MEDICAL CHART ABSTRACTION
Added: Oct 29, 2010 3:30 pm This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Subpart 12.6, as supplemented with additional information included in this notice. This announcement constitutes the only solicitation; and it is VA's intention to award this contract on a sole source basis. No telephone requests for information will be accepted; email cheri.wicks@va.gov. The submission of any data for review shall not impede award of this contract. A Justification for Other Than Full and Open Competition shall be published after award. The Department of Veterans, VA Boston Healthcare System, has a requirement for a Medical Chart Abstractor with specific skills. The solicitation number is VA-241-11-RQ-0049. This solicitation document and incorporated provisions and clauses are those in effect tough the most current Federal Acquisition Circular. This requirement is not set aside. The NAICS Code is 621399. The provision at 52.212-1, Instructions to Offerors-Commercial Items, applies to this acquisition. No addenda are included. The provision at 52.212-2, Evaluation-Commercial Items, applies to this acquisition and the criteria are technical ability, past performance, and price. A completed copy of the provision at 52.212-3, Offeror Representations and Certifications-Commercial Items shall be submitted. The clause at 52.212-4, Contract Terms and Conditions-Commercial Items applies. The clause at 52.212-5, Contract Terms and Conditions Required To Implement Statutes Or Executive Orders, applies. The attached solicitation contains all applicable requirements as well as the terms and conditions. The response date is November 9, 2010 at Noon Eastern Standard Time. B.2 PRICE/COST SCHEDULE BASE PERIOD: DATE OF AWARD THROUGH MAY 31, 2010 ITEM DESCRIPTION OF QTY UNIT AMOUNT NO. SUPPLIES/SERVICE 1. Perform Medical Chart Abstraction 1 Job _________ services associated with the study entitled "Validating the Patient Safety Indicators (PSI) in the VA: A Multi-Faceted Approach." Project will require approximately 32 hours of work each week for an estimated 6 months. All work shall be performed as stated in the Statement of Work. GRAND TOTAL:_____________________ B.3 STATEMENT OF WORK: RESEARCH NURSE ABSTRACTOR CONTRACT 1. Scope and Purpose of the Contract The Contractor shall provide medical chart abstraction to support the VA HSR&D funded study, "Validating the Patient Safety Indicators (PSI) in the VA: A Multi-faceted Approach," Dr. Amy K. Rosen (Principal Investigator and Supervisor). The Contractor shall devote 32 hours per week to the study for approximately six months. This task shall require a careful review of all components of the medical record (e.g., discharge record, admission and physical history, patient progress notes, nursing records, etc.). Over 30 data elements need to be extracted from each electronic medical record (EMR), a considerably complex task; about 4000 EMRs will be involved. The Chart Abstractor shall have to use some clinical judgment when examining the medical record. For example, different sections of the medical record may conflict with each other and the abstractor will be required to make judgments as to which section has the correct information. The Chart Abstractor shall also have to identify processes of care and understand the context in which care is delivered. Primary duties include, but are not limited to: 1. Pilot chart abstraction tools and review and edit chart abstraction guidelines; 2. Conduct medical chart abstraction from the VA Computerized Patient Record System (CPRS) and VistA. 3. Participate in project meetings to coordinate chart abstraction efforts with other nurse chart abstractors and to update the project team on findings. Specific items to be delivered to Dr. Amy Rosen, VA, by Contractor include, but are not limited to: 1. Piloted chart abstraction tools and edited chart abstraction guidelines after Contractor's review; 2. Data obtained tough medical chart abstraction from the VA Computerized Patient Record System (CPRS) and VistA. 3. Regular updates and reports, either verbal or written, on chart abstraction progress and findings. Breakdown of the specific tasks to be performed or components to be supplied: 1. Piloted chart abstraction tools and edited chart abstraction guidelines after Contractor's review; 2. Data obtained tough medical chart abstraction from the VA Computerized Patient Record System (CPRS) and VistA. 3. Regular updates and reports, either verbal or written, on chart abstraction progress and findings. Contractor must have the following qualifications: 1. Previous experience as a nurse researcher/nurse abstractor 2. Extensive experience in the review and abstraction of data from VA medical records using VA CPRS and VistA 3. Extensive experience in and knowledge of research protocols and practices 4. Extensive clinical knowledge and nursing experience Contractor is required to submit to Dr. Rosen and the project manager a monthly timesheet listing the number of hours worked, a brief description of the duties performed, and the amount to be invoiced. Dr. Amy Rosen and Dr. Ann Borzecki (Bedford VAMC) shall monitor the Contractor's performance. Contractor is required to meet weekly with Drs. Rosen and Borzecki in order to provide updates on the progress of duties and discuss any other issues relevant to the above named study. In addition, the Contractor will be available by telephone and/or email in order to provide updates on the progress of duties and discuss any other issues relevant to the above named studies. Contractor will perform duties at the VA Boston Healthcare System, COLMR, Building #9, Jamaica Plain Campus. In addition, Contractor shall also perform duties at the Bedford VAMC, Center for Health Quality, Outcomes, and Economic Research (CHQOER), Building 70 under Dr. Borzecki. At times, the Contractor may be able to perform duties remotely using One VA VPN/Remote Access and a laptop with VA encryption. Contractor will be provided with a work space/office to conduct the medical chart abstractions and a secure location to store any sensitive VA data/information allowing her to engage in safe data management practices. Contractor will need access to the VA CPRS, VistA, and One VA-VPN/Remote Access. Contractor is required to have a laptop that is encrypted according to VA standards. Contractor is required to complete all mandatory research trainings, including but not limited to, human subjects, data security, and privacy trainings, and ensure that these trainings are current in accordance with VA policy. Some specific guidelines that the Contractor must have knowledge of when performing work are: VHA Handbook 1200.05, VHA Intellectual Property Handbook 1200.18, and VA Cyber Security and Privacy Policies (VHA Handbook 1605.1, VA Directive and Handbook 6102, VA IT Directive 06-2, VHA Directive 6500, VA Directive 6502, VA Handbook 6502.1 and 6502.2, and VA Directive 6504). Contractor shall perform work for an estimated 32 hours per week on any day of the week as needed. Contractor shall perform the work according to a schedule as permitted by Dr. Rosen, Principal Investigator and will respond to Dr. Rosen's inquiries regarding the work to be performed and/or other study issues within a reasonable time frame. The frequency of how many times a certain task must be performed and the schedule as to which the tasks are to be performed will vary. ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS--COMMERCIAL ITEMS Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. The following clauses are incorporated into 52.212-4 as an addendum to this contract: 52.204-7 CENTRAL CONTRACTOR REGISTRATION (APR 2008) (a) Definitions. As used in this clause-- "Central Contractor Registration (CCR) database" means the primary Government repository for Contractor information required for the conduct of business with the Government. "Data Universal Numbering System (DUNS) number" means the 9-digit number assigned by Dun and Bradstreet, Inc. (D&B) to identify unique business entities. "Data Universal Numbering System +4 (DUNS+4) number" means the DUNS number assigned by D&B plus a 4-character suffix that may be assigned by a business concern. (D&B has no affiliation with this 4- character suffix.) This 4-character suffix may be assigned at the discretion of the business concern to establish additional CCR records for identifying alternative Electronic Funds Transfer (EFT) accounts (see the FAR at Subpart 32.11) for the same concern. "Registered in the CCR database" means that-- (1) The Contractor has entered all mandatory information, including the DUNS number or the DUNS+4 number, into the CCR database; and (2) The Government has validated all mandatory data fields, to include validation of the Taxpayer Identification Number (TIN) with the Internal Revenue Service (IRS), and has marked the record "Active". The Contractor will be required to provide consent for TIN validation to the Government as a part of the CCR registration process. (b)(1) By submission of an offer, the offeror acknowledges the requirement that a prospective awardee shall be registered in the CCR database prior to award, during performance, and tough final payment of any contract, basic agreement, basic ordering agreement, or blanket purchasing agreement resulting from this solicitation. (2) The offeror shall enter, in the block with its name and address on the cover page of its offer, the annotation "DUNS" or "DUNS +4" followed by the DUNS or DUNS +4 number that identifies the offeror's name and address exactly as stated in the offer. The DUNS number will be used by the Contracting Officer to verify that the offeror is registered in the CCR database. (c) If the offeror does not have a DUNS number, it should contact Dun and Bradstreet directly to obtain one. (1) An offeror may obtain a DUNS number-- (i) Via the Internet at http://fedgov.dnb.com/webform or if the offeror does not have internet access, it may call Dun and Bradstreet at 1-866-705-5711 if located within the United States; or (ii) If located outside the United States, by contacting the local Dun and Bradstreet office. The offeror should indicate that it is an offeror for a U.S. Government contract when contacting the local Dun and Bradstreet office. (2) The offeror should be prepared to provide the following information: (i) Company legal business. (ii) Tradestyle, doing business, or other name by which your entity is commonly recognized. (iii) Company Physical Street Address, City, State, and Zip Code. (iv) Company Mailing Address, City, State and Zip Code (if separate from physical). (v) Company Telephone Number. (vi) Date the company was started. (vii) Number of employees at your location. (viii) Chief executive officer/key manager. (ix) Line of business (industry). (x) Company Headquarters name and address (reporting relationship within your entity). (d) If the Offeror does not become