FA8224-15-R-0023-0003.pdf

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 T IT LE OF SIGNER (T ype or print)

30-105-04EXCEPT ION T O SF 30

APPROVED BY OIRM 11-84

ST ANDARD FORM 30 (Rev. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is to add DD Form 254 in the list of attachments and clause 5352.204-9000.

1. CONTRACT ID CODE P AGE OF P AGES

J 1 3

16A. NAME AND T IT LE OF CONT RACT ING OFFICER (T ype or print)

16C. DAT E SIGNED

BY

16B. UNIT ED ST AT ES OF AMERICA15C. DAT E SIGNED15B. CONT RACT OR/OFFEROR

(Signature of Contract ing Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONT RACT OR (No., Street , County, State and Zip Code) X FA8224-15-R-0023

X 9B. DAT ED (SEE IT EM 11)

14-Jan-2015

10B. DAT ED (SEE IT EM 13)

9A. AMENDMENT OF SOLICIT AT ION NO.

11. T HIS IT EM ONLY APPLIES T O AMENDMENT S OF SOLICIT AT IONS

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 P LACE DESIGNATED FOR THE RECEIP T OF OFFERS P RIOR TO THE HOUR AND DATE SP ECIFIED 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. ACCOUNT ING AND APPROPRIAT ION DAT A (If required)

13. T HIS IT EM APPLIES ONLY T O MODIFICAT IONS OF CONT RACT S/ORDERS.

IT MODIFIES T HE CONT RACT /ORDER NO. AS DESCRIBED IN IT EM 14.

A. T HIS CHANGE ORDER IS ISSUED PURSUANT T O: (Specify authority) T HE CHANGES SET FORT H IN IT EM 14 ARE MADE IN T HE

CONT RACT ORDER NO. IN IT EM 10A.

B. T HE ABOVE NUMBERED CONT RACT /ORDER IS MODIFIED T O REFLECT T HE ADMINIST RAT IVE CHANGES (such as changes in paying office, appropriat ion date, etc.) SET FORT H IN IT EM 14, PURSUANT T O T HE AUT HORIT Y OF FAR 43.103(B).

C. T HIS SUPPLEMENT AL AGREEMENT IS ENT ERED INT O PURSUANT T O AUT HORIT Y OF:

D. OT HER (Specify type of modificat ion and authority)

E. IMPORT ANT : Contractor is not , is required to sign this document and return copies to the issuing office.

14. DESCRIPT ION OF AMENDMENT /MODIFICAT ION (Organized by UCF sect ion headings, including solicitat ion/contract subject matter where feasible.)

10A. MOD. OF CONT RACT /ORDER NO.

U0003

2. AMENDMENT/MODIFICATION NO. 5. P ROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

19-Feb-2015

CODE

OL:H/PZIM

PZIMA EMILY POGUE

6038 ASPEN AVE B1289 UP

HILL AFB UT 84056-5805

FA8224 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/P URCHASE REQ. NO.

CODE

See Item 6

FACILIT Y CODECODE

EMAIL:TEL:

FA8224-15-R-0023

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION I - CONTRACT CLAUSES

The following have been added by full text:

5352.204-9000 NOTIFICATION OF GOVERNMENT SECURITY ACTIVITY AND VISITOR GROUP

SECURITY AGREEMENTS (MAR 2012)

This contract contains a DD Form 254, DOD Contract Security Classification Specification, and requires perfor-mance at a government location in the U.S. or overseas. Prior to beginning operations involving classified infor-mation on an installation identified on the DD Form 254, the contractor shall take the following actions:

(a) At least thirty days prior to beginning operations, notify the Information Protection Office shown in the distribu-tion block of the DD Form 254 as to:

(1) The name, address, and telephone number of this contract company’s representative and designated alternate in the U.S. or overseas area, as appropriate;

(2) The contract number and military contracting command;

(3) The highest classification category of defense information to which contractor employees will have access;

(4) The Air Force installations in the U.S. (in overseas areas, identify only the APO number(s)) where the contract work will be performed;

(5) The date contractor operations will begin on base in the U.S. or in the overseas area;

(6) The estimated completion date of operations on base in the U.S. or in the overseas area; and

(7) Any changes to information previously provided under this clause.

This requirement is in addition to visit request procedures contained in DOD 5220.22-M, National Industrial Securi-ty Program Operating Manual.

(b) Prior to beginning operations involving classified information on an installation identified on the DD Form 254 where the contractor is not required to have a facility security clearance, the contractor shall enter into a Visitor

Group Security Agreement (or understanding) with the installation commander to ensure that the contractor’s security procedures are properly integrated with those of the installation. As a minimum, the agreement shall identify the security actions that will be performed:

(1) By the installation for the contractor, such as providing storage and classified reproduction facilities, guard ser-vices, security forms, security inspections under DOD 5220.22-M, classified mail services, security badges, visitor control, and investigating security incidents; and

(2) Jointly by the contractor and the installation, such as packaging and addressing classified transmittals, security checks, internal security controls, and implementing emergency procedures to protect classified material.

(End of Clause)

FA8224-15-R-0023

SECTION J - LIST OF DOCUMENTS, EXHIBITS AND OTHER ATTACHMENTS

The Table of Contents has changed from:

Exhibit/Attachment Table of Contents

DOCUMENT TYPE DESCRIPTION PAGES DATE

Attachment 1 Performance Work

Statement (PWS)

21 03-FEB-2015

Attachment 2 CDRL A001 Status

Report

1 16-DEC-2014

Attachment 3 CDRL A002 Orientation

Report

1 16-DEC-2014

Attachment 4 CDRL A003 Quality Plan 1 16-DEC-2014

Attachment 5 Total Evaluated Price

(TEP) Worksheet

1 27-JAN-2015

to:

Exhibit/Attachment Table of Contents

DOCUMENT TYPE DESCRIPTION PAGES DATE

Attachment 1 Performance Work

Statement (PWS)

21 03-FEB-2015

Attachment 2 CDRL A001 Status

Report

1 16-DEC-2014

Attachment 3 CDRL A002 Orientation

Report

1 16-DEC-2014

Attachment 4 CDRL A003 Quality Plan 1 16-DEC-2014

Attachment 5 Total Evaluated Price

(TEP) Worksheet

1 27-JAN-2015

Attachment 6 DD Form 254 2 06-FEB-2015

(End of Summary of Changes)