Signed No-Cost Settlement Termination Modification (GSMS) SPE2D2-21-D-0131.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF. CONTRACT

, 1. CONTRACT I~ CODE I PAGE 1 OF 2

2. AMENDMENT/MODIFICATION NO. I 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. I 5. PROJECT NO. (If applicable)

P00004 See Blk. 16C

See Block-14

6. ISSUED BY CODE I SPE2D2 7. ADMINISTERED BY /If other than Mem 6) CODE I SPE2D2

DLA TROOP SUPPORT DLA TROOP SUPPORT

MEDICAL SUPPLY CHAIN FSGB MEDICAL SUPPLY CHAIN FSGB 700 ROBBINS AVENUE

PHILADELPHIA PA 19111 700 ROBBINS AVENUE

USA PHILADELPHIA PA 19111

Initiator: Phyllis Daraio USA PHPHAC7Tel: 215-737-7941 FAX: 215-737-5226 Email: PHYLLIS.DARAIO@DLAMIL

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

GOLDEN STATE MEDICAL SUPPLY, INC.

9B. DATED (SEE ITEM 11)

OBA GOLDEN STATE MEDICAL SUPPLY INC

5187 CAMINO RUIZ

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

USA SPE2D2-21-D-0131

X

10B. DATED (SEE ITEM 13)

2021 MAR 19

CODE 1HT23 FACILITY CODE

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICIT A TIO NS

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:

(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 solicttation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DA TE 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 ~AR43,103 (b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

X FAR 49.101(b) & FAR 52.212-4(1)

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 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)

Brian Current,Director Contracts & Marketing

15B. CONTRACTOR/~ FEROR

g~~ (Signature of person au1horizod to sign)

NSN 7540-01-152-8070

Previous edition unusable

15C. DATE SIGNED

1/8/2024

JASON WRAY

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

WRAY JASON.CHRISTOPHER.1238740742 =e~:2~,~~~~J=,CHRISTOPOOl.l 2387407

2 Q} /09/2024

(Signature of Contracting Officer)

STANDARD FORM 30 (REV.10-83)

Prescribed by GSA FAR (48 CFR) 53.243

CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 2 OF 2 PAGES

SPE2O2-21-D-0131 / P00004

1. This bilateral modification terminates Contract SPE2D2-21-D-0131 for convenience in its entirety in accordance with FAR 52.212-4(1). This termination is effective upon signature by both the Defense Logistics Agency ("DLA") and Golden State Medical Supply Inc. ( "GSMS") .

2. This modification also constitutes a no-cost settlement agreement between DLA and GSMS with respect to Contract SPE2p2-21-D-0131. GSMS unconditionally ' waives any charges against the Government because of the termination of Contract SPE2D2-21-D-0131 and releases the Government from all obligations under Contract SPE2D2-21-D-0131or due to its termination. GSMS unconditionally releases, waives, remises, saves harmless and forever discharges the Government from any and all claims, disputes, liabi l ity, obligations, appeals, causes of action, demands, costs, or requests for relief of any kind, which are in any way arising out of or related to Contract SPE2D2-21-D-0131.