36C24720R0049-0001000.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 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) N/A 508A

DEPARTMENT OF VETERANS AFFAIRS

VETERANS HEALTH ADMINISTRATION

Network Contracting Office (NCO) 7 2957 CLAIRMONT ROAD NE, Suite 1200 Atlanta

GA

30329 508A

DEPARTMENT OF VETERANS AFFAIRS

VETERANS HEALTH ADMINISTRATION

Network Contracting Office (NCO) 7 2957 CLAIRMONT ROAD NE, Suite 1200 Atlanta

GA

30329 To all Offerors/Bidders

36C24720R0049 03-18-2020

X

X

1. This amendment is to correct the FTE hours from 1 FTE to .09 FTE.

2. All other terms and conditions remain the same.

Don Grier Contracting Officer

CONTINUATION PAGE

SCHEDULE OF SERVICES

The Contractor shall furnish all personnel to provide services necessary to perform onsite Interventional Radiology Physician Services to eligible beneficiaries of the Department of Veterans Affairs Medical Center, Atlanta VAMC #508 (hereinafter referred to as VAMC).

The VA Radiology Services are accredited by ACR and follow the standards & guidelines set forth by American College of Radiology (ACR). A contractor providing onsite interventional radiologist services shall provide services that meet or exceed the American College of Radiology Guidelines http://www.acr.org/Quality-Safety/Standards-Guidelines/Practice-Guidelines-by-Modality/Interventional

Place of Performance: Services shall be provided on site, Atlanta VAMC Radiology Department (114), 1670 Clairmont Road Decatur, GA 30033

Pricing Instructions:

The offeror is instructed to edit the number of sub-clins to correspond with the number of key personnel submitted for the contract line item number (CLIN). Affiliate Offerors shall include the “title” of the personnel submitted. Other commercial health care Offerors shall identify by title/position or level of experience the key personnel submitted. Also, renumber SUB-CLINs if adding or removing Key Personnel. The offeror is instructed to include all other than price and cost information supporting the proposed price as directed in Instructions to Offerors addendum to 52.212-1 and.

The Contractor shall provide (.09) Interventional Radiologist to perform on-site Interventional Radiology procedures and exams. Service is to cover after-hours, on-call, Holidays and employee leave. The key personnel are to be credentialed and be available for scheduling to meet the requirements of the contract.

One FTE is usually defined by VA as a minimum of 80 hours every two weeks and does not include holidays.

Period of Performance: 4-1-2020 through 3-31-2021

Annual Cost

KEY PERSONNEL

NAME:____________

TITLE/LEVEL OF EXPERIENCE:____________

Daytime coverage

NAME:____________

TITLE/LEVEL OF EXPERIENCE:____________

Weekdays On-Call

NAME:____________

TITLE/LEVEL OF EXPERIENCE:___________

Weekends On-Call

NAME:____________

TITLE/LEVEL OF EXPERIENCE:___________

Holiday On-Call

TOTAL FOR BASE

Hours