36C25521R0004 0002.docx

36C25521R0004 0002

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)

02-02-2021

None 36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Leavenworth KS 66048

36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Leavenworth KS 66048 To all Offerors/Bidders

36C25521R0004

X

ONE(1)

This amendment is issued to clairfy the Government requirement for laboratory testing services to the VISN 15 Medical Centers located in Kansas, Missouri and Illinois.

Attachment 1 has been revised and is attached.

See on continuation pages, tests/panels that needed clarification. If clarifications were not provided, please list Similar tests panels with tests included.

Ashley Osborn Contract Specialist

CONTINUATION PAGE

ASPERGILLUS AB PNL, CF ID SERUM

Aspergillus Antibody, Complement Fixation Aspergillus Antibodies, Immunodiffusion (Aspergillus flavus, Aspergillus fumigatus, Aspergillus niger)

86604

Peanut (f13) IgE Cabbage (f216) IgE Grape (f259) IgE Egg White (f1) IgE Cow's Milk (f2) IgE Wheat (f4) IgE Rye (f5) IgE Barley (f6) IgE Oat (f7) IgE Corn (f8) IgE Rice (f9) IgE Soybean (f14) IgE White Bean (f15) IgE Crab (f23) IgE Shrimp (f24) IgE Tomato (f25) IgE Pork (f26) IgE Beef (f27) IgE Carrot (f31) IgE Orange (f33) IgE Potato (f35) IgE Tuna (f40) IgE Chicken Meat (f83) IgE Lettuce (f215) IgE Green Pepper (Unripe)(f263) IgE**

FOOD ALLERGY PROFILE,

IgE allergy testing for:

Cashew Nut (f202) Codfish (f3)

Cow's Milk (f2)

Egg White (f1)

Hazelnut (f17)

Peanut (f13)

Salmon (f41)

Scallop (f338)

Sesame Seed (f10)

Shrimp (f24)

Soybean (f14)

Tuna (f40)

Walnut (f256)

86003

GRASS PANEL

GRASSES ALLERGY PANEL #7

Phosphatidylserine Antibodies (IgG, IgA, IgM) Beta-2-Glycoprotein I Antibodies (IgG, IgA, IgM) 86146 (x3), 86147 (x3), 86148 (x3)

RESPIRATORY ALLERGY PROFILE, REGION IX

· IgE allergy testing for:

· Alternaria alternata (a mold) (m6)

· Aspergillus fumigatus (m3)

· Bermuda grass (g2)

· Cat dander (e1)

· Cladosporium herbarum (m2)

· Cockroach (i6)

· Common ragweed (short) (w1)

· Cottonwood (t14)

· Dermatophagoides farinae (d2)

· Dermatophagoides pteronyssinus (d1)

· Dog dander (e5)

· Elm (t8)

· Maple (box elder) (t1)

· Mountain cedar (Juniperus sabinoides) (t6)

· Mouse Urine Proteins (e72)

· Mulberry (t70)

· Nettle (Urtica dioica) (w20)

· Oak (t7)

· Penicillium notatum (m1)

· Russian thistle (prickly saltwort) (w11)

· Sheep sorrel (Rumex acetosella) (w18)

· Timothy grass (Phleum pratense) (g6)

· White ash (Fraxinus americana) (t15)

· Immunoglobulin E

82785, 86003

RESPIRATORY ALLERGY PROFILE, REGION V

· IgE allergy testing for:

· Aspergillus fumigatus (m3)

· Bermuda grass (g2)

· Birch (t3)

· Cat dander (e1)

· Cladosporium herbarum (m2)

· Cockroach (i6)

· Common ragweed (short) (w1)

· Cottonwood (t14)

· Dermatophagoides farinae (d2)

· Dermatophagoides pteronyssinus (d1)

· Dog dander (e5)

· Elm (t8)

· Maple (box elder) (t1)

· Mountain Cedar (t6)

· Mouse Urine Proteins (e72)

· Oak (t7)

· Pecan/Hickory (t22)

· Penicillium notatum (m1)

· Rough pigweed (w14)

· Russian Thistle (w11)

· Sheep sorrel (w18)

· Sycamore (t11)

· Timothy grass (g6)

· Walnut tree (t10)

· White ash (t15)

· White mulberry (t70)

· Immunoglobulin E

82785, RESPIRATORY ALLERGY PROFILE,REGION VIII

· IgE allergy testing for:

· Aspergillus fumigatus (m3)

· Bermuda grass (Cynodon dactylon) (g2)

· Cat dander (e1)

· Cladosporium herbarum (Hormodendrum) (m2)

· Cockroach (i6)

· Common Ragweed (short) (w1)

· Cottonwood (Populous deltoides) (t14)

· Dermatophagoides farinae (d2)

