3.

2. For the outlet valve disks, (PN 5-1-3525), the FAT shall consist of: Fifty (50) shall be inspected and tested to all the requirements of the drawing and of Para 4.2 of DTL-EA-R-1378D. Test results are required for the Para 3.4 physical properties of DTL-EA-R-1378D.

AGENT/SIMULANT TESTING is required for: the five (5) Hoses, Air Duct, Air Breathing (PN 5-19-916).

The AGENT/SIMULANT testing /inspection must be completed at a Government testing facility. The Contractor must comply with FAR clause

52.246-4515 (RI)/ECBC Inclusion of Testing Costs, which provides the procedure to attain a cost estimate and establish a test service agreement. The Contractor shall include Government test data with the Contractors FAT report.

The Government facility performing AGENT/SIMULANT testing shall be a certified laboratory per FAR clause 52.246-4516 (RI)/ECBC Lab

Performance Certification Requirements.

A packaging FAT is required and shall consist of three (3) packaged units and inspected IAW SPI PPL5-19-3051. In addition, a packaging

FAT is required for the four subcomponents listed In Para B of PPL5-19-3051 and shall consist of three (3) packaged units and inspected

IAW their respective SPIs. A COC is required for all materials. Pictures of the packaging and labels will be required.

A First Article Test Report shall be completed by the contractor documenting the results of all inspections and test (including suppliers and vendors inspection records and certifications, when applicable). The First Article Test Report shall include actual inspection and test results to include measurements, recorded test data, and certifications (if applicable) keyed to each drawing, specification and QAP requirement and identified by each individual QAP characteristic and drawing/specification characteristics.

The FAT report (FATR) shall be submitted through the local QAR to the Contracting Officer.

At least 15 calendar days before the beginning of first article tests, the Contractor shall notify the Contracting Officer, in writing, of the time and location of the testing so that the Government may witness the tests.

(b) The Contractor shall submit the first article test report within 270 calendar days from the date of this contract to the Contracting

Officer through the local DCMA QAR:

Grover Easterling, Contracting Officer, at email: Grover.Easterling@dla.mil

Gretchen Perry, Contract Specialist, at email: Gretchen.Perry@dla.mil

RDCB-DES-Q (QA) at email: USARMY.RIA.ECBC.MBX.DLA-TDP@MAIL.MIL

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marked First Article Test Report: Contract No. __________________, Lot/Item No. ______. Within 30 calendar days after the Government receives the test report, the Contracting Officer shall notify the Contractor, in writing, of the conditional approval, approval, or disapproval of the first article. The notice of conditional approval or approval shall not relieve the Contractor from complying with all requirements of the specifications and all other terms and conditions of this contract. A notice of conditional approval shall state any further action required of the Contractor. A notice of disapproval shall cite reasons for the disapproval.

(c) If the first article is disapproved, the Contractor, upon Government request, shall repeat any or all first article tests. After each request for additional tests, the Contractor shall make any necessary changes, modifications, or repairs to the first article or select another first article for testing. All costs related to these tests are to be borne by the Contractor, including any and all costs for additional tests following a disapproval. The Contractor shall then conduct the tests and deliver another report to the

Government under the terms and conditions and within the time specified by the Government. The Government shall take action on this report within the time specified in paragraph (b) above. The Government reserves the right to require an equitable adjustment of the contract price for any extension of the delivery schedule, or for any additional costs to the Government related to these tests.

(d) If the Contractor fails to deliver any first article report on time, or the Contracting Officer disapproves any first article, the

Contractor shall be deemed to have failed to make delivery within the meaning of the Default clause of this contract.

(e) Unless otherwise provided in the contract, and if the approved first article is not consumed or destroyed in testing, the Contractor may deliver the approved first article as part of the contract quantity if it meets all contract requirements for acceptance.

(f) If the Government does not act within the time specified in paragraph (b) or (c) above, the Contracting Officer shall, upon timely written request from the Contractor, equitably adjust under the changes clause of this contract the delivery or performance dates and/or the contract price, and any other contractual term affected by the delay.

