W56HZV18D0048W56HZV19F0088.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-18-D-0048 W56HZV19F0088 2019FEB07 SEE SCHEDULE DOA4

W56HZV

U.S. ARMY CONTRACTING COMMAND

WARREN, MICHIGAN 48397-5000

DAVID S. JOLEY

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

S1002A

DCMA ORLANDO

3555 MAGUIRE BLVD

ORLANDO, FL 32803-3726

X

32865 1JNU9

DRS NETWORK & IMAGING SYSTEMS, LLC

100 N BABCOCK ST

MELBOURNE, FL 32935-6715

SEE SCHEDULE

See Block 15

SEE SCHEDULE

HQ0338

DFAS-COLUMBUS CENTER

SOUTH ENTITLEMENT OPERATIONS

P O BOX 182317

COLUMBUS OH 43218-2264

X

X 2

SEE CONTRACT ADMINISTRATION DATA

SEE SCHEDULE

CHARLES SCOTT

CHARLES.B.SCOTT44.CIV@MAIL.MIL (586)282-6673

2019FEB07 /SIGNED/ 2019FEB07

$412,419.56

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)282-8398

Type of Contract 1: Firm Fixed Price

Kind of Contract: Service Contracts

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

Surveillance Criticality Designator: C

Weapon System: Breacher (Grizzly)

*** End of Narrative A0000 ***

Task Order W56HZV-19-F-0088 to Contract W56HZV-18-D-0048

1. The purpose of this task order is to award Gimbal Inspection Services

SECTION B:

2. CLIN 0011AA is established for the Inspection of 28 each Gimbals at a unit price of $14,729.27 to completed by 9 Apr 2019.

Summary:

3. $412,419.56 is awarded for the inspection of 28 Gimbals.

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

*** END OF NARRATIVE A0001 ***

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W56HZV-18-D-0048/W56HZV19F0088

DRS NETWORK & IMAGING SYSTEMS, LLC

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

0011 GIMBAL INSPECTIONS SERVICES

0011AA ORDERING YEAR ONE GIMBAL INSPECTIONS SERVICES 1 LO $ 412,419.56 _____________________________________________ __________________

SERVICE REQUESTED: GIMBAL INSPECTIONS SERVICES

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: EH9L0153EH PRON AMD: 01 ACRN: AA

AMS CD: SM2B1400000

PSC: R425

CLIN 0011 under Contract W56HZV-18-D-0048 procures

Gimbal inspection services.

Inspections shall be conducted by the contractor in accordace with SECTION C of this contract.

Gimbal inspections under CLIN 0011 shall be conducted on a firm fixed price basis.

Under ordering period ONE Gimbal Inspections are

$14,729.27 per unit. This order is for 28 inspections totalling $412,419.56. These units can be billed incrementally as completed.

In Accordance with SECTION C.1.4.6.2 of this Contract

The Goverment will batch Gimbals for Inspection. Each batch shall contain no less than ten units.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 07-FEB-2019

End Date: 09-APR-2019

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 09-APR-2019

$ 412,419.56

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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_____ _________ _____ ___________ ____ _______________ _________ _____ ___________ ____ __________

0011AA EH9L0153EH 2 AA $ 412,419.56

SM2B1400000

TOTAL $ 412,419.56

OBLIGATED OBLIGATED

ACRN ACCOUNTING CLASSIFICATION AMOUNTACRN ACCOUNTING CLASSIFICATION AMOUNT____ _________________________ ______________ _________________________ __________

AA 97 X4930AC9D 6D 26KB S20113 W56HZV $ 412,419.56 __________________

TOTAL $ 412,419.56

LINELINE

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

0011AA AA 97 0X0X4930AC9D S20113 6D0000SM2B140000026KB S20113 W56HZVT2HDW

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