M00318-21-Q-0020 Amend 0001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

Except as provi ded herei n, all t erms and condit ions of t he document referenced in Item 9A or 10A, as heretofore changed, remai ns unchanged and in ful l force and effect .

15A. NAME AND TIT LE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

ST ANDARD FORM 30 (Rev. 10-83) Prescr ibed by GSA

FAR (48 CFR) 53.243

The purpose of this amendment is to incorporate the f ollow ing changes:

a. Reduce CLIN 0001 quantity from 12 Tote to 2 Tote (260 Gallon Tote of concentrate).

b. Reduce delivery quantity f rom 12 Tote to 2 Tote (260 Gallon Tote of concentrate).

1. CONTRACT ID CODE P AGE OF P AGES

J 1 2

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

16C. DAT E SIGNED

BY 29-Jun-2021

16B. UNITED ST AT ES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contract ing Officer)(Signature of person author ized t o sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, Count y, Stat e and Zip Code) X M0031821Q0020

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

24-Jun-2021

10B. DAT ED (SEE IT EM 13)

9A. AMENDMENT OF SOLICITAT ION NO.

11. THIS IT EM ONLY APPLIES T O AMENDMENT S OF SOLICITATIONS

X The above numbered soli cit ati on i s amended as set forth in It em 14. The hour and date specified for rece ipt of Offer is ext ended, X is not extended.

Offer must acknowl edge rece ipt of t his amendment pri or to the hour and date specified in the sol ici tat ion or as amended by one of t he fol lowing methods:

(a) By compl eti ng Items 8 and 15, and returning 1 copi es of the amendment ; (b) By acknowledgi ng recei pt of thi s amendment on each copy of t he offer submit ted;

or (c) By s epara te let ter or t elegram whi ch i ncludes a refe rence t o t he s olic ita tion and amendment numbers . FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE P LACE DESIGNATED FOR THE RECEIPT OF OFFERS P RIOR TO THE HOUR AND DATE SP ECIFIED MAY RESULT IN

REJECTION OF YOUR OFFER. If by virtue of thi s amendment you desire t o change an offer already submit ted, s uch change may be made by t elegram or let ter, provided each t elegram or l ett er makes re ference to the sol ici tat ion and this amendment , and is received prior to the openi ng hour and dat e speci fi ed.

12. ACCOUNTING AND APPROPRIATION DAT A (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 FORT H IN ITEM 14 ARE MADE IN THE

CONT RACT ORDER NO. IN ITEM 10A.

B. T HE ABOVE NUMBERED CONT RACT /ORDER IS MODIFIED T O REFLECT THE ADMINIST RATIVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORT H IN ITEM 14, PURSUANT TO T HE AUTHORITY OF FAR 43.103(B).

C. T HIS SUPPLEMENT AL AGREEMENT IS ENT ERED INTO PURSUANT TO AUTHORITY OF:

D. OT HER (Specify type of modification and authorit y)

E. IMPORTANT: Contract or is not, is required to sign this document and return copies t o the issuing office.

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

10A. MOD. OF CONTRACT/ORDER NO.

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

6. ISSUED BY

3. EFFECTIVE DATE

29-Jun-2021

CODE

MCIPAC RCO- HI

BLDG 209 2ND ST

P.O. BOX 63063

KANEOHE BAY HI 96863-3063

M00318 7. ADMINISTERED BY (If other t han item 6)

4. REQUISITION/P URCHASE REQ. NO.

CODE

See I tem 6

FACILITY CODECODE

EMAIL:TEL:

M0031821Q0020

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

CLIN 0001

The pricing detail quantity has decreased by 10.00 from 12.00 to 2.00.

DELIVERIES AND PERFORMANCE

The following Delivery Schedule item for CLIN 0001 has been changed from:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

30-JUL-2021 12 MCBH - RANGE TRAINING FACILITY

CW02 MARIO A HEIKELL

MCBH RANGE TRAINING FACILITY

BLDG 1584

KANEOHE BAY HI 96863

808-257-3180 FOB: Destination

M00318

To:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

30-JUL-2021 2 MCBH - RANGE TRAINING FACILITY

CW02 MARIO A HEIKELL

MCBH RANGE TRAINING FACILITY

BLDG 1584

KANEOHE BAY HI 96863

808-257-3180 FOB: Destination

M00318

(End of Summary of Changes)