AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

4. REQUISITION/PURCHASE REQ. NO.

See Block 14

5. PROJECT NO. (If applicable)

6. ISSUED BY CODE SPE3S1 7. ADMINISTERED BY (If other than Item 6) CODE SPE3S1

8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)

AMERIQUAL GROUP, LLC 

DBA AMERIQUAL FOODS 

18200 HIGHWAY 41 N 

EVANSVILLE IN 47725-8588 

USA

CODE 0DVS0 FACILITY CODE

10A. MODIFICATION OF CONTRACT/ORDER NO.

SPE3S1-21-D-Z134

10B. DATED (SEE ITEM 13)

2021 SEP 13

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. 

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.

copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted;

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:

12. ACCOUNTING AND APPROPRIATION DATA (If required)

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.

X

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 43.103 (b).

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

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.)

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 (Type or print)

NSN 7540-01-152-8070 

Previous edition unusable

STANDARD FORM 30 (REV. 

10-83) Prescribed by GSA FAR (48 CFR) 

15B. CONTRACTOR/OFFEROR 16B. UNITED STATES OF AMERICA

(Signature of Contracting Officer) (Signature of person authorized to sign)

16A. NAME AND TITLE OF CONTRACTING OFFICER (Type or print)

(a) By completing Items 8 and 15, and returning

DLA TROOP SUPPORT 

SUBSISTENCE SUPPLY CHAIN 

700 ROBBINS AVENUE 

PHILADELPHIA PA 19111-5096 

USA 

 Initiator: Jayson Marbach 

 DJM0103 Tel: 215-737-7346-X-7346 Email: Jayson.1.Marbach@dla.mil

DLA TROOP SUPPORT 

SUBSISTENCE SUPPLY CHAIN 

700 ROBBINS AVENUE 

PHILADELPHIA PA 19111-5096 

USA

 15C. DATE SIGNED

Russell Manuel

16C. DATE SIGNED

2021 SEP 24

X

52.243-1

D. OTHER (Specify type of modification and authority)

3. EFFECTIVE DATE

See Blk. 16C

See Continuation Sheet

1. CONTRACT ID CODE

J

 2. AMENDMENT/MODIFICATION NO. 

P00001

(X)

 CHECK ONE

9A. AMENDMENT OF SOLICITATION NO. 

9B. DATED (SEE ITEM 11)

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS, 

 IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

PAGE 1 OF 2 
CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 2 OF 2 PAGES

SPE3S1-21-D-Z134 / P00001

I. The following amendment applies to contract Solicitation SPE3S1-21-R-0001: 

A. The specification listed below has been updated and applies to this solicitation. The specification is available on 

the Subsistence Frozen Site: http://www.dla.mil/TroopSupport/Subsistence/Operational-rations/frozen/ 

1. PCR-F-004, Change 01 Fruit Puree Squeeze, Packaged in a Flexible Pouch, Shelf Stable