Amendment A002.pdf

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

N/A

PAGE

2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE NO. 5. PROJECT NO. (If applicable)

A002 09/20/2022 N/A See Box 14

6. ISSUED BY CODE N/A 7. ADMINISTERED BY (If other than Item 6) CODE N/A

Department of Transportation Federal Highway Administration 610 East Fifth Street Vancouver WA 98661-3801

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and Zip Code) 9A. AMENDMENT OF SOLICITATION NO.

X

69056722B000005

9B. DATED (SEE ITEM 11)

08/11/2022

10A. MODIFICATION OF CONTRACT/ORDER NO.

N/A

10B. DATED (SEE ITEM 13)

CODE: N/A FACILITY CODE: N/A N/A

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

| X | The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers (__ ) is extended, ( x ) is not extended.

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 1 copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or telegram 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 telegram or letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

N/A

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

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

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.

N/A

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

N/A

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

N/A

D OTHER (Specify type of modification and authority) N/A

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

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

OR DOT 140(1), OR 140 - Klamath County Boat Marina to Lakeshore Drive

See page 2

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 (Type or print) 15a. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

N/A

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 16C. DATE SIGNED

BY_________________________________________ BY N/A___________________________ N/A (Signature of person authorized to sign) (Signature of Contracting Officer)

NSN 7540-01-152-8070

PREVIOUS EDITION NOT USABLE

30-105 STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

Amendment No. A002, dated 09-20-2022 OR DOT 140(1) Solicitation No. 69056722b000005 OR 140 - Klamath County Boat Page 2 Marina to Lakeshore Drive

REVISIONS ARE AS FOLLOWS:

STANDARD FORM 24

Removes old Bid Bond form with Expiration Date 8/31/2022, and Adds new Bid Bond form with Expiration Date 8/31/2025.

SECTION H

Pages H-3 through H-17, Section H Permits. Deletes old pages and Adds new pages tagged with Revised by Amendment A002 |.

Pages H-17a through H-17ac, Section H Permits. Adds new pages tagged with Revised by Amendment A002 |.

ENCLOSURES

Pages:

Standard Form 24 (Rev. 8/2016) / Standard Form 24 (Rev. 8/2016) Back H-3 through H-17 / H-17a through H-17ac

BID BOND

(See instructions on reverse)

OMB Control Number: 9000-0045 Expiration Date: 8/31/2025

PRINCIPAL (Legal name and business address) TYPE OF ORGANIZATION ("X" one)

STATE OF INCORPORATION

SURETY(IES) (Name and business address)

PERCENT

OF BID

PRICE

PENAL SUM OF BOND

AMOUNT NOT TO EXCEED

MILLION(S) THOUSAND(S) HUNDRED(S) CENTS

BID IDENTIFICATION

BID DATE INVITATION NUMBER

PRINCIPAL

SIGNATURE(S)

NAME(S) &

TITLE(S)

(Typed)

1.

1. 2.

2.

3.

3.

(Seal) (Seal) (Seal) Corporate Seal

INDIVIDUAL SURETY(IES)

SIGNATURE(S)

NAME(S)

(Typed)

1.

1.

2.

2.

(Seal) (Seal)

CORPORATE SURETY(IES)

SU

R

ET

Y

A

NAME &

ADDRESS

STATE OF INCORPORATION LIABILITY LIMIT ($)

SIGNATURE(S)

NAME(S) &

TITLE(S)

(Typed)

1.

1.

2.

2. Corporate Seal

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition is NOT usable

STANDARD FORM 24 (REV. 8/2016)

Prescribed by GSA - FAR (48 CFR) 53.228(a)

FOR (Construction, Supplies or Services)

OBLIGATION:

We, the Principal and Surety(ies) are firmly bound to the United States of America (hereinafter called the Government) in the above penal sum. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally. However, where the Sureties are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum "jointly and severally" as well as "severally" only for the purpose of allowing a joint action or actions against any or all of us. For all other purposes, each Surety binds itself, jointly and severally with the Principal, for the payment of the sum shown opposite the name of the Surety. If no limit of liability is indicated, the limit of liability is the full amount of the penal sum.

