AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

1. Contract ID Code
    V

Page        of Pages
   1                 3

2. Amendment/Modification No. P00085

3. Effective Date
March 25, 2005

4. Requisition/Purchase Req. No.
    05-NEXS-0027*DO1

5. Project No. (if applicable)
    13600

6. Issued By                                                  Code MDA906
DEPARTMENT OF DEFENSE
TRICARE MANAGEMENT ACTIVITY/CM
16401 E. CENTRETECH PARKWAY
AURORA, CO 80011-9066
ANGIE FIGUEROA 303 676-3626

7. Administered By (if other than Item 6)                    Code
SEE BLOCK 6

8. Name and Address of Contractor (No., Street, County, and Zip Code)

HUMANA MILITARY HEALTHCARE SERVICES,               Vendor ID: 00000265
500 W. MAIN STREET                                                               DUNS: 805349198
P.O. BOX 740062
LOUISVILLE KY 40202                                                            CAGE: 050S0

(x)

9A. Amendment of Solicitation No.

9B. Date (See Item 11)



X

10A. Modification of Contract/Order No.
MDA906-03-C-0010

10B. Date (See Item 13)
August 27, 2003

Code

Facility Code

 

 

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 [ X ] 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 ACKNOWLEDGMENT 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 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)
      97050501301889102000051140                        X

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACT/ORDERS.
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

(x)

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. The above numbered Contract/Order is modified to reflect the administrative changes (such as changes in paying office, appropriation date, etc) Set forth item 14, pursuant to the authority of FAR 43.103(b)

 

C. This supplemental agreement is entered into pursuant to authority of:
Paragraph H.1. Contractor Financial Underwriting of Healthcare Costs

X

D. Other (Specify type of modification and authority)
      FAR 52.217-9, OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

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.)

PURPOSE OF MODIFICATION: The purpose of this modification is to exercise option period II of the contract for the period 01 April 2005 to 31 March 2006.

A. In accordance with Federal Acquisition Regulation clause 52.217-9 entitled OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000), the Government hereby exercises option period II of the contract for Managed Care Support for services from 1 April 2005 through 31 March 2006. Contract line item numbers 0201 through 0212 are hereby incorporated and made a part of the contract.

15A. Name and Title of Signer (Type or Print)
David J. Baker
President & CEO

16A. Name and title of Contracting Officer (Type or Print)
STEPHEN M. GRIFFIN                                         303 676-3754
CONTRACTING OFFICER
Stephen.griffin@tma.osd.mil

15B. Contractor/Offeror

/s/  David J. Baker
_________________________________
(Signature of person authorized to sign)

15C. Date Signed

03-30-05

16B. United States of America

/s/  Stephen M. Griffin
_________________________________
(Signature of Contracting Officer)

16C. Date Signed

03-30-05

NSN 7540-01-152-8070                                                            30-105                                                       STANDARD FORM 30 (REV. 10-83)
PREVIOUS EDITIONS UNUSABLE                                                                                                        Prescribed by GSA FAR (48 CFR) 53.243