HomeMy WebLinkAbout3927
Cont-ractNumbe-r: 3927
Vendor:
NAVAL FACILITIES ENGINEERING COMMAND NW
(US NAVY)
Subject:
NAD Marine Park - Monitoring Well
Department:
Parks
File Class:
LEG 16-3
Begin Date:
06/01/1998
End Date:
05/31/2009
Review Date:
02/15/2011
Vault Date:
01/01/2011
Comments:
N44225598RPOOG11
May be renewed in 1 year terms thru 5/31/13
Written notification to terminate 5/09
DEPARTMENT OF THE NAVY
NAVAL FACILITIES ENGINEERING COMMAND NORTHWEST
1101 TAUTOG CIRCLE
SILVERDALE, WA 98315-1101
11011
RES.JM/850343
NAVFAC NW
MAt 12 2DOO
Ms. Cherie Henry
Deputy City Clerk
City of Bremerton
345 6th Street
Bremerton, WA 98337-1873
Dear Ms. Henry;
The terms of monitoring well lease N4425598RPOOG11 allow the
Navy to terminate it with written notification. This letter is
to serve as written notification that the Navy wishes to
terminate the lease as of the end of the current term on May 31,
2009.
Please contact Jeff Murdoch of my staff if there are any
questions. He can be reached at jeffrey.murdoch@navy.mil or at
396-0904 if there are any questions.
Sincerely,
~~U_~H~
Real Estate Contracting Officer
Copy to:
City of Bremerton (Wyn Birkenthal)
Contract Number: 3927
Vendor:
NAVAL FACILITIES ENGINEERING COMMAND NW
(US NAVY)
Subject:
NAD Marine Park - Monitoring Well
Department:
Parks
File Class:
LEG 16-3
Begin Date:
06/01/1998
End Date:
05/31/2009
Review Date:
04/01/2009
Vault Date:
Cormnents:
N44225598RPOOG11
May be renewed in 1 year terms thru 5/31/13
r,. ~.
1. CONTRACT ID CODE
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
.2. AMENDMENT/MODIFICATION NO. 3. EFFEC;W,E DATE 4. REQUISITION/PURCHASE REQ. NO.
Six (6) 1 June 2008
6. ISSUED BY CODE RES 7. ADMINISTERED BY (If other than Item 6)
Commanding Officer
NavalFacilities Engineering Command Nort.hwest
1101 Tautog Circle
Silverdale, WA 98315-1101
8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and Zip Code)
X 9A. AMENDMENT OF SOLICITATION NO.
City of Bremerton
Financial Services
345 6th Street Suite 600
Bremerton, WA 98337-1873
9B. DATED (SEE ITEM 11)
10A. MODIFICATION OF CONTRACT/ORDER NO.
N4425598RPOOG n
10B.-DATED (SEE ITEM 11)
CODE
I F;..c I LlTY CODE . U:. As of 1 June 1998
.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 f~r 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 compieting 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 your 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 openinghou~ and date specified.
. .12.. ACCOUNTINGif\NDAPPROPRIATION DATA (If required) . .
At.: 17 08081804 KU2E 0252 62470 P 068732 20 ROOOPS AL8RPOOG11 ER$100.00
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 INTHE 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.103(b).
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
.
.f
D. OTHER (Specify type of modification and authority)
E. IMPORTANT: Contractor is not, ,f is required to sign this document and return 4 copies to the issuing office.
14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
Modification Six (6) is issued to make two changes:
1. Change the notification address for the City of Bremerton
2. Amend Paragraph 5 ofthe Lease to extend the term an additional five years
Both as shown on the attached continuation sheet
16C. DATE SIGNED
JUN 2 $ 200S
NSN 7540-01-152-8070
Previous edition unusable
STANDARD FORM 30 (Rev. 10-83)
Prescribed by GSA FAR (48 CFR) 53.243
. DUPLICATE ORIGINAL
t ~ '.1
.1 NSTRUCTIONS
. -
. .
Instructions for items other than those that are self-explanatory, are as follows:
. .
(a) Iteml(Contract ID Code). Insert the contract type
identification code that appears in the .title block of
the contract being modified: .. .
(b) Item 3 (Effective date).
(1) For a solicitation amendment; change order, or
administrative change, the effective date shall be
the issue date of the amendment, change order,
or administrative change.
(2) For' a supplemental agreement, the effective
date shall be the date agreed to by the
contracting parties.
(3) For a modification issued as an initial or
confirming notice of termination for the
convenience of the . Government, the effective
date and the modification number of the
confirming notice shall be the same as the
effective date and modification number of the
initial notice. '
. (4) For a modification converting a termination for
default to a termination for the
convenience of the Government, the
effective date shall be the same as. the
effective date of the termination for default.
(5) ,For a, !l1odification confirming the contacting'
officer's determination of the amount due in
settlement of a contract. termination, the
effective date shall' be the same as the
effective'date of the initial decision.'
"'
(c) Item 6 (Issued Bv). Insert the name and address
of the issuing office. If applicable, insert the
appropriate issuing office code in the code block.
(d) Item 8 (Name and Address of Contractor). For
modifications to a contract or order, enter the
contractor's name, address, and code as shown in
the original contract or order, unless changed by
this or a previous modification.
(e) Item 9, (Amendment of Solicitation' No; - Dated),
and 10.. (Modification of Contract/Order No. -
Dated). Check the appropriate box and in the
corresponding blariks insert the number and date
of the original solicitation, contract, or order.
(f) Item 12 (Accountinq and Appropriation Data). When
appropriate, indicate the impact of the modification
on each affected accounting classification by
inserting one of the following entries.
-;i;;.:: ;,1, (.- ~1~ :' '~.\;" (~r:
. "'(1) Accountihg classification
Net increase $
(2)' AccoUnting classification
,. Net decrease $
NOTE: If there are changes to multiple accounting
classifications that cannot be placed in block 12; insert
an asterisk and the words "See continuation sheet".
(g) Item 13. Check the appropriate box to indicate the
type of modification. Insert in the corresponding
blank the authority under which the modification is
issued. Check whether or not contractor must sign
this document. (See FAR 43.103.) .
(h) Item 14 <Description of Amendment/Modification) .
(1) Organize amendments or modifications under
, the appropriate Uniform, Contract Format (UCF)
section headings from the applicable solicitation
or contract. The UCF table of contents,
however, shall not be set forth in this document
(2) Indicate the impact of the modification on the.
overall total contract price by inserting one of
. the following entries:
(i) Total contract price increased by $
(ii) Total contract price decreased by $
(iii) Total contract price unchanged.
(3) State reason for modification.
(4) When removing, reinstating, or adding funds,
identify the contract items and accoLinting
classifications.
(5) When the SF 30 is used to reflect a
determination by the. contracting officer of the
amount due in settlement of a contract
terminated for the convenience of the
Government, the entry in Item 14 of the
modification may be limited to --'
(i) A reference to the letter determination; and
(ii) A statement of the net amount determined
to be due in settlement of the contract.
(6) Include subject matter or short title of
solicitation/contract where feasible.
"
(i) Item 16B. The contracting officer's signature is not
required on solicitation amendments. The
contracting officer's signature is normally affixed last
on supplemental agreements.
STANDARD FORM 30 (REV. 10-83) BACK
..
Continuation Sheet
Modification 6 to
Lease N4425598RPOOG 11
Page 2 of2
Change 1. Change City of Bremerton address:
From:
City of Bremerton
239 4th Street
Bremerton, WA 98337-1812
To:
City of Bremerton
Financial Services
345 6th Street, Suite 600
Bremerton, W A 98337-1873
Change 2. Extend the term of the lease as follows:
This lease may be renewed, at the option of the Government, for the following terms at the following
rentals.
'('I,
Provided notice be given in writing to the lessor at least 30 days before the e.nd of the original term or any
renewal term: all other Jerrp~ and conditions of this lease shall remain the same during any renewal term.
Said notice shall be computed commenCing with the date of mailing.
This lease is hereby renewed for the period 1 June 2008 through 21 May 2009
Doc: 98G-ll continuation
Vendor
Subject
Department
Status Code
Amount
Begin Date
End Date
Review Date
Insurance
Comments
Contract Number 3927
NAVAL FACILITIES ENGINEERING COMMAND NW
NAD Marine Park
Parks
LAN File Class
$100.00
06/01/1998
05/31/2008
05/01/2008
GL $
AL $
E&O $
Insurance Total $
Insurance Review Date
(US NAVY)
N44225598RPOOGll
May be renewed in 1 yr terms thru 5/31/08
NOTICE OF RENEWAL OF GOVERNMENT LEASE
1. FROM: 2. CONTRACT NO.
Commanding Officer (Code RES)
Naval Facilities Engineering Command Northwest N4425598RPOOG 11
1101 Tautog Circle
Silverdale, W A 98315-110 1
3. TO:
City of Bremerton
239 Fourth Street
Bremerton, W A 98310
DUNS 556846970, CAGE Code 04DN7
4.
You are hereby notified that under the provisions of the Government lease described below, the United States
of America elects to renew the said lease as the same may have been amended, and does hereby renew,
extend, and adopt the said lease and all the terms, conditions, and general provisions thereof for the period
beginning 1 June 2007 and ending 31 May 2008.
5. REQUIRING ACTIVITY:
Commanding Officer, Naval Facilities Engineering Command Northwest, 1101 Tautog Circle, Silverdale, W A 98315-1101
6. DESCRIPTION OF LEASE:
Navy Lease N4425598RPOOG 11 provides for the installation, operation, and maintenance of two
monitoring wells, one each on two plots of land, one on the north end and one on the south end of Naval
. ....-. Ammunition Depot M~rine Park, Bremerton; Washington....
