SPRRA120D0014SPRRA120F0073.pdf

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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.

SPRRA1-20-D-0014 SPRRA120F0073 2020JAN28 SEE SCHEDULE DOA1

SPRRA1

DEFENSE LOGISTICS AGENCY

5201 MARTIN ROAD/DLA-AVN-AH

REDSTONE ARSENAL AL 35898-7340

KIMBERLEY J. COLLIER

EMAIL: KIMBERLEY.COLLIER@DLA.MIL

S4801A

DCMA SEATTLE

188 106TH AVE NE

SUITE 660

BELLEVUE WA 98004-8019

X

17564

AIRGLAS, INC

3500 OMALLEY RD

ANCHORAGE, AK 99507-4264

SEE SCHEDULE

See Block 15

SEE SCHEDULE

HQ0339

DFAS - COLUMBUS CENTER

WEST ENTITLEMENT OPERATIONS

P O BOX 182317

COLUMBUS OH 43218-2317

X

SEE CONTRACT ADMINISTRATION DATA

SEE SCHEDULE

JENNIFER BAKER

JENNIFER.BAKER@DLA.MIL (256)313-0669

2020JAN28 /SIGNED/ 2020JAN28

$824,660.00

CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SUPPLEMENTAL INFORMATION

Buyer Name: KIMBERLEY J. COLLIER

Buyer Office Symbol/Telephone Number: ZDB-B (AVN DIV)/(256)842-7556

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

Type of Business: Large Business Performing in U.S.

Surveillance Criticality Designator: B

Weapon System: CH-47

*** End of Narrative A0000 ***

A-1. DELIVERY ORDER SPRRA1-20-F-0073 IS ISSUED WITH FIRM-FIXED PRICES AND DELIVERY SCHEDULES PURSUANT AND IN ACCORDANCE WITH THE TERMS

AND CONDITIONS OF 3YR REQUIREMENST CONTRACT SPRRA1-20-D-0014.

A-2. THIS REQUIREMENT IS IN SUPPORT OF THE CH-47 BK WEAPON SYSTEM.

A-3. DELIVERY ORDER FOR SPRRA1-20-F-0073 IS FOR (AX9C0507AX) QUANTITY- 8EA; UNIT PRICE-$25,947.50; NSN- 1630-00-912-3166; PART NUMBER-

114SS662-11 AND (AX9C0508AX) QUANTITY-10EA; UNIT PRICE-$22,750.00; NSN- 1630-00-912-3167; PART NUMBER- 114SS662-13.

THE TOTAL AMOUNT OF THE DELIVERY ORDER IS $435,080.00.

A-4. ACCELERATED DELIVERY IS ACCEPTABLE AT NO ADDITIONAL COST TO THE GOVERNMENT.

A-5. CONTRACT POINT OF CONTACT INFORMATION:

NAME: JIM HAMMER

TELEPHONE NUMBER: 907-344-1450

E-MAIL ADDRESS: JIM@AIRGLAS.COM

A-6. DCMA ACO POINT OF CONTACT INFORMATION:

NAME: LAURA MUSGRAVE

TELEPHONE NUMBER: 425-463-4124

E-MAIL ADDRESS: LAURA.MUSGRAVE@DCMA.MIL

A-7. DLA POST AWARD POINT OF CONTACT INFORMATION:

DLAHSVPostAwardTeam@dla.mil

7408 WAREHOUSE ROAD

REDSTONE ARSENAL, AL 35898

*** END OF NARRATIVE A0001 ***

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SPRRA1-20-D-0014/SPRRA120F0073

AIRGLAS, 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 SKI ASSEMBLY,LANDIN

NSN: 1630-00-912-3166

Mfr CAGE: 77272

Mfr Part Number: 114SS662-11

0001AA PRODUCTION QUANTITY ORDERING PERIOD ONE 16 EA $ 25,947.50000 $ 415,160.00 _______________________________________ ______________ __________________

COMMODITY NAME: SKI ASSEMBLY,LANDIN

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: AX9C0507AX PRON AMD: 06 ACRN: AA

AMS CD: SM2B1100000

PSC: 1630

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

MIL-STD-129 MARKINGS SHALL APPLY

UNIT PACK: 001 INTERMEDIATE PACK: 000

LEVEL PRESERVATION: Military

LEVEL PACKING: A

ADDITIONAL PACKAGING REQUIREMENTS

ESTIMATED MAXIMUM UNIT PACKAGE WEIGHT (POUNDS) AND

SIZE (INCHES):

WT [450.0]

LN [167.0]

WD [66.0]

DP [53.0]

MIL-STD-2073-1 CODES, APPENDIX J

JI/A/MP [20] JII/CD [1] JIII/PM [ZZ] JIV/WM [GB]

JV/CD [LK] JVI/CT [R] JVII/UC [FD] JVII/IC [00]

JIX/A/PK [F] JX/SM [00] JVIIIA/OPI [M]

ALL WOOD PACKAGING MATERIAL (WPM) MUST BE ISPM-15

COMPLIANT.