registered in the CCR database in the time prescribed by the Contracting Officer, the Contracting Officer will proceed to award to the next otherwise successful registered Offeror. (e) Processing time, which normally takes 48 hours, should be taken into consideration when registering. Offerors who are not registered should consider applying for registration immediately upon receipt of this solicitation. (f) The Contractor is responsible for the accuracy and completeness of the data within the CCR database, and for any liability resulting from the Government's reliance on inaccurate or incomplete data. To remain registered in the CCR database after the initial registration, the Contractor is required to review and update on an annual basis from the date of initial registration or subsequent updates its information in the CCR database to ensure it is current, accurate and complete. Updating information in the CCR does not alter the terms and conditions of this contract and is not a substitute for a properly executed contractual document. (g)(1)(i) If a Contractor has legally changed its business name, "doing business as" name, or division name (whichever is shown on the contract), or has transferred the assets used in performing the contract, but has not completed the necessary requirements regarding novation and change-of-name agreements in Subpart 42.12, the Contractor shall provide the responsible Contracting Officer a minimum of one business day's written notification of its intention to (A) change the name in the CCR database; (B) comply with the requirements of Subpart 42.12 of the FAR; and (C) agree in writing to the timeline and procedures specified by the responsible Contracting Officer. The Contractor must provide with the notification sufficient documentation to support the legally changed name. (ii) If the Contractor fails to comply with the requirements of paragraph (g)(1)(i) of this clause, or fails to perform the agreement at paragraph (g)(1)(i)(C) of this clause, and, in the absence of a properly executed novation or change-of-name agreement, the CCR information that shows the Contractor to be other than the Contractor indicated in the contract will be considered to be incorrect information within the meaning of the "Suspension of Payment" paragraph of the electronic funds transfer (EFT) clause of this contract. (2) The Contractor shall not change the name or address for EFT payments or manual payments, as appropriate, in the CCR record to reflect an assignee for the purpose of assignment of claims (see FAR Subpart 32.8, Assignment of Claims). Assignees shall be separately registered in the CCR database. Information provided to the Contractor's CCR record that indicates payments, including those made by EFT, to an ultimate recipient other than that Contractor will be considered to be incorrect information within the meaning of the "Suspension of payment" paragraph of the EFT clause of this contract. (h) Offerors and Contractors may obtain information on registration and annual confirmation requirements via the internet at http://www.ccr.gov or by calling 1-888-227-2423, or 269-961-5757. (End of Clause) 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999) The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months. The Contracting Officer may exercise the option by written notice to the Contractor within 10 days of contract expiration. (End of Clause) 52.232-18 AVAILABILITY OF FUNDS (APR 1984) Funds are not presently available for this contract. The Government's obligation under this contract is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for this contract and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer. (End of Clause) 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es): http://www.acquisition.gov/far/index.html http://www.va.gov/oamm/oa/ars/policyreg/vaar/index.cfm 52.204-9 PERSONAL IDENTITY VERIFICATION OF SEP 2007 CONTRACTOR PERSONNEL 52.224-2 PRIVACY ACT APR 1984 52.224-1 PRIVACY ACT NOTIFICATION APR 1984 52.243-1 CHANGES--FIXED PRICE AUG 1987 ALTERNATE III APR 1984 VAAR 852.203-70 COMMERCIAL ADVERTISING (JAN 2008) The bidder or offeror agrees that if a contract is awarded to him/her, as a result of this solicitation, he/she will not advertise the award of the contract in his/her commercial advertising in such a manner as to state or imply that the Department of Veterans Affairs endorses a product, project or commercial line of endeavor. (End of Clause) VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984) The contractor shall obtain all necessary licenses and/or permits required to perform this work. He/she shall take all reasonable precautions necessary to protect persons and property from injury or damage during the performance of this contract. He/ she shall be responsible for any injury to himself/herself, his/her employees, as well as for any damage to personal or public property that occurs during the performance of this contract that is caused by his/her employees fault or negligence, and shall maintain personal liability and property damage insurance having coverage for a limit as required by the laws of the State of Massachusetts. Further, it is agreed that any negligence of the Government, its officers, agents, servants and employees, shall not be the responsibility of the contractor hereunder with the regard to any claims, loss, damage, injury, and liability resulting there from. (End of Clause) VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) The