6 ISSUE D BY CODE

GS-00F-0001U

1 CO N TRA CT/P U RCH O RD E R/ 

 A G RE E ME N T N O

W9133L

2 D ELIVERY O RD ER/ CA LL N O

W9133L-08-F-0306

P AGE 1 OF 15

5 P RIO RITY

CODE

8 DELIVERY FOB

X DEST INAT ION

OTHER

(See Sch edule if o t h er)

ORDER FOR SUPPLIES OR SERVICES

3 D A TE O F O RD E R/CA L L

2008 Sep 27

4 RE Q / P U RCH RE Q U E ST N O

W81M NB82212000

SEE ITEM 6

NGB-ZC-AQ - W 9133L

1411 JEFFERSON DAVIS HWY

AR LIN GTON VA 22202-3231

7 ADM INIST E RE D BY (if other than 6)

(YYYYMMMDD)

10 D E L IVE R TO FO B P O IN T BY (D ate)

(YYYYMMMDD) SKY LINE ULTD INC

JOEL RHOADES

16333 SOU TH GR EAT OAKS D R IVE

SU ITE 121

R OU N D R OC K TX 78681-3661

9 CONT RACT OR CODE 1V A N5 FACILIT Y

SEE SCHEDULE

12 D ISCO U N T TE RMS

N et 30 D ays

1 1 MA RK IF BU SIN ESS IS

SMALL

SMALL

D ISA D VA N TA G E D

W O MEN -OW N ED

1 3 M AIL INVOICE S T O T HE ADDRESS IN BLOCK

See Item 15

25 TOTAL $5,459,405.60

X

1 7 ACCOUNT ING AND AP P ROP RIAT ION DAT A/ L OCAL USE

CODE

18 IT EM NO 1 9 SCHEDUL E OF SUP P LIE S/ SERVICE S

* If quantity accepted by the Government is sam e as

quantity a ccepted below quantity ordered and encircle.

16 DELIVERY/

1 4 SHIP T O

Se e Sche dule

SEE SCHEDULE

F67100

MARK ALL

P AC KAG ES AND

P AP ERS W ITH

 IDENTIFIC ATIO N

NUMB ERS IN

BLO C KS 1 AND 2.

23 AMOUNT

15 PAYMENT W ILL BE MADE BY CODE

D FAS/LIMESTON E - F67100

ATTN : VEN D OR PAY

P.O. BOX 369020

COLUMBUS OH 43236-9020

Th is d eliv ery o rd er/call is is s u ed o n an o th er G o v ern men t ag en cy o r in acco rd an ce w ith an d s u b ject to terms an d co n d itio n s o f ab o v e n u mb ered co n tract

TYPE CALL

OF P URCHASE

ORDER

SEE SCHEDULE 24. UNITED STATES OF AMERICA

TEL: 703 607-1260

EMAIL:

CONTRACTING / ORDERING OFFICER

q u a n tity o rd ered , in d ica te b y X . If d ifferen t, en ter a ctu a l

BY:

If t his box is m arked, supplier m ust sign Accept ance and ret urn t he following num ber of copies:

NAME OF CONT RACT OR SIGNAT URE T YPED NAME AND T IT LE

(YYYYMMMDD)

DAT E SIGNE D

ACCE P T ANCE T HE CONT RACT OR HE REBY ACCE P T S T HE OFFE R REP RESE NT ED BY T HE NUM BE RED P URCHASE 

ORDE R AS IT M AY P REVIOUSL Y HAVE BEE N OR IS NOW M ODIFIE D, SUBJE CT T O AL L OF T HE T E RM S

AND CONDIT IONS SE T FORT H, AND AGRE ES T O P ERFORM T HE SAM E

Referen ce y o u r q u o te d ated

Fu rn is h th e fo llo w in g o n terms s p ecified h erein REF:

