W56HZV21R0068-0003.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

0003 2021MAR02

W56HZV

ACC-DTA

6501 E. 11 MILE RD.

DETROIT ARSENAL, MI 48397-5000

KATHY KESSLER

EMAIL: KATHY.A.KESSLER.CIV@MAIL.MIL

W56HZV-21-R-0068

2021MAR02

X

X

/SIGNED/

2 signed

SEE SECOND PAGE FOR DESCRIPTION

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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: KATHY KESSLER

Buyer Office Symbol/Telephone Number: CCTA-APS-A/(586)282-7228

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

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W56HZV-21-R-0068

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

0001AA DELETED _______

IN THE FOUR-DIGIT ITEM NUMBERS (CLINS) THAT FOLLOW,

THE NUMBERING SYSTEM THAT IS USED IS AS FOLLOWS:

THE FIRST THREE DIGITS SIGNIFY ITEM AND THE FOURTH

(LAST) DIGIT SIGNIFIES THE APPLICABLE ORDERING YEAR,

i.e., CLIN 0011 IS FOR THE FIRST ORDERING YEAR, CLIN

0012 IS FOR THE SECOND ORDERING YEAR, CLIN 0013 IS FOR

THE THIRD ORDERING YEAR, ETC.

THE FOLLOWING DEFINITIONS APPLY TO THE ENTIRE

SOLICITATION AND RESULTING CONTRACT:

FIRST ORDERING YEAR OF THE CONTRACT IS THE DATE OF

AWARD PLUS 364 DAYS.

SECOND ORDERING YEAR OF THE CONTRACT IS 365 DAYS

THROUGH 729 DAYS AFTER CONTRACT AWARD.

THIRD ORDERING YEAR OF THE CONTRACT IS 730 DAYS

THROUGH 1,094 DAYS AFTER CONTRACT AWARD.

OPTION 1: FOURTH ORDERING YEAR OF THE CONTRACT IS 1,095 DAYS

THROUGH 1,459 DAYS AFTER CONTRACT AWARD.

OPTION 2: FIFTH ORDERING YEAR OF THE CONTRACT IS 1,460 DAYS

THROUGH 1,824 DAYS AFTER CONTRACT AWARD.

*NOTE: THE PRICE APPLICABLE TO AN INDIVIDUAL ORDER IS

THE PRICE FOR THE ORDERING YEAR IN WHICH THE ORDER IS

ISSUED.

THE DELIVERY DATE DOES NOT DETERMINE THE

ORDERING YEAR.

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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

(End of narrative A001)

0001AB FIRST ARTICAL TEST (FAT) AND REPORT (FATR) $ $ __________________________________________ ______________ __________________

COMMODITY NAME: FIRST ARTICAL TEST (FAT)

FIRST ARTICLE TEST REPORT (FATR), PURSUANT TO THE

REQUIREMENTS OF FAR CLAUSE 52.209-3, "FIRST ARTICLE

APPROVAL - CONTRACTOR TESTING,"

(SEE SECTION I)

First Article Test Report (FATR) is due 180 days after award.

FATR approval/disapproval will be determined by the

Procurement Contracting Officer (PCO), who will be identified at time of award.

First Article Testing is broken into six separate parts as identified under section E, Narrative E001, Subsection E.4., First Article Testing. The offeror shall provide a price below for each part of the testing with the sum of the parts equaling the total

FAT price for CLIN 0001AA.

Part 1 - $______________

Part 2 - $______________

Part 3 - $______________

Part 4 - $_______________

Part 5 - $_______________

Part 6- $_______________

TOTAL FAT PRICE: $______________________

DO NOT ADD THIS PRICE IN WITH CLINS 0011-0015

(End of narrative B001)

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

DRAWING 5-77-3543

LEVEL PRESERVATION: Military

LEVEL PACKING: B

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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

Inspection and Acceptance _________________________

INSPECTION: Origin ACCEPTANCE: Destination

Deliveries or Performance _________________________

FOB POINT:

SHIP TO:

(Y00000) SHIPPING INSTRUCTIONS FOR CONSIGNEE

(SHIP-TO) WILL BE FURNISHED PRIOR

TO THE SCHEDULED DELIVERY DATE FOR

ITEMS REQUIRED UNDER THIS

REQUISITION.

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