Electronically_Signed_Award_W56HZV18D0094W56HZV18F0142.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-0094 W56HZV18F0142 2018SEP26 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

D9913

GENERAL DYNAMICS EUROPEAN LAND SYSTEMS-GERMANY

BARBAROSSASTR. 30

KAISERSLAUTERN, DE

GERMANY 67655

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

CHARLES SCOTT

CHARLES.B.SCOTT44.CIV@MAIL.MIL (586)282-7678

2018SEP26 /SIGNED/ 2018SEP26

$135,027.80

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: Service Contracts

Type of Business: Foreign Concern/Entity

Surveillance Criticality Designator: C

Weapon System: No Identified Army Weapons Systems

*** End of Narrative A0000 ***

Prior Amount of Award: $ 0.00

Increase Amount: $ 135,027.80

Total Cumulative Obligation: $ 135,027.80

1. Task Order W56HZV-18-F-0142 is issued under the terms and conditions of Contract W56HZV-18-D-0094.

2. Per the base contract, the following event is being activated for a total of 90 man-days under CLIN 0011AA.

The requirement for this event is the following:

a. One (1) Field Service Representative (FSR) for 90 man-days.

b. Period of Performance: 12 Oct 2018 through 25 Feb 2019.

c. Place of Performance:

DoDAAC: W36R4X

Building J-2050 Cook St.

Fort Bragg, NC 28310-5000

3. Two (2) Travel Flights are input under CLIN 0041AA to the Fort Bragg location above.

4. The total dollar value of this task order is $135,027.80 which includes $130,753.80 for CLIN 0011AA and $4,274.00 for CLIN 0041AA.

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

*** END OF NARRATIVE A0001 ***

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W56HZV-18-D-0094/W56HZV18F0142

GENERAL DYNAMICS EUROPEAN LAND SYSTEMS-GERMANY

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 REBS

0011AA ORDERING YEAR ONE FSR SUPPORT 1 WD $ 130,753.80 _____________________________ __________________

SERVICE REQUESTED: REBS

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0702T PRON AMD: 03 ACRN: AA

PSC: 5420

90 Work Days at $1,452.82 per day for a total of

$130,753.80.

IAW C.1.4.1

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 12-OCT-2018

End Date: 25-FEB-2019

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 25-FEB-2019

$ 130,753.80

DoDAAC: W36R4X

Building J-2050 Cook St.

Fort Bragg, NC 28310-5000

(End of narrative F001)

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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

0041 REBS

0041AA ORDERING YEAR ONE REBS FSR TRAVEL FORT BRAGG, NC 1 LO $ 4,274.00 ________________________________________________ __________________

SERVICE REQUESTED: REBS

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P18DN0702T PRON AMD: 03 ACRN: AA

PSC: 5420

Two (2) air travel round trip from Germany to

Fayetteville, NC. (Fort Bragg) $2,723.03 flight number one. $1550.97 flight number two.

IAW C.1.4.1.3.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 12-OCT-2018

End Date: 25-FEB-2019

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 25-FEB-2019

$ 4,274.00

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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_____ _________ _____ ___________ ____ _______________ _________ _____ ___________ ____ __________

0011AA P18DN0702T 2 A.0035119.3.5.1.1 AA $ 130,753.80

0041AA P18DN0702T 2 A.0035119.3.5.1.1 AA $ 4,274.00

TOTAL $ 135,027.80

OBLIGATED OBLIGATED

ACRN ACCOUNTING CLASSIFICATION AMOUNTACRN ACCOUNTING CLASSIFICATION AMOUNT____ _________________________ ______________ _________________________ __________

AA 021 201820202035 A5XDN MA4504ARF01 3101 L058065440 A.0035119.3.5.1.1 021001 $ 135,027.80 __________________

TOTAL $ 135,027.80

LINELINE

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

0011AA AA 021 201820202035 A5XDN MA4504ARF01 3101 L058065440 A.0035119.3.5.1.1 021001

0041AA AA 021 201820202035 A5XDN MA4504ARF01 3101 L058065440 A.0035119.3.5.1.1 021001

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