20 QUANT IT Y

ORDERED/

ACCEPT ED*

21 UNIT 22 UNIT PRICE

D IFFEREN CES

2 6

INSP E CT E D RECEIVED ACCEP T E D, AND CONFORM S T O T HE

CONT RACT EXCEP T AS NOT E D

2 7 a QUANT IT Y IN COL UM N 2 0 HAS BE E N

(YYYYMMMDD)

c DAT E d PRINT ED NAME AND T IT LE OF AUT HORIZED

 GOVERNM E NT RE P RE SENT AT IVE

b SIGNAT URE OF AUT HORIZ E D GOVE RNM E NT RE P RE SENT AT IVE

e M AIL ING ADDRE SS OF AUT HORIZ ED GOVE RNM ENT REP RESE NT AT IVE

36. I ce rtify this account is corre ct and prope r for paym e nt.

f T ELEPHONE NUMBER g E -M AIL ADDRESS

a DATE

(YYYYMMMDD)

b SIGNAT URE AND T IT LE OF CE RT IFYING OFFICE R

2 8 SHIP NO 2 9 DO VOUCHER NO 3 0

INIT IALS

32 PAID BY 33 AM OUNT VERIFIED

CORRECT FOR

35 BILL OF LADING NO

34 CHECK NUMBER

3 7 RECEIVED AT 38 RECEIVED BY 

(YYYYMMMDD)

31 PAYMENT

COMPLET E

PART IAL

FINAL

PART IAL

FINAL

DD For m 1155, DEC 2001 P RE VIOUS EDIT ION IS OBSOL ET E

39 DAT E RECEIVED 40 T OT AL

CONT AINERS

4 1 S/R ACCOUNT NO 4 2 S/R VOUCHE R NO

AD D R ESS

AN D

N AME

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Section B - Supplies or Services and Prices 

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 

0001 1 Lump 

Sum 

$5,055,555.20 $5,055,555.20 

Contract Labor 

FFP 

The contract shall provide all material, equipment and labor necessary to 

complete the requirement in the attach Statement Of Work. 

FOB: Destination 

PURCHASE REQUEST NUMBER: W81MNB82212000 

 ESTIMATED COST 

 ACRN AA $5,055,555.20 

 

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 

0002 1 Lump Sum $403,850.40 $403,850.40 NTE 

Contract Travel 

FFP 

Other Direct Cost (ODC) shall include all travel in accordance with JTR. All 

travel is cost reimbursable. 

FOB: Destination 

PURCHASE REQUEST NUMBER: W81MNB82212000 

 

 

 NET AMT $403,850.40 

 ACRN AA $403,850.40 

 

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ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 

2001 1 Dollars, 

U.S. 

$5,207,220.96 $5,207,220.96 

OPTION Contract Labor 

FFP 

The contract shall provide all material, equipment and labor necessary to complete 

the requirement in the attach Statement Of Work. 

FOB: Destination 

 

 

 NET AMT $5,207,220.96 

 

 

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 

2002 1 Dollars, 

U.S. 

$500,000.00 $500,000.00 

OPTION Contract Labor 

FFP 

Other Direct Cost (ODC) shall include all travel in accordance with JTR. All 

travel is cost reimbursable. 

FOB: Destination 

 

 

 NET AMT $500,000.00 

 

 

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 

3001 1 Lump Sum $5,363,437.63 $5,363,437.63 

OPTION Contract Labor 

FFP 

The contract shall provide all material, equipment and labor necessary to complete 

the requirement in the attach Statement Of Work. 

FOB: Destination 

 

 

 NET AMT $5,363,437.63 

 

 

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ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 

3002 1 Dollars, 

U.S. 

$500,000.00 $500,000.00 

OPTION Contract Labor 

FFP 

Other Direct Cost (ODC) shall include all travel in accordance with JTR. All 

travel is cost reimbursable. 

FOB: Destination 

 

 

 NET AMT $500,000.00 

 

 

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Section C - Descriptions and Specifications 

.

STATEMENT OF WORK 

STATE JOINT FORCES HEADQUARTERS 

J-1 DIRECTORATE 

HEALTH AND BENEFITS SUPPORT SPECIALIST 

TRANSITION ASSISTANCE ADVISORS 

1.0 INTRODUCTION 

The primary purpose of the Statement of Work is to provide the respective State Joint 

Forces Headquarters with a Department of Veteran Affairs, Health, and Benefits Support 

Specialist. 

