Amendment No. 1 - SF30 and cont. sheets001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

PAGE OF PAGES

2 ATIIENDMENTI ODIFICATION NO

0t

6 ISSUED BY

American Embassv- Lima Contracting Officd (GSO) Av. La Encalada Cdra l7 Monterrico

5 PROJECT NO (tf apptbabte)

CODE

8 NAME AND ADDRESS OF NTRACTOR ftuo.. street county. State and ZIP Cocie)

CODE

7 ADMINISTERED AY (/f othet than ltem 6) CODE

9A A[/tEN0MENT OF SOLICITATION NO

98 DATED (SEE /IEM 1,)

1OA MODIFICATION OF CONTRACT/ORDER NO

19P85023R0005 lOB OATED TSEE /IEM

'3)

06-08-2023

I1. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

l CONTRACT ID CODE

3 EFFECTIVE DATE

07 -03-2023

4 REOUISITION/PURCHASE REQ NO

(x)

FACILITY CODE

x

! nre above numbered solicilation is amended as sel iorth in llem 14 The hour and date specifed ior receipt ot Otrers ! is extenOeO. ! is not extenaeO

Offers must acknowledge receipl ofthis amendment pdor to the hour and date speofied in the solicitation or as amended, byone ofthe foilowing melhods:

(a)By complelrng items 8 and 15, and retuming _ copjes of the amendment; (b) By aclnowiedging receipt of this amendment on each copy of the offer submitted, or (c) 8y separate letler or telegram which includes a reference to lhe solicita{on and amendment numb€rs. FAILURE OF YOUR ACKNO\TIiLEDGMENT TO BE RECEIVED AT THE PLACE OESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED l\lAY RESULT lN REJECTION OF YOUR OFFER l, by virtue of thjs lhis amendment. and is received prior to the opening hour and date specifed

12 ACCOUNTING AND APPROPRIATION DATA ffreq./ired.)

I3. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

CHECK ONE A THIS CHANGE OROER lS ISSUED PURSUANTIO (Speciry aulhotity) THE CHANGES SET FORTH lN ITEM 14AREMADE lN THE CONTRACT ORDER NO IN ITEM lOA

8 THE ABOVE NUMSERED CONTRACT/ORDER lS MOOIFIED TO REFLECT THE AOMINISTRATIVE CHANGES (sucn as changes in paying otfae, appropriation date, etc.) SET FORTH lN ITEM 14, PURSUANT TO THE AUTHORIfi OF FAR 43.103(b)

C THIS SUPPLEMENTAT AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF

D OTHER (Spec,ily type of mo<lificalan and aulhorq)

E. IMPORTANT: Contractor ! is not, x is required to sign this document and return I copies to the issuing office

14 OESCRIPTION OF AME DMET{T/MODIFICATION lorganhed by lrcF s€clion headings, including solicilatbnbntract su,Fcl mattd where teasible.)

Original Request for Proposal is hereby amended as follows:

(cont.)

Exc€pt as provided herein, all terms and conditions of the document referenced in ltem 9A or 10A, as herelofore changed, remains unchanged and in full force and eflect.

15C DATE SIGNED ]68 UN

15A NAME AND TITLE OF SIGNER (Iype oTP'i,I)

158 CONTMCTOFYOFFEROR

16A. NAI,E AND TITLE OF CONTRACTING OFFICER (Type or pflnt)

Curt Whittaker

16C DATE IGNED

.9 -ry3 (S,gnature ol pe6on authorized to siJn)

NSN 7540,01,152-8070

PrevDUs edition unusable

STANDARD FORM 30 (REV. 1o 83) Prescnbed by GSA FAR (48 CFR) 53 243

Amendment No. 1 to RFP No. 19PE5023R00O5

PaEe 2

1. The currency in Price Tables under sections 8.6.1, 8.5.2, 8.5.3, 8.5.4 and 8.6.5, Column "Premium" should be in Soles instead of USD. Column should read: "Premium (Per

1,000 Soles).

2. The Monthly Payroll amounts for Life lnsurance by Law and Supplemental Life lnsurance under sections 8.6.1, 8.6.2, 8.6.3, 8.6.4 and 8.6.5 are modified to read: S/.4,45L,778.72.

Health insurance coverage set forth in this section shall be provided to the USG from primary health insurance providers registered as an "Empresa Prestadora de Salud" (EPS) or designated representatives licensed for this purpose in Peru. The health plan is setup for various networks which shall include basic, medium and high-level clinics. lf a company prefers to work through a broker or have a broker operate on their behali this shall be permitted. The agreement between the broker and the company shall be submitted as part of this offer. The contract forthe services will bebetweentheUSG and the company providing the services.

4. Section C.1.1.9 Hearing Aids - Changes currency for maximum amount from USD 1,500 to S/.5,700.00.

5. Section C.1.1.10Optical Care - Changes currency for maximum amount from USD 300 to s/.1,140.00.

6. Section C.1.1.11 - Dental Care - Changes currency for maximum amount as follows

Examinations and Treatment: S/ .72,12O.OO

Orthodontia: Sl.9,L2O.OO

7. Section C.1.1.15 - HIV/AIDS - Changes currency for maximum amount from USD 10,000 to s/.38,000.00.

8. Replaces Section C.2.1.2. Mandatory Life lnsurance (Peruvian Law 688) to read:

C.2.1.2. Mandatory Life lnsurance (Peruvian Law 688)

3. Section C.1 Health lnsurance Services, paragraph 2 is replaced entirely to read:

Employees receive the following levels of life insurance coverage from the first day of work:

Natural Death: 16 monthly adjusted salaries

Accidental Death: 32 monthly adjusted salaries

Permanent Disability: 32 monthly adjusted salaries

9. section J - List of Exhibits/Attachment is revised to include the following additional Exhibits:

Exhibit G - Health Claims Report (2018 - 20221

Exhibit H - Health Claims Monthly Report (2018 - 2022)

Exhibit l- Health Claims Report - Retirees

Exhibit J - Total Population by Agencies

Exhibit K - Life lnsurance Complete Data (age, salary, gender)

Exhibit L - Warranty Letters Report Exhibit M - Life lnsurance Claims Report

All other terms and conditions of original Request for Proposal No. 19PE5023R0005 remain the same and unchanged.