TIRE, PNEUMATIC, AIRC

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 DATE RECEIVED (YYYYMMMDD) PREVIOUS EDITION IS OBSOLETE. 31.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. SPE7LX-19-D-0029 SPE7LX-24-F-03D6 2024 APR 04 7007089140 DLA LAND AND MARITIME STRATEGIC ACQ PROGRAM DIRECTORATE PO BOX 3990 COLUMBUS OH 43218-3990 USA Criticality: B Pre-Award Survey : None 79343 X ASRC FEDERAL FACILITIES LOGISTICS, LLC 155 PASSAIC AVE FAIRFIELD NJ 07004-3561 USA 2024 APR 08 Fast Pay Net 15 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 $1,164.16 SPE7LX SPE7LX DO-C9 SL4701 DLA LAND AND MARITIME STRATEGIC ACQ PROGRAM DIRECTORATE PO BOX 3990 COLUMBUS OH 43218-3990 USA Local Admin: Mia Proskurenko Tel: 614-980-6151 Fax: 000-000-0000 Email: Mia.Proskurenko@dla.mil Submit Invoices IAW DFARS 252.232-7003 Samuel Freidet CODE Adobe Professional 8.0 PAGE 1 OF Samuel Freidet Samuel.Freidet@dla.mil 2024 APR 04 1 3 Award sent EDI, Do not duplicate shipment 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 SPE7LX-19-D-0029-SPE7LX-24-F-03D6 For PID, Packaging, and Marking Information see modification SPE7LX-19-D-0029-P00001, Attachment 1, Sections 24.0 - 24.2 of the PWS (pages 39 - 40). CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 3 OF 3 PAGES SPE7LX-19-D-0029-SPE7LX-24-F-03D6 SECTION B DO Counter: 197594 In accordance with FAR 52.213-1, Fast Pay applies to this Purchase Order PR: 7007089140 SUPPLIES/SERVICES: 2620008347441 SEE BASIC TIRE,PNEUMATIC,AIRC CLIN BASIC QUANTITY UI UNIT PRICE DOLLAR VALUE DELIVERY REF DATE CLIN . 0001 2154 1.000 EA 1,164.1600 1164.16 2024 APR 08 QTY VARIANCE: PLUS 0.00% MINUS 0.00% INSPECTION POINT: DESTINATION ACCEPTANCE POINT: DESTINATION DELIVER FOB: DESTINATION FOB PAYMENT METHOD: CONTRACTOR PARCEL POST ADDRESS: N0429A COMACCLOGWING DET AIMD 625 LAGUNA RD BLDG 65 POINT MUGU NAWC CA 93042-5051 US RDD 777 SHIPMENT. SHIP BY FASTEST TRACEABLE MEANS. DO NOT USE PARCEL POST. FREIGHT SHIPPING ADDRESS: N0429A NAVAL BASE VENTURA COUNTY RECEIVING OFFICER 625 LAGUNA RD BLDG 65 POINT MUGU NAWC CA 93042-5051 US M/F: (TCN) N0429A40941901 RDD: 777 PROJ: 770 TP 2 SUPP ADD: YSTOCK SIG: A FOR GOVERNMENT USE ONLY: (IPD) 06 DIC: A4A DIST: V3B ADV: 5X FC: J3 N0429A40941901 GOVT USE External External External Customer RDD/ ITEM PR PRLI PR PRLI Material Need Ship Date . 0001 7007089140 0001 N/A N/A N/A N/A * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *