00_RFQ Package_75H70626R00004_NONPSC RN_LPNS solicitation_01_06_2026.pdf

This is a combined synopsis/solicitation for commercial items prepared in accordance with the format in Federal Acquisition Regulation (FAR) Subpart 12.6, as supplemented with additional information included in this notice, FAR Part 12, Acquisition of Commercial Items (Title VIII of the Federal Acquisition Streamlining Act of 1994) (Public Law 103-355). This announcement constitutes the only solicitation;

quotes are being requested and a written solicitation will not be issued.

A. The Great Plains Area Indian Health Service (IHS) intends to award a Labor Hour Type Contract, Non-Personal Medical Service, Purchase Order with a Base Period and eight (8) Option Periods in response to Request for Quote (RFQ) 75H70626R00004.

Due to Service Unit funding constraints, the Government will obligate funds in three-month increments only. Accordingly, this contract includes a base period and quarterly option periods.

Exercise of any option is subject to the availability of funds and continued Government need.

B. This solicitation document and incorporated provisions and clauses are those in effect through Federal Acquisition Circular 2025-04 on June 11, 2025.

C. This RFQ is issued as 100% Indian Small Business Economic Enterprises (ISBEE) Set-Aside, and the associated NAICS Code is #561320, which has a small business standard size $34.0. Quoter is required to fill out the attached INDIAN FIRM REPRESENTATION FORM.

D. The quoted unit pricing must be all inclusive (to include, but not be limited to, travel, lodging, per diem, fringe benefits, federal, state and local taxes) plus all other costs pertinent to the performance of this contract. Utilize your most competitive and reasonable rates.

Complete the attached Request for Quote #75H70626R00004 SF-1449 for Non Personal Services – Outpatient Registered Nurse and License Practical Nurse.

Labor Hour Type, Non-Personal Medical Services to be provided for the Pine Ridge Comprehensive Health Care Facility, Indian Health Service, 607 Indian Health Road, 44B Pejuta RD, Pine Ridge, South Dakota 57770. See Performance Work Statement (PWS) attached. The period of performance will be a Base Period with eight (8) Option Periods. Base period shall be three (3) Months, and each option period shall be three (3) months.

E.

52.212-1 INSTRUCTIONS TO OFFERORS – COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES

NOV 2025

(DEVIATION)

Sub-paragraph (b) is replaced in its entirety by the following:

(b) Submission of quotes. All quotes must include the following information and submitted via email to ashleigh.yazzie@ihs.gov.

(1) Volume 1 – Label “Administrative Documents.” Signed and dated SF-1449 and all associated SF-30 amendments, if any. A completed copy of the representations and certifications at Federal Acquisition Regulation (FAR) 52.212-3 (see FAR 52.212-3(b) for those representations and certifications that the quoter shall complete electronically).

(2) Volume 2 – Label “Technical Capability and Approach.” The offeror shall demonstrate its ability to meet or exceed the requirements outlined in the Performance Work Statement (PWS). The offeror shall provide the following information: - A clear, detailed approach that outlines how the requirements of the PWS will be met. - Identify key personnel and demonstrate how they meet the qualifications stated in the PWS. - Resumes, certifications, and any other relevant documentation for all proposed key personnel. - Submit a proposed project schedule, ensuring alignment with the government’s required Period of mailto:ashleigh.yazzie@ihs.gov

Performance. The schedule must include tasks, milestones, and lead times, presented in a both narrative and chart formats. NO PRICING INFORMATION SHALL BE INCLUDED IN VOLUMES 1, 2, and 3.

Submit three (3) copies.

(3) Volume 3 – Label “Past Performance.” Include a minimum of 3 but no more than 5 Non-Personal Service Contracts in Outpatient Continence Department of similar or same scope and magnitude within the past five (5) years. Past performance information should include award information including modifications, fully-executed past performance reviews, and other information that demonstrate compliance to price, and technical capability. If available, include past performance evaluations from the Contractor Performance Assessment Reporting System (CPARS). Submit three (3) copies.

(4) Volume 4 – Label “Price.” Offerors shall provide detailed pricing aligned with the technical approach.

Include a budget narrative explaining cost assumptions and indicate any discount terms. Submit three (3) copies.

F. FAR 52.212-3 Offeror Representation and Certification – Commercial Products and Commercial

Service (OCT 2025). See attachment for full text. The Offeror shall complete only paragraphs (b) of this provision if the Offeror has completed the annual representations and certification electronically via the System for Award Management (SAM) website accessed through http://www.acquisition.gov. If the Offeror has not completed the annual representations and certifications electronically, the Offeror shall complete only paragraphs (c) through (p) of this provision.

G. FAR 52.212-2 Evaluation – Commercial Products and Commercial Services (NOV 2025)

(DEVIATION)

• For evaluation purposes only, the Government will evaluate the total price of the base period and all option periods. Evaluation does not obligate the Government to exercise any option.