,.,._,.. "",,' ..~ -~ .. ~.._... --''''-'~~' . - "'-~,- ,.. .
. . ; , { .~:
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..
Copy to: !
,. ...,... ,"". . .. .. ... .. ...... ._v.. ___ . _ .. ,'......--..-..-....... ~"'--' .....
. ' , ' .. /'-.,"J
NA VFAC NW Muniments (Original) DFAS Cleveland (via CIMAGE) NA VFACNWCode05ERSB
NA VFAC NW Lease File NA VFAC SW Code 05Be, NA VFAC NW Code 05ERDT
, , ,.
. ,
7. NAME, POSITION, AND TITLE ~~;, DATE
MICHAEL D. BRADY
. . MAY 2007
Director, Real Estate 2 1
Real Estate Contracting Officer Naval Facilities Engineering Command
Acting under direction of the
Secretary of the Navy .
8. NAVY ACCOUNTING DATA:
PAYMENT TO BE MADE BY: AMOUNT
DFAS Cleveland - Norfolk Accounts Payable, PO Box 998022,Cleveland, OR 44199 $100.00
.'
'.. ",' ,.
",:, . . .
ACCOUNTING CLASSIFICATION TO BE CHARGED (DISBURSEMENT)
. A: E. APPROPRJA-' C. SUE- ..D.OE!. . E.EU- . .. F.. d' G,........_ H., ..... ,..1,... .. ., ..,... ...J:.. ..' K,
..~ -. . , .-- --AMOUNT'" .,...~ ,
ACRN T10N HEAD CLASS CONTROL SA AAA TT PAA COST CODE
: AK 17071804 KU2E 0252 62470 P 068732 2D AKOOP5 AK8RPOOG 11 ER $100.00
.... .. Per Annum
I
il I' ",
" :,;l"
',;: '~~;.~.~' :':,:.- f) ,r. ,:d ';.:' ~.:(,:;~:! '.4..l!":' I. l":'
; : , ; , : t . ;-."~ ~" : ,': ~ .
DUPl\C~1E OR\G\N~l
Vendor
Subject
Department
Status Code
Amount
Begin Date
End Date
Review Date
Insurance
Comments
Contract Number 3927
NAVAL FACILITIES ENGINEERING COMMAND NW
NAD Marine Park
Parks
LAN
$100.00
06/01/98
05/31/2007
05/01/2007
GL $
AL $
E&O
Insurance Total $
Insurance Review Date
(US NAVY)
N44225598RPOOG11
May be renewed in 1 yr terms thru 5/31/08
11. CONTRACT ID CODE I PAGE OF PAGES
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1 I 1
2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 15. PROJECT NO. (If applicable)
Five (5) 6/01/2006
6. ISSUED BY CODE 05LR 7. ADMINISTERED BY (If other than Item 6) CODE I
Commanding Officer
Naval Facilities Engineering Command Northwest
1101 Tautog Circle
Silverdale, WA 98315-1101
8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and Zip Code) J& 9A. AMENDMENT OF SOLICITATION NO.
City of Bremerton
239 Fourth Street 9B. DATED (SEE ITEM 11)
Bremerton, WA 98310
DUNS 556846970, CAGE Code 04DN7
10A. MODIFICATION OF CONTRACT/ORDER NO.
N4425598RPOOG11
V 10B. DATED (SEE ITEM 11)
CODE I FACILITY CODE as of 1 June 1998
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 your 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)
CHECK ONE
13. THIS ITEM ONLY APPLIES TO MODIFICATION 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.
V
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.103(b).
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER (Specify type of modification and authority)
E. IMPORTANT: Contractor \/'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 Five (5) is issued to change the name and address of the using activity and paying office.
Name And Address of Using Activity Paying Office:
Naval Facilities Engineering Command Northwest Defense Finance and Accounting Service, Norfolk (Code FPV)
1101 Tautog Circle 1837 Morris Street, Suite 1401
Silverdale WA 98315-1101 PO Box 429100
, Norfolk, VA 23511-3431
This lease is hereby renewed for the period 1 June 2006 through 31 May 2007.
AJ 1706061804 KU2E 0252 62470 P 0687352 2D AJOOP5 AJ8RPOOG11 ER $100.00
Exce t as rovided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore chan ed, remains unchan ed and in full force and effect.
15A. NAME AND TITLE OF SIGNER T e or rint 16A. NAME AND TITLE OF CONTRACTING OFFICER T e or rint
15B. CONTRACTOR/OFFEROR
15C. DATE SIGNED
16C. DATE SIGNED
(Signature of person authorized to sign)
fficer)
MAY 1 9 2006
NSN 7540-01-152-8070
Previous edition unusable
STANDARD FORM 30 (Rev. 10-83)
Prescribed by GSA FAR (48 CFR) 53.243
DUPLICATE ORIG\NAL
........ '
',,'..,.,:1'...'.'.....
'. ,""~-':_.,.',
'-':..,". .,:~ ,:'," ~~:._~...~,.: ',.~ ~:." ';.
."~ ,.,..:.'...::....,.
, INSTRUCTIONS
.'; - ,":. ,,;.... ,':' ",~ :. ., :,
.........,..:
..,~..; 'b";'.
',....... '.- d .
IhstnJctiohs for iterhs,other than those thafa:re self-explahatorY;are'as follows:
. (EO Item 1 (Contract 10 Code). Insert the confr~dtype'
identification code that appears in the title block of
the contract bei~Q rl1odifi~d.
. .,~ ,. .', '" .' :" ,;.. .': ~. .
" (2) Accounting classification
, '" '. . Net 'decrease $
(b))tem 3 (Effectiv~ date)..
. .' , . , ~; ,~-., ,L '. -~ .
..... ;' NOTE:. .....If Jh,~~laa~e.~<?hqnge$~:t<?,>'fTIql~iple,accounting
;. ;" C/,3ssificatioristhat cahnOt 'beplace'd iI;' block 12, insert
" , ..' . an (3steriskaqcf)hewords/.',$ee continuation sheet",
.... '-, ~;,
.. (1) fpra,.~ql!c:itCl,t!o,n. ;?men,9meot" ,c:hange order, or
. ,...c:idrnirii9tratiVE! cD?Dge, J~e.yff~ct!ye,d,CltE!.sh,all.b,e (','
th~ j??~~ dat~.qf;th'E:larl\ej:1dm;~Jlt,J~h~~ige6.rger,
. . ,qrCiprlllnlstratlve.,.ch,a[)ge.,:;,:,,r; i' /:;),",>; ,,;:, ". """
;'(2)iFot a ~u;ppietn~rit~'(r;adr~~~~Wt,;the;;'eff~cti~e
date Shall be the date agreed to by the
'; ,:<contractingparties;"" ;:;,;;i;;:::\~:,,: .;' ,..';.' . , .;., ".;;
(9) Item 13. Check the appropriate box to indicate the
..type pf "rn9,djfiGatiQp. .:In$~.rt ,in t!1ecorresponding
...~l.an.kthE! ;3uth<?rJtyunder.which the modification is
;', . ': issue,d. Check whether or not,cof:ltractor must sign
.' '. .~~h!l5,docurn~nt. .,($~eFA.R 4,3) 03.),
. '..-'-'" '- "!' .,': -,' \, ",('.'.;, ..! '",'" -, .
(~) Item 14 (l?~s(;ription.off\ll1en.9ment/Modification) .
~ ' . -., ':'. .~ . . ;,', .. - ~' . '.. - , .
.p. .' ,., .
';~"(:'.~,'.. ':.~.',"'.' ':--;'. ,:' .\;?~:!:~;-',:: ,,:" .~ :,' '.;~~> .',.;,~
..,(3) For a modification issued .as qan,initial,.or
confirming notice of termination for the
convenience of the . Government,Jhe.effective . .
date and' the modification '!; number.," of: the"'. "!C! ,-, ..'
'. con~.rming' ,notic~/sh,all.:~be__.:r.the ~'s~me;.;as.;ith~_.;.'; !'~-'?"~:' .~,'
effective. date.aridmodification number' offhe'
in'lt'la',1 n.<.;'o'.:t...I..c.'e........,.. ..,-' '. '';'' ".':' ., :"""'';<''''h..:. :.'." . ......
';; ,:( -;,;.- " ',;:!: ,- ',' \'" . ~.: .' -.; " ' . ,;:, , ,. ~'; :
(1) ()rg~rlite' ameiidrH~hts"'b?mddifications under
the' appropriate . UniforrilContraCt 'F6fni'at '(UCF)
section headings from the applicable solicitation
or ,contract. The UCFtable" bfcontehts,
<,however, shall not be set forth in this document
(4) For.a modification converting a termination for
default ,. to. . a termination for the
convenienceof::the.; ":.Government ','I e/the. ',.' .
effeCtive' date shall t6e'~thEf j's'ame:.:.as<'the::.~\~,~:;:
'" . effective date ofthetermiri'atiori'lordefaUIt..;L' ;';>')!,::\:'\
;, .:. ''''' ~," I:', ~l_ ,;'.:.". ,. ...... :. ~..',. I : ~. ~:,,,~"."~. " .r..... .~: ..: ',...' ~ .:;~" .'. r~.-' 1 ~'.~. ". '.1~' .: '-'~..'C '.~'i.~' :...... "f,!'....:..!,... _.., ,-,'. :,. .:. _,..,.... '_'" :: ',lJ'," r) ,!'.' ~ '. -.' . ~'..: .,"" ..'.. ". ~ ~,,';.
