W15QKN18R0080-0001.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. Contract ID Code Page Of

2. Amendment/Modification No.

3. Effective Date

4. Requisition/Purchase Req No.

5. Project No. (If applicable)

6. Issued By Code 7. Administered By (If other than Item 6) Code

8. Name And Address Of Contractor (No., Street, City, County, State and Zip Code)

9A. Amendment Of Solicitation No.

9B. Dated (See Item 11)

10A. Modification Of Contract/Order No.

10B. Dated (See Item 13) Code Facility Code

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

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 amendments: (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 ONLY APPLIES TO MODIFICATIONS OF CONTRACTS/ORDERS

It Modifies The Contract/Order No. As Described In Item 14.

A. This Change Order is Issued Pursuant To: 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 data, 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.)

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 15C. Date Signed 16B. United States Of America 16C. Date Signed

By (Signature of person authorized to sign) (Signature of Contracting Officer)

NSN 7540-01-152-8070

PREVIOUS EDITIONS UNUSABLE

30-105-02 STANDARD FORM 30 (REV. 10-83)

Prescribed by GSA FAR (48 CFR) 53.243

SEE SCHEDULE

X

Firm Fixed Price

0001 2018MAR14

W15QKN

ARMY CONTRACTING COMMAND - NJ

PICATINNY ARSENAL, NJ 07806-5000

SERGIO F MORAGA

EMAIL: SERGIO.F.MORAGA.CIV@MAIL.MIL

W15QKN-18-R-0080

2018FEB08

X

X

/SIGNED/

2 signed

SEE SECOND PAGE FOR DESCRIPTION

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CONTINUATION SHEET

Reference No. of Document Being Continued Page of

Name of Offeror or Contractor:

PIIN/SIIN MOD/AMD

SECTION A - SUPPLEMENTAL INFORMATION

Buyer Name: SERGIO F MORAGA

Buyer Office Symbol/Telephone Number: ACC-NJ-SW/(973)724-2013

Type of Contract 1: Firm Fixed Price

Kind of Contract: Supply Contracts and Priced Orders

*** End of Narrative A0000 ***

Paragraph L.4.3.2 (5) is amended as follows (to remove or alter the underlined sentences and sentence fragments):

FROM:____

(5) Past Performance Questionnaire. For all contracts identified in Section 1, Past Performance Questionnaires must be completed and ______________________________ submitted (APPENDIX D). The Offeror shall complete Part I of the Past Performance Questionnaire and e-mail the questionnaire to both the

Government contracting activity and technical representative responsible for the past/current contract. The POCs shall be instructed to electronically complete Part II of the questionnaire and e-mail the entire questionnaire to the Contracting Officer and Contract

Specialist within thirty (30) calendar days of the release of the RFP, to sergio.f.moraga.civ@mail.mil. The Offeror shall also e-mail to __________________________________________________________ the Contract Specialist a list of all the POCs who were sent a questionnaire. The Government must receive this list within thirty (30) _________________________________________________________ calendar days after release of the RFP. The POC List shall be submitted in Word for Windows Table Format to include the following______________________________________ fields: Solicitation Number; Company Name; Contract Number; Government Agency; POC Last Name, First Name; POC Title; POC Telephone

Number; POC E-Mail Address; Date E-Mailed to POC (month/day).

TO:__

(5) Past Performance Questionnaire. For all contracts identified in Section 1, Past Performance Questionnaires must be completed and ______________________________ submitted (APPENDIX D). The Offeror shall complete Part I of the Past Performance Questionnaire and e-mail the questionnaire to both the

Government contracting activity and technical representative responsible for the past/current contract. The POCs shall be instructed to electronically complete Part II of the questionnaire and e-mail the entire questionnaire to the Contracting Officer and Contract

Specialist prior to RFP close date, to sergio.f.moraga.civ@mail.mil. The Offeror shall also e-mail to the Contract Specialist a list of all the POCs who were sent a questionnaire. The POC List shall be submitted in Word for Windows Table Format to include the following fields: Solicitation Number; Company Name; Contract Number; Government Agency; POC Last Name, First Name; POC Title; POC Telephone

Number; POC E-Mail Address; Date E-Mailed to POC (month/day).

*** END OF NARRATIVE A0002 ***

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W15QKN-18-R-0080 0001

SECTION A