AX5F0283AX_SPRRA115D00320001.pdf

PAGE 1 OF

ORDER FOR SUPPLIES OR SERVICES

1. CONTRACT PURCH ORDER/AGREEMENT NO. 2. DELIVERY ORDER/CALL NO. 3. DATE OF ORDER/CALL

(YYYYMMMDD)

4. REQUISITION/PURCH REQUEST NO. 5. PRIORITY

6. ISSUED BY CODE 7. ADMINISTERED BY (If other than 6) CODE 8. DELIVERY FOB

DESTINATION

OTHER

(See Schedule if other)

9. CONTRACTOR CODE FACILITY 10. DELIVER TO FOB POINT BY (Date) 11. X IF BUSINESS IS

SMALL

SMALL

NAME 12. DISCOUNT TERMS DISADVANTAGED

AND

ADDRESS

WOMAN-OWNED

13. MAIL INVOICES TO THE ADDRESS IN BLOCK

14. SHIP TO CODE 15. PAYMENT WILL BE MADE BY CODE MARK ALL

PACKAGES AND

PAPERS WITH

IDENTIFICATION

NUMBERS IN

BLOCKS 1 AND 2

16. DELIVERY/

CALL THIS DELIVERY ORDER IS ISSUED ON ANOTHER GOVERNMENT AGENCY OR IN ACCORDANCE WITH AND SUBJECT TO TERMS AND CONDITIONS OF ABOVE NUMBERED CONTRACT.

TYPE

OF

ORDER

PURCHASE

Reference your Oral Written Quotation ________________________ , Dated ________________.

____________________________ furnish the following on terms specified herein.

ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME.

NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE DATE SIGNED

If this box is marked, supplier must sign Acceptance and return the following number of copies:

17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE

18. ITEM NO. 19. SCHEDULE OF SUPPLIES/SERVICE 20. QUANTITY

ORDERED/

ACCEPTED*

21.

UNIT

22. UNIT PRICE 23. AMOUNT

* If quantity accepted by the Government is 24. UNITED STATES OF AMERICA 25. TOTAL same as quantity ordered, indicate by X. 26.

If different, enter actual quantity accepted below DIFFERENCES quantity ordered and encircle. BY: CONTRACTING/ORDERING OFFICER 27a. QUANTITY IN COLUMN 20 HAS BEEN

INSPECTED RECEIVED ACCEPTED, AND CONFORMS TO CONTRACT EXCEPT AS NOTED ____________________________________________________

b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE c. DATE d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

(YYYYMMMDD) REPRESENTATIVE

e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 28. SHIP. NO. 29. D.O. VOUCHER NO. 30. INITIALS

PARTIAL

32. PAID BY 33. AMOUNT VERIFIED CORRECT FOR

f. TELEPHONE NUMBER g. E-MAIL ADDRESS

FINAL

31. PAYMENT 34. CHECK NUMBER

36. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT.

COMPLETE

a. DATE b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

PARTIAL

35. BILL OF LADING NO.

FINAL

37. RECEIVED AT 38. RECEIVED BY (Print) 39. DATE RECEIVED

40. TOTAL CON-

TAINERS

41. S/R ACCOUNT NUMBER 42. S/R VOUCHER NO.

DD FORM 1155, DEC 2001 PREVIOUS EDITION IS OBSOLETE.

SPRRA1-15-D-0032 0001 2015SEP29 SEE SCHEDULE DOA1

SPRRA1

DEFENSE LOGISTICS AGENCY

5201 MARTIN ROAD/DLA-AVN-AH

REDSTONE ARSENAL AL 35898-7340

DANE MCGUIRE

EMAIL: DANE.V.MCGUIRE@US.ARMY.MIL

S4402A

DCMA DALLAS

600 N PEARL STREET SUITE 1630

DALLAS TX 75201-2843

X

0FC01

SUNBELT DESIGN & DEVELOPMENT, INC.