.(2) .Ihdicate..the:JmpactofJbg,moclification on the
,. . ,.. overaIi totai . tOntracCpricEf bY-inserting one of
the following entries:
.\1"
; '(i)Jotal;cqi:itraGtj)ricelncreased:b~Y:'$':':/ ..
. '.' ';,; '., ;::-..\:',:._,: ,: :1.'-, ~,\ ,::::, I:. :\ '.:'
.;..,.~. ;.. .,' ': ..":;.'~ ,; :_ 'J \;':\". ,:, ...~-' I,; ':;;./: ;'>:'. ; ,', ;', '~f
"""(ii) ''Total' conlrad piice' decreased'by$""""""'" ..
.(5)",f"Q["a..modification :confirming,;the contacting
'. "officer'sdetermination"'oftneamount due' 'in'"
..i", settlement ':of'.'cii'.coritract'::Jehnination,';'Jhe .' '.
:.',-.. .,":__.._....',..v""'!;.o"... ,',-.,... ,"'.',..' ':~.....,..,: ....._~_d;,;,'."'~'_""":"""'" :."'" "..~_..'
. ' "', effeCtive. date.shall:ib~:, the. ',.;sameJ "asnthe..' :.'
:,".~,'. ,',.~ffect!ve'dc,J~e. of t~.e)niJial q~c.ision.<: """ i~!"
;:Ji'l
(iii)Total contract price unchanged:" ..
':;L':.
"".'_' ,_' .,' ........ . ','!' .,::::(tl':::.t.~:.';~;::)';_~'.~' ,-_._r.,::I'.
':.';,"
(3) State reasQrn{)r mt;)dificcitiqrf:,
. . " . ,. '. ,; \; . .:: - I,.. '~ , 1,.' ..,; " . '. ".... ':: \'.. ~-~.; - ,
"( . : ..-",_f"/; ~', :....<~~".'..'-.;. ~:'_\;-..
(~rrtern 6 <issJ~d''j3Y). f~~~irth~ name'''a~'d''~ddres~' .'. ..' :. (4):W~~~ 'T~mbVirig;:Niri'st~Jj,ll,g,; pr"adding fun~s,
, of the. issuing office. . If applicable, insert the ... IdentIfy, the G(?n.!ract Ite.~,? and accounting
;", ;,1-." ~pprQPr.iClt.e.,i$s lJi n g _officecodeJri;tI\~\C??~.:/?'".'.'.;~Ock;X.;:<;,....;,;..';,:.';~,','. ......;::,'....;.,:2!.~~,~i.TI9~,tL<:>9.~.;::i.!;>',~. '.."'" .,.".;.,; ~." ::,c"""';"'"'" ,'-.c,,, ..;........"..,
., i <. ..~: , - '.' .'. 'l ;'_ .~~. <~ ',; .'..
(d) Item 'S(Nameand Address o1Hcohtractor). For (5) When the SF ':'30' "'is;.i'used to reflect a
modifications to a contract or order, enter the determ,ination by th.? c:ontr~cting officer of the
contractor's name, address, and code as shown in amounf:dUe'in.settlement '''oLa' contract
the original contract or order, unless changed by te'rminated f6rc":(;;tH~')6bn\/~h1e:hce of the
this ora previous modification. Government, Jpe'. .~otry. in)t~n;I .14 .of the
modification niay belimitl~d t(f~::-"N . '. ",," .'
(i) A reference to the letter determination; and
(e): Item 9, (Amendment of Solicitation No. - Dated),
and. 10. ((Modification of Contract/Order No. -
;" Dated).- Check thE,'lappropriate box and in the
" corresponding blanks insert the number and date
of the original solicitation, contract, or order.
\.':";~;r;, r": '.:
.'i. -': .~.-;, .:,
': 1'::( ~_ ,,> :~~...1V, ':~i\'i~- ;;., i..; -:~..
(ii) A statement of the net amount determined
to be due in settl~melJt of the,.contract.
+~,.~~ 1\.-/:" '. ," l"", ..,:'~i?.~-; .(,:
(f) Item 12 (Accountinq and Appropriation Data). When
appropriate, indicate the impact of the modification
ion <:<each :affected. accounting classification by
insertingoneiof the following entries.
(6) Include subject matter or short title of
solicitation/contract where feasible.
(i) Item 168. The contracting officer's signature is not
required on solicitation amendments. The
: contracting officer's .signature is normally affixed 'last
on supplemental agreements. . H ....... .
. STANDARD FORM 30 (REV, 10-83) BACK
. .
':. ~"./','): . Y.... . .:. ~ ;. \ "I '::'
., (1) Accoun,ting classification
Net increase . $
. .'~ :; '\ ;': .r~.:, ::.',
,....: '.,
('f,:' .>:." ':.~. .
:;_".i;.'.",""'.:-.".;.-._-:.. '.'.
, . .,.
'i
, ',,. ;....- -Ci' . ; .,~.~. . fr
\.t
'. ..'- ., ....:'!.,:.,,~, ,'. '-.. ',.".'
+--------------------------------------------------------------------------+
=FEnter
=FPress
'=Vendor Name
+Subject
=FDepartment
"Status Code
ENGINEERING FIELD ACTIVITY NW
NAD MARINE PARK
PARKS
LAN
(US NAVY)
=F
=F
=F
=F
=F
A
Search Criteria, Press Esc Key to Transmit
Del Key to Terminate Delete Mode
CHANGE Contract Transactions
Contract Number 3927
-(
=F
=F
=F
=F
Insurance
Type Amount
Amount
Begin Date
End Date
Review Date
$100.00 y
06/01/1998 =F
05/31/2006
05/01/2006
- -
$0.00 1=
-.-
~ Comments N44225598RPOOG11
~ MAY BE RENEWED IN 1 YR TERMS THRU 5/31/08 +
+--------------------------------------------------------------------------+
Insurance Total
Insurance Review Date
NOTICE OF RENEWAL OF GOVERNMENT LEASE
1. FROM:
Commanding Officer (Code 05LR)
Engineering Field Activity, Northwest
19917 7th Avenue NE
Poulsbo, WA 98370-7570
3. TO:
2.
CONTRACT NO.
N4425598RPOOG 11
City of Bremerton
2394th Street
Bremerton, WA 98337-1812
4.
You are hereby notified that under the provisions of the Government lease described below, the United
States of America elects to renew the said lease as the same may have been amended, and does hereby
renew, extend, and adopt the said lease and all the terms, conditions, and general provisions thereof for the
period beginning 1 June 2005 and ending 31 May 2006.
5. REQUIRING ACTIVITY:
Commanding Officer, Engineering Field Activity, Northwest, Naval Facilities Engineering Command, 19917 7th Avenue NE, Pou1sbo,
WA 98370-7570
6. DESCRIPTION OF LEASE:
Navy Lease N4425598RPOOG 11 provides for the installation, operation, and maintenance of two
monitoring wells, one each on two plots of land, one on the north end and one on the south end of Naval
Ammunition Depot Marine Park, Bremerton, Washington
Copy to:
ENGFLDACf NW Muniments (Original)
ENGFLDACf NW Lease File
DFAS San Diego (AIBAB-EFD)
SWDN (Code 05BP)
ENGFLDACT NW (05ERCO)
ENGFLDACT NW (0330Mf)
SOUTHWESTDIV (Code FM22C)
7. NAME, POSITION, AND TITLE
SIGNATURE ILL 0
B~!~~,
Naval Facilities Engineering Command
Acting under direction of the
Secretary of the Navy
DATE
MICHAEL D. BRADY
Director, Real Estate
Real Estate Contracting Officer
APR 2 1 2005
8. NAVY ACCOUNTING DATA:
PAYMENT TO BE MADE BY:
Defense Finance and Accounting Service, Oakland via DFAS (Code AIBAB-EFD), P.O.
Box 429100, San Diego, CA 92142
AMOUNT
$100.00
A B. APPROPRIA- C. SUB- D. OBI. E. BU-
ACRN nON HEAD CLASS CONTROL
K.
AMOUNT
AH 1705051804 KU2E 0252 68711 P 068732 2D AHOOP5 AH8RP00G1IER
$100.00
Per Annum
DUPUCATE ORIGINAL
+Enter Search Criteria, Press Esc Key to Transmit
Press Del Key to Terminate Delete Mode
CHANGE Contract Transactions
Contract Number 3927
+
~Vendor Name ENGINEERING FIELD ACTIVITY NW (US NAVY)
~Subject NAD MARINE PARK
Department PARKS
Status Code LAN
Amount $100.00
Begin Date 06/01/1998
Insurance End Date 05/31/2005
Type Amount Review Date 04/01/2005
+
+
+
Insurance Total $0.00
Insurance Review Date
+
Comments N44225598RP00Gll
MAY BE RENEWED IN 1 YR TERMS THRU 5/31/08
+
NOTICE OF RENEWAL OF GOVERNMENT LEASE
1. FROM: 2. CONTRACT NO.
Commanding Officer (Code 05LR) N4425598RP00G l I
Engineering Field Activity, Northwest
19917 7th Avenue NE
Poulsbo, WA 98370-7570
3. TO:
City of Bremerton
239 Fourth Street
Bremerton, WA 98337-1812
4. You are hereby notified that under the provisions of the Government lease described below, the United States of
America elects to renew the said lease as the same may have been amended, and does hereby renew, extend, and
adopt the said lease and all the terms, conditions, and general provisions thereof for the period beginning 1 June 2004
and ending 31 May 2005.
