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 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 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 electronic communication or letter, provided each electronic 

communication 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.

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:

X

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. 11/2016) 

Prescribed by GSA FAR (48 CFR) 53.243

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: Jacob Slotnick 

 PSPTPE2 Tel: 215-737-3942 FAX: 215-737-7431 Email: JACOB.SLOTNICK@DLA.MIL

DLA TROOP SUPPORT 

SUBSISTENCE SUPPLY CHAIN 

700 ROBBINS AVENUE 

PHILADELPHIA PA 19111-5096 

USA

 15C. DATE SIGNED

Jacob Slotnick 

 JACOB.SLOTNICK@DLA.MIL 

 2023 JUL 03

16C. DATE SIGNED

2023 JUL 03

X

D. OTHER (Specify type of modification and authority)

Pursuant to Authority of FAR 52.243-1 or FAR 52.212-4(c)

Jacob Slotnick

3. EFFECTIVE DATE

See Blk. 16C

See Continuation Sheet

1. CONTRACT ID CODE

J

2. AMENDMENT/MODIFICATION NO.

P00003

(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.

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

SPE3S1-21-D-Z134 / P00003

THIS CONTRACT IS MODIFIED TO INCLUDE FAR 52.204-27 PROHIBITION ON A BYTEDANCE COVERED APPLICATION, AS 

FOLLOWS: 

52.204-27 Prohibition on a ByteDance Covered Application (JUN 2023) 

(a) Definitions. As used in this clause— 

Covered application means the social networking service TikTok or any successor application or service 

developed or provided by ByteDance Limited, or an entity owned by 

ByteDance Limited. 

Information technology, as defined in 40 U.S.C. 11101(6)— 

(1) Means any equipment or interconnected system or subsystem of equipment, used in the automatic 

acquisition, storage, analysis, ev aluation, manipulation, 

management, movement, control, display, switching, interchange, transmission, or reception of data or 

information by the executive a gency, if the equipment is used by 

the executive agency directly or is used by a contractor under a contract with the executive agency that 

requires the use— 

(i) Of that equipment; or 

(ii) Of that equipment to a significant extent in the performance of a service or the furnishing of a 

product; 

(2) Includes computers, ancillary equipment (including imaging peripherals, input, output, and storage 

devices necessary for security and surveillance), peripheral equipment 

designed to be controlled by the central processing unit of a computer, software, firmware and similar 

procedures, services (including support services), and related 

resources; but 

(3) Does not include any equipment acquired by a Federal contractor incidental to a Federal contract. 

(b) Prohibition. Section 102 of Division R of the Consolidated Appropriations Act, 2023 (Pub. L. 117–

328), the No TikTok on Government Devices Act, and its implementing 

guidance under Office of Management and Budget (OMB) Memorandum M–23–13, dated February 27, 2023, "No 

TikTok on Government Devices" Implementation 

Guidance, collectively prohibit the presence or use of a covered application on executive agency 

information technology, including c ertain equipment used by Federal 

contractors. The Contractor is prohibited from having or using a covered application on any information 

technology owned or managed by the Government, or on any 

information technology used or provided by the Contractor under this contract, including equipment 

provided by the Contractor's employees; however, this prohibition does 

not apply if the Contracting Officer provides written notification to the Contractor that an exception 

has been granted in accordance with OMB Memorandum M–23–13. 

(c) Subcontracts. The Contractor shall insert the substance of this clause, including this paragraph (c), 

in all subcontracts, including subcontracts for the acquisition of 

commercial products or commercial services. 

(End of clause) 

IF THE CONTRACTOR DOES NOT AGREE TO THIS MODIFICATION OR IS NOT IN COMPLIANCE WITH THE CLAUSE, IT SHALL 

IMMEDIATELY NOTIFY THE 

CONTRACTING OFFICER IN WRITING.