36C25619Q0133_0003.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) 01-02-2019 564-19-1-150-0010 None 00502

ALEXANDRIA VA HEALTH CARE SYSTEM

NETWORK CONTRACTING OFFICE 16

ALEXANDRIA VA HEALTH CARE SYSTEM

PO BOX 69004

ALEXANDRIA

LA

71306-9004 00502

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE 16

ALEXANDRIA VA HEALTH CARE SYSTEM

2495 SHREVEPORT HIGHWAY

PINEVILLE

LA

71360-4004 To all Offerors/Bidders

36C25619Q0133 01-02-2019

X X X

See CONTINUATION Page

NOT APPLICABLE

X THE PURPOSE OF THIS AMENDMENT IS TO CORRECT A QUANTITY ERROR IN THE PRICE/COST SCHEDULE. THE CHANGES ARE AS FOLLOW:

A. Section A.1 PRICE/COST SCHEDULE, Item Number 0002, BASE PERIOD, the quantity is hereby changed from "12" to read "8".

B. All other terms and conditions remain unchanged.

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

Contract to provide all equipment, tools, materials, labor, transportation, site construction to include utility hook-up (power, data, telephone, etc.), equipment training, on-site installation, and anything else necessary to provide for an equipment lease for a new fully functioning/fully operable 1.5 Tesla (T) Mobile Magnetic Resonance Imaging (MRI) System trailer for the Gene Taylor Community Based Outpatient Clinic, Springfield, MO.

BASE PERIOD - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement Contract Period: Base POP Begin: 02-01-2019 POP End: 09-30-2019

OPTION YEAR 1 - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement Contract Period: Option 1 POP Begin: 10-01-2019 POP End: 09-30-2020

OPTION YEAR 2 - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement Contract Period: Option 2 POP Begin: 10-01-2020 POP End: 09-30-2021

OPTION YEAR 3 - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement Contract Period: Option 3 POP Begin: 10-01-2021 POP End: 09-30-2022

OPTION YEAR 4 - Lease Mobile MRI Trailer to include Equipment and Service in accordance with the Performance Work Statement Contract Period: Option 4 POP Begin: 10-01-2022 POP End: 09-30-2023

Contract to provide all equipment, tools, materials, labor, transportation, site construction to include disconnection of utility hook-up (power, data, telephone, etc.) on-site de-installation and anything else necessary to provide for the removal/deactivation of the 1.5 Tesla (T) Mobile Magnetic Resonance Imaging (MRI) System trailer at the Gene Taylor Community Based Outpatient Clinic, Springfield, MO.

All work associated with removal/de-activation in accordance with the performance work statement.

A.2 DELIVERY SCHEDULE

GENE TAYLOR COMMUNITY BASED OUTPATIENT CLINIC

1850 W Republic Street Springfield, MO 65810

USA

573-239-8906 Minh-Tri.Dang@va.gov

GENE TAYLOR COMMUNITY BASED OUTPATIENT CLINIC

1850 W Republic Street Springfield, MO 65810

USA

GENE TAYLOR COMMUNITY BASED OUTPATIENT CLINIC

1850 W Republic Street Springfield, MO 65810

USA

GENE TAYLOR COMMUNITY BASED OUTPATIENT CLINIC

1850 W Republic Street Springfield, MO 65810

USA

GENE TAYLOR COMMUNITY BASED OUTPATIENT CLINIC

1850 W Republic Street Springfield, MO 65810

USA

GENE TAYLOR COMMUNITY BASED OUTPATIENT CLINIC

1850 W Republic Street Springfield, MO 65810

USA

GENE TAYLOR COMMUNITY BASED OUTPATIENT CLINIC

1850 W Republic Street Springfield, MO 65810

USA

CONTINUATION PAGE