amendment 36C25722Q1099 0001.docx

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Attached to
Bulk Oxygen Services Federal contract opportunity
Solicitation number
36C25722Q1099
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 17

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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 NUMBERE

D 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 amendmen t, 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) 756-23-1-045-0007 36C257 Department of Veterans Affairs NCO 17 North Texas Healthcare System Regional Procurement Office West (RPO-W) 124 E. Hwy 67, Suite 100 Duncanville TX 75137 36C257

NCO 17

Department of Veterans Affairs North Texas Veterans Health Care Center 124 E. Hwy 67, Suite 100 Duncanville TX 75137

36C25722Q1099 09-09-2022

X x

See CONTINUATION Page x the purpose of this admenment is to revise the price/cost schedule reference pg 2- 5.

Frank Mendoza Contracting Officer

CONTINUATION PAGE

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM NUMBER
DESCRIPTION OF SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
12.00
MO
__________________
__________________

Bulk Oxygen: Backup Oxygen Tanks Contract Period: Base Year POP Begin: 10/01/2022 POP End: 09/30/2023 Contract Period: Base POP Begin: 10-01-2024 POP End: 09-01-2025

18.00
EA
__________________
__________________

Bulk Oxygen: Backup Oxygen Tanks Contract Period: Base Year POP Begin: 10/01/2022 POP End: 09/30/2023

3.21
CF
__________________
__________________

Bulk Oxygen: Liquefied Refrigerated Oxygen (2400 gallons) Contract Period: Base Year POP Begin: 10/01/2022 POP End: 09/30/2023

4.00
EA
__________________
__________________

Bulk Oxygen Emergency Fill Fee (Emergency Fills to be used only as required) Contract Period: Base Year POP Begin: 10/01/2022 POP End: 09/30/2023

1.00
YR
__________________
__________________

SERVICE OF BULK OXYGEN, Establishing base contract plus 4 options.

Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-01-2024

1.00
YR
__________________
__________________

SERVICE OF BULK OXYGEN, Establishing base contract plus 4 options.

Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-01-2025

1.00
YR
__________________
__________________

SERVICE OF BULK OXYGEN, Establishing base contract plus 4 options.

Contract Period: Option 3 POP Begin: 10-01-2025 POP End: 09-30-2026

1.00
YR
__________________
__________________

SERVICE OF BULK OXYGEN, Establishing base contract plus 4 options.

Contract Period: Option 4 POP Begin: 10-01-2026 POP End: 09-01-2027

GRAND TOTAL
__________________

A.2 DELIVERY SCHEDULE

ITEM NUMBER
QUANTITY
DELIVERY DATE
0001
SHIP TO:
El Paso Veterans Health Care Service

EPVAHCS LOGISTICS SERVICE

5001 N Piedras, El Paso, TX 79930

USA

12.00

MARK FOR:
Jesus Loayza

(915) 227-4403 jesus.loayza@va.gov

0002
SHIP TO:
El Paso Veterans Health Care Service

EPVAHCS LOGISTICS SERVICE

5001 N Piedras, El Paso, TX 79930

18.00

MARK FOR:
Jesus Loayza
0003
SHIP TO:
El Paso Veterans Health Care Service

EPVAHCS LOGISTICS SERVICE

5001 N Piedras, El Paso, TX 79930

3.21

MARK FOR:
Jesus Loayza
0004
SHIP TO:
El Paso Veterans Health Care Service

EPVAHCS LOGISTICS SERVICE

5001 N Piedras, El Paso, TX 79930

4.00

MARK FOR:
Jesus Loayza
1001
SHIP TO:
El Paso Veterans Health Care Service

EPVAHCS LOGISTICS SERVICE

5001 N Piedras, El Paso, TX 79930

1.00

MARK FOR:
Jesus Loayza
2001
SHIP TO:
El Paso Veterans Health Care Service

EPVAHCS LOGISTICS SERVICE

5001 N Piedras, El Paso, TX 79930

1.00

MARK FOR:
Jesus Loayza
3001
SHIP TO:
El Paso Veterans Health Care Service

EPVAHCS LOGISTICS SERVICE

5001 N Piedras, El Paso, TX 79930

1.00

MARK FOR:
Jesus Loayza
4001
SHIP TO:
El Paso Veterans Health Care Service

EPVAHCS LOGISTICS SERVICE

5001 N Piedras, El Paso, TX 79930

1.00

MARK FOR:
Jesus Loayza

End of Document Adm 0001

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