AmendmentA003.pdf

15C. DATE SIGNED

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE

2. AMENDMENT/MODIFICATION NO.

A003

3. EFFECTIVE DATE

04-05-2013

4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)

7. ADMINISTERED BY (If other than Item 6) CODE

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

Same as item 6

FACILITY CODE

9A. AMENDMENT OF SOLICITATION NO.

SEG-300-13-R-001

9B. DATED (SEE ITEM 11)

02-14-2013

10A. MODIFICATION OF CONTRACT/ORDER NO.

10B. DATED (SEE ITEM 13)

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 Offers Xis extended, is not extended.

Offers 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 your 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 ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS.

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

CHECK ONE 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, X is required to sign this document and return 1 copies to the issuing office.

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)

16C. DATE SIGNED

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

Myron Hirniak

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

This Amendment (A003) cancels Amendments 1 & 2, previously posted on FedBizOps on March 10, 2013 and March 31, 2013, and amends the Solicitation as follows:

- Add in section C.3 definition for catastrophic as stated on the second page of this Amendment.

- Solicitation paragraphs C.1.1.12 Medical Expenses Incurred Out of Country and C.1.1.13 Annual Maximum Limit are deleted and replaced as stated on the second page of this Amendment

PAGE OF PAGES

1 1

6. ISSUED BY CODE

Procurement and Contracting Office American Embassy, Cairo 8 Kamal El Din Salah Street Garden City, Cairo - Egypt

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

All prospective offeror (X)

CODE

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

NSN 7540-01-152-8070

Previous edition unusable

C.3 Definition:

Catastrophic cases: The definition of the catastrophic cases includes but is not limited to Renal Failure, Cancer, and Hepatitis C. A mechanism to include other cases would be subject to Management approval. The maximum approval per patient per contract year for catastrophic treatment is up to 400,000.00 EGP (Egyptian Pounds).

C.1.1.12 Medical expenses incurred out of country Medical expenses incurred out of country will be covered for employees and dependents when

(a) an illness or injury occurs when the individual is out of the country and treatment is medically necessary before the individual returns home or (b) the individual’s attending physician certifies and reports in advance that such treatment is medically necessary and unavailable locally. The report will be reviewed and prior approval must be obtained from the Embassy’s Medical Officer and the Insurance Company’s representative. Reimbursement will be made at the same percentage rate and subject to the same annual maximum limit as for expenses incurred in country.

C.1.1.13 Annual Maximum Limit - The maximum reimbursement per patient per contract year, not including expenses covered under C.1.1.4 is 200,000.00 EGP (Egyptian Pounds) and up to 400,000.00 EGP (Egyptian Pounds) for catastrophic treatment.