Okaloosa County BOCC — November 16, 2013 — TSA OTA Amendment — reading text

I. CONTRACT ID CODE PAGE OF PAGES AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT | 1 | 2 2, AMENDMENT/MODIFICATION NO. 3. EFFECTIVE DATE if, REQUISITION/PURCHASE REQ. NO. 5, PROJECT NO. (IF applicable) P00002 September 1, 2013 AAT3STD107 6. ISSUED BY CODE 7, ADMINISTERED BY (f other than hem 6) CODE Michelle Negron-Jimenez, Contract Specialist ISA-Office of Acquisition/TSA-25 701 S 12th Street Matthew Ashurst, Contracting Ofifcer ISA-Office of Acquisition/TSA-25 701 S 12" Street Arlington, VA 20598-6025 Arlington, VA 20598-6025 Email: MattliewAshurstra:dhs.gew Phone: 571 -227-5376 Email: michelle.negron-jimenez@dhs.gov Phone: 571 -227-5281 8, NAME AND ADDRESS OF CONTRACTOR (Wo, Street, county. State and ZIP: Cotk) C) 9A, AMENDMENT OF SOLICITATION NO. Okaloosa County Airport Administration Northwest Florida International Airport 1804 Lewis Tunrer Blvd, Ste 206 Fort Walton Beach, FL 32547 9B. DATED (SEE ITEM I I) 10A MODIFICATION OF CONTRACT/ORDE3NO. DUNS: 613277649 X | HSTSO4-12-H-CT1247 10B DATED (SEE ITEM 13) CODE FACILITY CODE 09/1 8/12 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 one (I) copy 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 inciudes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATA 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 data specified. 12. ACCOUNTING AND APPROPRIATION DATA (Jf required) 13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS, IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14. (4) JA. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CIIANGES 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 c, THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF: xX D. OTHER Specify type of modification and authority) Article XT —- Changes and/or Modifications E. IMPORTANT: Contractor is not, _X_is required to sign this document and return 1_copy to the issuing office. an 14. DESCRIPTION OF AMENDMENT/MODIFICATION (Organized by UCF section headings, including solicitationlamtram subject matter wheref easible.) The purpose of this modification is to modify Article VIM — Authorized Representatives and Article VI — Effective date and See page 2 for details Except at provided herein, alt terms and conditions of the document referenced in Item 9A or 10A. as heretofore changed, remains unchanged and in full force and ISA. NAME AND TITLE OF SIGNER (Type or print) I 6A, NAME AND TITLE OF CONTRACTING OFFICER (Type or print) DON R. AMUNDS, Chairman Matthew Ashurst issioners Contracting Officer 1513. CONTRACTOR/OFFEROR 15C. DATE SIGNED 1 6B. UNITED STATES OF AMERICA 16C. DATE SIGNED BY (Signature ofp erson authorized to sign) (Signature of Contracting Officer) NSN 7540.01-152-8070 30-105 STANDARD FO! . 10-83) PREVIOUS EDITION UNUSABLE Computer Generated Prescribed by GSA FAR (48 CFR) 53.24 OTA Agreement Number: HSTSO4-12-H-CT1247 Northwest Florida International Airport (VPS) Modification P00002 The purpose of this modification P00002 is to modify Article VIII — Authorized Representatives and Article VI — Effective Date and Term. Modification P00002 is issued as follows: 1) Article VIII — Authorized Representatives The Contracting Officer listed in Article VIII, is hereby deleted and replaced with the following: Contracting Officer: Matthew Ashurst Transportation Security Administration Office of Acquisition, TSA -25 701 S. 12% Street Arlington, VA 20598-6025 Phone: 571-227-5376 E-mail: Matthew. Asburst@tsa.dhs.gov 2) Article VI — Effective Date and Term The first paragraph of Article VI is hereby deleted in its entirety and replaced with the following: The effective date of this Agreement is September 18, 2012. Project completion is currently estimated to be on or about December 31, 2013 unless earlier terminated by the parties pursuant to Article XV — Termination as provided herein or extended by mutual agreement pursuant to Article XIII — Changes and/or Modiifcations. The period of performance for this effort is established to end on December 31, 2013 to allow the COUNTY time to submit a final invoice, close out the Design project, and address any other issues. 3) Except as provided herein, all other terms and conditions remain unchanged and in full force and effect. END OF MODIFICATION RECEIVED AUG 1920B ~ CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number_& {3-203 6~ rt P Tracking Number: TO91% Pa ts 1s Contractor/Lessee Name: ve hep ots trl ane be ang P rant Funded: YES_ No_%~ Check a AG, “yearend ¢ Bog A SEbvi deg a) ' Purpase: Enter d Expiration dete: 7 ‘3 reyect- Date/lem: _ }&- 3)-13 1. (%] GREATER THAN $50,000 Amount: * ASA, 260, 0 2. [.] GREATER THAN $25,000 Deportment: faa pert 3. [7] $25,000 OR LESS ’ Dept. Monitor Narne: Dav AR py vey Document hes bean reviewed and includes any attachments of exhibits. Purchasing Review uirements are met: Date: 4 hs g Director or designee Risk Management Review Date: F199 County Aitomey Review Date: a, (2 Following Okaloosa County approval: Confract & Grant Document has been recelved: Date: Contracts & Grants Manager