N68908-16-T-0177-U0001_SOW_Amendment_Liquid_Nitrogen.pdf

N4859117RCSK001

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 the amendment is to extend the solicitation close date and to add the Statement of Work.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 3

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

16C. DATE SIGNED

BY 15-Sep-2016

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 N68908-16-T-0177

X 9B. DATED (SEE ITEM 11)

12-Sep-2016

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 X is extended, 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

15-Sep-2016

CODE

NAVY MEDICINE EAST

ATTN: NANCY PURVIS

SUITE 1400

620 JOHN PAUL JONES CIRCLE

PORTSMOUTH VA 23708-2106

N68908 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

N68908-16-T-0177

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SOLICITATION/CONTRACT FORM

The required response date/time has changed from 15-Sep-2016 10:00 AM to 21-Sep-2016 10:00 AM.

The following have been added by full text:

STATEMENT OF WORK

STATEMENT OF WORK (N68908-16-T-0177)

SCOPE: Service Contract for Liquid Nitrogen Tanks for Naval Dosimetry Center Facility in Building 4

1. Contractor will provide a total of twelve (12) 230-liter or 240-liter liquid nitrogen tanks onsite.

2. Contractor will fill the tanks on site from its microbulk truck or exchange full tanks for empty tanks. The billing unit of measure is ccf (hundred cubic feet). Based on the conversion factor of 1 liter of liquid =

0.246 ccf of gas, a 230-liter tank holds 56.58 ccf. Tanks shall not exceed 61-7/8” x 26” in diameter and have roller casters 26” in diameter.

3. The contractor must retrieve the empty tanks from the nitrogen storage room (Bldg. 4, 1 st floor, Rm.

1352) and return full tanks to same.

4. Contractor must be able to routinely refill tanks on a weekly basis and as needed.

5. Contractor must leave a signed delivery ticket stating the total volume and total price of liquid nitrogen delivered at the time of delivery.

6. Contract is not to exceed $40,000.

7. Primary facility: Naval Dosimetry Center (NDC), Building 4, 8950 Brown Drive, Bethesda, MD 20889.

8. POC: Mr. Ben Morgan (Operations Head), 301-400-3039; Ms. Tracy Haynes (Secretary), 301-295-1402 at NDC, Bethesda, MD.

N68908-16-T-0177

STATEMENT OF WORK (N68908-16-T-0177)

SCOPE: Service Contract for Liquid Nitrogen Tanks for Naval Dosimetry Center Facility in Building 84T

1. Contractor will provide a total of ten (10) 230-liter or 240-liter liquid nitrogen tanks onsite.

Contractor will fill the tanks on site from its microbulk truck or exchange full tanks for empty tanks. The billing unit of measure is ccf (hundred cubic feet) of gas. Based on the conversion factor of 1 liter of liquid = 0.246 ccf of gas, a 230-liter tank holds 56.58 ccf. Tanks shall not exceed 61-7/8” x 26” in diameter and have roller casters 26” in diameter.

2. The contractor must retrieve the empty tanks from the nitrogen storage room (Bldg. 84T, Rm. 142) and return full tanks to same. NOTE: Due to weight limitations for the ramp to the loading dock at 84T tanks must be filled on the dock.

3. Contractor must be able to routinely refill tanks on a weekly basis and as needed.

4. Contractor must leave a signed delivery ticket stating the total volume and total price of liquid nitrogen delivered at the time of delivery.

5. Contract is not to exceed $40,000.

6. Primary facility: Naval Dosimetry Center (NDC), Building 84T, 8950 Brown Drive, Bethesda, MD 20889

7. POC: Mr. Ben Morgan (Operations Head), 301-400-3039; Ms. Tracy Haynes (Secretary), 301-295-1402 at NDC, Bethesda, MD.

(End of Summary of Changes)