LES_-_Health_Insurance_sf26_2012_-_2017.pdf

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P O Box 90

Gaborone, Botswana

November 3, 2017

Dear Prospective Offeror:

SUBJECT: Solicitation Number – 19BC4018R0002 Health Insurance Services Solicitation

The Embassy of the United States of America in Gaborone, Botswana invites you to submit a proposal for a customized Health Insurance services to employees of the Government of the United States of America in Botswana

The Embassy intends to conduct a pre-proposal conference, and all prospective offerors who have received a solicitation package are invited to attend. See Section L of the attached Request for Proposals (RFP).

PRE-PROPOSAL CONFERENCE

A pre-proposal conference to discuss the requirements of this solicitation will be held on Tuesday, November 14, 2017 at 10:00 AM at the American Embassy Gaborone. Offerors interested in attending should send names of their company representatives not more than one per company through this email: GABprocurement@state.gov or contact the point of contact below (POC) on or before November 09, 2017 at 4:00 PM.

Your proposal must be submitted before December 8, 2017 at 10:00 AM. No proposal will be accepted after this date and time.

In order for a proposal to be considered, you must also complete and submit the following:

1. SF-1449

2. Section B, Pricing Schedule

3. Section B, Retention Amounts in B.3

4. Section K, Representations and Certifications;

5. Additional information as required in Section L.

Direct any questions regarding this solicitation to Leonard Thebe by letter or by telephone +267-373-2356 during regular business hours.

Please note: Proposals that contain more benefits (even if there is no increase in cost) or fewer benefits than those stated in the solicitation may be deemed technically unacceptable.

The U.S. Government intends to award a contract to the responsible company submitting an acceptable offer at the lowest price. We intend to award a contract based on initial proposals, without holding discussions, although we may hold discussions with companies in the competitive range if there is a need to do so.

The successful offeror will be required to have a DUNS number and be registered in SAM/CCR through the following sites: DUNS – www.dnb.com and SAM/CCR www.sam.gov, prior to contract award.

Sincerely, Orlin Clements

Contracting Officer

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SOLICITATION, OFFER AND AWARD 1. THIS CONTRACT IS A RATED

ORDER

UNDER DPAS (15 CFR 350)

RATING PAGE 2 OF PAGES 57

2. CONTRACT (Proc. Inst. Ident.) NO.

3. SOLICITATION NO.

19BC4018R0002

4. TYPE OF SOLICITATION

[ ] SEALED BID (IFB)

[ X] NEGOTIATED

(RFP)

5. DATE ISSUED

Nov 3, 2017

6. REQUISITION/PURCHASE NO.

PR6686302

7. ISSUED BY

U.S. Embassy, Gaborone

P. O. Box 90, Gaborone, Botswana, Phone# 267 3953982

8. ADDRESS OFFER TO (If other than item 7)

NOTE: In sealed bid solicitation "offer" and "offeror mean "bid" and "Bidder".

SOLICITATION

9. Sealed offers in original and 2 copies for furnishing the supplies or services in the Schedule will be received at the place specified, in the depository located in until 10:00am local time December, 8, 2017

(hour) (date)

CAUTION - LATE Submissions, Modifications, and Withdrawals: See Section L. Provision No. 52.215-1 Deviation. All offers are subject to all terms and conditions contained in this solicitation.

10. FOR INFORMATION

CALL:

A. NAME

Orlin Clements

B. TELEPHONE NO. (Include Area Code) (NO COLLECT CALLS)

267 3953982 Ext. 2465

11. TABLE OF CONTENTS

(x) SEC. DESCRIPTION PAGE(S) (x) SEC. DESCRIPTION PAGE(S)

PART I - THE SCHEDULE PART II - CONTRACT CLAUSES

X A SOLICITATION/CONTRACT FORM 2 X I CONTRACT CLAUSES 26

X B SUPPLIES OR SERVICE AND

PRICES/COSTS

3 PART III - LIST OF DOCUMENTS, EXHIBITS, AND OTHER ATTACH.

X C DESCRIPTION/SPECS/WORK

STATEMENT

12 X J LIST OF ATTACHMENTS 36

X D PACKAGING AND MARKETING PART IV - REPRESENTATIONS AND INSTRUCTIONS

X E INSPECTION AND ACCEPTANCE 19 K REPRESENTATIONS, CERTIFICATIONS, AND 38

X F DELIVERIES OR PERFORMANCE 21 OTHER STATEMENTS OF OFFERORS

X G CONTRACT ADMINISTRATION 22 L INSTRS., COND., AND NOTICES TO OFFERORS 49

X H SPECIAL CONTRACT REQUIREMENTS 23 M EVALUATION FACTORS FOR AWARD 55

OFFER (Must be fully completed by offeror) NOTE: ITEM 12 does not apply if the solicitation includes the provisions at 52.214-16, Minimum Bid Acceptance Period.

