36C26224Q1603 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)

36C262 Department of Veterans Affairs Network Contracting Office 22 4811 Airport Plaza Drive Suite 600 Long Beach CA 90815

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

36C26224Q1603 08-23-2024

X

X

** HOUR & DATE for Receipt of Offers is EXTENDED to:

See CONTINUATION Page

The purpose of this Amendment is to extend the Solicitation due date until August 23, 2024 at 12PM Pacific Standard Time to add additional Quantity of 10 each to the delivery location of VA Long Beach Healthcare System.

All other terms and conditions remains the same.

Peter Kim Contracting Officer

CONTINUATION PAGE

Item Name: Countertop, Ice Dispensing Machine Brand Name or Equal: Follet, Symphony Plus 50 Series Ice and Water Dispenser, Model # 50CI425A-S or Equivalent.

Characteristics:

· Ice and water dispenser

· Countertop

· Stainless steel cabinet with accent trim

· Poly drain pan, grille and dispenser lid corrosion-resistant

· Sensor SAFE dispensing

· Air ice machine cooling

· Ventilation clearance of 3” on all sides

· 50lb ice storage capacity

· Quite Night sleep mode turns off ice machine when idle

· Automatic self-flushing of ice machine removes impurities

· Antimicrobial product protection

· Factory installed water filter

· 0.2 Micron Filter

· 4” leg kit

· Fully assembled and installs with three easy connections – electric, water and drain

· Dimensions: 21” W x 24.00” D x 40.00 H

· Electrical components: 115 V/60/1

· 7’ cord, NEMA 5-15 hospital grade plug

· Net weight 118lb

· Warranty of 3years parts and labor, 5-year compressor parts

Product image is for illustration purposes only.

· Quantity of 10 each

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

A.2 DELIVERY SCHEDULE

0002 VA Long Beach Healthcare System 10 09/30/2024 Building 149 5901 E. 7th Street Long Beach, CA 90822 image1.png