36C25721Q0188 0001.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) 04-01-2021 03-05-2021 671-21-1-039-0005 36C257-21-Q-0188 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

36C25721Q0188 12-03-2020 36C257-21-Q-0188

X

See CONTINUATION Page X

1. The purpose of this modification is to change Line Item 4 FROM: Defibrillator Dashboard System 1.2 (per R Series) TO: Defibrillator Dashboard System 2.x (per R Series)

2. To change the solicitation close date FROM: 21 Dec 2021 TO: 19 Mar2021

All other requirements remain the same.

CONTINUATION PAGE

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

3 R Series r Plus Defibrillator includes: Guidelines 2015- compatible AED w/ manual overide Code Readiness testing system High current biphasic waveform from rectilinear biphasic OneStep 3 lead ECG cable with AHA markings Advisory Defibrillation Built-in test port, compact flash card slot Integrated AC Power (120 VAC/60 Hz) 5.8 Ah lithium ion battery pack 5 year hospital warranty

LOCAL STOCK NUMBER: 30520005201310013

SurePowerT Rechargeable Lithium Ion Battery Pack ? 5.8 Ah Capacity ? High density lithium ion chemistry ? RunTimeT Indicator ? Automatic calibration ready ? Stores history of use and maintenance

LOCAL STOCK NUMBER: 8019-0535-01

R WiFi Card with Clock Sync and FIPS

LOCAL STOCK NUMBER: 8005-000103-01

Defibrillator Dashboard System 2.X (per R Series) .State of Readiness email alert .Configurable readiness alerts .Readiness status check from any PC on network .Time Sync Application One (1) year agreement that includes: .Updates & Patches to purchased software version .Patches to earlier software versions .24/7/365 telephone support for Severity 1 issues .Standard Technical Support for other issues

LOCAL STOCK NUMBER: 8400-100001

AED Plus with AED Cover. Includes: LCD screen showing voice prompt messages, device advisory messages, elapsed time, shock count and chest compression bar. Supplied with Public Safety PASS Cover, Softcase, Operator's Guide and (5) five year limited warranty.

LOCAL STOCK NUMBER: 20100000102011010

Type 123 Lithium Batteries, quantity of ten (10) with stoqrqage sleeve

LOCAL STOCK NUMBER: 8000-0807-01

CPR-D padzr one piece electrode pad with Real CPR Helpr. Supplied with gloves, barrier mask, scissors, razor, wet wipe and dry wipe. Five (5) year shelf-life.

LOCAL STOCK NUMBER: 8900-0800-01

A.2 DELIVERY SCHEDULE

10.00

10.00

10.00

10.00

4.00

2.00

2.00