N6809419R6026_0001.pdf

N6809420RCALS01

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

This amendment is issued to add pillow cases and provide answ ers to questions as show n in the summary of changes.

1. CONTRACT ID CODE PAGE OF PAGES

1 6

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

16C. DATE SIGNED

BY 03-Sep-2019

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 N6809419R6026

X 9B. DATED (SEE ITEM 11)

14-Aug-2019

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.

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

6. ISSUED BY

3. EFFECTIVE DATE

03-Sep-2019

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:

N6809419R6026

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

SUBCLIN 0001AK is added as follows:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001AK 4,035 Each

PILLOWCASE

FFP

FOB: Destination

MILSTRIP: N6809420RCALS01

ADDITIONAL MARKINGS: NAVAL BRANCH HEALTH CLINIC BLDG

1402 PORT HUENEME

PSC CD: S209

NET AMT

SUBCLIN 1001AK is added as follows:

1001AK 4,035 Each

OPTION PILLOW CASES

FFP

FOB: Destination

ADDITIONAL MARKINGS: NAVAL BRANCH HEALTH CLINIC BLDG

SUBCLIN 2001AK is added as follows:

2001AK 4,035 Each

OPTION PILLOWCASE

FFP

FOB: Destination

ADDITIONAL MARKINGS: NAVAL BRANCH HEALTH CLINIC BLDG

SUBCLIN 3001AK is added as follows:

3001AK 4,035 Each

OPTION PILLOW CASES

FFP

FOB: Destination

ADDITIONAL MARKINGS: NAVAL BRANCH HEALTH CLINIC BLDG

SUBCLIN 4001AK is added as follows:

4001AK 4,035 Each

OPTION PILLOW CASES

FFP

FOB: Destination

ADDITIONAL MARKINGS: NAVAL BRANCH HEALTH CLINIC BLDG

DELIVERIES AND PERFORMANCE

The following Delivery Schedule for SUBCLIN 0001AK has been added:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

POP 01-NOV-2019 TO

30-SEP-2020

N/A NAVAL AMBULATORY CARE CENTER

MARY LAWS

162 FIRST STREET BLDG 1402

PORT HUENEME CA 93043-4316

805-982-6402

FOB: Destination

N66099

The following Delivery Schedule for SUBCLIN 1001AK has been added:

POP 01-OCT-2020 TO

30-SEP-2021

N/A NAVAL AMBULATORY CARE CENTER

MARY LAWS

162 FIRST STREET BLDG 1402

PORT HUENEME CA 93043-4316

805-982-6402

The following Delivery Schedule for SUBCLIN 2001AK has been added:

POP 01-OCT-2021 TO

30-SEP-2022

N/A NAVAL AMBULATORY CARE CENTER

MARY LAWS

162 FIRST STREET BLDG 1402

PORT HUENEME CA 93043-4316

805-982-6402

The following Delivery Schedule for SUBCLIN 3001AK has been added:

POP 01-OCT-2022 TO

30-SEP-2023

N/A NAVAL AMBULATORY CARE CENTER

MARY LAWS

162 FIRST STREET BLDG 1402

PORT HUENEME CA 93043-4316

805-982-6402

The following Delivery Schedule for SUBCLIN 4001AK has been added:

POP 01-OCT-2023 TO

30-SEP-2024

N/A NAVAL AMBULATORY CARE CENTER

MARY LAWS

162 FIRST STREET BLDG 1402

PORT HUENEME CA 93043-4316

805-982-6402

INSPECTION AND ACCEPTANCE

The following Acceptance/Inspection Schedule was added for SUBCLIN 0001AK:

INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

Destination Government Destination Government

The following Acceptance/Inspection Schedule was added for SUBCLIN 1001AK:

The following Acceptance/Inspection Schedule was added for SUBCLIN 2001AK:

The following Acceptance/Inspection Schedule was added for SUBCLIN 3001AK:

The following Acceptance/Inspection Schedule was added for SUBCLIN 4001AK:

(End of Summary of Changes)