S02 - 36C24W24Q0115 0001 - RFQ - Patient Lifts.pdf

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)

36C24W

1 3

36C24W

Department of Veterans Affairs Regional Procurement Office West (RPOW) 3237 Peacekeeper Way Building 200 Suite 204 McClellan Park CA 95652 Brian Anderson brian.anderson8@va.gov

36C24W

Regional Procurement Office West (RPOW) 3237 Peacekeeper Way Building 200 Suite 204

McClellan Park CA 95652

To all Offerors/Bidders

36C24W24Q0115

X

X X

August 21, 2024 3pm CDT

See CONTINUATION Page

See Continuation Page

Timothy L Garrity Contract Officer

VA-VHA-RPOW-2024-0034

CONTINUATION PAGE

The purpose of this amendment is to clarify the items needed for this requirement. The table on Page 1, of the combined synopsis/solicitation, the third line item in the line-item table as reads, “Manufacturer Part #: 3156075. Item Description: Brand Name Description: Universal Slingbar 450 Equal-to-Product: Slingbar. Quantity: 05 EA.” Correction is made to read, “Manufacturer Part #: 35259162. Item Description: Liko Sling 35259162 Solo High Sling L Box 20 (Or Equal).

Quantity: 05 EA.”

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

5.00 EA __________________ __________________

Golvo Mobile Lift included options: 3156075 Uni Sling Bar (Or Equal)

PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing PRODUCT/SERVICE CODE: 6515 - Medical and Surgical Instruments, Equipment, and Supplies

2000045 Golvo 9000 BATTUP Lithium-ion Battery (Or Equal)

PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing

Liko Sling 35259162 Solo High Sling L Box 20 (Or Equal)

PRINCIPAL NAICS CODE: 339113 - Surgical Appliance and Supplies Manufacturing

GRAND TOTAL __________________

A.2 DELIVERY SCHEDULE

ITEM

NUMBER SHIPPING INFORMATION QUANTITY

DELIVERY

DATE

0001 SHIP TO: Department of Veterans Affairs San Diego VA Healthcare System 5608 Eastgate Drive San Diego, CA 92121

USA

5.00 90 DAYS

MARK FOR: Renae Hillock

(858) 642-3448 renae.hillock@va.gov

FOB: DESTINATION

0002 SHIP TO: Same As 0001 5.00

0003 SHIP TO: Same As 0001 5.00

A.2 DELIVERY SCHEDULE