VA770-17-R-0423-00001000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE

OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

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:

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

E. IMPORTANT:

is extended,

(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 electronic communication 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 is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, 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.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

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 letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

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

D. OTHER

BY

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

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

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) National CMOP 00001 11-20-2017 None 36C770 Department of Veterans Affairs National CMOP 3450 S. 4th St. Trafficway Leavenworth

KS

66048-5581 36C770 Department of Veterans Affairs National CMOP 3450 S. 4th St. Trafficway Leavenworth

KS

66048-5581 To all Offerors/Bidders

VA770-17-R-0423

11-20-2017

X X X X The purpose of this amendment is to change the date on Attachment 4 and change the time for the site visit at Elam Farms

A. The date on Attachment 4 Past Performance Questionnaireis changed from October 20, 2017 to now read December 4, 2017. See below.

B. The time for the site visit to Elam Farms is changed from 11:00 am to now read 10:00 am.

Leah Thurman Contracting Officer

PAST PERFORMANCE QUESTIONNAIRE

Network Contracting Office 15/Consolidated Mail Outpatient Pharmacy (CMOP) is conducting a competitive acquisition for Document Printing and Insertion Services.

The offeror has identified you as a reference to validate the offeror’s past performance. Please complete the following questionnaire to assist our evaluation of the contractor’s past performance and return no later than 3:00 p.m. CDT, December 4, 2017 to Leah Thurman, NCO 15/CMOP, Fax 913-684-0179 or e-mail at leah.thurman@va.gov.

Name of Contractor being evaluated: _______________________________________________

1) How long has your company had this contract with this contractor? ____________________

2) Type of service being provided: ________________________________________________

3) Where is the service being provided? ____________________________________________

4) What is total value of this contract? _____________________________________________

5) Management Effectiveness

· Contractor provided experienced personnel with technical and administrative abilities to meet contract requirements.

Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor maintained appropriate staffing levels (number/qualifications) Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor’s overall management effectiveness Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

6) Quality of Service and Workmanship

· Contractor provided professional services Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor maintained the quality of storage facilities Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor’s overall quality of service Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

7) Timeliness/Adherence to Schedules

· Contractor transported your cargo within the timeframe as identified in your contract Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor was proactive in keeping you informed of schedule conflicts if they were going to occur Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor responded to emergency requirements in a timely manner.

Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Overall contractor timeliness Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

8) Quality/Training Control

· Contractor provided an adequate quality control plan to ensure reoccurring facility inspections during contact duration.

Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor adhered to its quality control plan and ensured the plan was available for review upon request.

Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor’s overall quality control Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

9) Customer Satisfaction

· Contractor maintained a professional working relationship Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor was reasonable and cooperative in resolving customer complaints Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Contractor was flexible in responding to urgent requirements Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

· Overall customer satisfaction Exceptional ____Very Good ______Satisfactory _____ Marginal _____ Unacceptable_____

10) Please provide any other examples or comments concerning the contractor’s performance that would be relevant in assessing the probability of successful contract performance:

Rating System:

Exceptional: Performance meets contractual requirements and exceeds many to the contractor’s benefit. The contractual performance was accomplished with few minor problems for which corrective action taken was highly effective.

Very Good: Performance meets contractual requirements and exceeds some to the contractor’s benefit. The contractual performance was accomplished with some minor problems for which corrective action taken was effective.

Satisfactory: Performance meets contractual requirements. The contractual performance was accomplished with some minor problems for which corrective action taken appears or was satisfactory.

Marginal: Performance does not meet some contractual requirements. The contractual performance reflects a serious problem for which the contractor has identified some corrective actions. The proposed actions appear only marginally effective or have not been fully implemented.

Unacceptable: Performance does not meet most contractual requirements and recovery is not likely in a timely manner. The contractual performance contains serious problems for which the contractor has identified corrective actions. The proposed actions appear or were ineffective.

Your Name: _____________________________Your Title: _____________________________

Your Phone #: ___________________________Your Fax: ______________________________

Your e-mail address: ____________________________________________________________