Exhibit 4.14
| | | | | | | |
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT | 1. CONTRACT ID CODE | | PAGE OF PAGES |
| | | 1 | 3 |
2. AMENDMENT/MODIFICATION NO.
0001 | 3. EFFECTIVE DATE
10/05/2015 | 4. REQUISITION/PURCHASE REQ. NO. | 5. PROJECT NO.(If applicable) |
6. ISSUED BY | CODE | ASPR–BARDA | 7. ADMINISTERED BY (If other than Item 6) | CODE | ASPR–BARDA01 |
ASPR–BARDA 200 Independence Ave., S.W. Room 640–G Washington DC 20201 | ASPR–BARDA 330 Independence Ave, SW, Rm G644 Washington DC 20201 |
8. NAME AND ADDRESS OF CONTRACTOR (No., street, county, State and ZIP Code)
MEDIWOUND LTD 1477616 MEDIWOUND LTD 42 HAYARKON 42 HAYARKON YAVNE 00812 | (x) | 9A. AMENDMENT OF SOLICITATION NO. |
| | | | |
| 9B. DATED(SEE ITEM 11) |
| | | | |
x | 10A. MODIFICATION OF CONTRACT/ORDER NO. HHSO100201500035C |
| | | | |
| 10B. DATED(SEE ITEM 13) |
CODE 1477616 | FACILITY CODE | | 09/29/2015 | | | |
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. 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 B 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 ACKNOWLEDGEMENT 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) |
2015.1990002.26201 |
13. THIS ITEM ONLY APPLIES TO MODIFICATION OF CONTRACTS/ORDERS. IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
CHECK ONE | 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: |
| |
| D. OTHER(Specify type of modification and authority) |
| |
E. IMPORTANT: Contractor ☒ 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.)
Tax ID Number: C0–0000387
DUNS Number: 532040334
PURPOSE: To add option CLINs 0003, 0004, and 0005A into PRISM as an administrative modification. This modification only clarifies language and does not change the any amounts obligated in the base contract.
Funds Obligated Prior to this Modification | $40,430,469.00 |
Funds Obligated with mod #01 $ 0.00 | |
Total Funds Obligated to Date | $40,430,469.00 |
Continued ....
| | | |
Except as provided herein, all terms and conditions of the document [ILLIGIBLE] as heretofore changed, remains unchanged and in full force and effect. |
15A. NAME AND TITLE OF SIGNER(Type or print) | | 16A. NAME AND TITLE OF CONTRACTING OFFICER(Type or print) |
Gal Cohen President & Chief Executive Officer MediWound Ltd | Sharon Malka Chief Finance Officer MediWound Ltd. | BROOKE T. BERNOLD |
15B. CONTRACTOR/OFFEROR | I5C. DATE SIGNED | 16B.UNITED STATES OF AMERICA | 16C. DATE SIGNED |
 | |  | |
(Signature of person authorized to sign) | 10/06/2015 | (Signature of Contracting Officer) | 10/7/2015 |
NSN 7540-01-152-8070 | | STANDARD FORM 30 (REV. 10-83) |
Previous edition unusable | | Prescribed by GSA |
| | FAR (48 CFR) 53.243 |
| | | |
| | | |
CONTINUATION SHEET | REFERENCE NO. OF DOCUMENT BEING CONTINUED | PAGE OF |
HHS0100201500035C/0001 | 2 | 3 |
NAME OFOFFEROR OR CONTRACTOR
MEDIWOUND LTD 1477616
| | | | | |
ITEM NO. (A) | SUPPLIES/SERVICES (B) | QUANTITY (C) | UNIT (D) | UNIT PRICE (E) | AMOUNT (F) |
| Expiration date: September28, 2020 (Unchanged) | | | | |
| | | | | |
| 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 andeffect Delivery: 10/05/2015 Delivery Location Code: HHS/OS/ASPR HHS/OS/ASPR 200 C StSW WASHINGTON DC20201 US | | | | |
| | | | | |
| Appr. Yr.: 2015 CAN: 1990002 Object Class: 26201 FOB: Destination Period of Performance: 09/29/2015 to 09/28/2020 | | | | |
| | | | | |
| Change Item1to read as follows (amount shown is the obligated amount): | | | | |
| | | | | |
1 | ASPR-15-08828 -- CLIN 0001 Advanced development studies for NexoBrid Obligated Amount: $0.00 | | | | 0.00 |
| | | | | |
| Change Item 2 to read as follows (amount shown is the obligated amount): | | | | |
| | | | | |
2 | ASPR-15-08828 -- CLIN 0002 initial purchase storage and delivery of NexoBrid Obligated Amount: $0.00 | | | | 0.00 |
| | | | | |
| Add Item 3 as follows: | | | | |
| | | | | |
3 | CLIN 0003 Phase IV post marketing commitments/Requirements Amount: $5,639,146.00 (Option Line Item) | | | | 0.00 |
| | | | | |
| Add Item 4 as follows: | | | | |
| | | | | |
4 | CLIN--0004A Pediatric Study Amount: $11,925,619.00 (Option Line Item) | | | | 0.00 |
| | | | | |
| Add Item 5 as follows: | | | | |
| | | | | |
5 | CLIN--0004B Burn Induced Compartment SyndromeStudy Amount: $4,447,713.00 (Option Line Item) | | | | 0.00 |
| | | | | |
| Add Item 6 as follows: Continued . . . | | | | |
| | | | | |
NSN 7540-01-152.8067 | | | | OPTIONAL FORM 336 (4-86) Sponsored by GSA FAR (48 CFR): 53.110 |
| | | |
CONTINUATION SHEET | REFERENCE NO. OF DOCUMENT BEING CONTINUED | PAGE OF |
HHS0100201500035C/0001 | 3 | 3 |
NAME OF OFFEROR OR CONTRACTOR
MEDIWOUND LTD 1477616
| | | | | |
ITEM NO. (A) | SUPPLIES/SERVICES (B) | QUANTITY (C) | UNIT (D) | UNIT PRICE (E) | AMOUNT (F) |
| | | | | |
6 | CLIN--0005A US Facility validation formanufacture of product Amount: $4,819,074.00 (Option Line Item) | | | | 0.00 |
| | | | | |
| Add Item 7 as follows: | | | | |
| | | | | |
7 | CLIN--0005B Additional Surge Capacity 1 to 23,530 Amount: $23,200,580.00 (Option Line Item) | | | | 0.00 |
| | | | | |
| Add Item 8 as follows: | | | | |
| | | | | |
8 | CLIN--0005B Additional Surge Capacity 23,531 to47,060 Amount: $22, 353,500.00 (Option Line Item) | | | | 0.00 |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
| | | | | |
NSN 7540-01-152-8067 | | | | OPTIONAL FORM 336 (4-86) Sponsored by GSA FAR (48 CFR)53.110 |