contracting officer reserves the right to designate representatives to act for him/her in furnishing technical guidance and advice or generally monitor the work to be performed under this contract. Such designation will be in writing and will define the scope and limitation of the designee's authority. A copy of the designation shall be furnished to the contractor. (End of Provision) VAAR 852.273-75 SECURITY REQUIREMENTS FOR UNCLASSIFIED INFORMATION TECHNOLOGY RESOURCES (Interim - October 2008) (a) The contractor and their personnel shall be subject to the same Federal laws, regulations, standards and VA policies as VA personnel, regarding information and information system security. These include, but are not limited to Federal Information Security Management Act (FISMA), Appendix III of OMB Circular A-130, and guidance and standards, available from the Department of Commerce's National Institute of Standards and Technology (NIST). This also includes the use of common security configurations available from NIST's Web site at: http://checklists.nist.gov (b) To ensure that appropriate security controls are in place, Contractors must follow the procedures set forth in "VA Information and Information System Security/Privacy Requirements for IT Contracts" located at the following Web site: http://www.iprm.oit.va.gov/docs/Security_and_Privacy_Requirements_for_IT_Contracts_Attachment.pdf (End of Clause) ELECTRONIC INVOICE SUBMISSION To improve the timeliness of payments and lower overall administrative costs, VA strongly encourages contractors to submit invoices using its electronic invoicing system. At present, electronic submission is voluntary and any nominal registration fees will be the responsibility of the contractor. VA intends to mandate electronic invoice submission, subject to completion of the federal rulemaking process. At present, VA is using a 3rd party agent to contact contractors regarding this service. In the meantime, contractors interested in registering for the electronic system should contact the VA's Financial Services Center at http://www.fsc.va.gov/einvoice.asp (End of Clause) D.1 CONTRACTOR PERSONNEL SECURITY REQUIREMENTS All contractor employees who require access to the Department of Veterans Affairs' computer systems shall be the subject of a background investigation and must receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to contract performance. This requirement is applicable to all subcontractor personnel requiring the same access. If the investigation is not completed prior to the start date of the contract, the contractor will be responsible for the actions of those individuals they provide to perform work for VA. 1. Position Sensitivity - The position sensitivity has been designated as LOW RISK 2. Background Investigation - The level of background investigation commensurate with the required level of access is National Agency Check. 3. Contractor Responsibilities a. The contractor shall bear the expense of obtaining background investigations. If the investigation is conducted by the Office of Personnel Management (OPM), the contractor shall reimburse VA within 30 days. b. The contractor shall prescreen all personnel requiring access to the computer systems to ensure they maintain a U.S. citizenship and are able to read, write, speak and understand the English language. c. The contractor shall submit or have their employees submit the following required forms to the VA Office of Security and Law Enforcement within 30 days of receipt: (i) Standard Form 85P, Questionnaire for Public Trust Positions (ii) Standard Form 85P-S, Supplemental Questionnaire for Selected Positions (iii) FD 258, U.S. Department of Justice Fingerprint Applicant Chart (iv) VA Form 0710, Authority for Release of Information Form (v) Optional Form 306, Declaration for Federal Employment (vi) Optional Form 612, Optional Application for Federal Employment d. The contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract. e. Failure to comply with the contractor personnel security requirements may result in termination of the contract for default. 4. Government Responsibilities a. The VA Office of Security and Law Enforcement will provide the necessary forms to the contractor or to the contractor's employees after receiving a list of names and addresses. b. Upon receipt, the VA Office of Security and Law Enforcement will review the completed forms for accuracy and forward the forms to OPM to conduct the background investigation. c. The VA facility will pay for investigations conducted by the Office of Personnel Management (OPM) in advance. In these instances, the contractor will reimburse the VA facility within 30 days. d. The VA Office of Security and Law Enforcement will notify the contracting officer and contractor after adjudicating the results of the background investigations received from OPM. e. The contracting officer will ensure that the contractor provides evidence that investigations have been completed or are in the process of being requested. D.2 VENDOR SUPPLIED PERSONNEL INFORMATION Please submit the name, address and social security number of the vendor supplied personnel as well as a person to contact from your company and the phone number and billing address. Contracting Specialist: Cheri K. Wicks Telephone: 774-826-2582 Station: 523 Order Number: Risk Level: LOW Vendor Name: Vendor POC (Name, Telephone #, E-mail): Vendor Address: Vendor Supplied