SPRHA424Q0520 0001 CUI - Amendment.pdf

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

J

2. AMENDMENT/MODIFICATION NO.

SPRHA4-24-Q-0520-0001

3. EFFECTIVE DATE

2 APR 2024

4. REQUISITION/PURCHASE REQ. NO.

FD20202400520 01

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: Johnny J Wakefield/DLA/AUB johnny.wakefield.2@us.af.mil Phone: (385) 519- 8310 Fax: (000) 000-0000 No Collect Calls

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.

SPRHA424Q0520

9B. DATED (SEE ITEM 11)

26-MAR-2024

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

See page 2 for the purpose of this 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.

1237209679C CUI Stamp

SPRHA4-24-Q-0520-0001

Continuation of block 14. DESCRIPTION OF AMENDMENT/MODIFICATION

The purpose of this amendment is to change the part number as follows:

From: 407377-100

To: 407377-910

END OF AMENDMENT

PART I - THE SCHEDULE

SECTION B

SUPPLIES OR SERVICES AND PRICES/COSTS

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

2 EA

CLIN ACRN ACRN Total

0001 AA

NSN: 6130-01-480-4580 WF

POWER SUPPLY

Manufacturer Part Number 21793 407377-910 Priority: R

Inspection: Origin Acceptance: Origin Inspection/Acceptance Report: 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

Class I ODS Substance Application/Use Quantity

NONE NONE NONE

Type / Ship To PACRN Mark For

A SW3210 ACCOUNT 09

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

Required Delivery

A SW3210 2 EA 29 MAY 2025 Non-MilStrip

Proposed Delivery

A SW3210 2 EA

Item No.

Not Separately Priced Quantity U/I Unit Price

1 LO NSP

Counterfeit Prevention Plan

CDRL A001

Priority: R

Inspection: Destination Acceptance: Destination Inspection/Acceptance Report: Letter of Transmittal Quality Assurance: IAW 1423 A001 Type / Ship To PACRN Mark For

B 1423 IAW 1423

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

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 49 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: