SIMPLIFIED SOLICITATION FORM

SIMPLIFIED SOLICITATION FORM

THIS SECTION OF THE FORM IS TO BE COMPLETED BY THE GOVERNMENT

DATE: 02NOV2026

RFQ #: SPRRA2-27-Q-A005

PRON #: 0098871125

Contract Specialist:
Phone Number:
Email Address:
Allison Darnell

256-986-0060

Contracting Officer:

Phone Number:

Email Address:

Michael Romine

256-214-9142

[email protected]

Unrestricted

Restricted Competition
(FAR Part 6)

[email protected]

Sole Source
(FAR Part 6)

THIS RFQ IS:

Mandatory Source
(FAR Part 8)

EDWOSB

WOSB

TOTAL SBSA

✔

DESCRIPTION

Part Number:

Noun:

NSN:

FAT Qty:

Production Qty:

POWER SUPPLY

6120-01-723-1669

13646200-10

SERIALIZATION

REQUIRED

Yes [
]
No [ ✔ ]

EXPORT

CONTROLLED

Yes [ ✔ ]
No [
]

IUID

REQUIRED

Yes [ ✔ ]
No [
]

DPAS

Rating
DO [ ✔ ]
DX [
]

PACKAGING AND MARKING

PACKAGING/PACKING/SPECIFICATIONS:

MIL-STD-2073-1 & MIL-STD-129 MARKINGS SHALL APPLY

Military
B

ESTIMATED MAXIMUM UNIT PACKAGE WEIGHT (POUNDS) AND SIZE (INCHES)

8.5
4.5

ALL WOOD PACKAGING MATERIAL (WPM) MUST BE ISPM-15 COMPLIANT

MIL-STD-2073-1 CODES, APPENDIX J

JI/A/MP [ GX ]

JII/CD [ 1

]

JVII/UC [ ED ]

JVII/IC [ 00 ]

JIII/PM [ 00 ]

JIV/WM [ K3 ]

JIX/A/PK [ F ]

JX/SM [ 39 ]

JV/CD [ LT ]

JVI/CT [ B ]

JVIIIA/OPI [ M ]

Contractor First
Article Test

Government First
Article Test

TESTING REQUIREMENT

Government
Production Lot Test

No Test Required

✔

SHIP TO:

SR W0H9 US ARMY AVN & MISSLES CMD AMCOM FLEET MGT CENTER AFMC HOLBROOK RD BLDG 722 FORT BLISS, TX, 79916-5801

** CFAT Report to be delivered to:

FIRST ARTICLE TEST REPORT WILL BE SENT ELECTRONICALLY

TO: [email protected]

IF THE FILE IS TOO LARGE OR ENCRYPTION IS NEEDED, A

DOD SAFE LINK WILL BE SENT TO YOU FOR UPLOAD USING

HTTPS://SAFE.APPS.MIL/ PLEASE USE THE

[email protected] EMAIL ADDRESS TO REQUEST THE LINK

INSPECTION:

ACCEPTANCE:

FOB POINT:

ORIGIN

ORIGIN

DESTINATION

DATE:

SIMPLIFIED SOLICITATION FORM CONTINUED

THIS SECTION OF THE FORM IS TO BE COMPLETED BY THE OFFEROR

QUOTE #:

QUOTE VALID FOR:

Company Name:

Cage Code/Facility Code:

Address:

Point of Contact:

Phone Number:

Email Address:

QUOTE

First Article Unit(s) (Contractor and Government)
Quantity:
Price:
Production Lot Units
Quantity:
Price:
Delivery Days (if applicable):
FAT Unit:
Production Unit:
Test Report:

ADDITIONAL NOTES

SUPPLEMENTAL INFORMATION

The following supplemental information is incorporated as part of this solicitation and applies to all submitted quotations.

1. EXPORT CONTROL (When Applicable)

“THE TECHNICAL DATA PACKAGE WILL BE PROVIDED VIA THE DoD SAFE SITE,

https://safe.apps.mil/ , WHICH CONTAINS TECHNICAL DATA WHOSE EXPORT IS