F__F10_Contract_Mod_Req_Template.pdf
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- 140A1627B0003
About this file
This document is a Contract Modification Request form (revised December 2021) used to request proposals from contractors for performing additional work under an existing contract.
The form serves as a formal mechanism for government agencies to request contractor proposals for work modifications. Block 6 contains the primary work description and requires contractors to provide all means, methods, and technology, along with furnishing all plant, labor, and materials necessary to complete the described work. Attachments such as Purchase Requests (PR), Statements of Work (SOW), and drawings should be included if applicable. The Contracting Officer must obtain a formal proposal and explicitly directs the contractor not to commence work until receiving a signed SF 30 modification. The Contracting Officer indicates funding status by selecting one of three options: Funding Not Applicable, Funds Currently Available, or Funds Not Currently Available. The contractor responds with a proposed amount and detailed cost breakdown for both prime and subcontract costs. Work authorization is contingent upon government acceptance of the proposal and receipt of the signed SF 30 modification. The form requires signatures and dates from the Requesting Office, Contracting Officer's Representative, Contracting Officer, and Contractor to establish a binding proposal for the contract modification.
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Text version
CONTRACT MODIFICATION REQUEST
REVISED ON DEC 2021
1. REQUESTING OFFICE 2. CONTRACT NUMBER 3. TASK ORDER NUMBER
4. CONTRACTOR 5. PROJECT TITLE AND LOCATION
6. REQUEST CONTRACTING OFFICER OBTAIN A PROPOSAL FROM THE CONTRACTOR TO PROVIDE ALL MEANS, METHODS, AND TECHNLOGY, AS WELL AS, FURNISH ALL PLANT, LABOR, AND MATERIALS TO
PERFORM ALL WORK NECESSARY TO ACCOMPLISH THE FOLLOWING DESCRIBED WORK:
PLEASE SEE ATTACHMENT(S) IF APPLICABLE:
EXAMPLES: PR, SOW, DRAWINGS, ETC.
NOTE: INDEPENDENT GOVERNMENT ESTIMATES WILL REMAIN INTERNAL USE ONLY.
7. REQUESTOR:
DATE: SIGNATURE:
8. CONTRACTING OFFICER’S REPRESENTATIVE:
DATE: SIGNATURE:
9. CONTRACTING OFFICER: CONTRACTOR, YOU ARE HEREBY REQUESTED TO PROVIDE A PROPOSAL
FOR THE WORK DESCRIBED IN BLOCK 6. DO NOT START WORK UNDER THIS PROPOSED CHANGE
UNTIL YOU RECEIVE A COPY OF THE SIGNED SF 30 MODIFICATION. SUBMIT YOUR PROPOSAL IN THE
SPACE BELOW AND ATTACH A DETAILED BREAKDOWN OF PRIME AND SUBCONTRACT COSTS.
FUNDING NOT APPLICABLE.
FUNDS ARE CURRENTLY AVAILABLE.
FUNDS ARE NOT CURRENTLY AVAILABLE.
DATE: SIGNATURE: TITLE: CONTRACTING OFFICER
10. CONTRACTOR: I PROPOSE TO PROVIDE ALL MEANS, METHODS, AND TECHNLOGY, AS WELL AS, ALL PLANT, LABOR, AND MATERIALS TO PERFORM THE WORK DESCRIBED IN BLOCK 6 UPON
ACCEPTANCE OF THIS PROPOSAL BY THE GOVERNMENT AND RECEIPT OF A SIGNED SF 30
MODIFICATION.
PROPOSED AMOUNT: $__________________
DATE: SIGNATURE: TITLE:
| 1 REQUESTING OFFICE: |
| 2 CONTRACT NUMBER: |
| 3 TASK ORDER NUMBER: |
| 4 CONTRACTOR: |
| 5 PROJECT TITLE AND LOCATION: |
| EXAMPLES PR SOW DRAWINGS ETC 1: |
| EXAMPLES PR SOW DRAWINGS ETC 2: |
| PROPOSED AMOUNT: |
| Text1: |
| Date3_af_date: |
| Date4_af_date: |
| Date10_af_date: |
| Date11_af_date: |
| Text14: |
| Check Box15: Off |
| Check Box16: Off |
| Check Box17: Off |
File details come from the government source that posted it. Updated .