W911SA27PA013 P00001 KO Signed.pdf

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 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 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.

12. ACCOUNTING AND APPROPRIATION DATA (If required)

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

IT MODIFIES THE CONTRACT/ORDER NUMBER AS DESCRIBED IN ITEM 14.

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

NUMBER 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

(Signature of person authorized to sign)

15C. DATE SIGNED 16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer)

16C. DATE SIGNED

Previous edition unusable STANDARD FORM 30 (REV. 11/2016) Prescribed by GSA FAR (48 CFR) 53.243

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. CONTRACT ID CODE PAGE OF PAGES

2. AMENDMENT/MODIFICATION NUMBER 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQUISITION NUMBER 5. PROJECT NUMBER (If applicable)

6. ISSUED BY CODE 7. ADMINISTERED BY (If other than Item 6) CODE

8. NAME AND ADDRESS OF CONTRACTOR (Number, street, county, State and ZIP Code) (X) 9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED (SEE ITEM 11)

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED (SEE ITEM 13)

CODE FACILITY CODE

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

Solicitation/Contract Form

The following changes have been made:

INFORMATION FROM TO

Reference Description

Header only - Purchase Requisition Number

Reference Value

W90T7E0012499418

Supplies or Services & Prices or Costs

The following CLIN(s) / SLIN(s) / ELIN(s) were modified:

INFORMATI

ON

FROM TO AMOUNT

Funded Amount

USD 1,005.00 USD

-1,005.00

INFORMATI

ON

FROM TO AMOUNT

Funded Amount

USD 3,517.50 USD

-3,517.50

INFORMATI

ON

FROM TO AMOUNT

Funded USD 2,763.75 USD

W911SA27PA013P00001

Amount -2,763.75

Contract Administration Data

As a result of this modification, the total obligated amount was decreased by USD 7,286.25 from USD 7,286.25 to USD 0.00.

The following ACRNs were added or modified:

As a result of this modification, ACRN AA was removed, deobligating USD 7,286.25.

ACRN LOA Total Amount Changed

AA ^^^021^2027^2027^^2020^000^^260^D^121^^^^^^^021001^A2AEG

^^S.0119610.1.3.9^^6100.260B^^121012QITR^

USD -7,286.25

Line Item PR/MIPR - PR Line Item# CIN Amount

CLIN 0001 W90T7E0012499418

- 0001

USD -1,005.00

CLIN 0002 W90T7E0012499418

- 0002

USD -3,517.50

CLIN 0003 W90T7E0012499418

- 0003

USD -2,763.75

W911SA27PA013P00001

KO DIRECTORATE OF CONTRACTIN, BLDG 1108 SOUTH R STREET

FORT MCCOY, WI 54656-5142

UNITED STATES

DUSTIN ROBERTSON, CONTRACT SPECIALIST, EMAIL: DUSTIN.T.ROBERTSON4.CIV@ARMY.MIL TELEPHONE: 502-898-1255 ALEXANDER SCOTT, CONTRACTING OFFICER, EMAIL: ALEXANDER.J.SCOTT24.CIV@ARMY.MIL TELEPHONE: 502-898-2123 AdminBy:

SCD: PAS:

ContractorNameAdd: FIREBEYONDTHESKY, LLC

90 N CORONA ST APT 1406

DENVER, CO 80218-3882

UNITED STATES

ANGELA MITCHELL, EMAIL: ANGELA.MITCHELL79@ICLOUD.COM TELEPHONE: 7208826435

Contract Specialist: Dustin Robertson, dustin.t.robertson4.civ@army.mil.