19JA8025Q0001 - Amendment 0001.pdf

AMENDMENT OF SOLICITATION / MODIFICATION OF CONTRACT

1. CONTRACT ID CODE PAGE OF PAGES

1 3

2. MODIFICATION NO.

3. EFFECTIVE DATE

See Item 16C

4. REQUISITION/PURCHASE REQ. NO.

PR14937041 / PR14915044

5. PROJECT NO.

6. ISSUED BY CODE

7. ADMINISTERED BY CODE

Procurement/Contracting Office U.S. Embassy Tokyo 1-10-5 Akasaka Minato-ku, Tokyo 107-8420

See Item 6.

8. NAME AND ADDRESS OF CONTRACTOR

9a. AMENDMENT OF SOLICITATION NO.

19JA8025Q0001

9b. DATED 01/22/2025

10a. MODIFICATION OF CONTRACT/PURCHASE ORDER NO.

10b. DATED

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___ 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 your 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

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

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

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: 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

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

14. DESCRIPTION OF AMENDMENT/MODIFICATION

The purpose of this amendment to the solicitation is to:

a. Confirm by certification that contractor is not in violation with Executive Order 14173 Ending Illegal Discrimination and Restoring Merit-Based Opportunity; and

b. Incorporate the provision Certification Regarding Compliance with applicable Federal anti-discrimination laws in Section 5 of the solicitation.

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

16A. NAME OF CONTRACTING OFFICER

Christopher G. Staff

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

February 21, 2025

NSN 7540-01-152-8070 STANDARD FORM 30 (REV. 10-83)

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

Request for Quotations (RFQ) No. 19JA8025Q0001 Amendment No. 0001

Certification Regarding Compliance with applicable Federal anti-discrimination laws

No funds awarded under this contract may be used for any initiatives or programs, or any activities that do not comply with Executive Order 14173 titled Ending Illegal Discrimination and Restoring Merit-Based Opportunity.

The Contractor shall submit, prior to award or upon request from the Contracting Officer, a certification that confirms:

1.Its compliance in all respects with all applicable Federal anti-discrimination laws is material to the government’s payment decisions for purposes of section 3729(b)(4) of title 31, United States Code and;

2.It does not operate any programs promoting Diversity, Equity, and Inclusion that violate any applicable Federal anti-discrimination laws.

(End of provision)

The following page is Certification Regarding Compliance with applicable Federal anti-discrimination laws.

Offerors shall complete the attached certification statement, signed and dated, and return along with their quote to the email address stated within the solicitation.

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Request for Quotations (RFQ) No. 19JA8025Q0001 Amendment No. 0001

CERTIFICATION REGARDING COMPLIANCE WITH APPLICABLE FEDERAL ANTI-DISCRIMINATION LAW

All Department of State contractors must cer�fy that they do not operate any programs promo�ng DEI that violate any applicable an�-discrimina�on laws and agree that such cer�fica�on is material for purposes of the government’s payment decision and therefore subject to the False Claims Act. See 31 U.S.C. 3729(b)(4).

DIRECTIONS FOR CONTRACTORS and/or OFFERORS

1. Read the en�re cer�fica�on provided below.

2. A�er you have read the provisions, please check the appropriate boxes.

3. Upon comple�on of Step 2, fill out the representa�on below. NOTE: This certification is made by a person with the authority to bind the contractor or offeror.

4. Return completed form to the Contrac�ng Officer/POC stated in paragraph 3. Quota�ons on the page 2 of Cover Leter of the RFQ.

CERTIFICATION:

The Contractor or prospec�ve offeror cer�fies they:

☐ are in compliance in all respects with all applicable Federal an�-discrimina�on laws is material to the government’s payment decisions for purposes of sec�on 31 USC 3729(b)(4) (False Claims Act); and

☐ do not operate any programs promo�ng Diversity, Equity, and Inclusion that violate any applicable Federal an�-discrimina�on laws.

Contractor or Offeror Name (Printed or Typed): ___________________________________________

Authorized Representa�ve Name and Title: ______________________________________________

Authorized Representa�ve Signature and Date: ____________________________________________

Solicitation or Contract Number: Request for Quotations (RFQ) No. 19JA8025Q0001

Embassy of the United States of America

Tokyo, Japan