W56HZV16D00530003.pdf

PAGE 1 OF

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-0053 0003 2018APR23 SEE SCHEDULE DOA4

W56HZV

U.S. ARMY CONTRACTING COMMAND

WARREN, MICHIGAN 48397-5000

DAVID S. JOLEY

EMAIL: DAVID.S.JOLEY.CIV@MAIL.MIL

SGR18A

DCMA EUROPE

CMR 410, BOX 761

APO, AE 09046

X

K7705

W F E L LTD

CROSSLEY PARK

STOCKPORT CHESHIRE, GB

UNITED KINGDOM SK4 5DY

SEE SCHEDULE

See Block 15

SEE SCHEDULE

HQ0339

DFAS-COLUMBUS CENTER

DFAS-CO WEST ENTITLEMENT OPERATIONS

P.O. BOX 182317

COLUMBUS, OH 43218-2381

X

X 2

SEE CONTRACT ADMINISTRATION DATA

SEE SCHEDULE

JENNIFER SCHNEIDER

JENNIFER.A.SCHNEIDER17.CIV@MAIL.MIL (586)282-7678

2018APR23 /SIGNED/ 2018APR23

$4,557,754.01

CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SUPPLEMENTAL INFORMATION

Buyer Name: DAVID S. JOLEY

Buyer Office Symbol/Telephone Number: CCTA-HCP-B/(586)282-7678

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

Type of Business: Foreign Concern/Entity

Surveillance Criticality Designator: B

Weapon System: No Identified Army Weapons Systems

*** End of Narrative A0000 ***

Delivery Order 0003 to Contract W56HZV-16-D-0053.

1. The purpose of this delivery order is to award second ordering year (second ordering year is from 6-1-17 through 5-31-18) production and service quantities for the Dry Support Bridge Extension Retrofit. Units are added as follows:

CLIN QTY Kit Type PRON Fund Type Delivery Dates

0012AA 7 A P18DN0212T APA 30 Sep 2019 to 29 Nov 2019

0022AA 4 B P18DN0242T APA 31 Jan 2020

0042AA 3 ASL P18DN0222T APA 30 Sep 2019 to 31 Jan 2020

0052AA 3 Pallets P18DN0262T APA 30 Sep 2019 to 31 Jan 2020

0072AA 2 Install A P18DN0202T APA 31 Mar 2020 to 29 May 2020

0082AA 1 Install B P18DN0232T APA 31 Jul 2020

0122AA 3 Mnt Trng P18DN0252T APA 28 May 2021 to 30 Nov 2021

2. The total dollar amount for Delivery Order 0003 is calculated using the Great British Pound (GBP) amounts from Narrative B0002 in

Contract W56HZV-16-D-0053 as follows:

CLIN GBP CF USD QTY Extended Cost

0012AA 261,695.61 1.3952 $365,117.72 7 $2,555,824.04

0022AA 246,282.79 1.3952 $343,613.75 4 $1,374,455.00

0042AA 49,553.19 1.3952 $69,136.61 3 $207,409.83

0052AA 2,485.74 1.3952 $3,468.10 3 $10,404.30

0072AA 78,450.25 1.3952 $109,453.79 2 $218,907.58

0082AA 69,129.55 1.3952 $96,449.55 1 $96,449.55

0122AA 22,530.51 1.3952 $31,434.57 3 $94,303.71

Total $4,557,754.01

3. The total value of Delivery Order 0003 for Contract W56HZV-16-D-0053 is $4,557,754.01.

4. All other contract terms and conditions are to remain in full force and effect.

*** END OF NARRATIVE A0001 ***

2 12

W56HZV-16-D-0053/0003

W F E L LTD

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 RETROFIT KIT A

NSN: 9999-99-999-9999

0012AA SECOND ORDERING YEAR 7 EA $ 365,117.72000 $ 2,555,824.04 ____________________ ______________ __________________

COMMODITY NAME: RETROFIT KIT A

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0212T PRON AMD: 02 ACRN: AA

PSC: 5420

Retrofit Kit A shall be manufactured and assembled to include the items listed at C.4.1.1.

(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 W502E88089N021 Y00000 M Y00000 3

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 4 30-SEP-2019

002 3 29-NOV-2019

FOB POINT: Origin

SHIP TO:

(Y00000) SHIPPING INSTRUCTIONS FOR CONSIGNEE

(SHIP-TO) WILL BE FURNISHED PRIOR

TO THE SCHEDULED DELIVERY DATE FOR

ITEMS REQUIRED UNDER THIS

REQUISITION.

