36C24425R0054 0001.docx
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- Solicitation number
- 36C24425R0054
About this file
This document is a Standard Form 30 Amendment of Solicitation/Modification of Contract for the Department of Veterans Affairs Network Contracting Office 4. The amendment updates the Price Schedule for solicitation 36C24425R0054, adding two new Contract Line Item Numbers (CLINs) for ambulance services at the Lebanon VAMC. The contract covers various medical transportation services including Advanced Life Support (ALS) and Basic Life Support (BLS) emergency and non-emergency transports, wheelchair van transportation, and additional services like oxygen administration and waiting time.
The contract includes 12 line items with specific pricing for different transportation services, such as emergency and non-emergency ALS and BLS transports (inside and outside 30 miles), wheelchair van transportation, mileage trips, oxygen administration, and waiting time. The ordering period spans from 09-30-2025 to 09-29-2030, with the primary NAICS code 621910 for Ambulance Services. The product/service code is V225 for Transportation/Travel/Relocation, specifically Ambulance services. The amendment was issued by Cynthia Laemmerhirt, Contract Specialist, with an effective date of 07-17-2025.
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Text version
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 ADMINISTRATIVE 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 date 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 30
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) None 36C244 Department of Veterans Affairs Network Contracting Office 4 Coatesville VAMC 1400 Blackhorse Hill Road Coatesville PA 19320 Cynthia Laemmerhirt cynthia.laemmerhirt@va.gov 00244 Department of Veterans Affairs Network Contracting Office 4
To all Offerors/Bidders
36C24425R0054 07-17-2025
X X X See CONTINUATION Page X The purpose of this amendment is for the following items:
1. To update the Price Schedule. CLINs 0001 and 0004 were added.
Cynthia Laemmerhirt Contract Specialist
CONTINUATION PAGE
A.1 PRICE/COST SCHEDULE
ITEM INFORMATION
| ITEM NUMBER |
| DESCRIPTION OF SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 1,200.00 |
| EA |
| ______________ |
| ______________ |
(A0427) Advanced Life Support, Emergency Transport, Level 1 (ALS 1) (One-way trip is equivalent to one each for the unit of issue base rate to include first 30 miles and initial 30 minutes of Wait Time) Ordering Period: 09-30-2025 - 09-29-2030 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,200.00 |
| EA |
| ______________ |
| ______________ |
(A0427) Advanced Life Support, Non-Emergency Transport, Level 1 (ALS 1) Inside 30 miles (One-way trip is equivalent to one each for the unit of issue base rate to include first 30 miles and initial 30 minutes of Wait Time) Ordering Period: 09-30-2025 - 09-29-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 300.00 |
| EA |
| ______________ |
| ______________ |
(A0427) Advanced Life Support, Non-Emergency Transport, Level 1 (ALS 1) Outside 30 miles (One-way trip is equivalent to one each for the unit of issue base rate to include first 30 miles and initial 30 minutes of Wait Time) Ordering Period: 09-30-2025 - 09-29-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 1,000.00 |
| EA |
| ______________ |
| ______________ |
(A0428) Basic Life Support, Emergency Transport (One-way trip is equivalent to one each for the unit of issue base rate to include first 30 miles and initial 30 minutes of Wait Time) Ordering Period: 09-30-2025 - 09-29-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 7,200.00 |
| EA |
| ______________ |
| ______________ |
(A0428) Basic Life Support, Non-Emergency Transport - Inside 30 miles (One-way trip is equivalent to one each for the unit of base rate, to include first 30 miles and initial 30 minutes of Wait Time)
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 300.00 |
| EA |
| ______________ |
| ______________ |
(A0428) Basic Life Support, Non-Emergency Transport - Outside 30 miles (One-way trip is equivalent to one each for the unit of base rate, to include first 30 miles and initial 30 minutes of Wait Time) Ordering Period: 09-30-2025 - 09-29-2030
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 34,800.00 |
| EA |
| ______________ |
| ______________ |
(A0130) Wheelchair Van Transportation - Inside 30 miles (One-way trip is equivalent to one each for the unit of issue base rate to include first 30 miles and initial 30 minutes of Wait Time)
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 300.00 |
| EA |
| ______________ |
| ______________ |
(A0130) Wheelchair Van Transportation Service - Outside 30 miles (One-way trip is equivalent to one each for the unit of issue base rate to include first 30 miles and initial 30 minutes of Wait Time)
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 3,000.00 |
| EA |
| ______________ |
| ______________ |
(A0425) Mileage Trip ALS and BLS starting at 31 miles
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 212,460.00 |
| EA |
| ______________ |
| ______________ |
(S0209) Mileage Trip Wheelchair Van starting at 31 miles
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 900.00 |
| EA |
| ________________ |
| ________________ |
(A0422) Oxygen Administration
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| 900.00 |
| EA |
| ________________ |
| ________________ |
(A0420) Waiting Time - 15-min Increments (after 30 minutes grace period shall be paid in 15-minute increments)
PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance
| GRAND TOTAL |
| _______________ |
End of Document
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