W9114F-16-T-0111-0001.pdf

0010918434

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

The purpose of the amendment is to: 1) add CLINs 0005, 0006, and 0007 w ith additional quantities of mobile pow ered computing carts, pow er cords, and outlet strips and 2) extend the offer due date to Monday, 12 September at 15:00 Germany time.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 4

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

16C. DATE SIGNED

BY 02-Sep-2016

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) X W9114F-16-T-0111

X 9B. DATED (SEE ITEM 11)

26-Aug-2016

10B. DATED (SEE ITEM 13)

9A. AMENDMENT OF SOLICITATION NO.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

X The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offer X 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 1 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.

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:

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.)

10A. MOD. OF CONTRACT/ORDER NO.

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

6. ISSUED BY

3. EFFECTIVE DATE

02-Sep-2016

CODE

W40M EUR REGIONAL CONTRACT OFC

CONTRACTING OFFICE KO

POC: ELENA M. RASPITHA

CMR 402

APO AE 09180

W9114F 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

X 1

W9114F-16-T-0111

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SOLICITATION/CONTRACT FORM

The required response date/time has changed from 07-Sep-2016 04:00 PM to 12-Sep-2016 03:00 PM.

SUPPLIES OR SERVICES AND PRICES

CLIN 0005 is added as follows:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0005 4 Each

MOBILE POWERED COMPUTING CARTS

FFP

Rubbermaid Healthcare M38 MOBILE COMPUTING CARTS, Brand-Name or Equal with external bar code scanner bin, keyless locking storage drawer, bulk storage and t-rack for accesories, and 35 or 55 AMP SLA battery. 220V/50Hz with German Safety Plug.

FOB: Destination

MFR PART NR: 1849201

NET AMT

CLIN 0006 is added as follows:

0006 4 Each

POWER CORDS

FFP

Rubbermaid, Brand-Name or Equal, batteries, power supply, power cord. European spiral power cord, 220V/50Hz. Hospital grade 2.5 ft extendable to 8 ft. (NO

ADAPTOR PLUG IS ACCEPTED)

MFR PART NR: 4170113

CLIN 0007 is added as follows:

0007 4 Each

OUTLET STRIP

FFP

Rubbermaid, Brand-Name or Equal, 3-Prong outlet strip for 220V/50Hz, German Safety Plug.

MFR PART NR: M06022201

DELIVERIES AND PERFORMANCE

The following Delivery Schedule item has been added to CLIN 0005:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

06-OCT-2016 4 LANDSTUHL REGIONAL MEDICAL

CENTER

LANDSTUHL REGIONAL MEDICAL

CENTER

DR. HITZELBERGER STRASSE

3739 BLDG

LANDSTUHL 66849

WK4NKV

The following Delivery Schedule item has been added to CLIN 0006:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

06-OCT-2016 4 LANDSTUHL REGIONAL MEDICAL

CENTER

LANDSTUHL REGIONAL MEDICAL

CENTER

DR. HITZELBERGER STRASSE

3739 BLDG

LANDSTUHL 66849

The following Delivery Schedule item has been added to CLIN 0007:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC

06-OCT-2016 4 LANDSTUHL REGIONAL MEDICAL

CENTER

LANDSTUHL REGIONAL MEDICAL

CENTER

DR. HITZELBERGER STRASSE

3739 BLDG

LANDSTUHL 66849

INSPECTION AND ACCEPTANCE

The following Acceptance/Inspection Schedule was added for CLIN 0005:

INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

Destination Government Destination Government

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

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

(End of Summary of Changes)