OR D ER FOR SUPPLIES OR SER VICES
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1 OR D ER FOR SUPPLIES OR SER VICES P AGE 1 OF 7 1. CO N TRA CT/P U RCH. O RD E R/ A G RE E M E N T N O. N D D E L IVE RY O RD E R/ CA L L N O. 3. D A TE O F O RD E R/CA L L ( YYYYM M M D D ) 2014 Oc t RE Q./ P U RCH. RE Q U E ST N O. N R C N P RIO RITY 6. ISSUED BY CODE MILITAR Y SEALIFT COMMAN D, SSU GU AM MSC, SSU GU AM PSC 455, BOX 198 APO AP N ADM INIST E RED BY (if o th er th an 6 ) SEE IT EM 6 CODE 8. DELIVERY FOB DEST INAT IO X OT HER (See Schedule if othe 9. CONT RACT OR CODE 0M9K3 FACILIT Y N AME AN D AD D R ESS C ABR AS MAR IN E C OR POR ATIO N J O SEPH C R U Z 1026 C ABR AS H IGH W AY, SU ITE 114 PITI GU D E L IVE R TO FO B P O IN T BY (D ate) ( YYYYM M M D D ) SEE SCHEDULE 1 2. D ISCO U N T TE RM S 1 1. M A RK IF BU SIN E SS SM A L L SM A L L D ISA D VA N TA G W O M E N -O W N E 1 4. SHIP T O SEE SCHEDULE CODE 1 3. M AIL INVOICES T O T HE ADDRE SS IN BL OCK See Item P AYM E NT W IL L BE M ADE BY CODE W AW F SU BMIT ELEC TR O N IC IN VOIC ES IAW W AW F C O N TR AC T C LAU SE MSC W O R LD W ID E D C AN Y MARK ALL P AC KAG ES AND P APERS W ITH IDENTIFIC ATIO N NUMB ERS IN B LO C KS 1 AND T YP E OF ORDER DEL IVERY/ CAL L P URCHASE X This delivery order/call is issued on another G overnment agency or in accordance w ith and subject to terms and conditions of above numbered contract. Referen ce y ou r q u ote d ated Furnish the follow ing on terms specified herein. RE F : ACCE P T ANCE. T HE CONT RACT OR HERE BY ACCE P T S T HE OFFE R RE P RE SE NT E D BY T HE NUM BE RE D P URCHASE ORDER AS IT M AY P RE VIOUSL Y HAVE BE E N OR IS NOW M ODIFIE D, SUBJE CT T O ALL OF T HE T E RM S AND CONDIT IONS SET FORT H, AND AGREE S T O P E RFORM T HE SAM E. NAM E OF CONT RACT OR SIGNAT URE T YP E D NAM E AND T IT L E X If t h is bo x is m ark ed, sup p lier m ust sign Accep t ance an d ret urn t h e fo llo wing n um ber of co pies: ACCOUNT ING AND AP P ROP RIAT ION DAT A/ L OCAL USE DAT E SIGNE ( YYYYM M M D D Se e Sche d u le 1 8. IT E M NO SCHEDULE OF SUP P L IE S/ SE RVICES 2 0. QUANT IT Y ORDERE D/ ACCEP T E D* 21. UNIT 22. UNIT P RICE 2 3. AM OUNT * If q u a n tity a ccep ted b y th e G o vern m en t is s a m e a s S EE S CHEDULE 24. UNITED STATES OF AMERICA TEL: (b) (6) quantity ordered, indicate by X. If different, enter actual quantity accepted below quantity ordered and encircle. BY: Joshua McKay 2 7 a. QUANT IT Y IN COLUM N 2 0 HAS BEE N (b) (6) INSP ECT E D RE CEIVE D ACCE P T E D, AND CONFORM S T O T HE CONT RACT EXCEP T AS NOT ED b. SIGNAT URE OF AUT HORIZED GOVERNM ENT REP RESENT AT IVE 25. T OT AL $30, CONTRACTING / ORDERING OFFICER DIFFEREN CES c. DAT E d. P RINT E D NAM E AND T IT L E OF AUT HORIZ E D ( YYYYM M M D D ) GOVERNM ENT REP RESENT AT IVE e. M AILING ADDRESS OF AUT HORIZED GOVERNM ENT REP RESENT AT IVE 2 8. SHIP NO DO VOUCHER NO. 30. INIT IALS f. T E LE P HONE NUM BE R g. E -M AIL ADDRESS P ART IAL FINAL 32. P AID BY 33. AM OUNT VERIFIED CORRE CT FOR 36. I ce r tify th is acco u n t is co r r e ct an d p r op e r fo r p aym e nt. a. DAT E b. SIGNAT URE AND T IT L E OF CE RT IFYING OFFICE R ( YYYYM M M D D ) 3 1. P AYM E NT COM P LE T E P ART IAL FINAL 34. CHECK NUM BER 35. BIL L OF L ADING NO.
