W912CH24R0036-0004.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

0004 2025JUN05

W912CH

ACC-DTA

6501 E. 11 MILE RD.

DETROIT ARSENAL, MI 48397-5000

JUSTINE BROUGHTON

EMAIL: JUSTINE.R.BROUGHTON.CIV@ARMY.MIL

W912CH-24-R-0036

2025APR14

X

X

/SIGNED/

2 signed

SEE SECOND PAGE FOR DESCRIPTION

1 3

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: JUSTINE BROUGHTON

Buyer Office Symbol/Telephone Number: CCTA-APS-B/(586)282-7504

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

SOLICITATION: W912CH-24-R-0036

AMENDMENT: 0004

1. The purpose of this amendment is to:

SECTION J:

Change CDRL A004 TEST PROCEDURE to add 14. DISTRIBUTATION: A. ADDRESSEE: HYPERLINK "mailto:usarmy.detroit.ccdc-gvsc.mbx.sidm-team-mailbox@army.mil"usarmy.detroit.ccdc-gvsc.mbx.sidm-team-mailbox@army.mil, Scott L. Follen, Contracting Officer, HYPERLINK

"mailto:scott.l.follen2.civ@army.mil"scott.l.follen2.civ@army.mil and Justine R. Broughton, Contract Specialist, Justine.r.broughton.civ@army.mil

Change CDRL A005 TEST/INSPECTION REPORT to add 14. DISTRIBUTATION: A. ADDRESSEE: HYPERLINK "mailto:usarmy.detroit.ccdc-gvsc.mbx.sidm-team-mailbox@army.mil"usarmy.detroit.ccdc-gvsc.mbx.sidm-team-mailbox@army.mil, Scott L. Follen, Contracting Officer, HYPERLINK

"mailto:scott.l.follen2.civ@army.mil"scott.l.follen2.civ@army.mil and Justine R. Broughton, Contract Specialist, Justine.r.broughton.civ@army.mil

2. All other terms and conditions, except for those addressed above, remain unchanged and are in full force and affect.

*** END OF NARRATIVE A0005 ***

2 3

W912CH-24-R-0036

CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION J - LIST OF ATTACHMENTS

List of Number List of Number

Addenda Title Date of Pages Transmitted By Addenda Title Date of Pages Transmitted By________________ ____________________________________________________________ _______________ ____________ _______________________________ ____________________________________________________________ _______________ ____________ _______________

Exhibit A CONTRACT DATA REQUIREMENTS LIST 01-FEB-2001 004 DATA

3 3

PIIN/SIIN

MOD/AMD

ATT/EXH ID

PAGE

Exhibit A

DD FORM 1423, FEB 2001

CONTRACT DATA REQUIREMENT LIST, PREVIOUS EDITION MAY BE USED Form Approval OMB No. 0704-0188

The public reporting burden for this collection of information is estimated to average 110 hours per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to Department of Defense, Executive Services Directorate (0704-0188). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number. Please do not return your form to the above organization. Send completed form to the Government Issuing Contracting Officer for the Contract/PR No. listed in Block E.

A. CONTRACT LINE ITEM NO.:

B. EXHIBIT:

C. CATEGORY:

TDP _X_ TM ____ OTHER ____

D. SYSTEM/ITEM:

E. CONTRACT/PR NO.:

F. CONTRACTOR:

1. DATA ITEM NO: A001

2. TITLE: ENGINEERING CHANGE PROPOSAL (ECP)

3. SUBTITLE: N/A

4. AUTHORITY: DI-SESS-80639E

5. CONTRACT REFERENCE: SECTION C

6. REQUIRING OFFICE:

7. DD250 REQ: LT

8. APP CODE: N/A

9. DIST. STATEMENT REQ: SEE ITEM 16

10. FREQUENCY: ASREQ

11. AS OF DATE: N/A

12. DATE OF FIRST SUBMISSION: ASREQ

13. DATE OF SUBS. SUBMISSION: ASREQ

14. DISTRIBUTION: SEE ITEM 16

A. ADDRESSEE:

B. COPIES:

DRAFT:

FINAL:

REG REPRO:

15. TOTAL COPIES: SEE ITEM 16

16. REMARKS: DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (i.e., MICROSOFT OFFICE OR PORTABLE DOCUMENT FORMAT (pdf)). *UNLESS

OTHERWISE SPECIFIED THE DISTRIBUTION STATEMENT ASSIGNED TO THE ECP SHALL BE THE MOST RESTRICTIVE DISTRIBUTION STATEMENT OF THE AFFECTED

ITEMS IDENTIFIED IN THE ECP. **SUBMIT ELECTRONICALLY TO THE PROCURING CONTRACTING OFFICER AT scott.l.follen2.civ@army.miL; COPY FURNISH

TO THE ADMINISTRATIVE CONTRACTING OFFICE AT (ACO TBD) AND ENGINEERING POC AT Tristan.d.sayers@ARMY.MIL. DOCUMENTATION SHALL BE IN

ACCORDANCE WITH PARAGRAPH 3.3.1 OF SAE-EIA-649-1 (CURRENT REVISION) USING DD FORM 1692 (CURRENT REVISION) LOCATED AT http://www.dtic.mil/whs/directives/infomgt/forms/ .

