W56HZV16D00130002.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.

W56HZV-16-D-0013 0002 2017AUG31 SEE SCHEDULE DOA4

W56HZV

U.S. ARMY CONTRACTING COMMAND

WARREN, MICHIGAN 48397-5000

DEBORAH ROTH

EMAIL: DEBORAH.L.ROTH6.CIV@MAIL.MIL

S3605A

DCMA DAYTON

AREA C, BUILDING 30

1725 VAN PATTON DRIVE

WRIGHT-PATTERSON AFB, OH 45433-5302 X

1CHX5 65GR5

KONECRANES INC

4401 GATEWAY BLVD

SPRINGFIELD, OH 45502-9339

SEE SCHEDULE

See Block 15

SEE SCHEDULE

HQ0337

DFAS-CO/NORTH ENTITLEMENT OPERATION

P.O. BOX 182317

COLUMBUS OH 43218-2266

X

X 2

SEE CONTRACT ADMINISTRATION DATA

SEE SCHEDULE

JUSTIN A. KALOUSDIAN

JUSTIN.A.KALOUSDIAN.CIV@MAIL.MIL (586)282-8729

2017AUG31 /SIGNED/ 2017AUG31

$242,942.71

CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SUPPLEMENTAL INFORMATION

Buyer Name: DEBORAH ROTH

Buyer Office Symbol/Telephone Number: CCTA-AHP-B/(586)282-6163

Type of Contract 1: Firm Fixed Price

Kind of Contract: Service Contracts

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

Surveillance Criticality Designator: A

Weapon System: Recovery Vehicle, M51/M74/M88

*** End of Narrative A0000 ***

CONTRACT: W56HZV-16-D-0013

DELIVERY ORDER: 0002

PURPOSE: Repair of Winches and Tear Down and Inspection

VALUE: $242,942.70

The purpose of this Delivery Order 0002 on contract W56HZV-16-D-0013 is to accomplish the following:

1. To establish CLIN 0012AA and Delivery Order 0002 contract W56HZV-16-D-0013 for teardown and inspection of 4 ea Winch Drum Power Op.

The contractor shall deliver the tear down and inspection report IAW CDRL A002 of the base contract. The value of CLIN 0012AA is

$6,797.76.

2. To establish CLIN 0022AA and Delivery Order 0002 on contract W56HZV-16-D-0013 for Winch Repair. These units were inspected under CLIN

0011AC. This CLIN authorizes the repair and delivery of 4 EA Winch, Drum, Power OP for the following S/Ns:

S/N Value

00012 $ 28,699.11

00215 $ 26,379.22

00230 $ 33,547.89

00282 $ 29,002.49

Total $117,628.71

3. To establish CLIN 0022AB and Delivery Order 0002 on contract W56HZV-16-D-0013 for Winch Repair. These units were inspected under CLIN

0011AB. This CLIN authorizes the repair and delivery of 4 EA Winch, Drum, Power OP for the following S/Ns:

S/N Value

00115 $ 47,377.90

00368 $ 24,960.35

00615 $ 22,097.07

00913 $ 24,080.97

Total $118,516.23

4. In consideration of this delivery order, agreed to herein as complete and equitable adjustment for CLIN 0012AA,0022AA,and 0022AB,the contractor hereby releases the Government from any and all liability under this contract for further equitable adjustments attibutable to such facts or circumstances giving rise to incorporation into this delivery order.

5. The total value of this delivery order $242,942.70.

*** END OF NARRATIVE A0001 ***

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W56HZV-16-D-0013/0002

KONECRANES 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

0012 WINCH,DRUM,POWER OP

NSN: 3950-01-434-3231

Mfr CAGE: 19207

Mfr Part Number: 12364530

0012AA SECOND ORDERING YEAR TEARDOWN AND INSPECTION 4 EA $ 1,699.44000 $ 6,797.76 ____________________________________________ ______________ __________________

COMMODITY NAME: WINCH,DRUM,POWER OP

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: EH71S058EH PRON AMD: 02 ACRN: AA

AMS CD: SM2B1400000

PSC: 3950

CLIN 0012AA is for the tear down, inspection, and report for all necessary items to be replaced.

Reference base contract scope of work paragraph

C.2.2.1 to C.2.205.

