Amendment of Solicitation 0001 (GMC Health Insurance) signed.pdf

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Provision of Health Insurance for Locally Employed Staff of U. S. Embassy Phnom Penh
Solicitation number
19CB6022R0027
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SENSITIVE BUT UNCLASSIFIED

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE

PAGE OF PAGES

1 1

2. AMENDMENT/MODIFICATION NO.

3. EFFECTIVE DATE

See block 16C

4. REQUISITION/PURCHASE REQ. NO.

5. PROJECT NO. (If applicable)

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

CODE

U.S. Embassy Phnom Penh #1, Street 96, Sankat Wat Phnom, Daun Penh

Phnom Pen, Cambodia

Tel: 023 728 000; Fax: 023 728 504

U.S Embassy Phnom Penh

General Service Office and Human Resource Office

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

X

9A. AMENDMENT OF SOLICITATION NO.

19CB6022R0027

9B. DATED (SEE ITEM 11)

October 07, 2022

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

CODE FACILITY CODE

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.

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_______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 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.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

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.

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)

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

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

The purpose of this amendment is to change the pre-proposal conference date to December 01, 2022, at 14:00 -

17:00, Cambodian local time.

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)

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

Zoë Treuer

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

15C.DATE SIGNED 16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

16C.DATE SIGNED

Previous edition unusable STANDARD FORM 30 (REV. 11/2016)

Prescribed by GSA FAR (48 CFR) 53.243

5 PROJECT NO If applicable:
5 PROJECT NO If applicableRow1:
8 NAME AND ADDRESS OF CONTRACTOR NO streetcitycountyStateand ZIP Code:
CODE:
FACILITY CODE:
XRow1:
10A MODIFICATION OF CONTRACTORDER NO:
10B DATED SEE ITEM 13:
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:
13 THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTSORDERS IT MODIFIES THE CONTRACTORDER NO AS DESCRIBED IN ITEM 14Row1:
13 THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTSORDERS IT MODIFIES THE CONTRACTORDER NO AS DESCRIBED IN ITEM 14Row2:
13 THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTSORDERS IT MODIFIES THE CONTRACTORDER NO AS DESCRIBED IN ITEM 14Row3:
C THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
13 THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTSORDERS IT MODIFIES THE CONTRACTORDER NO AS DESCRIBED IN ITEM 14Row4:
D OTHER Specify type of modification and authority:
is required to sign this document and return: Off
copies to the issuing office:
16A NAME OF CONTRACTING OFFICER Type or print:
15CDATE SIGNED:
16CDATE SIGNED: 10/25/22
2022-10-25T17:19:27+0700
Treuer, Zoe R

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