36C26323Q0252 0003 SF30 Amendment Revise Price Cost Schedule.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)

1 6

0003 N/A

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

2501 W. 22nd St.

Sioux Falls SD 57105 John Becker john.becker3@va.gov

Department of Veterans Affairs

NETWORK 23 CONTRACTING OFFICE

2501 W. 22nd St.

Sioux Falls SD 57105

To all Offerors/Bidders 36C26323Q0252

03-21-2023 X

X X

3/28/2023, 11:00AM CST

See CONTINUATION Page

X one (1)

The purpose of this Solicitation Amendment is to revise the Price/Cost Schedule to add On-Call Services.

The offer due date/time is extended to 3/28/2023, 11:00AM CST.

Offeror shall acknowledge this Amendment by attaching a signed copy of this Amendment with offer.

John Becker Contracting Officer

VA-VHA-2020-BEE57D1B

A.1 PRICE/COST SCHEDULE

ITEM

NUMBER

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 Base Period 2,080.00 HR _____________ _____________

1.0 FTEE Diagnostic Radiological Technologist - Cardiovascular

(DRT-CV)

2080 Hours per year.

Contract Period: Base POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians (except Mental Health Specialists) PRODUCT/SERVICE CODE: Q522 - Medical - Radiology

0002 Base Period 960.00 HR _____________ _____________

On-Call Services 960 Hours per year.

Contract Period: Base POP Begin: 05-01-2023 POP End: 04-30-2024 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians

GRAND TOTAL _____________

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

1001 Option Period 1 2,080.00 HR _____________ _____________

1.0 FTEE Diagnostic Radiological Technologist - Cardiovascular

(DRT-CV)

2080 Hours per year.

Contract Period: Option 1 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians

1002 Option Period 1 960.00 HR _____________ _____________

On-Call Service 960 Hours per year.

Contract Period: Option 1 POP Begin: 05-01-2024 POP End: 04-30-2025 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians

BASE TOTAL _____________

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

2001 Option Period 2 2,080.00 HR _____________ _____________

1.0 FTEE Diagnostic Radiological Technologist - Cardiovascular

(DRT-CV)

2080 Hours per year.

Contract Period: Option 2 POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians

2002 Option Period 2 960.00 HR _____________ _____________

960 Hours per year.

Contract Period: Option 2 POP Begin: 05-01-2025 POP End: 04-30-2026 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians

OPTION TOTAL _____________

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

3001 Option Period 3 2,080.00 HR _____________ _____________

1.0 FTEE Diagnostic Radiological Technologist - Cardiovascular

(DRT-CV)

2080 Hours per year.

Contract Period: Option 3 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians

3002 Option Period 3 960.00 HR _____________ _____________

960 Hours per year.

Contract Period: Option 3 POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians

DESCRIPTION OF

SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

4001 Option Period 4 2,080.00 HR _____________ _____________

1.0 FTEE Diagnostic Radiological Technologist - Cardiovascular

(DRT-CV)

2080 Hours per year.

Contract Period: Option 4 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians

4002 Option Period 4 960.00 HR _____________ _____________

960 Hours per year.

Contract Period: Option 4 POP Begin: 05-01-2027 POP End: 04-30-2028 PRINCIPAL NAICS CODE: 621111 - Offices of Physicians

BASE TOTAL:

OPTION PERIOD 1 TOTAL:

OPTION PERIOD 2 TOTAL:

OPTION PERIOD 3 TOTAL:

OPTION PERIOD 4 TOTAL:

TOTAL CONTRACT COST

A.1 PRICE/COST SCHEDULE