36C26218Q0699-00001000.docx

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Attached to
BLADDERSCANNERS Federal contract opportunity
Solicitation number
36C26218Q0699
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 22

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36C26218Q0699 00001 36C26218Q0699 00001.docx

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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 ITE M 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 r eference 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) 00001 05-30-2018 691-18-3-685-0120

NONE

00262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815 00262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815 To all Offerors/Bidders

36C26218Q0699

X See CONTINUATION Page

THIS MODIFICATION IS TO INCLUDE AN ADDITIONAL REQUEST TO THE SOLICITATION.

********PLEASE VERIFY IF THERE IS A

FACTORY WARRANTY

INCLUDED FOR THE REQUESTED ITEMS******

CONTINUATION PAGE

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM NUMBER
DESCRIPTION OF SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
0001
ITEM:0270-0870 BLADDERSCANNER
47.00
EA
__________________
__________________
0002
ITEM:0270-0870 BLADDERSCANNER FOR BIOMED - REPLACEMENTS
3.00
EA
__________________
__________________
0003
ITEM:0003-1220 TRAINING, BIOMED TECH "PRIME SPP - CHOICE"
1.00
JB
__________________
__________________
0004
ITEM: 0270-0868 PRINTER, THERMAL, BLADDERSCAN PRIME
50.00
EA
__________________
__________________
0005
ITEM: 0800-0532 CART, BLADDERSCANNER
47.00
EA
__________________
__________________
0006
ITEM: 0800-0532 CART, BLADDERSCANNER FOR BIOMED - REPLACEMENTS
3.00
EA
__________________
__________________
0007
ITEM: SHIPPING & SPECIAL HANDLING FEES
1.00
JB
__________________
__________________
0008
ITEM: FACTORY WARRANTY INCLUDED
1.00
EA
__________________
__________________
GRAND TOTAL
__________________

A.2 DELIVERY SCHEDULE

ITEM NUMBER
QUANTITY
DELIVERY DATE

47.00

3.00

1.00

50.00

47.00

3.00

1.00

1.00

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