B.08.03 W911KB 22-B-0005 EAR069 Amendment 0003.pdf

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

PROJECT TITLE/LOCATION: EAR069, W911KB-22-B-0005 Demo Dorms 751&753 Eareckson Air Station, ALASKA

This solicitation is hereby amended as follow s:

A) This amednemnt provides changes to the "PRE-AWARD QUESTIONNAIRE" Page 1. The Average gross receipt has been changed from 3 to 5 years.

B) BID DUE DATE HAS NOT BEEN EXTENDED AND SHALL BE SUBMITTED BY April 8th, 2022, 2:00pm Alaska Standard Time.

C) YOU ARE REQUIRED TO ACKNOWLEDGE RECEIPT OF THIS AMENDMENT ON THIS STANDARD FORM 30.

-POC for this amendment is Ron Perry (ronald.perry@usace.army.mil)

1. CONTRACT ID CODE PAGE OF PAGES

J 1 2

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

16C. DATE SIGNED

BY 07-Apr-2022

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 W911KB22B0005

X 9B. DATED (SEE ITEM 11)

02-Mar-2022

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 is extended, X 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)

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

07-Apr-2022

CODE

U.S. ARMY ENGINEER DISTRICT, ALASKA

CEPOA-CT

2204 TALLEY STREET

JBER AK 99506-0898

W911KB 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

PRE-AWARD QUESTIONNAIRE

EAR069 Demo Dorms 751&753 at Eareckson Air Station

Eareckson Air Station, Alaska Solicitation W911KB 22-B-0005

Amendment 0003

CONTRACTOR NAME AND ADDRESS:

TYPE OF BUSINESS:

Individual Partnership LLC Joint Venture Corporation in the State of ______________________

SIZE: Small (Average gross receipt for the past 5 years is less than or equal to $16.5M) Large

1. Financial Ability: Please attach a certified current balance sheet and latest profit and loss statement signed by an officer of the company. The last financial statement will be acceptable if it is less than 6 months old.

Dun & Bradstreet Rating _________ Thomas Register Rating __________

2. Ability to comply with required delivery; List current work with the expected completion date, dollar value, firm/agency, point of contact, and telephone.

3. Reputation and Integrity:

Name POC Telephone No.

Bank:

Subcontractor:

Other:

4. Conforming to the requirements of the standard nondiscrimination clause: (Describe how this is accomplished.)

j4ct9tma Highlight j4ct9tma Highlight

W911KB22B0005

5. Necessary capability to perform: (Describe technical capability.)

6. Equipment and facilities:

7. Performance and Payment Bonds:

8. List all pending contract claims. State nature of claim, amount, and approximate date filed.

9. List all pending lawsuits or unsatisfied judgments against your firm, the nature of same and Court where filed or adjudicated. Lawsuits or judgments where full payment will be made or are covered by your insurance are not to be included.

Signed:____________________________________

Typed/Printed Name:____________________________________ Title:____________________________________ Date:_________________