5. REQUIRING ACTIVITY: Commanding Officer, Engineering Field Activity, Northwest, Naval Facilities
Engineering Command, 19917 7th Avenue NE, Poulsbo, WA 98370-7570.
6. DESCRIPTION OF LEASE:
Navy Lease N4425598RP00GI 1 provides for the installation, operation, and maintenance of two monitoring
wells, one each on two plots of land, one on the north end and one on the south end of Naval Ammunition Depot
Marine Park, Bremerton, Washington.
ENGFLDAcTC°py to:NW (Muniments) DFAS San Diego (AIBAB-EFD) ENGFLDACT NW (05ER.CO)
ENGFLDACT NW (Lease File) SOUTHWESTDIV (05BP) [ ENGFLDACT ~ (0330MT)
ENGFLDACT ~ (Contract Admin File) I SOUTHWESTDIV (01CA.JR)
7. NAME, POSITION, AND TITLE S.I_G~NAT~UREa ,~, _Q,~) DATE
MICHAEL D. BRADY
Director, Reai Estate By direction of the Commander,
Real Estate Contracting Officer Naval Facilities Engineering Command
Actingunderdirectionofthe APR 1 6 ~
Secretary of the Navy
8. NAVY ACCOUNTING DATA:
PAYMENT TO BE MADE BY: AMOUNT
Defense Finance and Accounting Service, Oakland via DFAS (Code AIBAB-EFD), P.O. $I00.00
Box 429100, San Diego, CA 92142.
ACCOUNTING CLASSIFICAIiON 10 BE CHARGED (DISBURSEMENT)
G B APPROPPdA C SUB- D OBJ E BI.J- F G H I J K.
ACRN TION HEAD CLASS CONTROL SA AAA ~f PAA COST CODE AMOUNr
1704041804 KU2E 0252 68711 P 068732 2D AG00P5 AG8RP00GI IER $100.00
Per Annum
DUPLICATE ORIGI 'tAL
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT t I 2
2. AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ. NO. 5. PROJECT NO. (If applicable)
Four (4) 1' June 2003 xx
6. ISSUED BY CODE 05LR 7. ADMINISTERED BY (If other than Item 6) CODE I
Commanding Officer
Engineering Field Activity Northwest
19917 7th Avenue NE
Poulsbo, WA 98370-7570
8. NAME AND ADDRESS OF CONTRACTOR (No,, street, county, State and Zip Cede) X~ 9A. AMENDMENT OF SOLICITATION NO.
City of Bremerton
C/O Parks and Recreation Depadment I' J 98. DATED (SEE ITEM 11)
680 Lebo Boulevard
Bremerton, WA 98310
J 10A. MODIFICATION OF CONTRACT/ORDER NO,
N4425598RP00G 11
J I~'; I 108. DATED (SEE ITEM 11)
I las of I June 1998
CODE I FACILITY CODE '
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
[~The above numbered solicitation is amended as set for[h 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) Ey
separate letter or taiegram which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGEMENT TO 88 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 your desire to change an offer already subm~ed, 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)
AF 17 03031804 KU2E 0252 68711 P 068732 2D AF00P5 AF8RP00G11ER $100.00
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 THEA~~~ENUMBEREDC~NTRACT~~RDER~SM~D~F~EDT~REFLE~TTHEADM~N~STRAT~VEcHANGES(suchaschangesinpaying~~ce~
appropriation date, etc. ) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR.t03(b).
] C THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
] D. OTHER (Specify type of modification and authority)
E. IMPORTANT: Contractor [] is not, [] is required to sign this document and return 4 copies to the issuing office.
14. DESCRIPTION OF AMENDMENT/MODIFICATION (O~ganized by UCF section beadings, including solicitation/contract subject matter whare feasible.)
AMENDS PARAGRAPH 5 OF THE LEASE TO READ AS FOLLOWS:
SEE ATTACHED CONTINUATION SHEET
15A. NAME AND TITLE OF SIGNER (Type or print) 16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or pdnt)
C_..O~'~.~ ~O'~.~_.lnf.~Lt~ MICHAEL D. BRADY
~OJ~O ~ REAL ESTATE CONTRACTING OFFICER
158. C NT TOP/OFFEROR ~ ~ 15C. DATESIGNED ~T~_~ 16C. DATESIGNED
(Sign§ture of ~ authorized to sign) "O ~,~ - (Sig-nafu re of Contractin~Offi~)r) 03
NSN 7540-01-152~070 STANDARD FORM 30 (Rev. 10~3)
Previous edition unusable DUPLICATE ORIGINAL Pres~had by GSA FAR (48 CFR) 53,243
Page 2 of 2
Modification 4
N4425598RP00Gll
Payment Schedule
Navy Lease N4425598RP00G11
With City of Bremerton
This lease may be renewed, at the option of the Government, for the following terms at the following
rentals
Period Covered Due Amount
I Jun 03-31 May 04 I Jun 04 $100.00
I Jun 04-31 May 05 1 Jun 05 $ I00.00
1 Jun 05-31 May 06 1 Jun 06 $ 100.00
1 Jun 06-31 May 07 1 Jun 07 $100.00
I Jun 07-31 May 08 I Jun 08 $100.00
Provided notice be given in writing to the Lessor at least 30 days before the end of the original term or any
renewal term; all other terms and conditions of this lease shall remain the same during any renewal term.
Said notice shall be computed commencing with the date of mailing.
This lease is hereby renewed for the period 1 June 2003 through 31 May 2004
+Browse: Next Previous First Last Update Delete Restart X - Exit +
+Retrieve the Next record +
+Found: 5 Record(s) MAINTAIN Contract Transactions +
+ Contract Number 3927 +
+ +
+Vendor Name ENGINEERING FIELD ACTIVITY NW (US NAVY) +
+Subject NAD MARINE PARK +
+Department P~KS +
+Status Code LAN +
+ Amount $100.00 +
+ Begin Date 06/01/1998 +
+ Insurance End Date 05/31/2003 +
+ Type Amount Review Date 04/01/2003 +
+ +
+ +
+ +
+ Insurance Total $0.00 +
+ Insurance Review Date +
+ +
+ Comments N44225598RP00Gll +
+ +
+ +
NOTICE OF RENEWAL OF GOVERNMENT LEASE '~' ~ "~,~,~a~
I. FROM: I 2. CONTRACT NO.
Commanding Officer (Code 05LR) N4425598RP00G11
Engineering Field Activity, Northwest
19917 7th Avenue NE
Poulsbo, WA 98370-7570
3. TO:
City of Bremerton
c/o Parks and Recreation Department
680 Lebo Boulevard
Bremerton, WA 98310-3308
4. You are hereby notified that under the provisions of the Government lease described below, the United States of
America elects to renew the said lease as the same may have been amended, and does hereby renew, extend, and
adopt the said lease and all the terms, conditions, and general provisions thereof for the period beginning 1 June 2002
and ending 31 May 2003.
5. REQUIRING ACTIVITY: Commanding Officer, Engineering Field Activity, Northwest, Naval Facilities
Engineering Command, 19917 7th Avenue NE, Poulsbo, WA 98370-7570.
6. DESCRIPTION OF LEASE:
Navy Lease N4425598RP00G11 provides for the installation, operation, and maintenance of two monitoring
wells, one each on two plots of land, one on the north end and one on the south end of Naval Ammunition Depot
Marine Park, Bremerton, Washington.
Copy to:
ENGFLDACT NW (Muniments) DFAS Oakland ENGFLDACT NW (05ER.KH)
ENGFLDACT NW (Lease File) DFAS San Diego (AIBAB-EFD) ENGFLDACT NW (0330MT)
ENGFLDACT NW (Contract Admin File) SOUTHWESTDIV (05BP) SOUTHWESTDIV l01CA.JR)
7. NAME, POSITION, AND TITLE SIGNATURE DATE
MICHAEL D. BRADY ~/~
Director, Real Estate By direction of the Commander,
Real Estate Contracting Officer Naval Facilities Engineering Command ~ 2 0 ~
Acting under direction of the
Secretar~ of the Navy
8. NAVY ACCOUNTING DATA:
PAYMENT TO BE MADE BY: AMOUNT
Defense Finance and Accounting Service, Oakland via DFAS (Code AIBAB-EFD), P.O. $100.00
Box 429100, San Diego, CA 92142.
ACCOUNTING CLASSIFICATION TO BE CHARGED (DISBURSEMENT)
E B APPROPRIA- C SUB- D OBJ. E BU- F G. H. I J. K
ACRN TION HEAD CLASS CONTROL SA AAA TT PAA COST CODE AMOUNT
1702021B04 KU2E 0252 68711 P 068732 2D AE00P5 AESRPOOGI IER $100 00
Per Atmum
DUPLICATE ORIGINAL
1. CONTRACTIDCODE PAGE OF PAGES
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1
2. AMENDMENT/MODIFICATION NO* 13. EFFECTIVE DATE 4. REQUISITION/PURCHASE REQ* NO* 5. PR(~JECT NO. (~fapplicable)
Three (3) I 1 Dec 00
6. ISSUED BY CODE 0 5LR 7. ADMINISTERED BY (lfother than Item 6) CODE
Commanding Officer
Engineering Field Activity, Northwest
Naval Facilities Engineering Command
19917 7th Avenue NE
Poulsbo, WA 98370-7570
S. NAME AND ADDRESS OF CONTRACTOR (No., street, co~, State atk4 ZIP Cede) ~ 9A. AMENDMENT OF SOLICITATION NO.
II
City of Bremerton
c/o Parks and Recreation Department I 199'DATED (SEEITEM
680 Lebo Boulevard
I I
Bremerton, WA 98310-3308 I II°A' ~DIFICATION. OF CONTRACT/ORDER
Ixl
N4425598RP00Gll
I J l0B. DATED (SEE ITEM 13)
CODE IF^ClLITYCODE AS of 1 Jun 98
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
U The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers ~J is extended, ~-~ is not ex-
tended.