2 Page 2 of 7 Section B - Supplies or Services and Prices ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT Lot $30, $30, FY Industrial Assist - Bfly Valve FFP Provide all necessary labor, material, transportation, supervision, equipment, engineering design, and other incidental work required for: - Industrial Assistance to Goverment in replacement of 24" Butterfly Valve. See Service Order Attached. FOB: Destination PURCHASE REQUEST NUMBER: N RCN7104 NET AMT $30, ACRN AA CIN: N RCN $30,431.59
3 Page 3 of 7 Section C - Descriptions and Specifications STATEMENT OF WORK: S.O ABSTRACT: 1.1 This item describes the requirement to provide assistance for the replacement of a 24 inch Butterfly Valve. 2.0 REFERENCE/ENCLOSURES: 2.1 References: , Docking Plan (USNS Byrd) 2.2 Enclosures: NONE 3.0 ITEM LOCATION/DESCRIPTION: 3.1 Location/Quantity: Fire Main High Sea Chest Isolation Valve, AMR Sea Chest Fr 66 P (High Sea Chest); 1735 mm x 1497 mm Hull opening (5ft-9in x 4ft-11in) 4.0 GOVERNMENT FURNISHED EQUIPMENT/MATERIAL/SERVICES: 4.1 Government Provided Equipment (GFE): NONE 4.2 Government Provided Material (GFM): inch Butterfly Valve, Lug Paint 4.3 Government Provided Services (GFS): NONE 5.0 NOTES: 5.1 Ship is tied up STBD side to. Sea chest is on the port side of the ship. 6.0 QUALITY ASSURANCE REQUIREMENTS: 6.1 All work performed shall be to the satisfaction of the ships Chief Engineer. 7.0 STATEMENT OF WORK REQUIRED: 7.1 All work performed in this service order shall take place in a single continuous evolution. Work shall not stop until the new valve is in place and has been satisfactorily op tested. 7.2 Provide divers to install a cofferdam over the High Seachest (3.1.2).
4 Page 4 of A diver shall be on station to monitor the cofferdam for the duration of the evolution Once system isolation has been verified by Ship s force and all sea valves and the cofferdam are maintaining system isolation and that there is no water ingress, the contractor with ship s force shall Lock Out / Tag Out: FM COV (High MOV), FM COV (Low MOV, FM COV (Low Manual Isolation) and any additional valves as required. 7.3 Rig the existing 24 inch wafer style butterfly valve out of place from the fire main Suction Header, palletize it, and rig it over Cargo Elevator #5 to turn over to ships force. 7.4 Install new GFM 24 inch lug style butterfly valve using contractor furnished fasteners. Forty (40) each of the fasteners will be required Fasteners: Forty (40) each, Bolts, ASTM A-307, GR 8, Galvanized Steel 1 1/4" - 7 thread, 4 3/4" Length 7.5 Operationally test the valve to the satisfaction of the Chief Engineer. No leakage between the valve and suction line is acceptable. 7.6 For all rigging only fixed deck and hull structure may be used for rigging attachments. This includes stiffeners and existing pad eyes. Pipes, cables, cable runs, ducting, railing, etc. may not be used for rigging connections Any insulation that must be removed/disturbed to install beam clamps or other temporary rigging attachments shall be reinstalled to match surrounding The temporary removal of duct work to accommodate rigging by the contractor is acceptable. All ductwork that is removed shall be reinstalled by the contractor. 7.7 Touch up paint disturbed surfaces with GFM Paint. 8.0 VESSEL AVAILABILITY: POP: 10/03/ /09/ VESSEL LOCATION: LIMA Pier
5 Page 5 of 7 Section E - Inspection and Acceptance INSPECTION AND ACCEPTANCE TERMS Supplies/services will be inspected/accepted at: CLIN INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY 0008 N/A N/A N/A Government
6 Page 6 of 7 Section F - Deliveries or Performance DELIVERY INFORMATION CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC 0008 POP 03-OCT-2014 TO 09-OCT-2014 N/A N/A FOB: Destination
7 Page 7 of 7 Section G - Contract Administration Data ACCOUNTING AND APPROPRIATION DATA AA: 97 X 4930 ND2A F AMOUNT: $30, CIN N RCN : $30,431.59
OR D ER FOR SUPPLIES OR SER VICES
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