W9136419R8003_0001_Asphalt_Repair_MOD1.pdf

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 add OBI 1-6 line items.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 5

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

16C. DATE SIGNED

BY 30-May-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 W9136419R8003

X 9B. DATED (SEE ITEM 11)

20-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 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 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

30-May-2019

CODE

180 FW CONTRACTING OFFICE

2660 S EBER ROAD

SWANTON OH 43558-8752

W91364 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE

See Item 6

FACILITY CODECODE

EMAIL:TEL:

W9136419R8003

SECTION SF 30 BLOCK 14 CONTINUATION PAGE

SUMMARY OF CHANGES

SECTION SF 1449 - CONTINUATION SHEET

SUPPLIES OR SERVICES AND PRICES

CLIN 0002 is added as follows:

ITEM NO SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0002 1 Job Optional Bid Item # 1

FFP

Southgate Road past the intersection at Triple Nickle Rd. to the north side of the driveway to Building 155 drive to Northgate Rd (Worked along with Phase 2).

FOB: Destination

PSC CD: Z1LB

NET AMT

CLIN 0003 is added as follows:

0003 1 Job Optional Bid Item # 2

FFP

Southgate road from the drive to building 155 to Northgate Rd. (This will not be worked as part of phase 2).

CLIN 0004 is added as follows:

0004 1 Job Optional Bid Item # 3

FFP

Triple Nickel Road (Worked along with Phase 2).

CLIN 0005 is added as follows:

0005 1 Square

Yard

Optional Bid Item # 4

FFP

Provide a unit cost for additional removal and replacement of 4” of asphalt as described in paragraph 1.03.B.3. The price shall be based on an 80 square yard section (12’ wide x 60’ section). This work may be separate or continuous with other indicated sections shown on the drawings. Additional repairs shall be accomplished at the same time as those indicated with the base bid. Price shall be in $_____/per square yard (SY).

CLIN 0006 is added as follows:

0006 1 Square

Yard

Optional Bid Item # 5

Provide a unit cost to prepare and seal pavements according to this statement of work. Price shall be in $_____/per square yard (SY). Minimum quantity to be added is 200 SY. Additional quantities will be done concurrently with phase 2, 3 or 4 or as a separate phase if a large enough area is added.

CLIN 0007 is added as follows:

0007 Linear

Foot

Optional Bid Item # 6

Provide a unit cost for additional crack filling. Price shall be $_____/lineal foot.

Assume an average crack is ½” wide by ½” deep. Minimum quantity to be added is 1000 lf. Additional quantities will be done concurrently with phase1, 2, 3 or 4 or as a separate phase if a large enough area is added.

INSPECTION AND ACCEPTANCE

The following Acceptance/Inspection Schedule was added for CLIN 0002:

INSPECT AT INSPECT BY ACCEPT AT ACCEPT BY

Destination Government Destination Government

The following Acceptance/Inspection Schedule was added for CLIN 0003:

The following Acceptance/Inspection Schedule was added for CLIN 0004:

The following Acceptance/Inspection Schedule was added for CLIN 0005:

The following Acceptance/Inspection Schedule was added for CLIN 0006:

The following Acceptance/Inspection Schedule was added for CLIN 0007:

(End of Summary of Changes)