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 emendment; ~o) 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 ACKNOWLEDGE-
MENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECE PT OF OFFERS PR OR TO THE HOUR AND DATE SPECIFIED MAY RESULT
IN REJECTION OF YOUR OP~:I=H. 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 {~' req~r~)
13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACT§/ORDERS,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
(~ THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify avlho~ty) THE CHANGES SET FORTH IN ITEM f4 ARE MADE ~N THE CON-
TRACT ORDER NO. IN ITEM f0A.
THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES (such as changes in paying office,
X approprfoJio~ Egte, ~tc.) SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.t03(b).
THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER (Specify type of modification and autho~ty)
E. IMPORTANT: Contractor [] is not, [] is required to sign this document and return copies to the issuing office.
Modification Three (3) is issued to include DUNS Number 556846970 and
CAGE Code 04DN7 and to change the address of the Payee as follows:
City of Bremerton City of Bremerton
c/o Parks and Recreation Department 239 Fourth Street
680 Lebo Boulevard Bremerton, WA 98337
Bremerton, WA 98310-3308
Except as provided he~ein, all terms and com~flons 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 orprf~t) J6A. NAME AND TITLE OF CONTRACTING OFFICER (~,pe
MICHAEL D. BPJ%DY
Real Estate Contr.actin~ Officer
168. UNITED STAT OF AMERIC ' F6C. DATE SIGNED
15B. CONTRACTOR/OFFEROR fSC. DATE SIGNED BY ~'~_.z~. - ~
0
5
2000
(Signature oSperson authorized to sign) (Sig;,ature of Contnzcting O~cer)
NSN 7540-01-152-B070 30-105-02 STANDARD FORM 30 (Rev. 10-83)
FAR (48 ~F~) 53.243
PREVIOUS EDITION UNUSABLE DUPLICATE ORIGINAL .
INSTRUCTIONS
Instructions for items other than those that are self-explanatory, are as follows:
(a) Item 1 (Contract ID Code). Insert the contract type (2) Accounting classification .............................
identification code that appears in the title block of Net decrease $ ............................
the contract being modified.
NOTE: If there are changes to multiple accounting
(b) Item 3 (Effective date), classifications that cannot be placed in block 12,
insert an asterisk and the words "See continuation
(1) For a solicitation amendment, change order, or sheet".
administrative change, the effective date shall be
the issue date of the amendment, change order, or (g) Item 13. Check the appropriate box to indicate the
administrative change, type of modification. Insert in the corresponding
blank the authority under which the modification is
(2) For a supplemental agreement, the effective date issued. Check whether or not contractor must sign
shall be the date agreed to by the contracting this document. (See FAR 43.103.)
parties.
(h) Item 14 (Description of Amendment/Modification/.
(3) For a modification issued as an initial or confirm-
ing notice of termination for the convenience of (1) Organize amendments or modifications under the
the Government, the effective date and the modi- appropriate Uniform Contract Format (UCF) .
fication number of the confirming notice shall be section headings from the applicable solicitation
the same as the effective date and modification or contract. The UCF table of contents, however,
number of the initial notice, shall not be set forth in this document.
(4) For a modification converting a termination for (2) Indicate the impact of the modification on the
default to a termination for the convenience of overall total contract price by inserting one of the
the Government, the effective date shall be the following entries:
same as the effective date of the termination for
default. (i) Total contract price increased by $ ...........
(5) For a modification confirming the contracting (ii)Total contract price decreased by $ ...........
officer's determination of the amount due in
settlement of a contract termination, the effec- (iii) Total contract price unchanged.
tive date shall be the same as the effective date
of the initial decision. (3) State reason for modification.
(c) Item 6 (Issued By). Insert the name and address of (4) When removing, reinstating, or adding funds,
the issuing office. If applicable, insert the appropriate identify the contract items and accounting classi-
issuing office code in the code block, fications.
(d) Item 8 (Name and Address of Contractor). For modi- (5) When the SF30 is used to reflect a determination
fications to a contract or order, enter the contractor's by the contracting officer of the amount due in
name, address, and code as shown in the original con- settlement of a contract terminated for the con-
tract or order, unless changed by this or a previous venience of the Government, the entry in Item 14
modification, of the modification may be limited to --
(e) Items 9, (Amendment of Solicitation No. -- Dated), (i) A reference to the letter determination; and
and 10, (Modification of Contract/Order No.--
Da. ted). Check the appropriate box and in the corres- (ii) A statement of the net amount determined
ponding blanks insert the number and date of the to be due in settlement of the contract.
original solicitation, contract, or order.
(6) Include subject matter or short-title of solicita-
(f) Item 12 (Accounting and Appropriation Data). When tion/contract where feasible.
appropriate, indicate the impact of the modification
on each affected accounting classification by inserting (i) Item 16B. The contracting officer's signature is not
one of the following entries: required on solicitation amendments. The contracting
officer's signature is normally affixed last on supple-
(1) Accounting classification .............................. mental agreements.
Net increase $ .............................
STANDARD FORM 30 BACK (Rev. 10-83)
~ 1988 - 242-450/90156
.AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT f. CONTRACTID CODE PAGE OF PAGES
2. AMENDMENT/MODIFICATIONone (1) NO. 3. EFFECTIVE1 Feb 2000DATE 4. REQUISITION/PURCHASE RED. NO. 5. PROJECT NO. (If applicable)
6. ISSUED BY CODE 05LP. 7. ADMINISTERED BY (lfother than Item 6) CODE I
Commanding Officer
Engineering Field Activity, Northwest
Naval Facilities Engineering Command
19917 7th Avenue NE
Poulsbo, WA 98370-7570
8. NAME AND ADDRESS OF CONTRACTOR (No., ~reer, co~,;ty, Stut¢ a~ Z~P CoRe) i~_~ 9A. AMENDMENT OF SOLICITATION NO.
City of Bremerton
c/o Parks and Recreation Department 9B. DATED($EEIFEM
680 Lebo Avenue
Bremerton, WA 98310-3308 10A. MODIFICATION OF CONTRACT/ORDER
NO.
N4425598RP00Gll
CODE I FACILITY CODE AS of 1 Jun 98
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
~] The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers L--J is extended, [] is not ex-
tended.
Offers must acknowledge receipt of this amendment prier to the hour and date specified in the solicitation or as amended, by one of the following methods:
(a) By completing Items 8 and 15, and returning copies of the amendment; fo By acknowledging receipt of this amendment on each copy of the o far
submitted; or (c) By separate letter or telegram which includes a reterence to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGE-
MENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY RESULT
IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to ~hange an offer alreacly submitted, such change may be made by telegram or
letter, provided each telegram or letter makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.
12 ACCOUNTING AND APPROPRIATION DATA (~frequir~)
13. THIS ITEM APPLIES ONLY TO MODIFIC~,TIONS OF CONTRACTS/ORDERS.
IT MODIFIES THE CONTRACT/ORDER N'O, AS DESCRtBED IN ITEM 14.
(%.~ A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (specify au3horJty) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CON-
TRACT ORDER NO. IN ITEM t0A.
X Public Law 104-134
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES fsuch c.~ chan$e$ in Raying o3~ce,
appropriation dare, 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:
O. OTHER (Specify type of nu~lJficution and authority)
E. IMPORTANT: Contractor I ~ /snot. ~ isrequiredtosignthisd~umentandreturn 3 copiestot~issuingoffice.
Navy Lease Contract N4425598RP00Gll is hereby amended to add the following
clauses, which are attached hereto and made a part hereof:
a. F~_R 52.232-33 - Payment by Electronic Funds Transfer - Central
Contractor Registration (May 1999)
b. DF~ 252.204-7004 - Required Central Contractor Registration (March
1998)
Except as provided herein, all terms and conditions of the document ~elerenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force
and elfect
15A. NAME AND TITLE OF SIGNER (Type orprinO 16A. NAME AND TITLE OF CONTRACTING OFFICER (?~'pe orpriat)
L~ S. ~ MICH3%EL D. BRADY
~yor Real Estate Contracting Officer
15B. CO ACTOR/OFFERORs_.// ._~.._. 15C. DATE SIGNED 16B. UNITED STATES OF AMERICA 16C. DATE SIGNED
- ~' (Signature of person authorized to sign) (S gnature of Conlracting Offltce~) ' ''~
.s. ?B,o-o~-,S2-BO,O s°-I) PLICATE ORIGINAL STANDARD FORM 30 (Rev. 10-83)
PREVIOUS EDITION UNUSABLE Prescribe b GSA
FAR (48 ~F~) 53.243
INSTRUCTIONS
Instructions for items other than those that are self-explanatory, are as follows:
(a) Item 1 (Contract ID Code). Insert the contract type (2) Accounting classification
identification code that appears in the title block of Net decrease $ ............................
the contract being modified.
