amdt_001.pdf

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:

(a) By completing items 8 and 15, and returning 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 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.

E. IMPORTANT: Contractor is not is required to sign this document and return copies to the issuing office.

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

2. AMENDMENT/MODIFICATION NUMBER 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)

7. ADMINISTERED BY (If other than Item 6) CODE

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

FACILITY CODE

9A. AMENDMENT OF SOLICITATION NUMBER

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED (SEE ITEM 13)

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended. is not extended.

12. ACCOUNTING AND APPROPRIATION DATA (If required) copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.

CHECK ONE A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER

NUMBER IN ITEM 10A.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority)

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.

15C. DATE SIGNED

15A. NAME AND TITLE OF SIGNER (Type or print)

16C. DATE SIGNED

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

PAGE OF PAGES

6. ISSUED BY CODE

8. NAME AND ADDRESS OF CONTRACTOR (Number, street, county, State and ZIP Code) (X)

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

Previous edition unusable

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Amendment 001 to Solicitation 47PF0018R0183 for Landscaping and Related Services at the Carl B. Stokes USCH (Cleveland, OH) and the Donald J. Pease FB (Medina, OH) adds the following to the solicitation:

1. GSA Form 527

2. Contractor's Cost Proposal Worksheet

R5 AMD Southern Services Team 201 Superior Ave.

Cleveland, OH 44114

USA

R5 AMD Southern Services Team 201 Superior Ave.

Cleveland, OH 44114

USA

N/A

EQ5P2SS2F1-18-0155-AM0001

47PF0018R0183

N/A

9B. DATED (SEE ITEM 11)

09/25/2018

1 9

09/26/2018

Each additional document can be found attached.

INSTRUCTIONS (Back Page):

Instructions for items other than those that are self-explanatory, are as follows:

Item 1 (Contract ID Code). Insert the contract type identification code that appears in the title block of the contract being modified.

Item 3 (Effective date).

(1)

(2)

(3)

(4)

(5)

For a solicitation amendment, change order, or administrative change, the effective date shall be the issue date of the amendment, change order, or administrative change.

For a supplemental agreement, the effective date shall be the date agreed to by the contracting parties.

For a modification issued as an initial or confirming notice of termination for the convenience of the Government, the effective date and the modification number of the confirming notice shall be the same as the effective date and modification number of the initial notice.

For a modification converting a termination for default to a termination for the convenience of the Government, the effective date shall be the same as the effective date of the termination for default.

For a modification confirming the contracting officer's determination of the amount due in settlement of a contract termination, the effective date shall be the same as the effective date of the initial decision.

(a)

(b)

(c)

(d)

(e)

(f)

Item 6 (Issued By). Insert the name and address of the issuing office. If applicable, insert the appropriate issuing office code in the code block.

Item 8 (Name and Address of Contractor). For modifications to a contract or order, enter the contractor's name, address, and code as shown in the original contract or order, unless changed by this or a previous modification.

Items 9, (Amendment of Solicitation Number - Dated), and 10, (Modification of Contract/Order Number - Dated). Check the appropriate box and in the corresponding blanks insert the number and date of the original solicitation, contract, or order.

Item 12 (Accounting and Appropriation Data).

When appropriate, indicate the impact of the modification on each affected accounting classification by inserting one of the following entries:

(2) Accounting classification Net decrease $

Include subject matter or short title of solicitation/contract where feasible.

Item 16B. The contracting officer's signature is not required on solicitation amendments. The contracting officer's signature is normally affixed last on supplemental agreements.

(i)

NOTE: If there are changes to multiple accounting classifications that cannot be placed in block 12, insert an asterisk and the words "See continuation sheet".

Item 13. Check the appropriate box to indicate the type of modification. Insert in the corresponding blank the authority under which the modification is issued. Check whether or not contractor must sign this document. (See FAR 43.103.)

Item 14 (Description of Amendment/Modification).

Organize amendments or modifications under the appropriate Uniform Contract Format (UCF) section headings from the applicable solicitation or contract. The UCF table of contents, however, shall not be set forth in this document.

Indicate the impact of the modification on the overall total contract price by inserting one of the following entries:

(i) Total contract price increased by $

(ii) Total contract price decreased by $

(iii) Total contract price unchanged.

State reason for modification.

When removing, reinstating, or adding funds, identify the contract items and accounting classifications.

