Amendment_0001.pdf

W912EF19R0002

W68SBV80781991

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 Amendment 0001 is to incorporate the Small Business Participation Plan and Offeror Experience Form.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 6

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

16C. DATE SIGNED

BY 04-Apr-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 W912EF19R0002

X 9B. DATED (SEE ITEM 11)

28-Mar-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 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

04-Apr-2019

CODE

USAED, WALLA WALLA - CONTRACTING DIV.

JULIE M. MORRIS

201 N. THIRD AVENUE

WALLA WALLA WA 99362-1876

W912EF 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION 00 21 00 - INSTRUCTIONS

The following have been added by full text:

OFFEROR EXPERIENCE FORM

OFFEROR EXPERIENCE FORM

Technical Subfactor: __________ Subfactor Title: ___________________________

Name of Offeror: ______________________________

Project Title: _________________________________________________________________

Contract/Project Number: _________________________

Project Location: _________________________________

Total Contract Value: $_______________

(Final value if completed, current value if not completed)

If Offeror performed as Subcontractor, Value of Subcontract: $_______________

Construction Phase Start Date: ___________________________________

Construction Phase Completion Date: ______________________________

(Actual date if project has been completed, anticipated date if project is not complete)

Name of Customer/Client: ______________________________________________________

Telephone Number of Customer/Client: __________________________________________

Email Address of Customer/Client: ______________________________________________

Description of Project’s Scope:

Offeror’s role and responsibility during construction of the project:

(Indicate whether your firm performed as a prime or subcontractor.)

Describe the relevancy of the reference project with the scope required in this solicitation:

SMALL BUSINESS PARTICIPATION

SMALL BUSINESS PARTICIPATION PLAN – ENCL 4

All Offerors (both large and small businesses) are required to complete a Small Business Participation Proposal.

Offerors should propose the level of participation of small businesses (as a small business prime and/or small business sub-contractors) in the performance of the acquisition relative to the objectives/goals set forth in the evaluation of this area.

(a) Check the applicable size and categories for the PRIME offeror only -- Check all applicable boxes:

{ } Large Prime

{ } Historically Black Colleges or Universities and Minority Institutions (HBCU) or

{ } Small Business Prime; also categorized as a

{ } Small Disadvantaged Business (SDB)

{ } Woman-Owned Small Business (WOSB)

{ } Historically Underutilized Business Zone (HUB Zone) Small Business

{ } Veteran Owned Small Business (VOSB)

{ } Service Disabled Veteran Owned Small Business (SDVOSB)

(b) Submit the total combined percentage of work to be performed by both large and small businesses (include the percentage of work to be performed both by Prime and Sub-contractors):

Example: If Prime proposes a price of $1,000,000 (including all options), and small business(es) will provide $250,000 in services/supplies as a prime or subcontractor, the

% planned for small businesses is 25%; and 75% for large business equaling 100%.

Total Percentage planned for Large Business(es) % = $

Total Percentage planned for Small Business(es) _% = $

100%

When combined, Large and Small

Business totals must equal

100%.

(c) Please indicate the total percentage of participation to be performed by each type of subcategory small business.

The percentage of work performed by Small Businesses that qualify in multiple small business categories may be counted in each category:

Example: Victory Prop Mgt (WOSB and SDVOSB) performing 2%; and Williams

Group (SDB, HubZ and WOSB) performing 3%. Results equate to: SDB 3%;

HubZone 3%; WOSB 5%; SDVOSB 2%; VOSB 2%;). SDVOSBs are also VOSBs automatically; however

VOSBs are not automatically SDVOSBs.

Small Disadvantaged Business %

HUB Zone Small Business %

Woman Owned Small Business %

Service Disabled Veteran Owned SB %

Veteran Owned Small Business %

HBCU /MI %

(d) List principle supplies/services to be performed by Small Businesses:

Example: If a Small Business qualifies also as a WOSB and a SDVOSB, and you can add them to each category below in which they qualify.

Name of Company Identify Type of Service/Supply

Small Business (SB):

Small Disadvantaged Business (SDB):

Women-Owned Small Business (WOSB):

Historically Underutilized Business Zone (HUB Zone):

Veteran Owned Small Business (VOSB):

Service Disabled Veteran Owned Small Business (SDVO):

Historically Black Colleges and Universities and Minority Institutions (HBCU/MI):

(e) Describe the extent of commitment to use small businesses (for example, what types of commitments if any are in place for this specific acquisition either – small business prime, written contract, verbal, enforceable, non-enforceable, joint venturing, mentor- protégé, etc.)

(End of Summary of Changes)