2.0 OBJECTIVE 

 The objective is to serve as the statewide point of contact and coordinator, and to provide 

technical support to managers, supervisors, Guard members and their family members as to the 

benefits and entitlements available through Department of Veterans Affairs and to provide 

technical assistance in resolving entitlements to TRICARE. The contractor will work with 

Family Programs all Employer Support organizations. 

3.0 Place of Performance 

There are 54 states and territories projected that will require a contract employee at the 

time of award. The distribution of contractor employees will be coordinated with the contractor 

after award. All states and territories will eventually be provided with a contractor under this 

contract. Some states may require more than one contractor employee. The addition of 

contractor employees to a particular state is based on Uniformed Service Members and Families 

supported in that state. The number of states requiring a contractor employee may increase or 

decrease during the life of the contract, depending on mission within the states. 

3.0 TECHNICAL AND SUBJECT MATTER REQUIREMENTS 

 3.1 Personnel Requirements 

 The contractor shall provide the State Joint Forces Headquarters with a professional 

experienced in Department of Veterans Affairs programs and policies, specifically Veterans 

Health Administration and Veterans Benefits Administration. The Support Specialist will also 

be knowledgeable on TRICARE programs and policies, pre and post mobilization 

entitlements/requirements, medical hold over status, ADMME AND TAMP. The Support 

Specialist will be knowledgeable of Army and Air National Guard statuses and entitlements. 

 3.2 TASKING REQUIREMENTS 

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 3.2a Provides information and assistance to Guard members and their families in 

understanding and obtaining benefits and services through Veterans Affairs and the military 

health system. Coordinates with appropriate Veterans Affairs, TRICARE, Veteran Service 

Organizations, and other resources to provide required information and assistance. Participates 

in the mobilization and demobilization process to brief/advise Guard members and their families 

on available entitlements and information resources. Researches and resolves issues associated 

with entitlements when Guard members/and or their family members encounter problems. 

3.2b Performs non-clinical case management of wounded and injured Guard members 

returning from contingency operations. Facilitates medical care and benefits application to 

ensure optimal transition from the military treatment facilities to the members’ local community. 

This includes coordinating with federal, state, local, and community support organizations. 

Assistance will be provided to all active and former National Guard members. 

3.2c Coordinates with Veterans Affairs centers to assist law enforcement, court systems, state 

mental health authorities and fire departments with awareness concerning Service members and 

veterans that may need crisis intervention. 

3.2d Assist JFHQ personnel with the operation of reintegration programs for Guard members 

returning from deployment. Intent is to assist reintegration personnel with obtaining Veterans 

Affairs support for reintegration activities. It is not the intent that Transition Assistance 

Advisors be used to manage the day to day operation of reintegration programs. 

 3.2e Provides advice to the Joint Forces Headquarters and coordinates with Family Support 

Specialists, Employer Support Groups, regarding entitlements available through Department of 

Veterans Affairs and other Veterans entitlement and benefit programs. 

 3.2f Provides basic or preliminary education and training to State Joint Forces Headquarters 

staff as to the entitlements available through the Veterans Affairs, TRICARE and Veterans 

Service Organizations. Works with local, state and Veterans Integrated Service Network (VISN) 

Veterans Affairs personnel to meet education and training requirements. 

 3.2g Provides monthly reports to the State Joint Forces Headquarters J-1 that identify barriers 

encountered by Guard members and their families regarding receipt of entitlements and the 

actions taken to overcome them. Performs periodic analysis of problems encountered and 

resolved to determine trends and areas that require further attention. 

 3.2h Analyzes, interprets and clarifies changes in the various Veterans Affairs entitlements 

and provides updates to Joint Forces Headquarters Staff and Guard members and their families. 

 3.2i Coordinates with and assists the State National Guard Military Personnel Offices in 

identifying/tracking National Guard members who have been wounded/injured while on Active 

Duty status. 

