The file's text, extracted by GovTribe without its formatting.
5. PROJECT NUMBER (if applicable)
CODE
7. ADMINISTERED BY
2. AMENDMENT/MODIFICATION NUMBER
CODE
6. ISSUED BY
8. NAME AND ADDRESS OF CONTRACTOR
4. REQUISITION/PURCHASE REQ. NUMBER
3. EFFECTIVE DATE
9A. AMENDMENT OF SOLICITATION NUMBER
9B. DATED
PAGE OF PAGES
10A. MODIFICATION
OF CONTRACT/ORDER NUMBER
10B. DATED
BPA NO.
1. CONTRACT ID CODE
FACILITY CODE
CODE
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:
The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers
E. IMPORTANT:
is extended,
(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 is not extended.
12. ACCOUNTING AND APPROPRIATION DATA
(REV. 11/2016)
is required to sign this document and return ___________ copies to the issuing office is not, 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.
15C. DATE SIGNED
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADM
INISTRATIVE CHANGES
SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
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 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 d ate specified.
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER
Contractor
16C. DATE SIGNED
14. DESCRIPTION OF AMENDMENT/MODIFICATION
16B. UNITED STATES OF AMERICA
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 AND TITLE OF CONTRACTING OFFICER
15B. CONTRACTOR/OFFEROR
STANDARD FORM 3
PREVIOUS EDITION NOT USABLE
Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)
(If required)
(SEE ITEM 11)
(SEE ITEM 13)
(X)
CHECK
ONE
13. THIS ITEM APPLIES ONLY TO
MODIFICATIONS OF CONTRACTS/ORDERS,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
(Signature of person authorized to sign) (Signature of Contracting Officer) 05-13-2019 528-19-4-4855-0095 None Department of Veterans Affairs Network Contracting Office (NCO) 2 2875 Union Road Suite 3500 Cheektowaga NY 14227 Department of Veterans Affairs Network Contracting Office (NCO) 2 2875 Union Road Suite 3500 Cheektowaga NY 14227 To all Offerors/Bidders
36C24219Q0631 05-13-2019
X X X
See CONTINUATION Page 528-3690160-4855-820100 0100C00Q3 X One The purpose of this Amendment 0001 is to correct the B.3 Price Schedule and B.4 Price Worksheet to accurately reflect annual requirements for medical gas fills and tank rentals. These documents are required to be completed and submitted as Part 2 of the quote submission as specified in Section E under FAR 52.212-2 Evaluation instr uctions.
It is also noted the quantities reflected in the Statement of Work are estimated monthly requirements, not annual estimates as reflected in the B.4 Price Worksheet.
*All other terms and conditions remain unchanged.
Michelle A. Harsch Contracting Officer
CONTINUATION PAGE
B.3 PRICE SCHEDULE
Base Period: 8/1/2019-7/31/2020
| CLIN -Base Year |
| SUPPLIES/ SERVICES |
| UOM |
| UNIT PRICE -Base Year |
| 0001 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI) |
| CY |
| 0003 |
| Customer owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 0004 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 0005 |
| Customer owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 0006 |
| Vendor owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 0007 |
| Customer owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 0008 |
| Vendor owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 0009 |
| Customer owned cylinder: Air Compressed – Size E |
| CY |
| 0010 |
| Vendor owned cylinder: Air Compressed – Size E |
| CY |
| 0011 |
| Customer owned cylinder: Air Compressed – Size H |
| CY |
| 0012 |
| Vendor owned cylinder: Air Compressed – Size H |
| CY |
| 0013 |
| Vendor owned cylinder: Nitrogen Compressed - Size E |
| CY |
| 0014 |
| Customer owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 0015 |
| Vendor owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 0016 |
| Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 0017 |
| Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 0018 |
| Vendor owned cylinder: Helium compressed USP – Size A |
| CY |
| 0019 |
| Customer owned cylinder: Helium compressed USP – Size H |
| CY |
| 0020 |
| Vendor owned cylinder: Helium compressed USP – Size H |
| CY |
| 0021 |
| Vendor owned cylinder: Biological Atmosphere - Size H |
| CY |
| 0022 |
| Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 0023 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 0024 |
| Customer owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 0025 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 0026 |
| Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2) |
| CY |
| 0027 |
| Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB |
| CY |
| 0028 |
| Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2 |
| CY |
| 0029 |
| Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 0030 |
| Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 0031 |
| Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF |
| CY |
| 0032 |
| Customer owned cylinder: Argon Compressed, USP - Size B |