MARK FOR: SHIPPING INSTRUCTIONS FOR CONSIGNEE

(SHIP-TO) WILL BE FURNISHED PRIOR

TO THE SCHEDULED DELIVERY DATE FOR

ITEMS REQUIRED UNDER THIS

REQUISITION.

CONTRACT/DELIVERY ORDER NUMBER ______________________________

W56HZV-16-D-0053/0003

A modification to the contract will be issued to

3 12

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

provide the "MARK FOR" instructions prior to the delivery date.

(End of narrative F001)

4 12

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0022 RETROFIT KIT B

NSN: 9999-99-999-9999

0022AA SECOND ORDERING YEAR 4 EA $ 343,613.75000 $ 1,374,455.00 ____________________ ______________ __________________

COMMODITY NAME: RETROFIT KIT B

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0242T PRON AMD: 02 ACRN: AB

PSC: 5420

Retrofit Kit B shall be manufactured and assembled to include the items listed at C.4.1.2.

(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 W502E88089N024 Y00000 M Y00000 3

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 4 31-JAN-2020

FOB POINT: Origin

SHIP TO:

(Y00000) SHIPPING INSTRUCTIONS FOR CONSIGNEE

(SHIP-TO) WILL BE FURNISHED PRIOR

TO THE SCHEDULED DELIVERY DATE FOR

ITEMS REQUIRED UNDER THIS

REQUISITION.

MARK FOR: SEE BELOW FOR SHIPPING INSTRUCTIONS

CONTRACT/DELIVERY ORDER NUMBER ______________________________

W56HZV-16-D-0053/0003

A modification to the contract wil be issued to provide "MARK FOR" instructions prior to the delivery date.

(End of narrative F001)

5 12

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0042 DSB 46m Retrofit ASL

NSN: 9999-99-999-9999

0042AA SECOND ORDERING YEAR 3 EA $ 69,136.61000 $ 207,409.83 _____________________ ______________ __________________

COMMODITY NAME: DSB 46m Retrofit ASL

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0222T PRON AMD: 02 ACRN: AC

PSC: 5420

Each Associated Stockage List (ASL) kit shall include the items listed at C.4.1.4.

(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 W502E88089N022 Y00000 M Y00000 3

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 1 30-SEP-2019

002 1 29-NOV-2019

003 1 31-JAN-2020

FOB POINT: Origin

SHIP TO:

(Y00000) SHIPPING INSTRUCTIONS FOR CONSIGNEE

(SHIP-TO) WILL BE FURNISHED PRIOR

TO THE SCHEDULED DELIVERY DATE FOR

ITEMS REQUIRED UNDER THIS

REQUISITION.

MARK FOR: SEE BELOW FOR SHIPPING INSTRUCTIONS

CONTRACT/DELIVERY ORDER NUMBER ______________________________

W56HZV-16-D-0053/0003

A modification to the contract wil be issued to provide "MARK FOR" instructions prior to the delivery date.

(End of narrative F001)

6 12

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0052 DSB TRAINING PALLETS

NSN: 9999-99-999-9999

0052AA SECOND ORDERING YEAR 3 EA $ 3,468.10000 $ 10,404.30 _____________________ ______________ __________________

COMMODITY NAME: DSB TRAINING PALLETS

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0262T PRON AMD: 02 ACRN: AD

PSC: 5420

Training pallets shall be kitted IAW C.4.1.5.

(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 W502E88089N026 Y00000 M Y00000 3

DEL REL CD QUANTITY DEL DATE __________ ______________ ___________

001 1 30-SEP-2019

002 1 29-NOV-2019

003 1 31-JAN-2020

FOB POINT: Origin

SHIP TO:

(Y00000) SHIPPING INSTRUCTIONS FOR CONSIGNEE

(SHIP-TO) WILL BE FURNISHED PRIOR

TO THE SCHEDULED DELIVERY DATE FOR

ITEMS REQUIRED UNDER THIS

REQUISITION.

MARK FOR: SEE BELOW FOR SHIPPING INSTRUCTIONS

CONTRACT/DELIVERY ORDER NUMBER ______________________________

W56HZV-16-D-0053/0003

A modification to the contract wil be issued to provide "MARK FOR" instructions prior to the delivery date.

7 12

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

(End of narrative F001)

8 12

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0072 INSTALL RETROFIT KIT A

0072AA SECOND ORDERING YEAR 1 LO $ 218,907.58 _______________________ __________________

SERVICE REQUESTED: INSTALL RETROFIT KIT A

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0202T PRON AMD: 02 ACRN: AE

PSC: 5420

The funding for two installations is included at a unit price of

$109,453.79 per unit.