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 3.2j As required, participates on councils/teams representing organizations and agencies 

involved in obtaining, and resolving entitlements and benefits issues for National Guard 

members or their families. 

4.0 GOVERNMENT FURNISHED MATERIALS 

 The Contract Support Specialist will be provided office space, telephone, computer 

equipment, and normal office supplies as provided for permanent staff. The Contractor will have 

access to National Guard and DVA material, publications, resolutions, forms, directives, etc. as 

required to perform program analysis and implementation guidance. 

5.0 SECURITY REQUIREMENTS 

 The contract Support Specialist must secure access to government facilities where 

Air/Army National Guard work is to be performed. 

 Nothing in the Contract is to be construed as a personal service. Nothing in this contract 

is to be construed as performance of inherently governmental functions. In the case of any 

question or conflict in either of these subjects, the Contractor shall notify the Contracting Officer 

in writing, with details describing the concern or conflict. 

6.0 TASKING REQUIREMENTS 

 The government will provide a list after award detailing the states and the number of personnel 

to be assigned. 

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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 

0001 Destination Government Destination Government 

0002 Destination Government Destination Government 

2001 Destination Government Destination Government 

2002 Destination Government Destination Government 

3001 Destination Government Destination Government 

3002 Destination Government Destination Government 

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Section F - Deliveries or Performance 

DELIVERY INFORMATION 

CLIN DELIVERY DATE QUANTITY SHIP TO ADDRESS UIC 

 

0001 POP 30-SEP-2008 TO 

29-SEP-2009 

N/A N/A 

FOB: Destination 

 

 

0002 POP 29-SEP-2008 TO 

29-SEP-2009 

N/A N/A 

FOB: Destination 

 

 

2001 POP 30-SEP-2009 TO 

29-SEP-2010 

N/A N/A 

FOB: Destination 

 

 

2002 POP 30-SEP-2009 TO 

29-SEP-2010 

N/A N/A 

FOB: Destination 

 

 

3001 POP 30-SEP-2010 TO 

29-SEP-2011 

N/A N/A 

FOB: Destination 

 

 

3002 POP 30-SEP-2010 TO 

30-SEP-2011 

N/A N/A 

FOB: Destination 

 

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Section G - Contract Administration Data 

1. GOVERNMENT CONTRACTING PERSONNEL: 

a. The Contracting point(s) of contact for this contract will be the following: 

Contract Specialist: 

Office: 703-607-1260 

Address: 

National Guard Bureau (NGB-AQ) 

1411 Jefferson Davis Highway, Suite 8100 

Arlington, VA 22202-3231 

Fax: 703-607-1742 

b. All contracting actions and/or correspondence should be forwarded through the COR appointed in the 

contract schedule. 

2. CONTRACTING OFFICER’S REPRESENTATIVE (COR): 

a. The Contracting Officer has appointed the following individuals as the primary and alternate COR for 

this contract: 

Primary COR:

Deputy Surgeon 

 for Warrior Support 

Address: 

National Guard Bureau 

1411 Jefferson Davis HWY 

Arlington, VA 22202 

(703) 607-5485 

b. The COR will act as the Contracting Officer’s representative for technical matters, providing technical 

direction and discussion as necessary with respect to the specification or statement of work, and 

monitoring the progress and quality of the contractor’s performance. The COR is NOT an 

Administrative Contracting Officer (ACO) and does not have authority to take any action, either 

directly or indirectly, that would change the pricing, quantity, quality, place of performance, delivery 

schedule, or any other term and condition of the contract, or to direct the accomplishment of effort that 

goes beyond the scope the statement of work in the contract. 

c. When, in the opinion of the contractor, the COR requests efforts outside the existing scope of the 

contract, the contractor shall promptly notify the contracting officer in writing. The contractor under 

such direction shall take no action until the contracting officer has resolved the issue or has otherwise 

issued a modification to the contract. 

d. In the absence of the Primary COR named above (due to reasons such as leave, illness, and official 

travel), all responsibilities and functions assigned to the Primary COR shall be the responsibility of the 

Alternate COR (if appointed) acting on behalf of the Primary COR. 