(g)

(h)

When the SF 30 is used to reflect a determination by the contracting officer of the amount due in settlement of a contract terminated for the convenience of the Government, the entry in Item 14 of the modification may be limited to --

(i) A reference to the letter determination; and

(ii) A statement of the net amount determined to be due in settlement of the contract.

(1)

(2)

(3)

(4)

(5)

(6)

STANDARD FORM 30 (REV. 11/2016) BACK

(1) Accounting classification Net increase $

CONTRACTOR'S QUALIFICATIONS AND FINANCIAL INFORMATION OMB Control Number: 3090-0007 Expiration Date: 9/30/2021

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 3090-0007. We estimate that it will take 2.5 hours to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: General Services Administration, Regulatory Secretariat Division (M1V1CB), 1800 F Street, NW, Washington, DC 20405.

SECTION I - GENERAL INFORMATION

1A. NAME

1B. STREET ADDRESS

1C. CITY 1D. STATE 1E. ZIP CODE

2. TYPE OF ORGANIZATION (Check one)

A. SOLE PROPRIETORSHIP

B. GENERAL PARTNERSHIP

C. LIMITED PARTNERSHIP

D. CORPORATION

E. SUBCHAPTER S CORPORATION

I. OTHER (Specify below)

3. TAXPAYER ID NUMBER 4. DATE ORGANIZATION ESTABLISHED 5. STATE OF INCORPORATION

6. TRADE STYLE NAME (Provide a copy of filing) 7. KIND OF PRODUCT OR SERVICE PROVIDED

8. FORMER BUSINESS NAME

D. RETAILER

E. OTHER (Specify) B. FIFO

A. LIFO C. AVERAGE COST

D. OTHER (Specify)

11. OWNERSHIP INFORMATION-PARTNERS-PRINCIPAL STOCKHOLDERS-OTHERS

NAME

10. INVENTORY VALUATION METHOD

9. KIND OF BUSINESS

A. MANUFACTURER

B. CONTRACTOR

C. WHOLESALER

TITLE

(If partner, state G(General) or L(Limited) in column)

ACTUAL TITLE G OR L

PERCENT

BUSINESS OWNED

12. PARENT COMPANY (If applicable)

13. IF "YES" TO ANY QUESTION BELOW, PROVIDE DETAILED

INFORMATION IN SECTION VIII, REMARKS YES NO

A. NAME

B. CITY C. STATE

A. HAVE YOU, OR ANY OF YOUR AFFILIATES EVER FILED FOR BANKRUPTCY?

B. DO YOU HAVE ANY JUDGMENTS, LIENS, OR PENDING SUITS?

C. DO YOU HAVE ANY CONTINGENT LIABILITIES?

D. HAVE YOU OR ANY OF YOUR AFFILIATES DISCONTINUED BUSINESS OPERATIONS WITH

OUTSTANDING DEBTS?

SECTION II - GOVERNMENT FINANCIAL AID AND INDEBTEDNESS

14A. ARE YOU DELINQUENT ON ANY FEDERAL DEBT (OMB CIRCULAR A-129)

(If "Yes", provide detailed information, Section VIII, Remarks)

14B. DO YOU OWE THE

GOVERNMENT

FOR ANY

CONTRACT OR

OTHER CLAIMS?

YES NO

IF "YES", COMPLETE THE ITEMS BELOW

AGENCY CLAIM AMOUNT PAYMENT MATURITY BALANCE

15A. AGENCY INVOLVED WITH DELINQUENCY 15B. AMOUNT OF DELINQUENCY ($)

16. ARE YOU

CURRENTLY

RECEIVING

GOVERNMENT

FINANCING?

YES NO

YES

NO (Go to Section III )

17. COMPLETE ITEMS BELOW IF APPLICABLE

A. INDUSTRIAL REVENUE BONDS

B. GUARANTEED LOANS

C. ADVANCED PAYMENTS

D. PROGRESS PAYMENTS

AUTHORIZED ($) IN USE ($) GOVERNMENT AGENCY INVOLVED

E. OTHER (Specify)

GENERAL SERVICES ADMINISTRATION GSA 527 (REV. 10/2015)

F. LIMITED LIABILITY COMPANY

G. JOINT VENTURE

H. TRUST

TYPE OF FINANCING

GSA 527 (REV. 10/2015) PAGE 2

SECTION III - FINANCIAL STATEMENTS

Prepared Financial Statements with notes may be provided in lieu of completing Section III

When financial statements are prepared or certified by independent accountants and transcribed to this form, please furnish the name and address of accountant of accounting firm.

