FA4809-12-T-0008-0004.pdf

F3T2CM2044AQ01

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

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)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is to change the statement of w ork and add provision 52.212-1 by reference.

POC:MSgt John McComas /Phone: 919-722-1766 /Fax: 919-722-5424 /Email:john.mccomas@seymourjohnson.af.mil

1. CONTRACT ID CODE PAGE OF PAGES

J 1 6

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

16C. DATE SIGNED

BY 07-Jun-2012

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

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

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) X FA4809-12-T-0008

X 9B. DATED (SEE ITEM 11)

23-May-2012

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

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 Offer is extended, X is not extended.

Offer 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)

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 date, 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.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

07-Jun-2012

CODE

4TH CONTRACTING SQUADRON

1600 WRIGHT BROTHERS AVENUE, BLDG 3010

SEYMOUR JOHNSON AFB NC 27531-2459

FA4809 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

FA4809-12-T-0008

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

The following have been added by reference:

52.212-1 Instructions to Offerors--Commercial Items FEB 2012

The following have been modified:

STATEMENT OF WORK

STATEMENT OF WORK

FOR

BREATHABLE AIR SYSTEM

7 JUN 2012

1. PURPOSE: This Statement of Work defines the task that the contractor will undertake to purchase, remove current system and install Breathable Air System in the following facility, Bldg 4735. The breathable air system must be capable of producing "Grade D" air to support 9 supplied air respirators for a constant work cycle. System must have service port to retrieve air samples.

2. SCOPE: The contractor shall provide all equipment, materials, labor and service required to provide a technical solution, equipment and subsequent installation of the Breathable Air System.

3. LOCATION: This work is to be accomplished on Seymour Johnson Air Force Base Goldsboro, NC Bldg 4735.

4. SITE VISIT: 31 May 2012, 10:00 AM

5. WARRANTY: The contractor shall guarantee all workmanship for a period of one year after completion of work.

6. WORKMANSHIP: The installation of Breathable Air System will be a turn-key operation for Bldg 4735;

also, the Breathable Air System willl be placed in the location where the current system is installed. The contractor shall provide all qualified personnel, equipment, and service required to install product and service listed in solicitation FA4809-12-T-0008.

a. The compressor must sit on a concrete pad with the dimensions of 34 inches by 79 inches.

b. All other parts of the system will be contained within a separate 3 foot by 11.5 foot space due to the limited area within the building (see below for pictures of system currently installed).

c. Current pipes/tanks and plumbing installed in the building should be re-used if serviceable. Line and tanks should be pressure tested to ensure that they do not leak. If lines are determined unserviceable, they should be repaired and any repairs made to lines should use existing hangers and holes. (Note: Any modifications to the infrastructure must be coordinated through the 4 Civil Engineering Services Squadron prior to making the modification)

d. The 4th Component Maintenace Squadron will perform QA inspection for compliance with standard installation practices.

7. CLEANUP: The contractor is responsible to return the work site to the condition in which it was found. If removal of equipment and/or material is necessary to perform, or required by this contract, the contractor shall be responsible for disposal and shall comply with all applicable industry rules and regulations. Government POC shall be notified prior to disposing of any government owned materials/equipment.

8. PERIOD OF PERFORMANCE: All work shall be accomplished within 90 days after contract award.

9. WORK HOURS: The contractor shall coordinate with the 4th Contacting Squadron 48 hours in advance arrival to perform installation. The contractor shall observe the same work hours of the 4 CMS, 0700- 1700 hour or make arrangements to deviate from this schedule known in advance. However, work that will interfere with normal operations shall be pre-coordinated with affected agencies and accomplished during designated maintenance times.

(End of Summary of Changes)