(g) Before first article approval, the Contracting Officer may, by written authorization, authorize the Contractor to acquire specific materials or components or to commence production to the extent essential to meet the delivery schedules. Until first article approval is granted, only costs for the first article and costs incurred under this authorization are allocable to this contract for

(1) progress payments, or

(2) termination settlements if the contract is terminated for the convenience of the Government. If first article tests reveal deviations from contract requirements, the Contractor shall, at the location designated by the Government, make the required changes or replace all items produced under this contract at no change in the contract price.

(h) The Government may waive the requirement for first article approval test where supplies identical or similar to those called for in the schedule have been previously furnished by the offeror/contractor and have been accepted by the Government. The offeror/contractor may request a waiver.

(i) The Contractor shall produce both the first article and the production quantity at the same facility.

(End of Clause)

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SECTION J - LIST OF ATTACHMENTS

List of Number List of Number

Addenda Title Date of Pages Transmitted By Addenda Title Date of Pages Transmitted By________________ ____________________________________________________________ _______________ ____________ _______________________________ ____________________________________________________________ _______________ ____________ _______________

Exhibit A CONTRACT DATA REQUIREMENTS LIST 21-DEC-2016 005 DATA

14 14

MOD/AMD

ATT/EXH ID

PAGE

Exhibit A

CONTRACT DATA REQUIREMENTS LIST

DD FORM 1423 (MECHANIZED)

CATEGORY: MISC SYSTEM/ITEM: M13A1 GPFU

TO CONTRACT/PR: EH68E552EH

NSN: 4240-00-964-9061

1. SEQUENCE NUMBER 14. DRFT/REG/REPRO

2. TITLE OF DATA ITEM DISTRIBUTION COPIES

3. SUBTITLE

4. DATA ITEM NUMBER

5. CONTRACT REFERENCE

6. TECHNICAL OFFICE 7. DD 8. APP 9. DIST STATEMENT

250 CODE REQUIRED

10. FREQUENCY 11. AS OF DATE

12. DATE OF 1ST SUBMISSION 13. DATE OF SUBSEQUENT SUBMISSION

1. A001 14.

SEE ADDRESS CODE / /

2. ENGINEERING CHANGE PROPOSAL (ECP) DISTRIBUTION

ATTACHED**

3.

4. DI-SESS-80639

5. SECTION C

6. RDCB-DEM 7. LT 8. N/A 9. *

10. ASREQ 11. N/A 15. TOTAL 0 / 0 / 0

12. ASREQ 13. ASREQ

16. REMARKS

DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (e.g., MICROSOFT OFFICE OR

PORTABLE DOCUMENT FORMAT (pdf)). *DISTRIBUTION STATEMENT WILL BE ASSIGNED

AND IMPLEMENTED BY THE DOD CONFIGURATION MANAGER. **SUBMIT ELECTRONICALLY TO

mailto:USARMY.RIA.ECBC.MBX.CMACTION@MAIL.MIL. ELECTRONIC FILES SHALL BE

LESS THAN 7MB. THE PREFERRED METHOD IS THE DD FORM 1692 WHICH IS LOCATED AT

http://www.dtic.mil/whs/directives/infomgt/forms/. CONTRACTOR FORMAT

ALTERNATIVE TO THE DD FORM IS ACCEPTABLE PROVIDED THE NECESSARY DATA

ELEMENTS ARE PROVIDED.

1. A002 14.

SEE ADDRESS CODE / /

2. REQUEST FOR VARIANCE (RFV) DISTRIBUTION

ATTACHED**

3.