12. In compliance with the above, the undersigned agrees, if this offer is accepted within calendar days (120 calendar days unless a different period is instead by the offer) from the date for receipt of offers specified above, to furnish any or all items upon which prices are offered at the price set opposite each item, delivered at the designated point(s), within the time specified in the schedule.

13. DISCOUNT FOR PROMPT PAYMENT SEE

(See section I, Clause No 52.232-8)

10 CALENDAR

DAYS

20 CALENDAR

DAYS

30 CALENDAR

DAYS

CALENDAR DAYS

14. ACKNOWLEDGMENT OF AMENDMENTS AMENDMENT NO. DATE AMENDMENT NO. DATE

(The offeror acknowledges receipt of amendments to the solicitation for offerors and related documents numbered and dated

15A. NAME CODE FACILITY 16. NAME AND TITLE OF PERSON AUTHORIZED

AND

ADDRESS OF OFFEROR

TO SIGN OFFER (Type or print)

15B. TELEPHONE NO. (Include area code)

15C. CHECK IF REMITTANCE

ADDRESS [ ] IS DIFFERENT

FROM ABOVE - ENTER SUCH ADDRESS IN

SCHEDULE

17. SIGNATURE

18. OFFER DATE

AWARD (To be completed by Government)

19. ACCEPTED AS TO ITEM NUMBERED

20. AMOUNT

21. ACCOUNTING AND APPROPRIATION

22. AUTHORITY FOR USING OTHER THAN FULL AND OPEN COMPETITION:

[ ] 10 U.S.C. 2304(c)( ) [ ] 41 U.S.C. 253(c)( )

23. SUBMIT INVOICES TO ADDRESS

SHOWN IN See G.2

(4 copies unless otherwise specified)

ITEM

24. ADMINISTRATION BY (If other than Item 7)

CODE

25. PAYMENT WILL BE MADE BY

CODE

26. NAME OF CONTRACTING OFFICER (Type of print)

1. UNITED STATES OF

AMERICA

2. AWARD DATE

IMPORTANT - Award will be made on this form, or on the Standard Form 26, or by other authorized official written notice.

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PART I: PRICE - HEALTH INSURANCE

SECTION B

B.1. HEALTH INSURANCE SERVICES

The Contractor shall provide Health Insurance services to employees of the Government of the United States of

America in Botswana. The groups of employees who shall be provided this insurance are listed in C.1.2. This insurance shall be provided in accordance with Section C.

B.1.1. Official Residence Expense (ORE) Staff and Embassy Association Employees (EAE) are included under this contract only as a rider; the Contractor shall bill the Chief of Mission and Deputy Chief of Mission (for ORE

Staff), the Embassy Association (for EAEs) at the rates specified below. See Section G for billing procedures.

B.2. PRICES

This is a fixed price with economic price adjustment requirements type contract under which will be issued firm, fixed-price task orders. The fixed prices/premium rates for the health insurance services as specified in Section C are as follows:

The Contractor shall include VAT as a separate charge on the Invoice and as a separate line item in Section B.

The below prices are stated in ____________________ currency (offeror to state currency.)

Local companies shall offer in local currency.

B.2.1. BASE YEAR OF CONTRACT:

Bi-Weekly Rates Per Employee Salary Range:

GROUP 1 0-3199 BWP Per month

CATEGORY Estimated number of premiums Bi-weekly Rate per Premium Total

Employee (self only) 1

Employee + 1 dependent

Employee + 2 dependents

Employee + 3 dependents

Employee + 4

Employee + 5

Parents

VAT

Grand Total 3

GROUP 2

3200-6199 BWP per month

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Employee (self only) 22

Employee + 1 dependent 8

Employee + 2 dependents 7

Employee + 3 dependents 4

Employee + 4 dependents 1

Employee + 5 dependents 0

Parents 1

VAT

Grand Total 43

GROUP 3 6200 + BWP per month

Employee (self only) 51

Employee + 1 dependent 39

Employee + 2 dependents 19

Employee + 3 dependents 22

Employee + 4 dependents 12

Employee + 5 dependents 1

Parents 13

Grand Total 157

Total Price for Base Year (Subtotals of all three groups x 26): _________________________

