SPRRA220P0104-P00002.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. Contract ID Code Page Of

2. Amendment/Modification No.

3. Effective Date

4. Requisition/Purchase Req No.

5. Project No. (If applicable)

6. Issued By Code 7. Administered By (If other than Item 6) Code

8. Name And Address Of Contractor (No., Street, City, County, State and Zip Code)

9A. Amendment Of Solicitation No.

9B. Dated (See Item 11)

10A. Modification Of Contract/Order No.

10B. Dated (See Item 13) Code Facility Code

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 amendments: (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 ITEM ONLY APPLIES TO MODIFICATIONS OF CONTRACTS/ORDERS

It Modifies The Contract/Order No. As Described In Item 14.

A. This Change Order is Issued Pursuant To: 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 data, etc.) Set

Forth In Item 14, Pursuant To The 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.)

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.

15A. Name And Title Of Signer (Type or print)

16A. Name And Title Of Contracting Officer (Type or print)

15B. Contractor/Offeror 15C. Date Signed 16B. United States Of America 16C. Date Signed

By (Signature of person authorized to sign) (Signature of Contracting Officer)

NSN 7540-01-152-8070

PREVIOUS EDITIONS UNUSABLE

30-105-02 STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

SEE SCHEDULE

X

Firm Fixed Price

P00002 2020JUL29

SPRRA2

DEFENSE LOGISTICS AGENCY

5201 MARTIN ROAD/DLA-AVN-AH

REDSTONE ARSENAL AL 35898-7340

LATOYA S. ORR

EMAIL: LATOYA.ORR@DLA.MIL

S2206A

DCMA BOSTON

BUILDING 1108

HANSCOM AFB, MA 01731-1610

9X175

COSTA PRECISION MANUFACTURING CORP.

PLAINS RD

CLAREMONT, XX 03743-0990

SPRRA2-20-P-0104

2020JUL06

NO CHANGE TO OBLIGATION DATA

X 14.103(a)(3)

X

SEE SECOND PAGE FOR DESCRIPTION

/SIGNED/ 2020JUL30

TRACY HAYWOOD

TRACY.HAYWOOD@DLA.MIL (256)690-5423

1 4

CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION A - SUPPLEMENTAL INFORMATION

Buyer Name: LATOYA S. ORR

Buyer Office Symbol/Telephone Number: DLA-AVN-AHC/(256)924-7926

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

Kind of Modification: G

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

Surveillance Criticality Designator: C

Weapon System: Patriot

Paying Office: HQ0337

DFAS-COLUMBUS CENTER

NORTH ENTITLEMENT OPERATIONS

P.O. BOX 182317

COLUMBUS OH 43218-2317

*** End of Narrative A0000 ***

DUE TO A SYSTEMIC ERROR P00002 IS THE FIRST MODIFICATION ISSUED UNDER CONTRACT SPRRA2-20-P-0104.

THE PURPOSE OF THIS MODIFICATION IS FOR THE FOLLOWING:

1. TO CHANGE CLIN 0001AA DELIVERY DATE FROM 07 MAY 2021 TO 23 JUNE 2021.

2. TO CHANGE CLIN 0001AA ACCEPTANCE FROM ORIGIN TO DESTINATION.

ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME.

*** END OF NARRATIVE A0002 ***

2 4

SPRRA2-20-P-0104

P00002

COSTA PRECISION MANUFACTURING CORP.

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

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

0001 HOLDER,PRINTED CIRC

NSN: 5998-01-682-1184

Mfr CAGE: 18876

Mfr Part Number: 13660133-4

0001AA GOVERNMENT TESTED FIRST ARTICLE 1 EA $ 4,500.00000 $ 4,500.00 _______________________________ ______________ __________________

COMMODITY NAME: HOLDER,PRINTED CIRC

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: D10H0045D1 PRON AMD: 04 ACRN: AA

AMS CD: SM2B1100000

PSC: 5998

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

MIL-STD-129 MARKINGS SHALL APPLY

UNIT PACK: 001 INTERMEDIATE PACK: 000

LEVEL PRESERVATION: Military

LEVEL PACKING: B

MIL-STD-129 MARKINGS SHALL APPLY

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

COMPLIANT

MIL-STD-2073-1 CODES, APPENDIX J:

JI/A/MP [41] JII/CD [1] JIII/PM [00] JIV/WM [EC]

JV/CD [NA] JVI/CT [A] JVII/UC [ED] JVII/IC [00]

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

ESTIMATED MAXIMUM UNIT PACKAGE WEIGHT (POUNDS) AND

SIZE (INCHES):

WT [10.5]

LN [26.0]

WD [10.0]

DP [6.0]

(End of narrative D001)

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Destination

Government Approval/Disapproval Days: 90

Deliveries or Performance _________________________

DOC SUPPL

3 4

SPRRA2-20-P-0104

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

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

002 SPRRA200070900 W31P0W J 2

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 1 23-JUN-2021

FOB POINT: Destination

SHIP TO:

(W31P0W) SR HEADQUARTERS US ARMY AVIATION &

REDSTONE TECHNICAL TEST CENTER

COTTONWOOD RD BLDG 8022 MF 4500

REDSTONE ARSENAL,AL,35898-8052

CONTRACT/DELIVERY ORDER NUMBER ______________________________

SPRRA2-20-P-0104/0000

4 4

SPRRA2-20-P-0104