B3_Amd_01_Insurance_Information.pdf

W45XMAGATEATTENDANTS

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

Amendment#01 to revise the Insurance Requirement information to the solicitation. See Continuation Page for additional information.

Proposal Due Date remains unchanged: 16 February 2017 12:00PM E-Mail ALL QUOTES TO: CIV-OPS.Proposals@usace.army.mil

Point of Contact (POC): Daisy Ciarlariello, (817) 886-1051, Daisy.Ciarlariello@usace.army.mil

1. CONTRACT ID CODE PAGE OF PAGES

J 1 3

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

16C. DATE SIGNED

BY 19-Jan-2017

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 W9126G-17-T-0064

X 9B. DATED (SEE ITEM 11)

17-Jan-2017

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

19-Jan-2017

CODE

US ARMY ENGINEER DISTRICT, FORT WORTH

ATTN: CESWF-CT

819 TAYLOR ST, ROOM 2A17

FORT WORTH TX 76102-0300

W9126G 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W9126G-17-T-0064

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

The following have been added by full text:

Amd#01 INSURANCE

Prior to commencement of work, the Contractor shall furnish the original of his Insurance Certificate directly to the Contracting Officer, Fort Worth District, Corps of Engineers, ATTN: CESWF-CT-S, P.O. Box 17300, Fort Worth, Texas 76102-0300 and one copy directly to the Lake and Project Office. The Contractor shall maintain, during the entire period of his performance under this contract, the following minimum insurance requirements:

Submit a copy of Insurance Certificate directly to:

US Army Corp of Engineers Belton Lake Office ATTN: Ronnie Bruggman

3740 FM 1670

Belton, Texas 76513

Or email to: Daisy.Ciarlariello@usace.army.mil Phone: (817) 886-1051 Fax: (817)886-6403

(a) Comprehensive general liability insurance for bodily injury in the minimum limits of $500,000 per occurrence. No property damage liability is required.

(b) Comprehensive automobile liability insurance covering the operation of all automobiles used in connection with the performance of the contract in the minimum limits of $200,000 per person and $100,000 per accident for bodily injury and $20,000 per accident for property damage.

(c) Workmen's Compensation and Employer's Liability Insurance in the minimum amount of $100,000.00 or in compliance with applicable State statutes.

(d) An endorsement to the effect that any cancellation or any material change adversely affecting the Government's interest shall not be effective until 30 days after the insurer or the Contractor gives written notice to the Contracting Officer.

NOTE:

(1) It is recommended that the contractor furnish a copy of the foregoing requirements to his insurance company in order to assure that an Insurance Certificate is issued meeting the minimum requirements shown. The Insurance Certificate shall also show the contract number to which it applies as well as a brief description and location of the work.

REQUIRED INSURANCE – In accordance with FAR 52.228-5

Prior to commencement of work, the Contractor shall furnish the original of his Insurance Certificate directly to the lake office. The Contractor shall maintain, during the entire period of his performance under this contract, the minimum insurance requirements of the State of Texas: $30,000 for each injured person, up to a total of $60,000 per accident, and $25,000 for property damage per accident. This basic coverage is called 30/60/25 coverage.

Amd#01

(End of Summary of Changes) mailto:Daisy.Ciarlariello@usace.army.mil