Personnel Name: SSN: Home Address: Date of Birth: Place of Birth: Current Clearance(s) Issued by Other Departments/Agencies D. 3 STATEMENT OF COMMITMENT AND UNDERSTANDING FOR VA CONTRACTORS WHO POSSESS OR HANDLE VA SENSITIVE INFORMATION OR PERSONAL DATA As a contractor of the Department of Veterans Affairs (VA), I am committed to safeguarding the personal information that veterans and their families have entrusted to the Department. I am also committed to safeguarding the personal information which VA employees and applicants have provided. To ensure that I understand my obligations and responsibilities in handling the personal information of veterans and their families, I have completed both the annual General Privacy Awareness Training (or VHA Privacy Training, as applicable) and the annual VA Cyber Security Training. I know that I should contact the Contracting Officer whom will then get in touch with the Information Security Officer or Regional or General Counsel, when I am unsure whether or how I may gather or create, maintain, use, disclose or dispose of information about veterans and their families, and VA employees and applicants. I further understand that if I fail to comply with applicable confidentiality statutes and regulations, I may be subject to civil and criminal penalties, including fines and imprisonment. I also recognize that VA may impose sanctions, up to and including termination of contract for violation of applicable confidentiality and security statutes, regulations and policies. I certify that I have completed the training outlined above and am committed to safeguarding personal information about veterans and their families, and VA employees and applicants. _____________________________ ___________________________ [Print or type Contractor name] Signature ______________________________ ___________________________ Position Title Date D.4 PRIVACY POLICY TRAINING All contractor and subcontractor employees performing work under this contract and having access to patient records and other privacy act information are required to complete the VHA's mandatory "VHA Privacy Policy" training course. The course is available on-line at the Veteran's Health Administration's (VHA) Employee Education System (EES) website: https://www.ees-learning.net/librix/. The basic course is designed to be finished in 50-60 minutes. If you choose to read information behind the MORE buttons, self-test questions, and scenarios, it may take you about 30 more minutes to finish. When the course is successfully completed, a training certificate will be issued on-line. Submittal: Training completion certificates or proof of training for contractor furnished training for all applicable contractor and subcontractor employees shall be forwarded as one submittal package to the Contracting Officer within ten (10) calendar days of Contract or Purchase Order award. D.5 CYBER SECURITY TRAINING All contractor and subcontractor employees performing work under this contract and having access to VA computer systems are required to complete the VA's mandatory "VA Cyber Security Awareness" training course. The course is available on-line at the Veteran's Health Administration's (VHA) Employee Education System (EES) website: https://www.ees-learning.net/librix/. The course is designed to take approximately 1 hour. When the course is successfully completed, a training certificate will be issued on-line. Submittal: Training completion certificates for all applicable contractor and subcontractor employees shall be forwarded as one submittal package to the Contracting Officer within ten (10) calendar days of Contract or Purchase Order award. 52.204-3 TAXPAYER IDENTIFICATION (OCT 1998) (a) Definitions. "Common parent," as used in this provision, means that corporate entity that owns or controls an affiliated group of corporations that files its Federal income tax returns on a consolidated basis, and of which the offeror is a member. "Taxpayer Identification Number (TIN)," as used in this provision, means the number required by the Internal Revenue Service (IRS) to be used by the offeror in reporting income tax and other returns. The TIN may be either a Social Security Number or an Employer Identification Number. (b) All offerors must submit the information required in paragraphs (d) tough (f) of this provision to comply with debt collection requirements of 31 U.S.C. 7701(c) and 3325(d), reporting requirements of 26 U.S.C. 6041, 6041A, and 6050M, and implementing regulations issued by the IRS. If the resulting contract is subject to the payment reporting requirements described in Federal Acquisition Regulation (FAR) 4.904, the failure or refusal by the offeror to furnish the information may result in a 31 percent reduction of payments otherwise due under the contract. (c) The TIN may be used by the Government to collect and report on any delinquent amounts arising out of the offeror's relationship with the Government (31 U.S.C. 7701(c)(3)). If the resultingcontract is subject to the payment reporting requirements described in FAR 4.904, the TIN provided hereunder may be matched with IRS records to verify the accuracy of the offeror's TIN. (d) Taxpayer Identification Number (TIN). [ ] TIN:. ____________________________ [ ] TIN has been applied for. [ ] TIN is not required because: [ ] Offeror is a nonresident alien, foreign corporation, or foreign partnership that does not have income effectively connected with the conduct of