Attachment 3 - Model Task Order V2.pdf

FBI HRD Medical Operations and Readiness Unit (MORU) FBI RFP No.: (Occupational Medical Exam Services) Contractor: TBD

Task Order for Occupational Medical Exam Services

Section B – Supplies/Services and Prices/Cost

B.1 CLINs In accordance with the task order, the Contractor shall be responsible for furnishing all personnel, equipment, material, supplies, support and management, except as specified herein to be furnished by the government, and shall do all which is necessary and incidental to the successful and timely performance of program management support services as set forth in the Statement of Work.

Base Year

CLIN Description PoP: 12 Months Firm Fixed Price 0001 Pre-Employment (Applicant) Physical

Examinations

9/1/2020-8/31/2021 TBD

0002 Fitness for Duty (FFD) Periodic Examinations

9/1/2020-8/31/2021 TBD

0003 Department of State/Embassy Personnel Examinations

9/1/2020-8/31/2021 TBD

0004 Hazardous Materials Response Examinations

9/1/2020-8/31/2021 TBD

0005 Department of Transportation Physical Exams (CDL Drivers)

9/1/2020-8/31/2021 TBD

0006 Respiratory Protection Examinations 9/1/2020-8/31/2021 TBD 0007 Diver Examinations – Navy Dive (NOAA) 9/1/2020-8/31/2021 TBD 0008 Language Specialists 9/1/2020-8/31/2021 TBD 0009 Hepatitis B Vaccinations – At Risk

Employees 9/1/2020-8/31/2021

TBD

00100009 Travel Medicine and/or Immunizations 9/1/2020-8/31/2021 TBD 00110010 Federal Aviation Administration (FAA)

Examinations

9/1/2020-8/31/2021 TBD

00120011 A La Carte Services (see pricing model) 9/1/2020-8/31/2021 TBD

Option Year 1

1001 Pre-Employment (Applicant) Physical

Examinations

9/1/2021-8/31/2022 TBD

1002 Fitness for Duty (FFD) Periodic Examinations

9/1/2021-8/31/2022 TBD

1003 Department of State/Embassy Personnel Examinations

9/1/2021-8/31/2022 TBD

1004 Hazardous Materials Response Examinations

9/1/2021-8/31/2022 TBD

1005 Department of Transportation Physical Exams (CDL Drivers)

9/1/2021-8/31/2022 TBD

1006 Respiratory Protection Examinations 9/1/2021-8/31/2022 TBD 1007 Diver Examinations – Navy Dive (NOAA) 9/1/2021-8/31/2022 TBD 1008 Language Specialists 9/1/2021-8/31/2022 TBD 1009 Hepatitis B Vaccinations – At Risk

Employees 9/1/2021-8/31/2022

TBD

100910 Travel Medicine and/or Immunizations 9/1/2021-8/31/2022 TBD

10101 Federal Aviation Administration (FAA) Examinations

9/1/2021-8/31/2022 TBD

10112 A La Carte Services (see pricing model) 9/1/2021-8/31/2022 TBD

Option Year 2

2001 Pre-Employment (Applicant) Physical

Examinations

9/1/2022-8/31/2023 TBD

2002 Fitness for Duty (FFD) Periodic Examinations

9/1/2022-8/31/2023 TBD

2003 Department of State/Embassy Personnel Examinations

9/1/2022-8/31/2023 TBD

2004 Hazardous Materials Response Examinations

9/1/2022-8/31/2023 TBD

2005 Department of Transportation Physical Exams (CDL Drivers)

9/1/2022-8/31/2023 TBD

2006 Respiratory Protection Examinations 9/1/2022-8/31/2023 TBD 2007 Diver Examinations – Navy Dive (NOAA) 9/1/2022-8/31/2023 TBD 2008 Language Specialists 9/1/2022-8/31/2023 TBD 2009 Hepatitis B Vaccinations – At Risk

