36E79722R0038 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 NUMBERE

D 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 amendmen t, 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) 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

36E79722R0038 10-04-2022

X x x

X Acceptance of alternate bottle size

This amendment allows for an alternate bottle size of 500 count bottles as an option versus the 1000 count bottles.

The 100 c ount bottles are still required, but offerors have the option to submit an offer for either the 1000 count bottles, or the 500 count bottles.

Revised Schedule of Supp lies section of the solicitation can be found on pages 2-6 of this modification, and should be completed/submitted along with a signed copy of this amendment.

Diana Martinez Contracting Officer

Continuation of SF-1449, Block 3:

The following information shall be entered by the Contracting Officer at the time of contract award according to the timeframes specified in this solicitation’s Section B, Scope of Contract, Section 1.4 Contract Effective Date, Implementation Period, and Ordering Period.

Contract Award/Effective Date: ___________________

Implementation Period: __________________________

Ordering Period (Base Year): _____________________

Offerors shall not enter information into the above fields.

Continuation of SF-1449, Blocks 19 through 24:

To be considered for award, offerors must submit a price for line items 1, 2a or 2b, 3, 4a or 4b, 5, 6a or 6b, 7, 8a or 8b, 9, and 10a or 10b for the base year and all four option years. One award will be made in the aggregate for line items 1, 2a or 2b, 3, 4a or 4b, 5, 6a or 6b, 7, 8a or 8b, 9, and 10a or 10b for the base year and all four option years. Offered prices shall not exceed two decimal places.

Line Item 1 DOXEPIN HCL 100MG CAP, 100s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 2,243 Bottles $_________ $__________ Option Year One 2,243 Bottles $_________ $__________ Option Year Two 2,243 Bottles $_________ $__________ Option Year Three 2,243 Bottles $_________ $__________ Option Year Four 2,243 Bottles $_________ $__________

Line Item 2a DOXEPIN HCL 100MG CAP, 1000s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 549 Bottles $_________ $__________ Option Year One 549 Bottles $_________ $__________ Option Year Two 549 Bottles $_________ $__________ Option Year Three 549 Bottles $_________ $__________ Option Year Four 549 Bottles $_________ $__________

OR

Line Item 2b DOXEPIN HCL 100MG CAP, 500s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 1,098 Bottles $_________ $__________ Option Year One 1,098 Bottles $_________ $__________ Option Year Two 1,098 Bottles $_________ $__________ Option Year Three 1,098 Bottles $_________ $__________ Option Year Four 1,098 Bottles $_________ $__________

Line Item 3 DOXEPIN HCL 10MG CAP, 100s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 10,313 Bottles $_________ $__________ Option Year One 10,313 Bottles $_________ $__________ Option Year Two 10,313 Bottles $_________ $__________ Option Year Three 10,313 Bottles $_________ $__________ Option Year Four 10,313 Bottles $_________ $__________

Line Item 4a DOXEPIN HCL 10MG CAP, 1000s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 4,659 Bottles $_________ $__________ Option Year One 4,659 Bottles $_________ $__________ Option Year Two 4,659 Bottles $_________ $__________ Option Year Three 4,659 Bottles $_________ $__________ Option Year Four 4,659 Bottles $_________ $__________

OR

Line Item 4b DOXEPIN HCL 10MG CAP, 500s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 9,318 Bottles $_________ $__________ Option Year One 9,318 Bottles $_________ $__________ Option Year Two 9,318 Bottles $_________ $__________ Option Year Three 9,318 Bottles $_________ $__________ Option Year Four 9,318 Bottles $_________ $__________

Line Item 5 DOXEPIN HCL 25MG CAP, 100s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 9,198 Bottles $_________ $__________ Option Year One 9,198 Bottles $_________ $__________ Option Year Two 9,198 Bottles $_________ $__________ Option Year Three 9,198 Bottles $_________ $__________ Option Year Four 9,198 Bottles $_________ $__________

Line Item 6a DOXEPIN HCL 25MG CAP, 1000s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 1,937 Bottles $_________ $__________ Option Year One 1,937 Bottles $_________ $__________ Option Year Two 1,937 Bottles $_________ $__________ Option Year Three 1,937 Bottles $_________ $__________ Option Year Four 1,937 Bottles $_________ $__________

OR

Line Item 6b DOXEPIN HCL 25MG CAP, 500s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 3,874 Bottles $_________ $__________ Option Year One 3,874 Bottles $_________ $__________ Option Year Two 3,874 Bottles $_________ $__________ Option Year Three 3,874 Bottles $_________ $__________ Option Year Four 3,874 Bottles $_________ $__________

Line Item 7 DOXEPIN HCL 50MG CAP, 100s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 3,790 Bottles $_________ $__________ Option Year One 3,790 Bottles $_________ $__________ Option Year Two 3,790 Bottles $_________ $__________ Option Year Three 3,790 Bottles $_________ $__________ Option Year Four 3,790 Bottles $_________ $__________

Line Item 8a DOXEPIN HCL 50MG CAP, 1000s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 1,625 Bottles $_________ $__________ Option Year One 1,625 Bottles $_________ $__________ Option Year Two 1,625 Bottles $_________ $__________ Option Year Three 1,625 Bottles $_________ $__________ Option Year Four 1,625 Bottles $_________ $__________

OR

Line Item 8b DOXEPIN HCL 50MG CAP, 500s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 3,250 Bottles $_________ $__________ Option Year One 3,250 Bottles $_________ $__________ Option Year Two 3,250 Bottles $_________ $__________ Option Year Three 3,250 Bottles $_________ $__________ Option Year Four 3,250 Bottles $_________ $__________

Line Item 9 DOXEPIN HCL 75MG CAP, 100s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 921 Bottles $_________ $__________ Option Year One 921 Bottles $_________ $__________ Option Year Two 921 Bottles $_________ $__________ Option Year Three 921 Bottles $_________ $__________ Option Year Four 921 Bottles $_________ $__________

Line Item 10a DOXEPIN HCL 75MG CAP, 1000s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 520 Bottles $_________ $__________ Option Year One 520 Bottles $_________ $__________ Option Year Two 520 Bottles $_________ $__________ Option Year Three 520 Bottles $_________ $__________ Option Year Four 520 Bottles $_________ $__________

OR

Line Item 10b DOXEPIN HCL 75MG CAP, 500s

NDC # __________________

ANDA#_________________

Schedule of Supplies Quantity Unit Unit Price Amount Base Year 1,040 Bottles $_________ $__________ Option Year One 1,040 Bottles $_________ $__________ Option Year Two 1,040 Bottles $_________ $__________ Option Year Three 1,040 Bottles $_________ $__________ Option Year Four 1,040 Bottles $_________ $__________

Amendment 0001