a trade or business in the United States and does not have an office or place of business or a fiscal paying agent in the United States; [ ] Offeror is an agency or instrumentality of a foreign government; [ ] Offeror is an agency or instrumentality of the Federal Government. (e) Type of organization. [ ] Sole proprietorship; [ ] Partnership; [ ] Corporate entity (not tax-exempt); [ ] Corporate entity (tax-exempt); [ ] Government entity (Federal, State, or local); [ ] Foreign government; [ ] International organization per 26 CFR 1.6049-4; [ ] Other ___________________________________________ (f) Common parent. [ ] Offeror is not owned or controlled by a common parent as defined in paragraph (a) of this provision. [ ] Name and TIN of common parent: Name ____________________________________________________ TIN ____________________________________________________ (End of Provision) 52.204-8 ANNUAL REPRESENTATIONS AND CERTIFICATIONS (OCT 2010) (a)(1) The North American Industry Classification System (NAICS) code for this acquisition is 621399. (2) The small business size standard is $6.5M. (3) The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees. (b)(1) If the clause at 52.204-7, Central Contractor Registration, is included in this solicitation, paragraph (d) of this provision applies. (2) If the clause at 52.204-7 is not included in this solicitation, and the offeror is currently registered in CCR, and has completed the ORCA electronically, the offeror may choose to use paragraph (d) of this provision instead of completing the corresponding individual representations and certifications in the solicitation. The offeror shall indicate which option applies by checking one of the following boxes: [ ] (i) Paragraph (d) applies. [ ] (ii) Paragraph (d) does not apply and the offeror has completed the individual representations and certifications in the solicitation. (c)(1) The following representations or certifications in ORCA are applicable to this solicitation as indicated: (i) 52.203-2, Certificate of Independent Price Determination. This provision applies to solicitations when a firm-fixed-price contract or fixed-price contract with economic price adjustment is contemplated, unless-- (A) The acquisition is to be made under the simplified acquisition procedures in Part 13; (B) The solicitation is a request for technical proposals under two-step sealed bidding procedures; or (C) The solicitation is for utility services for which rates are set by law or regulation. (ii) 52.203-11, Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions. This provision applies to solicitations expected to exceed $150,000. (iii) 52.204-3, Taxpayer Identification. This provision applies to solicitations that do not include the clause at 52.204-7, Central Contractor Registration. (iv) 52.204-5, Women-Owned Business (Other Than Small Business). This provision applies to solicitations that-- (A) Are not set aside for small business concerns; (B) Exceed the simplified acquisition teshold; and (C) Are for contracts that will be performed in the United States or its outlying areas. (v) 52.209-5, Certification Regarding Responsibility Matters. This provision applies to solicitations where the contract value is expected to exceed the simplified acquisition teshold. (vi) 52.214-14, Place of Performance--Sealed Bidding. This provision applies to invitations for bids except those in which the place of performance is specified by the Government. (vii) 52.215-6, Place of Performance. This provision applies to solicitations unless the place of performance is specified by the Government. (viii) 52.219-1, Small Business Program Representations (Basic & Alternate I). This provision applies to solicitations when the contract will be performed in the United States or its outlying areas. (A) The basic provision applies when the solicitations are issued by other than DoD, NASA, and the Coast Guard. (B) The provision with its Alternate I applies to solicitations issued by DoD, NASA, or the Coast Guard. (ix) 52.219-2, Equal Low Bids. This provision applies to solicitations when contracting by sealed bidding and the contract will be performed in the United States or its outlying areas. (x) 52.222-22, Previous Contracts and Compliance Reports. This provision applies to solicitations that include the clause at 52.222-26, Equal Opportunity. (xi) 52.222-25, Affirmative Action Compliance. This provision applies to solicitations, other than those for construction, when the solicitation includes the clause at 52.222-26, Equal Opportunity. (xii) 52.222-38, Compliance with Veterans' Employment Reporting Requirements. This provision applies to solicitations when it is anticipated the contract award will exceed the simplified acquisition teshold and the contract is not for acquisition of commercial items. (xiii) 52.223-1, Biobased Product Certification. This provision applies to solicitations that require the delivery or specify the use of USDA-designated items; or include the clause at 52.223-2, Affirmative Procurement of Biobased Products Under Service and Construction Contracts. (xiv) 52.223-4, Recovered Material Certification. This provision applies to solicitations that are for, or specify the use of, EPA- designated items. (xv) 52.225-2, Buy American Act Certificate. This provision applies to solicitations containing the clause at 52.225-1. (xvi) 52.225-4, Buy American Act--Free Trade Agreements--Israeli Trade Act Certificate. (Basic, Alternate