W56HZV21C0097-P00003.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

P00003 2021SEP27

W56HZV

ACC-DTA

6501 E. 11 MILE RD.

DETROIT ARSENAL, MI 48397-5000

DAVID S. JOLEY

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

S3101A

DCMA MUNITIONS & SUPPORT SYSTEMS -

SPRINGFIELD

BLDG 93, ARDEC

PICATINNY NJ 07806-5000

0V4D3

ACROW CORP OF AMERICA

181 NEW RD STE 202

PARSIPPANY, NJ 07054-5645

W56HZV-21-C-0097

2021JUN10

SEE SECTION G (IF APPLICABLE)

X 43.103(a)(3)

X

SEE SECOND PAGE FOR DESCRIPTION

/SIGNED/ 2021SEP27

JENNIFER SCHNEIDER

JENNIFER.A.SCHNEIDER17.CIV@MAIL.MIL (586)282-8396

1 57

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: DAVID S. JOLEY

Buyer Office Symbol/Telephone Number: CCTA-HCP-B/(586)282-8398

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

Kind of Modification: G

Type of Business: Other Small Business Performing in U.S.

Surveillance Criticality Designator: C

Weapon System: No Identified Army Weapons Systems

Paying Office: HQ0337

DFAS-COLUMBUS CENTER

NORTH ENTITLEMENT OPERATIONS

P.O. BOX 182317

COLUMBUS OH 43218-2317

*** End of Narrative A0000 ***

Modification P00003 to Contract W56HZV-21-C-0097

1. The purpose of this modification is to add Travel, Program Management, and CDRL amounts that were originally planned to be awarded on the base contract award. As a result, the following changes are incorporated into the contract.

