1282A726Q0005 Full.pdf

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

82A7

LAKEWOOD CO 80401

1617 COLE BLVD

USDA FOREST SERVICE

JOB CORPS AQM

5699 CODE 16. ADMINISTERED BYCODE

X

X

621111

SIZE STANDARD:

% FOR:SET ASIDE:UNRESTRICTED OR82A7

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

01/13/2026 1700 ES

12/15/2025

303-275-5393LOUIS LIEB

(No collect calls)

INFORMATION CALL:

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

4. ORDER NUMBER3. AWARD/ 6. SOLICITATION

1282A726Q0005

5. SOLICITATION NUMBER

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

1 22 1160865OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

TELEPHONE NO.

17a. CONTRACTOR/

LAONA WI 54541

4155 COUNTY HWY H

BLACKWELL JOB CORPS CENTER

USDA FOREST SERVICE

15. DELIVER TO

LAKEWOOD CO 80401

1617 COLE BLVD

USDA FOREST SERVICE

9. ISSUED BY

7.

2. CONTRACT NO.

EFFECTIVE DATE

$16

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)

JOB CORPS AQM

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.

Medical Services; Blackwell Job Corps Center;

Laonia, WI

The Contractor shall provide Medical Services to Blackwell JCC in accordance with the Terms and Conditions herein.

This Firm Fixed Price contract is for a Base Year with four (4) one year options which may be exercised at the sole discretion of the Government.

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

HEREIN, IS ACCEPTED AS TO ITEMS:

XX

DATED

GRACE H. WALTON

. 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.

Period of Performance: 02/01/2026 to 01/31/2031

0001 Blackwell Medical Services - Base Year 400 HR

Product/Service Code: Q201

Product/Service Description: MEDICAL- MANAGED

HEALTHCARE

Delivery: 01/31/2027

Period of Performance: 02/01/2026 to 01/31/2027

1001 Blackwell Medical Services - Option Year One 400 HR

(Option Line Item)

Product/Service Code: Q201

Product/Service Description: MEDICAL- MANAGED

HEALTHCARE

Delivery: 01/31/2028

Period of Performance: 02/01/2027 to 01/31/2028

2001 Blackwell Medical Services - Option Year Two 400 HR

(Option Line Item)

Product/Service Code: Q201

Product/Service Description: MEDICAL- MANAGED

HEALTHCARE

Delivery: 01/31/2029

Period of Performance: 02/01/2028 to 01/31/2029

3001 Blackwell Medical Services - Option Year Three 400 HR

Continued ...

32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT REPRESENTATIVE

32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT REPRESENTATIVE

22 2 of

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

NAME OF OFFEROR OR CONTRACTOR

3 22

CONTINUATION SHEET

REFERENCE NO. OF DOCUMENT BEING CONTINUED PAGE OF

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

1282A726Q0005

(Option Line Item)

Product/Service Code: Q201

Product/Service Description: MEDICAL- MANAGED

HEALTHCARE

Delivery: 01/31/2030

Period of Performance: 02/01/2029 to 01/31/2030

4001 Blackwell Medical Services - Option Year Four 400 HR

(Option Line Item)

Product/Service Code: Q201

Product/Service Description: MEDICAL- MANAGED

HEALTHCARE

Delivery: 01/31/2031

Period of Performance: 02/01/2030 to 01/31/2031

5001 Blackwell Medical Services - Option to Extend 200 HR

Servies IAW FAR 52.217-8

Product/Service Code: Q201

Product/Service Description: MEDICAL- MANAGED

HEALTHCARE

Delivery: 08/01/2031

Period of Performance: 02/01/2031 to 08/01/2031

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

Sponsored by GSA

FAR (48 CFR) 53.110

Blackwell Medical Services 1282A726Q0005

Statement of Requirement The Blackwell Job Corps Center has a need for basic health services provided by licensed medical professionals that includes examinations and assessments, treatment, issuance of prescriptions and immunizations, monitoring health conditions, recommending hospitalization, follow-up care, and prevention planning and intervention.

Additional Information

• Contractors are only responsible for providing for basic health care as detailed in the SOW in accordance with the Policy and Requirements Handbook (PRH) Exhibit 6-4 (Job Corp Basic Health Care Responsibilities) https://supportservices.jobcorps.gov/health/Pages/default.aspx

• Emergency Services: Emergency services are not included into the scope of work. Should the center require emergency medical assistance, the center shall contact 911 for immediate assistance.

• Hours per Week: The requirement is a firm-fixed priced contract for 400 total annual hours. It is acceptable for the center/contractor to ‘flex’ hours from one week to another as long as ALL the total annual hours are provided by the end of the contract period of performance. (Funding is for 50 weeks per annum)

• Missed Days: All diligence and effort shall be made to make up any missed days/hours as soon as possible. Upon mutual agreement, additional hours can be provided outside the established schedule in order to make up any missed days.

Location Blackwell Job Corp Center 4155 County Road H

Laona, WI 54541

Schedule of Items/Price Schedule

Project Description: Medical Services at Blackwell Job Corp Center

Vendor Name: __________________________________Vendor UEI:___________________

19.

ITEM

NO.

20.

SCHEDULE OF SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT

PRICE

24.

