AMD_0001_INCORPORATION_OF_PREAWARD_SURVEY_W912P617B0004_WAUKEGAN_DREDGING.pdf

W81G6670947646

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

REFERENCE: INVITATION FOR BIDS - W912P6-17-B-0004, WAUKEGAN HARBOR APPROACH CHANNEL DREDGING, WAUKEGAN, IL

- NOTE, THE CONTRACT SPECIALIST IS ERICKA HILLARD AT 312-846-5378

A. Inadvertently omitted from the Solicitation package, as posted to FBO on July 28, 2017, w as Attachment A, w herein containing a pre-aw ard survey form. Accordingly, provided herew ith is said form. Bidders are required to FULLY complete the enclosed pre-aw ard survey and submit it along w ith all other deliverables required by this Solicitation (see Bid Note 3f under Section 00100 of the Solicitation, “IMPORTANT BID NOTES.”

B. THE BID OPENING DATE REMAINS AUGUST 28, 2017 AT 1PM Central Time - The Point of Contact for this Amendment is Regina Blair at 312-846-5371.

-Continues on next page

1. CONTRACT ID CODE PAGE OF PAGES

1 3

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

16C. DATE SIGNED

BY 29-Jul-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 W912P6-17-B-0004

X 9B. DATED (SEE ITEM 11)

28-Jul-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

29-Jul-2017

CODE

U.S. ARMY ENGINEER DISTRICT, CHICAGO

231 SOUTH LASALLE STREET SUITE 1500

CHICAGO IL 60604-1437

W912P6 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

The following items are applicable to this modification:

PREAWARD SURVEY FORM

ATTACHMENT A

PREAWARD SURVEY INFORMATION

(RE: Subparts 9.104-1 and 9.105-1 of the Federal Acquisition Regulation) CONTRACTOR:

SOLICITATION W912P6-17-B-0004, WAUKEGAN HARBOR APPROACH CHANNEL DREDGING, WAUKEGAN, ILLINOIS, LAKE COUNTY

Please complete the below form to assist in the completion of a Pre-award Survey:

Month and Year started in business:

1. Year and State Incorporated:

2. Key Personnel:

President/Owner :

Vice President/Partner:

Secretary/Treasurer:

3. Number of Full-Time Employees:

Surety:

Agency:

Agent:

Address, City & State:

Telephone#:

4. Insurance Company:

Agency:

Agent:

5. Financial Institution Information:

Name of Bank:

W912P6-17-B-0004

Contact Person:

6. References: Provide the names and contact information of three references. Information obtained from references will be used to determine if you have been diligent in the following areas: a) Quality of Work; b) Timely Performance; c) Effectiveness of Management; d) Compliance with Safety Standards; and e) Compliance with Labor Standards.

7. Does your company have any ongoing projects that may cause a problem with completing or beginning performance of the subject project?

END OF FORM