36C25626Q0260 0005.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) None Department of Veterans Affairs Veterans Health Administration Network Contracting Office 16 2575 Keystone Crossing Fayetteville

AR

72703 Department of Veterans Affairs Veterans Healthcare System of the Ozarks Network Contracting Office 16 2575 Keystone Crossing Fayetteville

AR

72703 To all Offerors/Bidders

36C25626Q0260

X X X The purpose of this amendment is to post a revised statement of work.

A. Remove the previous statement of work and replace it with the attached statement of work dated 01/23/2026.

B. All other terms and conditions remain unchanged.

Joseph Warren Contracting Officer

CONTINUATION PAGE

STATEMENT OF WORK

01/23/2026 OR #17 Epoxy Floor Repair John L. McClellan Memorial Veterans Hospital Central Arkansas Veterans Healthcare System (CAVHS) Little Rock, AR

1. Background: The flooring for Operating Room #17 in 2C is chipping due to wear and tear. The epoxy in the center of the room has cracked open, exposing the layer underneath. The room is currently not being operated in until the epoxy flooring is repaired.

2. Scope: The contractor shall furnish all labor, materials, tools, equipment, transportation to remove existing coating on the floor and base and apply a new coat in John L. McClellan Memorial Veterans Hospital at 4300 West 7th Street Little Rock, AR 72205.

3. Delivery: Vendor shall deliver equipment no later than 30-days from the date of award.

One unit to be delivered to each of the following sites Monday – Friday (Excluding National Holidays), 8am – 4:30pm:

Central Arkansas Veterans Healthcare System 4300 West 7th street Little Rock, AR. 72205

4. Delivery Hours: All deliveries shall be scheduled 48 hours in advance. Deliveries pertaining to this contract will need to be performed Monday through Friday unless a Federal holiday falls on one of these days. Typical hours are between 8am and 4pm. If delivery is required outside of these hours of operations, it must be coordinated with the project Contracting Officer’s Representative (COR). On the days listed below delivery shall not be scheduled unless unique situations arise and prior approval between the delivery and CAVHS parties involved is agreed upon.

5. Scheduling Arrangements: Scheduled work will be performed only during weekends. (Saturday and Sunday) Contractor shall schedule all work within 1 week of contract award, approved by VA COR.

6. Government Observed Holidays: The Government hereby provides notice, and Contractor hereby acknowledges receipt that Government personnel observe the listed days as holidays:

In addition to the days designated as holidays, the Government observes the following days:

1. Any other day designated by Executive Order.

2. Any other day designated by the President’s Proclamation; and

3. Any other day designated by the Federal Statute.

7. Changes to the Statement of Work: The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract and such changes will be executed bi-laterally in accordance with FAR 52.212-4(c). The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitments or issue changes, which will affect price, quantity, or quality of performance of this contract. In the event the contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase in costs incurred as a result thereof. Costs incurred by the contractor through the actions of parties other than the Contracting Officer shall be borne by the contractor.

8. Invoicing/Payment: Contractor shall submit invoices after delivery, installation, testing and acceptance by government representative. No advance payments shall be authorized. A proper invoice must include:

a) Name and address of Contractor

b) Facility’s name and address where supply was delivered

c) Invoice date

d) Contract number and Purchase Order (PO) number

e) Contract Line-Item Number (LIN)

f) Description, quantity, unit of measure, unit price and total price of item(s) ordered.

g) Name and address of authorized official to whom payment is to be sent.

h) Name, title, phone number, email of person to be notified if invoice is defective.

9. Delivery Location: Central Arkansas Veterans Healthcare System 4300 West 7th street Little Rock, AR. 72205

10. Confidentiality and nondisclosure: The contractor understands and agrees that confidential information (patients, employee, or facility) must always be secured and protected. The contractor r and its personnel shall be held liable in the event a breach of confidentiality occurs as a result of the Supplier or its employees. Each contract employee will be required to read and sign the Contractor Rules of Behavior and provide the original signature page to the COR.

