36C78618R0433-0002000.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

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) 07-17-2018 8928-000020

892-NRM-FY18-007

43C1 Department of Veterans Affairs NCA Contracting Service 75 Barrett Heights Rd. Suite 309 Stafford

VA

22556 43C1 Department of Veterans Affairs NCA Contracting Service 75 Barrett Heights Rd. Suite 309 Stafford

VA

22556 To all Offerors/Bidders

36C78618R0433 07-11-2018

X x x x Solicitation 36C78618R0433 is hereby amended to provide the attached Past Performance Questionnaire (PPQ). A PPQ should only be submitted if no CPARS exists. For clarification, this PPQ may be completed by the offeror and submitted with the offer as described in SUBMISSION OF PROPOSALS on pages 10-11.

Evaluation Factor 1, Past Performance is changed. This section on page 9 and paragraph b. on page 11 are hereby changed to read: “The offeror shall provide three (3) Past Performance references for projects that are equal in size and complexity to the Scope of Work. Submit CPARS evaluations (final or interim) and/or Past Performance Questionnaires (PPQ). A PPQ should only be submitted if no CPARS exists. The point of contact name, email address and phone number shall be included. Past Performance will be rated on an acceptable or unacceptable basis.”

David J. Dixon Contracting Officer

PAST PERFORMANCE QUESTIONNAIRE

INSTRUCTIONS: The offeror shall provide Past Performance for (3) projects that are equal in size and complexity to the Statement of Work. The point of contact name, email address and phone number shall be included. (One contract reference per form; form may be duplicated)

Contractor (Offeror) Information:

Name: _____________________________________________________________________ Address: ___________________________________________________________________ Telephone Number: ___________________________________________________________ E-mail: ______________________________________________________________________

Contract Information:

Name of company/agency the offeror provided service for: ___________________________________ Contract Number: _____________________________________________________________ Type of Contract: _______________________________________________________________ Contract Dollar Value: ___________________________________________________________ Date of Award: _________________________________________________________________ Status: Completed, Yes____ No____ If not completed, projected completion date____________ If not completed, why?___________________________________________________________

Point of Contact Information for the company/agency the offeror serviced:

Name of the Contract Person & position: ________________________________________ Address: ______________________________________________________________________ Telephone Number: _____________________________________________________________ E-mail: ________________________________________________________________________

Description of Supply/Service(s) provided, location & relevancy of work:

Complexity of Product/Service, if any:

Percentage of Work completed by your company/by subcontractor:

Provide information on problems encountered during performance of this contract and corrective actions, (if applicable):

(End of Section) End of Document