Okaloosa County BOCC — December 16, 2014 — Contract Coord Sheet - TSA Agreement-Bag Sys

CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease: Number: None Tracking Number: {I G 3 ~/ S Contractor/Lessee Name: TSA(Homeland Security) Grant Funded: YES_X_NO___ Purpose: Grant funding to Design Upgrade to Baggage. Handling System at VPS CLOSEOUT Date/Term: N/A 1, GREATER THAN $50,000 Amount: $259,560 2, ] GREATER THAN $25,000 Department: Airports 3. E] $25,000 OR LESS Dept. MonitorName: Harman | Document has been reviewed and includes any attachmerits.or exhibits. Purchasing ‘Review Date: it “2 Y-/ va ; Risk Management Review Approved.cds written: ‘Leto Ite 2. Date: IQ-a- (U4 Risk Manatyer or designes County Altorney Review esse pate: [-eU ~1Y Goynty Attoiney * (es Following Okdloosa County approval: Contracts & Grants Document has been received: Date: | Contracts .& Grants Manager AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT 1. GONTRAGT ID CODE re OF Pies 2. AMENDMENTIMODIFIGATION NO, 3, EFFECTIVE DATE 4. REQUISITIONPURCHASE REQ, NO. 5, PROJECT NO. (if appieabia) P90002 See Block 160 6, GSUED BY 7, AOMINISTRATED BY (father tran Ham 6) Office of Acquisition, TSA-10 Office of Financlal Management, TSA-16 Transportation Security Administration Office of Security Technology 601 South 12" Street 701 South 12" Street Arlington, VA 22202-4220 Arlington, VA 22202-4220 3, NAME AND ADDRESS OF CONTRACTOR (No, atroet, county, Sale end ZIP Code) iL] tA, AMENDMENT OF SOLICITATION NO, Okaloosa County, Board of County Cornmissioners c/o Northwest Florida Regional Airport 0B, DATED (SBE ITEM 17) 1804 Lewls Turner Bivd., Suite 206 Fort Walton Beach, FL. 32647 [is| HOA, MODIFICATION OF CONTRAOTIORDER NO, HSTS04-12-H-CT1 247 Ta. DATED (SEE ITEM 74 CAGE SODE ° FACILITY CODE 02/24/2041 { d Tt. THIS ai ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS C The above numbered sellcitation Is avianded as sat forth In Item 14, The hour and date speotfied for rocelpt of Offer is [| extended Cl Is not extended, Offers must acknowledge recelpt of this amendment prlor to the hour and date specified In the solleltation on a& amended, by one of the following methods; (a) By completing Item 8. and 15, and retuming coplae of the amencment; (b) acknowledging racelpt of this amendment on each copy of the offer submitted; or (o) By separate letter or telegram which includes a reference fo the sollollatian and amendment numbers, FAILURE OF YOUR ACKNOWLEDG. MENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR REGEIPT OF OFFERS PRIOR TO THE HOUR ANO DATE SPEGIFIED MAY RESULT IN REJECTION OF YOUR OFFER, If by virtue of thls amendment you desire to change an offer already submitted, such change may he made by telegram or letier, provided each telegram or letter makes reference to the snileltation and this amendment, and is recelved prior to the opening hours and dale Specified, 12. ACCOUNTING AND APPROPRIATION DATA (iFrequirog) « ($25,084.00) De-Obligated 13. THIS (TEM APPLIES ONLY ODIFICATIONS OF CONTRACTS/ORDERS IT MODIFIES THE CONTRACTIORDER NO, AS DESCRIBED IN ITEM 44, a "1 THIS CHANGE ORDER To ISSUED PUROUANT TO! (opscly aithoniyy THE CHANGES GET FORTH INTTEN 14 ARE MADE IN THE GONTRAGTORDER NG, INTIEM 104, rm ton on im “By THE ABOVE NUMBERED CONTRA TIORDER 18 MODIFIED TO REELECT THE ADMINISTRATIVE GANGES (utah as changes tt paying office, a N IF GO! appropriation data, ate.) SBT FORTH IN ITEM 44, G. THIS SUP ENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF: Mutual agreement between both partes, ee“). OTHER fapeoly Yoo of moditoation and audioriiy) AMS 3.10.10 Closeout of Completed Files and FAR Part 4,604 and FAR 1.602-2 Closeout of Contract Flies E, tFORTANT: Contractor LJ Is not, is required to sign this document and return 1 copy to the issulng offica, 44. DESCRIPTION GF AMENDMENT/MODIFICATION (Organized by UCF section headings, icluding solloitation/contract subject mater where taasinle) The purpose of this modification is to de-obligate residual funds and close the Agreement referenced in Block 10A above in its entirety, De-obligation of residual funding 8 referenced in Block 12 above, The funded amount of thls Agreement Is reduced from $259,560.00 by $25,084.00 to $234,476.00. The Contractor does remise, release, and discharge the Government, Ite officers, agents and employees, of and from all [labil Itles, obligations, claims and demands whatsoever under or arising from the said Agreement. Therefore, thls Agraament is hereby closed, at SZ The partlos hereby cerlify that alf contract actions required by the Agreement have bean fully and safisfactorlly accomplished. AHUETPINAL ACTIONIGHHINH . Excopt as provided hereln, all tenins and condillons of the document referenced In item 9A or 10A, aa horotofore changed, remains unchanged andl ih full fotea und affeat, (5A, NAME AND TITLE OF SIGNER {Type TGA, NAME AND TITLE OF CONTRACTING OFFICER {Type of prin) or pin Charles K. Windes, Jr,; that rman, Board of Kenneth Garthe County Commissioners, Okaloosa County Contracting Officer 768. GONTRAGTOR/OFFEROR 166, DATE SIGNED 168, UNITED STATES OF AMERICA 766. DATE SIGNED BY . (Signature of parson authorized to sign) (Signature of Contragting Offfesr} OME Control No, 2120-0598 (8F-30) FAA Tomplata No, 11 (Reverse) (8/87) TSAVGPMD Closeout Document (8), Rev, 10/27/2008