36C24622Q0245 0002.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) 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

36C24622Q0245 01-27-2022

X X X

12:00; 10 February 2022 See CONTINUATION Page X The purpose of this amendment is to add Patient Transportation Services for the Heart Transplant Program to the Liver Transplant Transportation requirement at the Hunter Holmes McGuire VA Medical Center in Richmond, VA.

1. Line items for the Heart Transplant Transportation requirement is hereby added to the Liver Transplant Transportation solicitation.

2. Reference the Schedule of Service on page two of this amendment.

Diane Stoskopf Contracting Officer

A.1 PRICE/COST SCHEDULE

Liver Transplant transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

Contract Period: Base POP Begin: 03-01-2022 POP End: 02-28-2023 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation PRODUCT/SERVICE CODE: V226 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Taxicab

LOCAL STOCK NUMBER: 000

Liver Weekend/weeknight transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2022 POP End: 02-28-2023 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver holiday transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2022 POP End: 02-28-2023 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver wheelchair accessible transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2022 POP End: 02-28-2023 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

LOCAL STOCK NUMBER: 00

Heart Transplant transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (S)W)

POP Begin: 04-01-2022 POP End: 02-28-2023 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Heart Weekend/Weeknight transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 04-01-2022 POP End: 02-28-2023

Heart holiday transportation to The Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes VAMC in accordance with the Statement of Work (SOW)

POP Begin: 04-01-2022 POP End: 02-28-2023

Heart wheelchair accessible transportation to the Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 04-01-2022 POP End: 02-28-2023 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Estimated Total of Base Year $ ___________________________

Liver Transplant transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

Contract Period: Option 1 POP Begin: 03-01-2023 POP End: 02-28-2024 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver Weekend/weeknight transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2023 POP End: 02-28-2024 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver holiday transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2023 POP End: 02-28-2024 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver wheelchair accessible transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2023 POP End: 02-28-2024 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Heart Transplant transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (S)W)

POP Begin: 03-01-2023 POP End: 02-28-2024

Heart Weekend/Weeknight transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2023 POP End: 02-28-2024

Heart holiday transportation to The Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2023 POP End: 02-28-2024

Heart wheelchair accessible transportation to the Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2023 POP End: 02-28-2024 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Estimated Total of Option Year 1 $________________________

Liver Transplant transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

Contract Period: Option 2 POP Begin: 03-01-2024 POP End: 02-28-2025 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver Weekend/weeknight transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2024 POP End: 02-28-2025 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver holiday transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2024 POP End: 02-28-2025 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver wheelchair accessible transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2024 POP End: 02-28-2025 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Heart Transplant transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (S)W)

POP Begin: 03-01-2024 POP End: 02-28-2025

Heart Weekend/Weeknight transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2024 POP End: 02-28-2025

Heart holiday transportation to The Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2024 POP End: 02-28-2025

Heart wheelchair accessible transportation to the Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2024 POP End: 02-28-2025 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Estimated Total of Option Year 2 $________________________

Liver Transplant transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

Contract Period: Option 3 POP Begin: 03-01-2025 POP End: 02-28-2026 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver Weekend/weeknight transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2025 POP End: 02-28-2026 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver holiday transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2025 POP End: 02-28-2026 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver wheelchair accessible transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2025 POP End: 02-28-2026 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Heart Transplant transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (S)W)

POP Begin: 03-01-2025 POP End: 02-28-2026

Heart Weekend/Weeknight transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2025 POP End: 02-28-2026

Heart holiday transportation to The Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2025 POP End: 02-28-2026

Heart wheelchair accessible transportation to the Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2025 POP End: 02-28-2026 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Estimated Total of Option Year 3 $________________________

Liver Transplant transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

Contract Period: Option 4 POP Begin: 03-01-2026 POP End: 02-28-2027 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver Weekend/weeknight transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2026 POP End: 02-28-2027 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver holiday transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2026 POP End: 02-28-2027 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Liver wheelchair accessible transportation to The Doorways (Hospital Hospitality House) and Central Virginia VA Health Care System (CVHCS) in accordance with the Statement of Work.

POP Begin: 03-01-2026 POP End: 02-28-2027 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Heart Transplant transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (S)W)

POP Begin: 03-01-2026 POP End: 02-28-2027

Heart Weekend/Weeknight transportation to the Doorways (Hospitality House) Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2026 POP End: 02-28-2027

Heart holiday transportation to The Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2026 POP End: 02-28-2027

Heart wheelchair accessible transportation to the Doorways (Hospitality House), Virginia Commonwealth University Medical Center and the Hunter Holmes McGuire VAMC in accordance with the Statement of Work (SOW)

POP Begin: 03-01-2026 POP End: 02-28-2027 PRINCIPAL NAICS CODE: 485991 - Special Needs Transportation

Estimated Total of Option Year 4 $________________________

Total estimated cost of Base plus 4 Option Years: $_________________

Solicitation – 36C24622Q0245 – Liver & Heart Transplant Transportation Services