17. PRICE GROUP:

18. ESTIMATED TOTAL PRICE:

1. DATA ITEM NO: A002

2. TITLE: REQUEST FOR VARIANCE (RFV)

3. SUBTITLE: N/A

4. AUTHORITY: DI-SESS-80640E

5. CONTRACT REFERENCE: SECTION C

6. REQUIRING OFFICE:

7. DD250 REQ: LT

8. APP CODE: N/A

9. DIST. STATEMENT REQ: SEE ITEM 16

10. FREQUENCY: ASREQ

11. AS OF DATE: N/A

12. DATE OF FIRST SUBMISSION: ASREQ

ATT/EXH ID

PAGE

Exhibit A

13. DATE OF SUBS. SUBMISSION: ASREQ

14. DISTRIBUTION: SEE ITEM 16

A. ADDRESSEE:

B. COPIES:

DRAFT:

FINAL:

REG REPRO:

15. TOTAL COPIES: SEE ITEM 16

16. REMARKS: DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (i.e., MICROSOFT OFFICE OR PORTABLE DOCUMENT FORMAT (pdf)). *UNLESS

OTHERWISE SPECIFIED THE DISTRIBUTION STATEMENT ASSIGNED TO THE RFV SHALL BE THE MOST RESTRICTIVE DISTRIBUTION STATEMENT OF THE AFFECTED

ITEMS IDENTIFIED IN THE RFV. **SUBMIT ELECTRONICALLY TO THE PROCURING CONTRACTING OFFICER AT scott.l.follen2.civ@army.miL; COPY FURNISH

TO THE ADMINISTRATIVE CONTRACTING OFFICE AT (ACO TBD) AND ENGINEERING POC AT Tristan.d.sayers.civ@ARMY.MIL. DOCUMENTATION SHALL BE IN

ACCORDANCE WITH PARAGRAPH 3.3.2 OF SAE-EIA-649-1 (CURRENT REVISION) USING DD FORM 1694 (CURRENT REVISION) LOCATED AT http://www.dtic.mil/whs/directives/infomgt/forms/ .

17. PRICE GROUP:

18. ESTIMATED TOTAL PRICE:

1. DATA ITEM NO: A003

2. TITLE: NOTICE OF REVISION (NOR)

3. SUBTITLE: N/A

4. AUTHORITY: DI-SESS-80642E

5. CONTRACT REFERENCE: SECTION C

6. REQUIRING OFFICE:

7. DD250 REQ: LT

8. APP CODE: N/A

9. DIST. STATEMENT REQ: SEE ITEM 16

10. FREQUENCY: ASREQ

11. AS OF DATE: N/A

12. DATE OF FIRST SUBMISSION: ASREQ

13. DATE OF SUBS. SUBMISSION: ASREQ

14. DISTRIBUTION: SEE ITEM 16

A. ADDRESSEE:

B. COPIES:

DRAFT:

FINAL:

REG REPRO:

15. TOTAL COPIES: SEE ITEM 16

16. REMARKS: DATA MUST BE IN GOVERNMENT COMPATIBLE SOFTWARE (i.e., MICROSOFT OFFICE OR PORTABLE DOCUMENT FORMAT (pdf)). *UNLESS

OTHERWISE SPECIFIED THE DISTRIBUTION STATEMENT ASSIGNED TO THE NOR SHALL BE THE MOST RESTRICTIVE DISTRIBUTION STATEMENT OF THE AFFECTED

ITEMS IDENTIFIED IN THE NOR. **SUBMIT ELECTRONICALLY TO THE PROCURING CONTRACTING OFFICER AT scott.l.follen2.civ@army.miL; COPY FURNISH

TO THE ADMINISTRATIVE CONTRACTING OFFICE AT (ACO TBD) AND ENGINEERING POC AT Tristan.d.sayers.civ@ARMY.MIL. DOCUMENTATION SHALL BE IN

ACCORDANCE WITH PARAGRAPH 3.3.4 OF SAE-EIA-649-1 (CURRENT REVISION) USING DD FORM 1695 (CURRENT REVISION) LOCATED AT http://www.dtic.mil/whs/directives/infomgt/forms/ .

