Justification and Approval (J&A) for other than full and open competition to issue a modification increasing the ceiling extending the period of performance to 72069625F00002 with Rwanda Medical Suppl... Justification and Approval (J&A) for other than full and open competition to issue a modification increasing the ceiling extending the period of performance to 72069625F00002 with Rwanda Medical Supply Ltd. The extension is necessary to ensure continuity of services and to prevent any disruption in the provision of quality-assured, life-saving commodities and services as the program transitions to new mechanisms and the contract completes its closeout.