N4008021R0030 Amendment 0001.pdf

ACQ5801718

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 TITLE OF SIGNER (Type or print)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83) Prescribed by GSA

FAR (48 CFR) 53.243

ROOFING IDIQ FOR NRDE COMMANDS AT NAS PATUXENT RIVER, NSF INDIAN HEAD AND NSF DAHLG

The purpose for this Amendment is to scedule the Site Visit for the Seed Project. The site visit for the Seed Project at the Naval Air Station Patuxent is scheduled for 1000 AM EST, on Tuesday, 23 February 2021. If a firm w ishes to attend, please fill out the Base Access Request Form and return to Benjamin Williams (Benjamin.w illiams9@navy.mil) and Raymond Vest (raymond.vest@navy.mil) no later than 1000 AM EST, on Monday, 22 February 2021. Due to base access restrictions, only US citizens w ill be allow ed to attend the Site Visit. As a result of this Amendment, the Request for Information (RFI) due date is extended by one w eek, to 25 February 2021.

All other terms and conditions remain unchanged.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 2

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

16C. DATE SIGNED

BY 18-Feb-2021

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

(Signature of Contracting Officer)(Signature of person authorized to sign)

8. NAME AND ADDRESS OF CONTRACTOR (No., Street , County, State and Zip Code) X N4008021R0030

X 9B. DATED (SEE ITEM 11)

04-Feb-2021

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

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 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 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)

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 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.)

10A. MOD. OF CONTRACT/ORDER NO.

2. AMENDMENT/MODIFICATION NO.

5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

18-Feb-2021

CODE

NAVAL FACILITIES ENGINEERING SYS COMMAND

1314 HARWOOD STREET SE

WASHINGTON DC 20374

N40080 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

N4008021R0030

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

(End of Summary of Changes)

CONTRACTOR BASE ACCESS REQUEST FORM

For All Contractors Requiring Base Access

Form available at www.nas.nawcad.navy.mil (*Designates Mandatory Fields)

I. Purpose of Visit Description of the work or visit purpose, time frame and classification level.

*Purpose of Visit:

*Start Date: *End Date: (Not to exceed 1 year)

*Will access to CLASSIFIED information be required? Yes No If Yes, at what classification level?j______________

II. Point of Contact (POC) Data Federal civil service/military, Contracting Officer’s Representative (COR), host or delegated alternate of the contract/visit.

Prefix: ____ First Name: __________Middle Initial: W

Last Name:

POC Work Phone Number: ____________________Ext.:

POC Work Fax Number: _______________________

POC Work E-mail Address/Signature: ______________________

III. Requestor Data The company/individual initiating this request. For example, a company’s Facility Security Officer (FSO).

Is the Requestor the Facility Security Officer? Yes No

*First Name:____________ Middle Initial: ____

*Last Name:_____________________________

Work Address:_______________________________________

Work City: State:__________

Work Zip Code: Work Country:

Work Phone Number:__________________________ Ext.:

Work Fax Number: ____________________________

Work Email Address: ____________________________

IV. Company Data Contact information for official business correspondence.

*Company Name: _______________________________________

CAGE Code:

Is Company incorporated in US? Yes No

*Is Company Foreign Owned, Controlled or Influenced (FOCI)?

Yes No

*Company Address: _________________________

*Company City: _______________ *Company State: ____

*Company Zip Code:_______ *Company Country: ___

*Company Phone Number: ___________

Company Fax Number: ______________

V. Contract Data All visits over 30 days require a contract number. If working on more than one, submit a base access request for each contract supported.

Contract Number: _______________________________

Expiration Date: _______________

(Continued next page)

Privacy Act of 1974: This form contains identifiable personal data which is to be safeguarded pursuant to the Privacy Act of 1974. This information is to be released only to authorized personnel having a need to know for official uses. When not in use, this form is to be stored in a locked cabinet or secured room.

http://www.nas.nawcad.navy.mil/

For form instructions and definitions, see next page.

