SOL-114-13-000001_Amend_02.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT [1 CONTRACT 10 CODE [PAGE OF PAGES

1 I 2

2 AMENDMENT/MODIFICATION NO 3 EFFECTIVE DATE 4 REOUISITION/PURCHASE REO NO

5 PROJECT NO. (If applicab/e)

000002 11/21/2012

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

Regional Contracting Office ()SAID Caucasus 11 George Ba1anchine Str.

Tbi1isi 0131 Georgia

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code) (X) 9A AMENDMENT OF SOLICITATION NO

I--

SOL-114-13-000001

X

9B, DATED (SEE ITEM 11)

11/01/2012

10A MODIFICATION OF CONTRACT/ORDER NO

10B. DATED (SEE ITEM 13)

CODE FACILITY CODE

11, THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

){ T he above numbered solicltallon is amended as set forth in Item 14. The hour and date specified for receipt of Offers .IS extended, )~is not extended.

Offers must acknOlovledge 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 retuming 1 copies of the amendment; (b) By acknowledging receipt ot this amendment on each copy 01 the offer submrtted; or (c) By separate letter or telegram which includes a relerence to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT 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. It 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 ONLY APPLIES TO MODIFtCATION 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 lOA

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 authonty)

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 sOlicilation/contract subject matter where feasible)

The purpose of this amenQ~er.t is to extend the due date of

Past Performance questionnaires.

~ROM: November 26, 2012

TO: December 7, 2012.

Change page is attached.

SB Plan: NO

The date is extended

Except as provided herein all tenns 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 o(person aufhorizedlo sign)

NSN 7540-01-152-8070

Previous edition unusable

15C DATE SIGNED

Sa:r;.ah R. Bueter . \

16C DATE SIGNED

STANDARD FORM 30 (REV. 10·83)

Prescnbed by GSA

FAR (48 CFR) 53.243

SOL-114-13-000001

Mission Evaluation Mechanism

ATTACHMENT 2 – PAST PERFORMANCE QUESTIONNAIRE

To Whom It May Concern:

We are in the process of bidding on SOL-114-13-000001 for USAID/Caucasus’ new Mission Evaluation Mechanism. Part of the requirement for bidding is providing our past performance information. Please fill out the following Past Performance Questionnaire and return to Lasha Matitaishvili email at lmatitaishvili@usaid.gov no later than Friday, December 7, 2012.

Should you need to confirm the veracity of this request, please contact Elizabeth Colarik at ecolarik@usaid.gov.

We appreciate your time and feedback.

Sincerely,