19GE5026R0041-0001.pdf
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- Attached to
- Life and Health Insurance Services for Locally Employed Staff at U. S. Embassy Kingston, Jamaica
- Solicitation number
- 19GE5026R0041
About this file
Summary of Amendment of Solicitation/Modification of Contract
This document is a Standard Form 30 Amendment of Solicitation/Modification of Contract issued by the State Department (Document Number: 19GE5026R0041, Amendment 0001) with an effective date of April 2, 2026. The amendment modifies maximum coverage amounts for health insurance benefits in Sub-Sections C.1.1.10 and C.1.1.11 of the underlying solicitation dated March 18, 2026. The contracting officer is Travis Keon, and the document was issued by Sarah Pfannkuche.
The amendment updates optical and dental care coverage maximums. Optical care coverage for prescription lenses, frames, and contact lenses is increased to a maximum of $47,700 Jamaican Dollar (JMD) per covered individual every two years with 80% minimum coverage and an annual cap. Dental care coverage is expanded to include examinations, x-rays, cleanings, fillings, extractions, false teeth, crowns, and bridges up to $508,800 JMD per covered individual per contract year with 80% minimum coverage and an annual cap. Additionally, orthodontia treatment is covered only if treatment begins before age 18 or results from an accident, with a maximum of four years of treatment and a $381,600 JMD lifetime limit per individual with 80% minimum coverage. All other terms and conditions of the original solicitation remain unchanged and in full force and effect.
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Document Number: 19GE5026R0041 PROCESSED Page 1 of 7
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
1. CONTRACT ID CODE RATING
2. AMENDMENT/MODIFICATION NUMBER
3. EFFECTIVE DATE
04/02/2026
4. REQUISITION/PURCHASE REQ. NUMBER 5. PROJECT NUMBER (If applicable)
CODE
Sarah Pfannkuche
NAME
TEL.
pfannkuches@State.gov
6. ISSUED BY CODE7. ADMINISTERED BY (If other than Item 6)
9A. AMENDMENT OF SOLICITATION NUMBER
19GE5026R0041
CODE FACILITY CODE
8. NAME AND ADDRESS OF CONTRACTOR (Number, street, country, state and ZIP Code) (X)
X 9B. DATED (SEE ITEM 11)
03/18/2026
10A. MODIFICATION OF CONTRACT/ORDER
NUMBER
10B. DATED (SEE ITEM 11)
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
X XThe 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 ____copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; 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 your 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.
12. ACCOUNTING AND APPROPRIATION DATA (If required)
13. THIS ITEM ONLY APPLIES TO MODIFICATION 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 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.)
This amendment is issued to modify the maximum amount stated in Sub-Sections C.1.1.10 and C.1.1.11 of Attachment 1 - Schedule and Clauses as follows:
1. Sub-Section C.1.1.10 - Optical Care: Prescription lenses and frames or contact lenses: Covered up to a maximum of $47,700 Jamaican Dollar (JMD) per covered individual every two years. 80% Minimum Coverage; with annual cap.
2. Sub-Section C.1.1.11 - Dental Care: Examinations and Treatment: Dentist’s fees, x-rays, examinations and treatment, cleanings, fillings, extractions, false teeth, crowns, and bridges up to a maximum of $508,800 Jamaican Dollar (JMD) per covered individual per contract year. 80% Minimum Coverage: with annual cap.
Orthodontia: Treatment is covered only if treatment begins before age 18, or if required as the result of an accident. A maximum of four years of orthodontia treatment will be covered per covered individual up to a maximum of $381,600 Jamaican Dollar (JMD) lifetime limit. 80% Minimum Coverage; with contract lifetime cap.
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) Travis Keon
(Signature of person authorized to sign)
15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED
By (Signature of Contracting Officer)
16B. UNITED STATES OF AMERICA 16C. DATE SIGNED
04/02/2026
NSN 7540-01-152-8070
Previous edition unusable
STANDARD FORM 30 (REV.
11/2016) Prescribed by GSA FAR (48 CFR) 53.243
CGFS // CGFS
Travis C Keon Digitally signed by Travis C Keon Date: 2026.04.02 14:12:55 +02'00'
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