NOTE: If there are changes to multiple accounting
(b) Item 3 (Effective date/, classifications that cannot be placed in block 12,
insert an asterisk and the words "See continuation
(1) For a solicitation amendment, change order, or sheet".
administrative change, the effective date shall be
the issue date of the amendment, change order, or (g) Item 13. Check the appropriate box to indicate the
administrative change, type of modification. Insert in the corresponding
blank the authority under which the modification is
(2) For a supplemental agreement, the effective date issued. Check whether or not contractor must sign
shall be the date agreed to by the contracting this document. (See FAR 43.103.)
parties.
(h) Item 14 (Description of Amendment/Modification).
(3) For a modification issued as an initial or confirm-
ing notice of termination for the convenience of (1) Organize amendments or modifications under the
the Government, the effective date and the modi- appropriate Uniform Contract Format (UCF)
fication number of the confirming notice shall be section headings from the applicable solicitation
the same as the effective date and modification or contract. The UCF table of contents, however,
number of the initial notice, shall not be set forth in this document.
(4) For a modification converting a termination for (2) Indicate the impact of the modification on the
default to a termination for the convenience of overall total contract price by inserting one of the
the Government, the effective date shall be the following entries:
same as the effective date of the termination for
default. ~ (i) Total contract price increased by $ ...........
(5) For a modification confirming the contracting (ii)Total contract price decreased by $ ...........
officer's determination of the amount due in
settlement of a contract termination, the effec- (iii) Total contract price unchanged.
tive date shall be the same as the effective date
of the initial decision. (3) State reason for modification.
(c) Item 6 (Issued By). Insert the name and address of (4) When removing, reinstating, or adding funds,
the issuing office. If applicable, insert the appropriate identify the contract items and accounting classi-
issuing office code in the code block, fications.
(d) Item 8 (Name and Address of Contractor). For modi- (5) When the SF30 is used to reflect a determination
fications to a contract or order, enter the contractor's by the contracting officer of the amount due in
name, address, and code as shown in the original con- settlement of a contract terminated for the con-
tract or order, unless changed by this or a previous venience of the Government, the entry in Item 14
modification, of the modification may be limited to --
(e) Items 9, (Amendment of Solicitation No. -- Dated), (i) A reference to the letter determination; and
and 10, (Modification of Contract/Order No.--
Dated). Check the appropriate box and in the corres- (ii) A statement of the net amount determined
ponding blanks insert the number and date of the to be due in settlement of the contract.
original solicitation, contract, or order.
(6) Include subject matter or short title of solicita-
(f) Item 12 (Accounting and Appropriation Data). When tion/contract where feasible.
appropriate, indicate the impact of the modification
on each affected accounting classification by inserting (i) Item 16B. The contracting officer's signature is not
one of the following entries: required on solicitation amendments. The contracting
officer's signature is normally affixed last on supple-
(1) Accounting classification .............................. mental agreements.
Net increase $ .............................
, ~ ~ ,q STANDARD FORM 30 BACK (Rev. 10-83)
· .l 1988 - 242-450/90156
FAR 52.232-33 - Payment by Electronic Funds Transfer - Central Contractor Registration (May
1999)
(a) Method of payment.
(1) All payments by the Government under this contract shall be made by electronic
funds transfer (EFT), except as provided in paragraph (a)(2) of this clause. As used in this ~
clause, the term "EFT" refers to the funds transfer and may also include the payment information
transfer.
(2) In the event the Government is unable to release one or more payments by EFT,
the Lessor agrees to either--
(i) Accept payment by check or some other mutually agreeable method of
payment; or
(ii) Request the Government to extend the payment due date until such time as the
Government can make payment by EFT (but see paragraph (d) of this clause).
(b) Lessor's EFT information. The Government shall make payment to the Lessor using
the EFT information contained in the Central Contractor Registration (CCR) database. In the
event that the EFT information changes, the Lessor ~tall be responsible for providing the
updated information to the CCR database.
(c) Mechanisms for EFT payment. The Government may make payment by EFT through
either the Automated Clearing House (ACH) network, subject to the rules of the National
Automated Clearing House Association, or the Fedwire Transfer System. The rules governing
Federal payments through the ACH are contained in 31 CFR part 210.
(d) Suspension ofpayment. If the Lessor's EFT information in the CCR database is
incorrect, then the Government need not make payment to the Lessor under this contract until
correct EFT information is entered into the CCR database; and any invoice or contract financing
request shall be deemed not to be a proper invoice for the purpose of prompt payment under this
contract. The prompt payment terms of the contract regarding notice of an improper invoice and
delays in accrual of interest penalties apply.
(e) Lessor EFT arrangements. If the Lessor has identified multiple payment receiving
points (i.e., more than one remittance address and/or EFT information set) in the CCR database,
and the Lessor has not notified the Government of the payment receiving point applicable to this
contract, the Government shall make payment to the first payment receiving point (EFT
information set or remittance address as applicable) listed in the CCR database.
(f) Liability for uncompleted or erroneous transfers.
(1) If an uncompleted or erroneous transfer occurs because the Government used the
Lessor's EFT information incorrectly, the Government remains responsible for-
(i) Making a correct payment;
(ii) Paying any prompt payment penalty due; and
(iii) Recovering any erroneously directed funds.
(2) If an uncompleted or erroneous transfer occurs because the Lessor's EFT
information was incorrect, or was revised within 30 days of Government release of the EFT
payment transaction instruction to the Federal Reserve System, and-
(i) If the funds are no longer under the control of the payment office, the
Government is deemed to have made payment and the Lessor is responsible for recovery of any
erroneously directed funds; or
(ii) If the funds remain under the control of the payment office, the Government
shall not make payment, and the provisions of paragraph (d) of this clause shall apply.
(g) EFT and prompt payment. A payment sha~ be deemed to have been made in a timely
manner in accordance with the prompt payment terms of this contract if, in the EFT payment
transaction instruction released to the Federal Reserve System, the date specified for settlement
of the payment is on or before the prompt payment due date, provided the specified payment date
is a valid date under the rules of the Federal Reserve System.
Oa) EFT and assignment of claims. If the Lessor assigns the proceeds of this contract as
provided for in the assignment of claims terms of this contract, the Lessor shall require as a
condition of any such assignment, that the assignee shall register in the CCR database and shall
be paid by EFT in accordance with the terms of this clause. In all respects, the requirements of
this clause shall apply to the assignee as if it were the Lessor. EFT information that shows the
ultimate recipient of the transfer to be other than the Lessor, in the absence of a proper
assignment of claims acceptable to the Government, is incorrect EFT information within the
meaning of paragraph (d) of this clause.
(i) Liability for change of EFT information by financial agent. The Government is not
liable for errors resulting from changes to EFT information made by the Lessor's financial agent.
(j) Payment information. The payment or disbursing office shall forward to the Lessor
available payment information that is suitable for transmission as of the date of release of the
EFT instruction to the Federal Reserve System. The Government may request the Lessor to
designate a desired format and method(s) for delivery of payment information from a list of
formats and methods the payment office is capable of executing. However, the Government does
2
not guarantee that any particular format or method of delivery is available at any particular
payment office and retains the latitude to use the format and delivery method most convenient to
the Government. If the Government makes payment by check in accordance with paragraph (a)
of this clause, the Government shall mail the payment information to the remittance address
contained in the CCR database.
DFAR 252.204-7004 - Required Central Contractor Registration (Mar 1998)
(a) Definitions. As used in this clause-
(I) "Central Contractor Registration (CCR) database" means the primary DOD repository
for contractor information required for the conduct of business with DOD.
(2) "Data Universal Number System (DUNS) number" means the 9-digit number
assigned by Dun and Bradstreet Information Services to identify unique business entities.
(3) "Data Universal Numbering System +4 (DUNS+4) number" means the DUNS
number assigned by Dun and Bmdstreet plus a 4-digit suffix that may be assigned by a parent
(controlling) business concern. This 4-digit suffix may be assigned at the discretion of the parent
business concern for such purposes as identifying subunits or affiliates of the parent business
concern.
(4) "Registered in the CCR database" means that all mandatory information, including the
DUNS number or the DUNS+4 number, if applicable, and the corresponding Commercial and
Government Entity (CAGE) code, is in the CCR database; the DUNS number and the CAGE
code have been validated; and all edits have been successfully completed.
(b)
(1) The lessor acknowledges the requirement of registration in the CCR database prior to
award, during performance, and through final payment of any contract.
(2) The lessor shall provide its DUNS or, if applicable, its DUNS+4 number, which will
be used by the Contracting Officer to verify that the lessor is registered in the CCR database.
(3) Lack of registration in the CCR database will make a lessor ineligible for award.
(4) DOD has established a goal of registering an applicant in the CCR database within 48
hours after receipt of a complete and accurate application via the Internet. However, registration
of an applicant submitting an application through a method other than the Internet may take up to
30 days. Therefore, lessors that are not registered should consider applying for registration
immediately.
(c) The Lessor is responsible for the accuracy and completeness of the data within the CCR,
and for any liability resulting from the Government's reliance on inaccurate or incomplete data.
To remain registered in the CCR database after the initial registration, the Lessor is required to
confirm on an annual basis that its information in the CCR database is accurate and complete.
(d) Lessors may obtain information on registration and annual confirmation requirements by
calling 1-888-227-2423, or via the Internet at http://ccr.edi.disa.mil.
NOTICE OF RENEWAL OF GOVERNMENT LEASE
l. FROM: 2. CONTRACT NO.
