Ft Leavenworth FFS Amendment(3) W9124J21R00190003.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

See Modification Narrative for details.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 3

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

16C. DATE SIGNED

BY 24-Nov-2021

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 W9124J21R0019

X 9B. DATED (SEE ITEM 11)

13-Oct-2021

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 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

24-Nov-2021

CODE

MICC - FSH

ATTN: MICC - FSH

2205 INFANTRY POST RD

210-466-2145

FORT SAM HOUSTON TX 78234-1361

W9124J 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W9124J21R0019

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

The following items are applicable to this modification:

MODIFICATION NARRATIVE

Amendment 03 is issued as follows:

a. Update Attachments A. Facility Map (dated 11202021), Attachment C. Bldg plans (dated 11202021), Attachment F. Workload Data Capabilities (dated 11192021), Attachment G. Pricing matrix (dated 11192021) and Attachment H. Staffing Matrix (dated 11192021).

b. Add Attachments P(1)‐P(4) HC Summaries FY20 and FY21 and Attachment Q. CBA Supplement (dated 04202020).

c. Provide Government responses to the Questions received.

d. No other actions are taken at this time.

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

The following have been modified:

ATTACHMENT LIST

Attachment A: Dining Facility Location Map 11/20/2021 Attachment B: Reserved Attachment C Dining Facility Building Plan 11/20/2021 Attachment D-1: GFP 12302020 Attachment D-2 REAL PROPERTY 12/30/2020 Attachment D-3 Durable PROPERTY 12/30/2020 Attachment E: Sample Materials List 12/30/2020 Attachment F: Estimated workload Data 11/19/2021 Attachment G: Pricing Matrix 11/19/2021 Attachment H: Staffing Matrix 11/19/2021 Attachment I: Reserved Attachment J: Facility Photos 12/30/2020 Attachment K: Consent Forms for Release of Past Performance Information Attachment L: Specific Relevant Contracts Reference Sheets Attachment M: Past Performance Questionnaire Attachment N: DoD SAFE FAQ Attachment O: Wage Determination 2015-5105 Rev 14 07/21/2021 Attachment P-1: HC Daily Summary FY20 Attachment P-2: HC Daily Summary FY21 Attachment P-3: HC Summary FY20 Attachment P-4: HC Summary FY21 Attachment Q: Supplemental Agreement 04/20/2020

(End of Summary of Changes)

W9124J21R0019