11. Information System Officer /Protection: The Supplier will not have access to VA Desktop computers, nor will they have access to online resources belonging to the government while conducting services.

12. Privacy Officer: The contractor will not have access to protected Patient Health Information (PHI) nor will they have the capability of accessing patient information during the services provided to the VA.

13. RECORDS MANAGER:

13.1. Supplier shall comply with all applicable records management laws and regulations, as well as National Archives and Records Administration (NARA) records policies, including but not limited to the Federal Records Act (44 U.S.C. Chapters. 21, 29, 31, 33), NARA regulations at 36 CFR Chapter XII Subchapter B, and those policies associated with the safeguarding of records covered by the Privacy Act of 1974 (5 U.S.C. 552a). These policies include the preservation of all records, regardless of form or characteristics, mode of transmission, or state of completion.

13.2. In accordance with 36 CFR 1222.32, all data created for Government use and delivered to, or falling under the legal control of, the Government are Federal records subject to the provisions of 44 U.S.C. chapters 21, 29, 31, and 33, the Freedom of Information Act (FOIA) (5 U.S.C. 552), as amended, and the Privacy Act of 1974 (5 U.S.C. 552a), as amended and must be managed and scheduled for disposition only as permitted by statute or regulation.

13.3. In accordance with 36 CFR 1222.32, Supplier shall maintain all records created for Government use or created in the course of performing the contract and/or delivered to, or under the legal control of the Government and must be managed in accordance with Federal law. Electronic records and associated metadata must be accompanied by sufficient technical documentation to permit understanding and use of the records and data.

13.4. Central Arkansas Veterans Healthcare System and its contractors/suppliers are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Records may not be removed from the legal custody of Central Arkansas Veterans Healthcare System or destroyed except for in accordance with the provisions of the agency records schedules and with the written concurrence of the Head of the Contracting Activity. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. In the event of any unlawful or accidental removal, defacing, alteration, or destruction of records, Supplier must report to Central Arkansas Veterans Healthcare System. The agency must report promptly to NARA in accordance with 36 CFR 1230.

13.5. The Supplier shall immediately notify the appropriate Contracting Officer upon discovery of any inadvertent or unauthorized disclosures of information, data, documentary materials, records or equipment. Disclosure of non-public information is limited to authorized personnel with a need-to-know as described in the [contract vehicle]. The Supplier shall ensure that the appropriate personnel, administrative, technical, and physical safeguards are established to ensure the security and confidentiality of this information, data, documentary material, records and/or equipment is properly protected. The Supplier shall not remove material from Government facilities or systems, or facilities or systems operated or maintained on the Government's behalf, without the express written permission of the Head of the Contracting Activity. When information, data, documentary material, records and/or equipment is no longer required, it shall be returned to Central Arkansas Veterans Healthcare System control or the Supplier must hold it until otherwise directed. Items returned to the Government shall be hand-carried, mailed, emailed, or securely electronically transmitted to the Contracting Officer or address prescribed in the [contract vehicle]. Destruction of records is EXPRESSLY PROHIBITED unless in accordance with Paragraph (4).

13.6. The Supplier is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under, or relating to, contracts. The Supplier (and any sub-contractor) is required to abide by Government and Central Arkansas Veterans Healthcare system guidance for protecting sensitive, proprietary information, classified, and controlled unclassified information.

13.7. The Supplier shall only use Government IT equipment for purposes specifically tied to or authorized by the contract and in accordance with Central Arkansas Veterans Healthcare System policy.

13.8. The Supplier shall not create or maintain any records containing any non-public Central Arkansas Veterans Healthcare System information that are not specifically tied to or authorized by the contract.

13.9. The Supplier shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected from public disclosure by an exemption to the Freedom of Information Act.

13.10. The Central Arkansas Veterans Healthcare System owns the rights to all data and records produced as part of this contract. All deliverables under the contract are the property of the U.S. Government for which Central Arkansas Veterans Healthcare System shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest. Any Supplier rights in the data or deliverables must be identified as required by FAR 52.227-11 through FAR 52.227-20.

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