4. DI-SESS-80640

5. SECTION C

6. RDCB-DEM 7. LT 8. N/A 9. *

10. ASREQ 11. N/A 15. TOTAL 0 / 0 / 0

12. ASREQ 13. ASREQ

SPRDL1-17-R-0030

ATT/EXH ID

PAGE

Exhibit A

16. REMARKS

DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (e.g., MICROSOFT OFFICE OR

PORTABLE DOCUMENT FORMAT (pdf)). *DISTRIBUTION STATEMENT WILL BE ASSIGNED

AND IMPLEMENTED BY THE DOD CONFIGURATION MANAGER. **SUBMIT ELECTRONICALLY TO

mailto:USARMY.RIA.ECBC.MBX.CMACTION@MAIL.MIL. ELECTRONIC FILES SHALL BE

LESS THAN 7MB. THE PREFERRED METHOD IS THE DD FORM 1694 WHICH IS LOCATED AT

http://www.dtic.mil/whs/directives/infomgt/forms/. CONTRACTOR FORMAT

ALTERNATIVE TO THE DD FORM IS ACCEPTABLE PROVIDED THE NECESSARY DATA

ELEMENTS ARE PROVIDED.

1. A003 14.

SEE ADDRESS CODE / /

2. NOTICE OF REVISION (NOR) DISTRIBUTION

ATTACHED**

3.

4. DI-SESS-80642

5. SECTION C

6. RDCB-DEM 7. LT 8. N/A 9. *

10. ASREQ 11. N/A 15. TOTAL 0 / 0 / 0

12. ASREQ 13. ASREQ

16. REMARKS

DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (e.g., MICROSOFT OFFICE OR

PORTABLE DOCUMENT FORMAT (pdf)). *DISTRIBUTION STATEMENT WILL BE ASSIGNED

AND IMPLEMENTED BY THE DOD CONFIGURATION MANAGER. **SUBMIT ELECTRONICALLY TO

mailto:USARMY.RIA.ECBC.MBX.CMACTION@MAIL.MIL. ELECTRONIC FILES SHALL BE

LESS THAN 7MB. THE PREFERRED METHOD IS THE DD FORM 1695 WHICH IS LOCATED AT

http://www.dtic.mil/whs/directives/infomgt/forms/. CONTRACTOR FORMAT

ALTERNATIVE TO THE DD FORM IS ACCEPTABLE PROVIDED THE NECESSARY DATA

ELEMENTS ARE PROVIDED.

1. A004 14.

RDCB-DES-E / 1 / 0

2. REPORT, RECORD OF MEETING/MINUTES THRU QAR / 1 / 0

PCO / 1 / 0

3.

4. DI-ADMN-81505

5. SECTION C/SOW

6. RDCB-DES-E 7. LT 8. N/A 9. N/A

10. ASREQ 11. N/A 15. TOTAL 0 / 3 / 0

12. ASREQ 13. ASREQ

16. REMARKS

MINUTES DUE WITHIN 30 DAYS AFTER MEETING MINUTES SHALL BE SUBMITTED

ELECTRONICALLY TO THE PCO.

1. A005 14.

2. TEST/INSPECTION REPORTS THRU QAR*** / 0 / 0

PCO / 1 / 0

3. FIRST ARTICLE TEST REPORT (FATR) RDCB-DES-Q / 1 / 0

(CONTRACTOR)

ATT/EXH ID

PAGE

Exhibit A

4. DI-NDTI-80809B

5. SECTION E

6. RDCB-DES-Q 7. LT 8. A** 9. C

10. ASREQ* 11. N/A 15. TOTAL 0 / 2 / 0

12. ASREQ* 13. ASREQ*

16. REMARKS

*FATR DATES SHALL BE STATED IN THE DELIVERY SCHEDULE. **THE GOVT HAS 30 DAYS AFTER RECEIPT OF FATR FOR APPROVAL/DISAPPROVAL.

***SUBMIT

ELECTRONICALLY THRU THE QAR TO THE CONTRACT SPECIALIST/PCO AND RDCB-DES-Q

(QA) AT mailto:USARMY.RIA.ECBC.MBX.DLA-TDP@MAIL.MIL.

1. A006 14.

ACO 0 / 1 / 0

2. TEST/INSPECTION REPORTS THRU QAR 0 / 1 / 0

PCO 0 / 1 / 0

3. PRODUCTION LOT ACCEPTANCE TEST REPORT

(CONTRACTOR)

4. DI-NDTI-80809B

5. SECTION E

6. RDCB-DES-Q 7. LT 8. ** 9. C

10. ASREQ* 11. N/A 15. TOTAL 0 / 3 / 0

12. ASREQ* 13. ASREQ

16. REMARKS

*THIS REPORT SHALL BE SUBMITTED AT THE COMPLETION OF A NEW PRODUCTION LOT.