(End of narrative C001)

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 W56HZV6320969Z W562RP J 2

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 4 25-SEP-2017

FOB POINT: Origin

SHIP TO:

(W562RP) SR ARMY GENERAL SUPPLY LMP STOCK RE

DLA DISTRIBUTION ANNISTON

7 FRANKFORD AVE 362

ANNISTON,AL,36201-4199

CONTRACT/DELIVERY ORDER NUMBER ______________________________

W56HZV-16-D-0013/0002

0022 WINCH,DRUM,POWER OP

NSN: 3950-01-434-3231

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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

Mfr CAGE: 19207

Mfr Part Number: 12364530

0022AA SECOND YEAR WINCH REPAIR 4 EA $ ** N/A ** $ 117,628.72 ________________________ ______________ __________________

COMMODITY NAME: WINCH,DRUM,POWER OP

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: EH71S230EH PRON AMD: 03 ACRN: AA

AMS CD: SM2B1400000

PSC: 3950

This CLIN authorizes the repair and delivery of 4 EA

WINCH, DRUM, POWER OP.

The serial number and repair cost for each WINCH, DRUM, POWER OP. is below:

00012 $28,699.11

00215 $26,379.22

00230 $33,547.89

00282 $29,002.49

Winches were inspected under 00011AC.

Reference Scope of Work Paragraph C.2.3.2 to C.2.6

Prices are stated in Attachment 0001 in Section J of the contract.

(End of narrative C001)

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 W56HZV7066968Z W562RP J 2

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 4 22-DEC-2017

FOB POINT: Origin

SHIP TO:

(W562RP) SR ARMY GENERAL SUPPLY LMP STOCK RE

DLA DISTRIBUTION ANNISTON

7 FRANKFORD AVE 362

ANNISTON,AL,36201-4199

CONTRACT/DELIVERY ORDER NUMBER ______________________________

W56HZV-16-D-0013/0002

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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

0022AB WINCH REPAIR 4 EA $ ** N/A ** $ 118,516.23 ____________ ______________ __________________

COMMODITY NAME: WINCH,DRUM,POWER OP

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: EH71S420EH PRON AMD: 02 ACRN: AA

AMS CD: SM2B1400000

PSC: 3950

This CLIN authorizes the repair and delivery of 4 EA

WINCH, DRUM, POWER OP.

The serial number and repair cost for each WINCH, DRUM, POWER OP. is below:

00115 $47,377.90

00368 $24,960.35

00615 $22,097.07

00913 $24,080.91

Winches were inspected under 00011AB.

Reference Scope of Work Paragraph C.2.3.2 to C.2.6

Prices are stated in Attachment 0001 in Section J of the contract.

(End of narrative C001)

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 W56HZV7158967Z W562RP J 2

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 4 22-JAN-2018

FOB POINT: Origin

SHIP TO:

(W562RP) SR ARMY GENERAL SUPPLY LMP STOCK RE

CENTRAL RECEIVING POINT

7 FRANKFORD AVE BLDG 362

ANNISTON,AL,36201-4199

CONTRACT/DELIVERY ORDER NUMBER ______________________________

W56HZV-16-D-0013/0002

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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_____ _________ _____ ___________ ____ _______________ _________ _____ ___________ ____ __________

0012AA EH71S058EH 2 AA $ 6,797.76

SM2B1400000

0022AA EH71S230EH 2 AA $ 117,628.72

SM2B1400000

0022AB EH71S420EH 2 AA $ 118,516.23

SM2B1400000

TOTAL $ 242,942.71

OBLIGATED OBLIGATED

ACRN ACCOUNTING CLASSIFICATION AMOUNTACRN ACCOUNTING CLASSIFICATION AMOUNT____ _________________________ ______________ _________________________ __________

AA 97 X4930AC9D 6D 26KB S20113 W56HZV $ 242,942.71 __________________

TOTAL $ 242,942.71

LINELINE

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

0012AA AA 97 0X0X4930AC9D S20113 6D0000SM2B140000026KB S20113 W56HZV

0022AA AA 97 0X0X4930AC9D S20113 6D0000SM2B140000026KB S20113 W56HZV

0022AB AA 97 0X0X4930AC9D S20113 6D0000SM2B140000026KB S20113 W56HZV

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