OT HER L E Assigned at the Order Level Specific to Each ...
8
6. ISSUED BY CODE W52P1J-20-D-0034 1. CONTRACT/PURCH. ORDER/ AGREEMENT NO. W911S0 2. DELIVERY ORDER/ CALL NO. 2A02 8 PAGE 1 OF 5. PRIORITY CODE 8. DELIVERY FOB DESTINATION X OTHER (See Schedule if other) ORDER FOR SUPPLIES OR SERVICES 3. DATE OF ORDER/CALL 2020 Aug 01 4. REQ./ PURCH. REQUEST NO. 0010993354 SEE ITEM 6 MICC - FORT EUSTIS 705 WASHINGTON BLVD SUITE 126 FORT EUSTIS VA 23604 7. ADMINISTERED BY (if other than 6) (YYYYMMMDD) 10. DELIVER TO FOB POINT BY (Date) (YYYYMMMDD) SAVI TECHNOLOGY INC DEMETRI PAPOULIAS 3601 EISENHOWER AVE STE 280 ALEXANDRIA VA 22304-6457 CODE 0J463 9. CONTRACTOR FACILITY SEE SCHEDULE 12. DISCOUNT TERMS N et 30 D ays MARK IF BUSINESS IS 11. SMALL SMALL DISADVANTAGED WOMEN-OWNED 13. MAIL INVOICES TO THE ADDRESS IN BLOCK See Item 15 25. TOTAL $346,989.78 7TH SUSTAINMENT BRIGADE 0007 TC BDE TRANSPORTATION BLDG 1610 PATCH ROAD FORT EUSTIS VA 23604 X 17. ACCOUNTING AND APPROPRIATION DATA/ LOCAL USE CODE 18. ITEM NO. 19. SCHEDULE OF SUPPLIES/ SERVICES * If quantity accepted by the Government is same as quantity accepted below quantity ordered and encircle. DELIVERY/ 16. 14. SHIP TO See Schedule W26AKG HQ0490 MARK ALL PACKAGES AND PAPERS WITH IDENTIFIC ATIO N NUMBERS IN BLOCKS 1 AND 2. 23. AMOUNT 15. PAYMENT WILL BE MADE BY CODE DFAS-IN, VP GFEBS 8899 E 56TH ST INDIANAPOLIS IN 46249-3800 This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract. TYPE CALL OF PURCHASE ORDER SEE SCHEDULE 24. UNITED STATES OF AMERICA TEL:757-501-8127 EMAIL: CONTRACTING / ORDERING OFFICER quantity ordered, indicate by X. If different, enter actual BY: 1 If this box is marked, supplier must sign Acceptance and return the following number of copies: X NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE (YYYYMMMDD) DATE SIGNED ACCEPTANCE. THE CONTRACTOR HEREBY ACCEPTS THE OFFER REPRESENTED BY THE NUMBERED PURCHASE ORDER AS IT MAY PREVIOUSLY HAVE BEEN OR IS NOW MODIFIED, SUBJECT TO ALL OF THE TERMS AND CONDITIONS SET FORTH, AND AGREES TO PERFORM THE SAME. Reference your quote dated Furnish the following on terms specified herein. REF: 20.QUANTITY ORDERED/ ACCEPTED* 21. UNIT 22. UNIT PRICE DIFFERENCES 26. INSPECTED RECEIVED ACCEPTED, AND CONFORMS TO THE CONTRACT EXCEPT AS NOTED 27a. QUANTITY IN COLUMN 20 HAS BEEN (YYYYMMMDD) c. DATE d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 36. I certify this account is correct and proper for paym ent. g. E-MAIL ADDRESS f. TELEPHONE NUMBER a. DATE (YYYYMMMDD) b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 28. SHIP NO. 29. DO VOUCHER NO. 30. INITIALS 32. PAID BY 33. AMOUNT VERIFIED CORRECT FOR 35. BILL OF LADING NO. 34. CHECK NUMBER 37. RECEIVED AT 38. RECEIVED BY (YYYYMMMDD) 31. PAYMENT COMPLETE PARTIAL FINAL PARTIAL FINAL DD Form 1155, DEC 2001 PREVIOUS EDITION IS OBSOLETE. 39. DATE RECEIVED 40.TOTAL CONTAINERS 41. S/R ACCOUNT NO. 42. S/R VOUCHER NO. AD D R E S S AN D N AME S A M P L E
Transcript of OT HER L E Assigned at the Order Level Specific to Each ...