TOTAL AMT

BASE YEAR SERVICES – February 1, 2026 through January 31, 2027

0001 Medical Services Base (8 hours per week) 400 HR $ $

BASE YEAR SERVICES TOTAL: $

https://supportservices.jobcorps.gov/health/Pages/default.aspx

19.

ITEM

NO.

20.

SCHEDULE OF SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT

PRICE

24.

TOTAL AMT

OPTION YEAR ONE SERVICES – February 1, 2027 through January 31, 2028

1001 Medical Services Option Year 1 (8 hours per week) 400 HR $ $

OPTION PERIOD ONE SERVICES TOTAL: $

ITEM

NO.

20.

SCHEDULE OF SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT

PRICE

24.

TOTAL AMT

OPTION YEAR TWO SERVICES – February 1, 2028 through January 31, 2029

2001 Medical Services Option Year 2 (8 hours per week) 400 HR $ $

OPTION PERIOD TWO SERVICES TOTAL: $

19.

ITEM

NO.

20.

SCHEDULE OF SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT

PRICE

24.

TOTAL AMT

OPTION YEAR THREE SERVICES – February 1, 2029 through January 31, 2030

3001 Medica Services Option Year 3

OPTION PERIOD THREE SERVICES TOTAL: $

NO.

20.

SCHEDULE OF SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT

PRICE

24.

TOTAL AMT

OPTION YEAR FOUR SERVICES – February 1, 2030 through January 31, 2031

4001 Medical Services Option Year 4

OPTION PERIOD FOUR SERVICES TOTAL: $

NO.

20.

SCHEDULE OF SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT

PRICE

24.

TOTAL AMT

Six Month Extension IAW 52.217-8 February 1, 2031 through August 01, 2031

5001 Medical Services – Six Month Extension 200 HR $ $

-8 IAW 52.217-8 SERVICES TOTAL: $

GRAND TOTAL WITH ALL OPTIONS: $____________________

Award Type

It is anticipated that a firm-fixed price requirements contract consisting of one (1) one-year base period and four (4) one-year option periods shall be awarded as a result of this solicitation. The total duration of this contract shall not exceed five (5) years, 6 months.

The Government intends to make one award from this solicitation. Therefore, to be considered responsive, contractors must submit pricing for all items.

Evaluation and Basis for Award

The provision at FAR 52.212-2, Evaluation—Commercial Products and Commercial Services is not applicable to this solicitation. In lieu of this provision, quotes will be evaluated in accordance with FAR 12.203 based on the criteria listed below. Award will be made to the offeror representing the best value to the Government.

• Technical Capability

• Past Performance

• Price

Federal Acquisition Regulation (FAR) and United States Department of Aquiculture Acquisition Regulation (AGAR) Clauses and Provisions The clauses and provisions contained herein are applicable to any order awarded as a result of this solicitation. The terms and conditions set forth herein supersede all other terms and conditions.

Acceptance of the order in accordance with (IAW) FAR 12.201-1(b)(2) constitutes acceptance of all terms and conditions contained herein.

As part of the Revolutionary FAR Overhaul (RFO), system updates may lag policy updates. The System for Award Management (SAM) may continue to require entities to complete representations based on provisions that are not included in this solicitation. Contracting officers will rely on representations from offers based on provisions in the solicitation. Entities are not required to, nor are they able to, update their entity registration to remove these representations in SAM.

52.252-1 Solicitation Provisions Incorporated by Reference Feb 1998 This solicitation incorporates one or more solicitation provisions 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. The offeror is cautioned that the listed provisions may include blocks that must be completed by the offeror and submitted with its quotation or offer. In lieu of submitting the full text of those provisions, the offeror may identify the provision by paragraph identifier and provide the appropriate information with its quotation or offer. Also, the full text of a solicitation provision may be accessed electronically at this/these address(es): https://www.acquisition.gov/far-overhaul/far-part-deviation-guide/far-overhaul-part-52 https://www.acquisition.gov/far-overhaul/far-part-deviation-guide/far-overhaul-part-52

52.212-1 Instructions to Offerors - Commercial Products and Commercial Services (Nov 2025)

(1) Offerors must have an active entity registration in the System for Award Management in order to submit an offer. https://www.sam.gov/SAM/

(2) Offers submitted in response to this solicitation shall include a technical proposal, a price proposal, and contractor representations and certifications.

a) Technical Proposal – The technical proposal shall address the evaluation factors in FAR 52.212-2. At a minimum technical proposal shall include a completed Quoter’s Questionnaire (Attachment 2) and the following :

i) Past Performance – provide a list of similar projects completed by your firm over the past three years. Include a brief description of the project, dollar amount, year completed, and project owner contact information (name, phone, and email). The government may use past performance information from any available source. If a company does not have past performance information available, information may be provided for predecessor companies, key personnel, or subcontractors. In the event that there is no past performance information available, the offeror will receive a neutral rating in this factor.

ii) Technical Capability

• Resumes for all candidates

• Unrestricted Medical licenses (including DEA, if applicable) for all candidates, valid in the State of Wisconsin

• Supervisory or Collaborative agreements for Nurse Practitioners and Physician’s

Assistant candidates (if applicable), valid in the Wisconsin.

