B.01.01_Amendment 0001_W91QVN-21-R-0224.pdf

411TH CSB, KOREA - CONST & SUPPLY TEAM

POC: MS. PAK, MYONG SUK

TEL: 05033-55-3397

EMAIL: MYONGSUK.PAK.LN@MAIL.MIL

APO AP 96271-5228

UNITED STATES

0011671008

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

A. The purpose of this amendment is to correct brand name, model number and stock number on CLIN0003 (Refer to highlighted in yellow ).

B. As a result the above changes, the closing date of the amendment is extended to 6 September 2021, 1300 hours (Korea Standard Time).

C. All other terms and conditions remain the same.

1. CONTRACT ID CODE PAGE OF PAGES

J 1 3

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

16C. DATE SIGNED

BY 30-Aug-2021

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 W91QVN21R0224

X 9B. DATED (SEE ITEM 11)

26-Aug-2021

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 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 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-Aug-2021

CODE

411TH CONTRACTING SUPPORT BRIGADE, KOREA

CONSTRUCTION & SUPPLY DIV, UNIT #15289

APO AP 96271

UNITED STATES

W91QVN 7. ADMINISTERED BY (If other than item 6)

4. REQUISITION/PURCHASE REQ. NO.

CODE W91QVN

FACILITY CODECODE

EMAIL:TEL:

W91QVN21R0224

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 02-Sep-2021 02:00 PM to 06-Sep-2021 01:00 PM.

SUPPLIES OR SERVICES AND PRICES

CLIN 0003

The CLIN description has changed from Shielded Glasses(KP-103B) to Shielded Glasses(J-378BS).

The following have been modified:

PPE SALIENT CHARACTERISTICS

# Brand

Name Model/Item

Stock#/ Catalog#

Nomenclature (Description)

Color Qty Picture

1 K2 KG-50 K01272942

K01302143 K01302165 K01302176 K01302223

SAFETY SHOES, MOD#KG-50,

MFG:K2

-FUNCTION:

1.SAFETY SHOES

2.GORE-TEX FINISH

3.ARMORFLEX

-CLOLR:BROWN

-MATERIAL:

UPPER:NATURAL NUBUCK

LEATHER

SOLE:RUBBER, PYLON

-WEIGHT:580gram=/-10gram (260mm 1ea)

Brown 25EA

2 K2 KV-80 K08042120

K08042131 K08042153 K08042186

INSULATION SAFETY SHOES

MOD#KV-80, MFG:K2

-FUNCTION:

1.ELECTRICAL SAFETY

PURPOSE SHOES

2.GORE-TEX FINISH

3.ARMORFLEX

-CLOLR:BLACK

-MATERIAL:

UPPER:WEATHER PROOF

NUBUC LEATHER

SOLE:RUBBER, PYLON

-WEIGHT:580gram=/-10gram (260mm 1ea)

Black 4EA

W91QVN21R0224

3 Myungshin Optics.

(J-378BS) K01253621 Shielded Glasses (J-378BS) A type of lenses that can be attached to individual lenses in protective goggles for workers wearing glasses.

Large lens for wide visibility.

Top and bottom opening and closing type size : FREE Anti-UV, Anti-Scratch Website:

https://www.navimro.com/g/62686/

Black 15EA

4 KRC KR-SG6-5.0 K04958516 Shielded Glasses (KR-SG6 Polarized Lens) Light wavelength range: 313 nm-365 nm Ultraviolet area: 99.9% Blocking

(ANTI-UV)

(VARIOUS LUMINOUS

TRANSMITTANCE) Apply KRC Polarization Lens

ANTI UV

ANTI SCRATCH

NON ANTI-FOG

Black 15EA

5 NAVIMRO Smart Glove

K06126332 PU(Poly Urethane) Half Coating Golve, Color:Black,10EA/PK

Black 10PK

6 3M COMFORT

GRIP

K12189443 Glove , Winter Type, Color :Gray, Mod#COMFORT GRIP,MFG:3M

Gray/ Black

150EA

7 Safety Vest,Mesh Type with Pocket Type, Color:Yellow,Light reflection, Refection Tape Color: White or Silver, Side Belt Type,With "DPW" Logo(Left Chest,Back)-Location:Left Chest, Color: black, Letters Size:H20mm x W65mm, Location:

Back, Color: black, Letters Size:H20mm x W100mm

30EA

8 Any-Guard KF-94 K40999431 Fine Particulate Matter Mask

- Material: Melt Blowm filter, Quadruple Filter

- Size: Adult

- Model# KF94

White 3000EA

(End of Summary of Changes)