5. PROJECT NUMBER (if applicable)
CODE
7. ADMINISTERED BY
2. AMENDMENT/MODIFICATION NUMBER
CODE
6. ISSUED BY
8. NAME AND ADDRESS OF CONTRACTOR
4. REQUISITION/PURCHASE REQ. NUMBER
3. EFFECTIVE DATE
9A. AMENDMENT OF SOLICITATION NUMBER
9B. DATED
PAGE OF PAGES
10A. MODIFICATION OF CONTRACT/ORDER NUMBER
10B. DATED
BPA NO.
1. CONTRACT ID CODE
FACILITY CODE
CODE
Offers 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:
The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers
E. IMPORTANT:
is extended,
(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 electronic communication 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
is not extended.
12. ACCOUNTING AND APPROPRIATION DATA
(REV. 11/2016)
is required to sign this document and return ___________ copies to the issuing office.
is not,
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.
15C. DATE SIGNED
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES
SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
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 letter
or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to
the opening hour and date specified.
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER
Contractor
16C. DATE SIGNED
14. DESCRIPTION OF AMENDMENT/MODIFICATION
16B. UNITED STATES OF AMERICA
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
16A. NAME AND TITLE OF CONTRACTING OFFICER
15B. CONTRACTOR/OFFEROR
STANDARD FORM 30
PREVIOUS EDITION NOT USABLE
Prescribed by GSA - FAR (48 CFR) 53.243
(Type or print)
(Type or print)
(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
(Number, street, county, State and ZIP Code)
(If other than Item 6)
(Specify type of modification and authority)
(such as changes in paying office, appropriation date, etc.)
(If required)
(SEE ITEM 11)
(SEE ITEM 13)
(X)
CHECK
ONE
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
(Signature of person authorized to sign)
(Signature of Contracting Officer)
1
2
0002
NA
Department of Veterans Affairs
VAMC (613)
VISN 5 Contract Satellite Office
510 Butler Avenue, Building 306A
Martinsburg WV 25405
Department of Veterans Affairs
VAMC (613)
VISN 5 Contract Satellite Office
510 Butler Avenue, Building 308B
Martinsburg WV 25405
To all Offerors/Bidders
36C24522R0085
X
X
X
This amendment is to modify language in Section B.5 Pricing Schedule. Amended language is detailed on the
following page.
George Sherrin
Contracting Officer
Page 2 of 2
Language to be replaced:
The contract shall include a contract line for a service hourly rate to be used for Veteran service when a CMS HCPCS is not available. For an item that is not otherwise classified in the CMS HCPCS, and for which VA assigns any miscellaneous or Not Otherwise Classified (NOC) code, the contractor shall submit a quote for the invoice price of the item plus the number of service hours proposed. The quote must be received no later than two business days after receipt of the request for quote. The Contracting Officer will issue a fixed price based on the quote, negotiated if necessary, or based on government estimate if a quote is not received.
Replacement language:
For an item or service that is not otherwise classified in the CMS HCPCS, and for which VA assigns any miscellaneous or Not Otherwise Classified (NOC) code, the contractor shall submit a quote. Quotes must be received no later than two (2) business days after receipt of VA s request for quote. The Contracting Officer or Prosthetics and Sensory Aids Service (PSAS) Official will issue a fixed price order based on the quote, negotiated if necessary, or based on the government estimate if a quote is not received. The Contracting Officer or PSAS Official may request additional supporting documentation as needed.