• Medical liability insurance coverage of at least $1,000,000.00.

b) Price Proposal – Include the following: 1) the completed Schedule of Items from Section B of this solicitation, and 2) acknowledgement of any amendments to this solicitation by following the instructions that accompany the amendment(s).

a. The requirement consists of 400 total annual hours for Medical Services. The Schedule of

Services must include the hourly rate(s) for each position(s) submitted in the quotation; i.e.

Physician, Nurse Practitioner, OR a combination of Physician and Physician Assistant (PA)/Nurse Practitioner (NP), as applicable to the Quote being submitted;

b.

***Please ensure the Schedule of Services coordinates with the positions being submitted on the Quote. If combining positions, the hours provided by each must be a fixed amount, that when added, totals 400 hours per year.

For example:

Option #1: Physician $0.00 per hour x 400 hours per year.

https://www.sam.gov/SAM/

OR

Option #2: Nurse Practitioner $0.00 per hour x 400 hours per year

OR

Option #3:

Physician $0.00 per hour x 200 hours PA/NP $0.00 per hour x 200 hours

c. Total hours for both positions must equal the total 400 hours per year.

3) Submit offer by email to Louis Lieb so that it is delivered into this inbox by email by 1700 Eastern Time, January 13, 2026. Emails should contain 3 separate attachments (Technical Proposal, Price Proposal, and Representations and Certifications) in Microsoft Word, Excel, or Adobe PDF format. Be aware that large attachments may increase the time required to deliver an email. It is the offerors responsibility to confirm receipt of the offer from Louis Lieb.

4) Address questions about this solicitation to Louis Lieb at Louis.Lieb@usda.gov no later than January 6, 2026, at 17:00 Eastern Time. This will ensure enough time to respond before the solicitation period ends. Please include the solicitation name and number as the subject line of the email.

(End of provision)

52.203-18 Prohibition on Contracting with Entities that Require Certain Internal Confidentiality Agreements or Statements-Representation (Jan 2017) 52.240-90 Security Prohibitions and Exclusions Representations and Certifications (Nov 2025)

The following provisions are applicable if checked:

☒ 52.203-11 Certification and Disclosure Regarding Payments to Influence Certain Federal Transactions (Sep 2024) ☒ 52.204-7 System for Award Management—Registration (Nov 2025) ☐ 52.204-90 Offeror Identification (Nov 2025) ☐ 52.207-6 Solicitation of Offers from Small Business Concerns and Small Business Teaming Arrangements or Joint Ventures (Multiple-Award Contracts) (Aug 2024) ☐ 52.209-12 Certification Regarding Tax Matters (Oct 2025) ☐ 52.219-2 Equal Low Bids (Nov 2025) ☐ 52.222-18 Certification Regarding Knowledge of Child Labor for Listed End Products (Feb 2021) ☐ 52.222-48 Exemption from Application of the Service Contract Labor Standards for Maintenance, Calibration, or Repair of Certain Equipment–Certification (Nov 2025) mailto:Louis.Lieb@usda.gov

☐ 52.222-52 Exemption from Application of the Service Contract Labor Standards for Certain Services-Certification (Nov 2025) ☐ 52.222-56 Certification Regarding Trafficking in Persons Compliance Plan (Oct 2020) ☐ 52.223-4 Recovered Material Certification (May 2008) ☐ 52.225-2 Buy American Certificate (Oct 2022) ☐ 52.225-4 Buy American-Free Trade Agreements-Israeli Trade Act Certificate (Nov 2025) ☐ 52.225-6 Trade Agreements-Certificate (Feb 2021) ☐ 52.226-3 Disaster or Emergency Area Representation (Nov 2007) ☐ 52.229-11 Tax on Certain Foreign Procurements—Notice and Representation (Jul 2025)

Other Applicable FAR Provisions 52.217-5 Evaluation of Options (Nov 2025) 52.233-2 Service of Protest (Sep 2025) 52.237-1 Site Visits (Apr 1984)

52.252-2 Clauses Incorporated by Reference Feb 1998 This solicitation 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 the clause may be accessed electronically at Internet address https://www.acquisition.gov/far-overhaul/far-part-deviation-guide/far-overhaul-part-52

52.212-4 Terms and Conditions—Commercial Products and Commercial Services (Nov 2025) 52.203-17 Contractor Employee Whistleblower Rights (Nov 2023) 52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (Jan 2017) 52.222-50 Combating Trafficking in Persons (Nov 2025) 52.226-8 Encouraging Contractor Policies to Ban Text Messaging While Driving (May 2024) 52.232-40 Providing Accelerated Payments to Small Business Subcontractors (Mar 2023) 52.233-3 Protest After Award (Sep 2025) 52.233-4 Applicable Law for Breach of Contract Claim (Sep 2025) 52.240-91 Security Prohibitions and Exclusions (Nov 2025) 52.244-6 Subcontracts for Commercial Products and Commercial Services (Nov 2025)

The following provisions are applicable if checked: .

