TRACK, AIRCRAFT SEAT

11.X IF BUSINESS IS | | SMALL | | SMALL DISAD- VANTAGED | | WOMEN-OWNED SL4701 Z50100 78286 S0707A 23. AMOUNT 3.DATE OF ORDER/CALL (YYYYMMDD) 20230417 27a.QUANTITY IN COLUMN 20 HAS BEEN | |INSPECTED | |RECEIVED | |ACCEPTED AND CONFORMS TO THE CONTRACT EXCEPT AS NOTED _________________________ ________________________ ____________________________________ _________________ NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE DATE SIGNED(YYYMMDD) | | If this box is marked, supplier must sign Acceptance and return the following number of copies: 24. UNITED STATES OF AMERICA Jeremy Reeves Jeremy.T.Reeves@dla.mil 04/17/2023 Jeremy Reeves 17.ACCOUNTING AND APPROPRIATION DATA/LOCAL USE BX: 97X4930 5CBX 001 2630 S33189 22.UNIT PRICE 21. UNIT 20.QUANTITY ORDERED/ ACCEPTED* 19. SCHEDULE OF SUPPLIES/SERVICES 18.ITEM NO Award Sent EDI, Do Not Duplicate Shipment. SEE SCHEDULE. PLEASE CONTACT THE DCMA IN BLOCK 7 FOR SHIPPING INSTRUCTIONS

TERMS AND CONDITIONS ARE IN ACCORDANCE WITH BASIC CONTRACT If quantity accepted by the Government is same as quantity ordered, indicate by X. If different, enter actual quantity accepted below quantity ordered and encircle. d.PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE c.DATE (YYYYMMDD) b.SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE 15. PAYMENT WILL BE MADE BY CODE DEF FIN AND ACCOUNTING SVC BSM P O BOX 182317 COLUMBUS OH 43218-2317 14.SHIP TO CODE MARK ALL PACKAGES AND PAPERS WITH IDENTIFICATION NUMBERS IN BLOCKS 1 AND 2. 8. DELIVERY FOB | | DESTINATION | | OTHER (See Schedule if other) 9.CONTRACTOR CODE FACILITY 7.ADMINISTERED BY (IF OTHER THAN 6) CODE SIKORSKY AIRCRAFT CORPORATION DBA SIKORSKY AIRCRAFT CORP 6900 MAIN ST STRATFORD CT 06614-1378 USA DCMA SIKORSKY AIRCRAFT STRATFORD 6900 MAIN ST STRATFORD CT 06615-9131 USA 6.ISSUED BY CODE DLA AVIATION 6090 STRATHMORE ROAD RICHMOND VA 23237 Local Admin: Lonnie Copeland Jr Tel: XXX-XXX-XXXX Email:Lonnie.Copeland@dla.mil PAGE 1 OF 2 5.PRIORITY N 4.Purchase Requisition Number 7002496166 2. DELIVERY ORDER/CALL NO. SPE4A6-23-F-ASAV 1.CONTRACT/PURCH ORDER/AGREEMENT NO. SPE4A5-15-D-0018 ORDER FOR SUPPLIES OR SERVICES SPE4A6 16. TYPE OF ORDER PURCHASE X DELIVERY CALL 42.S/R VOUCHER NO. 41.S/R ACCOUNT NUMBER 40.TOTAL CON- TAINERS 39.DATE RECEIVED (YYYYMMDD) 38.RECEIVED BY (PRINT) 37.RECEIVED AT DD FORM 1155, DEC 2001 PREVIOUS EDITION IS OBSOLETE ACCEPTANCE.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 furnish the following on items specified herein. This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of the above numbered contract. 30.INITIALS 26. DIFFERENCES 25.TOTAL $7344.00 13.MAIL INVOICES TO THE ADDRESS IN BLOCK Submit Invoices IAW DFARS 252.232-7003 12.DISCOUNT TERMS IAW Basic 10.DELIVER TO FOB POINT BY(DATE) (YYYYMMDD) | | PARTIAL | | FINAL 31.PAYMENT | | COMPLETE | | PARTIAL | | FINAL 28.SHIP. NO. 32.PAID BY 29.D.O.VOUCHER NO b.SIGNATURE AND TITLE OF CERTIFYING OFFICER a.DATE (YYYYMMDD) 36.I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT. g.E-MAIL ADDRESS f.TELEPHONE NUMBER e.MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 35. BILL OF LADING NO. 34. CHECK NUMBER 33. AMOUNT VERIFIED CORRECT FOR CRITICALITY:C 20230418 SEE SCHEDULE, DO NOT SHIP TO ADDRESSES ON THIS PAGE X SIKORSKY AIRCRAFT CORPORATION Reference PIID / Order Number SPE4A5-15-D-0018 /SPE4A6-23-F-ASAV PAGE 2 OF 2 DO Counter:166005 BDN: SCHEDULE NSN/PartNumber: 1680014317313 TRACK,AIRCRAFT SEAT MFR. CAGE 78286 P/N 70209-82480-064 QTY. VARIANCE +0.0% -0.0% SHIP TO: SHIP BY FASTEST TRACEABLE MEANS. DO NOT USE PARCEL POST. PARCEL:Z50100 COMMANDING OFFICER USCG AVIATION LOGISTICS CENTER 1664 WEEKSVILLE ROAD, BLDG 63 ELIZABETH CITY NC 27909-5001 USA Ref CLIN ITEM QUANTITY U/I UNIT PRICE TOTAL DELIVERY FOB INSP. ACC. 1097 0001 10.000 EA $734.40 $7344.00 18APR2023 ORIG ORIG ORIG MARK FOR DATA: TCN: Z5010031045048 RDD: 116 TP: 2 SUPP ADD: Y0001J PROJ: 60E SIG: A GOV USE ONLY: IDP: 06 DIC: A0A ADV: 2L FC: BJ FREIGHT: Z50100 COMMANDING OFFICER USCG AVIATION LOGISTICS CENTER 1664 WEEKSVILLE RD BLDG 63 ELIZABETH CITY NC 27909-5001 USA **********************************************************************************