4th Modification 01/11/2016 EYW HSTS0213HSLRO41 P00004
msnider@keysso.net; DRILLER@KEYSSQ.NET
keith.long tsa.dhs.gov; thomas.poitras@tsa.dhs.gov;aimee.jackson@dhs.gov
Dear Lt. Snider:
Attached is a fully-executed copy of Modification P00004 for your files.
It is advisable to attach a copy of this modification to the first FYI request for reimbursement
packets you submit just to assure that processing the request is not delayed.
If you have any questions,please contact me at 202-253-4220 or email kurt.allenL&dhs.gov.
Please identify the agreement number in the subject line when inquiring by emal
AWARD MODIFICATION ix rp Secusportation
ritAdministration
1 MODIFICATION NUMBER 2 AWARD NUMBER 3 REQUISITION NUMBER
Modification No. Agreement No:
P00004 HSTS0213HSLRO41 2116206SLRO97
4 CIPIENT 5 1,
SSUED BY
Name&Address: EYW Name&Address:
Kurt Allen
Key West International Airport Transportation Security Administration
491 South Roosevelt Blvd: 701 S. 12th Street
Key West,Florida 33040-5295 Arlington VA 20598-6025
E-mail: kurt.allen@tsa.dhs.gov
t.Mitch Snider,305-292-4625 hone: 202-253-4220
6 APPLICATION TITLE &DATE
Law Enforcement Officer Reimbursement Agreement Program
7/30/2007
7 WARD PERIODS 8 ISCAL DATA
Project Period: 10/01/2012 to03/31/201fAppropriation:
11 remains unchanged 5AV167A000D2016ADE010GE000031006100616SLR
revised to 903001107010000-4101-TSA
Obligated: $21,924.97
Funding Period 10-01-2015 to 09-30-2016 Authorized UDO:
Effective Date: Date of signature by Contracting Officer EIN: 5960000749 DUNS: 155639339�
9 ESCRIPTION OF MODIFICATION
Under the authority of Article XII—Agreement Modifications,the purpose of Modification P00004 to HSTS0213HSLRO41 is to
provide funding for activities supported by the TSA LEO Reimbursement Program.
In accordance with Article IV Amount of Award of HSTS0213HSLRO41,the Contracting Officer hereby adds ,$21,924.97 to this
award;
EYW-This modification fully funds an extension of the OTA Project Period for Key West International Airport(EYW)
Contract#HSTS0213HSLRO41 from October 1,2015 to March 31,2016.
Extension Allocation: $21,924.97
Cat II Airport
1,096.25 hours @$20.00 $21,924.97
Reimbursement is limited to actual costs not to exceed rate of$20.00 per hour and total FY 2016
allocation. Reimbursable activities eligible for partial reimbursement are subject to review,
certification, and validation of operational necessity based on the requirements within the
Statement of Joint Objective(SOJO).
PoP: 10/1/12-3/31/16
ACQ POC: Kurt Allen
Except as modified herein, all other terms and conditions remain unchanged.
End of Modification P00004
10 UTHORIZED SIGNATURES
NOT REQUIRED
Recipient's Signature Date
NOT REQUIRED Contracting Officer January 11, 2016
TYPED NAME AND TITLE
TYPED NAME AND TITLE