Signed_SPE4AX-15-D-9441_______XE01.pdf

ORDER FOR SUPPLIES OR SERVICES J

1. CONTRACT/PURCH ORDER/AGREEMENT NO.

SPE4AX-15-D-9441

2. DELIVERY ORDER/CALL NO.

SPE4AX-15-D-9441-XE01

3. DATE OF ORDER/CALL

(YYYYMMMDD)

23 OCT 2015

4. REQUISITION/PURCH REQUEST NO.

FD20601500642 01

5. PRIORITY

DO: A7

6. ISSUED BY CODE

DLA AVIATION, DLR PROCUREMENT OPERATIONS (AW)

235 BYRON ST STE 19A

ROBINS AFB GA 31098-1813

BUYER: Jacqueline L. Haynes/DLA-AWB

Jacqueline.Haynes@robins.af.mil

Phone: (478) 926- 4117 Fax: (478) 926-0000 No Collect Calls

7. ADMINISTERED BY (If other than 6) CODE

DCMA GARDEN CITY

605 STEWART AVENUE

GARDEN CITY 11530-4761

USA

SPRWA1 8. DELIVERY FOB

DESTINATION

OTHER

(See Schedule if other)

X

9. CONTRACTOR CODE FACILITY

BAE SYSTEMS INFORMATION AND ELECTRO

100 CAMPUS RD STE 1

TOTOWA NJ 07512-1213

UNITED STATES

(603) 885-0546 Attn: JOHN SLAVOSKI EMail Address: john.slavoski@baesystems.com

81413 72314 10. DELIVER TO FOB POINT BY (Date)

(YYYYMMMDD)

SEE SCHEDULE

12. DISCOUNT TERMS

NET 30 DAYS

11. X IF BUSINESS IS

SMALL

SMALL

DISAD-VANTAGED

WOMEN-OWNED

13. MAIL INVOICES TO

SEE BLK 15

14. SHIP TO CODE

SEE LINE ITEM SCHEDULE

15. PAYMENT WILL BE MADE BY CODE

(SEE ESP CLAUSE 252.232-7003.)

DFAS-COLUMBUS CENTER

NORTH ENTITLEMENT OPERATIONS

PO BOX 182266

1-800-756-4571

COLUMBUS OH 43218-2266

HQ0337

MARK ALL

PACKAGES AND

PAPERS WITH

IDENTIFICATION

NUMBERS IN

BLOCKS 1 AND 2.

16.

TYPE

OF

ORDER

DELIVERY/

CALL

PURCHASE

X This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract.

Reference your JS-12712-15-048 Dated: 17 SEP 2015 furnish the following terms specified herein.

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: (YYYYMMMDD)

18.

ITEM NO.

19.

SCHEDULE OF SUPPLIES/SERVICES

(SEE SCHEDULE)

20. QUANTITY

ORDERED/

ACCEPTED*

21.

UNIT

22.

UNIT PRICE

23.

AMOUNT

FMS REQUIREMENT

ROUTINE

REFERENCE PR# FD2060-15-00642-01. IN ACCORDANCE WITH BASIC CONTRACT SPE4AX-15-D-9414, P00002, DATED 5

OCTOBER 2015

EARLY DELIVERY IS AUTHORIZED AND ACCEPTED AT NO ADDITIONAL EXPENSE TO THE GOVERNMENT.

* If quantity accepted by the Government is same as quantity ordered, indicate by X. If different, enter actual quantity accepted below quantity ordered and encircle.

24. UNITED STATES OF AMERICA

BY: DEANA B. LORD

Deana.Lord@robins.af.mil

CONTRACTING/ORDERING OFFICER 23 -OCT -2015

25. $ 330,000.00

26.

DIFFERENCES

27a. QUANTITY IN COLUMN 20 HAS BEEN:

INSPECTED RECEIVED ACCEPTED, AND CONFORMS TO

THE CONTRACT EXCEPT AS NOTED:

28. SHIP. NO.

PARTIAL

FINAL

29. D.O. VOUCHER NO.

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

31. PAYMENT

COMPLETE

PARTIAL

FINAL

32. PAID BY

30.

INITIALS

33. AMOUNT VERIFIED CORRECT FOR

34. CHECK NUMBER

35. BILL OF LADING NO.

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

(YYYYMMMDD)

40. TOTAL CONTAINERS 41. S/R ACCOUNT NUMBER 42. S/R VOUCHER NO.

DD FORM 1155, DEC 2001 PREVIOUS EDITION IS OBSOLETE

17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE

SEE SCHEDULE

S3309A

SCD:B

EFT:T

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.

b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE c. DATE

(YYYYMMMDD)

d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

f. TELEPHONE NUMBER g. E-MAIL ADDRESS

a. DATE

(YYYYMMMDD)

b. SIGNATURE AND TITLE OF CONTRACTING OFFICER

Total

Indefinite Delivery Contract Order SPE4AX-15-D-9441-XE01

SUPPLIES OR SERVICES AND PRICES/COSTS

CIRCUIT CARD ASSEMPLY

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

5 EA $33,000.0000 $165,000.00

CLIN ACRN ACRN Total

0001 AA $165,000.00

NSN: 5998-01-381-3605 EW

Circuit Card Assembly Manufacturer Part Number 81413 333256-002 Associated Document(s) Line Item(s)

FD20601500642-01 0001

Priority: R

Inspection: Origin Address Code: 72314 Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below.

