SPRHA421R0449_______0001.pdf

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

J

2. AMENDMENT/MODIFICATION NO.

SPRHA4-21-R-0449-0001

3. EFFECTIVE DATE

13 SEP 2021

4. REQUISITION/PURCHASE REQ. NO.

FD20202101044

5. PROJECT NO (If applicable)

6. ISSUED BY CODE

DLA AVIATION - OGDEN, DLR PROCUREMENT OPS/AUB

6051 GUM LANE BLDG 1225

HILL AIR FORCE BASE UT 84056-5820

BUYER: Esther M. Hamilton/DLA esther.hamilton@us.af.mil Phone: (801) 777- 7382

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.

SPRHA421R0449

9B. DATED (SEE ITEM 11)

28-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. 27-SEP-2021 2:00 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.)

FMS REQUIREMENT

ROUTINE

See Page 2 for purpose of Amendment.

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-R-0449-0001

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

The purpose of this amendment is as follows:

1) Increase Item 0003 as follows:

FROM: 6EA

TO: 10 EA

2) Delete Item 0004 and reduce quantities as follows:

FROM: 10 EA

TO: 0 EA

3) Add IUID requirement to Item No 0001 and 0003.

4) Update Line of Accounting under Section G

5) Extend closing date as follows:

FROM: 28 May 2021 TO: 27 September 2021

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

9 EA

CLIN ACRN ACRN Total

0001 AB

NSN: 5998-01-322-7746 WF

ELECTRONIC COMPONEN

Manufacturer Part Number

0WEC9 16E10150-801

81755 16E10150-801 Associated Document(s) Line Item(s)

FD20202101044 0001

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Receiving Report Required Quality Assurance: Standard Inspection Foreign Military Sales :FMS Case:PK-D-QAO Buy American Act/Balance of Payments Program IUID Required: Yes Physical Item Markings:

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

* DPK002 ORIGIN

Type / Ship To PACRN Mark For

* DPK002 PAA DPKA00

Type / Ship To Quantity (U/I) On or Before Req No / Pri

Required Delivery

* DPK002 9 EA 26 JUN 2023 DPKA5411935101 / PRI: 3

Proposed Delivery

* DPK002 9 EA

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

CLIN ACRN ACRN Total

0002 AB

Data

COUNTERFEIT PREVENTION APPLIES IAW DD FORM 1423-1

Associated Document(s) Line Item(s)

FD20202101044 0002

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: IAW 1423-1 Type / Ship To PACRN Mark For

B 1423 IAW 1423-1

Type / Ship To Quantity (U/I) *ARO Contract 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, for WAWF purposes only, the contractor will use Ship To code FB2029 when completing the receiving report.

Contractor will coordinate submission with contract administrator.

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

10 EA

CLIN ACRN ACRN Total

0003 AB

NSN: 5998-01-322-7746 WF

ELECTRONIC COMPONEN

Manufacturer Part Number

0WEC9 16E10150-801

81755 16E10150-801 Associated Document(s) Line Item(s)

FD20202101044 0003

Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: Receiving Report Required

Quality Assurance: Standard Inspection Foreign Military Sales :FMS Case:PK-D-QAO Buy American Act/Balance of Payments Program 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.

* DPK002 ORIGIN

Type / Ship To PACRN Mark For

* DPK002 PAA DPKA00

Type / Ship To Quantity (U/I) On or Before Req No / Pri

Required Delivery

* DPK002 10 EA 26 JUN 2023 DPKG5411935205 / PRI: 3

Proposed Delivery

* DPK002 10 EA

SHIP TO / PLACE OF PERFORMANCE

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:

SHIP TO (FOREIGN MILITARY SALES)

TYPE/CODE: * DPK002

SUPPLEMENTAL ADDRESS CODE: DA2QAO

FMS CASE CODE/LOA: PK-D-QAO/006

MAPAC SHIP TO CODE: DPK002

MAPAC MARK FOR: DPKA00

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

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AB 9711X8242 .0002 4F X LC SH CQAOPK 000000 00000 006000 503000 F03000 $0.00

PSR: 508852 FSR: 067842 DSR: 136087 CIN: F2DCCW1222A1010000AB

ACRN TOTAL $ 0.00