RFQ_Medical_Gas_-_15B10619QVB170001.pdf

15B10619QVB170001 Page 1 of 10

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

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

1. REQUISITION NUMBER

5. SOLICITATION NUMBER

15B10619QVB170001

2. CONTRACT NO. 3. AWARD/EFFECTIVE

DATE

4. ORDER NUMBER 6. SOLICITATION ISSUE

DATE

08/08/2019

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

Lenitra Elliott

b. TELEPHONE NUMBER (No collect calls)

919-575-5000 x1048

8. OFFER DUE DATE / LOCAL

TIME

08/23/2019 10:00:00

CODE 15B106

Federal Bureau of Prisons FCC Butner

OLD NC HWY 75

Butner, NC 27509

9. ISSUED BY X UNRESTRICTED OR SET ASIDE: % FOR

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS: 325120

SIZE STANDARD: 1000

Employees

10. THE ACQUISITION IS

SEE

SCHEDULE

11. DELIVERY FOR FOB DESTINATION

UNLESS BLOCK IS MARKED

NET 30

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER DPAS

(15 CFR 700)

13b. RATING

X RFQ IFB RFP

14. METHOD OF SOLICITATION

15B106CODE15. DELIVER TO

Federal Bureau of Prisons FCC Butner

OLD NC HWY 75

Butner, NC 27509

CODE 15B10616. ADMINISTERED BY

Federal Bureau of Prisons FCC Butner

OLD NC HWY 75

Butner, NC 27509

FACILITY

CODE

CODE

TELEPHONE NO.

17a. CONTRACTOR/

OFFEROR

BBUXCODE18a. PAYMENT WILL BE MADE BY

Federal Bureau of Prisons FCC Butner

PO BOX 999

BUTNER, NC 27509

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

OFFER SEE ADDENDUM

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

CHECKED

19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

Delivery Date: 10/01/2019

MEDICAL GAS SERVICES FOR FISCAL YEAR 2020

10/1/2019 THROUGH 09/30/2020

PLEASE COMPLETE QUOTE FOR EACH

INDIVIDUAL LINE ITEM IN THE SPACE

PROVIDED

See Continuation Sheet(s) (Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA 26. TOTAL AWARD AMOUNT (For Govt. Use Only)

X 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA ARE X ARE NOT ATTACHED

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA ARE ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN ____ COPIES TO

ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND DELIVER ALL ITEMS SET FORTH

OR OTHERWISE IDENTIFIED ABOVE AND ON ANY ADDITIONAL SHEETS SUBJECT TO THE

TERMS AND CONDITIONS SPECIFIED.

29. AWARD OF CONTRACT: REF. _____________________________ OFFER

DATED _________________ . YOUR OFFER ON SOLICITATION (BLOCK 5)

INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE SET FORTH HEREIN,

IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER)

30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF THE CONTRACTING OFFICER (TYPE OR PRINT)

Lenitra Elliott

31c. DATE SIGNED

08/08/2019

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA - FAR (48 CFR) 53.212

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19.

ITEM NO.

20.

SCHEDULE OF SUPPLIES/SERVICES

21.

QUANTITY

22.

UNIT

23.

UNIT PRICE

24.

AMOUNT

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: _________________________________

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32c. DATE 32d. PRINTED NAME AND TITLE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32e. MAILING ADDRESS OF AUTHORIZED GOVERNMENT REPRESENTATIVE 32f. TELEPHONE NUMBER OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

PARTIAL FINAL

33. SHIP NUMBER 34. VOUCHER NUMBER 35. AMOUNT VERIFIED

CORRECT FOR

COMPLETE PARTIAL FINAL

36. PAYMENT 37. CHECK NUMBER

38. S/R ACCOUNT NUMBER 39. S/R VOUCHER NUMBER 40. PAID BY

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT 42a. RECEIVED BY (Print)

41b. SIGNATURE AND TITLE OF CERTIFYING OFFICER 41c. DATE

42b. RECEIVED AT (Location)

