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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 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)

1 16

A0001 UNCHANGED NONE

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

1303 5th St, Suite 300 Coralville IA 52241

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

1303 5th St, Suite 300 Coralville IA 52241

36C26321Q0102

12-02-2020 X

X X

See CONTINUATION Page

UNCHANGED

X 1

THE PURPOSE OF THIS AMENDMENT IS TO:

1. RESPOND TO VENDOR QUESTIONS. SEE QA.

2. PROVIDE AN UPDATED ITEM SCHEDULE. THIS SCHEDULE REPLACES THE CURRENT ITEM SCHEDULE IN SECTION B.3.

3. IN RESPONSE TO THE NEW ITEM SCHEDULE THE CEILING LIMITATION FOR THE LIFETIME OF THIS CONTRACT IS RAISED TO $4 MILLION. THE TOTAL OF ALL ORDERS PLACED AGAINST THIS IDIQ WILL NOT EXCEED THIS CEILING.

4. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.

12/17/2020

CONTINUATION PAGE

See attached document: QA.

B.3 PRICE/COST SCHEDULE

The Department of Veterans Affairs has set the ceiling limitation for this IDIQ at $4,000,000.00 for the lifetime of this contract. The total of all orders placed against this IDIQ will not exceed this ceiling.

The minimum guaranteed total is set at $75,000 for the lifetime of this contract.

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

126,200.00 ea __________________ __________________

PT

Contract Period: Base POP Begin:

POP End:

27,960.00 ea __________________ __________________

PTT

Contract Period: Base

203.00 BX __________________ __________________

D-Dimer Contract Period: Base

97.00 BX __________________ __________________

D-Dimer Controls Contract Period: Base

187.00 BX __________________ __________________

Fibrinogen Contract Period: Base

107.00 BX __________________ __________________

Low fibrinogen control Contract Period: Base

6.00 BX __________________ __________________

Lupus Inhibitor (screen) Contract Period: Base

Lupus Inhibitor (confrim) Contract Period: Base

Lupus Inhibitor (silica clot) Contract Period: Base

4.00 BX __________________ __________________

Protein C Contract Period: Base

7.00 BX __________________ __________________

Protein S Contract Period: Base

5.00 BX __________________ __________________

Antithrombin III Contract Period: Base

2.00 BX __________________ __________________

Factor II Contract Period: Base

Factor V Contract Period: Base

3.00 BX __________________ __________________

Factor VII Contract Period: Base

Factor VIII Contract Period: Base

1.00 BX __________________ __________________

Factor IX Contract Period: Base

Factor X Contract Period: Base

Factor XI Contract Period: Base

Factor XII Contract Period: Base

9.00 BX __________________ __________________

LMWH

Contract Period: Base

16.00 BX __________________ __________________

LMWH controls Contract Period: Base

90.00 BX __________________ __________________

UFH (Xa) Contract Period: Base

16.00 BX __________________ __________________

UFH controls Contract Period: Base

138,820.00 ea __________________ __________________

Contract Period: Ordering Period 1

30,756.00 ea __________________ __________________

Contract Period: Ordering Period 1

223.00 BX __________________ __________________

Contract Period: Ordering Period 1

107.00 BX __________________ __________________

Contract Period: Ordering Period 1

206.00 BX __________________ __________________

Contract Period: Ordering Period 1

118.00 BX __________________ __________________

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

8.00 BX __________________ __________________

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

Contract Period: Ordering Period 1

10.00 BX __________________ __________________

Contract Period: Ordering Period 1

18.00 BX __________________ __________________

Contract Period: Ordering Period 1

99.00 BX __________________ __________________

Contract Period: Ordering Period 1

18.00 BX __________________ __________________

Contract Period: Ordering Period 1

152,702.00 ea __________________ __________________

Contract Period: Ordering Period 2

33,831.00 ea __________________ __________________

Contract Period: Ordering Period 2

245.00 BX __________________ __________________

Contract Period: Ordering Period 2

118.00 BX __________________ __________________

Contract Period: Ordering Period 2

227.00 BX __________________ __________________

Contract Period: Ordering Period 2

130.00 BX __________________ __________________

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

Contract Period: Ordering Period 2

11.00 BX __________________ __________________

Contract Period: Ordering Period 2

20.00 BX __________________ __________________

Contract Period: Ordering Period 2

109.00 BX __________________ __________________

Contract Period: Ordering Period 2

20.00 BX __________________ __________________

Contract Period: Ordering Period 2

167,972.00 ea __________________ __________________

Contract Period: Ordering Period 3

37,215.00 ea __________________ __________________

Contract Period: Ordering Period 3

270.00 BX __________________ __________________

Contract Period: Ordering Period 3

130.00 BX __________________ __________________

Contract Period: Ordering Period 3

250.00 BX __________________ __________________

Contract Period: Ordering Period 3

143.00 BX __________________ __________________

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

Contract Period: Ordering Period 3

12.00 BX __________________ __________________

Contract Period: Ordering Period 3

22.00 BX __________________ __________________

Contract Period: Ordering Period 3

120.00 BX __________________ __________________

Contract Period: Ordering Period 3

22.00 BX __________________ __________________

Contract Period: Ordering Period 3

184,769.00 ea __________________ __________________

Contract Period: Ordering Period 4

40,936.00 ea __________________ __________________

Contract Period: Ordering Period 4

297.00 BX __________________ __________________

Contract Period: Ordering Period 4

143.00 BX __________________ __________________

Contract Period: Ordering Period 4

275.00 BX __________________ __________________

Contract Period: Ordering Period 4

157.00 BX __________________ __________________

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

11.00 BX __________________ __________________

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

Contract Period: Ordering Period 4

13.00 BX __________________ __________________

Contract Period: Ordering Period 4

24.00 BX __________________ __________________

Contract Period: Ordering Period 4

132.00 BX __________________ __________________

Contract Period: Ordering Period 4

24.00 BX __________________ __________________

Contract Period: Ordering Period 4

GRAND TOTAL __________________

See attached document: Attachments A - C - Template for Vendors UPDATED.

B.3 PRICE/COST SCHEDULE

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