SPRHA421Q0374_______0001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

J

2. AMENDMENT/MODIFICATION NO.

SPRHA4-21-Q-0374-0001

3. EFFECTIVE DATE

26 MAY 2021

4. REQUISITION/PURCHASE REQ. NO.

FD20202100374 01

5. PROJECT NO (If applicable)

6110-01-199-7549

6. ISSUED BY CODE

DLA AVIATION - OGDEN, DLR PROCUREMENT OPS/AUB

6051 GUM LANE BLDG 1225

HILL AIR FORCE BASE UT 84056-5820

BUYER: Stephanie Hatlem/DLA stephanie.hatlem@us.af.mil Phone: (385) 519- 8624

7. ADMINISTERED BY (If other than item 6) CODESPRHA4

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

CODE

X

9A. AMENDMENT OF SOLICITATION NO.

SPRHA421Q0374

9B. DATED (SEE ITEM 11)

19-APR-2021

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

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 amendment; ( 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. 16-JUN-2021 5:00 PM

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) 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 date, etc.) SET FORTH IN ITEM 14, PURSUANT TO 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.)

ROUTINE

SEE BELOW

15A. NAME AND TITLE OF SIGNER (Type or print)

15B. CONTRACTOR/OFFEROR

BY ________________________________________________________

(Signature of person authorized to sign)

15C. DATE SIGNED

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16B. UNITED STATES OF AMERICA

BY ____________________________________________________

(Signature of Contracting Officer)

16C. DATE SIGNED

FACILITY CODE

NSN 7540-01-152-8070

PREVIOUS EDITION UNUSABLE

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

PRESCRIBED BY GSA

FAR (48 CFR) 53.243

X

X X

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.

SPRHA4-21-Q-0374-0001

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

The purpose of this amendment is to increase CLIN 0001 quantity by seven (7), from five (5) to twelve (12). All other terms and conditions remain unchanged.

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

PANEL, POWER DISTRIBUTOR

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

12 EA

CLIN ACRN ACRN Total

0001 AA

NSN: 6110-01-199-7549 WF

PANEL, POWER DISTRIBUTOR

Manufacturer Part Number 81755 16E2503-833 Associated Document(s) Line Item(s)

FD20202100374 01 0001

Priority: R

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Standard Inspection IUID Required: Yes Physical Item Markings:

IAW MIL-STD-130

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

A SW3210 ORIGIN

Type / Ship To PACRN Mark For

A SW3210 09

Type / Ship To Quantity (U/I) *ARO Contract Req No / Pri

Required Delivery

A SW3210 12 EA *14 Months

Proposed Delivery

A SW3210 12 EA

Counterfeit Prevention Plan

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Counterfeit Prevention Plan

COUNTERFEIT PREVENTION PLAN - IAW DD 1423-1

Associated Document(s) Line Item(s)

FD20202100374 01 0002

Priority: R

Inspection: Destination Acceptance: Destination Quality Assurance: IAW DD 1423-1 (A001) Type / Ship To PACRN Mark For

B 1423 IAW 1423-1 (A001)

Type / Ship To Quantity (U/I) *ARO IAW

DD1423-1

Req No / Pri

Required Delivery

B 1423 1 LO *30 Calendar Days

Proposed Delivery

B 1423 1 LO

Although the Ship To code for this line item is B1423-1, for WAWF purposes only, the contractor will use Ship To code FB2029 when completing the receiving report.

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: A SW3210

DLA DISTRIBUTION DEPOT HILL

7537 WARDLEIGH RD BLDG 849W

CML 385 519 8898

HILL AFB UT 84056-5734 UT 84056-5734

USA

MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)

AWARD NUMBER:

TYPE/CODE: B 1423

IAW DD FORM 1423

MARK FOR: (See Individual Line Item) REQUISITION NUMBER: (See Individual Line Item) REQUISITION PRIORITY: (See Individual Line Item)

AWARD NUMBER:

PART I - THE SCHEDULE

SECTION G

CONTRACT ADMINISTRATION DATA

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable

ACRN Funds Citation Amount Chargeable

AA 97 X4930 .FC04 64 1 47 GH 15F16Z 01N000 00000 EERRCT 503000 F03000 $0.00

PSR: K24829 FSR: 001679 DSR: 223925 CIN: F2DCCW1077A1040000AA

ACRN TOTAL $ 0.00