Amendment W912WJ23A0007-0002.pdf

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. CONTRACT ID CODE PAGE OF PAGES

1 3

2. AMENDMENT/MODIFICATION NO.

3. EFFECTIVE DATE

06-Dec-2022

4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO.(If applicable)

6. ISSUED BY CODE W912WJ 7. ADMINISTERED BY (If other than item 6) CODE

U S ARMY ENGR DISTRICT, NEW ENGLAND

696 VIRGINIA RD

CONCORD MA 01742-2751

See Item 6

8. NAME AND ADDRESS OF CONT RACT OR (No., Street, County, State and Zip Code) X

9A. AMENDMENT OF SOLICITATION NO.

W912WJ-23-A-0007

X 9B. DATED (SEE ITEM 11)

17-Nov-2022

10A. MOD. OF CONT RACT /ORDER NO.

10B. DATED (SEE ITEM 13)

CODE FACILIT Y CODE

11. T HIS ITEM ONLY APPLIES TO AMENDMENT S OF SOLICIT AT IONS

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. ACCOUNT ING AND APPROPRIAT ION DAT A (If required)

13. T HIS ITEM APPLIES ONLY TO MODIFICAT IONS OF CONT RACT S/ORDERS.

IT MODIFIES T HE CONT RACT /ORDER NO. AS DESCRIBED IN ITEM 14.

A. T HIS CHANGE ORDER IS ISSUED PURSUANT T O: (Specify authority) T HE CHANGES SET FORT H IN ITEM 14 ARE MADE IN T HE

CONT RACT ORDER NO. IN ITEM 10A.

B. T HE ABOVE NUMBERED CONT RACT /ORDER IS MODIFIED TO REFLECT T HE ADMINIST RAT IVE CHANGES (such as changes in paying office, appropriation date, etc.) SET FORT H IN ITEM 14, PURSUANT TO T HE AUT HORIT Y OF FAR 43.103(B).

C. T HIS SUPPLEMENT AL AGREEMENT IS ENT ERED INT O PURSUANT TO AUT HORIT Y OF:

D. OTHER (Specify type of modification and authority)

E. IMPORT ANT: Contractor is not, is required to sign this document and return copies to the issuing office.

14. DESCRIPT ION OF AMENDMENT /MODIFICAT ION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

Amendment 0002 is being issued to revise the Bid Schedule. Pricing shall be provided for all tasks in order for quotes to be considered responsive.

Closing is extended until December 13, 2022 at 5:00 PM Eastern.

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) 16A. NAME AND TITLE OF CONT RACT ING OFFICER (Type or print)

SHEILA M WINSTONVINCUILLA / CONTRACTING OFFICER

TEL: 978-318-8159 EMAIL: Sheila.M.Winston@usace.army.mil

15B. CONT RACT OR/OFFEROR

(Signature of person authorized to sign)

15C. DATE SIGNED 16B. UNIT ED ST AT ES OF AMERICA

BY

(Signature of Contracting Officer)

16C. DATE SIGNED

06-Dec-2022

EXCEPT ION TO SF 30 30-105-04

ST ANDARD FORM 30 (Rev. 10-83) APPROVED BY OIRM 11-84 Prescribed by GSA

FAR (48 CFR) 53.243

mailto:Sheila.M.Winston@usace.army.mil

W912WJ-23-A-0007

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 06-Dec-2022 05:00 PM to 13-Dec-2022 05:00 PM.

BID SCHEDULE

OCCUPATIONAL MEDICAL SERVICES

BLANKET PURCHASE AGREEMENT

U.S. ARMY CORPS OF ENGINEERS

PERFORMANCE WORK STATEMENT

NEW ENGLAND DISTRICT

TEST EST QTY PER

YEAR

UNIT PRICE

01 Chest X-Ray PA & Lat 10

02 Audiometry 250

03 EKG 20

04 Serum PCB 20

05 Arsenic Level – Urine 20

06 Mercury Level – Urine 20

07 Blood Lead/ZPP 20

08 Heavy Metals Profile 20

09 Cadmium Profile 20

10 Enhanced Musculoskeletal Evaluation 10

11 Pulmonary Function Test 20

12 Respirator Questionnaire 20

13 General Medical Questionnaire 20

14 Chemistry Profile 20

15 CBC with Differential 20

16 Dipstick Urinalysis 20

17 Height/Weight 20

18 Vision – Modified (Near/Distance/Color) 20

19 M.D. Physical Exam 30

20 Vital Signs 20

21 Tetanus Diphtheria 20

22 TB Mantoux 10

23 Hepatitis B Injection #1 5

24 Psychological Eval 2

25 Hepatitis A Injection #1 5

26 Influenza Vaccine 5

27 DOT Form/Driver Card 15

28 Sickle Cell Screen 2

29 Long Bone X-Ray Series 2

30 Company Specific Form 30

31 Blood Collection 20

32 Neurological Sensory Exam 2

33 Cardiac Stress Test 5

34 Chemzyme 20

35 Complete Urinalysis 20

36 Periodic Questionnaire 10

37 M.D. Exam - Intermediate 10

38 Lipids Profile 20

39 Chart Review (PER 15 MIN INTERVAL) 60

40 Vision Test (Complete) 30

41 Urine Collection 20

42 Combined Medical Surv Questionnaire 20

43 Occupational Health Physician Consult

(PER 15 MIN INTERVAL)

*The quantity of each service/test listed is an estimate of the number required by the Government, however, shall not be perceived as the total number required. The Government may require less services than listed or more services than listed.

(End of Summary of Changes)