H. FAR 52.212-4 Contract Terms and Conditions-Commercial Products and Commercial Services – Alternate I (NOV 2025). Applied to this acquisition and it’s by reference.

I. FAR 52.212-5 Contract Terms and Conditions Required to Implement Statutes or Executive Orders Commercial Products and Commercial Services (Oct 2025). See attachment for full text.

J. Attached are the Federal Acquisition Regulations (FAR) & Health & Human Services Acquisition Regulation (HHSAR) clauses that are applicable including below.

K. SECURITY CLEARANCE

A security pre-clearance must be performed for any employees referred to IHS through this contract.

Fingerprints must be completed and adjudicated prior to services being performed under this contract.

No contract award shall be made to any vendor or provider listed on the OIG Exclusion List http://exclusions.oig.hhs.gov throughout the duration of the contract. It shall be the responsibility of the contractor to notify the acquisition official if there is a change in provider.

Performance of this contract will require routine access by employees of the Contractor or its subcontractors to facilities or systems controlled by the Indian Health Service (I.H.S.). Before starting work requiring routine access to I.H.S. facilities or systems each person must complete http://www.acquisition.gov/ http://exclusions.oig.hhs.gov/ an FBI National Criminal History Check (Fingerprint Check) adjudicated by an I.H.S. employee using the Office of Personnel Management Personnel Investigations Processing System.

Contractors shall allow five (5) business days for I.H.S. processing of fingerprints taken electronically at an I.H.S. site and thirty (30) business days for non-electronic processing of fingerprints using FBI Form FD-258. A list of I.H.S. sites with electronic fingerprint capability is available from the Contracting Officer.

In addition, no Contractor or subcontractor employee shall be permitted to perform work under this contract if listed on the HHS Office of Inspector General List of Excluded Individuals/Entities (LEIE), http://exclusions.oig.hhs.gov. As soon as practicable prior to the start of work, the performance of the work the Contractor shall provide to the Contracting Officer the names of all individuals to be used in performance of work for screening against the LEIE. During the performance, the Contractor shall provide the Contracting Officer the names of any additional or substitute employees for screening before they begin work.

The Contractor is responsible for conducting security preclearance investigations in sufficient depth to ensure that each Contractor or subcontractor employee referred to I.H.S. is not on the LEIE and can obtain a favorable fingerprint clearance. Each security preclearance shall be conducted sufficiently in advance of the start of performance to avoid delays caused by denial of access. If this is a Time and Materials, Labor-Hour or Cost Reimbursement contract, the contractor shall not charge for or be reimbursed for labor hours or other costs incurred for employees who are unable to perform due to denial or access or the excess time required to resolve and clear unfavorable security clearance findings. If this is a Fixed Price contract, denial of access due to security clearance findings shall not be a basis for excusable delay or an increase to the contract amount.

The Government will pay for the cost to process the contractor's suitability clearances.

However, multiple investigations for the same position may, at the Contracting Officers discretion, lead to reduction(s) in the contract price of no more than the cost of the extra investigation(s).

Employees that DO NOT have access to LMS, contractors, volunteers, or IHS employees with IPA's or MOA's to tribal organizations please, click here IHS Sexual Abuse Prevention website.

When the contractors have completed and passed the training, please have them send a copy of the last page of the training with Name, Date, and Time to their Supervisor, COR, and Kimmen LeBeau, e-mail: Kimmen.LeBeau@ihs.gov.

"Contract Personnel will arrive on a Business Day ONLY to complete all Orientation and Background procedures. The Clinical Director or Designee will ensure all Orientation and Background procedures have been completed and an email will be sent to the Contracting department to state as such. The Contract Personnel will NOT see patients until Background/Fingerprints have been cleared."

http://exclusions.oig.hhs.gov/ mailto:Kimmen.LeBeau@ihs.gov

"The standards of medical practice and duties of the Contractor through its Contract Personnel shall be determined pursuant to the bylaws of the Service Unit. The regulations of the hospital, applicable provisions of law, other rules and regulations of any and all governmental authorities relating to licensure and regulation of Contract Personnel and hospitals must be followed. Also, the standards and recommendations of Centers for Medicare and Medicaid Services (CMS) or the Accreditation organization must be adhered to. The Contract Personnel shall be required to participate in a quality improvement program, which is consistent with current requirements for ongoing monitoring and evaluation of the quality and appropriateness of care."

L. Offers will be accepted electronically, Submit via e-mail to the following:

Great Plains Area Indian Health Service Division of Acquisition Management Attn: Ashleigh Yazzie, Contract Specialist Email: ashleigh.yazzie@ihs.gov

All questions must be submitted in writing via email 8 days prior to Closing Date, please submit by email to: ashleigh.yazzie@ihs.gov ; before February 05, 2026 by 12:00 pm MST. Contractors will need a Unique Entity ID (UEI) number, TIN number, and be registered with www.sam.gov.