REPORT SHALL BE SUBMITTED TO THE QUALITY ASSURANCE REPRESENTATIVE (QAR)

WHENEVER A NEW LOT OF MATERIAL HAS COMPLETED TESTING. PRIOR TO BEGINNING

PRODUCTION, THE CONTRACTOR SHALL SUBMIT A QUALITY PLAN TO THE QAR FOR

REVIEW AND APPROVAL, ON HOW THEY WILL COMPLY WITH THE REQUIREMENTS OF THE

PRODUCTION LOT TEST. ONCE THE QAR APPROVES THE QUALITY PLAN FOR THE

PRODUCTION LOT TESTING, THE APPROVED METHOD WILL BE USED THROUGHOUT THE

LIFE OF THE CONTRACT TO VALIDATE COMPLIANCE WITH THE CONTRACT CLAUSE. QAR

WILL PROVIDE WRITTEN APPROVAL OF THE QA PLAN TO THE CONTRACTOR. **THE

CONTRACTOR SHALL SUBMIT THE PRODUCTION LOT TEST REPORT TO THE QAR ON A

DD1222 OR COMPARABLE DOCUMENT FOR ACCEPTANCE WITHIN TEN DAYS OF COMPLETION

OF THE TESTING. THE QAR HAS 30 WORK DAYS AFTER RECEIPT TO REVIEW AND

PROVIDE APPROVAL/DISAPPROVAL IN WRITING TO THE CONTRACTOR. APPROVAL OF

THE PRODUCTION LOT TEST REPORT SHALL BE APPROVAL OF THE LOT.

1. A007 14.

RDCB-DES-Q / 1 / 0

2. TEST/INSPECTION REPORTS THRU QAR / 1 / 0

PCO / 1 / 0

3. PRODUCTION LOT ACCEPTANCE TEST REPORT

(GOVERNMENT)

4. DI-NDTI-80809B

5. SECTION E

6. RDCB-DES-Q 7. LT 8. N/A 9. N/A

10. ASREQ* 11. N/A 15. TOTAL 0/ 3 / 0

ATT/EXH ID

PAGE

Exhibit A

12. ASREQ 13. ASREQ

16. REMARKS

*THIS REPORT SHALL BE SUBMITTED THRU THE QAR TO THE ADDRESSEES WHENEVER A

NEW LOT OF MATERIAL (REQUIRING AGENT TESTING) IS RECEIVED AND TESTED AT A

GOVERNMENT LAB. TESTING SHALL BE PERFORMED IAW THE CONTRACT CLAUSE FOR THIS

REQUIREMENT. THIS REPORT MAY BE SUBMITTED WITH THE FATR.

1. A008 14.

QAR 0 / 1 / 0

2. CERTIFICATE OF COMPLIANCE PCO 0 / 1 / 0

(Blocks 3 thru 19 of Form 010) RDCB-DES-Q 0 / 1 / 0

3.

4. DI-MISC-81356A*

5. SECTION I**

6. RDCB-DES-Q (RI) 7. LT 8. N/A 9. N/A

10. ASREQ 11. N/A 15. TOTAL 0 / 3 / 0

12. ASREQ 13. ASREQ

16. REMARKS

*MODIFY DI-MISC-81356, 2.I TO READ: "A STATEMENT ON CONTRACTOR LETTERHEAD,

CERTIFYING THAT ALL ITEMS FURNISHED ON THE CONTRACT ARE IN FULL COMPLIANCE

WITH THE TDP (INCLUDING REVISION OF THE DRAWING AND SPECIFICATION), ALL

SPECIFICATIONS AND CONTRACT REQUIREMENTS.". SUBMIT CERTIFICATE OF

COMPLIANCE(S) WITH THE FIRST ARTICLE TEST REPORT. 2.G TO READ NSN (IF

APPLICABLE) AND PART NUMBER. **FIRST ARTICLE APPROVAL CONTRACTOR TESTING.