· Dermatophagoides pteronyssinus (d1)

· Dog dander (e5)

· Elm (t8)

· Maple (box elder) (t1)

· Maple leaf sycamore, London Plane (t11)

· Mountain cedar (Juniperus sabinoides) (t6)

· Mouse Urine Proteins (e72)

· Mulberry (t70)

· Oak (t7)

· Pecan/Hickory (Carya soecue, pecan) (t22)

· Penicillium notatum (m1)

· Rough marsh elder (Iva) (w16)

· Rough pigweed (Amaranthus retroflexus) (w14)

· Russian thistle (Saltwort, Salsola kali) (w11)

· Timothy grass (Phleum pratense) (g6)

· Walnut (Juglans californica) (t10)

· White ash (Fraxinus americana) (t15)

· Immunoglobulin E 82785, MISC. ALLERGEN TESTING;

· IgE allergy testing for:

· Almond (f20)

· Brazil Nut (f18)

· Cashew Nut (f202)

· Hazelnut (f17)

· Macadamia Nut (rf345)

· Peanut (f13)

· Pecan Nut (f201)

· Pistachio (f203)

· Walnut (f256) Bass Black (Sea Bass) (Centropristis striata) IgE

· Soy Component nGly m 5, beta-conglycinin IgE

· Soy Component rGly m 4, PR-10 IgE

· Soy Component nGly m 6 Glycinin IgE 82785, 86003

Dog Dander (e5) IgE Mouse (e88) IgE Rat Epithelia (e73) IgE Goose Feathers (e70) IgE

86003

ALLERGY PNL #18, NUT MIX;GROUP

· IgE allergy testing for:

· Cashew Nut (f202)

· Coconut (f36)

· Hazelnut (f17)

· Peanut (f13)

· Pecan (f201)

· Sesame Seed (f10) 86003

ALLERGY PNL #19, SEAFOOD;GROUP

· IgE allergy testing for:

· Codfish (f3)

· Crab (f23)

· Lobster (f80)

· Salmon (f41)

· Shrimp (f24)

· Tuna (f40) 86003

BREAST PLUS PANEL W/O BRCA (SJC 92586)

VIRAL HEPATITIS (LEP)

STREPTOZYME SCREEN W/RE

ALLERGY SEAFOOD PANEL WIT

Codfish (f3) IgE Gulf Flounder (rf147) IgE** Tuna (f40) IgE Salmon (f41) IgE Trout (f204) IgE Crab (f23) IgE Shrimp (f24) IgE Lobster (f80) IgE 86003

ALLERGY NUT PANEL WITHOUT

Peanut (f13) IgE Hazelnut (f17) IgE Brazil Nut (f18) IgE Almond (f20) IgE Walnut (f256) IgE

HEAVY METALS GROUP #22

Arsenic, Urine; Mercury, Random Urine; Cadmium, Random Urine; and Creatinine, Random Urine 82175, 82300, 82570, 83825

CHEM TEST 15

TREE ALLERGY PANEL #1

· Maple (Box Elder) (t1)

· Birch (t3)

· Elm (t8)

· Cottonwood (t14)

· White Ash (t15) 86003

Gulf Flounder (rf147) IgE** Tuna (f40) IgE Salmon (f41) IgE Trout (f204) IgE 86003

TREE ALLERGY PANEL #5

· Maple (Box Elder) (t1)

· Birch (t3)

· Elm (t8)

· Walnut Tree (t10)

· Cottonwood (t14) 86003

RAST BASIC 10, ALLERGY PA

· English Plantain (w9)

· Lamb's Quarters (Goose Foot) (w10)

· Russian Thistle (w11)

· Rough Pigweed (w14)

· Scale (w15)

86003

IMMUNO/AGGLUTINATION ID

Stemphylium botryosum (m10) IgE, Cladosporium herbarum (m2) IgE, Aspergillus fumigatus (m3) IgE, Mucor racemosus (m4) IgE, Alternaria alternata (m6) IgE, Phoma betae (m13) IgE, Candida albicans (m5) IgE, Epicoccum purpurascens (m14) IgE, Fusarium moniliforme (m9) IgE 86003

ALLERGY PANEL #21

ALLERGY NORTHEAST REGIONA

· IgE allergy testing for:

· Alternaria alternata (m6)

· Cat Dander (e1)

· Cladosporium herbarum (m2)

· Common Ragweed (Short) (w1)

· Dermatophagoides farinae (d2)

· Dog Dander (e5)

· June Grass (Kentucky Blue) (g8)

· Lamb's Quarters (Goose Foot) (w10)

· Oak (t7)

· Timothy Grass (g6) 86003

STAGE II

Hybridization/gene expression Alternative Name(s) PAM50 Risk of Recurrence Score 81520

