P00009 SPE2D219D0066 NDC Change.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1

1. CONTRACT I� CODE

I

2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO.

I

5. PROJECT NO. (If applicable)

P00009 See Blk.16C See Block 14

6. ISSUED BY CODE SPE2D2 7. ADMINISTERED BY (If other than Item 6) CODE I SPE2D2

DLA TROOP SUPPORT DLA TROOP SUPPORT

MEDICAL SUPPLY CHAIN FSGB

MEDICAL SUPPLY CHAIN FSGB 7 00 ROBBINS AVENUE

PHILADELPHIA PA 19111 700 ROBBINS AVENUE

USA PHILADELPHIA PA 19111

Initi ator: Kyle Lewicki

USA DKL0040 Tel: 215-737-3696 Em ail: Kyle.Lewicki@dla.mil

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

9B. DATED (SEE ITEM 11)

GOLDEN STATE MEDICAL SUPPLY INC

5187 CAMINO RUIZ

CAMARILLO CA 93012-8601 10A. MODIFICATION OF CONTRACT/ORDER NO.

USA

SPE2D2-19-D-0066

X

10B. DATED (SEE ITEM 13)

2018 OCT 26

CODE 1HT23 FACILITY CODE

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

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

(al 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 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.

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:

X FAR 52.212-4(c)

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor D is not, 0 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.)

See Continuation Sheet

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 1 0A, 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)

NSN 7540-01-152-8070

Previous edition unusable

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

(Signature of Contracting Officer)

STANDARD FORM 30 (REV.10-83)

Prescribed by GSA FAR (48 CFR) 53.243

JASON WRAY