SUBMIT ELECTRONICALLY TO THE PCO.

1. A009 14.

THRU QAR 0 / 1 / 0

2. QUALITY PROGRAM PLAN (QPP) PCO 0 / 1 / 0

3.

4. DI-QCIC-81722*

5. SECTION E

6. RDCB-DES-Q (RI) 7. LT 8. A 9. N/A

10. ASREQ 11. N/A 15. TOTAL 0 / 2 / 0

12. ASREQ 13. WHEN REVISED

16. REMARKS

PLAN SHALL BE SUBMITTED PRIOR TO SUBMISSION OF FIRST ARTICLE TEST (FAT) (IF

REQUIRED) OR PRIOR TO INITIATION OF PRODUCTION. *THE QUALITY PROGRAM PLAN

SHALL ALSO INCLUDE HOW THE CONTRACTOR WILL COMPLY WITH THE REQUIREMENTS OF

THE PRODUCTION LOT ACCEPTANCE TESTING (CONFORMANCE INSPECTION). *THE GOV'T

HAS 14 DAYS AFTER RECEIPT OF THE PLAN FOR APPROVAL/DISAPPROVAL. IF

DISAPPROVED, THE CONTRACTOR HAS 14 DAYS TO CORRECT AND RESUBMIT WITH GOV'T

REVISIONS. ANY CHANGES TO THE PLAN SHALL BE SUBMITTED FOR GOV'T REVIEW AND

APPROVAL PRIOR TO IMPLEMENTATION.

1. A010 14.

2. TRANSPORTATION DISCREPANCY REPORT AMSTA-LC-CIAT** / 1 /

ATT/EXH ID

PAGE

Exhibit A

3.

4. DI-MGMT-80554

5. SOW, ACTBY INST, PARA 2A(1)

6. AMSTA-LC-CIA 7. NO 8. 9. N/A

10. ASREQ 11. ASREQ 15. TOTAL 0 / 1 / 0

12. * 13.

16. REMARKS

*SUBMISSION REQUIRED UPON DISCOVERY OF TRANSPORTATION DISCREPANCY WHEN

MATERIAL IS RECEIVED AT CONTRACTOR'S FACILITY.

**E-MAIL mailto:USARMY.DETROIT.TACOM.MBX.ILSC-TRANSPORTATION@MAIL.MIL

1. A011 14.

AMSTA-LC-CIAC** / 1 /

2. REPORT OF SHIPPING (ITEM) AND

3. PACKAGING DISCREPANCY

4. DI-MGMT-80503

5. SOW, ACCOUNTABILITY PARA 2A(2)

6. AMSTA-LC-CIA 7. NO 8. 9. N/A

10. ASREQ 11. ASREQ 15. TOTAL 0 / 1 / 0

12. * 13.

16. REMARKS

*SUBMISSION REQUIRED UPON DISCOVERY OF SHIPPING DISCREPANCY WHEN MATERIEL

IS RECEIVED AT CONTRACTOR'S FACILITY. REPORT SHALL BE SUBMITTED WITHIN

3 DAYS OF DISCREPANCY.

EMAIL mailto:usarmy.detroit.tacom.mbx.ilsc-ami-sdr@mail.mil

-------------------------------------------------------------------------------1. A012 14.

AMSTA-LC-CIAT* / 1 /

2. GOVERNMENT FURNISHED MATERIAL (GFM)

3. CONSUMPTION REPORT

4. DI-MGMT-80438B

5. SOW, ACTBY INST, PARA 5

6. AMSTA-LC-CIA 7. DD 8. 9. N/A

10. MTHLY 11. 0 15. TOTAL 0 / 1 / 0

12. 40DAC 13. **

16. REMARKS

SUBMISSION REQUIRED TO REFLECT GFM CONSUMED DURING REPORT PERIOD-NEGATIVE

REPORT REQUIRED. **10TH DAY OF MONTH FOLLOWING REPORT MONTH.

*E-MAIL mailto:USARMY.DETROIT.TACOM.MBX.ILSC-MCA@MAIL.MIL

DATE: 21 December 2016