VI. Contractor/Visitor Data Information concerning the contractor requesting base access.

*Position Title: _______________

*Date of Birth:____________________

*SSN: (or applicable Foreign National ID number)

Prefix: ____ *First Name: __________________Middle Initial: ____

*Last Name: _____________________

Nickname: _____________ Maiden Name:

*Birth City: _______________________ *Birth State: ____

*Birth Country: ______

*Citizenship: ______

Home Email Address: _____________________________

Home Phone Number: _____________________________

Home Address:___________________________________

Home City: _________________________ Home State: ____

Home Zip Code:_______________ *Country of Residence:_________

Please indicate your working status at this installation.

On-Site (Employed in a federal facility)

Off-Site (Employed in a private facility)

Visitor (At the installation in a visit capacity only, short term > 30 days)

Will Contractor/Visitor need a picture ID/ hard badge? Yes No

If contractor will be working ON-SITE aboard the complex or in a federally-leased facility, complete the following:

Work Site Location: 505

Primary Building Number:505 Room Number:

Suite Number: Unit Identification Code (UIC #)

Phone # 301-757- 5258 (If unknown, enter phone number of POC who will be able to locate the contractor.)

Benefiting Site Location: Competency Code

Team Code Supported: (a) , (b) , (c) ,

(d) , (e)

Essential Personnel Status: Key Essential Non-Essential (Must be verified by the government POC) After hours access? Yes No

If contractor will be supporting the installation at private contractor facility

OFF-SITE, complete the following address information:

Company Work Address:

Company Work City: Company Work State:

Company Work Zip Code: Company Work Country:

Company Work Phone Number:

Company Work Fax Number:

Work Email Address:

If contractor is a VISITOR aboard the station, please identify the primary building(s) to be visited:

*Locations to be Visited/Building Number(s): Bldg 505

CONTRACTOR BASE ACCESS REQUEST FORM

Privacy Act of 1974: This form contains identifiable personal data which is to be safeguarded pursuant to the Privacy Act of 1974. This information is to be released only to authorized personnel having a need to know for official uses. When not in use, this form is to be stored in a locked cabinet or secured room

Section I. Purpose of Visit Purpose of Visit: A description of the work or visit purpose. For example: To support the F/A-18 E/F program.

Start Date: Provide the estimated date that the contractor will report to work (mm-dd-yyyy).

End Date: Provide the date that the contractor’s work/visit will expire.

Work/visit maximum is 1 year.

Will access to CLASSIFIED information be required? Yes/ No If Yes, at what classification level? Indicate Confidential, Secret or Top Secret.

Section II. Point of Contact (POC) Data The POC is the civil service or military government official sponsoring this visit.

Prefix: Mr. or Ms. First Name/Middle Initial/Last Name: Provide first name, middle initial and last name of the point of contact (POC).

Work Phone Number/Ext./Fax Number: Provide work phone and fax number of the POC and extension, if applicable.

Work Email Address/Signature: Provide the POC’s work email address. If the POC does not have an email address or network access, this form should be signed by the POC and faxed or hand carried to the Pass Office.

Section III. Requestor Data The company/individual initiating this request.

Is the requestor the Facility Security Officer (FSO)? Yes /No.

First Name/Middle Initial/Last Name: Provide first name, middle initial and last name of the requestor.

Work Address: Provide work mailing address of the requestor including street address, city, state, zip and country.

Work Phone Number/Ext./Fax Number: Provide work phone and fax number of the requestor and extension, if applicable.

Work Email Address: Provide the work email address of the requestor.

Section IV. Company Data The company’s official business identification for correspondence purposes.

Company Name: Provide the official company name. CAGE Code: Indicate the company’s 5 digit Commercial & Government Entity (CAGE) code, if applicable. This code is used to identify a vendor by address or location for purposes of funds transfer, identification and correspondence, and is required for all contractor visit requests.

Is Company incorporated in the US? Yes/No. Is Company Foreign Owned, Controlled or Influenced (FOCI)? Yes/No Company Address: Provide official company mailing address of the company, including street address, city, state, zip and country.

