36C24618Q0626-00001000.docx

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Attached to
Eye Clinic Suite Federal contract opportunity
Solicitation number
36C24618Q0626
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 6

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36C24618Q0626 00001 36C24618Q0626 00001.docx

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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 ITE M 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 r eference 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

BY

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) 00001 04-16-2018 None Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667 Department of Veterans Affairs Network Contracting Office 6 100 Emancipation Drive Hampton VA 23667 To all Offerors/Bidders

36C24618Q0626 04-16-2018

X X X See CONTINUATION Page The purpose of this amendment is to make corrections to the Price/Cost Schedule.

Attached you will find a corrected copy of the Price/Cost Schedule which now includes the dimentions of the requested items.

All other provisions and clauses shall remain the same.

Keeshia Newman

CONTINUATION PAGE

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM NUMBER
DESCRIPTION OF SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
0001
OMEGA REFRACTING CABINET:

103” L X 18 X 231/2 D

15.00
EA
__________________
__________________
0002
OMEGA REFRACTING SYSTEM SINK Unit with Faucet, with No Chip

Edge Banding

15.00
EA
__________________
__________________
0003
OMEGA REFRACTING MODIFICATION CHARGE
15.00
EA
__________________
__________________
0004
OMEGA REFRACTING SYSTEM PC EXTENSION
15.00
EA
__________________
__________________
0005
UPCHARGE TO REVERSE OMEGA UNIT
15.00
EA
__________________
__________________
0006
MISCELLANEOUS PARTS
15.00
EA
__________________
__________________
0007
INSTALLATION CHARGE
15.00
EA
__________________
__________________
0008
OMEGA WALL CABINET OVER SINK:

26" H x 28.5" W x 8" D

2.00
EA
__________________
__________________
0009
RELIANCE FX-920-L CHAIR
2.00
EA
__________________
__________________
0010
RELIANCE FX-920 CUSHION SET
2.00
EA
__________________
__________________
0011
RELIANCE 7900-NC FLOOR UNIT
1.00
EA
__________________
__________________
0012
RELIANCE 7900-IC FLOOR UNIT W/WHEELCHAIR MODIFICATION
1.00
EA
__________________
__________________
0013
HAAG-STREIT 900 BQ LED SLIT LAMP:

Height to console: 36”. Height to pole top: 71”. Base: 21 x 21”.

Electrical (Standard UL Listed), 115 volts, 60 Hz, 3 amperes. Optional: 230 volts, 60 Hz, 1.5 amperes

1.00
EA
__________________
__________________
0014
FRONT SURFACE MIRROR SET
1.00
EA
__________________
__________________
0015
HEINE OMEGA 500 LED HQ UNPLUGGED W/ HC50L RHEOSTAT, Battery & EN50U Wall Charger
1.00
EA
__________________
__________________
0016
REICHERT 11636 MINUS CYLINDER
1.00
EA
__________________
__________________
0017
HEINE BETA 200 OPHTHALMOSCOPE Small Spot, Xenon, 3.5v
1.00
EA
__________________
__________________
0018
HEINE BETA 200 STREAK RETINOSCOPE
1.00
EA
__________________
__________________
0019
HEINE FINOFF TRANSILLUMINATOR 3.5V
1.00
EA
__________________
__________________
0020
HEINE BETA WELL HANDLE, 3.5V
3.00
EA
__________________
__________________
0021
HAAG-STREIT UNIT TOP FLANGE & PIN
1.00
EA
__________________
__________________
0022
HAAG-STREIT SMALL BASE PLATE FOR SLIT LAMP HEAD REST
1.00
EA
__________________
__________________
0023
HAAG-STREIT GLIDING PLATE
1.00
EA
__________________
__________________
0024
HAAG-STREIT LED UNIT TOP ONLY

LOCAL STOCK NUMBER: LED MODEL

1.00
EA
__________________
__________________
0025
UNIVERSAL 3 FT. POWER CORD
1.00
EA
__________________
__________________
0026
HAAG-STREIT LED CONVERSION KIT
1.00
EA
__________________
__________________
0027
MISCELLANEOUS PARTS
3.00
EA
__________________
__________________
0028
Haag-Streit BP/BQ/BX Applanation Tonometer
1.00
EA
__________________
__________________
0029
Reliance 5346 Pneumatic Stool, #637 Mushroom
2.00
EA
__________________
__________________
GRAND TOTAL
__________________

A.2 DELIVERY SCHEDULE

ITEM NUMBER
QUANTITY
DELIVERY DATE
0001-0029
SHIP TO:
Veterans Affairs Medical Center

508 Fulton Street Durham, NC 27705

USA

14 days ARO

MARK FOR:
919.416.8028

Kuruvilla.Kurian@va.gov

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