| CY |
| 0033 |
| Vendor owned cylinder: Argon Compressed, USP - Size B |
| CY |
Option Period 1: 8/1/2020-7/31/2021
| CLIN - Option Year 1 |
| SUPPLIES/ SERVICES |
| UOM |
| UNIT PRICE - Option Year 1 |
| 1001 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI) |
| CY |
| 1003 |
| Customer owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 1004 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 1005 |
| Customer owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 1006 |
| Vendor owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 1007 |
| Customer owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 1008 |
| Vendor owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 1009 |
| Customer owned cylinder: Air Compressed – Size E |
| CY |
| 1010 |
| Vendor owned cylinder: Air Compressed – Size E |
| CY |
| 1011 |
| Customer owned cylinder: Air Compressed – Size H |
| CY |
| 1012 |
| Vendor owned cylinder: Air Compressed – Size H |
| CY |
| 1013 |
| Vendor owned cylinder: Nitrogen Compressed - Size E |
| CY |
| 1014 |
| Customer owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 1015 |
| Vendor owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 1016 |
| Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 1017 |
| Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 1018 |
| Vendor owned cylinder: Helium compressed USP – Size A |
| CY |
| 1019 |
| Customer owned cylinder: Helium compressed USP – Size H |
| CY |
| 1020 |
| Vendor owned cylinder: Helium compressed USP – Size H |
| CY |
| 1021 |
| Vendor owned cylinder: Biological Atmosphere - Size H |
| CY |
| 1022 |
| Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 1023 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 1024 |
| Customer owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 1025 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 1026 |
| Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2) |
| CY |
| 1027 |
| Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB |
| CY |
| 1028 |
| Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2 |
| CY |
| 1029 |
| Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 1030 |
| Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 1031 |
| Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF |
| CY |
| 1032 |
| Customer owned cylinder: Argon Compressed, USP - Size B |
| CY |
| 1033 |
| Vendor owned cylinder: Argon Compressed, USP - Size B |
| CY |
Option Period 2: 8/1/2021-7/31/2022
| CLIN - Option Year 2 |
| SUPPLIES/ SERVICES |
| UOM |
| UNIT PRICE - Option Year 2 |
| 2001 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI) |
| CY |
| 2003 |
| Customer owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 2004 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 2005 |
| Customer owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 2006 |
| Vendor owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 2007 |
| Customer owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 2008 |
| Vendor owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 2009 |
| Customer owned cylinder: Air Compressed – Size E |
| CY |
| 2010 |
| Vendor owned cylinder: Air Compressed – Size E |
| CY |
| 2011 |
| Customer owned cylinder: Air Compressed – Size H |
| CY |
| 2012 |
| Vendor owned cylinder: Air Compressed – Size H |
| CY |
| 2013 |
| Vendor owned cylinder: Nitrogen Compressed - Size E |
| CY |
| 1014 |
| Customer owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 2015 |
| Vendor owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 2016 |
| Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 2017 |
| Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 2018 |
| Vendor owned cylinder: Helium compressed USP – Size A |
| CY |
| 2019 |
| Customer owned cylinder: Helium compressed USP – Size H |
| CY |
| 2020 |
| Vendor owned cylinder: Helium compressed USP – Size H |
| CY |
| 2021 |
| Vendor owned cylinder: Biological Atmosphere - Size H |
| CY |
| 2022 |
| Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 2023 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 2024 |
| Customer owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 2025 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 2026 |
| Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2) |
| CY |
| 2027 |
| Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB |
| CY |
| 2028 |
| Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2 |
| CY |
| 2029 |
| Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 2030 |
| Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 2031 |
| Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF |
| CY |
| 2032 |
| Customer owned cylinder: Argon Compressed, USP - Size B |
| CY |
| 2033 |
| Vendor owned cylinder: Argon Compressed, USP - Size B |
| CY |
Option Period 3: 8/1/2022-7/31/2023
| CLIN - Option Year 3 |
| SUPPLIES/ SERVICES |
| UOM |
| UNIT PRICE - Option Year 3 |
