19-Q-0011_Amendment_0003_SF30.pdf

0011354196

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 this amendment is to adjust support at specified events due to mission changes. See summary of changes. All other terms and conditions remain unchanged. The closing date is extended to Monday, July 1, 2019 at 8:00 AM Pacific Time.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 6

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

16C. DATE SIGNED

BY 27-Jun-2019

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 W9124X19Q0011

X 9B. DATED (SEE ITEM 11)

31-May-2019

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

27-Jun-2019

CODE

PURCHASING AND CONTRACTING

2452 FAIRVIEW DR.

CARSON CITY NV 89701

W9124X 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W9124X19Q0011

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 27-Jun-2019 11:59 PM to 01-Jul-2019 08:00 AM.

The 'issued by' organization has changed from

USPFO FOR NEVADA

FOR THE 152ND NV ANG

2452 FAIRVIEW DRIVE

CARSON CITY NV 89701-6807

to

PURCHASING AND CONTRACTING

2452 FAIRVIEW DR.

CARSON CITY NV 89701

SUPPLIES OR SERVICES AND PRICES

CLIN 0005

The CLIN extended description has changed from:

Two day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) Flight Provider each day in accordance with the Performance Work Statement.

To:

This Event is Cancelled.

The pricing detail quantity has decreased by 1.00 from 1.00 to 0.00.

CLIN 0006

Single day PHA/SRP event at the Nevada Army National Guard Las Vegas Readiness Center (LVRC) Clinic, 4500 W Silverado Ranch Blvd. Las Vegas, NV 89139. The Contractor shall provide two (2) Registered Nurses and one

(1) Behavioral Health Specialist in accordance with the Performance Work Statement.

Single day PHA/SRP event at the Nevada Army National Guard Las Vegas Readiness Center (LVRC) Clinic, 4500 W Silverado Ranch Blvd. Las Vegas, NV 89139. The Contractor shall provide two (2) Registered Nurses, one (1) Behavioral Health Specialist, one (1) 2-OP Mobile Practice, one (1) Portable Pano, two (2) Dental Assistants, one

(1) Treatment Dentist, one (1) Dental Event Manager, one (1) Live DENCLASS, and fifteen (15) Treatment Supplies in accordance with the Performance Work Statement. The Treatment Dentist will obtain approval from the

State Dental Officer prior to any extractions.

CLIN 0007

The CLIN description has changed from Plumb Lane Armory Services 4 August 2019 to Plumb Lane Armory Services 17 Aug 2019.

The CLIN extended description has changed from:

Single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) 2-OP Mobile Practice, one (1) Portable Pano, four (4) Dental Assistants, one (1) Treatment Dentist, one (1) Dental Event Manager, one (1) Live DENCLASS, thirty (30) Treatment Supplies, one (1) Audiology Vehicle, and one (1) Hearing Conservationist in accordance with the Performance Work Statement. The Treatment Dentist will obtain approval from the State Dental Officer prior to any extractions.

Single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) Flight Provider in accordance with the Performance Work

CLIN 0008

Single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) Portable Pano, two (2) Dental Assistants, one (1) Flight Provider, one (1) Physician Assistant, one (1) Behavioral Health Specialist, one (1) Audiology Vehicle, and one (1) Hearing Conservationist in accordance with the Performance Work Statement.

Single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) 2-OP Mobile Practice, one (1) Portable Pano, four (4) Dental Assistants, two (2) Treatment Dentists, one (1) Dental Event Manager, one (1) Live DENCLASS, thirty (30) Treatment Supplies, one (1) Flight Provider, one (1) Physician Assistant, one (1) Behavioral Health Specialist, one

(1) Audiology Vehicle, and one (1) Hearing Conservationist in accordance with the Performance Work Statement.

The Treatment Dentist will obtain approval from the State Dental Officer prior to any extractions.

CLIN 0011

Morning only (4 hours) portion of a single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) 2-OP Mobile Practice, one (1) Portable Pano, four (4) Dental Assistants, one (1) Treatment Dentist, one (1) Dental Event Manager, one (1) Live DENCLASS, fifteen (15) Treatment Supplies, one (1) Audiology Vehicle, and one (1) Hearing Conservationist in accordance with the Performance Work Statement. The Treatment Dentist will obtain approval from the State Dental Officer prior to any extractions. Note: See ITEM 0013 for the Afternoon only (4 hours) portion for this same single day event. Two ITEM Numbers are used for administrative purposes only to allow for two funding sources.