Invoice Processing Platform (IPP)

The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system. In compliance with the Office of Management and Budget (OMB) M-15-19 memorandum “Improving Government Efficiency and Saving Taxpayer Dollars Through Electronic Invoicing” directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors. Invoices submitted under any award will be required to utilize the Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and Processing of Payment Requests”.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the Treasury’s Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St. Louis (FRSTL).

Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register-however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov.

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973- 3131 (M-F 8AM to 6PM ET), or IPPCustomerSupport@fiscal.treasury.gov Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer.

ATTACHMENTS:

A. Notice to Quoter/Combined Synopsis/Solicitation B. SF18 Request for Quotations (Signature required) C. Performance Work Statement D. Clauses incorporated by reference and clauses in full text E. Indian Representation Form F. Dept. of Labor – Wage Determination mailto:William.Kohl@ihs.gov mailto:ashleigh.yazzie@ihs.gov https://www.ipp.gov/ mailto:IPPCustomerSupport@fiscal.treasury.gov

SEE ADDENDUMIS CHECKED

CODE 18a. PAYMENT WILL BE MADE BY

CODE

FACILITYCODE

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER

OFFEROR

See Schedule

CODE 16. ADMINISTERED BYCODE

X

X

561320

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR167

REQUEST FOR

PROPOSAL

(RFP)

INVITATION

FOR BID (IFB)

10. THIS ACQUISITION ISCODE

REQUEST FOR

QUOTE (RFQ)

14. METHOD OF SOLICITATION

13b. RATING

NORTH AMERICAN INDUSTRY

CLASSIFICATION STANDARD

(NAICS):

SMALL BUSINESS

02/05/2026 1200 MT

01/06/2026

ASHLEIGH YAZZIE

(No collect calls)

INFORMATION CALL:

FOR SOLICITATION 8. OFFER DUE DATE/LOCAL TIMEb. TELEPHONE NUMBER a. NAME

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

75H70626R00004

5. SOLICITATION NUMBER

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 1. REQUISITION NUMBER PAGE OF

1 12 OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

Multiple Destinations

15. DELIVER TO

Pine Ridge SD 57770 Pine Ridge PHS Indian Hospital

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$34

18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW

ISSUE DATE

DELIVERY FOR FREE ON BOARD

(FOB) DESTINATION UNLESS

BLOCK IS MARKED

11.

SEE SCHEDULEX

12. DISCOUNT TERMS THIS CONTRACT IS A RATED

ORDER UNDER THE DEFENSE

PRIORITIES AND ALLOCATIONS

SYSTEM - DPAS (15 CFR 700)

13a.

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

(SDVOSB)

HUBZONE SMALL

BUSINESS

8(A)

Pine Ridge Service Unit

WOMEN-OWNED SMALL

BUSINESS (WOSB)

ECONOMICALLY DISADVANTAGED

WOMEN-OWNED SMALL

BUSINESS (EDWOSB)

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

ADMINISTERED BY:

Pine Ridge Service Unit Pine Ridge PHS Indian Hospital 607 Indian Health Road E. Hwy 18 Pine Ridge SD 57770

NOTICE TO QUOTER

100% Small Business Buy Indian Set-Aside

REQUEST FOR QUOTES: RFQ 75H70626R00004

(Use Reverse and/or Attach Additional Sheets as Necessary)

HEREIN, IS ACCEPTED AS TO ITEMS:

XX

DATED

NICHOLE R. LEREW

. YOUR OFFER ON SOLICITATION (BLOCK 5),

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER

ARE

ARE

31c. DATE SIGNED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (Type or print)

ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL

SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

27a. SOLICITATION INCORPORATES BY REFERENCE (FEDERAL ACQUISITION REGULATION) FAR 52.212-1, 52.212-4. FAR 52.212-3

AND 52.212-5 ARE ATTACHED. ADDENDA

26. TOTAL AWARD AMOUNT (For Government Use Only)

OFFER

STANDARD FORM 1449 (REV. 11/2021)

Prescribed by GSA - FAR (48 CFR) 53.212

ARE NOT ATTACHED.

ARE NOT ATTACHED.

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

30b. NAME AND TITLE OF SIGNER (Type or print)

30a. SIGNATURE OF OFFEROR/CONTRACTOR

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

25. ACCOUNTING AND APPROPRIATION DATA

29. AWARD OF CONTRACT: REFERENCE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32c. DATE 32b. SIGNATURE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED:

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

40. PAID BY39. S/R VOUCHER NUMBER38. S/R ACCOUNT NUMBER

37. CHECK NUMBER

FINALPARTIAL

36. PAYMENT

FINALPARTIAL

35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER33. SHIP NUMBER

COMPLETE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

42d. TOTAL CONTAINERS42c. DATE REC'D (YY/MM/DD)

42b. RECEIVED AT (Location)

42a. RECEIVED BY (Print)

41c. DATE41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

STANDARD FORM 1449 (REV. 11/2021) BACK

24.