B.2.2. FIRST OPTION YEAR OF THE CONTRACT:

Bi-Weekly Rates Per Employee

0-3199 BWP per month

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GROUP 1

Employee (self only) 1

Employee + 1 dependent 1

Employee + 2 dependents 0

Employee + 3 dependents 1

Employee + 4 dependents 0

Employee + 5 dependents 0

Parents 0

VAT

Grand total 3

GROUP 2 3200-6199 BWP per month

Employee + 1 dependent 8

Employee + 2 dependents 7

Employee + 3 dependents 4

Employee + 4 dependents 1

Employee + 5 dependents 0

Parents 1

VAT

GROUP 3 6200+ Pula per month

Employee + 1 dependent 39

Employee + 2 dependents 19

Employee + 3 dependents 22

Employee + 4 dependents 12

Employee + 5 dependents 1

Parents 13

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Total Price for First Option Year (Subtotals of all three groups x 26): ___________________

B.2.3. SECOND OPTION YEAR OF THE CONTRACT:

GROUP 1 0-3199 Pula per month

Employee + 1 dependent 1

Employee + 2 dependents 0

Employee + 3 dependents 1

Employee + 4 dependents 0

Employee + 5 dependents 0

Parents 0

GROUP 2 3200-6199 Pula per month

Employee + 1 dependent 8

Employee + 2 dependents 7

Employee + 3 dependents 4

Employee + 4 dependents 1

Employee + 5 dependents 0

Parents 1

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Employee + 1 dependent 39

Employee + 2 dependents 19

Employee + 3 dependents 22

Employee + 4 dependents 12

Employee + 5 dependents 1

Parents 13

Total Price for Second Option Year (Subtotals of all three groups x 26): __________________

B.2.4. THIRD OPTION YEAR OF THE CONTRACT:

Employee + 1 dependent 1

Employee + 2 dependents 0

Employee + 3 dependents 1

Employee + 4 dependents 0

Employee + 5 dependents 0

Parents 0

VAT

Employee + 1 dependent 8

Employee + 2 dependents 7

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Employee + 3 dependents 4

Employee + 4 dependents 1

Employee + 5 dependents 0

Parents 1

Employee + 1 dependent 39

Employee + 2 dependents 19

Employee + 3 dependents 22

Employee + 4 dependents 12

Employee + 5 dependents 1

Parents 13

Total Price for Third Option Year (Subtotals of all three groups x 26): ___________________

B.2.5. FOURTH OPTION YEAR OF THE CONTRACT:

Employee + 1 dependent 1

Employee + 2 dependents 0

Employee + 3 dependents 1

Employee + 4 dependents 0

Employee + 5 dependents 0

Parents 0

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Employee + 1 dependent 8

Employee + 2 dependents 7

Employee + 3 dependents 4

Employee + 4 dependents 1

Employee + 5 dependents 0

Parents 1

VAT

Employee + 1 dependent 39

Employee + 2 dependents 19

Employee + 3 dependents 22

Employee + 4 dependents 12

Employee + 5 dependents 1

Parents 13

Total Price for Fourth Option Year (Subtotals of all three groups x 26): ___________________

GRAND TOTAL BASE PERIOD PLUS OPTION YEARS: = _________________________________

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Summery Price Schedule

Base Period

First Option Year

Second Option Year

Third Option Year

Fourth Option Year

Totals

B.3 ADMINISTRATIVE RETENTION AMOUNTS

B.3.1 If the Contractor requests a price adjustment under B.4 below, the Contractor must present cost experience data that includes the retention amount. For purposes of any economic price adjustment, this retention amount is a fixed amount that is a part of the premium amounts in B.2. This retention amount will not be adjusted for any reason.

The retention amount is part of the premium and may include, but not be limited to, such costs as overhead and general and administrative costs. It will also include any profit. Essentially, it includes all costs except the actual portion of the premium intended to fund claims paid to the health care provider/claimant. B.3.2 sets forth the retention amounts per premium paid for each category of premium and for each period of performance.

NOTE TO OFFEROR - Fill in the fixed retention amounts for each period of performance and for each category of premium. This fixed amount must be expressed in the currency in which the premium amount is proposed. The fixed retention amount shall NOT be expressed in terms of a percentage of the premium.

