C03_36C26123Q0092 0002.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

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)

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Sierra Nevada Health Care System 975 Kirman Avenue Reno NV 89502-2597

Department of Veterans Affairs VA Sierra Pacific Network (VISN 21) VA Sierra Nevada Health Care System 975 Kirman Avenue Reno NV 89502-2597

To all Offerors/Bidders 36C26123Q0092

X x

See CONTINUATION Page x 1

a. The purpose of this amendment is to add CLIN 5001, 5002, 6001, and 6002. See attached revised price schedule.

b. This RFQ has been extended and will now close on April 20, 2023, at 15:00 PM Pacific Standard Time.

IMPORTANT: Offeror must sign and acknowledge this amendment and return with quote.

Joleo Dianala 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 __________________ __________________

Clerical Support Administration

Contract Period: Base POP Begin: 04-10-2023 POP End: 04-09-2024 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers PRODUCT/SERVICE CODE: Q201 - Medical - General Health Care

MANUFACTURER PART NUMBER (MPN): NA

Other Patient Support Services: Space, Furniture and Equipment as needed.

Contract Period: Base POP Begin: 04-10-2023 POP End: 04-09-2024 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 1 POP Begin: 04-10-2024 POP End: 04-09-2025 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers needed.

Contract Period: Option 1 POP Begin: 04-10-2024 POP End: 04-09-2025 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 2 POP Begin: 04-10-2025 POP End: 04-09-2026 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers needed.

Contract Period: Option 2 POP Begin: 04-10-2025 POP End: 04-09-2026 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 3 POP Begin: 04-10-2026 POP End: 04-09-2027 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers needed.

Contract Period: Option 3 POP Begin: 04-10-2026 POP End: 04-09-2027 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 4 POP Begin: 04-10-2027 POP End: 04-09-2028 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers needed.

Contract Period: Option 4 POP Begin: 04-10-2027 POP End: 04-09-2028 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 5 POP Begin: 04-10-2028 POP End: 04-09-2029 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers needed.

Contract Period: Option 5 POP Begin: 04-10-2028 POP End: 04-09-2029 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

Contract Period: Option 6 POP Begin: 04-10-2029 POP End: 04-09-2030 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers needed.

Contract Period: Option 6 POP Begin: 04-10-2029 POP End: 04-09-2030 PRINCIPAL NAICS CODE: 621498 - All Other Outpatient Care Centers

GRAND TOTAL __________________