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

STANDARD FORM 1449 (REV. 2/2012) BACK

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Table of Contents

Section Description Page Number

1 Solicitation/Contract Form 2 Commodity or Services Schedule 3 Contract Clauses

52.27-103-72 DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS (JUNE

2004) DJAR-PGD-05-08 Implementation of Homeland Security Presidential Directive (HSPD) 12 - Policy for a Common Identification Standard for Federal Employees and Contractor 52.252-2 Clauses Incorporated by Reference (Feb 1998) 52.232-18 Availability Of Funds (Apr 1984)

4 List of Attachments 5 Solicitation Provisions

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Section 2 - Commodity or Services Schedule

SCHEDULE OF SUPPLIES/SERVICES

CONTINUATION SHEET

ITEM NO. SUPPLIES/SERVICES QUANTITY UNIT UNIT PRICE AMOUNT

0001 ARGON UH, SIZE 35, 35 CF 2.000000 EA $____________ $___________________

0002 BREATHING AIR MED, SIZE G, 244C 2.000000 EA $____________ $___________________

0003 CARBON DIOXIDE MED, SIZE G, 50 LB 4.000000 EA $____________ $___________________

0004 NITROUS OXIDE MED, SIZE G, 50 CF 10.000000 EA $____________ $___________________

0005 OXYGEN MED, SIZE 282, 282 C 10.000000 EA $____________ $___________________

0006 OXYGEN MED, SIZE M 125 CF 2.000000 EA $____________ $___________________

0007 NITROGEN INDUSTRIAL, SIZE 160, 160 CF 4.000000 EA $____________ $___________________

0008 NITROGEN INDUSTRIAL, SIZE 90, 90 CF 4.000000 EA $____________ $___________________

0009 OXYGEN INDUSTRIAL SIZE 20, 20 CF 4.000000 EA $____________ $___________________

0010 OXYGEN INDUSTRIAL, SIZE 40, 40 CF 4.000000 EA $____________ $___________________

0011 OXYGEN MEDICAL, SIZE E, 23 CF USPE 130.000000 EA $____________ $___________________

0012 OXYGEN MEDICAL, SIZE D, 14 CF 4.000000 EA $____________ $___________________

0013 NITROGEN MEDICAL, LIQUID 60.000000 LT $____________ $___________________

0014 BULK LIQUID OXYGEN 50,000.000000 CF $____________ $___________________

0015 RENTAL LARGE CYLINDERS, CLASS 1 1,265.000000 EA $____________ $___________________

0016 RENTAL SMALL CYLINDERS, CLASS II 600.000000 EA $____________ $___________________

0017 ENERGY SURCHARGE BULK MEDICAL OXYGEN 50,000.000000 EA $____________ $___________________

0018 RENTAL 12 MONTH BULK LIQUID OXYGEN TANK 12.000000 MO $____________ $___________________

0019 LIQUID OXYGEN RESERVE TANK, 160 GALLON 12.000000 MO $____________ $___________________

0020 OXYGEN MEDICAL C ALUM MOCAL 2.000000 EA $____________ $___________________

0021 MNIG NITROGEN 15.000000 EA $____________ $___________________

0022 HAZMAT 75.000000 EA $____________ $___________________

0023 DELIVERY 20.000000 EA $____________ $___________________

0024 FUEL SURCHARGE 60.000000 EA $____________ $___________________

0025 ARGON UHP33 CLASS 4 5.000000 EA $____________ $___________________

0026 BREATHING AIR MED, SIZE G, 244CF (AL USP300) 2.000000 EA $____________ $___________________

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0027 AIR USP E CGA 950 2.000000 EA $____________ $___________________