(End of narrative B001)

Kit A Installation IAW C.6.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 31-MAR-2020

End Date: 29-MAY-2020

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 29-MAY-2020

$ 218,907.58

A modification to the contract wil be issued to provide "MARK FOR" instructions prior to the delivery date.

(End of narrative F001)

9 12

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0082 INSTALL RETROFIT KIT B

0082AA SECOND ORDERING YEAR 1 LO $ 96,449.55 _______________________ __________________

SERVICE REQUESTED: INSTALL RETROFIT KIT B

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0232T PRON AMD: 02 ACRN: AF

PSC: 5420

Kit B Installation IAW C.6.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 01-JUL-2020

End Date: 31-JUL-2020

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 31-JUL-2020

$ 96,449.55

A modification to the contract wil be issued to provide "MARK FOR" instructions prior to the delivery date.

(End of narrative F001)

10 12

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

0122 MAINTAINER TRAINING

0122AA SECOND ORDERING YEAR 1 LO $ 94,303.71 ____________________ __________________

SERVICE REQUESTED: MAINTAINER TRAINING

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0252T PRON AMD: 02 ACRN: AG

PSC: 5420

The funding for three training sessions is included at a price of

$31,434.57 per session.

(End of narrative B001)

Maintainer Familiarization Training IAW C.8.1.2.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 01-MAY-2021

End Date: 30-NOV-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-NOV-2021

$ 94,303.71

A modification to the contract wil be issued to provide "MARK FOR" instructions prior to the delivery date.

(End of narrative F001)

11 12

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 P18DN0212T 2 A.0035119.3.5.2.1 AA $ 2,555,824.04

0022AA P18DN0242T 2 A.0035119.3.5.2.1 AB $ 1,374,455.00

0042AA P18DN0222T 2 A.0035119.3.5.2.1 AC $ 207,409.83

0052AA P18DN0262T 2 A.0035119.3.5.2.1 AD $ 10,404.30

0072AA P18DN0202T 2 A.0035119.3.5.2.1 AE $ 218,907.58

0082AA P18DN0232T 2 A.0035119.3.5.2.1 AF $ 96,449.55

0122AA P18DN0252T 2 A.0035119.3.5.2.1 AG $ 94,303.71

TOTAL $ 4,557,754.01

OBLIGATED OBLIGATED

ACRN ACCOUNTING CLASSIFICATION AMOUNTACRN ACCOUNTING CLASSIFICATION AMOUNT____ _________________________ ______________ _________________________ __________

AA 021 201820202035 A5XDN MA4504ARF01 3101 L055392272 A.0035119.3.5.2.1 021001 $ 2,555,824.04

AB 021 201820202035 A5XDN MA4504ARF01 3101 L055395262 A.0035119.3.5.2.1 021001 $ 1,374,455.00

AC 021 201820202035 A5XDN MA4504ARF01 3101 L055394725 A.0035119.3.5.2.1 021001 $ 207,409.83

AD 021 201820202035 A5XDN MA4504ARF01 3101 L055395267 A.0035119.3.5.2.1 021001 $ 10,404.30

AE 021 201820202035 A5XDN MA4504ARF01 3101 L055462850 A.0035119.3.5.2.1 021001 $ 218,907.58

AF 021 201820202035 A5XDN MA4504ARF01 3101 L055462910 A.0035119.3.5.2.1 021001 $ 96,449.55

AG 021 201820202035 A5XDN MA4504ARF01 3101 L055462744 A.0035119.3.5.2.1 021001 $ 94,303.71 __________________

TOTAL $ 4,557,754.01

LINELINE

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

0012AA AA 021 201820202035 A5XDN MA4504ARF01 3101 L055392272 A.0035119.3.5.2.1 021001

0022AA AB 021 201820202035 A5XDN MA4504ARF01 3101 L055395262 A.0035119.3.5.2.1 021001

0042AA AC 021 201820202035 A5XDN MA4504ARF01 3101 L055394725 A.0035119.3.5.2.1 021001

0052AA AD 021 201820202035 A5XDN MA4504ARF01 3101 L055395267 A.0035119.3.5.2.1 021001

0072AA AE 021 201820202035 A5XDN MA4504ARF01 3101 L055462850 A.0035119.3.5.2.1 021001

0082AA AF 021 201820202035 A5XDN MA4504ARF01 3101 L055462910 A.0035119.3.5.2.1 021001

0122AA AG 021 201820202035 A5XDN MA4504ARF01 3101 L055462744 A.0035119.3.5.2.1 021001

12 12