☐ 52.203-6 Restrictions on Subcontractor Sales to the Government (Jun 2020) ☐ 52.203-13 Contractor Code of Business Ethics and Conduct (Nov 2021) ☒ 52.203-17 Contractor Employee Whistleblower Rights (Nov 2023) ☐ 52.204-9 Personal Identity Verification of Contractor Personnel Jan 2011 ☒ 52.204-13 System for Award Management—Maintenance (Nov 2025) ☐ 52.204-91 Contractor identification (Nov 2025) ☒ 52.209-6 Protecting the Government’s Interest When Subcontracting with Contractors Debarred, Suspended, or Proposed for Debarment (Sep 2025) ☐ 52.209-9 Updates of Publicly Available Information Regarding Responsibility

Matters (Sep 2025) ☒ 52.209-10 Prohibition on Contracting with Inverted Domestic Corporations (Sep 2025) ☐ 52.219-4 Notice of Price Evaluation Preference for HUBZone Small Business Concerns (Nov 2025) ☐ 52.219-6 Notice of Total Small Business Aside (Nov 2025)

☐ Alternate I (Mar 2020).

☐ 52.219-8 Utilization of Small Business Concerns (Nov 2025) ☐ 52.219-9 Small Business Subcontracting Plan (Nov 2025) ☐ 52.219-14 Limitations on Subcontracting (Nov 2025) ☐ 52.219-16 Liquidated Damages—Subcontracting Plan(Nov 2025) ☐ 52.219-33 Nonmanufacturer Rule (Nov 2025) ☒ 52.222-3 Convict Labor (June 2003) ☐ 52.222-19 Child Labor—Cooperation with Authorities and Remedies (Nov 2025) ☒ 52.222-35 Equal Opportunity for Veterans (Nov 2025) ☒ 52.222-36 Equal Opportunity for Workers with Disabilities (Nov 2025) ☒ 52.222-37 Employment Reports on Veterans (Nov 2025) ☐ 52.222-40 Notification of Employee Rights Under the National Labor Relations Act (Dec 2010) ☒ 52.222-54 Employment Eligibility Verification (Nov 2025) ☒ 52.222-62 Paid Sick Leave Under Executive Order 13706 (Jan 2022) ☐ 52.223-9 Estimate of Percentage of Recovered Material Content for EPA-Designated Items (May 2008)

☐ Alternate I (May 2008) of 52.223-9 ☐ 52.223-11 Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (Nov 2025) ☐ 52.223-12 Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (Nov 2025) ☐ 52.223-23 Sustainable Products and Services ☒ 52.224-3 Privacy Training (Jan 2017) ☐ 52.225-1 Buy American-Supplies (Nov 2025) ☐ 52.225-3 Buy American--Free Trade Agreements--Israeli Trade Act (Nov 2025) ☐ 52.225-5 Trade Agreements (Nov 2023) ☐ 52.225-19 Contractor Personnel in a Designated Operational Area or Supporting a Diplomatic or Consular Mission outside the United States (May 2020) ☐ 52.225-26 Contractors Performing Private Security Functions Outside the United States (Oct 2016) ☐ 52.226-4 Notice of Disaster or Emergency Area Set-Aside (Nov 2007) ☐ 52.226-5 Restrictions on Subcontracting Outside Disaster or Emergency Area (Aug 2025) ☐ 52.229-12 Tax on Certain Foreign Procurements ☐ 52.232-29 Terms for Financing of Purchases of Commercial Products and Commercial Services (Nov 2021) ☐ 52.232-30 Installment Payments for Commercial Products and Commercial Services (Nov 2021)

☒ 52.232-33 Payment by Electronic Funds Transfer— System for Award Management (Oct 2018) ☐ 52.232-34 Payment by Electronic Funds Transfer—Other Than System for Award Management (Jul 2013) ☐ 52.232-36 Payment by Third Party (Nov 2025) ☐ 52.240-92 Security Requirements (Nov 2025) ☐ 52.247-64 Preference for Privately Owned U.S.-Flag Commercial Vessels (Nov 2025)

The Contractor shall comply with the following FAR Clauses for Commercial Services.

☒ 52.222-41 Service Contract Labor Standards (Aug 2018) ☐ 52.222-42 Statement of Equivalent Rates for Federal Hires (May 2014) ☒ 52.222-43 Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (Multiple Year and Option Contracts) (Aug 2018) ☐ 52.222-44 Fair Labor Standards Act and Service Contract Labor Standards -- Price Adjustment (May 2014) ☐ 52.222-51 Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment-Requirements (May 2014) ☐ 52.222-53 Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services-Requirements (Nov 2025)

Other Applicable Clauses

52.217-8 Option to Extend Services (Nov 1999) 30 calendar days prior to contract expiration 52.217-9 Option to Extend the Term of the Contract (Mar 2000)

(a) 30 Calendar days prior to contract expiration and 30 days

(c) five years and 6 months.

52.232-40 Providing Accelerated Payment to Small Business Subcontractors (Mar 2023) 52.232-90 Fast Payment Procedures (Nov 2025) 52.245-1 Government Property (Sep 2021) 52.237-7 Indemnification and Liability Insurance (Nov 2025): $1 million.

AGAR Clauses

452.204–70 Modification for Contract Closeout (Nov 2025)

(a) If unliquidated funds in the amount of $1000 or less remain on the contract, the Contracting Officer (Contracting Officer) shall issue a unilateral modification for deobligation. The contractor will receive a copy of the modification but will not be required to provide a signature. The Contracting Officer shall immediately proceed with contract closeout upon completion of the period of performance, receipt and acceptance of supplies or services, and final payment.

(b) Upon contract closeout for contracts utilizing SAP: if unliquidated funds of more than $1000 remain on the contract, the Contracting Officer shall issue a bilateral modification for deobligation.

