W56HZV-19-R-0106_0001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. Contract ID Code Page Of

2. Amendment/Modification No.

3. Effective Date

4. Requisition/Purchase Req No.

5. Project No. (If applicable)

6. Issued By Code 7. Administered By (If other than Item 6) Code

8. Name And Address Of Contractor (No., Street, City, County, State and Zip Code)

9A. Amendment Of Solicitation No.

9B. Dated (See Item 11)

10A. Modification Of Contract/Order No.

10B. Dated (See Item 13) Code Facility Code

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended, is not extended.

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended by one of the following methods:

(a) By completing items 8 and 15, and returning ____________ copies of the amendments: (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. Accounting And Appropriation Data (If required)

13. THIS ITEM ONLY APPLIES TO MODIFICATIONS OF CONTRACTS/ORDERS

It Modifies The Contract/Order No. As Described In Item 14.

A. This Change Order is Issued Pursuant To: The Changes Set Forth In Item 14 Are Made In

The Contract/Order No. In Item 10A.

B. The Above Numbered Contract/Order Is Modified To Reflect The Administrative Changes (such as changes in paying office, appropriation data, etc.) Set

Forth In Item 14, Pursuant To The Authority of FAR 43.103(b).

C. This Supplemental Agreement Is Entered Into Pursuant To Authority Of:

D. Other (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return _______________ copies to the Issuing Office.

14. Description Of Amendment/Modification (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Except as provided herein, all terms and conditions of the document referenced in item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. Name And Title Of Signer (Type or print)

16A. Name And Title Of Contracting Officer (Type or print)

15B. Contractor/Offeror 15C. Date Signed 16B. United States Of America 16C. Date Signed

By (Signature of person authorized to sign) (Signature of Contracting Officer)

NSN 7540-01-152-8070

PREVIOUS EDITIONS UNUSABLE

30-105-02 STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

SEE SCHEDULE

X

Firm Fixed Price

W56HZV

U.S. ARMY CONTRACTING COMMAND

WARREN, MICHIGAN 48397-5000

DEBORAH HOUGH

EMAIL: DEBORAH.A.HOUGH2.CIV@MAIL.MIL

W56HZV-19-R-0106

2019JUN28

X

X

2 signed

SEE SECOND PAGE FOR DESCRIPTION

1 4

CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION A - SUPPLEMENTAL INFORMATION

Buyer Name: DEBORAH HOUGH

Buyer Office Symbol/Telephone Number: CCTA-HDB-S/(586)282-6782

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

Weapon System: Collective Protection Equipment

*** End of Narrative A0000 ***

The purpose of amendment 0001 to solicitation W56HZV-19-R-0106 is to extend the closing date.

1. The solicitation closing date is hereby extended from 13 AUG 2019 to 20 SEP 2019.

2. As a result of amendment 0001, Section A is revised.

3. CLIN 0001AB First Article Test Report is added.

4. All other terms and conditions of solicitation W56HZV-19-R-0106 remain unchanged.

*** END OF NARRATIVE A0003 ***

2 4

W56HZV-19-R-0106

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

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS

0001 FIRST ARTICLE - SEPARATELY PR

NSN: 4240-01-282-0194

Mfr CAGE: 81361

Mfr Part Number: E5-19-9417

0001AB FIRST ARTICLE TEST SEPARATELY PRICED $ $ ____________________________________ ______________ __________________

COMMODITY NAME: FIRST ARTICLE - SEPARATELY PR

The contractor shall conduct a FAT on three (3) M20

Protective Entrances (PN 5-19-9417) to all testing and inspection requirements in accordance with (IAW) drawing: 5 -19-9417 and EA-E-1464. The contractor shall also conduct a FAT on ten (10) Protective

Entrance Modules (PN 5-19-9142) to all testing and inspection requirements IAW drawing: 5-19-9142 and EA-

M-1417B. The FAT shall also consist of all inspection requirements for packaging IAW SPI P5-19-9471. The

FAT shall also consist of seven (7) yards of Butyl

Cloth (PN 5-19-6310) tested and inspected IAW drawing

5-19-6310 and MIL-C-12189H. AGENT/SMULANT TESTING

REQUIRED. Testing shall be completed at a certified

Government Laboratory. BUTYL CLOTH TESTING IS

DESTRUCTIVE. The contractor shall include all

Government test data in the First Article Test Report

(FATR).

Government Production Lot Testing:

1. PLT shall be performed For the Butyl Cloth (PN 5-

19-6310), to all testing and inspection requirements for conformance inspection, prior to use, IAW drawing: 5-19-6310 and MIL-C-12198H. The Government facility performing agent testing shall be certified.

2. Same as for FAT

3. Same as for FAT

4. Same as outlined in number 1.

(End of narrative B001)

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: 20181327

Packaging and Marking _____________________

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Origin

Deliveries or Performance _________________________

3 4

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

FOB POINT: Destination

SHIP TO:

(W562RM) SU W0MC ARMY GENERAL SUPPLY

DLA DISTRIBUTION RED RIVER

HIGHWAY 82 WEST

TEXARKANA,TX,75507-5000

4 4