signed SF30 Amendment 4 07-16.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 11. CONTRACT ID CODE rAGE OF PAGES

I

2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REO. NO. 15. PROJECT NO. (If applicable)

Amendment # 4 07/16/2012 6.1SSUED BY CODE 7. ADMINISTERED BY (If other than Item 6) CODE I Centers for Medicare & Medicaid Services Kelley Williams-Vollmer 7500 Security Blvd. Contract Specialist Mail Stop B3-30-03 410-786-8177 Baltimore, MD 21244

B. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code) (X) SA. AMENDMENT OF SOLICITATION

NO.

CMS-2012-ESRD-FFPCOMP

SB. DATED (SEE ITEM 11)

07/16/2012

10A. MODIFICATION OF CONTRACT/ORDER NO.

D 10B. DATED (SEE ITEM 13)

CODE I 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 D 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 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 ofthis amendment your 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)

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

IT MODIFIES THE CONTRACT/ORDER NO. 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 NO.

IN ITEM 10A.

D D

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).

D

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

D D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor D is not, D 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 #4 is to: 1) Revise the RFP

2) Add J-2 - ESRD Manual Reference

3) Add J-18- Subcontracting Plan

4) Add J-20A- Information Security Attestation

5) Add J-20B - Compliance Attestation

6) Add the Slides from the Pre-proposal conference that was held on June 21, 2012

7) Add the Questions and Answers.

All other terms and conditions remain unchanged.

Except as provided herein, all terms and conditions of the document referenced in Item SA or 1 OA, as heretofore changed, remains unchanged and in full for and effect.

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

NSN 7540-01-152-8070

Previous edition unusable

15C. DATE SIGNED 16C. DATE SIGNED

~6~Jd._

STA. DARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243