AM03.SignIn.Sheet.Update.FormSF30.pdf

NSN 7540-01-152-8070 STANDARD FORM 30. (Rev. 10-83) Previous Edition unusable Prescribed by GSA FAR (48 CFR) 53.243

Page of Pages AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. Contract ID Code

2. AMENDMENT MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (if applicable)

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

(x) 9A. AMENDMENT OF SOLICITATION NO.

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NO.

8. NAME AND ADDRESS OF CONTRACTOR (NO., Street, Country, State and ZIP Code)

CODE FACILITY CODE

10B. DATED (SEE ITEM 13)

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 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 OR OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT IN REJECTION OF YOUR OFFER. If by virtue of this 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 ORDER ID 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)

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 AND TITLE OF CONTRACTING OFFICER (Type or print)

15B. CONTRACTOR/OFFEROR 16B. UNITED STATES OF AMERICA

(Signature of person authorized to sign)

15C. DATE SIGNED

(Signature of Contracting Officer)

16C. DATE SIGNED

Supplementary Page

PAGE 2 OF GS-09P-12-KS-D-0002/AM03

Description of Modification/Amendment:

The purpose of this amendment is to:

1. Provide an update to the Site Walk Sign-In sheet to include Enovity.

Supplementary Page

PAGE 3 OF GS-09P-12-KS-D-0002/AM03

PAGE 2 OF GS-09P-12-KS-D-0002/AM03

MEETING SIGN-IN SHEET

Project: RONALD DELLUMS O/M SITE WALK Meeting Date: October 27, 2011

Facilitator: Clevester Hines Place/Room: Ronald Dellums Federal Building, Oakland CA

Name Title Company Phone Fax E-Mail

Robert Gottschalk Kcorp Technology Services, Inc.

907-452-8119 907-452-8109 Bob.gottschalk@koyitlotsin a.com

Victoria Vargas Project Manager/Quality Control Manager

Yerba Buena Engineering & Construction

415-822-4400 415-822-0900 vvargas@yerba-buena.net

Daren Gerdes Project Manager Urban Services Group, Inc. 951-413-2484 951-413-2478 Daren.gerdes.ctr@dodmed ia.osd.mil

Mike Zimmerman General Maintenance Worker

Delta Building Services, Inc.

707-769-1142 707-769-1151 Badwire2003@yahoo.com

Angela Vamianakis President & CEO Delta Building Services, Inc.

818-727-7973 818-727-7382 Angela4delta@sbcglobal.n et

Reginald Spence Senior VP LB&B Associates, Inc. 301-596-2440 301-596-7879 rspence@lbbassociates.co m

Brent Anderson Regional Operations Manager

Meridian Management Corporation

714-558-7321 714-558-7328 banderson@mmcor.com

Bryan O’Connell Chief Executive Officer Meras Engineering 415-240-4918 415-358-4930 boconnell@meras.com

Marc Pollacchi Area Manager Meras Engineering 415-240-4918 415-358-4930

Sandra Gehring Inspections Sales Rep COSCO Fire Protection 925-455-2751 925-455-2761 sgehring@coscofire.com

Daniel Arbanas Director At Your Service Companies 602-943-6318 602-943-0118 aysdirector@aol.com

Julie Eiler Project Manager Matrix HG, Inc. 925-459-9200 925-459-9220 jailer@matrixhginc.com

David Rossi Manager, Business Development

Enovity 415-974-0390 x.2105 415-974-0399 drossi@enovity.com

PAGE 3 OF GS-09P-12-KS-D-0002/AM03

MEETING SIGN-IN SHEET

Project: RONALD DELLUMS O/M SITE WALK Meeting Date: October 27, 2011

Facilitator: Clevester Hines Place/Room: Ronald Dellums Federal Building, Oakland CA

Name Title Company Phone Fax E-Mail

450 GOLDEN GATE AVE, 4TH FL EAST

SAN FRANCISCO CA 94102