5. PROJECT NUMBER (if applicable) CODE 7. ADMINISTERED BY 2. AMENDMENT/MODIFICATION NUMBER CODE 6. ISSUED BY 8. NAME AND ADDRESS OF CONTRACTOR 4. REQUISITION/PURCHASE REQ. NUMBER 3. EFFECTIVE DATE 9A. AMENDMENT OF SOLICITATION NUMBER 9B. DATED PAGE OF PAGES 10A. MODIFICATION OF CONTRACT/ORDER NUMBER 10B. DATED BPA NO. 1. CONTRACT ID CODE FACILITY CODE CODE Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods: The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers E. IMPORTANT: is extended, (a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended. 12. ACCOUNTING AND APPROPRIATION DATA (REV. 11/2016) is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A. 15C. DATE SIGNED B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b). RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified. C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF: D. OTHER Contractor 16C. DATE SIGNED 14. DESCRIPTION OF AMENDMENT/MODIFICATION 16B. UNITED STATES OF AMERICA Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect. 15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER 15B. CONTRACTOR/OFFEROR STANDARD FORM 30 PREVIOUS EDITION NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.) (Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.) (If required) (SEE ITEM 11) (SEE ITEM 13) (X) CHECK ONE 13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS, IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14. 11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT (Signature of person authorized to sign) (Signature of Contracting Officer) 1 4 0004 12-02-2019 0 Department of Veterans Affairs Veterans Health Administration Network Contracting Office 16 2575 Keystone Crossing Fayetteville AR 72703 Department of Veterans Affairs Veterans Healthcare System of the Ozarks Network Contracting Office 16 2575 Keystone Crossing Fayetteville AR 72703 To all Offerors/Bidders 36C25619Q1532 X X X 1 See CONTINUATION Page X 1 1.) Change the SOW V.B.1. per the attach document, please update your pricing. 2.) Please update your pricing with the following schedule that includes the Emergency\Unschedule line item for repairs. 3.) Due Date 12-06-2019 at 2pm Reminder all amendments needs to be returned and signed Page 4 of 4 BILLING RATES PM must be billed monthly in accordance with Line Item 0001 through 0004 of the PRICE/COST SCHEDULES. Unscheduled/Emergency Services/Repairs/Replacements must be invoiced as follows: Trip charge for initial diagnostics - Regular Business Hours (M-F) must be at no additional cost to the Government. Trip charge for initial diagnostics must include the first hour of labor After Regular Business Hours (M-F) - $______ Trip charge for initial diagnostics must include the first hour of labor Saturday - $______ Trip charge for initial diagnostics must include the first hour of labor Sunday and Holidays - $______ The Contractor must furnish a copy of the original invoice for all parts associated with unscheduled /emergency services/repairs/replacements, using VA FORMS 08-3385a and 08-3385b. CONTINUATION PAGE A.1 PRICE/COST SCHEDULE ITEM INFORMATION ITEM NUMBER DESCRIPTION OF SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT 0001 12.00 MO _____________ _______________ Elevator Service Contract, Fayetteville, AR Contract Period: Base POP Begin: 01-01-2020 POP End: 12-31-2020 0002 1.00 YR ___$10,000___ ____$10,000____ Unscheduled/Emergency Services/Repairs/Replacements per section V.B. Contract Period: Base POP Begin: 01-01-2020 POP End: 12-31-2020 1001 12.00 MO _____________ ______________ Elevator Service Contract, Fayetteville, AR Contract Period: Option 1 POP Begin: 01-01-2021 POP End: 12-31-2021 1002 1.00 YR ___$10,000___ ____$10,000____ Unscheduled/Emergency Services/Repairs/Replacements per section V.B. Contract Period: Option 1 POP Begin: 01-01-2021 POP End: 12-31-2021 2001 12.00 MO _____________ _______________ Elevator Service Contract, Fayetteville, AR Contract Period: Option 2 POP Begin: 01-01-2022 POP End: 12-31-2022 2002 1.00 YR ___$10,000___ ____$10,000____ Unscheduled/Emergency Services/Repairs/Replacements per section V.B. Contract Period: Option 2 POP Begin: 01-01-2022 POP End: 12-31-2022 3001 12.00 MO _____________ ______________ Elevator Service Contract, Fayetteville, AR Contract Period: Option 3 POP Begin: 01-07-2023 POP End: 12-31-2023 3002 1.00 YR ___$10,000___ ____$10,000____ Unscheduled/Emergency Services/Repairs/Replacements per section V.B. Contract Period: Option 3 POP Begin: 01-01-2023 POP End: 12-31-2023 4001 12.00 MO _____________ ______________ Elevator Service Contract, Fayetteville, AR Contract Period: Option 4 POP Begin: 01-01-2024 POP End: 12-31-2024 4002 1.00 YR ___$10,000___ ____$10,000____ Unscheduled/Emergency Services/Repairs/Replacements per section V.B. Contract Period: Option 4 POP Begin: 01-01-2024 POP End: 12-31-2024 GRAND TOTAL _______________ A.2 DELIVERY SCHEDULE ITEM NUMBER QUANTITY DELIVERY DATE 0001 1.00 0002 1.00 0003 1.00 0004 1.00 0005 1.00