SUPPLEMENTAL INFORMATION: ZZ=PM-IAW DRAWING/SPECS;

WPMMUST BE ISPM-15 COMPLIANT

(End of narrative D001)

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Deliveries or Performance _________________________

DOC SUPPL

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

001 W58H0Z9142BK01 SW3211 J 2

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 16 21-NOV-2020

FOB POINT: Destination

SHIP TO:

(SW3211) DLA DISTRIBUTION DEPOT OKLAHOMA

3301 F AVE CEN REC BLDG 506 DR 22

TINKER AFB OK 73145-8000

TINKER AFB,OK,73145-8000

CONTRACT/DELIVERY ORDER NUMBER ______________________________

SPRRA1-20-D-0014/SPRRA120F0073

1001 SKI ASSEMBLY,LANDIN

NSN: 1630-00-912-3167

Mfr CAGE: 77272

Mfr Part Number: 114SS662-13

1001AA PRODUCTION QUANTITY ORDERING PERIOD ONE 18 EA $ 22,750.00000 $ 409,500.00 _______________________________________ ______________ __________________

COMMODITY NAME: SKI ASSEMBLY,LANDIN

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: AX9C0508AX PRON AMD: 05 ACRN: AA

AMS CD: SM2B1100000

PSC: 1630

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

MIL-STD-129 MARKINGS SHALL APPLY

UNIT PACK: 001 INTERMEDIATE PACK: 000

LEVEL PRESERVATION: Military

LEVEL PACKING: A

ADDITIONAL PACKAGING REQUIREMENTS

ESTIMATED MAXIMUM UNIT PACKAGE WEIGHT (POUNDS) AND

SIZE (INCHES):

WT [450.0]

LN [167.0]

WD [66.0]

DP [53.0]

4 6

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

MIL-STD-2073-1 CODES, APPENDIX J

JI/A/MP [20] JII/CD [1] JIII/PM [ZZ] JIV/WM [GB]

JV/CD [LK] JVI/CT [R] JVII/UC [FD] JVII/IC [00]

JIX/A/PK [F] JX/SM [00] JVIIIA/OPI [M]

ALL WOOD PACKAGING MATERIAL (WPM) MUST BE ISPM-15

COMPLIANT.

SUPPLEMENTAL INFORMATION: ZZ=PM-IAW DRAWING/SPECS;

WPM MUST BE ISPM-15 COMPLIANT

(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 ______ ________ ______ ______ ________ _____

001 W58H0Z9143BK01 SW3211 J 1

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 18 21-NOV-2020

FOB POINT: Destination

SHIP TO:

(SW3211) DLA DISTRIBUTION DEPOT OKLAHOMA

3301 F AVE CEN REC BLDG 506 DR 22

TINKER AFB OK 73145-8000

TINKER AFB,OK,73145-8000

CONTRACT/DELIVERY ORDER NUMBER ______________________________

SPRRA1-20-D-0014/SPRRA120F0073

5 6

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 AX9C0507AX 2 AA $ 415,160.00

SM2B1100000

1001AA AX9C0508AX 2 AA $ 409,500.00

SM2B1100000

TOTAL $ 824,660.00

OBLIGATED OBLIGATED

ACRN ACCOUNTING CLASSIFICATION AMOUNTACRN ACCOUNTING CLASSIFICATION AMOUNT____ _________________________ ______________ _________________________ __________

AA 97 X4930AC9C 6X 26KS S23204 W58H0Z $ 824,660.00 __________________

TOTAL $ 824,660.00

LINELINE

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

0001AA AA 97 0X0X4930AC9C S23204 6X0000SM2B110000026KS S23204 W58H0Z

1001AA AA 97 0X0X4930AC9C S23204 6X0000SM2B110000026KS S23204 W58H0Z

TAC CODE:

AXGE

*** END OF NARRATIVE G0001 ***

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