AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

See Block 14

4. REQUISITION/PURCHASE REQ. NO. 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.

SPE3S1-22-D-Z240

2021 DEC 22

10B. DATED (SEE ITEM 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.

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).

FAR 52.212-4(C) & Clauses FAR 52.245-1, FAR 52.245-2, FAR 52.256-9

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

E. IMPORTANT: Contractor is not, X is required to sign this document and return 1 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) 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: Debbie Goffman 

 PSPTRAA Tel: 215-737-2979 FAX: 215-737-4115 Email: DEBRA.GOFFMAN@DLA.MIL

DLA TROOP SUPPORT 

SUBSISTENCE SUPPLY CHAIN 

700 ROBBINS AVENUE 

PHILADELPHIA PA 19111-5096 

USA

 15C. DATE SIGNED

Debbie Goffman

2022 JAN 26

16C. DATE SIGNED

X

X

D. OTHER (Specify type of modification and authority)

See Blk. 16C

3. EFFECTIVE DATE

See Continuation Sheet

K

1. CONTRACT ID CODE

P00001

 2. AMENDMENT/MODIFICATION NO. 

(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 3

Debbie Goffman
CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED:

CONTINUED ON NEXT PAGE

PAGE 2 OF 3 PAGES

SPE3S1-22-D-Z240 / P00001

1. The Purpose of this modification is to formally transfer accountability of the following Government Furnished 

Equipment from contract SPE3S1-16-D-Z203 to contract SPE3S1-22-D-Z240 and to incorporate it into lease agreement as 

specified in the attachment. 

2. No cost or savings will result in these changes. 
CONTINUATION SHEET REFERENCE NO. OF DOCUMENT BEING CONTINUED: PAGE 3 OF 3 PAGES

SPE3S1-22-D-Z240 / P00001

Attachments

List of Attachments

Description File Name

ATTACH_gfe AMERIQUAL Poly tray 

GFE MOD P0001 

SPE3S122DZ240 - signed.

pdf

ATTACH__ Poly tray GFE Mod 

20210326144329293 - 

signed.pdf