Employees 9/1/2022-8/31/2023

TBD

20102009 Travel Medicine and/or Immunizations 9/1/2022-8/31/2023 TBD 20112010 Federal Aviation Administration (FAA)

Examinations

9/1/2022-8/31/2023 TBD

20112 A La Carte Services (see pricing model) 9/1/2022-8/31/2023 TBD

Option Year 3

3001 Pre-Employment (Applicant) Physical

Examinations

9/1/2023-8/31/2024 TBD

3002 Fitness for Duty (FFD) Periodic Examinations

9/1/2023-8/31/2024 TBD

3003 Department of State/Embassy Personnel Examinations

9/1/2023-8/31/2024 TBD

3004 Hazardous Materials Response Examinations

9/1/2023-8/31/2024 TBD

3005 Department of Transportation Physical Exams (CDL Drivers)

9/1/2023-8/31/2024 TBD

3006 Respiratory Protection Examinations 9/1/2023-8/31/2024 TBD 3007 Diver Examinations – Navy Dive (NOAA) 9/1/2023-8/31/2024 TBD 3008 Language Specialists 9/1/2023-8/31/2024 TBD 3009 Hepatitis B Vaccinations – At Risk

Employees 9/1/2023-8/31/2024

TBD

30103009 Travel Medicine and/or Immunizations 9/1/2023-8/31/2024 TBD 30113010 Federal Aviation Administration (FAA)

Examinations

9/1/2023-8/31/2024 TBD

30112 A La Carte Services (see pricing model) 9/1/2023-8/31/2024 TBD

Option Year 4

4001 Pre-Employment (Applicant) Physical

Examinations

9/1/2024-8/31/2025 TBD

4002 Fitness for Duty (FFD) Periodic Examinations

9/1/2024-8/31/2025 TBD

4003 Department of State/Embassy Personnel Examinations

9/1/2024-8/31/2025 TBD

4004 Hazardous Materials Response Examinations

9/1/2024-8/31/2025 TBD

4005 Department of Transportation Physical Exams (CDL Drivers)

9/1/2024-8/31/2025 TBD

4006 Respiratory Protection Examinations 9/1/2024-8/31/2025 TBD 4007 Diver Examinations – Navy Dive (NOAA) 9/1/2024-8/31/2025 TBD 4008 Language Specialists 9/1/2024-8/31/2025 TBD 4009 Hepatitis B Vaccinations – At Risk

Employees 9/1/2024-8/31/2025

TBD

40104009 Travel Medicine and/or Immunizations 9/1/2024-8/31/2025 TBD 40114010 Federal Aviation Administration (FAA)

Examinations

9/1/2024-8/31/2025 TBD

4011 A La Carte Services (see pricing model) 9/1/2024-8/31/2025 TBD

B.2 Contract/Task Order Type

This is a Firm Fixed Price per service single award IDIQ.

B.3 Minimum/Maximum Amounts

The minimum guaranteed amount is $50,000.00. The maximum contract ceiling amount is $110,000,000.00.

Section C – Descriptions and Specifications The United States Department of Justice (DOJ), Federal Bureau of Investigation (FBI), requires occupational medical services to be conducted for a set of identified positions that possess a Fitness for Duty (FFD) requirement. These positions are subject to FFD requirements prior to Entry on Duty (EOD) and periodically thereafter, to enable the FBI to assess the ability of these individuals to perform or continue to perform those functions essential to their positions in a safe manner.

The Contractor’s primary role is the delivery of occupational health services in areas designated by FBI.

Services include immunizations, lab work, Fitness for Duty (FFD) exams, OSHA mandated medical surveillance exams, official short-term travel reviews, provision of travel medications, and Department of State (DoS) medical clearances. NOTE: Immunizations are not authorized as part of an Applicant medical exam. Where licensed, the Contractor must be required to provide Commercial Driver’s License (CDL) medical clearance exams, and Federal Aviation Administration (FAA) medical clearance evaluations.

Locations capable of performing CDL and FAA evaluations shall be specifically identified in writing and provided to the Contracting Officer’s Representative (COR).

The work performed under this contract requires the Contractor to receive / access service authorization from FBI via service / work orders, assign the provider(s) to be used, schedule patients, perform examinations, collect results, submit required medical records, perform quality assurance (QA) reviews of the performed services and results for completeness, and transmit completed medical record reports to the location(s) designated by FBI.