CONDITIONS:

The Principal has submitted the bid identified above.

THEREFORE:

The above obligation is void if the Principal - (a) upon acceptance by the Government of the bid identified above, within the period specified therein for acceptance (sixty (60) days if no period is specified), executes the further contractual documents and gives the bond(s) required by the terms of the bid as accepted within the time specified (ten (10) days if no period is specified) after receipt of the forms by the principal; or (b) in the event of failure to execute such further contractual documents and give such bonds, pays the Government for any cost of procuring the work which exceeds the amount of the bid.

Each Surety executing this instrument agrees that its obligation is not impaired by any extension(s) of the time for acceptance of the bid that the Principal may grant to the Government.

Notice to the surety(ies) of extension(s) is waived. However, waiver of the notice applies only to extensions aggregating not more than sixty (60) calendar days in addition to the period originally allowed for acceptance of the bid.

WITNESS:

The Principal and Surety(ies) executed this bid bond and affixed their seals on the above date.

DATE BOND EXECUTED (Must not be later than bid opening date)

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 9000-0045. We estimate that it will take 1 hour 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.

JOINT VENTURE

OTHER (Specify)

PARTNERSHIPINDIVIDUAL

CORPORATION

69056722B000005 OR DOT 140(1), OR 140 - Klamath County Boat Marina to Lakeshore Drive

Revised by Amendment A002

INSTRUCTIONS

1. This form is authorized for use when a bid guaranty is required. Any deviation from this form will require the written approval of the Administrator of General Services.

2. Insert the full legal name and business address of the Principal in the space designated "Principal" on the face of the form. An authorized person shall sign the bond. Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not a member of the firm, partnership, or joint venture, or an officer of the corporation involved.

3. The bond may express penal sum as a percentage of the bid price. In these cases, the bond may state a maximum dollar limitation (e.g., 20% of the bid price but the amount not to exceed dollars).

4. (a) Corporations executing the bond as sureties must appear on the Department of the Treasury's list of approved sureties and must act within the limitations listed therein. The value put into the LIABILITY LIMIT block is the penal sum (i.e., the face value) of the bond, unless a co-surety arrangement is proposed.

(b) When multiple corporate sureties are involved, their names and addresses shall appear in the spaces (Surety A, Surety B, etc.) headed "CORPORATE SURETY(IES)." In the space designated "SURETY(IES)" on the face of the form, insert only the letter identifier corresponding to each of the sureties. Moreover, when co-surety arrangements exist, the parties may allocate their respective limitations of liability under the bond, provided that the sum total of their liability equals 100% of the bond penal sum.

(c) When individual sureties are involved, a completed Affidavit of Individual Surety (Standard Form 28) for each individual surety, shall accompany the bond.

The Government may require the surety to furnish additional substantiating information concerning its financial capability.

5. Corporations executing the bond shall affix their corporate seals. Individuals shall execute the bond opposite the word "Corporate Seal"; and shall affix an adhesive seal if executed in Maine, New Hampshire, or any other jurisdiction requiring adhesive seals.

6. Type the name and title of each person signing this bond in the space provided.

7. In its application to negotiated contracts, the terms "bid" and "bidder" shall include "proposal" and "offeror."

SU

R

ET

Y

B

NAME &

ADDRESS

STATE OF INCORPORATION LIABILITY LIMIT ($)

SIGNATURE(S)

NAME(S) &

TITLE(S)

(Typed)

1.

1.

2.

2. Corporate Seal

Corporate Seal

LIABILITY LIMIT ($)STATE OF INCORPORATION

2.

2.

1.

1.NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

C

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INCORPORATION

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

D

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INCORPORATION

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

E

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INCORPORATION

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

F

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INCORPORATION

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

G

STANDARD FORM 24 (REV. 8/2016) BACK

Revised by Amendment A002

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Permits Project: OR DOT 140(1), OR 140 - Klamath County Boat Marina to Lakeshore Drive

Revised by Amendment A002 |

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Revised by Amendment A002 |

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