Free Motion for Leave to File - District Court of Federal Claims - federal

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Case 1:03-cv-00289-FMA Document 18-19 Filed 08/15/2003 Page 1 of 2 1. CONTRACT ID CODE PAGE AMENbMENT OF SOLlClTATlONlMODlFlCATlON OF CONTRACT *
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2. AMENDMENI'/MODIFICATION NO.

4. REQUlSlTlONlPURCHASE REQ. NO.

5 . PROJECT NO. (lfapp/icab/e/

P00005
6 . ISSUED BY

NIA
7. ADMINISTERED BY (If Item than other

6) CODE

~SP~200

DEFENSE PERSONNEL SUPPORT CENTER 2800SOUTH 2OTH TREET PHILADELPHIA P i 19145-5099 CONTRA T SPECIALIST: N. MARTIN PHONE: 15-737-8422

SAME AS BLOCK 6

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8 . NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code]

SA. AMENDMENT OF SOLICITATION NO.

UNITED MEDICAL SUPPLY 5 1 17 NORTHEAST PARKWAY FORT WORTH, TX 76106

1I 90. DATED (SEE ITEM 1 I t
x

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1 OA. MODIFICATION OF CONTRACT/ORDER NO.

SP0200-97-D-7 133
1OB. DATED (SEE ITEM 131

CODE

51804

1 FACILITY CODE
1 1. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
as set forth in Item 14. The hour and datespecifiedforreceipt of Offers

01/30/97

c The abovenumberedsolicitationisamended ]

0

is efiended,

0

isnot

Offer must acknowledge receipt of this amendment prior t o the hour and date specified in the solicitation or as amended, by one of the following methods: (a) By completing Items 8 and-15, returning and copies of the amendment; (bl By acknowledging receipt of this amendment on each copy of the offer submitted; lor (cl By separate letter or telegram which includes a reference to the solicitationand amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED M A Y RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire t o change an offer already submined. such change-may bo made b y telegram o letter, provided each telegram-or letter makes referenca r t o the solicitation and this amendment, and is received prior to the opening hour and date specified.

12. A c c o u n t i n g a n d A p p r o p r i a t i o n D a t a (If required]

MEDICAWSURGICAL PRIME VENDOR - LONE STAR REGION

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13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS, IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

1x1 A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: Specify authority/ THE CHANGES SET FORTH IN ITEM 1 4 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM

>( ' B.
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1

10A.
THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES fsuch 8 s changes in p8ying office, appropriation date, etcl. SETFORTHINITEM 14. PURSUANTTOTHE AUTHORITY OF FAR 43.103(b).

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C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY O F D. OTHER ,Speciff type of/nodification and authoriryl

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E. IMPORTANT:

Contractor

not, required is is

t o sign this document

and return

01

copies the to

issuing office.

14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCFsecrion headings, including solicitation/contract subject matter where feasible./

The above referenced contract is hereby modified to reflect the changes cited on Page 2 of this document.

Except as provided herein, all terms and condltions forcz and effect. 1 5 A . NAME AND TITLE

of t h e d o c u m e n t r e f e r e n c e d in Item 9A or 1OA. a s h e r e t o f o r e c h a n g e d , r e m a i n s u n c h a n g e d a n d in f u l l

OF SIGNER (Type orprint/

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

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DATE 15C.

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16E. UNITE

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SIGNED

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OTANDARD

16 i 7 y L i 7 7 N ,

N5N 7540-01-152-9070

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Created using PerForm Pro software.

FORM 30 REV. 0.83)

PREVIOUS EDITION

Prescribed b y GSA

FAR I48 CFR) 5 3 . 2 4 3

Case 1:03-cv-00289-FMA

Document 18-19

Filed 08/15/2003

Page 2 of 2

MODIFICATION NUMBER: PO0006 CONTRACT NUMBER:SPO200-97-D-7133 MEDICAUSURGICAL PRIME VENDOR LONE STAR REGION

Page 2 of 2

1. The following Ordering and Receiving Point is hereby added to the Lone Star Region:
ORDERING POINT RECEIVING POINT

AF MLO/OL-2 DEA# BA4429937 AFMLO/OL-2 501 Felix St., Warehouse 6 Fort Wohh, TX 761 15-0627
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AFMLO/OL-2 501 Felix St., Warehouse 6 Fort Worth, TX 76115-0627
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Point of Contact: TSgf Koonce Telephone: 817-885-6964

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Estimated Dollar Value: $400,000.00 per year 2. There shall be no change in the contractual distribution fees as a result of the above-cited change. All other terms and conditions of the contract remain the same.