The contractor will receive a copy of the modification and will be required to provide a signature.

(The Contracting Officer may also request a “Contractor Release of Claims” be completed by the contractor, although not required for contracts and orders using SAP.) If the bilateral modification and Release of Claims are not returned to the Contracting Officer within 60 days, the Contracting Officer shall release the modification as unilateral and proceed with contract closeout upon completion of the period of performance, receipt and acceptance of supplies or services, and final payment.

(c) Upon contract closeout for contracts utilizing anything other than cost reimbursement, if unliquidated funds of more than $1000 remain on the contract, the Contracting Officer shall issue a bilateral modification for deobligation. The contractor will receive a copy of the modification and a ‘‘Contractor Release of Claims’’ and will be required to provide a signature on both forms. If the bilateral modification and Release of Claims are not returned to the Contracting Officer within 120 days, the Contracting Officer shall release the modification as unilateral and proceed with contract closeout upon completion of the period of performance, receipt and acceptance of supplies or services, and final payment.

(End of Clause)

452.204-71 Personal Identity Verification of Contractor Employees (Nov 2025)

(a) The contractor shall comply with the personal identity verification (PIV) policies and procedures established by the United States Department of Agriculture (USDA) Directives 4620-002 series.

(b) Should the USDA Directives 4620-002 require the exclusion of a contractor's employee, the contracting officer will notify the contractor in writing. The contractor must appoint a representative to manage compliance with the PIV policies established by the USDA Directives 4620-002 and to maintain a list of employees eligible for a USDA LincPass required for performance of the work.

(c) The responsibility of maintaining a sufficient workforce remains with the contractor. Contractor employees may be barred by the Government from performance of work should they be found ineligible or to have lost eligibility for a USDA LincPass. Failure to maintain a sufficient workforce of employees eligible for a USDA LincPass may be grounds for termination of the contract.

(d) The contractor shall insert this clause in all subcontracts when the subcontractor is required to have routine unaccompanied physical access to a Federally controlled facility and/or routine unaccompanied access to a Federally controlled information system.

(e) The PIV Sponsor for this contract is a designated program point of contact, which in most cases is the COR, unless otherwise specified in this contract. The PIV Sponsor will be available to receive contractor identity information from [hours and days to be added by CO] to [hours and days to be added by CO] at [office address for registration to be added by CO]. The Government will notify the contractor if there is a change in the PIV Sponsor, the office address, or the office hours for registration; however, it is the contractor's responsibility to meet all aspects of paragraphs (c), (d), and (e).

(End of Clause)

Attachment 1: Statement of Work – Medical Services

Project Medical Services for Blackwell Job Corps Civilian Conservation Center (JCCC) General Information

1.0 Scope of Work

1.1. The Physician and/or Nurse Practitioner/Physician Assistant shall provide ON-SITE

Medical services for all students on Center, in accordance with applicable Federal laws/regulations, OSHA and HIPAA requirements, state and local laws, and guidelines of the American Medical Association. The USDA Forest Service Job Corps Civilian Conservation Centers (JCCCC) provide academic, vocational, and life-learning skills to at risk youth and young adults at 24 Job Corps Centers across the United States (U.S.). As part of this program, youth and young adults at the Centers are provided healthcare services as follows: medical, dental, mental health, and drug & alcohol intervention. Each Forest Service JCCCC has a need for basic health services provided by licensed medical professionals that includes examinations and assessments, treatment, issuance of prescriptions and immunizations, monitoring health conditions, recommending hospitalization, follow-up care, and prevention planning and intervention.

1.2. Medical services must also include analysis and use of the most efficient and cost-effective practice of contemporary, evidence-based health care possible given available time, resources, and personnel. These services will involve coordinating and integrating the medical services program with other health and wellness components/activities on Center and providing medical services to enrollees and established students on Center.

1.3. The general emphasis of Medical services must be on the early identification and diagnosis of medical problems, basic health care and health promotion, prevention, and education designed to help students overcome barriers to employability as outlined in the Policy and Requirements Handbook (PRH) Chapter 2, Support Student Services, Section 2.3, R4. Health Services at the link below; continuing links to other reference materials are held within that web page.

d. https://prh.jobcorps.gov/Pages/Home.aspx

1.4. In addition, contracted personnel shall adhere to any such standards as may be established by the Office of the Director, Job Corps, US Department of Labor (DOL), and the Contractor. The contractor shall be responsible for the direct supervision of contractor’s personnel on the Center. Contractor’s on-Center staff shall coordinate with the Health and Wellness Director and/or Center Director on all matters of program operations and coordination with other Center activities.

2.0 Background:

https://prh.jobcorps.gov/Pages/Home.aspx

Job Corps is a U.S. Department of Labor (DOL), Employment and Training Administration (ETA) program. Job Corps is designed to assist young people who need and can benefit from the wide-range of services provided at a Job Corps center. Services include the following: basic education, High School Diploma (HSD) program; General Educational Development (GED); vocational skills training; residential living program; healthcare; and related support services. The comprehensive combination of training and support services is designed to help each student become a responsible and productive citizen. Student populations range from 100 to over 300 enrollments depending on the Center’s On Board Strength (OBS). Job Corps is a self-paced program: therefore, a student’s length of enrollment varies. Students may remain in the program for up to two years, but the average length of enrollment is approximately eight to nine months.