Section D – Packaging and Marking

The Contractor shall ensure that all items are preserved, packaged, packed and marked in accordance with best commercial practices to meet the packing requirements of the carrier, the DD 254 security requirements, and to ensure safe and timely delivery at the intended destination. All data and correspondence submitted shall reference:

• The Contract and Task Order Number

• Government End User Agency

• The name of the COR

• Address/mail stop

• Name of the Contractor

Containers shall be clearly marked as follows:

• Name of Contractor

• The Contract and Task Order Number

• Consignee(s) name and address

Any Contractor-imposed distribution restrictions shall be noted on the cover page, all applicable pages, and all specific paragraphs that contain information with Contractor-imposed restricted distribution requirements.

Section E – Inspection and Acceptance Criteria

FAR 52.246-4 - Inspection of Services – Fixed Price

All deliverables shall be submitted to the FBI COR.

The FBI will provide written notification of acceptance or rejection of all deliverables within fifteen (15) calendar days of the Scheduled delivery date or actual delivery date, whichever is later

Absent written notification of acceptance or rejection within fifteen (15) calendar days, it is the responsibility of the Contractor to confirm receipt and acceptance of the deliverable(s)

All notifications of rejection will be accompanied with an explanation of the specific deficiencies causing the rejection

If requested by either the Contractor or FBI, a meeting may be scheduled to discuss the deliverable in detail. All errors and omissions must be detailed in the first rejection.

One (1) re-submittal will be allowed to modify the deliverable and address items that were specifically rejected.

Section F – Deliverables or Performance

F.1 Period of Performance

The anticipated Task Order period of performance is described in the Table below.

PERIOD Description BEGIN END Base Year Occupation Medical Services 09/01/2020 08/31/2021

Option Year 1 Occupation Medical Services 09/01/2021 08/31/2022

Option Year 2 Occupation Medical Services 09/01/2022 08/31/2023

Option Year 3 Occupation Medical Services 09/01/2023 08/31/2024

Option Year 4 Occupation Medical Services 09/01/2024 08/31/2025

F.2 PLACE OF PERFORMANCE

The primary place of performance for this Task Order will be at contractor/subcontractor/provider locations nationwide in support of the FBI locations within the designated distance to all fifty-six (56) Field Office (FO) locations and three hundred and fifty – nine (359) Resident Agencies (RA) nationwide in the United States.

F.3 NOTICE TO THE GOVERNMENT OF DELAYS

In the event the Contractor encounters difficulty in meeting performance requirements, or when he/she anticipates difficulty in complying with the contract delivery schedule or completion date, or whenever the Contractor has knowledge that any actual or potential situation is delaying or threatens to delay the timely performance of this contract, the Contractor shall immediately notify the Contracting Officer and the COR, in writing, giving pertinent details; provided, however, that this data shall be informational only in character and that this provision shall not be construed as a waiver by the Government or any delivery schedule or date, or any rights or remedies provided by law or under this contract.

Section G – Contract Administration Data

G.1 Contracting Officer’s Representative The Contracting Officer’s Representative (COR) will provide all day-to-day technical and management direction for all work associated with this task order. The COR provides technical direction, clarification, and guidance with respect to existing specifications and Statement of Work as established in the task order.

The COR also monitors the progress and quality of the contractor’s performance. The COR shall promptly report contractor performance discrepancies and suggested corrective actions to the Contracting Officer for resolution.

The COR is NOT authorized to take any direct or indirect actions or make any commitments that will result in changes to price, quantity, quality, schedule, place of performance, delivery, or any other terms or conditions of the written task order.

The contractor is responsible for promptly providing written notification to the Contracting Officer if it believes that the COR has requested or directed any change to the existing contract (or task order). No action shall be taken by the contractor for any proposed change to the task order until the Contracting Officer has issued a written directive or written modification to the contract (or task order). The Government will not accept and is not liable for any alleged change to the contract unless the change is included in a written contract/task order modification or directive signed by the Contracting Officer.

COR authority IS NOT delegable.

