Dialysis Chairs

5. PROJECT NUMBER (if applicable)
   CODE
6. ADMINISTERED BY
7. AMENDMENT/MODIFICATION NUMBER
   CODE
8. ISSUED BY
9. NAME AND ADDRESS OF CONTRACTOR
10. REQUISITION/PURCHASE REQ. NUMBER
11. EFFECTIVE DATE
    9A. AMENDMENT OF SOLICITATION NUMBER
    9B. DATED
    PAGE OF PAGES
    10A. MODIFICATION OF CONTRACT/ORDER NUMBER
    10B. DATED
    BPA NO.
12. CONTRACT ID CODE
    FACILITY CODE
    CODE
    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:
    The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers
    E. IMPORTANT:
    is extended,
    (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 electronic communication which includes 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 DATE SPECIFIED MAY
    is not extended.
13. ACCOUNTING AND APPROPRIATION DATA
    (REV. 11/2016)
    is required to sign this document and return ___________ copies to the issuing office.
    is not,
    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.
    15C. DATE SIGNED
    B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES
    SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
    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 letter
    or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to
    the opening hour and date specified.
    C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
    D. OTHER
    Contractor
    16C. DATE SIGNED
14. DESCRIPTION OF AMENDMENT/MODIFICATION
    16B. UNITED STATES OF AMERICA
    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
    16A. NAME AND TITLE OF CONTRACTING OFFICER
    15B. CONTRACTOR/OFFEROR
    STANDARD FORM 30
    PREVIOUS EDITION NOT USABLE
    Prescribed by GSA - FAR (48 CFR) 53.243
    (Type or print)
    (Type or print)
    (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
    (Number, street, county, State and ZIP Code)
    (If other than Item 6)
    (Specify type of modification and authority)
    (such as changes in paying office, appropriation date, etc.)
    (If required)
    (SEE ITEM 11)
    (SEE ITEM 13)
    (X)
    CHECK
    ONE
15. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,
    IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
16. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
    AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
    (Signature of person authorized to sign)
    (Signature of Contracting Officer)

1
2

0001
07-23-2026

None
36C262
Department of Veterans Affairs
Network Contracting Office 22
4811 Airport Plaza Drive
Suite 600
Long Beach CA 90815

36C262
Department of Veterans Affairs
Network Contracting Office 22
4811 Airport Plaza Drive
Suite 600
Long Beach CA 90815
To all Offerors/Bidders

36C26226Q1121

X

X

X
1

X
1
This amendment is issued to revise/correct section B.3 of the solicitation 36C26226Q1121.
All other terms and conditions will remain unchanged.

Anthony Dela Cruz

VA-VHA-RPOW-2024-0101

B.3 PRICE/COST SCHEDULE (Revised)
ITEM INFORMATION
ITEM NUMBER
DESCRIPTION OF SUPPLIES/SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
0001

5.00
EA

BRAND NAME OR EQUAL
Offerors must submit sufficient technical information, including a detailed specification sheet, when proposing an equal product. Ascent Recliner - Navy Blue - Pattern Fortress - Grade 1 Includes: - Lays the chair into Trendelenburg Position- First Table- Molded Table with Lip and Logo- Black Handle- Black Foot Tray
MFG: CHAMPION MANUFACTURING, INC.

0002

5.00
EA

BRAND NAME OR EQUAL
Offerors must submit sufficient technical information, including a detailed specification sheet, when proposing an equal product. Central-Locking Caster System Used For: Casters
MFG: CHAMPION MANUFACTURING, INC.

0003

5.00
EA

BRAND NAME OR EQUAL
Offerors must submit sufficient technical information, including a detailed specification sheet, when proposing an equal product. Second Foldaway Side Table The Second Foldaway Side Table can only be purchased as an upgrade to a chair and cannot be purchased alone.
MFG: CHAMPION MANUFACTURING, INC.

0004

5.00
EA

BRAND NAME OR EQUAL
Offerors must submit sufficient technical information, including a detailed specification sheet, when proposing an equal product.
5 year enhanced warranty for Manual
MFG: CHAMPION MANUFACTURING, INC.

0005

3.00
EA

BRAND NAME OR EQUAL
Offerors must submit sufficient technical information, including a detailed specification sheet, when proposing an equal product.
5-year enhanced warranty for Manual For coverage of existing chairs reflecting the following serial numbers:
Serial# 650000002886
Serial# 650000002887
Serial# 650000002888
MFG: CHAMPION MANUFACTURING, INC.

GRAND TOTAL