18. ARE YOU THE INCUMBENT CONTRACTOR FOR THIS SOLICITATION?

NO

19A. NAME

19B. STREET ADDRESS

19C. CITY 19D. STATE 19E. ZIP CODE

20. IF TRANSCRIBED STATEMENTS DIFFER FROM INDEPENDENT ACCOUNTANT'S,

PLEASE DESCRIBE ADJUSTMENT IN SECTION VII, REMARKS. ALL OF THE

LISTED FIGURES ARE:

ACTUAL

IN THOUSANDS

IN MILLIONS

U.S. DOLLARS

FOREIGN CURRENCY (Specify)

21. BALANCE SHEET AS OF (Month, Day, Year) 22. FISCAL YEAR ENDS (Month, Day, Year) 23. PREPARED STATEMENTS

YES

ARE ATTACHED

24. ASSETS 25. LIABILITIES AND NET WORTH

A. Current Assets A. Current Liabilities

Cash Short Term cash investments Accounts receivable, less allowance for doubtful accounts of $ Inventories Other current assets (Itemize below)

Total Current Assets

B. Property, Plant and Equipment

Accounts payable Notes payable (current) Current portion of long term debt Accrued expenses Accrued taxes on income/excess profits Other current liabilities (Itemize below)

Total Current Liabilities

B. Other Liabilities

Land Buildings and equipment Leasehold improvements Less accumulated depreciation and amortization

Total Property, Plant and Equipment C. Other Assets

Investments in and advance to affiliated company Goodwill, less amortization Due from officer, employee Other (Itemize below)

Total Other Assets

D. TOTAL ASSETS

Mortgages Bonds Deferred income taxes Other long term debt

Total Other Liabilities

Total Liabilities

C. Minority Interest in Subsidiary D. Net Worth

Preferred stock Common stock Additional paid-in capital Retained earnings/owner's equity Less, Treasury stock

Total Net Worth

E. TOTAL LIABILITIES AND NET WORTH

SECTION IV - INCOME STATEMENT

26. FROM (Month, Day, Year) 27. TO (Month, Day, Year)

A. Net Sales

28. INCOME

Cost and Expenses Cost of Goods Sold Depreciation and Amortization

Selling, General, and Admin. Expenses Interest Expense Other Expenses (Itemize below)

Minority Interest in Earnings of Subsidiaries

Total Costs and Expenses

Earnings Before Taxes Taxes on Income Income Before Extraordinary Items Extraordinary Gains (Losses) Net of Taxes

NET INCOME (LOSS)

ZIP CODE

Yes No

Yes No

A.

B.

C.

CITY STATE ZIP CODE

Yes No

Yes No

AREA CODE NUMBER

AREA CODE NUMBER EXTENSION

AREA CODE NUMBER

STREET ADDRESS

37. Maximum Amount Authorized ($)

38. Amount Outstanding ($)

39. Loans Secured by Company's Assets - Real and Personal Property

BANK 1 BANK 2

SECTION V - BANKING AND FINANCE COMPANY INFORMATION

(Please attach a separate sheet using this format for any additional banks.)

ITEM

29. Name of Bank

30. Contact Person

31. Phone Number

32. Fax Number

33. Address

34. Amount Owing ($)

35. Term Loans

36. Line of Credit

D.

SECURED PARTY NAME CONTACT NAME

STREET ADDRESS CITY STATE ZIP CODE

SECURING ASSETS MATURITY DATE MONTHLY PAYMENT ($)

SECURED PARTY NAME CONTACT NAME

STREET ADDRESS CITY STATE ZIP CODE

SECURING ASSETS MATURITY DATE MONTHLY PAYMENT ($)

SECURED PARTY NAME CONTACT NAME

STREET ADDRESS CITY STATE ZIP CODE

SECURING ASSETS MATURITY DATE MONTHLY PAYMENT ($)

SECURED PARTY NAME CONTACT NAME

STREET ADDRESS CITY STATE ZIP CODE

SECURING ASSETS MATURITY DATE MONTHLY PAYMENT ($)

40. ARE ANY OF THE ASSETS SHOWN ON THE BALANCE SHEET

PLEDGED OR MORTGAGED, EXCEPT AS STATED ABOVE?

41B. TOTAL

LIABILITY ($)

41A. IF CONTRACTOR IS A PARTNERSHIP OR SOLE PROPIERTORSHIP,

ARE THE INDIVIDUAL LIABILITIES OF THE PROPIETOR(S) FOR

FEDERAL AND STATE INCOME AND/OR EXCESS PROFIT TAXES

INCLUDED ON THE BALANCE SHEET?