The task order COR is:

Name: Jennifer DeLapa, MSM, BSN, RN Email: JLDelapa@fbi.gov Telephone: 202-324-8001

G.2 Ordering Agency Contracting Officer’s Authority In no event shall any understanding, agreement, or written or verbal direction between the Contractor and any Government employee other than the Ordering Agency’s Contracting Officer on this task order result in an effective or binding modification. All such actions must be formalized by a proper contractual document executed by an appointed Contracting Officer. The Contractor is hereby put on notice that in the event a Government employee other than the Contracting Officer directs a change in the work to be performed or increase in scope of the work to be performed, it is the Contractor’s responsibility to make an inquiry of the Contracting Officer before making any deviation. Payments will not be made without being authorized by an appointed Contracting Officer with the legal authority to bind the Government.

The Ordering Agency Contracting Officer for this task order is:

Name: Joaquin Tucker Unit: Professional Services Acquisition Unit (PSAU) Email: jjtucker@fbi.gov Telephone: (256) 213-4212

The Contract Specialist for this task order is:

Name: Emily Moss Unit: Professional Services Acquisition Unit (PSAU) Email: egmoss@fbi.gov Telephone: (256) 213-2087

G.4 Invoicing

All monthly invoices shall be sent to central_invoices@fbi.gov.

Effective April 1, 2016, all commercial invoices shall be submitted via the following new process:

The invoice should be attached to an email, and sent to the following address: central_invoices@ic.fbi.gov

It is imperative that the invoice contain current and accurate contract information (contract/order number), otherwise the invoice risks being rejected.

mailto:jjtucker@fbi.gov mailto:egmoss@fbi.gov mailto:central_invoices@fbi.gov mailto:central_invoices@ic.fbi.gov

Upon receipt of the invoice, a confirmation email will be sent back to the sending email address. At this point, the invoice is considered received and will begin processing through the FBI's internal payment systems.

Please note, invoices received before 5pm EST (Monday-Friday) will be considered received that business day. Any invoice received after 5pm EST will be considered received and will be entered into the invoice system on the following business day.

A proper invoice shall include the following information:

• Name and address of the Contractor

• Invoice date and invoice number. Invoice numbering should begin at 0l and be consecutively numbered thereafter. (The Contractor should date invoices as close as possible to the date of mailing or transmission.)

• Contract number, Task Order number, contract line item number and, if applicable, an order number

• Description, quantity, unit of measure, unit price and extended price of the items delivered

• Shipping number and date of shipment including the bill of lading number and weight of shipment if shipped Government bill of lading

• Terms of any discount for prompt payment offered

• Name and address of official to whom payment is to be sent

• Name, title, and phone number of persons to notify in event of defective invoice

• Electronic Funds Transfer (ETF) banking information

• Contractor's First/Last Name, Number of Hours, Labor Category, Total number of hours (items can be in any order), Cumulative Number of Hours to date

• Taxpayer Identification Number (TIN). (The Contractor shall include its TIN on the invoice only if required elsewhere in this Contract)

The Contractor shall include this information on each and every invoice when invoicing for full or partial supplies/services delivered/performed. If an invoice does not contain the above information, the Bureau reserves the right to reject the invoice(s) as IMPROPER and notify the Contractor within seven (7) calendar days after receipt of the invoice at the designated billing office pursuant.

(Resubmission of a PROPER invoice(s) will be required).

Payment will be made by the FBI’s Commercial Payment Unit in accordance with the Prompt Payment Act, FAR clause 52.232-25 (JUL 2013) upon the COR's (or designee) certification of receipt of services and the CO final authorization for payment.

G.5 Working Files The Contractor shall maintain accurate working files on all work documentation including calculations, assumptions, interpretations of regulations, sources of information, and other raw data required in the performance of this task order. The Contractor shall provide the information contained in its working files upon request of the Ordering Agency Contracting Officer.

G.6 Accounting and Appropriation Data

This Task Order is subject to the availability of funds.

Section H – Special Provisions

H.1 Release of Information-Publications by Contractor Personnel

The Federal Bureau of Investigation (FBI) specifically requires that Contractor shall not divulge, publish, or disclose information or produce material acquired as or derived from the performance of their duties.