STAGE III

CHRONIC URTICARIA PANEL 3

· IgE Antibody (Anti-IgE IgG), Histamine Release (Chronic Urticaria)

83520, 86343

ALLERGY SHELLFISH PANEL 1

· IgE allergy testing for:

· Clam (f207)

· Crab (f23)

· Lobster (f80)

· Shrimp (f24) 86003

ALLERGY NUT PANEL #2

Peanut (f13) IgE,

· Hazelnut (f17) IgE,

· Brazil Nut (f18) IgE,

· Almond (f20) IgE,

· Walnut (f256) IgE 86003

ALLERGY FOOD PANEL #16

ALLERGY TREE PANEL # 6

· IgE allergy testing for:

· Mountain Cedar (t6)

· Elm (t8)

· Cottonwood (t14)

· White Ash (t15)

· Hickory/Pecan Tree (t22) 86003

ALLERGY WEED PANEL #6

Egg White (f1) IgE, Milk (f2) IgE, Codfish (f3) IgE, Wheat (f4) IgE, Corn (f8) IgE, Peanut (f13) IgE, Soybean (f14) IgE, Shrimp (f24) IgE, Pork (f26) IgE, Beef (f27) IgE, Egg Yolk (f75) IgE, Cocoa (f93) IgE 862003

EHSCR

ALLERGY-TREE PROFILE +IGE

Maple (Box Elder) (t1) IgE Hickory/Pecan Tree (t22) IgE Birch (t3) IgE Mountain Cedar (t6) IgE Walnut Tree, Californian (t10) IgE Oak (t7) IgE Elm (t8) IgE

862003

CASCADING REFLEX

RT-QUIC

ALLERGY FOOD PANEL 20

AUTOIMMUNE NEURO AB PNL

· If Autoimmune Neurology Antibody Comprehensive Panel suggests NMO-5 IgG, then Aquaporin-4 Antibody will be performed at an additional charge (CPT code(s): 86255).

· If Aquaporin-4 Ab is positive, then titer will be performed at an additional charge (CPT code(s): 86256).

· If Autoimmune Neurology Antibody Comprehensive Panel suggests ANNA-3, the titer will be performed at an additional charge (CPT code(s): 86256).

· If Autoimmune Neurology Antibody Comprehensive Panel suggests PCA2, then titer will be performed at an additional charge (CPT code(s): 86256).

· If Autoimmune Neurology Antibody Comprehensive Panel suggests PCA-Tr and Paraneoplastic Ab, WB shows DNER negative and Yo Negative, then DNER, Ab, IFA will be performed at an additional charge (CPT code(s): 86255).

· If DNER, Ab, IFA is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).

· If Autoimmune Neurology Antibody Comprehensive Panel suggests Myelin Antibody, then Myelin Ab titer will be performed at an additional charge (CPT code(s): 86256), and Myelin Assoc. Glycoprotein (MAG) Antibody w/Reflex to MAG-SGPG & MAG, EIA will be performed at an additional charge (CPT code(s): 84182, 83520 x2).

· If MAG Antibody (IgM), Western Blot is positive, then both MAG-SGPG Antibody (IgM), EIA and MAG Antibody (IgM), EIA will be performed at additional charge (CPT code(s): 83520 x2).

· If NMDAR1 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).

· If AMPAR1 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).

· If AMPAR2 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).

· If LGI-1 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).

· If CASPR2 Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).

· If DPPX Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).

· If GABA-B Receptor Ab is positive, then a titer will be performed at an additional charge (CPT code(s): 86256).

· If AChR Binding is Negative, then AChR Modulating Ab will be performed at an additional charge (CPT code(s): 83519).

· If AChR Binding is Positive (≥0.50), then AChR Blocking Ab will be performed at an additional charge (CPT code(s): 83519).

· If AChR Binding is Equivocal (0.31-0.49), then both AChR Blocking and AChR Modulating will be performed at additional charge (CPT code(s): 83519).

· If Anti-Striated Muscle Ab Screen is Positive, then Anti-Striated Muscle Ab Titer will be performed at an additional charge (CPT code(s): 86256).