| 3001 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI) |
| CY |
| 3003 |
| Customer owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 3004 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 3005 |
| Customer owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 3006 |
| Vendor owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 3007 |
| Customer owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 3008 |
| Vendor owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 3009 |
| Customer owned cylinder: Air Compressed – Size E |
| CY |
| 3010 |
| Vendor owned cylinder: Air Compressed – Size E |
| CY |
| 3011 |
| Customer owned cylinder: Air Compressed – Size H |
| CY |
| 3012 |
| Vendor owned cylinder: Air Compressed – Size H |
| CY |
| 3013 |
| Vendor owned cylinder: Nitrogen Compressed - Size E |
| CY |
| 3014 |
| Customer owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 3015 |
| Vendor owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 3016 |
| Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 3017 |
| Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 3018 |
| Vendor owned cylinder: Helium compressed USP – Size A |
| CY |
| 3019 |
| Customer owned cylinder: Helium compressed USP – Size H |
| CY |
| 3020 |
| Vendor owned cylinder: Helium compressed USP – Size H |
| CY |
| 3021 |
| Vendor owned cylinder: Biological Atmosphere - Size H |
| CY |
| 3022 |
| Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 3023 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 3024 |
| Customer owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 3025 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 3026 |
| Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2) |
| CY |
| 3027 |
| Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB |
| CY |
| 3028 |
| Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2 |
| CY |
| 3029 |
| Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 3030 |
| Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 3031 |
| Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF |
| CY |
| 3032 |
| Customer owned cylinder: Argon Compressed, USP - Size B |
| CY |
| 3033 |
| Vendor owned cylinder: Argon Compressed, USP - Size B |
| CY |
Option Period 4: 8/1/2023-7/31/2024
| CLIN - Option Year 4 |
| SUPPLIES/ SERVICES |
| UOM |
| UNIT PRICE - Option Year 4 |
| 4001 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size E (also aluminum for MRI) |
| CY |
| 4003 |
| Customer owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 4004 |
| Vendor owned cylinder: Oxygen Compressed, USP - Size H |
| CY |
| 4005 |
| Customer owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 4006 |
| Vendor owned cylinder: Carbon Dioxide USP – Size E |
| CY |
| 4007 |
| Customer owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 4008 |
| Vendor owned cylinder: Carbon Dioxide USP - Size H |
| CY |
| 4009 |
| Customer owned cylinder: Air Compressed – Size E |
| CY |
| 4010 |
| Vendor owned cylinder: Air Compressed – Size E |
| CY |
| 4011 |
| Customer owned cylinder: Air Compressed – Size H |
| CY |
| 4012 |
| Vendor owned cylinder: Air Compressed – Size H |
| CY |
| 4013 |
| Vendor owned cylinder: Nitrogen Compressed - Size E |
| CY |
| 4014 |
| Customer owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 4015 |
| Vendor owned cylinder: Nitrogen Compressed - Size H |
| CY |
| 4016 |
| Customer owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 4017 |
| Vendor owned cylinder: Compressed Gas, 90% Argon, 10% Methane, Size D |
| CY |
| 4018 |
| Vendor owned cylinder: Helium compressed USP – Size A |
| CY |
| 4019 |
| Customer owned cylinder: Helium compressed USP – Size H |
| CY |
| 4020 |
| Vendor owned cylinder: Helium compressed USP – Size H |
| CY |
| 4021 |
| Vendor owned cylinder: Biological Atmosphere - Size H |
| CY |
| 4022 |
| Customer owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 4023 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size E (also aluminum for MRI) |
| CY |
| 4024 |
| Customer owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 4025 |
| Vendor owned cylinder: Nitrous Oxide, USP – Size H |
| CY |
| 4026 |
| Vendor owned cylinder: Blood Gas Mixture - Size E (16%O2, 4% CO2, Balance N2) |
| CY |
| 4027 |
| Vendor owned cylinder: Lung Diffusion Mix - Size H CO 0.3000% +/- 2%, Methane 0.3000% +/- 2%, Oxygen 21.00% +/- 2%, NB |
| CY |
| 4028 |
| Vendor owned cylinder: Compressed Gas, 95% Oxygen 5% CO2 |
| CY |
| 4029 |
| Vendor owned cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 4030 |
| Customer owned (Batavia) cylinder: Oxygen Compressed, USP with built-in regulator, size E* |
| CY |
| 4031 |
| Vendor owned cylinder: Compressed Gas, Size H, 5% CO2, 5% H, Balance NF |
| CY |
| 4032 |
| Customer owned cylinder: Argon Compressed, USP - Size B |
| CY |
| 4033 |
| Vendor owned cylinder: Argon Compressed, USP - Size B |
| CY |
See attached document: B.4 Price Worksheet-Medical Gas Fills and Tank Rentals-528 and 528A4.