730 PEREZ ST

SAN ANTONIO, TX 78207-2318

SEE SCHEDULE X

See Block 15

SEE SCHEDULE

HQ0339

DFAS-COLUMBUS CENTER

DFAS-CO WEST ENTITLEMENT OPERATIONS

P.O. BOX 182381

COLUMBUS, OH 43218-2381

X

SEE CONTRACT ADMINISTRATION DATA

SEE SCHEDULE

KENNETH HANSEN

KENNETH.HANSEN@DLA.MIL (256)842-4458

2015SEP29 /SIGNED/ 2015SEP29

$485,280.00

CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SUPPLEMENTAL INFORMATION

Buyer Name: DANE MCGUIRE

Buyer Office Symbol/Telephone Number: DLA-AVN-AHA/(256)955-5335

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

Type of Business: Small Disadvantaged Business Performing in U.S.

Surveillance Criticality Designator: B

*** End of Narrative A0000 ***

1. DELIVERY ORDER 0001 IS ISSUED WITH FIRM FIXED PRICES AND FIRM DELIVERY SCHEDULES PURSUANT TO BASIC CONTRACT SPRRA1-15-D-0032 AND IS

SUBJECT TO AND INCORPORATES BY REFERENCE ALL PROVISIONS OF THE INDEFINITE DELIVERY/ INDEFINITE QUANTITY 3 YEAR (IDIQ) CONTRACT FOR

SUNBELT DESIGN & DEVELOPMENT,INC. NOUN: BOOM, HOIST, SUPPORT, P/N: 1010374A, NSN: 1680-01-579-9379, QTY 48 EACH.

2. DELIVERY ORDER 0001 IS FOR FOURTY EIGHT (48) EACH OF NOUN: BOOM, HOIST, SUPPORT, P/N: 1010374A, NSN: 1680-01-579-9379. THE UNIT PRICE

FOR DELIVERY ORDER 0001 IS $10,110.00 EACH, TOTAL CONTRACT COST IS $485,280.00.

3. UPON ISSUANCE OF DELIVERY ORDER 0001, ONE HUNDRED FIFTY TWO EACH (152)REMAIN AVAILABLE FOR ORDERING AGAINST THE MAXIMUM IDIQ QUANTITY

OF 200 EACH AS FOLLOWS:

IDIQ ORDERING MAXIMUM - 200

DELIVERY ORDER 0001 - 48___

REMAINING ORDERING QTY - 152

4. IDIQ EXPIRATION DATE IS SEPTEMBER 30, 2018.

5. THE TOTAL CLIN AMOUNT FOR DELIVERY ORDER 0001 IS $485,280.00.

6. COMPLETE THE FOLLOWING CONTRACTOR POINT OF CONTACT INFORMATION:

NAME: TIM MIDLANE

TELEPHONE NUMBER: (210)227-9162

E-MAIL ADDRESS: TRM@SUNBELTDESIGN.COM

7. SUNBELT DESIGN & DEVELOPMENT, INC. (CAGE CODE 0FC01) IS A HUBZONE CERTIFIED SMALL BUSINESS.

8. ACCELERATED DELIVERY AT NO ADDITIONAL COST TO THE GOVERNMENT IS ACCEPTABLE.

9. ALL TERMS AND CONDITIONS OF THE BASIC AWARD REMAIN UNCHANGED.

*** END OF NARRATIVE A0001 ***

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SPRRA1-15-D-0032/0001

SUNBELT DESIGN & DEVELOPMENT, INC.

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

SUPPLIES OR SERVICES AND PRICES/COSTS

0001 BOOM,HOIST SUPPORT

NSN: 1680-01-579-9379

Mfr CAGE: 81996

Mfr Part Number: 1010374

0001AA YEAR ONE (1) PRODUCTION QUANTITY WITH FIRST ___________________________________________

ARTICLE TEST 48 EA $ 10,110.00000 $ 485,280.00 ____________ ______________ __________________

COMMODITY NAME: BOOM,HOIST SUPPORT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: AX5F0283AX PRON AMD: 02 ACRN: AA

AMS CD: SM2B1100000

PSC: 1680

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

MIL-STD-129 MARKINGS SHALL APPLY

UNIT PACK: 001 INTERMEDIATE PACK: 000

LEVEL PRESERVATION: Military

LEVEL PACKING: B

ADDITIONAL PACKAGING REQUIREMENTS

ESTIMATED MAXIMUM UNIT PACKAGE WEIGHT (POUNDS) AND

SIZE (INCHES):

