36C24519R0024-0001000.docx

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) 09-05-2019 517-19-1-933-0002 None 36C245 U.S. Department of Veterans Affairs VA Capitol Healthcare Network (VISN 5) Contracting Office (90C) International Drive Linthicum Heights MD 21090 David J. Valenciabonilla, CS David.Valenciabonilla@va.gov 36C245 U.S. Department of Veterans Affairs VA Capitol Healthcare Network (VISN 5) Contracting Office (90C) 849 International Drive Linthicum Heights MD 21090 To all Offerors/Bidders

36C24519R0024 09-05-2019

X X X

THE PURPOSE OF THE AMENDMENT IS FOR THE FOLLOWING:

A) TO REMOVE THE PARAGRAPH IN THE PRICE/COST SCHEDULE TITLED "REIMBURSEMENT FOR ITEMS NOT HAVING A DEDICATED CODE".

B) SEE R

EVISED PRICE/COST SCHEDULE BELOW.

C) ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.

WILLIAM A. EPPS

CONTRACTING OFFICER

SECTION B - SUPPLIES OR SERVICES AND PRICE/COSTS

PRICE/COST SCHEDULE ITEM INFORMATION

PRICING SCHEDULE

The prices proposed shall not exceed the established Centers for Medicare and Medicaid Services (CMS) Healthcare Common Procedure Coding System (HCPCS) Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) fee schedules applicable to the geographic area. Please apply the best percentage discount that you offer against the CMS A- Code and the CMS L-Code fee schedule baseline.

The guaranteed minimum award amount for this contract is $50.00 per each IDIQ. The maximum aggregate value of orders that can be placed under this contract is $2,000,100.00 (maximum per year). The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

For fabrication and repair of orthotic appliances, the prices proposed shall not exceed the established L-Code prices applicable to the geographic area subject to this solicitation and at the time of performance. It should be noted that repair rates for 15-minute increments are now part of the L-Code pricing schedule. Considering this, please apply the best percentage discount that you offer against the L-Code pricing baseline.

Offerors are encouraged to give a discount on all L-Codes and A-Codes (Orthotic appliances, labor rates for repairs and components*).

Line Item 1: BASE YEAR

L-CODE PRICING LESS % DISCOUNT / A-CODE PRICING LESS % DISCOUNT

Line Item 1a: OPTION YEAR 1

L-CODE PRICING LESS % DISCOUNT / A-CODE PRICING LESS % DISCOUNT

Line Item 1b: OPTION YEAR 2

L-CODE PRICING LESS % DISCOUNT / A-CODE PRICING LESS % DISCOUNT

Line Item 1c: OPTION YEAR 3

L-CODE PRICING LESS % DISCOUNT / A-CODE PRICING LESS % DISCOUNT

Line Item 1d: OPTION YEAR 4:

L-CODE PRICING LESS % DISCOUNT / A-CODE PRICING LESS % DISCOUNT

Note:* It should be noted that L-Code and A-Code pricing are published by the Centers for Medicare and Medicaid Services (CMS) – Healthcare Common Procedure Coding System (HCPCS). The website for the L-Code & A-Code Pricing: http://www.cms.hhs.gov/ICD9ProviderDiagnosticCodes/01_overview.asp (DME, Orthotics and Prosthetics). The Codes are updated every year and are released in December, for the following year. The discounts shown in the Schedule above are for the categories as stated in the Description of Services above, with the CMS representing the L-Codes for Orthotics (new and repair) and the A-Codes for shoes, inserts and related items.

Ordering Officers (OOs) will be authorized to place orders against this contract. The Contracting Officer (CO) will furnish the Contractor with the names of individual authorized as OOs, by memorandum upon OO appointment. OOs are responsible for issuing and administering orders placed under this contract. OOs have no authority to modify the base contract. Any deviation from the terms of the base contract must be approved in writing by the CO responsible for this contract. The Contractor shall accept orders against this contract only from the CO and/or authorized OOs. Fulfilling orders from persons other than the CO or OO is not authorized for supplies/services provided under such orders. Contractor is responsible for correct wage titles and compliance with all applicable wage and hours laws. **Please note: All orders will be done through Contracting until Ordering Officers are put in place.