AMD 6 TO CONTRACT RE NHDP WITH MCDPH.PDF

1. CONTRACT ID CODE PAGE OF PAGES
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
1 3
2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)
0006 01/01/2016 HRS168204
6. ISSUED BY CODE NHDP 7. ADMINISTERED BY (If other than Item 6) CODE
HRSA/OAMP/NHDP
Office of Acquisition
Management and Policy
National Hansens Disease Program
Baton Rouge LA 70816
8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code) 9A. AMENDMENT OF SOLICITATION NO.
(x)
COUNTY OF MARICOPA 151577
MARICOPA, COUNTY OF 1645 E ROO 9B. DATED (SEE ITEM 11)
1645 E ROOSEVELT
PHOENIX AZ 850063638
10A. MODIFICATION OF CONTRACT/ORDER NO.
x
HHSH258201300005C
10B. DATED (SEE ITEM 13)
CODE 151577 FACILITY CODE 08/27/2013
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers is extended, is not extended.
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: (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 ACKNOWLEDGEMENT 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) Net Increase: $10,283.75
2016.3280075.25627
13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
CHECK ONE 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)
X FAR 52.217-9 - Option to Extend the Term of the Contract (MAR 2000)
E. IMPORTANT: Contractor x 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.)
Tax ID Number: 86-6000472
DUNS Number: 602062515
The purpose of this modification is to exercise option period three, January 1, 2016
through December 31, 2016. Due to current continuing resolution constraints only 3 months
of funding are being obligated at this time, January 1, 2016 through March 31, 2016.
Funding for the remaining portion of option period three shall only be obligated once a new
continuing resolution or budget is authorized.
1. The total price of the contract is $186,879.75.
2. The total obligated amount for this contract is increased by the sum of $10,283.75 from
Continued ...
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 CONTRACTING OFFICER (Type or print)
Chairman, Board of Supervisors JUN JI
15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 16C. DATE SIGNED
Digitally signed by Jun Ji -S
Jun Ji -S DN: ou=People, c=US, o=U.S. cn=Jun Government, Ji -S, ou=HHS, ou=HRSA, 30 Dec 2015
0.9.2342.19200300.100.1.1=2001568302
Date: 2015.12.30 10:37:13 -05'00'
(Signature of person authorized to sign) (Signature of Contracting Officer)
NSN 7540-01-152-8070 STANDARD FORM 30 (REV. 10-83)
Previous edition unusable Prescribed by GSA
_______________________________________ _____________________________________ FAR (48 CFR) 53.243
Maricopa County Attorney Date Clerk of the Board Date

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF
CONTINUATION SHEET
HHSH258201300005C/0006 2 3
NAME OF OFFEROR OR CONTRACTOR
COUNTY OF MARICOPA 151577
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
(A) (B) (C) (D) (E) (F)
$93,881.00 to $104,164.75.
3. The total funds currently available for
payment and allotted to this contract are
$12,836.00 for the period of September 1, 2013
through December 31, 2013; $10,076.25 for the
period January 1, 2014 through March 31, 2014;
$30,228.75 for the period April 1, 2014 through
December 31, 2014; $10,185.00 for the period
January 1, 2015 through March 31, 2015;
$30,555.00 for the period April 1, 2015 through
December 31, 2015 and $10,283.75 for the period
January 1, 2016 through March 31, 2016.
4. For further provisions on funding, see
Limitation of Costs clause (FAR 52.232-20).
5. Section B.2., Period of Performance, is hereby
changed to read September 1, 2013 through March
31, 2016.
Contracting Officer Representative (COR):
Irma E. Guerra, BSN, MPH
Director, Ambulatory Care
National Hansen's Disease Program
1770 Physician Park Drive
Baton Rouge, LA 70816
Telephone: 1-800-642-2477
Fax: 225-756-3806
Email: IGuerra@hrsa.gov
Contracts Office Point of Contact:
Charisse Whitney
National Hansen's Disease Program
1770 Physician Park Drive
Baton Rouge, LA 70816
Telephone: 225-756-3785
Fax: 225-756-3786
Delivery Location Code: NHDP/ADM/CONTRACTS
NHDP/ADM/CONTRACTS
1770 Physicians Park Drive
Baton Rouge LA 70816 US
Payment:
NHDP/FMO
1770 Physicians Park Drive
Financial Management Office
Baton Rouge LA 70816
Appr. Yr.: 2016 CAN: 3280075 Object Class: 25627
FOB: Destination
Continued ...
NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)
Sponsored by GSA
FAR (48 CFR) 53.110

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF
CONTINUATION SHEET
HHSH258201300005C/0006 3 3
NAME OF OFFEROR OR CONTRACTOR
COUNTY OF MARICOPA 151577
ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT
(A) (B) (C) (D) (E) (F)
Period of Performance: 01/01/2016 to 12/31/2016
8 NHDP 181 C 1886 Exercise Option Period Three 10,283.75
(January 1, 2016 - March 31, 2016) on Contract
HHSH258201300005C
Obligated Amount: $10,283.75
NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)
Sponsored by GSA
FAR (48 CFR) 53.110