36C24621Q0657 0001.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 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) 558-21-3-075-0148 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

36C24621Q0657 07-0 -2021

X X X

07/19/2021 10 AM EST

The above-mentioned solicitation is amended as follows.

a. Revised Performance Work Statement beginning on Page 2.

b. Technical questions are extended from 07/01/2021 to 07/14/2021 - 10 AM EST

c. Due dates for quotes is extended from 07/09/2021 to 07/19/2021

All other terms and conditions remain unchanged.

Rodney Wilson Contracting Officer

B.3 PERFORMANCE WORK STATEMENT

Engineering Basic/Skilled Labor

STATEMENT OF WORK (SOW)

IFCAP Tracking Number:

1. Contracting Officer’s Representative (COR).

Name:

Phone Number:

Fax Number:

E-Mail Address:

2. Contract Title. Required critical water systems testing and reporting for Sterile Processing Services.

3. Background/Dates of Service (Period of Performance). The Durham VA Health Care System (DVHCS) needs water sampling services to meet testing requirements for sterile processing services. The sampling should occur at the medical center in Durham, NC from TBD.

4. Specific Tasks.

The National Program Office for Sterile Processing Service (NPOSP) and the Office of Healthcare Environment and Facilities Program (HEFP) require the testing of critical and utility water systems impacting patient care. Critical and utility water systems should be tested as follows:

DURHAM VAMC

TOTAL

GREENVILLE HCC

TOTAL

5. DEFINITIONS/ACRONYMS:

1. DURHAM VAMC –VA Medical Center, located in Durham, VA J. OEM – Original Equipment Manufacturer.

K. QASP - Quality Assurance Surveillance Plan

6. MAINTENANCE CONFORMANCE STANDARDS:

0. Sterile Processing Service shall ensure that critical and utility water testing, reporting requirements are performed and mailed to contract service. .

7. Performance Monitoring

1. The vendor will submit analytical test results to the COR for proof of work completed. The COR will review reports to ensure that the vendor is meeting the standards of the contract and the Quality Assurance Surveillance Plan (QASP).

8. Place of Performance.

1. Durham VAMC 508 Fulton St Durham NC 27705

2. Greenville CBOC Greenville NC

9. Period of Performance.

1. 2021 – 2026.