SF30 Cover Page for_LES_Life_Insurance.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CO NTRACT ID CO DE

2. AMENDMENT/MO DIFICATIO N NO .

A001

3. EFFECTIVE DATE

11/06/2015

4. REQ UISITIO N/PURCHASE REQ . NO .

PR3850636-A001

5. PRO JECT NO . (If applicable)

6. ISSUED BY CO DE ET100 7. ADMINISTERED BY (If other than Item 6) CO DE

AMERICAN EMBASSY ADDIS ABABA

ENTOTO ROAD, P.O.BOX 1014, ATTN: GSO/PROCUREMENT

ADDIS ABABA,

ETHIOPIA

AMERICAN EMBASSY ADDIS ABABA

ENTOTO ROAD, P.O.BOX 1014, ATTN: GSO/PROCUREMENT

ADDIS ABABA,

ETHIOPIA

8. NAME AND ADDRESS O F CO NTRACTO R (NO., street,city,county,State,and ZIP Code)

NO VENDO R

X 9a. AMENDMENT O F SO LICITATIO N NO .

SET10016R0003

9b. DATED (SEE ITEM 11)

10/14/2015

UNITED STATES 10a. MO DIFICATIO N O F CO NTRACT/O RDER NO .

10b. DATED (SEE ITEM 13)

11. THIS ITEM O NLY APPLIES TO AMENDMENTS O F SO LICITATIO NS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

_ is extended, x 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 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 amendmen t numbers.

FAILURE O F YO UR ACKNO WLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FO R THE RECEIPT O F

O FFERS PRIO R TO THE HO UR AND DATE SPECIFIED MAY RESULT IN REJECTIO N O F YO UR O FFER. 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. ACCO UNTING AND APPRO PRIATIO N DATA (If required)

13. THIS ITEM APPLIES O NLY TO MO DIFICATIO NS O F CO NTRACTS/O RDERS,

IT MO DIFIES THE CO NTRACT/O RDER NO . AS DESCRIBED IN ITEM 14.

_ A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: 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. IMPO RTANT: Contractor _ is not, _ is required to sign this document and return copies to the issuing office.

14. DESCRIPTIO N O F AMENDMENT/MO DIFICATIO N (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Amendment is made to include detail employee statistics data on page 29 and correct (delete) duplicate information on column 4 table B.7.2 on page 5.

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, rema ins unchanged and in full force and effect.

15A. NAME AND TITLE O F SIGNER (Type or print)

16A. NAME O F CO NTRACTING O FFICER

15B. NAME O F CO NTRACTO R/O FFERO R

BY

(Signature of person authorized to sign)

15C.DATE

SIGNED

16B. UNITED STATES O F AMERICA, BY

(Signature of Contracting Officer)

16C.DATE SIGNED

11/05/2015

NSN 7540-01-152-8070 Standard Form 30 (revised 10/83)

Previous edition unusable Prescribed by GSA FAR (48 CFR) 53.243

11. SCHEDULE

(Include applicable Federal, State and local taxes)

ITEM NO.

(a)

SUPPLIES/SERVICES

(b)

QUANTITY

(c)

UNIT

(d)

UNIT PRICE

(e)

AMOUNT

(f)

1 LES l i fe insurance for five years (one base year and four option years ). Amendment i s made to include deta i l employee s tatis tics data on page 29 and correct (delete) dupl icate information on column 4 table B.7.2 on page 5.

Funding Information:

Tota l : $0.00

$0.00

1.00 EA $0.00 $0.00