SF30 Amendment pgs 1-4.pdf

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 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 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.

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

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

2. AMENDMENT/MODIFICATION NUMBER 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)

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

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

FACILITY CODE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED (SEE ITEM 13)

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.

12. ACCOUNTING AND APPROPRIATION DATA (If required) copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

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

IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER

NUMBER IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation data, 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)

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.

15C. DATE SIGNED

15A. NAME AND TITLE OF SIGNER (Type or print)

16C. DATE SIGNED

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

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

PAGE OF PAGES

6. ISSUED BY CODE

8. NAME AND ADDRESS OF CONTRACTOR (Number, street, county, State and ZIP Code) (X)

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

Previous edition unusable

00001 15B212

Kathy Cole, Contracting Officer - FAO

Amendment No. 00001 is issued to incorporate the changes identified on pages 2 of 4, 3 of 4, and 4 of 4, of this amendment.

The offer due date of October 15, 2021 at 2:00 PM CST remains unchanged.

Federal Bureau of Prisons FCI Herlong 741-925 Herlong Access Road A25 Herlong, CA 96113

218-21

15B61921R00000001

1 4

08/17/2021

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT-

CONTINUATION

CONTRACT ID CODE PAGE of

PAGES

Standard Form 1449 Section 3 – Contract Clauses

Page 22 of 49 – (35)(i) 52.222-50, Combating Trafficking in Persons (OCT 2020) (22 U.S.C. chapter 78 and E.O. 13627), is hereby applicable.

Standard Form 1449 Section 5 – Solicitation Provisions

Page 27 of 49, within 52.252-1, Solicitation Provisions Incorporated by Reference, 52.222-24, Pre- Award On-Site Equal Opportunity Compliance Evaluation (Feb 1999), is hereby removed and not applicable.

Page 28 of 49, the room number of the address contained within 52.233-2, Service of Protest (Sept 2006), is hereby updated to Room 901-5.

Attachment 1: Contract Pricing & Sub-Contract Certification

Pages 4 of 6, 5 of 6, and 6 of 6, Schedule of Items, is hereby updated as follows (changes in red):

• 2c1. Optometrist is changed to 2c3. Optometrist, 2c2. Mobile CT is changed to 2c1. Mobile CT, 2c3. Mobile MRI is changed to 2c2. Mobile MRI

• Mobile CT is changed from Per 8 hr. Session to Per 7 hr. Session

• Mobile MRI is changed from Per 8 hr. Session to Per 7 hr. Session

Base Year – FCI Herlong

Effective Date of Award (EDOA) through twelve (12) months from EDOA.

1a. Inpatient Facility Services: - Discount or + Premium to Medicare Part A 1b. Outpatient Facility Services: - __ Discount or + Premium to Medicare Part B 2a. Inpatient Physician Services: - Discount or + Premium to Medicare Part B 2b. Outpatient Physician Services: - Discount or + Premium to Medicare Part B 2c. Outpatient Institution Services: ***************************************** 2c1. Mobile CT $_______ Per 7 hr. Session 2c2. Mobile MRI $_______ Per 7 hr. Session 2c3. Optometrist: $_______ Per 8 hr. Session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT

APPLICABLE "-/+" PERCENTAGE. IF NO VARIANCE, ENTER "0".

Option Year 1 – FCI Herlong

Thirteen (13) months through twenty-four (24) months from EDOA.

1b. Outpatient Facility Services: - __ Discount or + Premium to Medicare Part B 2a. Inpatient Physician Services: - Discount or + Premium to Medicare Part B 2b. Outpatient Physician Services: - Discount or + Premium to Medicare Part B 2c. Outpatient Institution Services: ***************************************** 2c1. Mobile CT $_______ Per 7 hr. Session 2c2. Mobile MRI $_______ Per 7 hr. Session 2c3. Optometrist: $_______ Per 8 hr. Session

Option Year 2 – FCI Herlong

Twenty-five (25) months through thirty-six (36) months from EDOA.

1a. Inpatient Facility Services: - Discount or + Premium to Medicare Part A 1b. Outpatient Facility Services: - __ Discount or + Premium to Medicare Part B 2a. Inpatient Physician Services: - Discount or + Premium to Medicare Part B 2b. Outpatient Physician Services: - Discount or + Premium to Medicare Part B 2c. Outpatient Institution Services: ***************************************** 2c1. Mobile CT $_______ Per 7 hr. Session 2c2. Mobile MRI $_______ Per 7 hr. Session 2c3. Optometrist: $_______ Per 8 hr. Session

Option Year 3 – FCI Herlong

Thirty-seven (37) months through forty-eight (48) months from EDOA.

1a. Inpatient Facility Services: - Discount or + Premium to Medicare Part A 1b. Outpatient Facility Services: - __ Discount or + Premium to Medicare Part B 2a. Inpatient Physician Services: - Discount or + Premium to Medicare Part B 2b. Outpatient Physician Services: - Discount or + Premium to Medicare Part B 2c. Outpatient Institution Services: ***************************************** 2c1. Mobile CT $_______ Per 7 hr. Session 2c2. Mobile MRI $_______ Per 7 hr. Session 2c3. Optometrist: $_______ Per 8 hr. Session

Option Year 4 – FCI Herlong

Forty-nine (49) months through sixty (60) months from EDOA.

1b. Outpatient Facility Services: - __ Discount or + Premium to Medicare Part B 2a. Inpatient Physician Services: - Discount or + Premium to Medicare Part B 2b. Outpatient Physician Services: - Discount or + Premium to Medicare Part B 2c. Outpatient Institution Services: ***************************************** 2c1. Mobile CT $_______ Per 7 hr. Session 2c2. Mobile MRI $_______ Per 7 hr. Session 2c3. Optometrist: $_______ Per 8 hr. Session

Option to Extend Services as Authorized by FAR 52.217-8 – FCI Herlong

1b. Outpatient Facility Services: - __ Discount or + Premium to Medicare Part B 2a. Inpatient Physician Services: - Discount or + Premium to Medicare Part B 2b. Outpatient Physician Services: - Discount or + Premium to Medicare Part B 2c. Outpatient Institution Services: ***************************************** 2c1. Mobile CT $_______ Per 7 hr. Session 2c2. Mobile MRI $_______ Per 7 hr. Session 2c3. Optometrist: $_______ Per 8 hr. Session

NOTE: IF OFFERING A VARIANCE FROM THE BENCHMARK MEDICARE RATE, INSERT

APPLICABLE "-/+" PERCENTAGE. IF NO VARIANCE, ENTER "0".

All offerors are hereby advised that the successful Offeror’s unit pricing (to include discount percentage from or premium percentage to the benchmark Medicare rate) for the base year and all option years is public information, in accordance with Federal Acquisition Regulation (FAR) 15.503(b)(1)(iv). Accordingly, all successful unit pricing will be released to unsuccessful Offerors with the notification of award as well as to the general public when requested. Any party who objects to the release of their own unit pricing information, should they be awarded a contract in response to this solicitation, should not submit proposal in response to the solicitation.