YES NO

42. ARE YOU NOW IN OR PENDING DEFAULT ON ANY OBLIGATIONS, I.E., BANKS, FINANCIAL INSTITUTIONS, SUPPLIERS, OTHER?

NO YES (Explain in Section VII, Remarks)

NO YES (Provide detailed information in Section VII, Remarks)

GSA 527 (REV. 10/2015) PAGE 3

AREA CODE NUMBER EXTENSION

STREET ADDRESS

CITY STATE

SECTION VI - PRINCIPAL MERCHANDISE OR RAW MATERIAL SUPPLIER INFORMATION

(Please attach separate sheet(s) using this format for additional suppliers.)

43. PAST DUE ACCOUNTS PAYABLE ($)

ITEM 44. SUPPLIER 1 45. SUPPLIER 2

AREA CODE NUMBER EXTENSION

AREA CODE NUMBER

STREET ADDRESS

STATECITY ZIP CODE

ITEM 46. SUPPLIER 3 47. SUPPLIER 4

A. Name of Supplier B. Contact Person

C. Telephone

D. Fax

E. Address

F. Amount Now Owing ($) G. High Credit ($)

A. Name of Supplier B. Contact Person

C. Telephone

D. Fax

E. Address

F. Amount Now Owing ($) G. High Credit ($)

AREA CODE NUMBER EXTENSION

AREA CODE NUMBER

STREET ADDRESS

CITY STATE ZIP CODE

AREA CODE NUMBER EXTENSION

AREA CODE NUMBER

AREA CODE NUMBER EXTENSION

AREA CODE NUMBER

STREET ADDRESS

CITY STATE ZIP CODE

SECTION VII - CONSTRUCTION/SERVICE CONTRACTS INFORMATION (Public Buildings Service Contracts Only)

CONTRACTS IN FORCE

STREET ADDRESS

CITY STATE ZIP CODE

GSA 527 (REV. 10/2015) PAGE 4

ITEM 48. CONTRACT 1 49. CONTRACT 2

A. Location B. Owner's Name

C. Address

D. Type of Work E. Contract Amount ($) F. Percent Completed G. Estimated Completion Date

STREET ADDRESS

CITY STATE ZIP CODE

STREET ADDRESS

CITY STATE ZIP CODE

ITEM

A. Location B. Owner's Name

C. Address

D. Type of Work E. Contract Amount ($) F. Percent Completed G. Estimated Completion Date

50. CONTRACT 3 51. CONTRACT 4

STREET ADDRESS

CITY STATE ZIP CODECITY STATE ZIP CODE

STREET ADDRESS

GSA 527 (REV. 10/2015) PAGE 5

C. Address

D. Telephone

E. Type of Work F. Contract Amount ($) G. Amount Sublet ($)

STREET ADDRESS

CITY STATE ZIP CODE

AREA CODE NUMBER EXTENSION

STREET ADDRESS

CITY STATE ZIP CODE

AREA CODE NUMBER EXTENSION

ITEM 58. JOB 3 59. JOB 4

A. Location B. Contact's Name

C. Address

D. Telephone

E. Type of Work F. Contract Amount ($) G. Amount Sublet ($)

STREET ADDRESS

CITY STATE ZIP CODE

AREA CODE NUMBER EXTENSION

STREET ADDRESS

CITY STATE ZIP CODE

AREA CODE NUMBER EXTENSION

ITEM 60. JOB 5 61. JOB 6

A. Location B. Contact's Name

C. Address

D. Telephone

E. Type of Work F. Contract Amount ($) G. Amount Sublet ($)

STREET ADDRESS

CITY STATE ZIP CODE

AREA CODE NUMBER EXTENSION

STREET ADDRESS

CITY STATE ZIP CODE

AREA CODE NUMBER EXTENSION

ITEM 52. CONTRACT 5 53. CONTRACT 6

A. Location B. Owner's Name

C. Address

D. Type of Work E. Contract Amount ($) F. Percent Completed G. Estimated Completion Date

STREET ADDRESS

CITY STATE ZIP CODE

STREET ADDRESS

CITY STATE ZIP CODE

ITEM

A. Location B. Owner's Name

C. Address

D. Type of Work E. Contract Amount ($) F. Percent Completed G. Estimated Completion Date

54. CONTRACT 7 55. CONTRACT 8

STREET ADDRESS

CITY STATE ZIP CODE

STREET ADDRESS

CITY STATE ZIP CODE

LARGEST JOBS YOU HAVE COMPLETED IN THE LAST FIVE YEARS

ITEM 56. JOB 1 57. JOB 2

A. Location B. Contact's Name

CERTIFICATION

For the purpose of establishing financial responsibility with, or procuring credit from the General Services Administration, we furnish the above as a true and correct statement of our financial condition and further certify that all other statements are true and correct. There has been no material change in the applicant's financial condition since the date of the above statement. We agree to notify you immediately in writing of any materially unfavorable change in our financial condition. In the absence of such notice or of a new and full financial statement, this is to be considered as a continuing statement.

