HT9402-10-Q-0019 0001.pdf

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 15C. Date Signed 16C. Date Signed

(Signature of person authorized to sign)

16B. United States of America

(Signature of Contracting Officer)

NSN 7540-01-152-8070 30-105 STANDARD FORM 30 (REV. 10-83)

PREVIOUS EDITIONS UNUSABLE Prescribed by GSA FAR (48 CFR) 53.243

1. Contract ID Code Page of Pages AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1 3

2. Amendment/Modification No. 3. Effective Date 4. Requisition/Purchase Req. No. 5. Project No. (if applicable) 0001 Sep 14, 2010 10-OCIO-0004 J

6. Issued By Code HT9402 7. Administered By (If other than Item 6) Code SEE BLOCK 6

DEPARTMENT OF DEFENSE

TRICARE MANAGEMENT ACTIVITY/CM

16401 E. CENTRETECH PARKWAY

AURORA, CO 80011-9066

8. Name and Address of Contractor (No., Street, County, and Zip Code) (X) 9A. Amendment of Solicitation No.

HT9402-10-Q-0019

X 9B. Date (See Item 11) Sep 13, 2010 10A. Modification of Contract/Order No.

10B. Date (See Item 13)

Code Facility Code

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 Offers is extended X 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 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 ACKNOWLEDG- MENT 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)

9700130.1884 8404 P0141 2565 8CTIRTRO (APC:VJMG97) 012143 DRAC 00127 $

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACT/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

(x) 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 fourth 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.)

A. The purpose of this amendment is to add language to "EVALUATION INFORMATION" identified in Block 20 of the Standard Form 1449.

B. The lanugage in "EVALUATION INFORMATION" is changed:

FROM: This award will be a firm fixed price contract based on the lowest priced, technically acceptable quote, for the following Contract Line Item Numbers:

TO: This award, on an "all-or-none" basis, will be a firm fixed price contract based on the lowest priced, technically acceptable quote, for the following Contract Line Item Numbers:

SCHEDULE

Item No. Supplies/Services Quantity Unit Unit Price Amount

TRICARE Management Activity is a Department of Defense organization and is therefore exempt from federal and state taxes.

PROVIDE THE FOLLOWING INFORMATION:

1) DUNS Number: _____________________

2) Taxpayer Identification #: ______________

3) Cage Code: ________________________

4) Ordering Address:

5) Point of Contact: ____________________

a) Email Address: _____________________

b) Telephone #: ______________________

c) Fax #: ____________________________

6) Delivery After Receipt of Order (ARO):

7) Return a completed Representations and Certifications (FAR 52.212-3) or copy of active Online Representations and Certifications Application (ORCA).

PRICING INFORMATION:

1) Identify type of pricing (i.e. GSA, Open Market) for each item identified

a) GSA Information:

i) GSA Contract #: _____________________

ii) Expiration Date: _____________________

iii) Must provide a copy of the GSA Terms and Conditions

2) Provide a copy of the current price list for the items.

a) GSA Information: copy of the current price list containing the item(s) identified as GSA

3) Identify any additional discounts.

SUBMISSION OF QUOTATION:

1) Signed and dated quotes shall be received as specified in Block 8.

2) Quotes shall be submitted:

a) by email:

to: sandra.cleveland@tma.osd.mil cc: alicia.broner.ctr@tma.osd.mil; or

b) delivered to Attention: Sandra Cleveland at the address in Block 9.

3) All quotes, emails, and correspondence related to this RFQ must include the RFQ # HT9402-10-Q- 0019.

EVALUATION INFORMATION:

This award, on an "all-or-none" basis, will be a firm fixed price contract based on the lowest priced, technically acceptable quote, for the following Contract Line Item Numbers:

0001 Hardware

(See attached Specifications for CLIN 0001)

Firm-fixed price line item.

1 LT ______________ ______________

SCHEDULE

Item No. Supplies/Services Quantity Unit Unit Price Amount

0002 Software

Fiber Channel Switch License - Brand Name or Equal Cisco MDS 9124 On Demand Port Activation License-Increments of 8 Ports or Equal (SFPs purchased separately).

Part Number: 771020-000

An equal must provide licenses that enable 16 active 4GBps ports on the 24-port Fiber Channel Switch.

2 EA ______________ ______________

0003 Warranty: Includes Hardware and Software

(See attached Specifications for CLIN 0003)

0004 Services: Includes Installation and Configuration

(See attached Specifications for CLIN 0004)

0005 Technical Support and Maintenance: Includes Hardware and Software

(See atttached Specifications for CLIN 0005)

The monthly unit price includes the total of 12 months of technical support on two (2) Fiber Channel Switches and 12 months of maintenance on two (2) Fiber Channel Switch Licenses.)

12 MO ______________ ______________