75H71020P01294MOD1Casale Technology Group.pdf

(x) x 75H71020P01294 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 ACKNOWLEDGEMENT 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.

See Schedule

CHANDLER AZ 85249-4683

1542332

ANGELITA YVETTE CASALE 1542332

Shiprock NM 87420 US Hwy 491 North Northern Navajo Medical CTR

See Block 16CP00001

13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

12. ACCOUNTING AND APPROPRIATION DATA (If required) is not extended.is extended, Items 8 and 15, and returning

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

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

FACILITY CODE CODE

10B. DATED (SEE ITEM 13)

10A. MODIFICATION OF CONTRACT/ORDER NO.

9B. DATED (SEE ITEM 11)

9A. AMENDMENT OF SOLICITATION NO.

CODE

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

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

PAGE OF PAGES

4. REQUISITION/PURCHASE REQ. NO.3. EFFECTIVE DATE2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO. (If applicable)

1. CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

05/11/2020

Attn: ANGELITA J CASALE

CASALE TECHNOLOGY GROUP LLC

2021 E WESTCHESTER DR

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

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office, C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER (Specify type of modification and authority) appropriation data, etc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

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

ORDER NO. IN ITEM 10A.

FAR 52.212-4(c) - Changes x

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

X

Purchase Order No. 75H71020P01294 is hereby modified to reflect the following changes:

LIST OF CHANGES:

Reason for Modification: Other Administrative Action

Total Amount for this Modification: $0.00

New Total Amount for this Award: $137,641.00

LANGUAGE CHANGE FROM

Fee Schedule:

Continued ...

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)15A. NAME AND TITLE OF SIGNER (Type or print)

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

(Signature of person authorized to sign) (Signature of Contracting Officer)

MARGARET J. SHIRLEY-DAMON

STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

Previous edition unusable

Except as provided herein, all terms and conditions of the document referenced in Item 9 A or 10A, as heretofore changed, remains unchanged and in full force and effect .

05/18/2020

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

2 3

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

ANGELITA YVETTE CASALE 1542332

(A) (B) (C) (D) (E) (F)

75H71020P01294/P00001

K0Q22A#BGJ: HP LaserJet M609x - Printer -

Monochrome - Laser Duplex, Laser, A4/Legal, 1200 x 1200 dpi, up to 75 ppm

57 @ $1,600.00 ea./qty = $91,200.00

B5L47A#BGJ: HP Color LaserJet ENT MFP M577F

Printer, Color, Laser, Legal (8.5in x

14in),(Original)A4/Legal(Media) up to 40 ppm

(copying), Up to 40 ppm(Printing), 650 sheets

12 @ $1,405.00 ea./qty = $16,860.00

U8TH7E: HP 3y 9x5 NBD w/ DMR CLJ M57x MFP On-Site

Service

12 @ $594.00 ea./qty = $7,128.00

Total: $115,188.00

PRIORITY CODE: 20-3007-4YLC

TO:

K0Q22A#BGJ: HP LaserJet M609x - Printer -

Monochrome - Laser Duplex, Laser, A4/Legal, 1200 x 1200 dpi, up to 75 ppm

39 @ $1,600.00 ea./qty = $62,400.00

HP LaserJet M612x - Printer

18 @ $1,600.00 ea./qty = $28,800.00

PRIORITY CODE: 20-3007-4YLC

B5L47A#BGJ: HP Color LaserJet ENT MFP M577F

Printer, Color, Laser, Legal (8.5in x

14in),(Original)A4/Legal(Media) up to 40 ppm

(copying), Up to 40 ppm(Printing), 650 sheets

12 @ $1,405.00 ea./qty = $16,860.00

U8TH7E: HP 3y 9x5 NBD w/ DMR CLJ M57x MFP On-Site

Service

12 @ $594.00 ea./qty = $7,128.00

PRIORITY CODE: 20-3008-4YLC

TOTAL: $115,188.00

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 3

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

ANGELITA YVETTE CASALE 1542332

(A) (B) (C) (D) (E) (F)

75H71020P01294/P00001

Discount Terms: IHS NET 15P

Payment:

IHSNAVAJO

P.O. BOX 9020

WINDOW ROCK AZ 86515

All Other Terms and Conditions shall remain the same.

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110