W911RX-24-A-0001 Redacted.pdf

25. TOTAL

ENVISION XPRESS I NC

TIM BROCK

2301 S WATER ST

WICHI TA KS 67213-4819

CODE 3BLJ3

17. ACCOUNT ING AND APPROPRIAT ION DATA/ LOCAL USE

36. I cert ify t his account is cor rect and proper for payment.

6. ISSUED BY CODE

9. CONTRACTOR

CODE

18. IT EM NO. 19. SCHEDULE OF SUPPLIES/ SERVICES

26. QUANTITY IN COLUMN 20 HAS BEEN

SIGNAT URE OF AUTHORIZED GOVT. REP.DAT E

DATE SIGNATURE AND TIT LE OF CERTIFYING OFFICER

INSPECT ED RECEIVED ACCEPTED, AND CONFORMS T O THE

CONTRACT EXCEPT AS NOTED

37. RECEIVED AT 38. RECEIVED BY 39. DAT E RECEIVED

(Y YY Y MMMDD )

W911RX24A0001

1. CO NTRA CT/ P URCH. ORD ER/

A G REEMEN T N O .

* If quanti ty acce pted by the Gov ernm ent is sam e as quanti ty acce pted below quanti ty ordere d and enci rcle .

DELIVERY/16.

14. SHIP TO

W911RX

DD Form 1155, JAN 1998 (EG) PREVIOUS EDITION MAY BE USED.

SEE SCHEDULE

2. D ELIVERY O RDER/ CALL NO .

8PAGE 1 OF

5. P RIO RITY

CODE

8. DELIVERY FOB

DEST

OT HER

(See Schedule if other)

MA RK IF BUSINESS IS11.

SMALL

SMALL

D ISA DVA NTA G ED

WO MEN -O WN ED

HQ0490

MARK ALL

PACKAGES AND

PAPERS WITH

IDENTIFICATION

NUMBERS IN

BLOCKS 1 AND 2.

23. AMOUNT

27. SHIP NO. 28. DO VOUCHER NO.

PART IAL

FINAL

32. PAID BY 33. AMOUNT VERIFIED

CORRECT FOR

31. PAYMENT

COMPLETE

34. CHECK NUMBER

PART IAL

FINAL 35. BILL OF LADING NO.

40.T OTAL

CONTAINERS

41. S/R ACCOUNT NO. 42. S/R VOUCHER NO.

ORDER FOR SUPPLIES OR SERVICES

3. D ATE OF ORD ER/ CALL

2024 Sep 26

4. REQ ./ PU RCH. REQ UEST NO .

SEE ITEM 6

FACILIT Y 3BLJ3 10. D ELIVER TO FOB P OINT BY (D ate )

SEE SCHEDULE

12. D ISCO UN T TERMS

NET 30 Days

13. MAIL INVOICES TO THE ADDRESS IN BLOCK

See Item 15

15. PAYMENT WILL BE MADE BY CODE

DFAS - INDI ANAPOLI S CENTER

DFAS-IN , VP GFEBS 8899 E. 56TH ST.

I NDIANAPOLIS IN 46249-3800

This del ivery order/ cal l is iss ued on anot her Govt . agenc y or i n accordanc e w it h a nd subj ect t o t erms and condit ions of above numbere d cont rac t.

TYPE CALL

OF PURCHASE

ORDER

SEE SCHEDULE

X

7. ADMINISTERED BY

MI CC - FORT R ILEY (923RD CBN)

1792 12TH STREET

FORT R ILEY KS 66442

24. UNITED STATES OF AMERICA

CONTRACTING / ORDERING OFFICER

quanti ty order ed, indi cate by X. If dif fer ent, enter act ual

BY:RONALD L. KABAT

1If this box is marked, supplier must sign Acceptance and return the following number of copies:X

NAME OF CONTRACTOR SIGNAT URE TYPED NAME AND TIT LE

(YY Y YMMMD D )

DATE SIGNED

ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPT S THE OFFER REPRESENT ED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF T HE T ERMS

AND CONDIT IONS SET FORT H AND AGREES TO PERFORM THE SAME.

Reference your quote dat ed

Furnis h t he foll owi ng on te rms speci fi ed he rei n. REF:

20. QUANTIT Y

ORDERED/

ACCEPTED*

21. UNIT 22. UNIT PRICE

D IFFERENCES

29.

30.

INITIALS

Timothy J. Brock Purchasing and Contracts Manager 2024SEP26Envision Xpress, Inc.

W911RX24A0001

Section B - Supplies or Services and Prices

BPA Master Dollar Limit: $1,800,000.00 BPA Call Limit: $300,000.00

Period of Performance: 26-Sep-2024 to 25-Sep-2028

PSC Codes:

Section G - Contract Administration Data

CLAUSES INCORPORATED BY REFERENCE

252.232-7003 Electronic Submission of Payment Requests and Receiving

Reports

DEC 2018

Section I - Contract Clauses

52.203-3 Gratuities APR 1984 52.203-10 Price Or Fee Adjustment For Illegal Or Improper Activity MAY 2014 52.204-13 System for Award Management Maintenance OCT 2018 52.204-18 Commercial and Government Entity Code Maintenance AUG 2020 52.204-19 Incorporation by Reference of Representations and

Certifications.