Commanding Officer (Code 0$LR.LM) N4425598RP00G l l
Engineering Field Activity, Northwest
19917 7th Avenue NE
Poulsbo, WA 9g370-7570
3. TO:
City of Bremerton
c/o Parks and Recreation Department
680 Lebo Boulevard
Bremerton, WA 98310-3308
4. You are hereby notified that under the provisions of the Government lease described below, the United States of
America elects to renew the said lease as the same may have been amended, and does hereby renew, extend, and
adopt the said lease and all the terms, conditions, and general provisions thereof for the period beginning I June
2000 and ending 31 May 2001.
5. REQUIRING ACTIVITY: Commanding Officer, Engineering Field Activity, Northwest, Naval Facilities
Engineering Command, 19917 7th Avenue NE, Poulsbo, WA 98370-7570.
6. DESCRIPTION OF LEASE:
Navy Lease N4425598RP00GI l provides for the installation, operation, and maintenance of two monitoring
wells, one each on two plots of land, one on the north end and one on the south end of Naval Ammunition Depot
Marine Park, Bremerton, Washington.
Copy to:
ENGFLDACT NW (Muniments) DFAS Dp Loc Oakland (FPV) ENGFLDACT NW (05ER)
ENGFLDACT NW (Lease File) DFAS Dp Loc San Diego ENGFLDACT NW (0330MT)
ENGFLDACT NW (Contract Admin File) (FPVBB-EFD) SOUTHWESTDIV (0131)
SOUTHWESTDIV (04MG.NG)
7. NAME, POSITION, AND TITLE SIGNATURE DATE
M IC HAEL D. BRADY ~~e~
Director, Reat Estate ' ' r,
Real Estate Contracting Officer Naval Facilities Engineering Command
Acting under direction of the
Secretary of the Navy
8. NAVY ACCOUNTING DATA:
PAYMENT TO BE MADE BY: AMOUNT
Defense Finance and Accounting Service, Operating Location Oakland (Code FPV), P.O. $100.00
Box 23870, Oakland, CA 94623-3870 (via DFAS Dp Loc San Diego (Code FPVBB-EFD)).
^cco~xa, t~ C~.^SS~C^T~ON ~0 a£ C~:~aeD ~s~t~.SE~-~rr~
C B. APPROPRIA- C. SUB- D. OBJ. E. BU- F. O. I. L K.
ACRN TION HEAD CLASS CONTROL SA AAA ~' PAX COST CODE AMOUNT
[IUPLICATE ORIGINAL
~TANOARD FORM 2*e
~-~ ',. ~'t'~ ' U.S. Government DATE I NO.
.... ~ ..... Lease for Real Property (Shor~ Form) AS OF 0t JUNE 98 N4428898RP00Glt
This LESSOR [eases to the UNITED STATES CF AMER CA, hereinafter cai[ed the GOVERNMENT, the described premises on the terms stated herein,
includin~[i the conditions attached hereto.
1. LOCATION OF LEASED PREMISES
NAD M/URINE PARK, BREMERTON, WASHINGTON
DESCRIPTION OF LEASED PREMISES
TWO PLOTS OF LAND, ONE ON THE NORTH END AND ONE ON THE SOUTH END OF THE PAR~, PLOTS MEASURE APPROXIMATELY 36
SQUARE FEET EACH AND WILL BE USED FOR THE INSTALLATION, OPERATION, AND MAINTENANCE OF ONE MONITORING WELL AT
EACH LOCATION. MONITORING WELLS WILL BE "FLUSH MOUNT" TYPE. LOCATION OF THE PLOTS ON THE ATTACHED EXHIBIT
WIILL BE DETERMINED AT SITE VISIT BE'~/VEEN NAVY CONTRACT DRILLER AND CITY OF SREMERTON OFFICIAL.
3. TERM. To have and to hold:
For the term beginning 1 JUNE 1998 through 30 MAY 1999
From year to year. thereafter; but not beyond 30 MAY 2003 this [ease
MAY BE RENEWED BY THE GOVERNMENT BY GIVING AT LEAST 30 DAYS NOTICE IN WRITING TO THE LESSOR BEFORE THE LEASE
WOULD OTHERWISE EXPIRE, SAID NOTICE TO BE COMPUTED COMMENCING WITH THE DAY AFTER THE DATE OF MAILING.
4. TERMINATION, The Govern,,.,.[ may te[,,~;..[e this lease at any time by giving at least 30 days notice
to the Lessor. Said notice shall be computed commencJnl~ with the da~' after the date of mailing).
5. RENTAL. The Government shall pay the Lessor annual rent of $100.00 at the rate of $100.00
CITY OF BREMERTON
c/o PARKS AND RECREATION DEPARTMENT
680 LEBO BLVD
BREMERTON, WA 98310-3308
S. SERVICES AND UTILITIES (Enter ~X' in box for each item to be provided by Lessor as part of lease)
[] (1) HEAT i"J (5) CHILLED DRINKJNG WATER [] (10) JANITOR SERVICE AND SlJppLiES
7. SPECIAL OR OTHER PROVISION(S) AGREED UPON
GENERAL CLAUSES (GSA FORM 3517A) and REPRESENTATIONS AND CERTIFICATIONS (GSA FORM 3518A) ARE ATTACHED HERETO AND
MADE A PART HEREOF.
NAME AND ADDRESS OF USING ACTIVITY PAYING OFFICE
ENGINEERING FIELD ACTIVITY, NORTHWEST DFAS DP LOC OAKLAND (Code FPV)
19917 7TM AVE NUE N.E, P.O.BOX23870 OAKLAND, CA 94623-3870
POULSEO WA 98370-7570 via: DFAS DP LOC SANDIEGO (Code FPVBE-EFD)
P.O. BOX 429100
LESSOR SAN DIEGO CA 92142-9100
CITY OF BREMERTON
c/o PARKS AND RECREATION DEPARTMENT
680 LEBO AVE
BREMERT"G~' '~A 68310'3308 ~.~___~ ~ ~ ~
UNITED eJ'FATES OF AMERICA
, KObe, Z/1~ UllrZCl/
/~ .. Director, Real Estate Division
BY
Real P,~tate Contracting Officer
1798~81804 ~U2E I 0232 442~5 p 068711 8RPGI1 AA. SRPOIIC031 $100.00
DUPLICATE ORIGINAL
GENERAL CLAUSES (Simplified Leases)
(Acquisition of Leasehold Interests in Real Property for Leases Up to $100,000 Annual Rent)
The Government reserves the right, at any time after the lease is signed and during the term of the
lease, to inspect the leased premises and all other areas of the building to which access is necessary
to ensure a safe and healthy work environment for the Government tenants and the Lessor's
performance under this lease.
2. If the building is partially or totally destroyed or damaged by fire or other casualty so that the leased
space is untenantable as determined by the Government, the Government may terminate the lease
upon 15 calendar days written notice to the Lessor and no further rental will be due.
3. The Lessor shall maintain the demised premises, including the building, building systems, and all
equipment, fixtures, and appurtenances furnished by the Lessor under this lease, in good repair and
tenantable condition. Upon request of the Contracting Officer, the Lessor shall provide written
documentation that building systems have been maintained, tested, and are operational.
4. In the event the Lessor fails to perform any service, to provide any item, or meet any requirement of
this lease, the Government may perform the service, provide the item, or meet the requirement, either
directly or through a contract. The Government may deduct any costs incurred for the service or item,
including administrative costs, from the rental payments.
5. 52.252-2 CLAUSES INCORPORATED BY REFERENCE (VARIATION) (JUN 1988)
This contract incorporates one or more clauses by reference, with the same force and effect as if they
were given in full text. Upon request, the Contracting Officer will make their full text available or the
full text may be found on the Internet at http://www.gsa.gov/pbs/pe/standcla/standcla.htm.
6. The following clauses are incorporated by reference:
GSAR 552-203-5 COVENANT AGAINST CONTINGENT FEES (FEB 1990)
GSAR 552-203-73 PRICE ADJUSTMENT FOR ILLEGAL OR IMPROPER ACTIVITY
(SEP 1990) (Applicable to leases over $100,000.)
FAR 52.209-6 PROTECTING THE GOVERNMENT'S INTEREST VVHEN
SUBCONTRACTING WITH CONTRACTORS DEBARRED, SUSPENDED,
OR PROPOSED FOR DEBARMENT (AUG 1995) (Applicable to leases over
$25,000.)
FAR 52.219-9 SMALL, SMALL DISADVANTAGED AND WOMEN-OWNED SMALL
BUSINESS SUBCONTRACTING PLAN (AUG 1996) (Applicable to leases
over $500,000.)
FAR 52.219-16 LIQUIDATED DAMAGES - SMALL BUSINESS SUBCONTRACTING PLAN
(OCT 1995) (Applicable to leases over $500,000.)
FAR 52.222-24 PREAWARD EQUAL OPPORTUNITY COMPLIANCE REVIEW (APR 1984)
(Applicable to leases over $1 million.)
FAR 52.222-26 EQUAL OPPORTUNITY (APR 1984) (Applicable to leases over $10,000.)
FAR 52.222-35 AFFIRMATIVE ACTION FOR SPECIAL DISABLED AND VIETNAM ERA
VETERANS (APR 1984) (Applicable to leases over $10,000.)
FAR 52.222-36 AFFIRMATIVE ACTION FOR HANDICAPPED WORKERS (APR 1984)
(Applicable to leases over $2,500.)
INITIALS: '~.~/'~/ & N~M
LESSOR GOVE ENT GSA FORM 3517A PAGE 1 (REV 1/97)
FAR 52.222-37 EMPLOYMENT REPORTS ON SPECIAL DISABLED VETERANS AND
VETERANS OF THE VIETNAM ERA (JAN 1988) (Applicable to leases over
$10,000.)