3.0. Technical Requirements / Tasks

3.1. Task 1 – General

Provision of medical services requires, but is not limited to:

3.1.1. The Physician and/or Nurse Practitioner/Physician Assistant shall provide ON-SITE Medical services for all students on Center, in accordance with applicable Federal laws/regulations, OSHA and HIPAA requirements, state and local laws, and guidelines of the American Medical Association. The provider must possess the ability to work both independently and as a member of a healthcare team to provide optimal services to a population of financially disadvantaged youth, typically ranging from 16 to 24 years in age.

e.

3.1.2. Medical services must also include analysis and use of the most efficient and cost-effective practice of contemporary, evidence-based health care possible given available time, resources, and personnel. These services will involve coordinating and integrating the medical services program with other health and wellness components/activities on Center and providing medical services to enrollees and established students on Center.

3.1.3. The general emphasis of medical services must be on the early identification and diagnosis of medical problems, basic medical care, and medical promotion, prevention, and education as outlined in the Policy and Requirements Handbook (PRH) 2.3 Health Services and included in the required immunization, screenings, and laboratory test list in Exhibit 2-4 (Job Corp Basic Health Care Responsibilities) https://prh.jobcorps.gov/Pages/Home.aspx . Additional information regarding medical services can be located on the Job Corps Support Services website to include a Desk Reference Guide.

https://supportservices.jobcorps.gov/health/Pages/default.aspx.

f.

3.2. Task 2 - Additional Taskings – Contractor Personnel shall:

g.

https://prh.jobcorps.gov/Pages/Home.aspx

3.2.1. Possess the ability to work both independently and as a member of a healthcare team to provide optimal services to a population of financially disadvantaged youth, ranging from 16 to 24 years in age.

3.2.2. Provide supervision to Nurse Practitioner and/or Physician Assistant, if applicable, to comply with regulations in the state where the center is located.

3.2.3. Promptly review applicant files as requested; conduct an initial physical examination

(intake); and develop a medical treatment plan, as applicable.

3.2.4. Record all medical documentation, such as, diagnosis, treatment and management plans, medication, reason of denial into the program (if recommended), each student interaction and etc. on the Student Health Record (SHR) and Job Corps Health and Wellness Program forms in a timely manner.

3.2.5. During regular scheduled hours treat minor conditions (i.e. respiratory infections, cold and flu symptoms), episodic illness, provide first aid and CPR, and other care within capabilities.

3.2.6. Provide management, written diagnoses, and treatment plans as part of a chronic care management plan for students with chronic conditions/disabilities.

3.2.7. Provide treatment of acute conditions, education for health promotion and maintenance of a family planning program.

3.2.8. Provide medication prescriptions for controlled and non-controlled medications.

3.2.9. Collaborate with Substance Abuse Counselor, and Center Medical Counselor to prescribe medications and Schedule II medications and discuss long-term medication management, as needed.

3.2.10. Participate in Disability Accommodation Committee (DAC) meetings & file applicant review team meetings during regular scheduled hours, when requested.

3.2.11. Ensure medical equipment is properly cleaned and maintained.

3.2.12. On a monthly basis, report to the Center Director and HWD on all health- related matters; including student medical separations, justification and costs of needed special services, health and non-healthcare equipment repair and replacement needs, depletion of medical supplies and medications, and other areas deemed appropriate.

3.2.13. Establish an appropriate medical referral system for students who require special, or emergent, medical care.

3.2.14. Attend monthly conference calls, webinars, and DOL training, as available during regular scheduled hours of service.

3.2.15. Ensure patient privacy for all assessments, exams and procedures; maintain, safeguard, and ensure the confidentiality of all required student health records in accordance with the Health Insurance Portability and Accountability Act (HIPAA).

3.2.16. Participate in health and wellness program continuous quality improvement activities and advise and advise and assist the health education instructor in the development and implementation of the Health Education Program during visits and encounters on topics related to health and employability and provide the center with documentation of education in the student health record.

3.2.17. Coordination with other departments/programs on center, including but not limited to residential, recreation, education, vocation, student government association, and Health Eating and Active Lifestyles (HEALSs), to develop integrated promotion and education services.

3.2.18. Provide medical services in a positive and productive manner to facilitate student willingness to pursue recommended dental treatment plans, medical treatment plans and substance abuse treatment plans; and in such a manner to obtain positive student satisfaction survey results as determined by Job Corps.

3.2.19. Not to engage in any research projects and/or publications relating to Job Corps health activities without prior written approval from the Job Corps National Office in Lakewood, CO.

3.2.20. Report adverse student behavior incidents to the HWD or Contracting Officer’s (CO)

Representative (COR) in a timely manner.

3.2.21. Understand that health services shall be subject to monitoring and review by Job Corps assessment teams, and cooperation and compliance with such teams is required. Participate in DOL and Forest Service assessments, completing requested questionnaires, conferences, and monthly teleconferences in adherence to the PRH requirements.

