W52P1J-16-C-5004_P00003_Signed.pdf

ARMY CONTRACTING COMMAND ROCK ISLAND

3055 RODMAN AVENUE

ROCK ISLAND IL 61299-8000

SEE SCHEDULE

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

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)

30-105-04EXCEPTION TO SF 30

APPROVED BY OIRM 11-84

STANDARD FORM 30 (Rev. 10-83)

Prescribed by GSA

FAR (48 CFR) 53.243

See summary of changes.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 4

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

16C. DATE SIGNED

BY 10-Apr-2017

16B. UNITED STATES OF AMERICA15C. DATE SIGNED15B. CONTRACTOR/OFFEROR

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

8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code)

9B. DATED (SEE ITEM 11)

X W52P1J-16-C-5004

10B. DATED (SEE ITEM 13)

X

9A. AMENDMENT OF SOLICITATION NO.

02-May-2016

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 Offer is extended, is not extended.

Offer 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 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)

See Schedule

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

X

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

A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE

FAR 43.103a

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:

D. OTHER (Specify type of modification and authority)

E. IMPORTANT: Contractor is not, X is required to sign this document and return 1 copies to the issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

10A. MOD. OF CONTRACT/ORDER NO.

P00003

2. AMENDMENT/MODIFICATION NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY

3. EFFECTIVE DATE

05-Apr-2017

CODE

ARMY CONTRACTING COMMAND ROCK ISLAND

3055 RODMAN AVENUE

ROCK ISLAND IL 61299-8000

W52P1J 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE W52P1J

WILLMAN CONSTRUCTION INC

1129 W 3RD ST

DAVENPORT IA 52802-3537

FACILITY CODE1YMB7CODE

molly.j.lewis4.civ@mail.milEMAIL:309-782-1837TEL:

MOLLY J. LEWIS / CONTRACT SPECIALIST

Modification Control Number: lbaker17454

W52P1J-16-C-5004

P00003

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 30 - BLOCK 14 CONTINUATION PAGE

The following have been added by full text:

MOD P00003

The purpose of this modification is in accordance with FAR 52.243-4, Changes, to:

1. Add CLIN 0006 and funding in the amount of $17,792.50 for the Vibration Isolators.

2. Add CLIN 0007 and funding in the amount of $38,666.76 for the Switch Gear.

3. Add other terms and conditions remain unchanged.

SECTION 00010 - SOLICITATION CONTRACT FORM

The total cost of this contract was increased by $56,459.26 from $3,081,977.00 to $3,138,436.26.

CLIN 0006 is added as follows:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0006 1 Job $17,792.50 $17,792.50

PR 2011-6788 - VIBRATION ISOLATORS-FY 16

FFP

VIBRATION ISOLATOR WITHIN SCOPE CHANGE - FY 16 FUNDS IAW

PROPOSAL DATED 13 FEB 2017

FOB: Destination

PURCHASE REQUEST NUMBER: 0010647928-0005

NET AMT $17,792.50

ACRN AA

CIN: GFEBS001064792800005

$17,792.50

CLIN 0007 is added as follows:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0007 1 Job $38,666.76 $38,666.76

PR 2011-6788 - SWITCH GEAR - FY 17

FFP

SWITCH GEAR SCOPE CHANGE - FY 17 FUNDS FUNDS IAW PROPOSAL

DATED 13 FEB 2017

FOB: Destination

PURCHASE REQUEST NUMBER: 0010647928-0005

NET AMT $38,666.76

ACRN AC

CIN: GFEBS001064792800006

$38,666.76

INSPECTION AND ACCEPTANCE

The following Acceptance/Inspection Schedule was added for CLIN 0006:

INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

Destination Government Destination Government

The following Acceptance/Inspection Schedule was added for CLIN 0007:

INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

Destination Government Destination Government

SECTION 00800 - SPECIAL CONTRACT REQUIREMENTS

Accounting and Appropriation

Summary for the Payment Office

As a result of this modification, the total funded amount for this document was increased by $56,459.26 from

$3,081,977.00 to $3,138,436.26.

CLIN 0006:

Funding on CLIN 0006 is initiated as follows:

ACRN: AA

CIN: GFEBS001064792800005

Acctng Data: 0212016201620200000113132323 M.0051560.1 6100.9000021001

Increase: $17,792.50

Total: $17,792.50

Cost Code: A2ACV

CLIN 0007:

Funding on CLIN 0007 is initiated as follows:

ACRN: AC

CIN: GFEBS001064792800006

Acctng Data: 0212017201720200000113132323 M.0051560.3 6100.9000021001

Increase: $38,666.76

Total: $38,666.76

Cost Code: A2ACV

(End of Summary of Changes)