B.3.2.1 Retention Amounts per bi-weekly rates per employee salary range.

0-3199 Pula per month

Period of

Performance

Employee Employee

+ 1 dep.

Employee

+2 dep.

Employee

+3 dep.

Employee

+ 4 dep.

Employee

+ 5 dep.

Parent

Base Period

Option Year

3200-6199 Pula per month

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Employee Employee +

1 dep.

Employee

+2 dep.

Employee

+3 dep.

Employee +

4 dep.

Employee +

5 dep.

Parent

Base Period

6200+ Pula per month

Employee Employee +

1 dep.

Employee

+2 dep.

Employee

+3 dep.

Employee +

4 dep.

Employee +

5 dep.

Parent

Base Period

B.4. ECONOMIC PRICE ADJUSTMENT-HEALTH INSURANCE PREMIUMS

B.4.1. Premium Adjustment based on Experience - For health insurance, prices may be adjusted upward or downward based on the experience rating of the Mission(s) covered by this contract, and it specifically excludes all riders in B.1.1. No adjustment will be allowed during the first twelve months. After such time, the contractor or the Government may request an adjustment in premiums on an annual basis. Before any such adjustment is made, the contractor agrees to provide the Government a balance sheet showing two main components for the time period: (1) receipts (premiums received) minus the retention amount and (2) claims paid. The retention amount is not subject to adjustment. The Government reserves the right to have an independent third party review the balance sheet and make recommendations regarding the appropriateness of the requested adjustment. Any adjustment shall be subject to mutual agreement of the parties and shall result in a written modification to the contract. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

B.4.2. Premium Adjustment Based on Laws - The rates may also be adjusted during the performance period of the contract as a result of laws enacted by the host Government, if such change in the laws has a direct impact on the cost to the contractor to perform this contract at the contracted rate. In that event, the Contracting Officer may enter into negotiations with the

Contractor to modify the contract to adjust the premium rate. The contractor agrees to provide all documentation necessary to support any requested adjustment.

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B.4.2.1 Employee Pool – This clause is only in effect if the contractor included details in its offer regarding a pooling arrangement, of which this contract is a part.

Before any adjustment is made under this price adjustment clause, the Contractor must include in its proposal for adjustment, details setting forth how the pool impacts the request for equitable adjustment.

SECTION C

DESCRIPTION/SPECIFICATION/WORK STATEMENT

C.1. HEALTH INSURANCE SERVICES

The Government of the United States of America requires Health Insurance coverage for its employees as further described in C.1.2 in Botswana. The Government has determined that the prevailing practice by employers in Botswana is to provide for their employees health insurance protection and that the cost of such insurance protection is usually borne by both the employee and the employer on a basis of 60% of the premium paid for by employer and 40% of the premium paid for by the employee. For eligible employees who are regularly scheduled to work less than 30 hours per week: The USG will pay a prorated share of the premium cost for employee and dependent coverage, based on the number of hours the employee is regularly scheduled to work.

Health insurance protection will be representative of locally prevailing compensation practice as further described in C.1.2. The specific health benefit coverage under this contract is set forth in

Section C.

The Contractor shall insure that health care under this contract does not exclude HIV/AIDS care.

C.1.1 Employee and Dependent Health Services Benefits

The health benefits under this contract are as follows. Reimbursement of covered expenses is limited to the stated percentages of reasonable and customary costs.

Reimbursements or payments shall be made for the following covered benefits, subject to reasonable and customary costs in the locality where treatment was provided.

C.1.1.1. Hospitalization:

100% reimbursement of room and board for award room or semi-private room up to an annual maximum limit of P487,000. The cost of a private room will be reimbursed up to 100% limit of general ward or ICU (at agreed tariff) of the cost of a semi-private room. 100% reimbursement of hospital medical expenses including laboratory tests and x-rays, nursing care, operating room costs, intensive care, and prescription medicines up to annual maximum limit of P508,341. 100% coverage for ambulance.

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C.1.1.2. Professional Services and Treatment:

100% reimbursement of doctors, and surgeons, fees incurred while hospitalized, at a hospital up to annual maximum limit of P887,000 on an out-patient basis, at a clinic or doctor's office, or at home Doctors Visit (Hospital and Office) P5,421 annual maximum limit. 100% reimbursement for medical services and expenses when not hospitalized such as laboratory tests and x-rays, prescription medicines, routine annual physical examination, and inoculations up to annual maximum limit of P39,471.

