Amendment_0001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

6. 1SSUED BY

Federal Bureau of Prisons Field Acquisition Office

CODE

'----------1

U.S . Armed Forces Reserve Complex 346 Marine Forces Drive Grand Prairie, TX 75051

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

0210-12

7. ADMINISTERED BY (lfotherthan Item 6)

Federal Bureau of Prisons Federal Detention Center 351 Elliott Street Honolulu, Hawaii 96819

9A. AMENDMENT OF SOLI CIA TION NO.

)( IFBP06031200002

9B. DATED (SEE ITEM 11)

Oct 22, 2012

1 OA. MODIFICATION OF CONTRACT /ORDER NO.

D l OB. DATED (SEE ITEM 13)

CODE

IE] The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers D is extended, IE] 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 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 your desire to change an offer already submittedd, such .chang\! may be made. by teleqrarn or letter, Qtovided each telegram or letter makes reference to the solicitation and this amenclment, an IS rece1veo pnor to the opemng hour ana date speCIIIeO.

12. ACCOUNTING AND APPROPIRATION 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 n D D D

NO. IN ITEM lOA.

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES appropriation date, etc. ) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.1 03(b).

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

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor IJ is not, D is required to sign this document and return

(such as changes in paying office, copies to t he issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION ( Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Amendment 0001 will incorporate the following:

A site visit will be scheduled for Tuesday October 30, 2012 at 9:00am for all interested parties in the above listed solicitation. All individuals wishing to attend the site visit are required to complete the attached NCIC form . All completed forms must be sent to the attention of the Facilities Dept . Manager at 808-838-4520 (fax) or jmgreene@bop . gov (email) by no later than 4:00pm HAST, October 26, 2012.

Interested parties will also need to contact the facilities department at 808-838-4313 by no

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 1 OA, 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)

Mark Walker

Contracting Officer

15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED 16C. DATE SIGNED

l~:w~ Oct

(Signature of person authorized to sign) (Signature of Contracting Officer) 23, 20 1

D

NSN 7540-01-152-8070

Previous edition unusable

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

1. CONTRACT ID CODE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT- Continuation

2. AMENDMENT/MODIFICATION NO.

3.EFF. DATE

10/22/2012

4. REQUISITION/PURCHASE REQ. NO.

0210-12

PAGES

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

later than 4:00pm HAST, October 29, 2012 for instructions for gaining entry to the Federal Detention Center, Honolulu, Hawaii.

The offer due date remains November 15, 2012 at 14:00 CST.

All other terms and conditions remain the same.

Attachment

STANDARD FORM 30 (REV. 10-83)

BP- A0660

JUN 10

U.S. DEPARTMENT OF JUSTICE

NCIC CHECK CDFRM

FEDERAL BUREAU OF PRISONS

AUTHORIZATION FOR RELEASE OF INFORMATION

NCIC {National Crime Information Center) CHECK

I hereby authorize a representative of the Federal Bureau of Prisons to obtain any information on my criminal history background . I understand that this check must be done before I am allowed to enter/serve at any Bureau facility . I also understand that refusal to provide all necessary information may result in 1) denial of entry into a Bureau facility and 2) denial of volunteer/contract status .

1 . Name (Last , First , Middle)

2. Address (Street address) (City , State , County , Zip Code)

3 . Home Telephone Number (Area Code , Number)

4. Aliases/Nickname :

5. Citizenship (List the country you are a citizen of)

6. Social Security Number:

7 . Date of Birth (Month , day , year)

Sa. Sex: 8b. Race:

Be . Height: 8d . Weight :

Be . Color of Eyes : 9f . Color of Hair :

9. Place of Birth (City , State , County), (List city, county and country if outside the U.S . A)

10. The above listed information is true and correct. Applicant ' s Signature lOa . Date

PRIVACY ACT NOTICE

Authority for Collecting Information : E.O. 10450; 5 USC 1303-1305; 42 USC 2165 and 2455;

22 USC 2585 and 2519; and 5 USC 3301

Purposes and Uses: Information provided on this form will be furnished to individuals in order to obtain information regarding activities in connection with an investigation to determine (1) fitness for Federal employment, (2) clearance to perform contractual service for the Federal Government , (3) security clearance or access . The information obtained may be furnished to third parties as necessary in the fulfillment of official responsibilities.

Effects of Non-disclosures : Furnishing the requested information is voluntary , but failure to provide all or of part the information may result in lack of further consideration for employment , clearance or access, or in the termination of your employment .

PDF Prescribed by P1280

BP-A0660

J UNIO 10

CHEQUEO DE NCIC CDFRM

DEPARTAMENTO DE JUSTICIA DE EE.UU. AGENCIA FEDERAL DE PRISIONES

**This template is provided to assist Spanish-speaking persons who are not fluent in English to complete the corresponding Bureau form . It is a template only for instructional purposes, and should not be filled in . **

**Este modelo se provee para ayudar a las personas que hablan espanol y no dominan el ingles para que completen el formulario correspondiente de la Agencia . Es solo un modelo que sirve como ejemplo, y no se debe completar.**

AUTORIZACION PARA LA DISTRIBUCION DE INFORMACION

CHEQUEO DE NCIC (Centro Nacional de Informacion sobre el Crimen)

Por este medio autorizo a un representante de la Agencia Federal de Prisiones a obtener cualquier informacion sobre los antecedentes de mi historial cr iminal. Entiendo que este chequeo debe ser hecho antes de recibir permiso para entrar/servir en cualquier instalacion de la Agencia Federal de Prisiones . Tambien entiendo que la negacion a proveer toda la informacion necesaria puede resultar en 1) la negacion de mi entrada a una instalacion de la Agencia Federal de Prisi ones y 2) la negacion de mi clasificacion como voluntario/contratista .

1. Nombre (Apellido , Nombre, Segundo Nombre)

2. Direccion (Numero de Domicilio y Calle) (Ciudad, Estado , Condado, Codigo Postal)

3. Numero de Telefono de Casa (C odigo de Area , Numero):

4. Alias/Apodos:

5. Ciudadania (Indique el pais de su ciudadania)

6 . Numero de Seguridad Social:

7 . Fecha de Nacimiento (Mes , dia, ano)

Ba . Sexo : Bb. Raza:

Be. Estatura : Bd . Peso :

Be. Color de Ojos: 9f. Color de Cabello:

9 . Lugar de Nacimiento (Ciudad , la ciudad , el condado y el pais , Estado , Condado), (Indique si es afuera de EE . UU .)

10. La informacion anteriormente listada es verdadera ~ correcta .

Firma de Solicitante lOa. Fecha

AVISO SOBRE LA LEY DE PRIVACIDAD

Autoridad para Obtener Informacion: E . O. 10450; 5 USC 1303-1305 ; 42 USC 2165 y 2455; 22 usc 25B5 y 2519 ; y 5 usc 3301

Objetivos y Usos : La informacion provista en este formulario sera entregada a individuos, con el fin de obtener informacion en cuanto a actividades como parte de una in~estigacion realizada para determinar (1) la aptitud para obte ner empleo Federal , (2) la autorizacion para realizar servicio contratado para el Gobierno Federal , (3) la autorizacion de seguridad o acceso . La informacion obtenida puede ser entregada a terceras partes , como lo sea necesario , para realizar las responsabilidades oficiales.

Efectos de Informacion No Divulqada: El proveer la informacion solicitada es voluntar io , pero la falta de proveer toda o parte de la informacion puede resultar en la privacion de futura consideracion para empleo , para autorizacion o acceso , o puede resultar en la terminacion de su empleo.

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