6 . ISSUED BY CODE
W52P1J-20-D-0034
1 . CO N TRA CT/P U RCH . O RD E R/ A G RE E M E N T N O .
W 911S0
2 . D E L IVE RY O RD E R/ CA L L N O .
2A 02
8P AGE 1 OF
5 . P RIO RITY
CODE
8. DELIVERY FOB
DEST INAT IONXOT HER
(See Schedule if o ther)
OR D ER FOR SUPPLIES OR SER VICES
3 . D A TE O F O RD E R/CA L L
2020 Aug 01
4 . RE Q ./ P U RCH . RE Q U E ST N O .
0010993354
SEE IT EM 6MIC C - F OR T EU STIS705 W ASH IN GTON BLVD SU ITE 126F OR T EU STIS VA 23604
7 . ADM INIST ERED BY (if o th er th an 6 )
( YYYYM M M D D )
1 0 . D E L IVE R TO FO B P O IN T BY (D ate)
( YYYYM M M D D )SAVI TEC H N OLOGY IN CD EMETR I PAPOU LIAS3601 EISEN H OW ER AVE STE 280ALEXAN D R IA VA 22304-6457
CODE 0J4639 . CONT RACT OR FACILIT Y
SEE SCHEDULE1 2 . D ISCO U N T TE RM SN et 30 D ays
M A RK IF BU SIN E SS IS11.SM A L L
SM A L LD ISA D VA N TA G E D
W O M E N -O W N E D
13 . M AIL INVOICES T O T HE ADDRESS IN BLOCK
See Item 15
25 . T OT AL $346,989.78
7TH SU STAIN MEN T BR IGAD E0007 TC BD E TR AN SPOR TATIONBLD G 1610 PATC H R OADF OR T EU STIS VA 23604
X
17 . ACCOUNT ING AND AP P ROP RIAT ION DAT A/ LOCAL USE
CODE
18 . IT EM NO. 19 . SCHEDULE OF SUP P LIES/ SERVICES
* If q u a n t i ty a ccep ted b y th e G o vern m en t i s s a m e a s
q u a n t i t y a ccep ted b elo w q u a n t i ty o r d ered a n d en ci rcl e.
DELIVERY/16.
14 . SHIP T O
Se e Sche dule
W 26AKG H Q0490
MARK ALLP AC KAG ES AND
P AP ERS W ITH IDENTIFIC ATIO N
NUMB ERS INB LO C KS 1 AND 2 .
23 . AM OUNT
15 . P AYM ENT W ILL BE M ADE BY CODE
D F AS-IN , VP GF EBS8899 E 56TH STIN D IAN APOLIS IN 46249-3800
Th is d el iv ery o rd er/cal l is i ssu ed o n an o ther G o vern men t agency o r in acco rd ance w ith an d su b ject to terms an d co nd i t io ns o f abo ve n umb ered co n t ract .
T YP E CALL
OF P URCHASEORDER
SEE SCHEDULE24. UNITED STATES OF AMERICA
TEL: 757-501-8127
EMAIL:
CONTRACTING / ORDERING OFFICER
q u a n t i t y o rd er ed , in d ica te b y X . If d i f fer en t , en ter a ctu a l
BY:
1I f t h is box is m arked, supp lier m ust sign Accep tance and ret urn t he fo llowing num ber o f cop ies:X
NAM E OF CONT RACT OR SIGNAT URE T YP ED NAM E AND T IT LE( YYYYM M M D D )
DAT E SIGNED
ACCEP T ANCE. T HE CONT RACT OR HEREBY ACCEP T S T HE OFFER REP RESENT ED BY T HE NUM BERED P URCHASE ORDER AS IT M AY P REVIOUSLY HAVE BEEN OR IS NOW M ODIFIED, SUBJECT T O ALL OF T HE T ERM SAND CONDIT IONS SET FORT H, AND AGREES T O P ERFORM T HE SAM E.
