EMALL NON-NSN MATERIALS

ORDER FOR SUPPLIES OR SERVICES 1. CONTRACT/PURCH ORDER/AGREEMENT NO. 2. DELIVERY ORDER/CALL NO. 4. REQUISITION/PURCH REQUEST NO.3. DATE OF ORDER/CALL (YYYYMMMDD) 5. PRIORITY 6. ISSUED BY 7. ADMINISTERED BY (If other than 6) 8. DELIVERY FOB CODE CODE 9. CONTRACTOR FACILITY CODE NAME AND ADDRESS 10. DELIVER TO FOB POINT BY (Date) (YYYYMMMDD) 12. DISCOUNT TERMS 13. MAIL INVOICES TO THE ADDRESS IN BLOCK DESTINATION OTHER (See Schedule if other) 11. X IF BUSINESS IS SMALL SMALL DISAD- VANTAGED WOMEN-OWNED 14. SHIP TO 15. PAYMENT WILL BE MADE BY MARK ALL PACKAGES AND PAPERS WITH IDENTIFICATION NUMBERS IN BLOCKS 1 AND 2. CODE 16. TYPE OF ORDER DELIVERY/ CALL This delivery order/call is issued on another Government agency or in accordance with and subject to terms and conditions of above numbered contract. PURCHASE Reference your furnish the following on terms specified herein. 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. NAME OF CONTRACTOR SIGNATURE TYPED NAME AND TITLE DATE SIGNED (YYYYMMMDD) If this box is marked, supplier must sign Acceptance and return the following number of copies: 17. ACCOUNTING AND APPROPRIATION DATA/LOCAL USE 18. ITEM NO. 19. SCHEDULE OF SUPPLIES/SERVICES 20. QUANTITY ORDERED/ ACCEPTED* 21. UNIT 22. UNIT PRICE 23. AMOUNT * 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. 24. UNITED STATES OF AMERICA CONTRACTING/ORDERING OFFICER 25. TOTAL 26. DIFFERENCES 27a. QUANTITY IN COLUMN 20 HAS BEEN INSPECTED RECEIVED ACCEPTED, AND CONFORMS TO THE CONTRACT EXCEPT AS NOTED: b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVEc. DATE (YYYYMMMDD) e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 28. SHIP. NO. 29. D.O. VOUCHER NO. 30. INITIALS 32. PAID BY FINAL PARTIAL 33. AMOUNT VERIFIED CORRECT FOR f. TELEPHONE NUMBER g. E-MAIL ADDRESS 36. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT. a. DATE (YYYYMMMDD) b. SIGNATURE AND TITLE OF CERTIFYING OFFICER DD FORM 1155, DEC 2001 37. RECEIVED AT 38. RECEIVED BY (Print) 39. DATE RECEIVED (YYYYMMMDD) PREVIOUS EDITION IS OBSOLETE. 31. PAYMENT COMPLETE PARTIAL FINAL 40. TOTAL CON- TAINERS 41. S/R ACCOUNT NUMBER 42. S/R VOUCHER NO. 34. CHECK NUMBER 35. BILL OF LADING NO. SP47W1-21-D-0036 SP47W1-24-F-1763 2024 FEB 04 7006286603 DCSO FEDMALL 3990 EAST BROAD STREET COLUMBUS OH 43218 USA Criticality: C Pre-Award Survey : None 6XC33 X DARBONNIER TACTICAL SUPPLY LLC DBA DTS 951 NE 21ST CT OAK HARBOR WA 98277-2715 USA 2024 FEB 05 Net 30 days X X SEE SCHEDULE, DO NOT SHIP TO ADDRESSES ON THIS PAGE DEF FIN AND ACCOUNTING SVC BSM P O BOX 182317 COLUMBUS OH 43218-2317 USA X BX: 97X4930 5CBX 001 2620 S33189 $204.60 SP47W1 SP47W1 SL4701 DCSO FEDMALL 3990 EAST BROAD STREET COLUMBUS OH 43218 USA Local Admin: Jan Hegedus Tel: 215-737-4759 Email: jan.hegedus@dla.mil Submit Invoices IAW DFARS 252.232-7003 Jan Hegedus CODE Adobe Professional 8.0 PAGE 1 OF Jan Hegedus jan.hegedus@dla.mil 2024 FEB 04 1 3 See Section B. Terms and Conditions in accordance with Basic Contract CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: CONTINUED ON NEXT PAGE PAGE 2 OF 3 PAGES SP47W1-21-D-0036-SP47W1-24-F-1763 SECTION B DO Counter: 009753 PR: 7006286603 SUPPLIES/SERVICES: MFR. CAGE: 6XC33 P/N: 495ST-125W EMALL Non-NSN Materials CLIN BASIC QUANTITY UI UNIT PRICE DOLLAR VALUE DELIVERY REF DATE CLIN . 0001 0001 1.000 EA 204.6000 204.60 2024 FEB 05 QTY VARIANCE: PLUS 0.00% MINUS 0.00% FOB Orig, Insp & Accp at Other INSPECTION POINT: ACCEPTANCE POINT: DELIVER FOB: FOB PAYMENT METHOD: GOVERNMENT PERIOD OF PERFORMANCE 2021 AUG 16 - 2024 AUG 15 PARCEL POST ADDRESS: R09459 VAW 113 ATTENDING CTPL 13TH ST HANGAR 553 NAVAL BASE VENTURA POINT MUGU NAWC CA 93042 US VESSEL SHIPMENT. TRANSPORTATION SEE DLAD PROC NOTE C19. FIRST DESTINATION TRANSPORTATION SEE DLAD PROC NOTE C20 AND CONTRACT FREIGHT SHIPPING ADDRESS: R09459 VAW 113 BLDG 553 HAWKEYE ROAD POINT MUGU CA 93042 PT MUGU NAWC CA 93042 US SHIP BY TRACEABLE MEANS. DO NOT USE PARCEL POST. M/F: (TCN) R094594035F051 RDD: PROJ: TP 3 SUPP ADD: R09459 SIG: A FOR GOVERNMENT USE ONLY: (IPD) 13 DIC: A0B DIST: 4 ADV: FC: 7F R094594035F051 CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 3 OF 3 PAGES SP47W1-21-D-0036-SP47W1-24-F-1763 SECTION B CLIN: 0001 PR: 7006286603 PRLI: 0001 CONT’D GOVT USE External External External Customer RDD/ ITEM PR PRLI PR PRLI Material Need Ship Date . 0001 7006286603 0001 N/A N/A N/A N/A * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *