36E79720R0010-0002001.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 r eference 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 AU

THORITY 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 communicat ion 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) 01-16-2020 none Department of Veterans Affairs OPAL / National Acquisition Center Building 37 1st Avenue, One Block North of Cermak Hines, IL 60141 Department of Veterans Affairs OPAL / National Acquisition Center Building 37 1st Avenue, One Block North of Cermak Hines IL 60141 To all Offerors/Bidders

36E79720R0010 01-06-2020

X X X

X Amendment to Continuation of Standard Form 1449: Schedule of Supplies/Services

This amendment is issued to add NDC number and NDA/ANDA number entries for offerors to complete on the Continuation of Standard Form 1449 for Solicitation 36E79720R0010. Please see pages 2-4 of this modification for the updated Continuation of Standard Form 1449 that needs to be submitted to Stevan Vasich at Stevan.Vasich@va.gov by the solicitation due date of 1/28/2019.

All other solicitation terms and conditions remain unchanged.

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

To be considered for award, offeror(s) shall submit a price for all line items within each product group on which an offer is made for the base and all four option years. If after evaluation, a proposal offering multiple groups results in the lowest-priced, technically acceptable proposal for multiple product groups, the Government may award the multiple product groups under a single contract. However, the government reserves the right to award each group to a different offeror if it is determined to be in the best interest of the government. See 52.212-2 EVALUATION – COMMERICAL ITEMS (OCT 2014).

Offers for Pharmaceuticals sourced from countries not covered by the Trade Agreements Act (TAA) will be given consideration pursuant to Federal Acquisition Regulation (FAR)25.403(c).

Award will be made in the aggregate for Group 1, Human Insulin vials and disposable pens, line items: 1, 2, 3, 4, and 5 to the responsible contractor(s) per individual product group or a combination of product groups if this results in the lowest overall price to the Government. To be considered for award, offerors are required to submit an offer for line items 1, 2, 3, 4, and 5 for the base year and all four option years.

GROUP 1

Line Item 1

Human R

NDC #__________________

NDA/ANDA #_____________

Base Year 401,899 Vial(10ml) $_________ $__________ Option Year One 401,899 Vial(10ml) $_________ $__________ Option Year Two 401,899 Vial(10ml) $_________ $__________ Option Year Three 401,899 Vial(10ml) $_________ $__________ Option Year Four 401,899 Vial(10ml) $_________ $__________

Line Item 2

Human N

NDC #__________________

NDA/ANDA #_____________

Base Year 797,954 Vial(10ml) $_________ $__________ Option Year One 797,954 Vial(10ml) $_________ $__________ Option Year Two 797,954 Vial(10ml) $_________ $__________ Option Year Three 797,954 Vial(10ml) $_________ $__________ Option Year Four 797,954 Vial(10ml) $_________ $__________

Line Item 3

Human 70/30

NDC #__________________

NDA/ANDA #_____________

Base Year 786,765 Vial(10ml) $_________ $__________ Option Year One 786,765 Vial(10ml) $_________ $__________ Option Year Two 786,765 Vial(10ml) $_________ $__________ Option Year Three 786,765 Vial(10ml) $_________ $__________ Option Year Four 786,765 Vial(10ml) $_________ $__________

Line Item 4

Short Acting/Intermediate Analog Mix (75/25-Mix or 70/30 Mix)

NDC #__________________

NDA/ANDA #_____________

Base Year 132,521 Vial(10ml) $_________ $__________ Option Year One 132,521 Vial(10ml) $_________ $__________ Option Year Two 132,521 Vial(10ml) $_________ $__________ Option Year Three 132,521 Vial(10ml) $_________ $__________ Option Year Four 132,521 Vial(10ml) $_________ $__________

Line Item 5

Short Acting/Intermediate Analog Mix (75/25-Mix or 70/30 Mix)

NDC #__________________

NDA/ANDA #_____________

Base Year 235,244 Disposable Pen(5 X 3 ML) $_________ $__________

Option Year One 235,244 Disposable Pen(5 X 3 ML) $_________ $__________

Option Year Two 235,244 Disposable Pen(5 X 3 ML) $_________ $__________

Option Year Three 235,244 Disposable Pen(5 X 3 ML) $_________ $__________

Option Year Four 235,244 Disposable Pen(5 X 3 ML) $_________ $__________

Total Offered Price for Group 1 (Base + 4 Options): $_________________

Award will be made in the aggregate for Group 2, human insulin vials and disposable pens, line items: 1 and 2 to the responsible contractor(s) per individual product group or a combination of product groups if this results in the lowest overall price to the Government. To be considered for award, offerors are required to submit an offer for line items 1 and 2 for the base year and all four option years.

GROUP 2

Line Item 1

Short Acting Analog

NDC #__________________

NDA/ANDA #_____________

Base Year 1,180,380 Disposable Pen(5 X 3 ML)$_________ $__________

Option Year One 1,180,380 Disposable Pen(5 X 3 ML)$_________ $__________

Option Year Two 1,180,380 Disposable Pen(5 X 3 ML)$_________ $__________

Option Year Three 1,180,380 Disposable Pen(5 X 3 ML)$_________ $__________

Option Year Four 1,180,380 Disposable Pen(5 X 3 ML)$_________ $__________

Line Item 2

Short Acting Analog

NDC #__________________

NDA/ANDA #_____________

Base Year 1,287,581 Vial(10ml) $_________ $__________ Option Year One 1,287,581 Vial(10ml) $_________ $__________ Option Year Two 1,287,581 Vial(10ml) $_________ $__________ Option Year Three 1,287,581 Vial(10ml) $_________ $__________ Option Year Four 1,287,581 Vial(10ml) $_________ $_________

Total Offered Price for Group 2 (Base + 4 Options): $_________________