17. PRICE GROUP:

18. ESTIMATED TOTAL PRICE:

1. DATA ITEM NO.: A004

2. TITLE: TEST PROCEDURE

3. SUBTITLE: PRE-PRODUCTION PROCEDURE, PRETREATMENTS AND CHEMICAL AGENT RESISTANT COATINGS LOCAL WARREN - PAINTED MATERIEL

4. AUTHORITY: DI-NDTI-80603A

5. CONTRACT REFERENCE: Section E.6

6. REQUIRING OFFICE: GVSC SUS HCS

7. DD250 REQ: NO

8. APP CODE: A

9. DIST. STATEMENT: D

10. FREQUENCY: ONE/R

11. AS OF DATE: Date of Contract award

12. DATE OF FIRST SUB: 30DAC

13. DATE OF SUBS: N/A

14. DISTRIBUTION:

A. ADDRESSEE: HYPERLINK "mailto:usarmy.detroit.ccdc-gvsc.mbx.sidm-team-mailbox@army.mil" "mailto:usarmy.detroit.ccdc-gvsc.mbx.sidm-team-

ATT/EXH ID

PAGE

Exhibit A mailbox@army.mil" "_blank"usarmy.detroit.ccdc-gvsc.mbx.sidm-team-mailbox@army.mil, Scott L. Follen, Contracting Officer, HYPERLINK

"mailto:scott.l.follen2.civ@army.mil" o "mailto:scott.l.follen2.civ@army.mil" "_blank"scott.l.follen2.civ@army.mil and Justine R.

Broughton, Contract Specialist, Justine.r.broughton.civ@army.mil

B. COPIES: 2

DRAFT:

FINAL: 2

15. TOTAL: 2

16. REMARKS:

BLOCK 8 CONT. - PRIOR TO PRODUCTION, APPROVAL THRU THE CONTRACTING OFFICER IS REQUIRED W/IN 30 DAYS AFTER CONTRACT AWARD. CONTRACTING

OFFICER WILL ROUTE INTERNALLY TO THE APPROVING OFFICE (GVSC SUS HCS) CONTRACTING OFFICER SHALL PROVIDE PROCEDURE REVIEW RESPONSE BACK TO

CONTRACTOR.

The contract number must be cited on all phosphate coating procedures submitted for review and approval. Procedures shall include product name and manufacturer of all chemicals/materials to be used. All processes, equipment, controls along with testing and test frequencies used for painted material including application of supplemental finishes shall be described in detail.

17. PRICE GROUP: N/A

18. ESTIMATED TOTAL PRICE: N/A

1. DATA ITEM NO.: A005

2. TITLE: TEST/INSPECTION REPORT

3. SUBTITLE: PRE-PRODUCTION PROCEDURE, TEST REPORT PRETREATMENTS AND CHEMICAL AGENT RESISTANT COATINGS LOCAL WARREN - PAINTED MATERIEL

4. AUTHORITY: DI-NDTI-80809B

5. CONTRACT REFERENCE: Section E.

6. REQUIRING OFFICE: GVSC SUS HCS

7. DD250 REQ: NO

8. APP CODE: A

9. DIST. STATEMENT: D

10. FREQUENCY: ONE/R

11. AS OF DATE: Date of Contract award

12. DATE OF FIRST SUB: 60DAC

13. DATE OF SUBS: N/A

14. DISTRIBUTION:

A. ADDRESSEE: HYPERLINK "mailto:usarmy.detroit.ccdc-gvsc.mbx.sidm-team-mailbox@army.mil" "mailto:usarmy.detroit.ccdc-gvsc.mbx.sidm-team-mailbox@army.mil" "_blank"usarmy.detroit.ccdc-gvsc.mbx.sidm-team-mailbox@army.mil, Scott L. Follen, Contracting Officer, HYPERLINK

"mailto:scott.l.follen2.civ@army.mil" o "mailto:scott.l.follen2.civ@army.mil" "_blank"scott.l.follen2.civ@army.mil and Justine R.

Broughton, Contract Specialist, Justine.r.broughton.civ@army.mil

B. COPIES: 2

DRAFT:

FINAL: 2

15. TOTAL: 2

16. REMARKS:

BLOCK 8 CONT. - PRIOR TO PRODUCTION, APPROVAL THRU THE CONTRACTING OFFICER IS REQUIRED W/IN 60 DAYS AFTER CONTRACT AWARD. CONTRACTING

OFFICER WILL ROUTE INTERNALLY TO THE APPROVING OFFICE (GVSC SUS HCS) CONTRACTING OFFICER SHALL PROVIDE PROCEDURE REVIEW RESPONSE BACK TO

CONTRACTOR.

The contract number must be cited on all phosphate coating procedures submitted for review and approval. Procedures shall include product name and manufacturer of all chemicals/materials to be used. All processes, equipment, controls along with testing and test frequencies used for painted material including application of supplemental finishes shall be described in detail.

17. PRICE GROUP: N/A

18. ESTIMATED TOTAL PRICE: N/A

G. PREPARED BY: gvsc.mbx.sidm

H: DATE: 2024-07-23

I: APPROVED BY: Tristan Sayers

J: DATE: 2024-07-23