W912CH25Q0103-0001 EH5C0040EH Hose Assembly 2026MAR09.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

0001 2026MAR12

W912CH

ACC-DTA

6501 E. 11 MILE RD.

DETROIT ARSENAL, MI 48397-5000

KIMBERLY J. PARISEK

EMAIL: KIMBERLY.J.PARISEK.CIV@ARMY.MIL

W912CH-25-Q-0103

2026JAN27

X

X 2026APR13 02:00pm

/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

SUPPLEMENTAL INFORMATION

Buyer Name: KIMBERLY J. PARISEK

Buyer Office Symbol/Telephone Number: CCTA/(520)942-7021

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

Weapon System: Gas Masks

*** End of Narrative A0000 ***

SOLICITATION: W912CH-25-Q-0103

AMENDMENT: 0001

The purpose of Amendment 0001 to Request for Quotation W912CH-25-Q-0103 is as follows:

a) To update narrative A0001, paragraph 1 to reflect full and open competition.

b) To extend the offer due date and time as indicated below:

Monday, 13-APR-2026 at 2:00 p.m. (Eastern Time)

2) All other terms and conditions of W912CH-25-Q-0103 remain unchanged and in full force and effect.

*** END OF NARRATIVE A0003 ***

1. This request for quotation (RFQ) is full and open competition and will result in a firm fixed price (FFP) purchase order for the supply identified below:

REQUIREMENT

NOUN: HOSE ASSEMBLY

NSN: 4240-01-663-5690

PART NO.: 71012/6

PRODUCTION QUANTITY: 57 EA

OPTION QUANTITY: Up to 100%

UNIT OF ISSUE: Each (EA)

SURVEILLANCE CRITICALITY DESIGNATOR: B

2. There is a Technical Data Package (TDP) associated with this procurement. The TDP is distribution code "C", which limits access to US

Government agencies & their contractors. Please refer to Section C for additional information.

3. Military preservation, packing, and marking are required and shall be accomplished in accordance with Section D, all applicable requirements of MIL-STD-2073-1, and the Special Packaging Instruction (SPI).

4. All shipments shall be free on board (FOB) destination to the following address:

XU W0L7 BLUE GRASS ARMY DEPOT

XU GEN SUP STORAGE PT CRP WHSE 211

431 BATTLEFIELD MEMORIAL HIGHWAY

RICHMOND, KY, 40475-5070

DoDAAC: W22PVJ

NOTE: The Procuring Contracting Officer (PCO) has authorized the contractor to ship early when at no additional cost to the Government.

5. Please acknowledge all amendments to this RFQ in the space provided under Section A.

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W912CH-25-Q-0103

CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

6. This RFQ contains provisions/clauses that require you, the offeror, to complete fill-ins and/or representations. Please review and complete all such items. Otherwise, your offer may be determined ineligible for award.

7. To be considered for award: Please return one signed copy of your offer, in accordance with Section A, by the date and time indicated in the associated SAM.gov posting. All offers submitted in response to this RFQ shall be valid for a minimum of one hundred and eighty

(180) calendar days following the offer due date.

8. All questions regarding the requirements of this solicitation and applicable attachments must be submitted by 30 MAR 2026, 12:00 PM

EST to contract specialist(s) listed below. The Government will review all questions received but is not obligated to answer questions submitted after the date noted above prior to the solicitation close date.

Kim Parisek

CONTRACT SPECIALIST, ARMY CONTRACTING COMMAND - DETROIT ARSENAL

E-MAIL: kimberly.j.parisek.civ@army.mil

*** END OF NARRATIVE A0001 ***

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W912CH-25-Q-0103

SUPPLEMENTAL INFORMATION