I, and Alternate II) This provision applies to solicitations containing the clause at 52.225-3. (A) If the acquisition value is less than $25,000, the basic provision applies. (B) If the acquisition value is $25,000 or more but is less than $50,000, the provision with its Alternate I applies. (C) If the acquisition value is $50,000 or more but is less than $67,826, the provision with its Alternate II applies. (xvii) 52.225-6, Trade Agreements Certificate. This provision applies to solicitations containing the clause at 52.225-5. (xviii) 52.225-20, Prohibition on Conducting Restricted Business Operations in Sudan--Certification. This provision applies to all solicitations. (xix) 52.225-25, Prohibition on Engaging in Sanctioned Activities Relating to Iran--Certification. This provision applies to all solicitations. (xx) 52.226-2, Historically Black College or University and Minority Institution Representation. This provision applies to-- (A) Solicitations for research, studies, supplies, or services of the type normally acquired from higher educational institutions; and (B) For DoD, NASA, and Coast Guard acquisitions, solicitations that contain the clause at 52.219-23, Notice of Price Evaluation Adjustment for Small Disadvantaged Business Concerns. (2) The following certifications are applicable as indicated by the Contracting Officer: [ ](i) 52.219-19, Small Business Concern Representation for the Small Business Competitiveness Demonstration Program. [ ](ii) 52.219-21, Small Business Size Representation for Targeted Industry Categories Under the Small Business Competitiveness Demonstration Program. [ ](iii) 52.219-22, Small Disadvantaged Business Status. [ ](A) Basic. [ ](B) Alternate I. [ ](iv) 52.222-18, Certification Regarding Knowledge of Child Labor for Listed End Products. [ ](v) 52.222-48, Exemption from Application of the Service Contract Act to Contracts for Maintenance, Calibration, or Repair of Certain Equipment Certification. [ ](vi) 52.222-52 Exemption from Application of the Service Contract Act to Contracts for Certain Services--Certification. [ ](vii) 52.223-9, with its Alternate I, Estimate of Percentage of Recovered Material Content for EPA-Designated Products (Alternate I only). [ ](viii) 52.223-13, Certification of Toxic Chemical Release Reporting. [ ](ix) 52.227-6, Royalty Information. [ ](A) Basic. [ ](B) Alternate I. [ ](x) 52.227-15, Representation of Limited Rights Data and Restricted Computer Software. (d) The offeror has completed the annual representations and certifications electronically via the Online Representations and Certifications Application (ORCA) website at http://orca.bpn.gov. After reviewing the ORCA database information, the offeror verifies by submission of the offer that the representations and certifications currently posted electronically that apply to this solicitation as indicated in paragraph (c) of this provision have been entered or updated within the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201); except for the changes identified below [offeror to insert changes, identifying change by clause number, title, date]. These amended representation(s) and/or certification(s) are also incorporated in this offer and are current, accurate, and complete as of the date of this offer. ------------------------------------------------------------------------ FAR Clause # Title Date Change ------------------------------------------------------------------------ ------ ---------- ------ ------ ------------------------------------------------------------------------ Any changes provided by the offeror are applicable to this solicitation only, and do not result in an update to the representations and certifications posted on ORCA. (End of Provision) 52.216-1 TYPE OF CONTRACT (APR 1984) The Government contemplates award of a (Firm Fixed Price) contract resulting from this solicitation. (End of Provision) 52.219-1 SMALL BUSINESS PROGRAM REPRESENTATIONS (MAY 2004) (a)(1) The North American Industry Classification System (NAICS) code for this acquisition is-- 621399. (2) The small business size standard is $6.5M. (3) The small business size standard for a concern which submits an offer in its own name, other than on a construction or service contract, but which proposes to furnish a product which it did not itself manufacture, is 500 employees. (b) Representations. (1) The offeror represents as part of its offer that it [ ] is, [ ] is not a small business concern. (2) [Complete only if the offeror represented itself as a small business concern in paragraph (b)(1) of this provision.] The offeror represents, for general statistical purposes, that it [ ] is, [ ] is not, a small disadvantaged business concern as defined in 13 CFR 124.1002. (3) [Complete only if the offeror represented itself as a small business concern in paragraph (b)(1) of this provision.] The offeror represents as part of its offer that it [ ] is, [ ] is not a women-owned small business concern. (4) [Complete only if the offeror represented itself as a small business concern in paragraph (b)(1) of this provision.] The offeror represents as part of its offer that it [ ] is, [ ] is not a veteran-owned small business concern. (5) [Complete only if the offeror represented itself as a veteran-owned small business concern in paragraph (b)(4) of this provision.] The offeror represents as part of its offer that it [ ] is, [ ] is not a service-disabled veteran-owned small business concern. (6) [Complete