N6809418R6078_(01).pdf

N6809419RC44A02

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

The purpose of this amendment is to add the serial numbers as show n in the summary of changes.

1. CONTRACT ID CODE PAGE OF PAGES

1 12

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

16C. DATE SIGNED

BY

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 N6809418R6078

X 9B. DATED (SEE ITEM 11)

16-Jul-2018

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 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.

U0001

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

18-Jul-2018

CODE

NAVAL HOSPITAL CAMP PENDLETON

MATERIAL MGMT DEPT CODE 06B

NAVAL HOSPITAL, BOX 555191

CAMP PENDLETON CA 92055-5191

N68094 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

N6809418R6078

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

SUBCLIN 0001AA

The CLIN extended description has changed from:

Location: 13 ADC Dental Clinic, Camp Pendleton CA

To:

Location: 13 ADC Dental Clinic, Camp Pendleton CA Serial #: 32460804

The serial number has changed from 32460804 to 32460804.

SUBCLIN 0001AB

Location: 13 ADC Dental Clinic, Camp Pendleton CA Serial #: 32470815

SUBCLIN 0001AC

Location: 22 ADC Dental Clinic, Chappo, Camp Pendleton CA

Location: 22 ADC Dental Clinic, Chappo, Camp Pendleton CA Serial #: 32501001

SUBCLIN 0001AD

Location: 13 ADC Dental Clinic, Camp Pendleton CASerial #: 308C0230

SUBCLIN 0001AE

Location: 22 ADC Dental Clinic, Chappo, Camp Pendleton CASerial #: 0510C0784

SUBCLIN 0001AF

Location: Miramar Dental Clinic, Miramar CA

Location: Miramar Dental Clinic, Miramar CA Serial #: 032471409

SUBCLIN 0001AG

Location: 29 Palms Dental Clinic, 29 Palms CA

Location: 29 Palms Dental Clinic, 29 Palms CA Serial #: 09M0965

SUBCLIN 0001AH

Location: 29 Palms Dental Clinic, 29 Palms CA Serial #: 40422

SUBCLIN 0001AJ

Locaton: 29 Palms Dental Clinic, 29 Palms CA

Locaton: 29 Palms Dental Clinic, 29 Palms CASerial #: 409C0523

SUBCLIN 0001AK

Location: Branch Dental Clinic, Yuma AZ

Location: Branch Dental Clinic, Yuma AZ Serial #: BAA069565

SUBCLIN 0001AL

Location: Branch Dental Clinic, Yuma AZ Serial #: 3GTV605196

SUBCLIN 1001AA

SUBCLIN 1001AB

SUBCLIN 1001AC

SUBCLIN 1001AD

SUBCLIN 1001AE

SUBCLIN 1001AF

SUBCLIN 1001AG

SUBCLIN 1001AH

SUBCLIN 1001AJ

SUBCLIN 1001AK

SUBCLIN 1001AL

SUBCLIN 2001AA

SUBCLIN 2001AB

SUBCLIN 2001AC

SUBCLIN 2001AD

SUBCLIN 2001AE

SUBCLIN 2001AF

SUBCLIN 2001AG

SUBCLIN 2001AH

SUBCLIN 2001AJ

SUBCLIN 2001AK

SUBCLIN 2001AL

SUBCLIN 3001AA

SUBCLIN 3001AB

SUBCLIN 3001AC

SUBCLIN 3001AD

SUBCLIN 3001AE

SUBCLIN 3001AF

SUBCLIN 3001AG

SUBCLIN 3001AH

SUBCLIN 3001AJ

SUBCLIN 3001AK

SUBCLIN 3001AL

(End of Summary of Changes)