W58RGZ-17-R-0043_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

W58RGZ

ARMY CONTRACTING COMMAND-REDSTONE

REDSTONE ARSENAL AL 35898-5280

ASHLEY WILBOURN

EMAIL: ASHLEY.R.WILBOURN.CIV@MAIL.MIL

W58RGZ-17-R-0043

2017JUL21

X

X

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: ASHLEY WILBOURN

Buyer Office Symbol/Telephone Number: CCAM-CAD-D/(256)842-4771

Type of Contract 1: Firm Fixed Price

Type of Contract 2: Cost Plus Fixed Fee

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

A-1. The purpose of this amendment (0003) is for the following:

A-2. Update ELINs A004-A011, A015-A022, and A027-A028 to reflect the CLIN Contract Type of Firm Fixed Price.

A-3. Except as provided herein, all other terms and conditions remain in full effect.

*** END OF NARRATIVE A0004 ***

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W58RGZ-17-R-0043 0003

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

0007 CONTRACT DATA REQUIREMENTS LIST (CDRLS) _______________________________________

A001 TEST PLAN $ ** NSP ** _________ __________________

SERVICE REQUESTED: CDRL A001

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A002 TEST/INSPECTION REPORT $ ** NSP ** ______________________ __________________

SERVICE REQUESTED: CDRL A002

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A003 SPECIFICATION REQUIREMENT VERIFICATION MATRIX $ ** NSP ** _____________________________________________ __________________

SERVICE REQUESTED: CDRL A003

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A004 REPORT, RECORD OF MEETING/MINUTES $ ** NSP ** _________________________________ __________________

SERVICE REQUESTED: CDRL A004

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

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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

A005 CONTRACTOR VALIDATION PLAN $ ** NSP ** __________________________ __________________

SERVICE REQUESTED: CDRL A005

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A006 TEST PROCEDURE - ACCEPTANCE TEST PROCEDURES $ ** NSP ** ___________________________________________ __________________

SERVICE REQUESTED: CDRL A006

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A007 FIRST ARTICLE QUALIFICATION TEST PLAN AND _________________________________________

PROCEDURES $ ** NSP ** __________ __________________

SERVICE REQUESTED: CDRL A007

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A008 TEST/INSPECTION REPORT - FIRST ARTICLE TEST (FAT) _________________________________________________

REPORT $ ** NSP ** ______ __________________

SERVICE REQUESTED: CDRL A008

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A009 TEST PLAN - RE-QUALIFICATION PLAN $ ** NSP ** _________________________________ __________________

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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

SERVICE REQUESTED: CDRL A009

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A010 TEST/INSPECTION REPORT - RE-QUALIFICATION REPORT $ ** NSP ** ________________________________________________ __________________

SERVICE REQUESTED: CDRL A010

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A011 LEAD FREE CONTROL PLAN (LFCP) $ ** NSP ** _____________________________ __________________

SERVICE REQUESTED: CDRL A011

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A012 ENGINEERING CHANGE PROPOSAL (ECP) $ ** NSP ** _________________________________ __________________

SERVICE REQUESTED: CDRL A012

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A013 NOTICE OF REVISION (NOR) $ ** NSP ** ________________________ __________________

SERVICE REQUESTED: CDRL A013

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

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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: Destination ACCEPTANCE: Destination

A014 ENGINEERING RELEASE RECORD (ERR) $ ** NSP ** ________________________________ __________________

SERVICE REQUESTED: CDRL A014

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A015 TECHNICAL REPORT - STUDY/SERVICES $ ** NSP ** _________________________________ __________________

SERVICE REQUESTED: CDRL A015

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A016 CONFIGURATION AUDIT SUMMARY REPORT AND ______________________________________

CERTIFICATION $ ** NSP ** _____________ __________________

SERVICE REQUESTED: CDRL A016

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A017 PERFORMANCE ORIENTED PACKAGING TEST REPORT $ ** NSP ** __________________________________________ __________________

SERVICE REQUESTED: CDRL A017

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A018 TECHINCAL REPORT - STUDY/SERVICES - SHIPPING ____________________________________________

REPORT $ ** NSP ** ______ __________________

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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

SERVICE REQUESTED: CDRL A018

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A019 LOGISTICS PRODUCT DATA $ ** NSP ** ______________________ __________________

SERVICE REQUESTED: CDRL A019

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A020 ENGINEERING DATA FOR PROVISIONING (EDFP) $ ** NSP ** ________________________________________ __________________

SERVICE REQUESTED: CDRL A020

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A021 COTS MANUALS AND ASSOCIATED SUPPLEMENTAL DATA $ ** NSP ** _____________________________________________ __________________

SERVICE REQUESTED: CDRL A021

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A022 VALIDATION REPORT $ ** NSP ** _________________ __________________

SERVICE REQUESTED: CDRL A022

CLIN CONTRACT TYPE:

Firm Fixed Price

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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: Destination ACCEPTANCE: Destination

A023 GOVERNMENT FURNISHED EQUIPMENT REPAIR STATUS ____________________________________________

REPORT $ ** NSP ** ______ __________________

SERVICE REQUESTED: CDRL A023

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A024 SAFETY ASSESSMENT REPORT (SAR) $ ** NSP ** ______________________________ __________________

SERVICE REQUESTED: CDRL A024

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A025 SYSTEM SAFETY HAZARD ANALYSIS REPORT (SSHAR) $ ** NSP ** ____________________________________________ __________________

SERVICE REQUESTED: CDRL A025

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A026 HEALTH HAZARD ASSESSMENT REPORT (HHAR) $ ** NSP ** ______________________________________ __________________

SERVICE REQUESTED: CDRL A026

CLIN CONTRACT TYPE:

Cost Plus Fixed Fee

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

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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 SCIENTIFIC AND TECHNICAL REPORT $ ** NSP ** _______________________________ __________________

SERVICE REQUESTED: CDRL A027

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

A028 HAZARDOUS MATERIALS MANAGEMENT PROGRAM (HMMP) _____________________________________________

REPORT $ ** NSP ** ______ __________________

SERVICE REQUESTED: CDRL A028

CLIN CONTRACT TYPE:

Firm Fixed Price

Inspection and Acceptance _________________________

INSPECTION: Destination ACCEPTANCE: Destination

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