For purposes of this clause, "Information" shall include but not be limited to: in any media or all media including on the web or web sites; publication, studies, books, these, photographs, films or public announcements, press releases describing any part of the subject matter of this contract or any phase of any program hereunder, except to the extent such is:

(i.) already known to the contractor prior to the commencement of the contract

(ii.) required by law, regulation, subpoena or government or judicial order to be disclosed, including the Freedom of Information Act.

No release of information shall be made without the prior written consent of the Office of Public Affairs and the Contracting Officer. The contractor and author are warned that disclosure is not without potential consequences. The FBI will make every effort to review quoted publications in a timely manner to accommodate these and other publications

Where appropriate, in accordance with established academic publishing practices, the FBI reserves the right to author/co-author any publication derived from this contract.

THESE OBLIGATIONS DO NOT CEASE UPON COMPLETION OF THIS

CONTRACT.

H.2. Drawings and Specifications

If applicable, all documents, drawings, and specifications generated under this contract shall be made available for review by the Government at time of request.

H.3 Duplication of Efforts

The Contractor hereby certifies that costs for work to be performed under this contract and any subcontracts hereunder are not duplicative of any costs charged against any other Government contract, subcontract, or other Government source. The Contractor agrees to advise the CO, in writing, of any other Government contract or subcontract it has performed or is performing which involves work directly related to the purpose of this contract. The Contractor also certifies and agrees that any and all work performed under this contract shall be directly and exclusively for the use and benefit of the Government, not incidental to any other work, pursuit, research or purpose of the Contractor, whose responsibility it will be to account for it accordingly.

H.4 Travel

For any travel required under this Contract for which the Contractor intends to request government funding, the Contractor shall acquire written pre-approval from the COR and verification of funding. Any travel requirements will be reimbursed in accordance with the Federal Travel Regulation and FBI 50-mile travel policies. In accordance with the FBI travel policy, travel to and from the Contractor facility or designated work sites or travel within a 50-mile radius of these facilities shall not be reimbursed.

H.5 Work with FBI Partners

Throughout the life of the Task Order, the FBI may participate in collaborative efforts with other US Government entities, security-cleared US and Foreign National Contractors, and Foreign National agency personnel relating to the scope of work. Through various Task Orders awarded under the Contract, an awardee may be requested to coordinate and collaborate with other contractor or agencies supporting the same arena. All interactions between other contractor organizations and agencies shall be subject to Non- Disclosure Agreements to protect any proprietary information. Prior to any disclosure of information pertaining to a Task Order, the awardee shall obtain written authorization from the COR providing authorization and applicability of this contractual language and identifying the Task Order.

H.6 DJAR-PGD-08-05 Contractor Certification of Compliance with Federal Tax Requirements Contractor Certification of Compliance with Federal Tax Requirements

By submitting a response to a solicitation or accepting a contract award, the contractor certifies that, to the best of its knowledge and belief, the contractor has filed all Federal tax returns required during the three years preceding the certification, has not been convicted of a criminal offense under the Internal Revenue Code of 1986, and has not, more than 90 days prior to certification, been notified of any unpaid Federal tax assessment for which the liability remains unsatisfied, unless the assessment is the subject of an installment agreement or offer in compromise that has been approved by the Internal Revenue Service and is not in default, or the assessment is the subject of a non-frivolous administrative or judicial proceeding.

(End of Clause)

Section J – List of Documents, Exhibits and Other Attachments

The following documents are hereby incorporated by reference:

Attachment Description Pages Date

1 SF-1449

11 June 12, 2020

2 Instructions to Offeror’s (ITO) 16 June 12, 2020

3 Model Task Order 12 June 12, 2020 4 Statement of Work 21 June 12, 2020 5 Quality Assurance Surveillance

Plan (QASP) 14 June 12, 2020

6 Pricing Model Spreadsheet 2 tabs June 12, 2020 7 Key Management Personnel

Listing (KMPL) 1 June 12, 2020

8 Acquisition Risk Questionnaire

(ARQ)

3 June 12, 2020

9 Field Office and Resident Agency Locations

1 tab June 12, 2020

10 Forms 21 June 12, 2020 11 Relevant Experience Template 5 June 12, 2020 12 Past Performance

Questionnaire 4 June 12, 2020