SECTION B

2. The following CLINs are added to the contract:

CLIN Description Price

1201 FSR TRAVEL SUPPORT OF CLIN 1101 $8,768.50

1202 FSR TRAVEL SUPPORT OF CLIN 1102 $7,468.50

1203 FSR TRAVEL SUPPORT OF CLIN 1103 $14,143.00

1204 FSR TRAVEL SUPPORT OF CLIN 1104 $13,406.00

1205 FSR TRAVEL SUPPORT OF CLIN 1105 $6,209.50

1206 FSR TRAVEL SUPPORT OF CLIN 1106 $7,004.50

1207 FSR TRAVEL SUPPORT OF CLIN 1107 $34,989.50

1208 FSR TRAVEL SUPPORT OF CLIN 1108 $9,821.00

1209 FSR TRAVEL SUPPORT OF CLIN 1109 $1,736.50

1210 FSR TRAVEL SUPPORT OF CLIN 1110 $7,016.50

1211 FSR TRAVEL SUPPORT OF CLIN 1111 $6,714.50

1212 FSR TRAVEL SUPPORT OF CLIN 1112 $1,535.50

1213 FSR TRAVEL SUPPORT OF CLIN 1113 $4,020.00

1214 FSR TRAVEL SUPPORT OF CLIN 1114 $3,049.50

1215 FSR TRAVEL SUPPORT OF CLIN 1115 $1,666.80

1216 FSR TRAVEL SUPPORT OF CLIN 1116 $4,020.00

1217 FSR TRAVEL SUPPORT OF CLIN 1117 $3,049.50

1218 FSR TRAVEL SUPPORT OF CLIN 1118 $1,666.80

1300AA PROGRAM MANAGEMENT START OF WORK $40,894.01

1300AB PROGRAM MANAGEMENT MONTH 1 $57,306.76

1300AC PROGRAM MANAGEMENT MONTH 2 $57,306.76

1300AD PROGRAM MANAGEMENT MONTH 3 $57,306.76

1300AE PROGRAM MANAGEMENT MONTH 4 $57,306.76

1300AF PROGRAM MANAGEMENT MONTH 5 $57,306.75

1300AG PROGRAM MANAGEMENT MONTH 6 $57,306.75

1300AH PROGRAM MANAGEMENT MONTH 7 $57,306.75

1300AJ PROGRAM MANAGEMENT MONTH 8 $57,306.75

1300AK PROGRAM MANAGEMENT MONTH 9 $57,306.75

1300AL PROGRAM MANAGEMENT MONTH 10 $57,306.75

A001 MILESTONE SCHEDULE $46,676.44

A002 MEETING AGENDA NSP

A003 RECORD OF MEETING MINUTES NSP

A004 TYPE I&II FIXED AND FLOAT BOM $16,496.09

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W56HZV-21-C-0097

P00003

ACROW CORP OF AMERICA

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

A009 TYPE I & II PLANS AND REPORTS $4,124.02

A010 COMPLIANCE MATRIX $46,676.44

A011 TYPE I TEST READINESS REVIEW $2,474.41

A012 COMBINED PVT TEST READINESS $1,404.22

A013 CONFIGURATION AUDIT PLAN NSP

A014 CORROSION CONTROL PLAN $4,124.02

A015 FIXED PIER STRUCTURAL STRENGTH NSP

A016 CONTRACTOR PIER TEST PLANS NSP

A017 TEST INCIDENT REPORTS (TIR) $1,404.22

A018 REQUEST FOR DEVIATIONS $9,637.53

A019 CONTRACTOR PIER TEST RESULTS NSP

A020 FAILURE ANALYSIS REPORT $5,616.88

A024 PACKAGING REQUIREMENTS $6,251.31

A025 PRODUCT QUALITY PROGRAM PLAN $1,606.25

A026 NON-CONFORMANCE REPORT $9,637.53

A027 CERT OF TECH COMPLIANCE $1,606.25

TOTAL PRICE $907,983.26

SECTION J

3. CDRL attachment added to section J

CONCLUSION

4. The awarded amount on the contract is increased from $4,613,319.35 by $907,983.26 to $5,521,302.61.

5. All other terms and conditions, with the exception of this modification, are to remain in full force and effect.

*** END OF NARRATIVE A0005 ***

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W56HZV-21-C-0097

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

1201 FSR TRAVEL IN SUPPORT OF CLIN 1101 1 LO $ 8,768.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P20DN0742T PRON AMD: 01 ACRN: AS

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 31-OCT-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 31-OCT-2021

$ 8,768.50

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1202 FSR TRAVEL IN SUPPORT OF CLIN 1102 1 LO $ 7,468.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P20DN0742T PRON AMD: 01 ACRN: AS

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 31-OCT-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 31-OCT-2021

$ 7,468.50

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Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1203 FSR TRAVEL IN SUPPORT OF CLIN 1103 1 LO $ 14,143.00 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P20DN0742T PRON AMD: 01 ACRN: AS

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 31-OCT-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 31-OCT-2021

$ 14,143.00

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Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1204 FSR TRAVEL IN SUPPORT OF CLIN 1104 1 LO $ 13,406.00 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P20DN0742T PRON AMD: 01 ACRN: AS

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 31-OCT-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 31-OCT-2021

$ 13,406.00

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Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1205 FSR TRAVEL IN SUPPORT OF CLIN 1105 1 LO $ 6,209.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P20DN0742T PRON AMD: 01 ACRN: AS

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 31-OCT-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 31-OCT-2021

$ 6,209.50

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1206 FSR TRAVEL IN SUPPORT OF CLIN 1106 1 LO $ 7,004.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 7,004.50

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Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1207 FSR TRAVEL IN SUPPORT OF CLIN 1107 1 LO $ 34,989.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 34,989.50

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ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1208 FSR TRAVEL IN SUPPORT OF CLIN 1108 1 LO $ 9,821.00 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 9,821.00

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ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1209 FSR TRAVEL IN SUPPORT OF CLIN 1109 1 LO $ 1,736.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 1,736.50

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Reference No. of Document Being Continued

MOD/AMD

1210 FSR TRAVEL IN SUPPORT OF CLIN 1110 1 LO $ 7,016.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 7,016.50

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Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1211 FSR TRAVEL IN SUPPORT OF CLIN 1111 1 LO $ 6,714.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P20DN0742T PRON AMD: 01 ACRN: AS

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 31-OCT-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 31-OCT-2021

$ 6,714.50

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Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1212 FSR TRAVEL IN SUPPORT OF CLIN 1112 1 LO $ 1,535.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 1,535.50

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ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1213 FSR TRAVEL IN SUPPORT OF CLIN 1113 1 LO $ 4,020.00 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 4,020.00