AMOUNT

23.

UNIT PRICE

22.

UNIT

21.

QUANTITY

20.

SCHEDULE OF SUPPLIES/SERVICES

19.

ITEM NO.

RETURN RFQ TO: DHHS - Great Plains Area Indian

Health Service Department of Acquisition

Management Fed. Bldg. Room 309; 115 4th Ave SE;

Aberdeen, SD 57401

Email: ashleigh.yazzie@ihs.gov

GENERAL DESCRIPTION: Labor Hour Type Commercial

Item Purchase Order to provide a Non-Personal

Registered Nurse/License Practical Nurse Services to the Outpatient Departments according to the attached Performance Work Statement (PWS) for the

Great Plains Area - Indian Health Service - Pine

Ridge Service Unit, Pine Ridge, South Dakota

57770, and other health care centers including

Martin District Clinic, Kyle Health Center, Wanblee Health Center. The quoted unit price is an all-inclusive cost.

All-inclusive unit price is defined to include travel, lodging, per diem, fringe benefits, federal, state and local taxes, plus all other costs pertinent to the performance of this purchase order.

NAICS Code: 561320 Temporary Help Services. The

SBA set the size standard in millions of dollars

$34.0

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

12 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 12

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004

Base Period with Eight (8) Option periods extending multiple years. Base Period shall be three (3) months, and each option period shall be three (3) months.

Work Schedule: Please refer to the Performance

Work Statement C.3.5. Tour of Duties.

Period of Performance: Base Award with option periods. Options periods shall be in quarterly arrears.

Base: 3/1/2026 5/31/2026

1st Option Period: 6/1/2026 8/31/2026

2nd Option Period: 9/1/2026 11/30/2026

3rd Option Period: 12/1/2026 2/28/2027

4th Option Period: 3/1/2027 5/31/2027

5th Option Period: 6/1/2027 8/31/2027

6th Option Period: 9/1/2027 11/30/2027

7th Option Period: 12/1/2027 2/29/2028

8th Option Period: 3/1/2028 5/31/2028

EVALUATION AND SUBMITTAL:

52.212-1 INSTRUCTIONS TO OFFERORS - COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES NOV 2025

(DEVIATION)

Sub-paragraph (b) is replaced in its entirety by the following:

(b) Submission of quotes. All quotes must include the following information and submitted via email to ashleigh.yazzie@ihs.gov.

(1) Volume 1 - Label "Administrative Documents."

Signed and dated SF-1449 and all associated SF-30 amendments, if any. A completed copy of the representations and certifications at Federal

Acquisition Regulation (FAR) 52.212-3 (see FAR

52.212-3(b) for those representations and certifications that the quoter shall complete electronically).

(2) Volume 2 - Label " Technical Capability and

Approach." The offeror shall demonstrate its ability to meet or exceed the requirements outlined in the Performance Work Statement (PWS).

The offeror shall provide the following information: - A clear, detailed approach that

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Sponsored by GSA

FAR (48 CFR) 53.110

4 12

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004 outlines how the requirements of the PWS will be met. - Identify key personnel and demonstrate how they meet the qualifications stated in the PWS. -

Resumes, certifications, and any other relevant documentation for all proposed key personnel. -

Submit a proposed project schedule, ensuring alignment with the government's required Period of Performance. The schedule must include tasks, milestones, and lead times, presented in a both narrative and chart formats. NO PRICING

INFORMATION SHALL BE INCLUDED IN VOLUMES 1, 2,

and 3. Submit three (3) copies.

(3) Volume 3 - Label "Past Performance." Include a minimum of 3 but no more than 5 Non-Personal

Service Contracts in Outpatient Continence

Department of similar or same scope and magnitude within the past five (5) years. Past performance information should include award information including modifications, fully-executed past performance reviews, and other information that demonstrate compliance to price, and technical capability. If available, include past performance evaluations from the Contractor

Performance Assessment Reporting System (CPARS).

Submit three (3) copies.

(4) Volume 4 - Label "Price." Offerors shall provide detailed pricing aligned with the technical approach. Include a budget narrative explaining cost assumptions and indicate any discount terms. Submit three (3) copies.

All questions must be submitted in writing via email 8 days prior to Closing Date.

52.212-2 EVALUATION - COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES NOV 2025

(DEVIATION)

(a) Evaluation factors. The Government will award a contract resulting from this solicitation to the responsible Offeror whose offer to the solicitation will be most advantageous to the

Government, price and other factors considered.

The following factors shall be used to evaluate offers:

1. Technical capability and approach in order to meet the government's requirement as defined in

Attachment A - Performance Work Statement (PWS)

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

5 12

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004

2. Key Personnel shall meet the requirements listed in section (0.0) of the PWS

3. Capability to meet the Period of Performance Schedule

4. Past Performance of three (3) projects providing non-personal service contract for

Outpatient Continence Department services within the past five (5) years.

