36C24419Q0885-0003000.docx
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- Solicitation number
- 36C24419Q0885
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36C24419Q0885 0003 36C24419Q0885 0003.docx
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| 36C24419D0079-000.docx | DOCX document | |
| 36C24419Q0885-0004000.docx | DOCX document | |
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| 36C24419Q0885-001.docx | DOCX document | |
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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) 7/23/19 none 00244 Department of Veterans Affairs Network Contracting Office 4
00244 Department of Veterans Affairs Network Contracting Office 4
To all Offerors/Bidders
36C24419Q0885 07-23-2019
X X X
X This amendment to the above solicitation serves three purposes:
1. To make the clarification that Final Fixed cast refers to pindex cast for fabrication of individual units.
2. The "B.3 Deliv ery Schedule" is removed.
2.
The "B.2 Price Schedule" is updated again, disregard the prior two (refer to continuation pages 2-3).
All other terms and conditions remain the same. ***END OF AMENDMENT***
William Schlobohm Contracting Officer B.2 PRICE SCHEDULE (Offeror shall complete all fillable information below)
| ITEM NUMBER |
| DESCRIPTION OF SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
5 Year Estimated Total (Estimated 12 Month Cost x 5)
| 0001 |
| Dental Laboratory Services for Veteran Beneficiaries of the VA Butler Health Care System in accordance with the Statement of Work and Fixed Individual Unit Prices. |
| 60.00 |
| MONTHS |
TOTAL ESTIMATED 12 MONTH COST (ADDING UP ALL THE 12 MONTH TOTALS BELOW): $___________
*Note 1 - Estimated quantities below are not fixed. Actual usage will depend on actual need. The Individual unit prices will be utilized for each item below.
*Note 2 – There are no option years associated with this contract, but offerors may either provide Fixed Individual Unit prices that vary from year to year, or Fixed Individual Unit Prices that (take into consideration any perceived escalation) and remain the same for the duration of the contract. Either way the Five (5) Year Estimated Total for 60 Months will be evaluated.
| Description of Supplies/Services |
| Est. Annual Quantity |
| Unit |
| Fixed Individual Unit Price |
| Est. 12 Month Total |
| Nightguard Hard |
| 2 |
| EA |
| $________ |
| $________ |
| Nightguard dual laminate |
| 2 |
| EA |
| $________ |
| $________ |
| Custom tray |
| 35 |
| EA |
| $________ |
| $________ |
| Stent |
| 2 |
| EA |
| $________ |
| $________ |
| Final cast denture |
| 2 |
| EA |
| $________ |
| $________ |
| Final cast fixed Pindex |
| 2 |
| EA |
| $________ |
| $________ |
| Denture set up |
| 5 |
| EA |
| $________ |
| $________ |
| Partial set up |
| 5 |
| EA |
| $________ |
| $________ |
| Denture process |
| 5 |
| EA |
| $_________ |
| $________ |
| Partial process acrylic |
| 5 |
| EA |
| $_________ |
| $________ |
| Partial process flexible |
| 5 |
| EA |
| $_________ |
| $________ |
| Metal framework |
| 15 |
| EA |
| $_________ |
| $________ |
| Porcelain fused to metal |
| 10 |
| EA |
| $_________ |
| $________ |
| PFM gold alloy price |
| 10 |
| EA |
| $_________ |
| $________ |
| Full gold crown |
| 10 |
| EA |
| $_________ |
| $________ |
| FGC gold alloy price |
| 10 |
| EA |
| $_________ |
| $________ |
| Full porcelain crown (emax, zirconia) |
| 15 |
| EA |
| $_________ |
| $________ |
| Add clasp metal framework |
| 4 |
| EA |
| $_________ |
| $________ |
| Add denture tooth |
| 3 |
| EA |
| $_________ |
| $________ |
End of Document
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