W56HZV15D0083W56HZV19F0182.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-15-D-0083 W56HZV19F0182 2019JAN18 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-BRIDGE SYS. GMBH

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 SCHEDULE

CHARLES SCOTT

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

2019JAN18 /SIGNED/ 2019JAN18

$0.00

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)282-8398

Type of Contract 1: No Cost

Kind of Contract: Service Contracts

Type of Business: Foreign Concern/Entity

Surveillance Criticality Designator: C

*** End of Narrative A0000 ***

Prior Amount of Award: $218,788.87

Increase Amount: $ 0.00

Total Cumulative Obligation: $218,788.87

1. Task Order W56HZV19F0182 is issued under the terms and conditions of Contract W56HZV-15-D-0083.

SECTION B

2. Under CLIN 0013AH, the following event is being activated for a total of 30 man-days:

a. One (1) Field Service Representatives (FSR)s for a total of 30 man-days.

b. Period of Performance: 25 Jan 2019 through 8 Mar 2019

c. Place of Performance:

VSE

33472 Sterling Ponds

Sterling Heights, MI 48312

3. As a result of this task order, there are no events of 30 days remaining under ClIN 0013AB. CLIN 0013AB is added for reference only.

SUMMARY

4. The total dollar value of this task order is $0.00.

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

*** END OF NARRATIVE A0001 ***

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W56HZV-15-D-0083/W56HZV19F0182

GENERAL DYNAMICS EUROPEAN LAND SYSTEMS-BRIDGE SYS. GMBH

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

0013 ORDERING YEAR 3 FSR SUPPORT

0013AB FSR SUPPORT - LOCATION TBD 1 LO $ ** NSP ** ____________________________ __________________

SERVICE REQUESTED: ORDERING YEAR 3 FSR SUPPORT

CLIN CONTRACT TYPE:

No Cost

PSC: R425

180 Man-Days of Field Service Representative Support

(FSR) at six different CONUS locations at 30 days each to be determined in accordance with C.1.2.1.

The dates of for FSR performance will be provided to the contractor by the COR under separate cover.

30 Man-Days FSR support used on W56HZV19F0182. No

Man-Days FSR support will remain available for use after this task order. This order completes all consideration.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 25-JAN-2019

End Date: 08-MAR-2019

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 08-MAR-2019

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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

0013AH FSR SUPPORT - STERLING HEIGHTS, MI 1 LO $ ** NSP ** __________________________________ __________________

SERVICE REQUESTED: ORDERING YEAR 3 - FSR SUPPORT

CLIN CONTRACT TYPE:

No Cost

PSC: R425

30 Man-Days of Field Service Representative Support

(FSR) at Sterling Heights, MI in accordance with sections C.1.1 and C.1.2.1 of the contract.

The Government requires 30 Man-Days of FSR support, for a total of 30 Man-Days days.

The dates for FSR performance are 25 Jan 2019 through

8 Mar 2019.

No 30 Man-Day events remain available after this event. This order completes the consideration on the contract.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 25-JAN-2019

End Date: 08-MAR-2019

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 08-MAR-2019

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