CLEANER, BRAKE PARTS

11.X IF BUSINESS IS | | SMALL | | SMALL DISAD- VANTAGED | | WOMEN-OWNED SL4701 W80XYJ 79343 SPE4A6 23. AMOUNT 3.DATE OF ORDER/CALL (YYYYMMDD) 20230617 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 Tonya Green TONYA.GREEN@DLA.MIL 06/17/2023 Tonya Green 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. 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 SCIENCE APPLICATIONS INTERNATIONAL CORPORATION 155 PASSAIC AVE FAIRFIELD NJ 07004-3561 USA DLA AVIATION ASC COMMODITIES DIVISION 6090 STRATHMORE ROAD RICHMOND VA 23237 6.ISSUED BY CODE DLA AVIATION 6090 STRATHMORE ROAD RICHMOND VA 23237 Local Admin: Holly Dunnavant Tel: 804-279-6034 Email:Holly.Dunnavant@dla.mil PAGE 1 OF 2 5.PRIORITY DO-C9 4.Purchase Requisition Number 7003361646 2. DELIVERY ORDER/CALL NO. SPE4A7-23-F-C0YL 1.CONTRACT/PURCH ORDER/AGREEMENT NO. SPE4AX-16-D-9008 ORDER FOR SUPPLIES OR SERVICES SPE4A7 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CON- TAINERS 39.DATE RECEIVED (YYYYMMDD) 38.RECEIVED BY (PRINT) 37.RECEIVED AT DD FORM 1155, DEC 2001 PREVIOUS EDITION IS OBSOLETE ACCEPTANCE.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 $227.80 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 20230703 SEE SCHEDULE, DO NOT SHIP TO ADDRESSES ON THIS PAGE X SCIENCE APPLICATIONS INTERNATIONAL Reference PIID / Order Number SPE4AX-16-D-9008 /SPE4A7-23-F-C0YL PAGE 2 OF 2 DO Counter:864807 BDN: SCHEDULE NSN/PartNumber: 6850011670678 CLEANER,BRAKE PARTS WEIGHT: 1.190 CUBE: 0.052 MFR. CAGE 10136 P/N 05084 MFR. CAGE 1A864 P/N 0384-000 QTY. VARIANCE +0.0% -0.0% SHIP TO: SHIP BY TRACEABLE MEANS. DO NOT USE PARCEL POST. BBP:W80XYJ 0553 CS BN CO A COMPOSITE AWCF SSF BLDG 40054 MOTOR POOL ROAD FORT CAVAZOS TX 76544-0000 USA Ref CLIN ITEM QUANTITY U/I UNIT PRICE TOTAL DELIVERY FOB INSP. ACC. 1223 0001 85.000 CN $2.68 $227.80 03JUL2023 DEST DEST DEST MARK FOR DATA: TCN: W80XYJ31680002 RDD: 182 TP: 3 SUPP ADD: W9046W SIG: C GOV USE ONLY: IDP: 12 DIC: A0A DIST: V FC: Z9 FREIGHT: MARK FOR: W80XYJ W80XYJ 0553 CS BN CO A COMPOSITE AWCF SSF BLDG 40054 MOTOR POOL ROAD FORT CAVAZOS TX 76544-0000 USA 0553 CS BN CO A COMPOSITE AWCF SSF BLDG 40054 MOTOR POOL ROAD FORT CAVAZOS TX 76544-0000 USA **********************************************************************************