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Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1214 FSR TRAVEL IN SUPPORT OF CLIN 1114 1 LO $ 3,049.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 3,049.50

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1215 FSR TRAVEL IN SUPPORT OF CLIN 1115 1 LO $ 1,666.80 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 1,666.80

18 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1216 FSR TRAVEL IN SUPPORT OF CLIN 1116 1 LO $ 4,020.00 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 4,020.00

19 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1217 FSR TRAVEL IN SUPPORT OF CLIN 1117 1 LO $ 3,049.50 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0382T PRON AMD: 01 ACRN: AT

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 3,049.50

20 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1218 FSR TRAVEL IN SUPPORT OF CLIN 1118 1 LO $ 1,666.80 __________________________________ __________________

SERVICE REQUESTED: Acrow Travel Support

PSC: R425

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P20DN0742T PRON AMD: 01 ACRN: AS

IAW C.1.3.4 and C.1.3.4.1.

(End of narrative C001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 31-OCT-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 31-OCT-2021

$ 1,666.80

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Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300 PROGRAM MANAGEMENT

1300AA PROGRAM MANAGEMENT START OF WORK MEETING 1 LO $ 40,894.01 ________________________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 31-OCT-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 31-OCT-2021

$ 40,894.01

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Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AB PROGRAM MANAGEMENT MONTH 1 1 LO $ 57,306.76 __________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 01-NOV-2021

End Date: 30-NOV-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-NOV-2021

$ 57,306.76

23 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AC PROGRAM MANAGEMENT MONTH 2 1 LO $ 57,306.76 __________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 01-DEC-2021

End Date: 30-DEC-2021

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-DEC-2021

$ 57,306.76

24 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AD PROGRAM MANAGEMENT MONTH 3 1 LO $ 57,306.76 __________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 31-DEC-2021

End Date: 30-JAN-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-JAN-2022

$ 57,306.76

25 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AE PROGRAM MANAGEMENT MONTH 4 1 LO $ 57,306.76 __________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 31-JAN-2022

End Date: 28-FEB-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 28-FEB-2022

$ 57,306.76

26 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AF PROGRAM MANAGEMENT MONTH 5 1 LO $ 57,306.75 __________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 01-MAR-2022

End Date: 30-MAR-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-MAR-2022

$ 57,306.75

27 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AG PROGRAM MANAGEMENT MONTH 6 1 LO $ 57,306.75 __________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 31-MAR-2022

End Date: 30-APR-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-APR-2022

$ 57,306.75

28 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AH PROGRAM MANAGEMENT MONTH 7 1 LO $ 57,306.75 __________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 01-MAY-2022

End Date: 30-MAY-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-MAY-2022

$ 57,306.75

29 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AJ PROGRAM MANAGEMENT MONTH 8 1 LO $ 57,306.75 __________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 31-MAY-2022

End Date: 30-JUN-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-JUN-2022

$ 57,306.75

30 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AK PROGRAM MANAGEMENT MONTH 9 1 LO $ 57,306.75 __________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 01-JUL-2022

End Date: 30-JUL-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-JUL-2022

$ 57,306.75

31 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

1300AL PROGRAM MANAGEMENT MONTH 10 1 LO $ 57,306.75 ___________________________ __________________

SERVICE REQUESTED: PROGRAM MANAGEMENT

CLIN CONTRACT TYPE:

Firm Fixed Price

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

PSC: R425

To be performed IAW Section C.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 31-JUL-2022

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 57,306.75

32 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

5000 BASIC CLIN FOR ELIN ___________________

A001 SERVICE DATA ITEM - PRICED 1 LO $ 46,676.44 __________________________ __________________

SERVICE REQUESTED: MILESTONE SCHEDULE

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.1.2 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 46,676.44

33 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A002 MEETING AGENDA 1 LO $ ** NSP ** ______________ __________________

SERVICE REQUESTED: MEETING AGENDA

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

To be performed IAW C.1.2 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 SEE DD FORM 1423

34 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A003 RECORD OF MEETING MINUTES 1 LO $ ** NSP ** _________________________ __________________

SERVICE REQUESTED: RECORD OF MEETING MINUTES

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

To be performed IAW C.1.3.1, C.1.3.1.1, and C.4.3.1 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 SEE DD FORM 1423

35 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A004 SERVICE DATA ITEM - PRICED 1 LO $ 16,496.09 __________________________ __________________

SERVICE REQUESTED: TYPE I&II FIXED AND FLOAT BOM

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.2.1, C.2.2, and C.4.2.3 of the

Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 16,496.09

36 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A009 SERVICE DATA ITEM - PRICED 1 LO $ 4,124.02 __________________________ __________________

SERVICE REQUESTED: TYPE I & II PLANS AND REPORTS

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.3.3.1.3, C.4.2.6, and C.4.2.8 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 4,124.02

37 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A010 SERVICE DATA ITEM - PRICED 1 LO $ 46,676.44 __________________________ __________________

SERVICE REQUESTED: COMPLIANCE MATRIX

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.3.4 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 46,676.44

38 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A011 SERVICE DATA ITEM - PRICED 1 LO $ 2,474.41 __________________________ __________________

SERVICE REQUESTED: TYPE I TEST READINESS REVIEW

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.4.1.1.1 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 2,474.41

39 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A012 SERVICE DATA ITEM - PRICED 1 LO $ 1,404.22 __________________________ __________________

SERVICE REQUESTED: COMBINED PVT TEST READINESS

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.4.2.1.1 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 1,404.22

40 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A013 CONFIGURATION AUDIT PLAN 1 LO $ ** NSP ** ________________________ __________________

SERVICE REQUESTED: PHYSICAL CONFIGURATION AUDIT

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

To be performed IAW C.4.2.3 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 SEE DD FORM 1423

41 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A014 SERVICE DATA ITEM - PRICED 1 LO $ 4,124.02 __________________________ __________________

SERVICE REQUESTED: CORROSION CONTROL PLAN

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.4.2.7.1 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 4,124.02

42 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A015 TECHNICAL REVIEW SUMMARY REPORT 1 LO $ ** NSP ** _______________________________ __________________

SERVICE REQUESTED: FIXED PIER STRUCTUAL STRENGTH

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

To be performed IAW C.4.2.7.1 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 SEE DD FORM 1423

43 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A016 TYPE I&II FIXED PIER STUCTURAL 1 LO $ ** NSP ** ______________________________ __________________

SERVICE REQUESTED: CONTRACTOR TEST PLANS

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

To be performed IAW C.4.3.1 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 SEE DD FORM 1423

44 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A017 SERVICE DATA ITEM - PRICED 1 LO $ 1,404.22 __________________________ __________________

SERVICE REQUESTED: TEST INCIDENT REPORTS (TIR)

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.4.3.1 of the Scope and E.6.1.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 1,404.22

45 57

W56HZV-21-C-0097

Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A018 SERVICE DATA ITEM - PRICED 1 LO $ 9,637.53 __________________________ __________________

SERVICE REQUESTED: REQUEST FOR DEVIATIONS

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.4.3.1 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 9,637.53

46 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A019 TYPE I&II FIXED PIER STUCTURAL 1 LO $ ** NSP ** ______________________________ __________________

SERVICE REQUESTED: CONTRACTOR TEST RESULTS

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

To be performed IAW C.4.3.1 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 SEE DD FORM 1423

47 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A020 SERVICE DATA ITEM - PRICED 1 LO $ 5,616.88 __________________________ __________________

SERVICE REQUESTED: FAILURE ANALYSIS REPORT

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW C.4.4.1 of the Scope.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 5,616.88

48 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A024 SERVICE DATA ITEM - PRICED 1 LO $ 6,251.31 __________________________ __________________

SERVICE REQUESTED: PACKAGING REQUIREMENTS

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW Section D.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 6,251.31

49 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A025 SERVICE DATA ITEM - PRICED 1 LO $ 1,606.25 __________________________ __________________

SERVICE REQUESTED: PRODUCT QUALITY PROGRAM PLAN

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW Section E.4.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 1,606.25

50 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A026 SERVICE DATA ITEM - PRICED 1 LO $ 9,637.53 __________________________ __________________

SERVICE REQUESTED: NON-CONFORMANCE REPORT

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW Section E.6.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 9,637.53

51 57

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Page of

Name of Offeror or Contractor:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

Reference No. of Document Being Continued

MOD/AMD

A027 SERVICE DATA ITEM - PRICED 1 LO $ 1,606.25 __________________________ __________________

SERVICE REQUESTED: CERT OF TECH COMPLIANCE

CLIN CONTRACT TYPE:

Firm Fixed Price

PSC: R425

PRON: P21DN0392T PRON AMD: 05 ACRN: AU

To be performed IAW E.9.1.

(End of narrative B001)

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

Deliveries or Performance _________________________

Period of Performance

Start Date: 24-SEP-2021

End Date: 30-AUG-2022

DLVR SCH PERF COMPL

REL CD QUANTITY DATE ________ ______________ __________

001 1 30-AUG-2022

$ 1,606.25

52 57

W56HZV-21-C-0097

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION G - CONTRACT ADMINISTRATION DATA

PRON/ PRON/

AMS CD/ AMS CD/

LINE MIPR/ OBLG JO NO/ INCREASE/ CUMULATIVELINE MIPR/ OBLG JO NO/ INCREASE/ CUMULATIVE

ITEM GFEBS ATA STAT ACCT ASSIGN ACRN PRIOR AMOUNT DECREASE AMOUNTITEM GFEBS ATA STAT ACCT ASSIGN ACRN PRIOR AMOUNT DECREASE AMOUNT_____ _________ _____ ___________ ____ ____________ __________ ________________ _________ _____ ___________ ____ ____________ __________ ___________

1201 P20DN0742T 2 A.0043964.4.1.7.6 AS $ 0.00 $ 8,768.50 $ 8,768.50

1202 P20DN0742T 2 A.0043964.4.1.7.6 AS $ 0.00 $ 7,468.50 $ 7,468.50

1203 P20DN0742T 2 A.0043964.4.1.7.6 AS $ 0.00 $ 14,143.00 $ 14,143.00

1204 P20DN0742T 2 A.0043964.4.1.7.6 AS $ 0.00 $ 13,406.00 $ 13,406.00

1205 P20DN0742T 2 A.0043964.4.1.7.6 AS $ 0.00 $ 6,209.50 $ 6,209.50

1206 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 7,004.50 $ 7,004.50

1207 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 34,989.50 $ 34,989.50

1208 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 9,821.00 $ 9,821.00

1209 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 1,736.50 $ 1,736.50

1210 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 7,016.50 $ 7,016.50

1211 P20DN0742T 2 A.0043964.4.1.7.6 AS $ 0.00 $ 6,714.50 $ 6,714.50

1212 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 1,535.50 $ 1,535.50

1213 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 4,020.00 $ 4,020.00

1214 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 3,049.50 $ 3,049.50

1215 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 1,666.80 $ 1,666.80

1216 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 4,020.00 $ 4,020.00

1217 P21DN0382T 2 A.0048673.4.1.7.7 AT $ 0.00 $ 3,049.50 $ 3,049.50

1218 P20DN0742T 2 A.0043964.4.1.7.6 AS $ 0.00 $ 1,666.80 $ 1,666.80

1300AA P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 40,894.01 $ 40,894.01

1300AB P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.76 $ 57,306.76

53 57

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Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

PRON/ PRON/

AMS CD/ AMS CD/

LINE MIPR/ OBLG JO NO/ INCREASE/ CUMULATIVELINE MIPR/ OBLG JO NO/ INCREASE/ CUMULATIVE

ITEM GFEBS ATA STAT ACCT ASSIGN ACRN PRIOR AMOUNT DECREASE AMOUNTITEM GFEBS ATA STAT ACCT ASSIGN ACRN PRIOR AMOUNT DECREASE AMOUNT_____ _________ _____ ___________ ____ ____________ __________ ________________ _________ _____ ___________ ____ ____________ __________ ___________

1300AC P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.76 $ 57,306.76

1300AD P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.76 $ 57,306.76

1300AE P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.76 $ 57,306.76

1300AF P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.75 $ 57,306.75

1300AG P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.75 $ 57,306.75

1300AH P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.75 $ 57,306.75

1300AJ P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.75 $ 57,306.75

1300AK P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.75 $ 57,306.75

1300AL P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 57,306.75 $ 57,306.75