Morning only (4 hours) portion of a single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) 2-OP Mobile Practice, one (1) Portable Pano, four (4) Dental Assistants, one (1) Treatment Dentist, one (1) Dental Event Manager, one (1) Live DENCLASS, fifteen (15) Treatment Supplies, one (1) Behavioral Health Specialist, one (1) Audiology Vehicle, and one (1) Hearing Conservationist in accordance with the Performance Work Statement. The Treatment Dentist will obtain approval from the State Dental Officer prior to any extractions. Note: See ITEM 0013 for the Afternoon only (4 hours) portion for this same single day event. Two ITEM Numbers are used for administrative purposes only to allow for two funding sources.

CLIN 0012

Single day PHA/SRP event at the Nevada Army National Guard Las Vegas Readiness Center (LVRC) Clinic, 4500 W Silverado Ranch Blvd. Las Vegas, NV 89139. The Contractor shall provide one (1) 2-OP Mobile Practice, two

(2) Dental Assistants, one (1) Treatment Dentist, one (1) Dental Event Manager, one (1) Live DENCLASS, thirty

(30) Treatment Supplies, one (1) Behavioral Health Specialist, and two (2) Registered Nurses in accordance with the Performance Work Statement. The Treatment Dentist will obtain approval from the State Dental Officer prior to

Single day PHA/SRP event at the Nevada Army National Guard Las Vegas Readiness Center (LVRC) Clinic, 4500 W Silverado Ranch Blvd. Las Vegas, NV 89139. The Contractor shall provide one (1) 2-OP Mobile Practice, four

(4) Dental Assistants, two (2) Treatment Dentists, one (1) Dental Event Manager, one (1) Live DENCLASS, thirty

(30) Treatment Supplies, one (1) Behavioral Health Specialist, and two (2) Registered Nurses in accordance with the Performance Work Statement. The Treatment Dentist will obtain approval from the State Dental Officer prior to

CLIN 0013

Afternoon only (4 hours) portion of a single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) 2-OP Mobile Practice, one (1) Portable Pano, four (4) Dental Assistants, one (1) Treatment Dentist, one (1) Dental Event Manager, one (1) Live DENCLASS, fifteen (15) Treatment Supplies, one (1) Audiology Vehicle, and one (1) Hearing Conservationist in accordance with the Performance Work Statement. The Treatment Dentist will obtain approval from the State Dental Officer prior to any extractions. Note: See ITEM 0011 for the Morning only (4 hours) portion for this same single day event. Two ITEM Numbers are used for administrative purposes only to allow for two funding sources.

Afternoon only (4 hours) portion of a single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) 2-OP Mobile Practice, one (1) Portable Pano, four (4) Dental Assistants, one (1) Treatment Dentist, one (1) Dental Event Manager, one (1) Live DENCLASS, fifteen (15) Treatment Supplies, one (1) Behavioral Health Specialist, one (1) Audiology Vehicle, and one (1) Hearing Conservationist in accordance with the Performance Work Statement. The Treatment Dentist will obtain approval from the State Dental Officer prior to any extractions. Note: See ITEM 0011 for the Morning only (4 hours) portion for this same single day event. Two ITEM Numbers are used for administrative purposes only to allow for two funding sources.

CLIN 0017

Single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) Flight Provider, one (1) Audiology Vehicle, one (1) Hearing Conservationist, one (1) Portable Pano, and one (1) Dental Assistant in accordance with the Performance Work

Single day PHA/SRP event at the Nevada Army National Guard Plumb Lane Armory, 685 E. Plumb Lane. Reno, NV 89502. The Contractor shall provide one (1) Flight Provider, one (1) Physician Assistant, one (1) Audiology Vehicle, one (1) Hearing Conservationist, one (1) Portable Pano, and one (1) Dental Assistant in accordance with the Performance Work Statement.

CLIN 0018

Reporting data in the Enterprise Contractor Manpower ReportingApplication https://www.ecmra.mil/Default.aspx .

Do not price this CLIN if notintended to be invoiced separately.

Reporting data in the Enterprise Contractor Manpower ReportingApplication https://www.ecmra.mil/Default.aspx .

Do not price this CLIN if not intended to be invoiced separately.

DELIVERIES AND PERFORMANCE

The following Delivery Schedule item for CLIN 0005 has been changed from:

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

POP 03-AUG-2019 TO

04-AUG-2019

N/A N/A

FOB: Destination

DELIVERY DATE QUANTITY SHIP TO ADDRESS DODAAC /

CAGE

POP 03-AUG-2019 TO

04-AUG-2019

The following Delivery Schedule item for CLIN 0007 has been changed from:

CAGE

POP 04-AUG-2019 TO

04-AUG-2019

CAGE

POP 17-AUG-2019 TO

17-AUG-2019

(End of Summary of Changes)