sf-30_Osceola_Road_Maintenance.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE PAGE OF PAGES

1 4

2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)

0001 07/25/2018 907995

6. ISSUED BY CODE 7. ADMINISTERED BY (If other than Item 6) CODE

USDA Forest Service National Forests in Florida 325 John Knox Road, Suite F-100 Tallahassee, FL 32303

Same as block 6

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State, and ZIP Code) (X) 9A. AMENDMENT OF SOLICITATION NO.

X

12428318R0005

9B. DATED (SEE ITEM 11)

07/24/2018

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

CODE FACILITY CODE

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in item 14. The hour and date specified for receipt of Offers is extended, is not extended.

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:

(a) By completing Items 8 and 15, and returning _01_ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

or (c) By separate letter or telegram 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 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 telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

(X) 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.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.

The purpose of this amendment is to correct the Contract Document, Exhibits or Attachments Section cover page and add the two (2) page experience questionaire under Attachement 8 of this solicitation. Please remove the Contract Document, Exhibits or Attachments Section cover page and replace with the attached page. Also, please insert the two (2) page experience questionaire under Attachement 8 of this solicitation.

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 (Type or print) 16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

LAWANDA HENRY

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 16C. DATE SIGNED

/s/ Lawanda Henry 07/25/2018 (Signature of person authorized to sign) (Signature of Contracting Officer)

NSN 7540-01-152-8070

Previous edition unusable

30-105 STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

CONTRACT DOCUMENTS, EXHIBITS OR ATTACHMENTS

Attachment 1: Performance Work Statement (PWS) 28 pages

Attachment 2: Work Order and Notice of Noncompliance (FS-6300-12) 01 page

Attachment 3: Osceola National Forest Road Maintenance Tracking Spreadsheet 05 pages

Attachment 4: Wage Determination FL236 - Baker County, FL 06 pages

Attachment 5: Wage Determination FL183 - Columbia County, FL 05 pages

Attachment 6: Quality Assurance Surveillance Plan (QASP) 16 pages

Attachment 7: Technical Exhibits 07 pages

Attachment 8: Experience Questionnaire 02 pages

--END-

Experience Questionnaire

CONTRACTOR NAME, ADDRESS, TELEPHONE, FAX, E-MAIL

SUBMITTED TO:

USDA Forest Service

National Forests in Florida 325 John Knox Road, Suite F-100 Tallahassee, FL 32303

How many years do you or your firm have in the line of work contemplated by this solicitation? ______

How many years experience in contracting have your or your business had as:

(a) a prime contractor __________ (b) a sub-contractor ____________

List below all projects of similar or higher dollar value and scope your business has completed within the past three years.

Use separate sheet for continuation.

AWARDING AGENCY/OWNER CONTRACT AMOUNT

PROJECT LOCATION DATE BEGUN

CONTRACT NUMBER DATE COMPLETED

CONTRACTING OFFICER NAME AND PHONE NUMBER

PROJECT ENGINEER/COR/COTR NAME AND PHONE NUMBER

BRIEF DESCRIPTION OF WORK

AWARDING AGENCY/OWNER CONTRACT AMOUNT

PROJECT LOCATION DATE BEGUN

CONTRACT NUMBER DATE COMPLETED

CONTRACTING OFFICER NAME AND PHONE NUMBER

PROJECT ENGINEER/COR/COTR NAME AND PHONE NUMBER

BRIEF DESCRIPTION OF WORK

AWARDING AGENCY /OWNER CONTRACT AMOUNT

PROJECT LOCATION DATE BEGUN

CONTRACT NUMBER DATE COMPLETED

CONTRACTING OFFICER NAME AND PHONE NUMBER

PROJECT ENGINEER/COR/COTR NAME AND PHONE NUMBER

BRIEF DESCRIPTION OF WORK

List below all of your firm’s contractual commitments running concurrently with the work contemplated by this solicitation:

Use separate sheet for continuation.

NAME, ADDRESS, AND TELEPHONE NUMBER OF BUSINESS OR GOVERNMENT

AGENCY

CONTRACT

NUMBER

DOLLAR

AMOUNT

PERCENT

COMPLETE

EXPECTED

COMPLETION

DATE

List below information for major subcontractors planned for this project.

NAME, ADDRESS, AND TELEPHONE NUMBER TYPE OF WORK DOLLAR AMOUNT

On a separate sheet provide a brief resume of principal individuals in your firm, including the proposed project manager and superintendent. Include at a minimum the individual’s name, present position, years of experience, years with your firm, and type of duties.

CERTIFICATION

I certify that all of the statements made by me are complete and correct to the best of my knowledge and that any persons named as references are authorized to furnish the Forest service with any information needed to verify my capability to perform this project.

CERTIFYING OFFICIAL’S NAME AND TITLE

SIGNATURE DATE