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3. ACCOUNTING FOR CONTRACT SERVICES: 

The Secretary of the Army has implemented Accounting for Contract Services. This initiative has been put in place 

to obtain better visibility of the contractor service workforce. The Assistant Secretary of the Army (Manpower and 

Reserve Affairs) and the Assistant Secretary of the Army (Acquisition, Logistics and Technology) have 

implemented guidance to comply with this DoD Business Initiative Council (BIC) sponsored initiative. These 

contract reporting requirements are mandatory. By acceptance of this contract and performance under this contract, 

the contractor agrees to comply with these reporting requirements. 

The Office of the Assistant Secretary of the Army (Manpower & Reserve Affairs) operates and maintains a secure 

Army data collection site [Contractor Manpower Reporting (CMR) System] where the contractor will report ALL 

contractor manpower (including sub-contractor manpower) required for performance of this contract. The 

contractor is required to completely fill in all the information in the format using the following web address: 

 https://contractormanpower.army.pentagon.mil 

The required information includes: (1) Contracting Office, Contracting Officer, Contracting Officer's Technical 

Representative; (2) Contract number, including task and delivery order number; (3) Beginning and ending dates 

covered by reporting period; (4) Contractor name, address, phone number, e-mail address, identity of contractor 

employee entering data; (5) Estimated direct labor hours (including sub-contractors); (6) Estimated direct labor 

dollars paid this reporting period (including sub-contractors); (7) Total payments (including sub-contractors); (8) 

Predominant Federal Service Code (FSC) reflecting services provided by contractor (and separate predominant FSC 

for each sub-contractor if different); (9) Estimated data collection cost; (10) Organizational title associated with the 

Unit Identification Code (UIC) for the Army Requiring Activity (National Guard Bureau UIC is W00QFF); (11) 

Locations where contractor and sub-contractors perform the work (specified by zip code in the United States and 

nearest city, country, when in an overseas location, using standardized nomenclature provided on website); (12) 

Presence of deployment or contingency contract language; and (13) Number of contractor and sub-contractor 

employees deployed in theater this reporting period (by country). As part of its submission, the contractor will also 

provide the estimated total cost (if any) incurred to comply with this reporting requirement. Reporting period will 

be the period of performance not to exceed 12 months ending September 30 of each government fiscal year and 

must be reported by 31 October of each calendar year. Contractors may use a direct XML data transfer to the 

database server or fill in the fields on the website. The XML direct transfer is a format for transferring files from a 

contractor's systems to the secure web site without the need for separate data entries for each required data element 

at the web site. The specific formats for the XML direct transfer may be downloaded from the web site. 

4. GENERAL INVOICE PREPARATION & SUBMITTAL INSTRUCTIONS: 

a. An invoice is a written and/or electronic request for payment under the contract for supplies delivered 

or for services rendered. In order to be proper, an invoice must include, as applicable, the following: 

i. Name and address of the contractor 

ii. Invoice Date 

iii. Contract Number, or other authorization for supplies delivered or services performed 

(including order number and contract line item number) 

iv. Name and address of contractor official to who payment is to be sent (must be the same as 

that in the contract or on a proper notice of assignment) 

v. Name (where practical), title, phone number and mailing address of person to notified in the 

event of a defective invoice. 

vi. Any other information or documentation required by other requirements of the contract (such 

as evidence of shipment) 

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b. Invoices should match terms and CLIN structure of the contract for ease of payment by Defense 

Finance and Accounting Service (DFAS). 

c. Invoices shall be processed for approval and payment within 5 working days of the completion of 

work. 

d. Receipt of payments by a representative of the contractor’s designated bank shall constitute a full 

accord and satisfaction of the Government’s obligation under the contract to the extent of the amount 

of the payment made. 

e. This contract requires invoice submittal in accordance with Wide Area Workflow (WAWF). Submit 

one electronic original of all invoices to DFAS. IMPORTANT: DFAS must receive electronic 

submittal from the contractor in compliance with DFARS 252.232-7003. The COR(s) will certify all 

invoices for payment. For payment inquiries after submittal, please contact the DFAS Customer 

Service Desk or visit the Vendor Pay Inquiry System at the following web address: 

http://www.dfas mil/money/vendor/ 

5. WIDE AREA WORKFLOW INVOICE INSTRUCTIONS: 

Contractor shall submit payment request using the following method(s) as mutually agreed to by 

the Contractor, the Contracting Officer, the contract administration office, and the payment 

office. 