DEC 2014

52.204-27 Prohibition on a ByteDance Covered Application JUN 2023 52.219-8 Utilization of Small Business Concerns FEB 2024 52.219-9 Small Business Subcontracting Plan SEP 2023 52.219-16 Liquidated Damages-Subcontracting Plan SEP 2021 52.223-5 Pollution Prevention and Right-to-Know Information MAY 2024 52.228-5 Insurance - Work On A Government Installation JAN 1997 52.242-5 Payments to Small Business Subcontractors JAN 2017 52.244-5 Competition In Subcontracting AUG 2024 52.252-2 Clauses Incorporated By Reference FEB 1998 252.203-7000 Requirements Relating to Compensation of Former DoD

Officials

SEP 2011

252.203-7002 Requirement to Inform Employees of Whistleblower Rights DEC 2022 252.204-7012 Safeguarding Covered Defense Information and Cyber

Incident Reporting

MAY 2024

252.204-7015 Notice of Authorized Disclosure of Information for Litigation Support

JAN 2023

252.204-7018 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services

JAN 2023

252.205-7000 Provision Of Information To Cooperative Agreement Holders JUN 2023 252.219-7003 Alt I Small Business Subcontracting Plan (DoD Contracts)(DEC

2019) Alternate I

DEC 2019

252.223-7008 Prohibition of Hexavalent Chromium JAN 2023 252.225-7001 Buy American and Balance of Payments Program FEB 2024 252.225-7002 Qualifying Country Sources As Subcontractors MAR 2022 252.225-7012 Preference For Certain Domestic Commodities APR 2022 252.225-7048 Export-Controlled Items JUN 2013 252.225-7056 Prohibition Regarding Business Operations with the Maduro

Regime

JAN 2023

252.225-7060 Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region

JUN 2023

252.226-7001 Utilization of Indian Organizations, Indian-Owned Economic Enterprises, and Native Hawaiian Small Business Concerns

JAN 2023

252.232-7010 Levies on Contract Payments DEC 2006 252.243-7001 Pricing Of Contract Modifications DEC 1991 252.243-7002 Requests for Equitable Adjustment DEC 2022 252.244-7000 Subcontracts for Commercial Products or Commercial

Services

NOV 2023

CLAUSES INCORPORATED BY FULL TEXT

252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (JAN 2023)

(a) Definitions. As used in this clause—

“Department of Defense Activity Address Code (DoDAAC)” is a six position code that uniquely identifies a unit, activity, or organization.

“Document type” means the type of payment request or receiving report available for creation in Wide Area WorkFlow (WAWF).

“Local processing office (LPO)” is the office responsible for payment certification when payment certification is done external to the entitlement system.

“Payment request” and “receiving report” are defined in the clause at 252.232-7003, Electronic Submission of Payment Requests and Receiving Reports.

(b) Electronic invoicing. The WAWF system provides the method to electronically process vendor payment requests and receiving reports, as authorized by Defense Federal Acquisition Regulation Supplement (DFARS) 252.232- 7003, Electronic Submission of Payment Requests and Receiving Reports.

(c) WAWF access. To access WAWF, the Contractor shall—

(1) Have a designated electronic business point of contact in the System for Award Management at https://www.sam.gov; and

(2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registration available at this web site.

(d) WAWF training. The Contractor should follow the training instructions of the WAWF Web-Based Training Course and use the Practice Training Site before submitting payment requests through WAWF. Both can be accessed by selecting the “Web Based Training” link on the WAWF home page at https://wawf.eb.mil/.

(e) WAWF methods of document submission. Document submissions may be via web entry, Electronic Data Interchange, or File Transfer Protocol.

(f) WAWF payment instructions. The Contractor shall use the following information when submitting payment requests and receiving reports in WAWF for this contract or task or delivery order:

(1) Document type. The Contractor shall submit payment requests using the following document type(s):

(i) For cost-type line items, including labor-hour or time-and-materials, submit a cost voucher.

(ii) For fixed price line items—

(A) That require shipment of a deliverable, submit the invoice and receiving report specified by the Contracting Officer.

(B) For services that do not require shipment of a deliverable, submit either the Invoice 2in1, which meets the requirements for the invoice and receiving report, or the applicable invoice and receiving report, as specified by the Contracting Officer.

“Invoice 2in1”

(iii) For customary progress payments based on costs incurred, submit a progress payment request.

(iv) For performance based payments, submit a performance based payment request.

Section K - Representations, Certifications and Other Statements of Offerors

52.209-7 Information Regarding Responsibility Matters OCT 2018 52.229-11 Tax on Certain Foreign Procurements--Notice and

Representation

JUN 2020

252.203-7005 Representation Relating to Compensation of Former DoD Officials

SEP 2022

252.204-7017 Prohibition on the Acquisition of Covered Defense Telecommunications Equipment or Services -- Representation

MAY 2021

252.225-7000 Buy American--Balance Of Payments Program Certificate FEB 2024 252.225-7055 Representation Regarding Business Operations with the

Maduro Regime

MAY 2022

252.225-7059 Prohibition on Certain Procurements from the Xinjiang Uyghur Autonomous Region - Representation

JUN 2023

Section L - Instructions, Conditions and Notices to Bidders

52.201-1 Acquisition 360: Voluntary Survey SEP 2023 52.204-7 System for Award Management OCT 2018 52.204-16 Commercial and Government Entity Code Reporting AUG 2020 252.204-7024 Notice on the Use of the Supplier Performance Risk System MAR 2023 252.215-7007 Notice of Intent to Resolicit JUN 2012