SF-30 Amendment of Solicitation 0001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF

CONTRACT

1. CONTRACT ID CODE

PAGE OF PAGES

1 28

2. AMENDMENT/MODIFICATION NO.

3. EFFECTIVE DATE

September 28, 2022

4. REQUISITION/PURCHASE REQ. NO.

5. PROJECT NO. (If applicable)

6. ISSUED BY CODE

7. ADMINISTERED BY (If other than Item 6)

CODE

American Embassy in Amman, Jordan

Abdoun, Alumawyeen St. P.O. Box 354, Amman 11118.

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

9a. AMENDMENT OF SOLICITATION NO.

19J01022R0001

9b. DATED (SEE ITEM 11)

August 17th, 2022 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 one (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 amendmen t 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 email or letter, provided each email or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specifie d.

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, [ ] 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.)

The Solicitation # 19J01022R0001 is hereby amended due to the following:

1. Amend solicitation by incorporating the following point under Section H point H.5. (Report Requirements)

H.5.1. The contractor shall provide the COR with annual analytic and summary reports, these reports should include but not li mited to number of maternity cases, chronic cases, cancer and/or congenital, number of deaths, disability cases with the claim amount, receipts (premiums received), number of insurance plans and claims paid. The contractor shall provide the COR with these reports on an annual basis or as requested by the COR and the Contracting Officer.

2. Attachment A - Minutes of Pre-Proposal Conference from September 08th, 2022.

3. Attachment B - Questions and Answers from interested Offerors submitted during the conference, prior or after to the conference.

4. Attachment C - Claims Report

5. Attachment D - Employee Data

6. Extending the Proposals due date to October 20th, 2022 at 04:00 PM Amman (local 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 OF CONTRACTING OFFICER

Christophe Triplett

15B. NAME OF CONTRACTOR/OFFEROR

BY

(Signature of person authorized to sign)

15C.DATE

SIGNED

16B. UNITED STATES OF AMERICA

BY

(Signature of Contracting Officer)

16C.DATE SIGNED

NSN 7540-01-152-8070 Standard Form 30 (revised 10/83)

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