only if the offeror represented itself as a small business concern in paragraph (b)(1) of this provision.] The offeror represents, as part of its offer, that-- (i) It [ ] is, [ ] is not a HUBZone small business concern listed, on the date of this representation, on the List of Qualified HUBZone Small Business Concerns maintained by the Small Business Administration, and no material change in ownership and control, principal office, or HUBZone employee percentage has occurred since it was certified by the Small Business Administration in accordance with 13 CFR Part 126; and (ii) It [ ] is, [ ] is not a joint venture that complies with the requirements of 13 CFR Part 126, and the representation in paragraph (b)(6)(i) of this provision is accurate for the HUBZone small business concern or concerns that are participating in the joint venture. [The offeror shall enter the name or names of the HUBZone small business concern or concerns that are participating in the joint venture:____________.] Each HUBZone small business concern participating in the joint venture shall submit a separate signed copy of the HUBZone representation. (c) Definitions. As used in this provision-- "Service-disabled veteran-owned small business concern"-- (1) Means a small business concern-- (i) Not less than 51 percent of which is owned by one or more service-disabled veterans or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more service-disabled veterans; and (ii) The management and daily business operations of which are controlled by one or more service-disabled veterans or, in the case of a service-disabled veteran with permanent and severe disability, the spouse or permanent caregiver of such veteran. (2) "Service-disabled veteran" means a veteran, as defined in 38 U.S.C. 101(2), with a disability that is service-connected, as defined in 38 U.S.C. 101(16). "Small business concern" means a concern, including its affiliates, that is independently owned and operated, not dominant in the field of operation in which it is bidding on Government contracts, and qualified as a small business under the criteria in 13 CFR Part 121 and the size standard in paragraph (a) of this provision. "Veteran-owned small business concern" means a small business concern-- (1) Not less than 51 percent of which is owned by one or more veterans (as defined at 38 U.S.C. 101(2)) or, in the case of any publicly owned business, not less than 51 percent of the stock of which is owned by one or more veterans; and (2) The management and daily business operations of which are controlled by one or more veterans. "Women-owned small business concern" means a small business concern-- (1) That is at least 51 percent owned by one or more women; or in the case of any publicly owned business, at least 51 percent of the stock of which is owned by one or more women; and (2) Whose management and daily business operations are controlled by one or more women. (d) Notice. (1) If this solicitation is for supplies and has been set aside, in whole or in part, for small business concerns, then the clause in this solicitation providing notice of the set-aside contains restrictions on the source of the end items to be furnished. (2) Under 15 U.S.C. 645(d), any person who misrepresents a firm's status as a small, HUBZone small, small disadvantaged, or women- owned small business concern in order to obtain a contract to be awarded under the preference programs established pursuant to section 8(a),8(d), 9, or 15 of the Small Business Act or any other provision of Federal law that specifically references section 8(d) for a definition of program eligibility, shall-- (i) Be punished by imposition of fine, imprisonment, or both; (ii) Be subject to administrative remedies, including suspension and debarment; and (iii) Be ineligible for participation in programs conducted under the authority of the Act. (End of Provision) 52.222-22 PREVIOUS CONTRACTS AND COMPLIANCE REPORTS (FEB 1999) The offeror represents that-- (a) It [ ] has, [ ] has not participated in a previous contract or subcontract subject to the Equal Opportunity clause of this solicitation; the clause originally contained in Section 310 of Executive Order No. 10925, or the clause contained in Section 201 of Executive Order No. 11114; (b) It [ ] has, [ ] has not filed all required compliance reports; and (c) Representations indicating submission of required compliance reports, signed by proposed subcontractors, will be obtained before subcontract awards. (End of Provision) 52.233-2 SERVICE OF PROTEST (SEP 2006) (a) Protests, as defined in section 33.101 of the Federal Acquisition Regulation, that are filed directly with an agency, and copies of any protests that are filed with the Government Accountability Office (GAO), shall be served on the Contracting Officer (addressed as follows) by obtaining written and dated acknowledgment of receipt from: Cheri K. Wicks Contracting Officer Hand-Carried Address: Department of Veterans Affairs VA Boston Healthcare System Bldg 3, 4th Floor 940 Belmont Street Brockton MA 02301 Mailing Address: Department of Veterans Affairs VA Boston Healthcare System Contracting Officer (90C) 940 Belmont Street Brockton MA 02301 (b) The copy of any protest shall be received in the office designated above within one day of filing a protest with the GAO. (End of Provision)
VA24111RQ0049 Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 1
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