SF-30_001 Amendment 0001 - 05JUN2026_Signed.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE

PAGE 1 OF 8 PAGES

2. AMENDMENT/MODIFICATION

NO. 0001

3. EFFECTIVE DATE

June 5, 2026

4. REQUISITION/PURCHASE

REQ. NO. PR15758452

5. PROJECT NO. (If applicable)

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

COD:

GSO/Procurement TIRANA

U.S. Embassy Rruga Stavro Vinjau, No. 14

TIRANE

GSO/Procurement TIRANA U.S. Embassy

Rruga Stavro Vinjau, No. 14

TIRANE

8. NAME AND ADDRESS OF CONTRACTOR (NO., street,city,county,State,and ZIP Code)

X 9a. AMENDMENT OF SOLICITATION NO.

19AL6026R0001

9b. DATED (SEE ITEM 11) May 8, 2026

10a. MODIFICATION OF

CONTRACT/ORDER NO.

10b. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

[ X ] The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers [X] 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 __1 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.

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, [X] is required to sign this document and return _1__ 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 modification is to update the Solicitation #19AL6026R0001as follows:

1. Correct a typographical error in Section C.1.1.9 by changing the stated maximum amount from USD to ALL (see continuation sheet).

2. Add Clause 52.228-3, Workers’ Compensation Insurance (Defense Base Act) (JUL 2014), to Section I – Contract Clauses.

3. Incorporate Defense Base Act (DBA) insurance requirements into Section B – Pricing, and Section L – Instructions, Conditions, and Notices to Offerors (see continuation sheet).

4. Extend the due date for receipt of offers to June 18, 2026, at 16:30 Local Time (Tirana).

All other terms and conditions of the document identified in Item 9A or 10A, including any prior modifications, remain unchanged and in full force and effect, except as expressly modified by this action.

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

16A. NAME OF CONTRACTING OFFICER

Chris Carlisle

15B. NAME OF CONTRACTOR/OFFEROR

BY

(Signature of person authorized to sign)

15C.DATE

SIGNED

16B. UNITED STATES OF AMERICA

BY ____________

16C.DATE

SIGNED

June 5, 2026

NSN 7540-01-152-8070 Standard Form 30 (revised 10/83) Previous edition unusable Prescribed by GSA FAR (48 CFR) 53.243

06/05/2026 08:22 GMT

Carlisle, Chris (CarlisleCJ@state.gov)

Continuation sheet – SF30

1) Section C.1.1.9 will read as follows:

C.1.1.9 Hearing Aids: Minimum Coverage – 80% Examinations and Treatment: 80% Minimum Coverage Hearing Aid Apparatus: Limited to one apparatus per ear. The maximum coverage is ALL 121,425 per covered individual per three-year period. 80% Minimum Coverage; with annual cap.

2) Clause 52.228-3 WORKERS’ COMPENSATION INSURANCE (Defense Base Act) (JUL 2014) is added under Section I - Contract Clauses

3) DBA Insurance requirement is added in Section B. Pricing and Section L INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS

Section L - Paragraph below is added under Section L - INSTRUCTIONS, CONDITIONS AND NOTICES TO OFFERORS - Preceding L.1

The Offeror shall include Defense Base Act (DBA) insurance premium costs covering their employees working on the contract to include American citizens, Individuals hired in the United States or its possessions, regardless of citizenship, Host Country Nationals (HCNs) and Third Country Nationals (TCNs) working overseas. The offeror shall obtain DBA insurance directly from any Department of Labor approved providers at the DOL website at http://www.dol.gov/owcp/dlhwc/lscarrier.htm

On Section B it is added a line item for DBA insurance and a line for Total including DBA insurance

SECTION B

Part I – Price – Health Insurance B.2 Prices B.2.3 Health Insurance - Base Year of Contract

Bi-Weekly Rates Per Premium Category Estimated Number of

Premiums* Rate per Premium

Extended Bi-Weekly Total

a. Self 56

b. Self Plus One 41

c. Family (3 or more individual)

d. Subtotal 234 Total Price for Base Year (d x 26)**

DBA insurance Base Year Total including DBA

*Estimated number of premiums does not include any Riders (B.1.1) **does not include any premiums for Riders.

