W15QKN16R0005-0002.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

0002 2016JUN16

W15QKN

ARMY CONTRACTING COMMAND - NJ

PICATINNY ARSENAL, NJ 07806-5000

WILLIAM JOSEPH LABANCE

EMAIL: WILLIAM.J.LABANCE.CIV@MAIL.MIL

W15QKN-16-R-0005

2016MAY31

X

X 2016JUL11 03:30pm

/SIGNED/

2 signed

SEE SECOND PAGE FOR DESCRIPTION

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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: WILLIAM JOSEPH LABANCE

Buyer Office Symbol/Telephone Number: ACC-NJ-MA/(973)724-6673

Type of Contract 1: Firm Fixed Price

Kind of Contract: Other

*** End of Narrative A0000 ***

The purpose of this amendment is as follows:

1. To add Lot Acceptance Test (LAT) CLINs for the Base Year and for Option Year 1.

2. To provide an extension of the RFP deadline from 30 June 2016 to 11 July 2016.

3. All other terms and conditions remain the same and are in full force and effect.

*** END OF NARRATIVE A0003 ***

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W15QKN-16-R-0005 0002

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

0006 BASE YEAR LOT ACCEPTANCE TEST UNITS 128 EA $ ** NSP ** $ ** NSP ** ___________________________________ ______________ __________________

COMMODITY NAME: MK 419 MOD 1 MFF

CLIN CONTRACT TYPE:

Firm Fixed Price

Government LOT Acceptance Testing shall be conducted and report submitted within 12 months after award.

Size = 128 fuzes per lot to be delivered. To be determined at time of award.

SHIP TO:

Naval Surface Warfare Center Dahlgren

Ammunition Preparation

17349 Foster Road, Bldg. 455

Dahlgren, VA

22448-5158

Mark For: Jason Koonts, E33

(End of narrative A001)

Packaging and Marking _____________________

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Deliveries or Performance _________________________

DOC SUPPL

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

001 3

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 128 AS REQUIRED

FOB POINT: Origin

SHIP TO:

(Y00003) SEE NARRATIVE ON DD 1423

0007 OPTION 1 LOT ACCEPTANCE TEST UNITS 128 EA $ ** NSP ** $ ** NSP ** __________________________________ ______________ __________________

COMMODITY NAME: MK 419 MOD 1 MFF

CLIN CONTRACT TYPE:

Firm Fixed Price

Government LOT Acceptance Testing shall be conducted and report submitted within 12 months after award.

3 4

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

Size = 128 fuzes per lot to be delivered. To be determined at time of award.

SHIP TO:

Naval Surface Warfare Center Dahlgren

Ammunition Preparation

17349 Foster Road, Bldg. 455

Dahlgren, VA

22448-5158

Mark For: Jason Koonts, E33

(End of narrative A001)

Packaging and Marking _____________________

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Deliveries or Performance _________________________

DOC SUPPL

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

001 3

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 128 AS REQUIRED

FOB POINT: Origin

SHIP TO:

(Y00003) SEE NARRATIVE ON DD 1423

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