HomeMy WebLinkAbout3873 P00006 EFF 8.11.2004 pg 230-297-2EXCEPTION TO SF 30 30-105-04 STANDARD FORM 30 (Rev. 10-83)
APPROVED BY OIRM 11-84 Prescribed by GSA
FAR (48 CFR) 5 3.24 3
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.(Ifapplicable)
P00006 11 -Aug -2004
6. ISSUED BY CODE N44255 7. ADMINISTERED BY (Ifother than item 6) CODE
NAVFAC EFANORTHV EST POULSBO
See Item 6199177THAVENE
POULSBO M 98370-7570
8. NAME AND ADDRESS OF CONTRACTOR (No., Street, County, State and Zip Code) 9A. AMENDMENT OF SOLICITATION NO.
CITY OF BREMERTON
3027 OLYMPUS DR 9B. DATED (SEE ITEM 11)
BREMERTON UJA 98310-4799
X 10A MOD. OF CONTRACT/ORDER NO. N44255 -96-K/ 2292
X
lOB. DATED (SEE ITEM 13)
22 -Dec -1997CODE04DN7IFACILITYCODE
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
ElThe above numbered solicitation is amended asset forth in Item 14. The hour and date specified for receipt of0ffer 11 is extended, Elis not extended.
Offermust acknowledge receipt ofthis amendment prior to thehour and date specified in the solicitation or as amended by one ofthe following methods:
a) By completing Items 8 and 15, and returning copies ofthe amendment, (b) By acknowledging receipt ofthis amendment on each copy ofthe offersubmitted;
or (c) By separate letter or telegramwhich includes areference to thesolicitation andamendment numbers. FAILURE OF YOURACKNOWLEDGMENTTO BE
RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOURAND DATE SPECIFIED MAY RESULT IN
REJECTION OF YOUR OFFER. Ifby virtue ofthis 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. ACCOUNTINGAND 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.
X 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 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.)
Modification Control Number: gaskelgf041055
See Page 2.
Except as provided herein, all terms and conditions ofthe 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)
MARCIA LBOYD / CONTRACT SPECIALIST
TEL: (360) 3960247 EMAIL: Marcia.Boyd@navyrnI
15B. CONTRACTOR/OFFEROR 15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 16C. DATE SIGNED
11 -Aug -2004
Signature of person authorized to sign) Signature of Contracting Officer)
EXCEPTION TO SF 30 30-105-04 STANDARD FORM 30 (Rev. 10-83)
APPROVED BY OIRM 11-84 Prescribed by GSA
FAR (48 CFR) 5 3.24 3
N44255 -96-M-2292
P00006
Page 2 of 2
SECTION SF 30 BLOCK 14 CONTINUATION PAGE
The following items are applicable to this modification:
This modification provides for a change to the billing address for the contract/accounts listed below. The account
numbers and locations are consistent with modification P00004.
Contractor Contract Number Account Number Location Comments
City of Bremerton N44255 -96-M-2292 54-5940-0 (water) Camp McKean
54-5940-0 (sewer) Camp McKean
25-0235-1 (fireline) 300 S. Wycoff Original contract
reflected an address
of 314 Wycoff Ave.
This has been
corrected as noted in
the "Location"
column to the left.
25-0230-1 (water) 300 S. Wycoff
25-0230-1 (sewer) 300 S. Wycoff The account number
noted in the
Account Number"
column to the left
supersedes account
number 25-0232-0.
The billing address is hereby revised to:
Commander, Navy Region Northwest
Code N44A3 (Utilities)
1101 Tautog Circle, Suite 303
Silverdale, WA 98315-1199
RATESCHEDULE:
The above rates are as set forth in City of Bremerton Ordinance No. 4881 (see modification P00005).
This contract only provides coverage for the above noted accounts.