36C25219Q0001-0001000.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) 12-03-2018 Multiple None 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 To all Offerors/Bidders

36C25219Q0001

X X X

See CONTINUATION Page Multiple will be included on individual orders.

X The purpose of this amendment is to replace the CLIN schedule of RFQ 36C25219Q0001. Pages 8-15 of RFQ 36C25219Q0001 are hereby replaced with pages 2-11 of this amendment.

Two line items were inadvertently left off of the original RFQ document.

Ryan McMillin Contracting Officer

B.2 DELIVERY SCHEDULE

ITEM NUMBER

DELIVERY DATE

Department of Veteran Affairs 3001 Green Bay Rd.

North Chicago, IL 60064

USA

SEE SOW AND CLINS

Department of Veteran Affairs 5000 W. National Ave.

Milwaukee, WI 53295 U.S.A.

SEE SOW AND CLINS

5000 South 5th Avenue Hines, IL 60141 United States

SEE SOW AND CLINS

Department of Veteran Affairs 820 South Damen Avenue Chicago, IL 60612 3728

SEE SOW AND CLINS

Department of Veteran Affairs 325 East H. Street Iron Mountain, MI 49801

SEE SOW AND CLINS

Department of Veteran Affairs 500 E. Veterans St.

Tomah, WI 54660

SEE SOW AND CLINS

2851 University Avenue Green Bay, WI 54311

US

SEE SOW AND CLINS

OFFERORS ARE TO WRITE IN THEIR PRICING FOR 1 CT INJECTOR, MODEL INDICATED IN THE CLIN PER FACILITY, PER YEAR. THE PRICE IS TO INCLUDE ONE YEAR OF SERVICE, SAID SERVICE WILL INCLUDE ONE ANNUAL PM AND THE MINIMUM FOR THIS IDIQ CONTRACT IS $6,000.00 AND THE MAX CEILING IS $800,000.00. THE CURRENT VISN 12 INVENTORY OF INJECTORS PER FACILITY IS LISTED AFTER THE SOW.

IT IS LIKELY THAT AWARD COULD OCCUR A FEW DAYS AFTER 12/01/2018. THE BASE YEAR WILL STILL END ON 11/30/2018.

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

1.00

YR

Contract Period: Base POP Begin: 12-01-2018 POP End: 11-30-2019

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

Contract Period: Option 1 POP Begin: 12-01-2019 POP End: 11-30-2020

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

Contract Period: Option 2 POP Begin: 12-01-2020 POP End: 11-30-2021

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

Contract Period: Option 3 POP Begin: 12-01-2021 POP End: 11-30-2022

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

Contract Period: Option 4 POP Begin: 12-01-2022 POP End: 11-30-2023

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR

1.00

YR