5. Price

(b) Options. The Government will evaluate offers for award purposes by adding the total price for all options to the total price for the basic requirement. The Government may determine that an offer is unacceptable if the option prices are significantly unbalanced. Evaluation of options shall not obligate the government to exercise the option(s).

(c) Notice of award. A written notice of award or acceptance of an offer, mailed or otherwise furnished to the successful offeror within the time for acceptance specified in the offer, shall result in a binding contract without further action by either party. Before the offer's specified expiration time, the Government may accept an offer (or part of an offer), whether or not there are negotiations after its receipt, unless a written notice of withdrawal is received before award.

ATTACHMENTS:

A. Notice to Quoter/Combined

Synopsis/Solicitation

B. SF18 Request for Quotations (Signature required)

C. Performance Work Statement

D. Clauses incorporated by reference and clauses in full text

E. Indian Representation Form

F. Dept. of Labor - Wage Determination

Quotation must set forth full, accurate and complete information as required by the Request for Quotation (RFQ) and be returned no later than the date referenced in Block #08 of the Request for Quotation form SF-1449. All required information must be submitted to be considered

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

6 12

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004 responsive and eligible for award.

ACCEPTANCE PERIOD: Your quote must stipulate that it is predicated upon all the terms and conditions of this Solicitation. In addition, it must contain a statement to the effect that it is firm for a period of at least 60 days from the date of receipt by the Government.

Period of Performance: 03/01/2026 to 05/31/2028

1 Base Period: 3 MONTHS

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

Delivery Location Code: IHSPINERIDGE

PINE RIDGE

607 Indian Health Road

E. Hwy 18

IHSPINERIDGE SD 57770 US

Period of Performance: 03/01/2026 to 05/31/2026

2 1st Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

7 12

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 06/01/2026 to 08/31/2026

3 2nd Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 09/01/2026 to 11/30/2026

4 3rd Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

8 12

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 12/01/2026 to 02/28/2027

5 4th Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance Ends: 05/31/2027

6 5th Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Continued ...

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

9 12

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

(A) (B) (C) (D) (E) (F)

75H70626R00004

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 06/01/2027 to 08/31/2027

7 6th Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 09/01/2027 to 11/30/2027

8 7th Option Period:

Ten (10) Registered Nurses/License Practical

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Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 12/01/2027 to 02/29/2028

9 8th Option Period:

Ten (10) Registered Nurses/License Practical

Nurses (RNs/LPNs)

Estimated 1,760 (One-month hours)

Estimated 5,280 (three-months hours)

Registered Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

License Practical Nurse Rate:

$_________________ PER HOUR

$_________________ TOTAL

(Option Line Item)

Delivery Location Code: IHSPINERIDGE

IHSPINERIDGE

607 Indian Health Road

E. Hwy 18

PINE RIDGE SD 57770 US

Period of Performance: 03/01/2028 to 05/31/2028

Continued ...

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The Contractor must provide only new equipment and new parts for the required products described herein; no used, refurbished, or remanufactured equipment or parts shall be provided under any circumstances. Absolutely no Gray Market Goods or

Counterfeit Electronic Parts shall be provided.

Gray Market Goods are defined as genuine branded goods intentionally or unintentionally sold outside of an authorized sales-territory or by non-authorized dealers in an authorized territory. All equipment shall be accompanied by the Original Equipment Manufacturers (OEMs) warranty. Counterfeit Electronic Parts are defined as unlawful or unauthorized reproduction, substitution, or alteration that has been knowingly mismarked, misidentified, or otherwise misrepresented to be an authentic, unmodified electronic part from the original manufacturer, or a source with the express written authority of the original manufacturer or current design activity, including an authorized aftermarket manufacturer.

Unlawful or unauthorized substitution includes used electronic parts represented as new, or the false identification of grade, serial number, lot number, date code, or performance characteristics.

Invoice Processing Platform (IPP)

The Indian Health Service (IHS) is in the process of implementing an electronic invoicing system.

In compliance with the Office of Management and

Budget (OMB) M-15-19 memorandum, Improving

Government Efficiency and Saving Taxpayer Dollars

Through Electronic Invoicing, directing Federal agencies to adopt electronic invoicing as the primary means to disburse payment to vendors.

Invoices submitted under any award resulting from this solicitation will be required to utilize the

Invoice Processing Platform (IPP) in accordance with HHSAR 352.232-71, Electronic Submission and

Processing of Payment Requests.

IPP is a secure, web-based electronic invoicing system provided by the U.S. Department of the

Treasurys Bureau of the Fiscal Service, in partnership with the Federal Reserve Bank of St.

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Louis (FRSTL). Respondents to this solicitation are encouraged to register an account with IPP if they have not already done so. If your organization is already registered to use IPP, you will not be required to re-register- however, we encourage you make sure your organization and designated IPP user accounts are valid and up to date.

The IPP website address is: https://www.ipp.gov

If you require assistance registering or IPP account access, please contact the IPP Helpdesk at (866) 973-3131 (M-F 8AM to 6PM ET), or

IPPCustomerSupport@fiscal.treasury.gov

Should the contractor feel that use of the IPP would be unduly burdensome, their response to this solicitation should include an explanation of this position for a determination by the contracting officer.

The Government reserves the right to accept or reject services if the level or work is unsatisfactory.

NSN 7540-01-152-8067 OPTIONAL FORM 336 (4-86)

Pine Ridge Indian Health Service Out-Patient Nursing Services Performance Work Statement

Performance Work Statement (PWS) Out-Patient Nursing Services for the Pine Ridge Service Unit

Great Plains Area Indian Health Service

This is a Labor-Hour, Non-Personal Services Requirement. While limited performance – based elements are included, the Government prescribes minimum staffing levels, work schedules, and coverage requirements due to the mission-critical nature of outpatient healthcare services.

1) Background

The mission of the Pine Ridge Service Unit (PRSU) Indian Health Service is to raise the physical, mental, social and spiritual health of American Indians and Alaska Natives to the highest level. To meet this mission, The Pine Ridge Service Unit requires contractor support to assist the nursing department during times of acute nursing staff shortages in the Out-Patient clinics. The Pine Ridge Reservation is located in the southwestern corner of South Dakota, approximately 100 miles from Rapid City. Surrounded by rolling prairie, Badlands and Black Hills, the Pine Ridge Reservation is home to the Oglala Lakota Nation.

C.2) General Requirements

C.2.1 Purpose of Contract The Contractor shall provide qualified Registered and Licensed Practical Nurses to work at the PRSU for acceptance by the Chief Nurse Executive, Deputy Chief Nurse Executive or CEO Designee at PRSU. The purpose of this non-personal service contract is to provide direct patient care, supporting the current Out-Patient Nursing staff which includes all specialty clinics and PRSU outlaying locations i.e. community outreach, especially in times of staffing shortages.

1. Require the contractor to be a temporary nursing agency; No more than 50% of the contractor workforce will be accepted with Licensed Practical Nurse qualifications. Contractor personnel shall work in an Out-Patient Clinic Nursing Department, but may be floated to the Emergency Room or Acute Care In-Patient units to act as a patient observer or pass medications or other intermittent care needs as staffing needs arise. Contractor personnel will be assigned to a shift after orientation that supports the mission of the facility, but may be either a day or evening shift. The shifts are either 8 or 10 hours.

2. Require Contractor to assume sole and exclusive responsibility for withholding federal and State taxes, paying federal and social security taxes.

The minimum staffing requirement for this contract is the equivalent for 0-10 full time Registered Nurses and Licensed Practical Nurse nursing services to the Pine Ridge Service Unit over the course of the contract. Since the PRSU operates 365 days a year, this contract may require multiple individual Contractor Personnel to meet this requirement. The Government may significantly increase or decrease the level of effort of this task order at any time by contract modification in response to staffing requirements. It is of utmost importance the contractor renders seamless coverage and provides continuity care. The contractor shall furnish licensed, experienced personnel, with the relevant background in accordance with the terms and conditions specified in the resulting contract.

The Number of RNs/LPNs are not to exceed 10 providers throughout the duration of this contract. The RNs/LPNs will be assisting in all areas of the outpatient clinic.

C.2.2 Contract Type This is a labor hour type service contract for Out-Patient Nursing Units which includes all specialty clinics and all locations for the Pine Ridge Service Unit which consist of Pine Ridge IHS Hospital, Mobile Clinic, Kyle Health Center, Wanblee Health Center, and the LaCreek Health Center. However, there are significant constraints on the contractor's solution to achieving the purpose of this contract.

The PRSU staffing levels are determined by acuity and standards of care. Therefore, this contract establishes a minimum level of support coverage that must be maintained during each shift. While there are no restrictions on the maximum number of Contractor Personnel hired for this contract, the nursing service physical presence cannot fall below contractually established minimums regardless of patient workload. The practical consequence of this for the Contractor is that although it is a performance-based contract, the staffing requirement takes on the characteristics of a labor hour contract in that the contract identifies specified skill types/levels for a stipulated number of hours.

Throughout this contract, all references to "Contractor" refers to the awardee. All references to "Contractor Personnel” refer to Contractor staffing provided in support of the contract.

C.2.3 Contract Performance Period The contract performance period will be for 90 days from award date.

In addition, this contract can be terminated for the convenience of PRSU if, a sufficient number of permanent government providers are hired to serve in this work capacity. In this event, an authorized government CO shall provide a preliminary written notice to contractor, 60 days in advance.

***The Government may require the removal and replacement of Personnel as a result of security actions or other reasons, e.g., removal of unqualified or habitually careless Personnel or the removal of Personnel that cannot perform the assigned tasks or display unacceptable conduct and behavior.

C.2.4 Contract Place of Performance

1. Pine Ridge Service Unit 607 Indian Health Road, Pine Ridge, SD 57770.

2. Kyle Health Center 1000 Health Center Rd. Kyle SD 57752

3. Wanblee health Center 210 1st St, Wanblee SD 57577

4. Lacreek Health Center 119 S 1st Ave, Martin SD 57551

5. Mobile Unit/Clinic

6. Pine Ridge Jail,

7. Community Outreach (i.e., school activities)

C.3) Labor Hour Type Requirements

C.3.1 Scope

The contractor shall furnish Out-Patient Nursing services. These services will be compatible with the facility’s operating capacity and equipment. The contractor shall report to the Chief Nurse Executive, Deputy Chief Nurse Executive or CEO Designee at PRSU.. Contract services shall cover the range of Out- Patient clinic nursing services typically provided in rural civilian practice, including but not limited to the following: EKG completion, cardiac monitoring, medication administration, immunization administration, patient education related to wellness and chronic illness appropriate to patient learning preference and education level, wound care including vacuum assisted closure dressings, general diabetes education, head-to-toe physical examination and documentation of normal and abnormal findings for all ages, preventative wellness screenings including for intimate partner violence, diabetes foot checks, alcohol use disorder, smoking practices, breast feeding use, falls risk, social determinants of health, Depression screening, vital sign assessment and reassessment, mini-mental screening, measurement and fitting of DME supplies, Point of care testing, lab sample collection, intravenous catheter placement and removal, foley catheter care and placement.

The services to be delivered under this contract by the Contractor to the Government are non-personal services and no employer-employee relationship exists or will exist under the contract between the Government and the Contractor Personnel.

Contractor Personnel under this contract shall not be:

Placed in a position where they are under the supervision or evaluation of a government employee (except for mandatory peer review and authorized "work direction"): or

Placed in a position of supervision, management, or control over government personnel, or personnel of other contractors, or become a part of the government.

Given the nature of the contract requirements and the medical working environment, it may be necessary for specifically designated Government supervisory personnel to provide "work direction" to the Contractor Personnel. This is accomplished while preserving the non-personal services nature of the contract. The operational need to work as a team is accomplished in a manner consistent with preserving the management responsibilities of the Contractor.

The Contractor is at all times responsible for the quality of Contractor Personnel work. It is the direct responsibility of the Contractor to perform all tasks normally associated with an employer-employee relationship, e.g., completing time cards, resolving quality of work issues, ensuring high motivation and morale, and resolving Government-identified Contractor performance concerns.

The physical absence of an on-site Contractor direct line supervisor does not relieve the Contractor of these responsibilities. For example, the completion and accuracy of time cards is a direct responsibility of the Contractor, not the Government. It is also the direct responsibility of the Contractor to ensure any documents needing to go with time cards are also submitted (eg. HIM deficiencies form). Since this is a non-personal services contract, the Government will not assume the supervisory functions except to the extent of providing the work direction addressed above.

The Contractor Personnel will be required to work in both the adult, pediatric, women’s health, orthopedic, podiatry, mobile unit and isolation sections of the clinics. The Contractor Personnel may be assigned to work in the emergency department and the acute care in-patient department as needed for limited nursing actions such as patient observation, medication passes, vitals collection, or point of care testing. The Contractor shall be flexible in rotating temporarily, or permanently moving into, other shifts upon notification by the COR. The Contractor Personnel identified for rotation or temporary move into a new shift will be required to undergo orientation to the new shift and unit. Hours may vary: day shifts, evening shifts, and weekends and holidays. The Contractor Personnel are expected to complete their shift to the end of their scheduled shift. Approval to leave early may be requested and may approved by the Supervisor or designee. In cases of expected inclement weather, contractor personnel are expected to secure quarters close enough to the facility to present for their scheduled shift during snow storms, blizzards, icy road conditions, or cold/heat extremes.

To Request for housing accommodations during inclement weather please contact Housing/Facilities and Contractor Officer Representative (COR):

To function effectively and efficiently as a team member in this environment, the work demands Contractor Personnel with a high degree of knowledge, skills, and abilities. Contractor management plays a key role in sustaining this high performing, highly motivated, and responsive Registered Nurses and Licensed Practical Nurses to support effort that enhances the image of the PRSU and gains the confidence of the supported Native American population.

MAJOR TASKS: Position provides direct care in assessing, planning implementing and evaluating care for patients. Responsible for performing direct patient care duties to all ages of patients with diverse acute & chronic health problems.