FAR 52,232-23 ASSIGNMENT OF CLAIMS (JAN 1986)
GSAR 552,232-71 PROMPT PAYMENT (APR 1989)
FAC 90-33 NAVY CONTRACT DISPUTES (MAY 1996)
THE FOLLOWING APPLY WHEN COST OR PRICING DATA IS SUBMITTED:
FAR52.215-22 PRICE REDUCTION FOR DEFECTIVE COST OR PRICING DATA
(JAN 1991) (Applicable when cost or pricing data is required for work or
services exceeding $500,000.)
FAR 52.215-24 SUBCONTRACTOR COST OR PRICING DATA (OCT 1995) (Applicable
when the clause 52.215-22 is applicable.)
The information collection requirements contained in this solicitation/contract, that are not required by
regulation, have been approved by the Office of Management and Budget pursuant to the Paperwork
Reduction Act and assigned the OMB Control No. 3090-0163.
INITIALS: ..~,~ J'~ & ~
LESSOR ~;OVERNMENT GSA FORM 3517A PAGE2 (REV 1/97)
REPRESENTATIONS AND CERTIFICAT ONS (Short Form) Solicitation Number I Dated
(Simplified Acquisition of Leasehold Interests in Real Property for
Leases Up to $100,000 Annual Rent)
Complete appropriate boxes, sign the form, and attach to offer.
The Offeror makes the following Representations and Certifications. NOTE: The "Offeror," as used on this form, is the owner of the
property offered, not an individual or agent representing the owner.
1. SMALL BUSINESS REPRESENTA'FION (JAN 1997)
(a) It [ ) is,~ is not a small business. "Small" means a concern, including its affiliates, that is lndependent{y owned and
operated, i~ not dominant in the field of operation, and has average annual gross revenues of $15 million or less for the
preceding three fiscal years.
(b) It [ ] is, ~is not a small disadvantaged business. (See 48 CFR 52.219-1 for definitions.)
(c) it [ ] Js,~is not a women-owned small business. (See 48 CFR 52.219-1 for definitions.)
2. 52.222-22- PREVIOUS CONTR~,CTS AND COMPLIANCE REPORTS (APR 1984)
(Applicable to leases which exceed $10,000.)
The Offeror represents that --
(a) It [ ] has [~haa not participated in a previous contract or subcontract subject either to the E ua O o
this solic~ta~n, the clause ori ina con ' ' q p rtunity clause of
Section 201 of Execut ve Ord~g~ No.Y111 ~t~Ined ,n Sect,on 310 of Executive Order No. 10925, or the c~use contained in
(b) It [ ] has, ~] has not filed all required compliance reports; and
(c) Representations indicating submission of required compliance reports, si ned by ro osed subcontractors, will
obtained before subcontract awards. (Approved by OMB under Control Numg~er I215.{~0~°~.) be
3. 52.222-25- AFFIRMATIVE ACTION COMPLIANCE (APR 1984)
~ (Applicable to leases which exceed $10,000.)
(Applicable to contracts which include the clause at FAR 62.222-25, Equal Opportunity.)
The Offeror represents that --
(a) Itl ] has developed and has on fi · [ ] has not developed and does not have on file, at each establishment affirmative
action programs required by the ru es and regulations of the Secretary of Labor (41 CFR 60-1 and 60-2), or
(b) It [ ] has not previous y had contracts subject to the written affirmative action pro rams requirement
regulations of (he Secratar/of Labor. (Approved by OMB under Control Number 121g~0072.) of the rules and
52.222-21 - CERTIFICATION OF NONSEGREGATED FACILITIES (APR 1984)
(Applicable to leases which exceed $10,000.)
(a) "Segregated facilities," as used in this provision, means any waiting rooms, work areas, rest room
.restaurants and other eating areas, time cocks locker rooms and other o~ ....... ,~.M__. s .and .wash rooms,
· · , ~. ....,~.,~; ,~,,=~,~mg areas parking lots drinkng
f~o_u_n~a_in_.s_,~re~.c[eati,o.n.or, ent..ertamment areas, transportaton, and housing ~aclllties provlBed for arnnlnv~.,~ that
~,~,u~_~y e_x~lcs a~re..ctwe or are in fact segregated on the basis of race, color, r'eri~ion ~/;~'=~,¥,:,%'F~',~TJ'~
By the submission of this offer, the Offeror certifies that it does not and will not maintain or rovide for its emplo ees any
(b) segregated facilities at any of its establishments, and that it does not and will not permit ifps employees to e~orm their
services at any location under ts control where se.qre~ated facilities are mainta ned. The Offeror agrees t~at a breach
of this certification is a violation of the Equat 0pport-uni~'y clause in the contract.
(c) The Offeror further agrees that (except where it has obtained identical certifications from proposed subcontractors for
specific time per~ods) ~t will-
(l) Obtain identical certifications from oroposed subcontractors before the award of subcontracts under which the
subcontractor will be sul~ject to the Equal Opportunity clause;
132/ Retain the certifications in the files; and
Forward the following notca to the proposed subcontractors (except if the proposed subcontractors have
submitted identical certifications for specific time periods).
NOTICE TO PROSPECTIVE SUBCONTRACTORS OF REQUIREMENT FOR CERTIFICATIONS OF NONSEGREGATED
FACILITIES.
A Certiflcat on of Nonseqregated Facilities must be submitted before the award of a subcontract under which the subcontractor
will be subject to the Equal Opportunity clause, The certification may be submitted either for each subcontract or for all
subcontracts during a period (i.e., quarterJy, semiannually, or annually).
INITIALS'. ~L/ &
LESSOR GOVERNMENT GSA FORM 3518A PAGE 1 (REV 1/97)
NOTE: The penalty for makJn(3 false statements in offers is prescribed in 18 U,S.C. 1001.
(Approved by OMB under Con'[roi Number 1215-0072,)
5. 52.203-11 CERTIFICATION AND DISCLOSURE REGARDING PAYMENTS TO INFLUENCE CERTAIN FEDERAL
TRANSACTIONS (APR 1991) (DEVIATION)
(Applicable to leases which exceed $100,000.)
la) The definitions and prohibit OhS contained in the clause, at FAR 52.203-12 Limitat on on Payments to Influence Certain
Federal Transactions are hereby incorporated by reference in paragraph lb) of this certificafion.
lb) The offeror, by signing its offer, hereby certifies to the best of his or her knowledge and belief that on or after
December 23, 1989, --
(1) No Fedora appropriated funds have been paid or will be paid to any person for influencing or attempt ng to
influence an officer or employee of any agency~ a Member of Con ross an
.a~n.,~p~o~e~e ,os a _M, .e . ,mb. .e r of Congress on his or her behalf ingcon~e~p,°~ffi,c.~r.°,r~.empl°ye,,e of Congress, or
(2) any ~Jnas other than Federal appropriated funds (includin{:l profit or fee received under a cove"ed Federal
transaction) have been paid, or wil/be paid, to any person for'influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress, or an emplo ee of a
Member of Congress on his or her behalf in connection with this solictafion, the offeror shall com~¥e~ta and
submit, with its offer, OMB standard form LLL, Disclosure of Lobbying Activities, to the Contractln Officer; and
(3) He or she w nc ude the language of this certificafion in all subcontract awards at any tier an~ require that al
rec pients of subcontract awards in excess of $100,000 shall certify and disclose accordingly.
lc) Submission of th s certification and disclosure is a prerequisite for making or entering into this contract imposed by
section 1352, title 31, United States Code. Any person who makes an expenditure prohibited under this provision or
who fails to file or amend the disclosure form to be filed or amended by. this provision shall be subject to a civi pena ty
of not less than $10,000, and not more than $100,000, for each such fa lure.
6. 52.204-3 TAXPAYER IDENTIFICATION (SEP 1989) (VARIATION)
la) U.S.C. 6041, 6041A, and 6050M and implementing regulations issued by the Internal Revenue Serwce ~IRS) Failure or
The Offeror is required to submit taxpayer identification nformation in order to comp y with reporting re uirements of 26
refusal by the Offeror to furnish the nformation may result in a 20 percent reduction of payments othen,vis~' due under
the contract. Taxpay.er nformation on the payee, if different from the offeror, is also required; hoWever, it may be
~ provided at the tree of award.
(b) Offeror's Taxpayer Identification Number ('TIN).
~TiN:~ [ ] TIN has been applied for. [ ] TIN is not required.
(c) Corporate Status.
,~Corporafion; [ ] Not a corporate entity; [ ] Sole proprietorship [ ] Partnership
(d) Common Parent.
ommon parent~ as used in this solicitation provision, means that corporate entity that owns or controls an affiliated
group of corporations that files its Federal income tax returns on a consolidated basis, and of which the Offeror is a
member.
Offer0r is not owned or controlled by a common parent.
Name and TIN of common parent: Name
TIN
(e) Payee's Taxpayer identification Number.
[ ] TIN: [ ] TIN has been applied for. [ ] TIN is not required.
7. OFFEROR'S DUNS NUMBER (AUG 1996) (enter number, if known):
OFFEROR OR Nam.e and Addr~de) Telephone Number
AUTHORIZED 23~9 ~'~
REPRESENTATIVE t~'eet ~,O ~:~' ~/
~lf~nafur~ .... " Dat~
INITIALS: ~1~/ & ~
LESSOR GOVERNMENT GSA FORM 3518A PAGE 2 (REv 1/97)
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