0028 NITROUS OXIDE USP E CGA 910 4.000000 EA $____________ $___________________

0029 NITROGEN MEDICAL NF E CGA 2.000000 EA $____________ $___________________

0030 OX USP250 10.000000 EA $____________ $___________________

0031 USPDA OXYGEN SUP DA MED CGGA 870 8.000000 EA $____________ $___________________

0032 8026564942 NI DEWARREFILL NITROGEN DWAR REF 4.000000 EA $____________ $___________________

0033 NITROGEN MEDICAL NF 200 CGA 20.000000 EA $____________ $___________________

0034 NITROUS OXIDE USP SZ 56LBS 8.000000 EA $____________ $___________________

0035 OXYGEN USP MEDICAL PURE 200 CGA 540 12.000000 EA $____________ $___________________

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Section 3 - Contract Clauses

Clauses By Full Text

52.27-103-72 DOJ CONTRACTOR RESIDENCY REQUIREMENT BUREAU OF PRISONS (JUNE 2004)

For three of the five years immediately prior to submission of an offer/bid/quote, or prior to performance under a contract or commitment, individuals or contractor employees providing services must have:

1. Legally resided in the United States (U.S.);

2. worked for the U.S. overseas in a Federal or military capacity; or

3. been a dependent of a Federal or military employee serving overseas.

If the individual is not a U.S. citizen, they must be from a country allied with the U.S. The following website provides current information regarding allied countries: http://www.opm.gov/employ/html/citizen.htm By signing this contract or commitment document, or by commencing performance, the contractor agrees to this restriction.

[End of Clause]

DJAR-PGD-05-08 Implementation of Homeland Security Presidential Directive (HSPD) 12 - Policy for a Common Identification Standard for Federal Employees and Contractor

NOTICE OF CONTRACTOR PERSONNEL SECURITY REQUIREMENTS

Compliance with Homeland Security Presidential Directive-12 (HSPD-12) and Federal Information Processing Standard Publication 201 (FIPS 201)' entitled "Personal Identification Verification (PIV) for Federal Employees and Contractors," Phase I.

1. Long-Term Contractor Personnel:

In order to be compliant with HSPD-12/PIV I, the following investigative requirements must be met for each new long-term2 contractor employee whose background investigation (BI) process begins on or after October 27, 2005:

a. Contractor Personnel must present two forms of identification in original form prior to badge issuance (acceptable documents are listed in Form 1-9, OMB No. 1615-0047, " Employment Eligibility Verification," and at least one document must be a valid State or Federal government-issued picture ID);

b. Contractor Personnel must appear in person at least once before a DOJ official who is responsible for checking the identification documents. This identity proofing must be completed sometime during the clearance process but prior to badge issuance and must be documented by the DOJ official;

c. Contractor Personnel must undergo a BI commensurate with the designated risk level associated with the duties of each position.

Outlined below are the minimum BI requirements for each risk level:

•High Risk - Background Investigation (5 year scope) •Moderate Risk - Limited Background Investigation (LBI) or Minimum Background Investigation (MBI) •Low Risk - National Agency Check with Inquiries (NACI) investigation

d. The pre-appointment BI waiver requirements for all position sensitivity levels are a:

1) Favorable review of the security questionnaire form;

2) Favorable fingerprint results;

3) Favorable credit report, if required;3

4) Waiver request memorandum, including both the Office of Personnel Management schedule date and position sensitivity/risk level; and 5) Favorable review of the National Agency Check (NAC)4 portion of the applicable BI that is determined by position sensitivity/risk level.

A badge may be issued following approval of the above waiver requirements.

If the NAC is not received within five days of OPM' s scheduling date, the badge can be issued based on a favorable review of the Security Questionnaire and the Federal Bureau of Investigation Criminal History Check (i.e., fingerprint check results).

e. Badge re-validation will occur once the investigation is completed and favorably adjudicated. If the BI results so justify, badges issued under these procedures will be suspended or revoked.

2. Short-Term Contractor Personnel:

It is the policy of the DOJ that short-term contractors having access to DOJ information systems and/or DOJ facilities or space for six months or fewer are subject to the identity proofing requirements listed in items la. and lb. above. The pre-appointment waiver requirements for short-term contractors are:

a.Favorable review of the security questionnaire form;

15B10619QVB170001 Page 7 of 10 b.Favorable fingerprint results;

c.Favorable credit report, if required;5 and d.Waiver request memorandum indicating both the position sensitivity/risk level and the duration of the appointment. The commensurate BI does not need to be initiated.