C.1.1.3. Prescription Drugs and Medicines:

100% reimbursement of the cost of medicines and drugs for which a prescription is legally required when hospitalized and 95% reimbursement up to annual maximum limit of P7,550 when not hospitalized. Chronic medications up to annual maximum limit of P42,000. Expenses incurred for medicines, vitamins, cold remedies, etc., that are available over the counter without a prescription will not be reimbursed even if prescribed by a physician.

C.1.1.4. Obstetrical Care:

100% reimbursement of obstetrical related medical expenses including prenatal and postnatal care . P7500 for normal delivery and P11000 for Caesarean up to annual maximum which is

P887,000

C.1.1.5. Physical Therapy:

100% reimbursement up to annual maximum limit of

P4973.

C.1.1.6. Psychiatric Treatment:

100% reimbursement up to P40,000 annual maximum limit local currency (pula).

C.1.1.7. Optical Care:

100% reimbursement for eye examination and treatment and prescription eyeglass or contact lenses, maximum amount of P100 for examination; P7,550 for prescription; P550 for frames and

P1,050 for lenses. 50% reimbursement for lens per patient every year with maximum of 35

USD. No reimbursement for nonprescription lenses, or tinting.

C.1.1.8 Dental Care:

100% reimbursement up to P8,179 annual maximum limit local currency per person of expenses for dental Services including dentists, fees, x-rays, examination and treatment, cleaning, fillings, extractions, false teeth, crowns, and bridges.

C.1.1.9. Hearing Aids:

100% reimbursement of the cost of a hearing aid apparatus and related examination up to annual maximum limit of P5,400. Limited to one apparatus per ear per patient in a three-year period.

C.1.1.10. Alternative Treatment - Chiropractic, Homeopathic, Acupuncture and Traditional

Healing, P2000 annual maximum limit.

C.1.1.11. Other Benefits (For Employees Only)

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100% reimbursement for medications to suppress opportunistic infections, such as tuberculosis and toxoplasmosis for employees who have HIV/AIDS; as well as brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV to the employee's child. The duration of this treatment is to be determined by the employee's physician following WHO or CDC guidelines.

C.1.1.12 Maximum Limits:

The contractor shall reimburse covered expenses up to a limit of P961,606 local currency per covered individual and dependents (combined) per contract year. Expenses incurred under section C.1.1.11 of the plan are subject to a separate annual maximum limit of USD 10,000 per employee.

C.1.2 Health Benefits Conditions and Limitations.

Conditions and limitations on the entitlement to health care under this contract are as follows:

No reimbursement for elective cosmetic surgery; spa cures; rejuvenation cures; massage;

exercise therapy; long term rehabilitative therapy; non-medical hospital charges such as telephones or television; home help, family help, or similar household assistance; fees of persons who are not licensed physicians or nurses; or services or supplies which have not been prescribed or approved by a physician or nurse.

No reimbursement for expenses that will be reimbursed or paid directly under a host country medical program, the U.S. workers, compensation program, or a post's LE Staff Workers' compensation program.

No reimbursement for expenses related to an illness or injury that is a result of an unlawful action on the part of the patient; the practice of a dangerous sport; excessive or illegal use of alcohol or drugs; a self-inflicted wound; or service in the armed forces of any country.

There is reimbursement for medical expenses incurred outside of Botswana, though subject to the same maximum reimbursement rates (in foreign currency equivalents) described in C.1.1.1 through C.1.1.12 and C.1.2. There is no reimbursement for round trip transportation expenses to travel out of country for medical treatment.

C.1.3 Eligible Participants

C.1.3.1 Eligible Employees - The employees eligible for the health insurance services include the following:

Eligible employees are Locally Employed Staff who are (1) working on a full-time or part-time basis under non-temporary direct hire appointments or under personal services agreements/contracts (PSA/PSC) that are not time limited to less than one year and (2) paid under the terms of the Local Compensation Plan.

C.1.3.2 Location of Employment

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The individuals covered by C.1.3.1 must be employed within the geographic boundaries of Botswana by:

U.S. Department of State

U.S. Agency for International Development

U.S. Department of Defense

U.S. Department of Health and Human Services

U.S. Department of Justice

U.S. International Broadcasting Bureau (IBB)

U.S. Peace Corps

C.1.3.3 Participants Covered Under a Rider

C.1.3.3.1 All current active employees of the Chief of Mission and the

Deputy Chief of Mission assigned to their respective official Government residences and paid under an ORE account. All costs for ORE employees are the responsibility of the employing officer, not the U.S. Government.

