SF30 RFQ19PE5025Q0015.pdf

PAGE OF PAGESAMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE

2. AMENDMENT/MODIFICATION NO.

3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO.

PR15111962-0001

5. PROJECT NO. (If applicable)

6. ISSUED BY CODE PE500 7. ADMINISTERED BY (If other than Item 6) CODE

AMERICAN EMBASSY LIMA

Av. Lima Polo cdra 2 s/n, Monterrico, Surco, ATTN: GSO/Procurement Lima

PERU

AMERICAN EMBASSY LIMA

Av. Lima Polo cdra 2 s/n, Monterrico, Surco, ATTN: GSO/Procurement Lima

PERU

(X) 9A. AMENDMENT OF SOLICITATION

NO.

19PE5025Q0015

x

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NO.

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

CODE FACILITY CODE

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 is 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, 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.)

The purpose of this amendment to the solicitation is to:

a. Confirm by certification that contractor is not in violation with Executive Order 14173 Ending Illegal Discrimination and Restoring Merit-Based Opportunity; and

b. Incorporate the provision Certification Regarding Compliance with applicable Federal anti-discrimination laws in Section 2 of the solicitation.

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

15B. CONTRACTOR/OFFEROR

(Signature of person authorized to sign)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

16C. DATE SIGNED

NSN 7540-01-152-8070

Previous edition unusable

STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

02/14/2025

02/03/2025

1. The attached certification in next page, must be completed, signed and dated, and must be returned along with the proposal.

2. The following provisions are incorporated in Section 2 – Contract Clauses:

Certification Regarding Compliance with applicable Federal anti-discrimination laws

No funds awarded under this contract may be used for any initiatives or programs, or any activities that do not comply with Executive Order 14173 titled Ending Illegal Discrimination and Restoring Merit-Based Opportunity.

The Contractor shall submit, prior to award or upon request from the Contracting Officer, a certification that confirms:

1.Its compliance in all respects with all applicable Federal anti-discrimination laws is material to the government’s payment decisions for purposes of section 3729(b)(4) of title 31, United States Code and;

2.It does not operate any programs promoting Diversity, Equity, and Inclusion that violate any applicable Federal anti-discrimination laws.

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CERTIFICATION REGARDING COMPLIANCE WITH APPLICABLE FEDERAL ANTI-DISCRIMINATION LAW

All Department of State contractors must cer�fy that they do not operate any programs promo�ng DEI that violate any applicable an�-discrimina�on laws and agree that such cer�fica�on is material for purposes of the government’s payment decision and therefore subject to the False Claims Act. See 31 U.S.C. 3729(b)(4).

DIRECTIONS FOR CONTRACTORS and/or OFFERORS

1. Read the en�re cer�fica�on provided below.

2. A�er you have read the provisions, please check the appropriate boxes.

3. Upon comple�on of Step 2, fill out the representa�on below. NOTE: This certification is made by a person with the authority to bind the contractor or offeror.

4. Return completed form to the Contrac�ng Officer/POC shown in the e-mail.

CERTIFICATION:

The Contractor or prospec�ve offeror cer�fies they:

☐ are in compliance in all respects with all applicable Federal an�-discrimina�on laws is material to the government’s payment decisions for purposes of sec�on 31 USC 3729(b)(4) (False Claims Act); and

☐ do not operate any programs promo�ng Diversity, Equity, and Inclusion that violate any applicable Federal an�-discrimina�on laws.

Contractor or Offeror Name (Printed or Typed): ___________________________________________

Authorized Representa�ve Name and Title: ______________________________________________

Authorized Representa�ve Signature and Date: ____________________________________________

Embassy of the United States of America Lima, Peru