3.2.22. Provide periodic education to staff as requested on topics mutually agreed upon.

3.2.23. Comply with all state, federal and Job Corps infection control policies and procedures.

3.2.24. Contractor will work with the center to develop a system to account for all time billed to the center.

4.0. Government Furnished

Adequate workspace, equipment, supplies, and materials as needed to accomplish the work requirements outlined herein, including examination rooms and furniture, assessment equipment, telephone, computer, a fax machine, office supplies, PPE, and similar items. These supplies and property shall be utilized during the performance of this contract only while providing student care.

Contractor shall report to:

Blackwell Job Corps Center 4155 County Road Laona, WI 54541

5.0. Deliverables / Schedule

5.1. Deliverables

No deliverables are required for this contract.

5.2 Schedule and Availability

5.2.1. Medical services are required on center (with rare exceptions) on a weekly basis, during days of the week and hours of the day established in coordination with Center personnel. The days and times of services shall be upon mutual agreement between the Contractor and center personnel and must be considered reasonable. A reasonable schedule would be considered providing services one (1) or two (2) days a week, M- F, 8am – 5pm.

5.2.2. Center OBS and the PRH may change at any time; consequently, the quantity of required medical services hours may vary, depending on the needs of the student population. However, any changes to the required hours will be executed via a bilateral modification to the contract.

5.2.3. Key Personnel must provide a current contact number to the Center HWD or COR.

When Key Personnel are unavailable for an extended period of time, as determined by the Contracting Officer, the Contractor will provide an acceptable substitute to provide services.

5.2.4. Contractor will contact the CD or designee 24 hours in advanced for cancellation of services. For planned absences, the Contractor will coordinate with Center staff and the CO to provide an approved substitute, as well as a current emergency contact number. All substitute personnel will be approved by the national and regional offices prior to work being performed.

5.2.5. Contractor Personnel will not be scheduled to work on the following Government holidays:

• New Year’s Day – January 1

• Martin Luther King Junior’s Birthday – Third Monday in January,

• Presidents Day – third Monday in February,

• Memorial Day – Last Monday in May,

• Juneteenth Day – June 19th,

• Independence Day – July 4,

• Labor Day – First Monday in September.

• Columbus Day – Second Monday in October,

• Veteran’s Day – November 11,

• Thanksgiving Day – fourth Thursday in November

• Christmas Day – December 25

6.0. Travel

Travel is not anticipated or authorized for this statement of work.

7.0. Contractor’s Key Personnel:

7.1. Contractor personnel shall:

7.1.1. Have an active, unrestricted license to practice independently in the state where services will be provided.

7.1.2. Maintain licensing requirements/certification/accreditation and required insurance coverage during the entire performance period with proof being submitted to the CO upon request.

7.1.3. Agree to a criminal background check, and drug testing, as a prerequisite for contract performance, if determined necessary by the CO.

7.1.4. Information obtained through the background check may be used in determining contractor’s qualification for this contract. Information regarding a person’s race, national origin, color, sex, religion, disability, genetic information (including family medical history), or age will not be evaluated or have any impact on the determination of qualifications for this contract.

7.1.5. Government may terminate the contract if the background check is determined to be unacceptable or if any aspect would jeopardize the health and safety of the students. Are responsible for maintaining their own malpractice/professional liability insurance and general liability insurance for each individual and/or company, with each contractor working on students listed as a covered entity.

8.0. Security Requirements

The space, equipment, and supplies used by contractor personnel shall be secured at all times, per Center requirements. The Contractor shall review and be familiar with Center security procedures.

9.0. Data Rights

Student records and all reports generated are property of the US Government.

10.0. Governing Regulations, Handbooks, and References:

The Contractor shall provide Health and Wellness (H&W) services as specified in the following documents:

• Job Corps Federal Regulations (Title 20 Code of Federal Regulations, Part 684 as amended, Job Corps Program under Title TV-B of the Job Training Partnership Act.

• Applicable Technical Assistance Guides (TAG s)

• Job Corps CMHC Desk Reference

• Job Corps Health & Wellness information and Department of Labor PRH:

https://supportservices.jobcorps.gov/health/Pages/default.aspx https://prh.jobcorps.gov/

• Job Corps Support Services:

11.0. INVOICE PROCEEDURES:

• Invoices shall be submitted on a monthly basis between the first and fifteenth of the following month;

• Invoices shall include only those services rendered during the billing period;

• Invoices shall be billed at the rates, and in accordance with the Contract Line Item Numbers

(CLIN), as listed in the Schedule of Items;

• Invoices shall be submitted through the INVOICING PROCESSING PLATFORM (IPP) which can be accessed at: http://www.ipp.gov/index.htm

• IPP Customer Support – 1 (866) 973 – 3131

12.0. CONTRACTORS PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS)

A. In accordance with FAR 42.1502 – Past performance evaluation shall be prepared at least annually and at the time the work under a contract or order is completed for each contract and/or order that exceeds the simplified acquisition threshold (SAT). This includes any contract and/or order that is below the SAT and is modified, which results in the contract exceeding the SAT.

(a) FAR 42.1502 directs all Federal agencies to collect past performance information on contracts. The Department of Agriculture (USDA) has implemented the Contractor Performance Assessment Reporting System (CPARS) to comply with this regulation. One or more past performance evaluations will be conducted in order to record your contract performance as required by FAR 42.15.