 Wide Area Workflow (WAWF) (see instructions below) 

 Web Invoicing System (WInS)(https://ecweb.dfas.mil) 

 American National Standards Institute (ANSI) X.12 electronic data interchange (EDI) 

formats (http://www.X12.org and http://www.dfas.mil/ecedi) 

 Other (please specify)____________________________________ 

DFAS POC and Phone: DFAS LIMESTONE, 1-800-756-4571, Option 2, option 3 

WAWF is the preferred method to electronically process vendor request for payment. This 

application allows DOD vendors to submit and track Invoices and Receipt/Acceptance 

documents electronically. Contractors electing to use WAWF shall (i) register to use WAWF at 

https://wawf.eb.mil and (ii) ensure an electronic business point of contact (POC) is designated 

in the Central Contractor Registration site at http://www.ccr.gov within ten (10) calendar days 

after award of this contract/order. 

Questions concerning payments should be directed to the Defense Finance and Accounting 

Service (DFAS) Limestone (F67100) at 1-800-756-4571, Option 2, option 3 or faxed to 1-866-

392-7091. Please have your purchase order/contract number ready when calling about 

payments. 

You can easily access payment and receipt information using the DFAS web site at 

http://www.dfas.mil/contractorpay.html . Your purchase order/contract number or invoice 

number will be required to inquire about the status of your payment. 

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The following codes and information will be required to assure successful flow of WAWF 

documents. 

TYPE OF DOCUMENT [Check the appropriate block] 

Commercial Item Financing

Construction Invoice (Contractor Only) 

Invoice (Contractor Only) 

Invoice and Receiving Report (COMBO)

Invoice as 2-in-1 (Services Only)

Performance Based Payment (Government Only) 

Progress Payment (Government Only) 

Cost Voucher (Government Only) 

Receiving Report (Government Only) 

Receiving Report With Unique Identification (UID) Data (Government Only) 

 UID is a new globally unique “part identifier” containing data elements used to 

track DoD parts through their life cycle. 

Summary Cost Voucher (Government Only) 

CAGE CODE 1VAN5 DUNNS NUMBER: 039425777 TAX ID: 542049330

 ISSUE BY DODAAC: W81MNB

 ADMIN BY DODAAC: W9133L

 INSPECT BY DODAAC: W81MNB

 ACCEPT BY DODAAC: W81MNB 

 SHIP TO DODAAC: W81MNB

 LOCAL PROCESSING OFFICE DODDAC: N/A

 PAYMENT OFFICE FISCAL STATION CODE: F67100

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 EMAIL POINTS OF CONTACT LISTING: (Use Group e-mail accounts if applicable) 

 INSPECTOR: 

 ACCEPTOR: 

 RECEIVING OFFICE POC: 

CONTRACT ADMINISTRATOR 

CONTRACTING OFFICER 

 ADDITIONAL CONTACT: 

"Please pay particular attention to the correct DODAAC Codes outlined in the 

payment instructions included in the contract. This will facilitate faster payment 

of invoices. Please feel free to contact us if the instructions are unclear."

ACCOUNTING AND APPROPRIATION DATA 

AA: 218206500008181055131G96310002512376NFPW81MNB822120006NFP37044220 

AMOUNT: $5,459,405.60 

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Section I - Contract Clauses 

CLAUSES INCORPORATED BY REFERENCE 

252.232-7003 Electronic Submission of Payment Requests and Receiving 

Reports 

MAR 2008 

252.232-7003 Electronic Submission of Payment Requests and Receiving 

Reports 

MAR 2008 

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