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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

0001 2022NOV16

W56HZV

ACC-DTA

6501 E. 11 MILE RD.

DETROIT ARSENAL, MI 48397-5000

KATLYN M. MARCK

EMAIL: KATLYN.M.MARCK.CIV@ARMY.MIL

W56HZV-22-Q-0065

2022OCT28

X

X 2022DEC05 04:00pm

/SIGNED/

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

SUPPLEMENTAL INFORMATION

Buyer Name: KATLYN M. MARCK

Buyer Office Symbol/Telephone Number: CCTA-APS-C/(586)282-7225

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

This solicitation is intended to result in the award of a single Requirements contract for the estimated supplies specified. The resulting contract will establish pricing to be utilized through issuance of delivery orders for discrete quantities for the period stated in the schedule. The Government bears no responsibility to issue an initial minimum order upon base contract award. For further guidance related to a Requirements type contract, see FAR clause 52.216-21, Requirements.

1. This Request for Quote (RFQ), W56HZV-22-Q-0065, will result in a Firm Fixed Price 2-year Requirements Contract for the procurement of the following:

Noun NSN Part Number Estimated Quantity Each Year

COVER,ACCESS 2590-01-688-1638 12655912 19 EA

2. The Technical Data Package (TDP) is competitive and limited to DoD and US DoD Contractors only. Access to the TDP is restricted, requiring vendors to submit a request for access in SAM.gov. Access will be granted pending verification of the contractor's active registration in JCP. Section A, narrative A.04 DISTRIBUTION AND DESTRUCTION OF EXPORT CONTROL TECHNICAL DATA PACKAGE includes more information.

3. Packaging requirements are in accordance with Section D - PACKAGING AND MARKING, D.01 PACKAGING REQUIREMENTS

(SPECIFICATIONS/STANDARDS).

4. Interested Offerors shall submit a proposal via email to the Contract Specialist (katlyn.m.marck.civ@army.mil) and cc the corresponding Contracting Officer (valencia.d.lane.civ@army.mil) with the subject header: Proposal Submission - W56HZV-22-Q-0065

(company name). Once a proposal is received, the Contract Specialist/Contracting Officer will reply with the respective Offeror stating receipt of proposal submission.

*** END OF NARRATIVE A0001 ***

Amendment 0001 to Solicitation W56HZV-22-Q-0065

1. The purpose of this amendment 0001 is to revise the manufacturer part number in the following areas:

Section A - SUPPLEMENTAL INFORMATION, Narrative A0001, Part Number__________________________________________________________________

From: 104A0364

To: 12655912

SECTION B - SUPPLIES OR SERVICES AND PRICES/COSTS:__________________________________________________

CLIN 0011 and CLIN 0012:

FROM:

Mfr CAGE: 2X262

Mfr Part Number: 104A0364

TO:

Mfr CAGE: 19207

Mfr Part Number: 12655912

2. As a result of these revisions, the closing date is extended from 28 November 2022 to 05 December 2022.

3. Except as specifically provided in this amendment, all other terms and conditions remain unchanged and in full force and effect.

2 4

W56HZV-22-Q-0065

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

*** END OF NARRATIVE A0003 ***

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

SUPPLIES OR SERVICES AND PRICES/COSTS

0011 FIRST ORDERING YEAR EST 19 EA $ $ ___________________ ______________ __________________

NSN: 2590-01-688-1638

COMMODITY NAME: COVER,ACCESS

CLIN CONTRACT TYPE:

Firm Fixed Price

Mfr CAGE: 19207

Mfr Part Number: 12655912

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: TDP 12655912

DATE: 03-JUN-2021

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING CLAUSE

LEVEL PRESERVATION: Military

LEVEL PACKING: B

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

0012 SECOND ORDERING YEAR EST 19 EA $ $ ____________________ ______________ __________________

NSN: 2590-01-688-1638

COMMODITY NAME: COVER,ACCESS

CLIN CONTRACT TYPE:

Firm Fixed Price

Mfr CAGE: 19207

Mfr Part Number: 12655912

Description/Specs./Work Statement _________________________________

TOP DRAWING NR: TDP 12655912

DATE: 03-JUN-2021

Packaging and Marking _____________________

PACKAGING/PACKING/SPECIFICATIONS:

SEE PACKAGING CLAUSE

LEVEL PRESERVATION: Military

LEVEL PACKING: B

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

4 4

SUPPLEMENTAL INFORMATION
SUPPLIES OR SERVICES AND PRICES/COSTS

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