SPRDL121R0051-0001.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

0001 2024FEB06

SPRDL1

DLA LAND WARREN

WARREN, MI 48397-5000

DEREK RUTKOWSKI

EMAIL: DEREK.RUTKOWSKI@DLA.MIL

SPRDL1-21-R-0051

2023SEP27

X

X 2024MAR06 05:00pm

/SIGNED/

2 signed

SEE SECOND PAGE FOR DESCRIPTION

1 4

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: DEREK RUTKOWSKI

Buyer Office Symbol/Telephone Number: ZGAB/(586)282-3199

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

1. The purpose of Amendment 0001 to solicitation SPRDL1-21-R-0051 is to change the type of procurement from a 5 year Long Term Contract

(LTC) with a Minimum Quantity Required of 3 EA and a Maximum Quantity Required of 33 EA to a One-Time buy of 51 EA.

2. All other terms and conditions remain the same.

*** END OF NARRATIVE A0003 ***

2 4

SPRDL1-21-R-0051

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 CIRCUIT CARD ASSEMBLY

NSN: 5998-01-675-3291

Mfr CAGE: 19200

Mfr Part Number: 13059192

0001AA PRODUCTION QUANTITY 51 EA $ $ ______________________ ______________ __________________

COMMODITY NAME: CIRCUIT CARD ASSEMBLY

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: EH0L0014EH PRON AMD: 04

AMS CD: SM2B1100000

This item is restricted to the following manufacturer or authorized distributors.

MFR: North Atlantic Industries

CAGE: 0VGU1

Part Number: 13059192

(End of narrative B001)

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: 13059192:19200

DATE: 03-MAR-2020

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING REQUIREMENTS CLAUSE FOR DETAILS

UNIT PACK: 001

LEVEL PRESERVATION: Commercial

LEVEL PACKING: Commercial

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Inspection/Acceptance at Origin means that you MUST contact the DCMA to arrange for a Government inspection BEFORE you ship the supplies called out in this order. Failure to have the items inspected and accepted will result in their rejection at the destination. The rejected supplies will be returned to you at your expense.

(End of narrative E001)

Deliveries or Performance _________________________

DOC SUPPL

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

3 4

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

001 W52H099312750Z W90454 J 2

DEL REL CD QUANTITY DAYS AFTER AWARD __________ ______________ ________________

001 51 0280

FOB POINT: Destination

SHIP TO:

(W90454) SU W4GG HQ US ARMY TACOM

TEAM ARMOR PARTNERSHIP FACILITY

WHSE BLDG 88037 LOGISTICS LANE

FORT CAVAZOS,TX,76544-0000

0011 DELETED _______

0012 DELETED _______

0013 DELETED _______

0014 DELETED _______

0015 DELETED _______

4 4