1. Provides direct patient care for Outpatient care patients of all ages with diverse medical and nursing diagnoses.

2. Receives patients, conducts proper patient identification x 2.

3. Intervention includes but is not limited to: Dressing changes; ambulation; assists with activities of daily living; range of motion - limited physical therapy; administering medications and vaccines as prescribed by the provider including all routes of administration PO, IM, IV, etc);

respiratory treatment and oxygen therapy; fitting of assistive devices, splints, or durable medical equipment; patient education adjusted to appropriate level; urinary catheter placement;

collection of tissue and biological samples, venipuncture for collection of blood samples; and set-up for minor procedures following aseptic techniques.

4. Preforms nursing reassessments independently to evaluate patient response to nursing interventions and updates/revises plan of care based on changes in health status and reassessments.

5. The Contractor shall provide coverage in the as needed during staff vacancies, vacation, sick leave, etc.

6. Provides instruction to patients on disease process, procedures, plan of care, use of equipment, specimen's collection of health maintenance and document per educational plans and policies.

7. Assess the biophysical, psychosocial, emotional, educational, spiritual, and cultural needs of all medical, surgical and pediatric patients in accordance with established patient care standards.

Plan nursing care for patients utilizing the nursing process and in accordance with established unit standards and license scope.

8. Initiate treatments, medications, emergency and resuscitative measures based on appropriate utilization of standing orders and unit protocols. Document observations, nursing interventions, therapeutic measures administered and patient response to treatment and reevaluation of nursing care according to facility standards.

9. Maintains complete nursing documentation, medical record confidentiality and safeguards medical information. Follows CMS, TJC requirements for nursing documentation, utilizes approved forms and participates in the overall monitoring and compliance with these standards.

10. Consult with primary care providers and other healthcare professionals on patients to coordinate diagnostic and therapeutic regimens for patients.

11. Provide patient and family education which include counseling and assisting the patient/family to understand and accept implications of care, diagnosis, and treatment.

12. The contract Registered Nurse and Licensed Practical Nurse will perform primary functions of assessing, planning, implementing and evaluating the care of all assigned patients in the Outpatient Department, Specialty Clinic Departments, Mobile Clinic, Kyle Health Center, Wanblee Health Center, and LaCreek Health Center. The contract Registered Nurse and Licensed Practical Nurse is responsible for meeting established Unit Standards of Nursing Practice; for managing supplies and equipment on the unit, and promoting teamwork with primary care providers, personnel of other departments and the patient community.

13. The contract Registered Nurse and Licensed Practical Nurse shall generate and maintain appropriate electronic health care information on beneficiaries to whom treatment is provided in accordance with IHS regulations.

14. The contract Registered Nurse and Licensed Practical Nurse shall comply with all IHS facility infection control and safety procedures, practices, and standards.

15. Develops a plan of care for individual patients identifying problems, needs of the patient, and patient driven health goals makes adjustments to the plan of care as needed, and evaluates the plan of care.

16. Contractor personnel must be able to assist in a cardiac arrest situation. This will include knowing CPR and recognizing anaphylaxis and respond to other emergency situations with other staff members. American Heart Association BLS, ACLS, and PALS is required by the Indian Health Service for consideration of a contract candidate.

17. Only perform procedures consistent with the PRSU and PRSU operating capacity and equipment.

Performs quality control checks on point of care equipment, defibrillators, isolation room environment compliance, alarm system functionality, and any other equipment assigned for routine quality control review. This position will be expected to personally perform the full range of nursing procedures offered by the Pine Ridge Service Unit Out-Patient Clinic and Specialty Clinic Nursing Department. These include, but are not limited to Adult and Pediatric Venipuncture and Skin puncture for IV placement and/or blood sample collection, assisting physician with cast application or cast removal placement of nasogastric tubes, oral and nasal airway suction, cardiac telemetry placement and monitoring, placement and monitoring of oxygen therapy, wide range of wound care including vacuum assisted closure dressings, medication and vaccine administration (oral, transdermal, intravenous, intramuscular, sublingual subcutaneous, nasal, rectal, nebulized, etc), application and use of defibrillator including pacing functions, use of patient ambulation assistive devices, fitting of supportive splint devices, durable medical equipment and supplies, orogastric feeding tube devices, placement and care of urinary catheters, care of gastric ostomy and replacement of collection bags, and set up of procedure equipment and supply trays using aseptic technique.

18. Collect, interpret and record; and communicate pertinent patient data relevant to the patient's care before, during and after patient visit.

19. Accurately review, confirm, and complete orders for each patient as placed by medical provider:

admission, transfer, discharge, medication, diagnostic testing, diet, code status, ambulation, infection control precautions, fall risk precautions, and assessment/reassessment orders. Have knowledge of and appropriately utilize facility standing orders.

20. Communicate/document the psychosocial health status of the patient to include patients' perception of care, expectations/goals of care, coping mechanisms, knowledge level, ability to understand, philosophical and religious beliefs and cultural practices.

21. Respect and maintain the basic rights of patients, to include but not be limited to personal dignity.

22. Accurately document according to PRSU policies and the PRSU Nursing Department policies and procedures within EHR, RPMS, and within other…