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Performance Work Statement Exhibits

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EXHIBIT 1 REQUIREMENTS

ESTIMATED WORKLOAD DATA

ITEM NAME/DESCRIPTION (MEDCOM PHA SALEM)

EVENT DATA

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 9 SEP 2016/ 1300

3 Dates of Event : 10 SEP 2016 / 0800 11 SEP 2016 / 1730

4 Scheduled Times 0800 1730

6 Number of Soldiers: MIN: 350 MAX: 450

7 Number of Mobilizing Soldiers: MIN: 0 MAX: 0

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 10-11 SEP 2016

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

9 9 SEP 2016: PA/NP for PHAs (1) Total: 10-100

10 10-11 SEP 2016 Medical Provider Services: (2 Physicians, PA’s, or NP’s) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 2 REQUIREMENTS

ITEM NAME/DESCRIPTION (MEDCOM PHA SALEM)

EVENT DATA

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 21 OCT 2016/ 1300

3 Dates of Event : 22 OCT 2016 / 0800 23 OCT 2016 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 22-23 OCT 2016

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

9 21 OCT 2016: 2 PA/NP for PHAs Total: 10-200

10 22-23 OCT 2016: Medical Provider Services: (3 Physicians, PA’s, or NP’s) Total: 350-450

Hearing Screenings: (1 Hearing tech., 1 Mobile Hearing Practice (8 Sound

Proof booths) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 3 REQUIREMENTS

ITEM NAME/DESCRIPTION (MEDCOM PHA BEND)

1 Places of Performance (Address): 875 Simpson Ave, Bend, OR 97723-3118

Start Date/Time End Date/Time

2 Set Up Date: 4 NOV 2016/ 1300

3 Dates of Event : 5 NOV 2016 / 0800 6 NOV 2016 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 5-6 NOV 2016

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

9 Medical Provider Services: (3 Physicians, PA’s, or NP’s) Total: 350-450

Hearing Screenings: (1 Hearing tech., 1 Mobile Hearing Practice (8 sound

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 4 REQUIREMENTS

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 4 NOV 2016/ 1300

3 Dates of Event : 5 NOV 2016 / 0800 6 NOV 2016 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 5-6 NOV 2016

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

9 4 NOV 2016: 2 PA/NP for PHAs Total: 10-200

10 5-6 NOV 2016 Medical Provider Services: (3 Physicians, PA’s, or NP’s) Total: 350-450

Hearing Screenings: (1 Hearing tech, 1 Mobile Hearing Practice (8 sound

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 5 REQUIREMENTS

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 2 DEC 2016/ 1300

3 Dates of Event : 3 DEC 2016 / 0800 4 DEC 2016 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 3-4 DEC 2016

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

9 2 DEC 2016: 3 PA/NP for PHAs Total: 10-100

2 DEC 2016: Hearing Screenings: (1 Hearing tech., 1 Mobile Hearing

Practice (8 sound Proof booths) Total: 10-150

11 3-4 DEC 2016: Medical Provider Services: (1 Physician, PA, or NP) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 6 REQUIREMENTS

ITEM NAME/DESCRIPTION (MEDCOM PHA CLACKAMAS)

1 Places of Performance (Address): 15300 SE Minuteman Way, Clackamas, OR 97015-9372

Start Date/Time End Date/Time

2 Set Up Date: 6 JAN 2017/ 1300

3 Dates of Event : 7 JAN 2017 / 0800 8 JAN 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 7-8 JAN 2017

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

6 JAN 2016: Hearing Screenings: (1 Hearing tech, 1 Mobile Hearing Practice

(8 sound proof booths) ), 1 PA/NP for PHAs Total: 10-150

10 7-8 JAN 2016 Medical Provider Services: (3 Physicians, PA’s, or NP’s) Total: 350-450

Hearing Screenings: (2 Hearing tech., 2 Mobile Hearing Practice (16 sound

Proof booths) Total: 700-900

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 7 REQUIREMENTS

ITEM NAME/DESCRIPTION (MEDCOM PHA MEDFORD)

1 Places of Performance (Address): 1701 S. Pacific Hwy, Medford, OR 97501-7914

Start Date/Time End Date/Time

2 Set Up Date: 6 JAN 2017/ 1300

3 Dates of Event : 7 JAN 2017 / 0800 8 JAN 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 7-8 JAN 2017

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

10 Medical Provider Services: (3 Physicians, PA’s, or NP’s) Total: 350-450

Hearing Screenings: (1 Hearing tech., 1 Mobile Hearing Practice (8 sound

Proof booths) ) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 8 REQUIREMENTS

ITEM NAME/DESCRIPTION (MEDCOM PHA KLIEVER)