NAME OF BUSINESS BY (Signature of Authorized Official)

NAME OF AUTHORIZED OFFICIAL (Type or print)

TITLE OF AUTHORIZED OFFICIAL (Type or print)

DATE

GSA 527 (REV. 10/2015) PAGE 6

NUMBER

STREET ADDRESS

CITY STATE ZIP CODE

AREA CODE NUMBER EXTENSION

AREA CODE NUMBER

STREET ADDRESS

CITY STATE ZIP CODE

64. PRESENT AMOUNT OF BONDING

COVERAGE ($)

65. HAS YOUR APPLICATION FOR SURETY

BOND EVER BEEN DECLINED? (If Yes, please provide detailed information in

Remarks)

66. DURING THE PAST 2 YEARS, HAVE YOU BEEN CHARGED WITH A

FAILURE TO MEET THE CLAIMS OF YOUR SUBCONTRACTORS OR

SUPPLIERS? (If Yes, please provide detailed information in Remarks)

YES NO YES NO

SECTION VIII - REMARKS

REMARKS (Cite those sections of the form relating to your remarks. If additional space is required, attach additional sheet(s).)

LIST COMPANIES FROM WHOM YOU OBTAIN SURETY BONDS

ITEM 62. SURETY COMPANY 1 63. SURETY COMPANY 2

A. Company Name B. Contact's Name

C. Telephone

D. Fax

E. Address

AREA CODE NUMBER EXTENSION

AREA CODE

CONTRACTOR'S COST PROPOSAL FORMAT

CONTRACTOR'S NAME:

LOCATION 2 :

DONALD J. PEASE, 143 LIBERTY STREET, MEDINA, OHIO 44256

DESCRIPTION OF SERVICE:

LANDSCAPING SERVICES

CONTRACT PERIOD:

Press Button to Clear Cells Below

SECTION I - DIRECT LABOR COST NUMBER OF EMPLOYEES:

1. Landscaping Labor manhours X $ per hour = $ -

2. Supervisory Labor manhours X $ per hour = $ -

3. Vacations: Vacation Hours: -

a. (Landscaping) manhours X $ per hour = $ -

b. (Supervisor) manhours X $ per hour = $ -

4. Paid Sick Leave: Paid Sick Leave Hour -

a. (Landscaping) manhours X $ per hour = $ -

b. (Supervisor) manhours X $ per hour = $ -

5. Holidays: Holiday Hours: -

a. (Landscaping) manhours X $ per hour = $ -

b. (Supervisor) manhours X $ per hour = $ -

6. TOTAL MANHOURS: -

7. TOTAL LABOR COST (Add labor, vacation and holidays): $ -

8. Health and Welfare - hours X $ per hour = $ -

9. Workman's Compensation % of Total Labor Cost = $ -

10. Social Security Tax % of Total Labor Cost = $ -

11. Federal Unemployment Tax % of 1st $7,000 per employee = $ -

12. State Unemployment Tax $ -

13. Other Fringe Benefits (pension, education, etc.)

hours X $ per hour = $ -

14. TOTAL FRINGE BENEFIT COST $ -

15. TOTAL DIRECT COSTS (Add labor, fringe benefits and payroll tax) $ -

SECTION II - OTHER DIRECT COSTS

16. Materials ( % of Direct Labor Costs) $ -

17. Equipment ( % of Direct Labor Costs) $ -

18. Subcontracts (please attach separate list) $

19. TOTAL OTHER DIRECT COSTS $ -

SECTION III - INDIRECT COSTS

20. General and Administrative ( % of Direct & Other Costs) $ -

21. Profit ( % of Total Costs and G&A) $ -

22. TOTAL INDIRECT COSTS $ -

23. TOTAL COST FOR BASIC SERVICE (for a one-year period) $ - (Sum of Direct, Other Direct and Indirect Costs)