SPRHA423R0022_______0002.pdf

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

2. AMENDMENT/MODIFICATION NO.

SPRHA4-23-R-0022-0002

3. EFFECTIVE DATE

21 FEB 2023

4. REQUISITION/PURCHASE REQ. NO.

FD20202300022

5. PROJECT NO (If applicable)

5998-01-664-xxxx

6. ISSUED BY CODE

DLA AVIATION - OGDEN, DLR PROCUREMENT OPS/AUB

6051 GUM LANE BLDG 1225

HILL AIR FORCE BASE UT 84056-5820

BUYER: Michelle L Mihu/DLA michelle.mihu@us.af.mil Phone: (385) 519- 8013

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.

SPRHA423R0022

9B. DATED (SEE ITEM 11)

9-JAN-2023

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.

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

PURPOSE OF AMD 0002: See page 2

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.

SPRHA4-23-R-0022-0002

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

PURPOSE OF AMD 0002:

1. Change BOTH Inspection and Acceptance from Origin to Destination for CLINs:

2. Update Quality Assurance requirements for CLINS:

All other terms and conditions remain unchanged.

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

61 EA

CLIN ACRN ACRN Total

0001 AC

NSN: 5998-01-664-0158 FJ

CIRCUIT CARD ASSEMBLY

EMI Filter Electronic components Manufacturer Part Number 26401 21729-0500 Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Origin Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Standard Inspection Applicability: None ;

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.

A SW3210 ORIGIN

Type / Ship To PACRN Mark For

A SW3210 PAA 09

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

Required Delivery

A SW3210 61 EA *15 Months

Proposed Delivery

A SW3210 61 EA

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

119 EA

CLIN ACRN ACRN Total

0002 AC

NSN: 5998-01-664-1209 FJ

CIRCUIT CARD ASSEMBLY

CPU

Eelctronic components Manufacturer Part Number 26401 21729-0200 Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Inspection and acceptance will be performed at destination by the 523 EMXS IAW TO 11G7-2-3-8-2.

Applicability: None ;

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.

A SW3210 ORIGIN

Type / Ship To PACRN Mark For

A SW3210 PAB 09

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

Required Delivery

A SW3210 119 EA *15 Months

Proposed Delivery

A SW3210 119 EA

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

59 EA

CLIN ACRN ACRN Total

0003 AC

NSN: 5998-01-664-1866 FJ

CIRCUIT CARD ASSEMBLY

Voice Message Unit-VMU Electronic components Manufacturer Part Number 26401 21729-0400 Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Inspection and acceptance will be performed at destination by the 523 EMXS IAW TO 11G7-2-3-8-2.

Applicability: None ;

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.

A SW3210 ORIGIN

Type / Ship To PACRN Mark For

A SW3210 PAB 09

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

Required Delivery

A SW3210 59 EA *15 Months

Proposed Delivery

A SW3210 59 EA

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

60 EA

CLIN ACRN ACRN Total

0004 AC

NSN: 5998-01-664-3608 FJ

CIRCUIT CARD ASSEMBLY

Sybol Generator Electronic components Manufacturer Part Number 26401 21729-0300 Priority: R

Limitations of Liability: Other Than High Value Item

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Receiving Report Required Quality Assurance: Inspection and acceptance will be performed at destination by the 523 EMXS IAW TO 11G7-2-3-8-2.

Applicability: None ;

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.

A SW3210 ORIGIN

Type / Ship To PACRN Mark For

A SW3210 PAB 09

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

Required Delivery

A SW3210 60 EA *15 Months

Proposed Delivery

A SW3210 60 EA

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

COUNTERFEIT PREVENION PLAN

IAW DD FORM 1423-1 ATTACHED HERE TO

Priority: R

Inspection: Destination Acceptance: Destination Quality Assurance: IAW DD FORM 1423-1 Type / Ship To Quantity (U/I) *ARO Contract Req No / Pri

Required Delivery

+ IAW1423 1 LO *30 Calendar Days

Proposed Delivery

+ IAW1423 1 LO

SHIP TO / PLACE OF PERFORMANCE

TYPE/CODE: + IAW1423

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

AWARD NUMBER:

TYPE/CODE: A SW3210

DLA DISTRIBUTION DEPOT HILL

7537 WARDLEIGH RD BLDG 849W

CML 385 519 8898

HILL AFB UT 84056-5734

HILL AFB UT 84056-5734 49 84056-5734

USA

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

AWARD NUMBER: