36C24720Q0277-0002000.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 NUMBERE

D 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 amendmen t, 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) 03-16-2020 none Y Department of Veterans Affairs Central Alabama Veterans Health Care 215 Perry Hill Road Montgomery AL 36109-3798 Y Department of Veterans Affairs Central Alabama Health Care System East Campus 2400 Hospital Road Tuskegee AL 36083-5001 To all Offerors/Bidders

36C24720Q0277 03-16-2020

X x x x This amendment has the following information:

1. There was an adminstrative error on the Past Performance Information. The Past Performance Survey will be submitted on March 20, 2020, 3:00 pm est with your soliciation,

2. The referance Instructions: The location is Central Alabama Veterans Health Care System, this is the correct location Please submi t this document,

3. ALL other terms and conditions shall remain the same.

Benford Brundage Contracting Officer.

PAST PERFORMANCE INFORMATION

OFFEROR INSTRUCTIONS: A separate record must be completed for each Past Performance Information and Survey; Offeror must directly send to the evaluator, requesting they complete and return to the Contracting Officer as indicated on the attached Past Performance Survey, no later than 3:00 pm EST, 20 March 2020. Please attached this COMPLETED document with your solicitation. Further, Offeror must include a copy of each requested Past Performance Information page with proposal submission. Please complete and return to Earnest.Ellison@va.gov, Please submit with Solicitation.

Name of Offeror being evaluated:

Address of Offeror:

Contract Details (i.e. Contract Number / Delivery or Task Order Number, Title, Location, etc.):

Name of Evaluator:

Position held or function in relation to project:

Company Name:

Address:

Contact Phone Number:

Facsimile Number:

Please complete and return to Earnest.Ellison@va.gov, Please submit with Solicitation.

PAST PERFORMANCE SURVEY

REFERENCE INSTRUCTIONS: Central Alabama Veterans Health Care System (CAVHCS), Montgomery Al is considering the offeror listed above for award of a VA contract. Your comments would be appreciated regarding this firm’s past performance. The intent of this form is to evaluate Courier Service. Your comments are considered Source Selection Sensitive; therefore, you are advised that the Federal Acquisition Regulation (at FAR 15.506(e) prohibits the release of the names of individuals providing reference information about Offeror’s past performance.

Please evaluate the past performance using only the following ratings without variation. If the rating is Marginal or Unacceptable, please provide additional information in the appropriate block or in the remarks section of this form.

“O” = Outstanding = Performance greatly exceeded the contract requirements

“A” = Above Average = Performance exceeded the contract requirements

“S” = Satisfactory = Performance met the contract requirements

“M” = Marginal = Performance met the minimum contract requirements but some material aspects of the Contractor’s performance were less than satisfactory

“U” = Unacceptable = Performance was poor and/or did not satisfy contract requirements

Q1. To what extent did the Contractor comply with contract requirements?

O A S M U

Q2. If reports were required, were they accurate in meeting contract requirements?

O A S M U

Q3. To what extent did the Contractor use appropriate personnel for contract requirements?

O A S M U

Q5. Quality control:

O A S M U