Rider Category*** Biweekly Rate per Premium in ALL C.1.1.21 Excess Coverage

***not included in the Total Price for Base Year Calculation http://www.dol.gov/owcp/dlhwc/lscarrier.htm

B.2.4 Health Insurance - First Option Year of Contract

Premiums* Rate per Premium

Extended Bi-Weekly Total

a. Self 58

b. Self Plus One 43

c. Family (3 or more individual)

d. Subtotal 240 Total Price for Option Year 1 (d x 26)**

*Estimated number of premiums does not include any Riders (B.1.1) **does not include any premiums for Riders.

Rider Category*** Biweekly Rate per Premium in ALL

B.2.5 Health Insurance - Second Option Year of Contract

Category Estimated Number of Premiums* Rate per

Premium Extended Bi-Weekly

Total

a. Self 60

b. Self Plus One 45

c. Family (3 or more individual)

d. Subtotal 246

Year 2 (d x 26)**

B.2.6 Health Insurance - Third Option Year of Contract

Category Estimated Number of Premiums* Rate per

Premium Extended Bi-Weekly

Total

a. Self 62

a. Self Plus One 47

b. Family (3 or more individual)

c. Subtotal 252

Year 3 (d x 26)**

B.2.7 Health Insurance - Fourth Option Year of Contract

Premiums* Rate per Premium

Extended Bi-Weekly Total

a. Self 64

b. Self Plus One 49

c. Family (3 or more individual)

d. Subtotal 258

Year 4 (d x 26)**

B.2.8 Health Insurance - Option to Extend Services (max 6 months) FAR 52.217-8

Bi-Weekly Rates Per Premium***

Premiums* Rate per Premium

Extended Bi-Weekly Total

a. Self 64

b. Self Plus One 49

c. Family (3 or more individual)

d. Subtotal 258 Total Price for Option to Extend services (d x 13)**

*Estimated number of premiums does not include any Riders (B.1.1)

***not to be included in the grand total in Table B.2.9

B.2.9 Health Insurance – Grand Total of Base plus All Option Years including DBA Insurance

Base Year Total

First Option Year Total Second Option Year Total

Third Option Year Total

Fourth Option Year Total

Health Insurance - Grand Total of Base plus all Option Years

Part II : Price – Group Life Insurance

B.6.1. Life Insurance - Base Year of Contract

Bi-Weekly Rates per Employee Type of Insurance Premium

(per 1,000 of Salary) Estimated Payroll, ALL (Bi-Weekly in Thousands)

Bi-Weekly Total

a. Basic Life and Accidental Death 21,074.60

b. Total Price for Base Year (a x 26) DBA Insurance

B.6.2. Life Insurance - First Option Year of Contract

(per 1,000 of Salary) Estimated Payroll, ALL (Bi-Weekly in Thousands)

Bi-Weekly Total

Death 21,496.10

b. Total Price for First Option Year (a x 26)

B.6.3. Life Insurance - Second Option Year of Contract

(per 1,000 of Salary) Estimated Payroll, ALL (Bi-Weekly in Thousands)

Bi-Weekly Total

Death 21,926.02

b. Total Price for Second Option Year (a x 26)

B.6.4. Life Insurance - Third Option Year of Contract

(per 1,000 of Salary) Estimated Payroll, ALL (Bi-Weekly in Thousands)

Bi-Weekly Total

a. Basic Life and Accidental Death 22,364.54

b. Total Price for Third Option Year (a x 26)

B.6.5. Life Insurance - Fourth Option Year of Contract

(per 1,000 of Salary) Estimated Payroll, ALL (Bi-Weekly in Thousands)

Bi-Weekly Total

a. Basic Life and Accidental Death 22,811.83

b. Total Price for Fourth Option Year (a x 26)

B.6.6. Life Insurance - Option to Extend Services (6 months) FAR 52.217-8)*

(per 1,000 of Salary) Estimated Payroll, ALL (Bi-Weekly in Thousands)

Bi-Weekly Total,

a. Basic Life and Accidental Death 22,811.83

b. Total Price for Option to Extend Services (a x 13) DBA Insurance

*not to be included in the grand total in Table B.6.7

B.6.7. Life Insurance - Grand Total of Base plus all Option Years including DBA Insurance

Base Year Total

First Option Year Total Second Option Year Total

Third Option Year Total

Fourth Option Year Total

Life Insurance - Grand Total of Base plus all Option Years