191D3225Q0004 A0002 SAM.pdf

1. CONTRACT ID CODE PAGE OF PAGES

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1 3

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

00002 See Box 16c

6. ISSUED BY CODE JAKAR19007 7. ADMINISTERED BY (If other than Item 6)

CODE

U.S. Embassy – GSO/Contracting office Jl. Merdeka Selatan 3-5 Jakarta 10110 Phone: (6221)5083-1000

Same as box 6

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

POTENTIAL OFFEROR 9B. DATED (SEE ITEM 11)

X

10A. MODIFICATION OF CONTRACT/ORDER NO.

191D3225Q0004

10B. DATED (SEE ITEM 13)

CODE FACILITY CODE August 13th, 2025

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 one (1) copy 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 DATA 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 data 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.

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)B.3.6, B.4.1.5B.4.2.5, B.4.3.5, and B.4.4.5

E. IMPORTANT: Contractor is not, is required to sign this document and return _1_ copy to the issuing office.

14. Description of Amendment/Modification (Organized by UCF section headings, including solicitation/contract subject matter where feasible) This solicitation is hereby amended as follows:

1. Light Jackets are for Jakarta and Medan only.

2. Revision of Exhibit A to reflect the revised list of light jacket.

3. The deadline of submissions of proposal is hereby extended from September 4, 2025, to Tuesday, September 9, 2025, 16.00, Jakarta time.

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)

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

(Signature of person authorized to sign)

BY ___/S/ Bryant H. Whitfield ________ (Signature of Contracting Officer)

Sep 4, 2025

NSN 7540-01-152-8070 30-105 STANDARD FORM 30 (REV. 0-83)

Previous edition unusable Prescribed by GSA FAR (48 CFR) 53.243

REVISION OF EXHIBIT A: Package Distribu�on