1 Places of Performance (Address): 10000 NE 33rd Dr, Portland, OR 97211

Start Date/Time End Date/Time

2 Set Up Date: 10 FEB 2017/ 1300

3 Dates of Event : 11 FEB 2017 / 0800 12 FEB 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 11-12 FEB 2017

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

10 Medical Provider Services: (3 Physicians, PA’s, or NP’s) Total: 350-450

Proof booths) ) Total: 700-900

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 9 REQUIREMENTS

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 10 FEB 2017/ 1300

3 Dates of Event : 11 FEB 2017 / 0800 12 FEB 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 11-12 FEB 2017

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

10 10 FEB 2017: 2 PA/NP for PHAs Total: 10-150

11 11-12 FEB 2017 Medical Provider Services: (3 Physicians, PA’s, or NP’s) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 10 REQUIREMENTS

ITEM NAME/DESCRIPTION (MEDCOM PHA LAGRANDE)

1 Places of Performance (Address): 404 12TH Street, La Grande, OR 97850-2820

Start Date/Time End Date/Time

2 Set Up Date: 3 MAR 2017/ 1300

3 Dates of Event : 4 MAR 2017 / 0800 5 MAR 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 4-5 MAR 2017

Check in/briefing 0800

PHA Services, Hearing Services begin 0815

PHA Services, Hearing Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

9 Medical Provider Services: (3 Physicians, PA’s, or NP’s) Total: 350-450

Proof booths) Total: 700-900

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 11 REQUIREMENTS

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 3 MAR 2017/ 1300

3 Dates of Event : 4 MAR 2017 / 0800 5 MAR 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 4-5 MAR 2017

Check in/briefing 0800

PHA Services begin 0815

PHA Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

10 3 MAR 2017: 2 PA/NP for PHAs Total: 10-150

11 4-5 MAR 2017 Medical Provider Services: (3 Physicians, PA’s, or NP’s) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 12 REQUIREMENTS

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 31 MAY 2017/ 1300

3 Dates of Event : 1 APR 2017 / 0800 2 APR 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 1-2 APR 2017

Check in/briefing 0800

PHA Services begin 0815

PHA Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

10 31 MAY 2017: 1 PA/NP for PHAs Total: 10-150

11 Medical Provider Services: (1 Physician, PA, or NP) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 13 REQUIREMENTS

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 5 MAY 2017/ 1300

3 Dates of Event : 6 MAY 2017 / 0800 7 MAY 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 6-7 MAY 2017

Check in/briefing 0800

PHA Services begin 0815

PHA Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

10 5 MAY 2017: 1 PA/NP for PHAs Total: 10-150

11 6-7 MAY 2017: Medical Provider Services: (1 Physician, PA, or NP) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 14 REQUIREMENTS

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 2 JUN 2017/ 1300

3 Dates of Event : 3 JUN 2017 / 0800 4 JUN 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 3-4 JUN 2017

Check in/briefing 0800

PHA Services begin 0815

PHA Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

11 2 JUN 2017: 1 PA/NP for PHAs Total: 10-150

10 3-4 JUN 2017 Medical Provider Services: (1 Physician, PA, or NP) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 15 REQUIREMENTS

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 7 JUL 2017/ 1300

3 Dates of Event : 8 JUL 2017 / 0800 9 JUL 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 8-9 JUL 2017

Check in/briefing 0800

PHA Services begin 0815

PHA Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

11 7 JUL 2017: 1 PA/NP for PHAs Total: 10-150

10 8-9 JUL 2017 Medical Provider Services: (1 Physician, PA, or NP) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

EXHIBIT 16 REQUIREMENTS

1 Places of Performance (Address): 3225 State Street, Salem, OR 97309

Start Date/Time End Date/Time

2 Set Up Date: 4 AUG 2017/ 1300

3 Dates of Event : 5 AUG 2017 / 0800 6 AUG 2017 / 1730

EVENT SCHEDULE

Set Up One Day Prior to Event (1300 – 1700)

Event 5-6 AUG 2017

Check in/briefing 0800

PHA Services begin 0815

PHA Services complete 1730

POC for event Set Up or clarification at any time during the event if the POCs on the ground are unable to assist with an issue please call (numbers to be given upon award of the contract).

POC during event (to be provided after contract is awarded) Services are coordinated through the Oregon National Guard

Office of the State Surgeon.

INDIVIDUAL SERVICES

10 4 AUG 2017: 1 PA/NP for PHAs Total: 10-150

11 5-6 AUG 2017 Medical Provider Services: (1 Physician, PA, or NP) Total: 350-450

All above processes and services will be discussed for clarification Thursday and Friday immediately before the event.

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