Title Number Date Tailoring

ISO 9001-2008 2008

Foreign Military Sales Buy American Act/Balance of Payments Program Physical Item Markings:

IAW MIL-STD-130

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

* DKS005 ORIGIN

Type / Ship To PACRN Mark For

* DKS005 PAA DKSU00 / KS-D-KDA

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

Required Delivery

* DKS005 5 EA 1 MAY 2017 DKSU5V41770141 / PRI:

NOTE: Contact the AFSAC's 555 ILS Distribution Flight-Transportation, Tamara Dresbach, Comm 937-522-6571, or Charles Boyd, Comm 937-522-6564 for in-the-clear--text Ship-To address.

CIRCUIT CARD ASSEMBLY

Item No.

Firm Fixed Price Quantity U/I Unit Price Amount

CIRCUIT CARD ASSEMBLY

5 EA $33,000.0000 $165,000.00

CLIN ACRN ACRN Total

0002 AB $165,000.00

NSN: 5998-01-381-3605 EW

Circuit Card Assembly Manufacturer Part Number 81413 333256-002 Associated Document(s) Line Item(s)

FD20601500642-01 0001AA

Priority: R

Inspection: Origin Address Code: 72314 Acceptance: Origin Inspection/Acceptance Report: WAWF Quality Assurance: Higher Level Contract Quality Requirements The Contractor shall comply with the standard(s) listed below.

Title Number Date Tailoring

ISO 9001-2008 2008

Foreign Military Sales Buy American Act/Balance of Payments Program Physical Item Markings:

IAW MIL-STD-130

Transportation From Continental United States CONUS (CONUS) Sources

TYPE / SHIP TO CODE F.O.B.

* DKS007 ORIGIN

Type / Ship To PACRN Mark For

* DKS007 PAA DKSU00 / KS-D-KDB

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

Required Delivery

* DKS007 5 EA 1 MAY 2017 DKSU5V51040844 / PRI:

NOTE: Contact the AFSAC's 555 ILS Distribution Flight-Transportation, Tamara Dresbach, Comm 937-522-6571, or Charles Boyd, Comm 937-522-6564 for in-the-clear--text Ship To address.

SHIP TO (FOREIGN MILITARY SALES)

TYPE/CODE: * DKS005

SUPPLEMENTAL ADDRESS CODE: DA5KDA

FMS CASE CODE/LOA: KS-D-KDA/001

MAPAC SHIP TO CODE: DKS005

MAPAC MARK FOR: DKSU00

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

AWARD NUMBER: SPE4AX-15-D-9441-XE01

BASIC CONTRACT NUMBER: SPE4AX-15-D-9441

TYPE/CODE: * DKS007

SUPPLEMENTAL ADDRESS CODE: DA7KDB

FMS CASE CODE/LOA: KS-D-KDB/001

MAPAC SHIP TO CODE: DKS007

MAPAC MARK FOR: DKSU00

REQUISITION NUMBER: (See Individual Line Item)

REQUISITION PRIORITY: (See Individual Line Item)

AWARD NUMBER: SPE4AX-15-D-9441-XE01

BASIC CONTRACT NUMBER: SPE4AX-15-D-9441

CONTRACT CLAUSES

TRANSPORTATION FUNDS INFORMATION: See attached DD Form 1653 G-1

ACCOUNTING AND APPROPRIATION DATA (AUG 1998)

Accounting and Appropriation Chargeable ACRN Funds Citation Amount Chargeable

AA 9711X8242 .0002 4F X 47 SR CKDAKS 000000 00000 001000 503000 HQ0104 $165,000.00

PSR: F49332 FSR: 068369 DSR: 273120

AB 9711X8242 .0002 4F X 47 SR CKDBKS 000000 00000 001000 503000 HQ0104 $165,000.00

PSR: 394198 FSR: 009295 DSR: 273402

REFERENCE:

AA SDN: F3QL095078B001 $165,000.00

AB SDN: F3QL095078B001 $165,000.00

ACRN TOTAL $ 330,000.00

LIST OF DOCUMENTS, EXHIBITS OR ATTACHMENTS

Form Number Description/File Name Date Number of Pages DD FORM 1653 Transportation Requirements 17MAR2015 2

AFMC FORM 158 Packaging Data 17MAR2015 2