AMD RE TB EPI STUDIES WITH CDC.PDF

1. CONTRACT ID CODE PAGE OF PAGES
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1 2
2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)
00005 08/04/2015 00HCVJEG-2015-82893
6. ISSUED BY CODE 8219 7. ADMINISTERED BY (If other than Item 6) CODE 2536
Centers for Disease Control and Prevention Centers for Disease Control and Prevention (PGO)
(CDC) Acquisition and Assistance Branch 1
Procurement and Grants Office (PGO) 2920 Brandywine Road, MS E-15
2920 Brandywine Road Atlanta, GA 30341-5539
Atlanta, GA 30341-5539
8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code) () 9A. AMENDMENT OF SOLICITATION NO.
MARICOPA, COUNTY OF
1645 E ROOSEVELT
9B. DATED (See Item 11)
PHOENIX, AZ 85006-3638
10A. MODIFICATION OF CONTRACT/ORDER NO.
200-2011-41279/0001
X
10B. DATED (See Item 13)
CODE 602062515 FACILITY CODE 09/29/2011
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 ACKNOWLEGMENT
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)
939ZRQU 2555 2015 75-15-0950 5610411101 Increase $389005.00
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:
X
FAR 43.103(a)(3) Bilateral Agreement Between the Parties
D. OTHER (Specify type of modification and authority)
E. IMPORTANT: Contractor is not, X is required to sign this document and return 1 copies to the issuing office.
14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
The purpose of this modificaiton is to:
A. Revise the Statement of Work as described in Section C below.
B. Increase the price of CLIN 0006 by $25,799.00 from $363,206.00 to $389,005.00.
C. Exercise Option Period 5 with a period of performance from September 29, 2015 to September 28th,
2016.
D. Obligate $389,005.00 to CLIN 0006. Total value of this task order is hereby increased by
$25,799.00 from $1,477,209.00 to $1,503,008.00. Total funding for this task order is increased
by $389,005.00 from $1,114,003.00 to $1,503,008.00.
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 OF CONTRACTING OFFICER
Patrick Winders
15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 16C. DATE SIGNED
___________________________________________ BY ___________________________________________
(Signature of person authorized to sign) (Signature of Contracting Officer)
NSN 7540-01-152-8070 STANDARD FORM 30 (REV. 10-83)
PREVIOUS EDITION UNUSABLE 30-105 Prescribed by GSA
FAR (48 CFR) 53.243

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Section B: Supplies/Services & Price/Cost
Option 5 Option Period 5 Items:
ITEM SUPPLIES / SERVICES QTY / UNIT UNIT PRICE EXTENDED PRICE
0006 TBESC Research 1 Each $582,453.00 $582,453.00
Tuberculosis Epidemiologic Studies
Consortium (TBESC) Research entitled,
“Improving the Diagnosis and Treatment
of Latent TB Infection” and in
accordance with Section C, Statement of
Work (SOW).
Performance Period:
September 29, 2015 through September
28, 2016
Line(s) Of Accounting:
939ZRQU 2555 2015 75-15-0950
5610411101 $582,453.00
Section C:
Revise the Statement of Work as follows:
(1) Part IV of the Technical Requirements, subpart 20 is revised as follows:
“attend two TBESC meetings per year and stay until the end of each meeting.”
TO READ:
attend one TBESC meeting per year and stay until the end of the meeting.
(2) Increase patient enrollment by 200 patients from 500 enrollees to 700 enrollees.

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