A badge may be issued following approval of the above waiver requirements and the badge will expire six months from the date of issuance. This process can only be used once for a short-term contractor in a twelve month period. This will ensure that any consecutive short-term appointments are subject to the full PFV-I identity proofing process.

For example, if a contractor employee requires daily access for a three or four-week period, this contractor would be cleared according to the above short-term requirements. However, if a second request is submitted for the same contractor employee within a twelve-month period for the purpose of extending the initial contract or for employment under a totally different contract for another three or four-week period, this contractor would now be considered "long-term" and must be cleared according to the long-term requirements as stated in this interim policy.

3. Intermittent Contractors:

An exception to the above-mentioned short-term requirements would be intermittent contractors.

a. For purposes of this policy, "intermittent" is defined as those contractor employees needing access to DOJ information systems and/or DOJ facilities or space for a maximum of one day per week, regardless of the duration of the required intermittent access. For example, the water delivery contractor that delivers water one time each week and is working on a one-year contract.

b. Contractors requiring intermittent access should follow the Department's escort policy. Please reference the August 11, 2004, and January 29, 2001, Department Security Officer policy memoranda that conveys the requirements for contractor facility escorted access.

c. Due to extenuating circumstances, if a component requests unescorted access or DOJ IT system access for an intermittent contractor, the same pre-employment background investigation waiver requirements that apply to short-term contractors are required.

d. If an intermittent contractor is approved for unescorted access, the contractor will only be issued a daily badge. The daily badge will be issued upon entrance into a DOJ facility or space and must be returned upon exiting the same facility or space.

e. If an intermittent contractor is approved for unescorted access, the approval will not exceed one year. If the intermittent contractor requires unescorted access beyond one year, the contractor will need to be re-approved each year.

4. An individual transferring from another department or agency shall not be re-adjudicated provided the individual has a current (within the last five years), favorably adjudicated BI meeting HSPD-12 and DOJ's BI requirements.

5.The DOJ's current escorted contractor policy remains unchanged by this acquisition notice.

NOTES:

1. FIPS 201 is available at: www.csrc.nist.gov/publications/fips/fips201 /FIPS-201-22505.pdf.

2. Under HSPD-12, long-term contractors are contractors having access to DOJ information systems and/or DOJ facilities or space for six months or longer. The PIV-I identity proofing process, including initiation and adjudication of the required background investigation, is required for all new long-term contractors regardless of whether it is the current practice to issue a badge. The second phase of HSPD-12 implementation (PIV-II) requires badge issuance to all affected long-term contractors.

3. For contractors in position sensitivity/risk levels above level 1, a favorable review of a credit check is required as part of the pre-appointment waiver package.

4. In order to avoid a delay in the hiring process, components should request an Advance NAC Report when initiating investigations to OPM. Per OPM 's instructions, to obtain an Advance NAC Report, a Code " 3" must be placed in block "B " of the " Agency Use Only " section of the investigative form. This report is available for all case types.

5. For contractors in position sensitivity/risk levels above level 1, a favorable review of a credit check is required as part of the pre-appointment waiver package.

(End of Clause)

52.252-2 Clauses Incorporated by Reference (Feb 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this / these address(es):

##www.acquisition.gov [Insert one or more Internet addresses]

(End of clause)

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52.232-18 Availability Of Funds (Apr 1984)

Funds are not presently available for this contract. The Government's obligation under this contract is contingent upon the availability of appropriated funds from which payment for contract purposes can be made. No legal liability on the part of the Government for any payment may arise until funds are made available to the Contracting Officer for this contract and until the Contractor receives notice of such availability, to be confirmed in writing by the Contracting Officer.

(End of clause)

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Section 4 - List of Attachments

This Section Is Intentionally Left Blank

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Section 5 - Solicitation Provisions

This Section Is Intentionally Left Blank