A001 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 46,676.44 $ 46,676.44

A004 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 16,496.09 $ 16,496.09

A009 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 4,124.02 $ 4,124.02

A010 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 46,676.44 $ 46,676.44

A011 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 2,474.41 $ 2,474.41

A012 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 1,404.22 $ 1,404.22

A014 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 4,124.02 $ 4,124.02

A017 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 1,404.22 $ 1,404.22

A018 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 9,637.53 $ 9,637.53

A020 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 5,616.88 $ 5,616.88

A024 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 6,251.31 $ 6,251.31

54 57

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Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

PRON/ PRON/

AMS CD/ AMS CD/

LINE MIPR/ OBLG JO NO/ INCREASE/ CUMULATIVELINE MIPR/ OBLG JO NO/ INCREASE/ CUMULATIVE

ITEM GFEBS ATA STAT ACCT ASSIGN ACRN PRIOR AMOUNT DECREASE AMOUNTITEM GFEBS ATA STAT ACCT ASSIGN ACRN PRIOR AMOUNT DECREASE AMOUNT_____ _________ _____ ___________ ____ ____________ __________ ________________ _________ _____ ___________ ____ ____________ __________ ___________

A025 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 1,606.25 $ 1,606.25

A026 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 9,637.53 $ 9,637.53

A027 P21DN0392T 2 A.0048673.4.1.7.7 AU $ 0.00 $ 1,606.25 $ 1,606.25

NET CHANGE $ 907,983.26

INCREASE/ INCREASE/

ACRN ACCOUNTING CLASSIFICATION DECREASEACRN ACCOUNTING CLASSIFICATION DECREASE____ _________________________ ______________ _________________________ __________

AS 021 202020212040 A5XDN 654804H02RF01 3101 L073501411 A.0043964.4.1.7.6 021001 $ 58,376.80

AT 021 202120222040 A5XDN 654804H02RF01 252G L073501688 A.0048673.4.1.7.7 021001 $ 77,909.30

AU 021 202120222040 A5XDN 654804H02RF01 252G L073501692 A.0048673.4.1.7.7 021001 $ 771,697.16 __________________

NET CHANGE $ 907,983.26

PRIOR AMOUNT INCREASE/DECREASE CUMULATIVE PRIOR AMOUNT INCREASE/DECREASE CUMULATIVE

OF AWARD AMOUNT OBLIG AMT OF AWARD AMOUNT OBLIG AMT _____________ __________________ ___________ _____________ __________________ ___________

NET CHANGE FOR AWARD: $ 4,613,319.35 $ 907,983.26 $ 5,521,302.61

LINELINE

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

1201 AS 021 202020212040 A5XDN 654804H02RF01 3101 L073501411 A.0043964.4.1.7.6 021001

1202 AS 021 202020212040 A5XDN 654804H02RF01 3101 L073501411 A.0043964.4.1.7.6 021001

1203 AS 021 202020212040 A5XDN 654804H02RF01 3101 L073501411 A.0043964.4.1.7.6 021001

1204 AS 021 202020212040 A5XDN 654804H02RF01 3101 L073501411 A.0043964.4.1.7.6 021001

1205 AS 021 202020212040 A5XDN 654804H02RF01 3101 L073501411 A.0043964.4.1.7.6 021001

1206 AT 021 202120222040 A5XDN 654804H02RF01 252G L073501688 A.0048673.4.1.7.7 021001

1207 AT 021 202120222040 A5XDN 654804H02RF01 252G L073501688 A.0048673.4.1.7.7 021001

1208 AT 021 202120222040 A5XDN 654804H02RF01 252G L073501688 A.0048673.4.1.7.7 021001

1209 AT 021 202120222040 A5XDN 654804H02RF01 252G L073501688 A.0048673.4.1.7.7 021001

1210 AT 021 202120222040 A5XDN 654804H02RF01 252G L073501688 A.0048673.4.1.7.7 021001

1211 AS 021 202020212040 A5XDN 654804H02RF01 3101 L073501411 A.0043964.4.1.7.6 021001

1212 AT 021 202120222040 A5XDN 654804H02RF01 252G L073501688 A.0048673.4.1.7.7 021001

1213 AT 021 202120222040 A5XDN 654804H02RF01 252G…