Company Phone/Fax Number: Provide company’s main phone and fax numbers.

Section V. Contract Data The official document outlining the requirements for base access. All visits over 30 days require a contract number. If working on more than one contract, submit a base access request for each contract supported.

Contract Number: Provide the 13-character contract number that the contractor/visitor will be working under or applicable agreement number.

For example: N0042196D0006.

Expiration Date: Provide the expiration date of the contract or delivery order (mm-dd-yyyy).

(Continued on next page)

FORM INSTRUCTIONS

NOTE: ONLY COMPLETE THOSE AREAS HIGHLIGHTED IN RED AND RETURN.

Privacy Act of 1974: This form contains identifiable personal data which is to be safeguarded pursuant to the Privacy Act of 1974. This information is to be released only to authorized personnel having a need to know for official uses. When not in use this form is to be stored in a locked cabinet or secured room.

Section VI. Contractor/Visitor Data Information concerning the contractor requesting base access.

Position Title: Example: Management Analyst SSN: Enter U.S. Social Security number or applicable passport, visa, alien registration or invitational travel order number.

Date of Birth: (mm-dd-yyyy) Prefix: Mr. or Ms. First Name/Middle Initial/Last Name: Provide first name, middle initial and last name of the contractor.

Nickname: Provide a name the contractor uses other than official name.

Birth City/State/Country: Provide city, state and country of where the contractor was born.

Citizenship: List the country of citizenship. If foreign national, contact the contractor’s on-site security team or Competency 7.4.1 at 301-757-2960.

Home Email Address: Provide a home email address, if applicable.

Home Phone Number: Provide a home telephone number.

Home Address/City/State/Zip: Provide a home mailing address including 5-digit address with street, route, etc., city, state and zip code.

On-Site: Check this line if the contractor will be provided a workstation/working space aboard the complex or in a federally-leased facility.

Off-Site: Check this line if there is no workspace provided for the contractor on station.

Visitor: Check this line if the contractor is in a visit capacity and not on contract to provide services to this site.

Will the Contractor Need a Picture ID/Hard Badge? Yes/No

ON-SITE

Building Number: Provide a valid ON-SITE building number. A validation of on-site buildings will be performed upon processing of request.

Room Number: Provide ON-SITE room number.

Work Site Location: List the physical location, such as Pax, Alameda, etc., where the contractor will actually be working.

Benefiting Site Location: Provide the site which is benefiting from the contractor’s support, such as working at Jacksonville for Pax River.

UIC: Provide the 5-digit unit identification code. Example: 00421.

Phone #: Provide ON-SITE phone number where the contractor will be working. If not available, list the phone number of the government POC.

Competency Code: Provide the competency code the contractor will be assigned to.

Team Code Supported: If supporting a NAVAIR/NAWCAD/NAS organization, provide a valid six-character team code. Provide up to 5 team codes as applicable. At least one is required. Example: I21300. To find Team Code Listing, visit this site: ftp://otrs.navair.navy.mil/OTRS/TEAM%20CODES/.

Essential Personnel Status: Indicate whether this position is a designated key, essential or nonessential position. Contact the government POC for designation.

After hours access: Does the contractor’s job require access to a government facility after normal working hours? Yes/No.

OFF-SITE

Work Address/City/State/Zip: Provide the contractor’s work street address, city, state and zip code.

Work Country: Provide the contractor’s work country.

Work Phone/Fax Number: Provide the contractor’s work site phone and fax numbers.

Work Email Address: Provide the contractor’s work email address.

VISITOR

Location(s) to be Visited/Building Number(s): Indicate the building(s) the contractor will require access to during visit. A validation of on-site buildings will be performed upon processing of request.

FORM INSTRUCTIONS

Privacy Act of 1974: This form contains identifiable personal data which is to be safeguarded pursuant to the Privacy Act of 1974. This information is to be released only to authorized personnel having a need to know for official uses. When not in use, this form is to be stored in a locked cabinet or secured room