WT [270]

LN [70]

WD [29]

DP [30]

MIL-STD-2073-1 CODES, APPENDIX J

JI/A/MP [42] JII/CD [1] JIII/PM [00] JIV/WM [GB]

JV/CD [ZZ] JVI/CT [Z]

JVII/UC [F2] JVII/IC [00]JIX/A/PK [F] JX/SM [00]

JVIIIA/OPI [M]

SUPPLEMENTAL INFORMATION:

ALL WOOD PACKAGING (WPM) MUST BE ISPM-15 COMPLIANT.

ZZ=LP/NA, Z= AS REQUIRED TO PROTECT ITEM.

(End of narrative D001)

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Deliveries or Performance _________________________

DOC SUPPL

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

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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 W58H0Z5029BE02 W25G1U J 2

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 5 10-AUG-2016

002 5 10-SEP-2016

003 5 11-OCT-2016

004 5 10-NOV-2016

005 5 10-DEC-2016

006 5 10-JAN-2017

007 5 10-FEB-2017

008 5 10-MAR-2017

009 5 10-APR-2017

010 3 10-MAY-2017

FOB POINT: Origin

SHIP TO:

(W25G1U) SR W1BG DLA DISTRIBUTION

DDSP NEW CUMBERLAND FACILITY

2001 NORMANDY DRIVE DOOR 113 TO 134

NEW CUMBERLAND,PA,17070-5002

CONTRACT/DELIVERY ORDER NUMBER ______________________________

SPRRA1-15-D-0032/0001

NEW CUMBERLAND ARMY DEPOT (W25G1U)__________________________________

FOR DELIVERIES TO NEW CUMBERLAND ARMY DEPOT

(W25G1U) - ANNOTATE COMMERCIAL AND GOVERNMENT TRUCK

BILLS OF LADING: DELIVERY THROUGH SOUTH

GATE ONLY, BUILDING MISSION DOOR 113, 134.

CARRIER TO CALL (717) 770-6969/7172 FOR

APPOINTMENT 24 HOURS IN ADVANCE OF DELIVERY.

APPOINTMENT HOURS: MONDAY THROUGH FRIDAY

BETWEEN 0800-1600.

YEAR ONE DELIVERIES SHALL COMMENCE 315 DAYS AFTER

THE DATE OF DELIVERY ORDER AWARD AT A RATE OF 5

EACH PER MONTH UNTIL SHIPPED COMPLETE.

(End of narrative F001)

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Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

CONTRACT ADMINISTRATION DATA

PRON/ PRON/

AMS CD/ AMS CD/

LINE MIPR/ OBLG JO NO/ OBLIGATEDLINE MIPR/ OBLG JO NO/ OBLIGATED

ITEM GFEBS ATA STAT ACCT ASSIGN ACRN AMOUNTITEM GFEBS ATA STAT ACCT ASSIGN ACRN AMOUNT_____ _________ _____ ___________ ____ _______________ _________ _____ ___________ ____ __________

0001AA AX5F0283AX 2 AA $ 485,280.00

SM2B1100000

TOTAL $ 485,280.00

OBLIGATED OBLIGATED

ACRN ACCOUNTING CLASSIFICATION AMOUNTACRN ACCOUNTING CLASSIFICATION AMOUNT____ _________________________ ______________ _________________________ __________

AA 97 X4930AC9C 6X 26KS S23204 W58H0Z $ 485,280.00 __________________

TOTAL $ 485,280.00

LINELINE

ITEM ACRN EDI/SFIS ACCOUNTING CLASSIFICATIONITEM ACRN EDI/SFIS ACCOUNTING CLASSIFICATION_____ ____ _______________________________________ ____ __________________________________

0001AA AA 97 0X0X4930AC9C S23204 6X0000SM2B110000026KS S23204 W58H0Z

TAC CODE IS AXGE

*** END OF NARRATIVE G0001 ***

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