Referen ce y ou r q u o te d ated
Furn ish the fo l lo w in g on terms sp eci fied h erein .REF :
20. QUANT IT YORDERED/ACCEP T ED*
21. UNIT 22 . UNIT P RICE
D IFFE RE N CE S26 .
INSP ECT ED RECEIVED ACCEP T ED, AND CONFORM S T O T HECONT RACT EXCEP T AS NOT ED
27a. QUANT IT Y IN COLUM N 20 HAS BEEN
( YYYYM M M D D )
c. DAT E d. PRINT ED NAM E AND T IT LE OF AUT HORIZEDGOVERNM ENT REP RESENT AT IVE
b. SIGNAT URE OF AUT HORIZED GOVERNM ENT REP RESENT AT IVE
e. M AIL ING ADDRESS OF AUT HORIZED GOVERNM ENT REP RESENT AT IVE
36. I ce r tify th is account is corr e ct and pr ope r for paym e nt.
g. E-M AIL ADDRESSf. T ELEP HONE NUM BER
a. DAT E( YYYYM M M D D )
b. SIGNAT URE AND T IT LE OF CERT IFYING OFFICER
28 . SHIP NO. 29 . DO VOUCHER NO.30 .INIT IALS
32 . P AID BY 33 . AM OUNT VERIFIEDCORRECT FOR
35 . BILL OF LADING NO.
34 . CHECK NUM BER
37 . RECEIVED AT 38 . RECEIVED BY ( YYYYM M M D D )
31 . P AYM ENT
COM P LET EP ART IALFINAL
P ART IAL
FINAL
DD Form 1155, DEC 2001 P REVIOUS EDIT ION IS OBSOLET E.
39 . DAT E RECEIVED 40 . T OT ALCONT AINERS
41 . S/R ACCOUNT NO. 42 . S/R VOUCHER NO.
AD D R ESSAN DN AME
S AM P
L E
julie.l.lawrence
Highlight
julie.l.lawrence
Sticky Note
Assigned at the Order Level
julie.l.lawrence
Sticky Note
Specific to Each Order
julie.l.lawrence
Sticky Note
Ordering Organization
julie.l.lawrence
Sticky Note
Ship to Information specific to Order
julie.l.lawrence
Sticky Note
Base contract has multiple pay authority clause. The DFAS agency selected corresponds to the ordering agency.
W52P1J-20-D-0034 2A02
Page 2 of 8
Section B - Supplies or Services and Prices
UNIT UNIT PRICE AMOUNT ITEM NO SUPPLIES/SERVICES 0008AB
QUANTITY 1 Each $15,770.74 $15,770.74
PDK III Model LITE-PDK III-RI002-001-5, Portable Deployment Kit w/Printer - ruggedized tablet w/read/write software applications, w/barcode scanner, RFID pod interrogator (150 feet) w/9’ USB cable, satellite modem w/GPS, power adaptors, Thermal transfer portable printer, 4 port USB 3 hub, in Transit Case, 5-year warranty. 90 day Deliver Required$15,770.74 FOB: Destination PURCHASE REQUEST NUMBER: 0010993354
NET AMT $15,770.74
ACRN AA CIN: GFEBS001099335400008AB
$15,770.74
S AM P
L E
W52P1J-20-D-0034 2A02
Page 3 of 8
Section E - Inspection and Acceptance
INSPECTION AND ACCEPTANCE TERMS
Supplies/services will be inspected/accepted at:
INSPECT BY ACCEPT AT ACCEPT BY CLIN INSPECT AT 0008AB Government N/A
S AM P
L E
W52P1J-20-D-0034 2A02
Page 4 of 8
QUANTITY SHIP TO ADDRESS DODAAC
Section F - Deliveries or Performance
DELIVERY INFORMATION
CLIN DELIVERY DATE
0008AB 01-OCT-2020 1 7TH SUSTAINMENT BRIGADE 0007 TC BDE TRANSPORTATION BLDG 1610 PATCH ROAD FORT EUSTIS VA 23604 757-878-5963/590FOB: Destination
S AM P
L E
W52P1J-20-D-0034 2A02
Page 5 of 8
Section G - Contract Administration Data
ACCOUNTING AND APPROPRIATION DATA
6100.0122021001 AA: 02120172017202000001111132330040187616 COST CODE: A76CC AMOUNT: $15,770.74 CIN GFEBS001099335400008AB: $15,770.74
S AM P
L E
W52P1J-20-D-0034 2A02
Page 6 of 8
Section I - Contract Clauses
CLAUSES INCORPORATED BY REFERENCE
52.204-7 System for Award Management OCT 2016 252.232-7003 Electronic Submission of Payment Requests and Receiving
Reports JUN 2012
252.232-7010 Levies on Contract Payments DEC 2006
CLAUSES INCORPORATED BY FULL TEXT
52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)
This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):
http://farsite.hill.af.mil/
(End of clause)
252.232-7006 WIDE AREA WORKFLOW PAYMENT INSTRUCTIONS (MAY 2013)
(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.
