36C25718Q9942-0001001.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

BY

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)

1 4

671-18-3-039-0332

N/A

Department of Veterans Affairs VISN17 Network Contracting Activity 7400 Merton Minter Blvd. (10N17/90C) San Antonio TX 78229

Department of Veterans Affairs VISN17 Network Contracting Activity 7400 Merton Minter Blvd. (10N17/90C) San Antonio TX 78229

To all Offerors/Bidders

36C25718Q9942

08-22-2018

X

See CONTINUATION Page

X

The purpose of this amendment is to remove CLINS 0018,0020 and 0022.

See schedule.

All other terms remain unchanged.

Michael J. Tusinger

NCO1815L2-4195

CONTINUATION PAGE

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT

UNIT

PRICE AMOUNT

1.00 EA __________ ________________

MANO SCAN HMR WS WITH CART

LOCAL STOCK NUMBER: 47177

ASSY MANO SCAN CART

LOCAL STOCK NUMBER: FGS-8039

PS MONITOR 22IN ELO MULTITOUCH

LOCAL STOCK NUMBER: 111489

PS PRINTER DELL LASER

LOCAL STOCK NUMBER: 111490

MANO SCAN

LOCAL STOCK NUMBER: FGS-0582

CALIBRATION SET UP MODULAR CART

LOCAL STOCK NUMBER: 3282

ASSY MODULAR CART ACCESSORY KIT

LOCAL STOCK NUMBER: 3283

CAL CHAMBER MOUNT MVS

LOCAL STOCK NUMBER: 80026

2.00 EA __________ ________________

ESOPHAGEAL HRM PRACTICAL GUIDE

LOCAL STOCK NUMBER: FGS-8043

2.00 EA __________ ________________

MANO SCAN CATHETER CARE POSTER

LOCAL STOCK NUMBER: US1-6036-5

MANO SCAN V3.0 SOFTWARE KIT

LOCAL STOCK NUMBER: 400100121

MANO SCAN ESO SOFTWARE V3.3

LOCAL STOCK NUMBER: FGS-0628

MANO SCAN A120 MODULE

LOCAL STOCK NUMBER: FGS-4374

MANO SCAN Z A200 MODULE

LOCAL STOCK NUMBER: 4189

ASSY ACCESSORY KIT HRMZ

LOCAL STOCK NUMBER: 4284

MANO SCAN ESO Z CATHETER

LOCAL STOCK NUMBER: 3890

HRM CATHERTER EXTENDED WARRANTY 1 YR

LOCAL STOCK NUMBER: 80372

PS, A120 POWER CORD

LOCAL STOCK NUMBER: 2680

MANO SCAN ESO CATHETER SD SMALL

LOCAL STOCK NUMBER: 3886

HRM CATHETER EXTENDED WARRANTY, 1 YR

LOCAL STOCK NUMBER: 80372

GRAND

TOTAL

A.2 DELIVERY SCHEDULE

ITEM NUMBER QUANTITY

DELIVERY

DATE

0001-

SHIP TO: Audie L Murphy VA Hospital 7400 Merton Miner Blvd Supply Warehouse San Antonio, TX 78229 4404

USA

1.00 30 Days ARO

MARK

FOR:

Chirstopher Carson 1-210-617-5300 Christopher.Carson2@va.gov

A.2 DELIVERY SCHEDULE