(b) The past performance evaluation process is a totally paperless process using

CPARS. CPARS is a web-based system that allows for electronic processing of the performance evaluation report. Once the report is processed, it is available in the Past Performance Information Retrieval System (PPIRS) for Government use in evaluating past performance as part of a source selection action.

(c) We request that you furnish the CO with the name, position title, phone number, and email address for each person designated to have access to your firm’s past performance evaluation(s) for the contract no later than 30 days after award. Each person granted access will have the ability to provide comments in the Contractor portion of the report and state whether or not the Contractor agrees with the evaluation, before returning the report to the Assessing Official. The report https://supportservices.jobcorps.gov/health/Pages/default.aspx https://prh.jobcorps.gov/ http://www.ipp.gov/index.htm information must be protected as source selection sensitive information not releasable to the public.

(d) When your Contractor Representative(s) (Past Performance Points of Contact) are registered in CPARS, they will receive an automatically generated email with detailed login instructions. Further details, systems requirements, and training information for CPARS is available at http://www.cpars.csd.disa.mil/. The CPARS User Manual, registration for Online Training for Contractor Representatives, and a practice application may be found at this site.

(e) Within 60 days after the end of a performance period, the CO will complete an interim or final past performance evaluation, and the report will be accessible at http://www.cpars.csd.disa.mil/. Contractor Representatives may then provide comments in response to the evaluation or return the evaluation without comment. Comments are limited to the space provided in Block 22. Your comments should focus on objective facts in the Assessing Official’s narrative and should provide your views on the causes and ramifications of the assessed performance. In addition to the ratings and supporting narratives, blocks 1 – 17 should be reviewed for accuracy, as these include key fields that will be used by the Government to identify your firm in future source selection actions. If you elect not to provide comments, please acknowledge receipt of the evaluation by indicating “No comment” in Block 22, and then signing and dating Block 23 of the form. Without a statement in Block 22, you will be unable to sign and submit the evaluation back to the Government. If you do not sign and submit the CPAR within 60 days, it will automatically be returned to the Government and will be annotated: “The report was delivered/received by the contractor on (date). The contractor neither signed nor offered comment in response to this assessment.” Your response is due within 60 calendar days after receipt of the CPAR.

(f) The following guidelines apply concerning your use of the past performance evaluation:

(1) Protect the evaluation as “source selection information.” After review, transmit the evaluation by completing and submitting the form through CPARS. If for some reason you are unable to view and/or submit the form through CPARS, contact the CO for instructions.

(2) Strictly control access to the evaluation within your organization.

Ensure the evaluation is never released to persons or entities outside of your control.

(3) Prohibit the use of or reference to evaluation data for advertising, promotional material, pre-award surveys, responsibility determinations, production readiness reviews, or other similar purposes.

(g) If you wish to discuss a past performance evaluation, you should request a http://www.cpars.csd.disa.mil/ meeting in writing to the CO no later than seven days following your receipt of the evaluation. The meeting will be held in person or via telephone or other means during your 60-day review period.

(h) A copy of the completed past performance evaluation will be available in CPARS for your viewing and for Government use supporting source selection actions after it has been finalized.

B. Contractors must register at the following websites:

CPARS: http://www.cpars.csd.disa.mil/ and PPIRS: http://www.ppirs.gov/ http://www.ppirs.gov/

ATTACHMENT 2 – QUOTER’S QUESTIONNAIRE

☐ Completed Schedule of Services with proposed pricing for the base year and 4 Option Years.

☐ Quoter confirms the attached Scope of work has been thoroughly reviewed before submitting a quotation.

☐ The registration process at www.SAM.gov has been successfully completed.

☐ Quoter confirms the provision FAR 52.204-26 and FAR 52.212-3, the annual representations and certifications, has been electronically completed at www.SAM.gov. The complete provision can be found at https://www.acquisition.gov/browse/index/far.

☐ Contract Federal Tax ID Number is provided:__________________________ ☐ Contractor SAM Unique Entity ID number is provided: _________________________ ☐ A copy of the applicable State license for each proposed Key Personnel is provided.

☐ A copy of the Drug Enforcement Administration (DEA) registration for each proposed Key Personnel is provided

☐ Proof of Medical Liability Insurance, in accordance with FAR 52.237-7; 52.228-5 and AGAR 452.228-71 is provided.

☐ A resume for each proposed Key Personnel is provided.

☐ All Key Personnel and substitute personnel will consent to a background check.

Contractor’s Point of Contact (POC) Information is provided:

Name: Company:

Position: Email:

Phone: Fax:

☐ The following questions have been answered as provided below:

1. Within the past 5 years have you failed to complete any work awarded to you or been terminated for default or breach of contract? If yes, explain.

2. How will your company provide a qualified substitute, when necessary?

3. Please describe any prior experience in working with disadvantaged young adults, any special training received that would be an advantage to this position, and why you feel your company is best suited to providing care to the students.

h.

☐ The following three (3) professional references of similar past work performance is provided:

i. Name: Organization:

j. Phone: Email:______________________________________

k. Name: Organization:

l. Phone: Email:______________________________________

m. Name: Organization:

n. Phone: Email:

☐ I certify that all of the information provided above is complete, true, and correct to the best of my knowledge.

Sign:______________________________________ Date:_______________________________________ http://www.sam.gov/ http://www.sam.gov/ https://www.acquisition.gov/browse/index/far