W56HZV16D00530004.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-0053 0004 2018MAY18 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

WEST ENTITLEMENT OPERATIONS

P O BOX 182317

COLUMBUS OH 43218-2317

X

X 2

SEE CONTRACT ADMINISTRATION DATA

SEE SCHEDULE

JENNIFER SCHNEIDER

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

2018MAY18 /SIGNED/ 2018MAY18

$209,016.00

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 0004 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) service quantities for the Dry Support Bridge Extension Retrofit. Units are added as follows:

CLIN QTY Description PRON Fund Type Delivery Dates

0112AA 4 Operator Training P18DN0302T APA 29 May 2020

2. The total dollar amount for Delivery Order 0004 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

0112AA 38,775.85 1.3476 $52,254 4 $209,016

3. The total value of Delivery Order 0004 for Contract W56HZV-16-D-0053 is $209,016.00.

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

*** END OF NARRATIVE A0001 ***

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W56HZV-16-D-0053/0004

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

0112 DSB OPERATOR TRAINING COURSES

0112AA SECOND ORDERING YEAR 1 LO $ 209,016.00 ______________________________ __________________

SERVICE REQUESTED: DSB OPERATOR TRAINING COURSES

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0302T PRON AMD: 01 ACRN: AA

PSC: 5420

The funding of four training sessions is included at a price of

$52,254 per session.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 31-JAN-2020

End Date: 29-MAY-2020

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 29-MAY-2020

$ 209,016.00

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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_____ _________ _____ ___________ ____ _______________ _________ _____ ___________ ____ __________

0112AA P18DN0302T 2 A.0035119.3.5.2.5 AA $ 209,016.00

TOTAL $ 209,016.00

OBLIGATED OBLIGATED

ACRN ACCOUNTING CLASSIFICATION AMOUNTACRN ACCOUNTING CLASSIFICATION AMOUNT____ _________________________ ______________ _________________________ __________

AA 021 201820202035 A5XDN MA4504ARF01 252G L055804563 A.0035119.3.5.2.5 021001 $ 209,016.00 __________________

TOTAL $ 209,016.00

LINELINE

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

0112AA AA 021 201820202035 A5XDN MA4504ARF01 252G L055804563 A.0035119.3.5.2.5 021001

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