86255 (x20), 86341 (x2), 84182 (x11), 83519 (x5)

CHEM TEST 02

CHRONIC URTICARIA PNL 2

· Histamine Release (Chronic Urticaria)

· Thyroid Peroxidase Antibodies (TPO)

· Thyroglobulin Antibodies

· TSH

· IgE Antibody (Anti-IgE IgG)

83520, 84443, 86343, 86376, 86800

COMPREHENSIVE KIDNEY PNL

FOOD SPECIFIC IGG ALLERGY

· Casein (f78) IgG

· Cacao (Chocolate) (f93) IgG

· Codfish (f3) IgG

· Coffee (f221) IgG

· Maize/Corn (f8) IgG

· Egg White (f1) IgG

· Peanut (f13) IgG

· Soybean (f14) IgG

· Tomato (f25) IgG

· Wheat (f4) IgG

· Yeast (Bakers/Brewers) (f45) IgG Methodology Immunoassay (IA) 86001

HEAVY METALS #28

TREE NUT ALLERGY PANEL

· IgE allergy testing for:

· Brazil Nut (f18)

· Cashew Nut (f202)

· Hazelnut (f17)

· Macadamia Nut (rf345)

· Peanut (f13)

· Pecan Nut (f201)

· Pistachio (f203)

· Walnut (f256)

86003

Alcohol, Ethyl g/dL(%)

DRUG SCREEN, SERUM/PLASMA

ALCOHOL

AMPHETAMINE

BARBITURATES

BENZODIAZEPINES

BUPRENORPHINE

CANNABINOIDS

COCAINE

METHADONE

OPIATES

OXYCODONE

PHENCYCLIDINE

SYNTHETIC STIMULANTS,QUAL URINE

TOXICOLOGY SCREEN W/MARI-BLD

PAIN MANAGEMENT PROFILE 6

Initial screen of 6-Acetylmorphine, Alcohol Metabolites, Amphetamines, Barbiturates, Benzodiazepines, Marijuana Metabolite, Cocaine Metabolite, Methadone Metabolite, Opiates, Oxycodone, Phencyclidine drug classes. Specimen validity consisting of Creatinine, Oxidant, and pH testing.

If screen of drug class is positive, a confirmation of the drug class will be performed at an additional charge (CPT code(s): dependent upon the confirmed drug class).

Confirmation includes the following analytes within their associated drug class:

6-Acetylmorphine: 6-Acetylmorphine Alcohol Metabolites: Ethyl Glucuronide (ETG), Ethyl Sulfate (ETS) Amphetamines: Amphetamine, Methamphetamine Barbiturates: Amobarbital, Butalbital, Pentobarbital, Phenobarbital, Secobarbital Benzodiazepines: Alphahydroxyalprazolam, Alphahydroxymidazolam, Alphahydroxytriazolam, Aminoclonazepam, Hydroxyethylflurazepam, Lorazepam, Nordiazepam, Oxazepam, Temazepam Marijuana Metabolite: Marijuana Metabolite Cocaine Metabolite: Benzoylecgonine Methadone Metabolite: EDDP, Methadone Opiates: Codeine, Hydrocodone, Hydromorphone, Morphine, Norhydrocodone Oxycodone: Noroxycodone, Oxycodone, Oxymorphone Phencyclidine: Phencyclidine

PROG DRUG SCREEN #306

DRUG SCREEN, PAIN 1

· Amphetamines, Barbiturates, Benzodiazepines, Marijuana Metabolite, Cocaine Metabolite, Methadone Metabolite, Opiates, Oxycodone, Phencyclidine

· Specimen validity consisting of Creatinine, Oxidant, and pH testing.

80307

DRUG PANEL 9-50 W/ETOH, U

SYN STIM, UR

Bath Salts

PAIN MGMT,SYN STIM QN,U

Prescription Drug Monitoring,Bath Salts,Pain Management

ANTIPSYCHOTIC(S)CONFIRM

Aripiprazole, Chlorpromazine, Clozapine, Fluphenazine, Haloperidol, Loxapine, Mesoridazine, Molindone, Olanzapine, Quetiapine, Risperidone, Thioridazine, Thiothixene, Trifluoperazine, Ziprasidone

If screening drug class result is equal to or greater than the cutoff, then confirmation testing will be performed at an additional charge (CPT code(s): 80342 or 80343 or 80344).

Methodology Liquid Chromatography/Tandem Mass Spectrometry (LC/MS/MS) 80307

THERAPEUTIC AND DRUGS OF ABAUSE, HAIR

Includes:

Amphetamines; Barbiturates; Benzodiazepines; Cocaine/Metabolites; GC/MS Hair Drug Screen; Hair Length; Methamphetamine/MDMA; Opiates; Oxycodone/Oxymorphone; Phencyclidine

Test may reflex to the following for confirmation:

NMS 5900H - Cocaine Confirmation, Hair; NMS 5901H - Opiates Confirmation, Hair (Forensic); NMS 5902H - PCP; Confirmation, Hair (Forensic); NMS 5903H - Amphetamines Confirmation, Hair (Forensic); NMS 5904H - Barbiturates Confirmation, Hair (Forensic); NMS 5905H - Benzodiazepines Confirmation, Hair (Forensic) 80307

See attached document: S02 Attachment 1 Test Schedule Final posted Revised Jan 24 21 Email.