(b) Electronic invoicing. The WAWF system is the method to electronically process vendor payment requests andreceiving reports, as authorized by DFARS 252.232-7003, Electronic Submissionof 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 athttps://www.acquisition.gov; and
(2) Be registered to use WAWF at https://wawf.eb.mil/ following the step-by-step procedures for self-registrationavailable at this Web site.
(d) WAWF training. The Contractor should follow the training instructions of the WAWF Web-Based TrainingCourse and use the Practice Training Site before submitting payment requests throughWAWF. Both can be accessed by selecting the “Web Based Training” link on the WAWF home page athttps://wawf.eb.mil/.
S AM P
L E
julie.l.lawrence
Sticky Note
Clause required for each order for payment instructions.
W52P1J-20-D-0034 2A02
Page 7 of 8
(e) WAWF methods of document submission. Document submissions may be via Web entry, Electronic DataInterchange, or File Transfer Protocol.
(f) WAWF payment instructions. The Contractor must use the following information when submitting paymentrequests and receiving reports in WAWF for this contract/order:
(1) Document type. The Contractor shall use the following document type(s).
Invoicing and Receiving Report (Combo)
(2) Inspection/acceptance location. The Contractor shall select the following inspection/acceptance location(s) inWAWF, as specified by the contracting officer.
Inspection/Acceptance (I/A) to be performed at Origin by Defense Contract Management Agency (DCMA) I/A sub-delegated to DCMA Baltimore (S2101A)
217 East Redwood Street Suite 1800 Baltimore, MD 21202-3375 Ship From Label: DODAAC 0J463 ATTN: Rosemary Johnston / PH: 571-227-7918
(3) Document routing. The Contractor shall use the information in the Routing Data Table below only to fill inapplicable fields in WAWF when creating payment requests and receiving reports in thesystem.
Routing Data Table* -------------------------------------------------------------------------------------------- Field Name in WAWF Data to be entered in WAWF -------------------------------------------------------------------------------------------- Pay Official DoDAAC Issue By DoDAAC Admin DoDAAC Inspect By DoDAAC Ship To Code Ship From Code --------------------------------------------------------------------------------------------
(*Contracting Officer: Insert applicable DoDAAC information or “See schedule” if multiple ship to/acceptance locations apply, or “Not applicable.”)
(4) Payment request and supporting documentation. The Contractor shall ensure a payment request includesappropriate contract line item and subline item descriptions of the work performed or supplies delivered, unitprice/cost per unit, fee (if applicable), and all relevant back-up documentation, as defined in DFARS Appendix F,(e.g. timesheets) in support of each payment request.
(5) WAWF email notifications. The Contractor shall enter the email address identified below in the “SendAdditional Email Notifications” field of WAWF once a document is submitted in the system.
, Government Ordering Contracting Officer, , Government Ordering Purchasing Agent,
, Customer Point of Contact,
S AM P
L E
julie.l.lawrence
Sticky Note
DoDAACs are specific to each order adn are assigned at the order level within the WAWF clause.
julie.l.lawrence
Sticky Note
Add Order Point of Contacts.
W52P1J-20-D-0034 2A02
Page 8 of 8
(g) WAWF point of contact. (1) The Contractor may obtain clarification regarding invoicing in WAWF from thefollowing contracting activity's WAWF point of contact.
, Government Ordering Contracting Officer, , Government Ordering Purchasing Agent,
(2) For technical WAWF help, contact the WAWF helpdesk at 866-618-5988.
(End of clause)
S AM P
L E