C.1.3.3.2 All current active employees of the Employee Association at

Embassy Botswana. All costs for employees of the Embassy Employee Association are the responsibility of the Employee Association, not the U.S. Government.

C.1.4 Individuals Not Eligible for Coverage

Not eligible are those working under temporary direct hire appointments; those working on

When Actually Employed (WAE) schedules; those working under a PSC (Peace Corps) or PSA that is time limited to less than one year; non-personal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Botswana who provides services to other local organizations as well as to the U.S. Mission; employees of

USAID institutional contractors; and Peace Corps personal services contractors as indicated in

MS 43.

C.1.5 Other Eligible Participants

Eligible employees may elect to enroll their eligible dependents. For the purposes of this plan, an employee's dependents are defined as the employee's legal spouse (limit one) and unmarried, economically dependent children who primarily reside with the employee unless away at school.

Child is defined as the employee's natural child, adopted child, stepchild, or foster child. An eligible child will be covered until the end of the contract year in which he/she reaches age 18, or age 25 if a full time student. There is no age limit for an eligible child who is physically or mentally handicapped so as to be unable to live independently. Employee’s parents who are currently covered are authorized to be grandfathered into the plan.

C.1.6. Eligibility

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C.1.6.1. Term of Eligibility and Effective Date

Each current active eligible employee is enrolled for health benefits under this contract upon award and thereafter during the performance period of this contract. Each new eligible employee will be enrolled upon entering on duty with the United States Government. An employee is considered active ("on the rolls") whenever such employee is on approved leave, whether paid or unpaid.

During a period of leave without pay or unpaid leave beyond one pay period the employee is responsible for the full cost of premiums. The USG will pay the premium directly to the contractor, and will collect the full cost from the employee. Alternatively, the employee may elect to have coverage cease if he/she prefers not to pay the premium.

C.1.6.2. Period of Ineligibility.

Employees and their dependents are not entitled to health benefits during any period of employment for which premiums are not paid.

Additionally, employee's dependents are not entitled to health benefits during any period of employment during which the employee was not eligible to participate.

During a period of extended (beyond one pay period) of Leave Without Pay or unpaid leave, the employee is responsible for the full cost of the insurance premiums for self and dependents. The Mission will pay the premiums directly to the contractor, and will collect the full cost from the employee on a quarterly basis. Alternatively, the employee may elect to have coverage cease if that employee prefers not to pay the premium.

C.1.7. BROCHURE REQUIREMENT.

C.1.7.1. The contractor shall provide a document (brochure/pamphlet/other written document) in English and Setswana that sets forth a complete listing of the health insurance benefits to be provided under this contract. This brochure shall be provided in sufficient quantities so that each covered employee receives a copy. The contractor shall furnish all copies of the brochures to the COR, who will ensure that appropriate distribution is made.

C.1.7.2. The contractor shall provide the document described in C.1.7.1 to the

COR not later than 30 days after date of contract award. The Contractor shall provide additional brochures for new employees within ten (10) days of the COR’s request.

C.1.7.3. The contractor assumes full responsibility for ensuring that the document described in C.1.7.1 accurately reflects the requirements of the contract, as implemented by the contractor’s technical proposal. In all cases, the contract shall take precedence. Should the COR discover that the brochure contains inaccuracies, the contractor will be notified in writing;

however, failure on the part of the Government to notice any inaccuracies shall in no way limit, revise or otherwise affect the requirement under this contract for the contractor to fully comply

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C.2.0 Paragraph C.2 is reserved.

C.3.0 DEFINITIONS

FMO The Financial Management Officer or the paying office for all U.S. Government

Agencies except AID.

COR Contracting Officer's Representative (Human Resources Officer at post).

Contributory Insurance for which the employee contributes toward the premium.

Dependent An employee's dependents are defined as the employee's legal spouse

(limit one) and unmarried, economically dependent children who primarily reside with the employee unless away at school. Child is defined as the employee's natural child, adopted child, stepchild, or foster child. An eligible child will be covered until the end of the contract year in which he/she reaches age 18, or age

25 if a full time student. There is no age limit for an eligible child who is physically or mentally handicapped so as to be unable to live independently.

Parents, grandparents, siblings, and other relatives are not eligible dependents.

(Employees parents who are currently covered are authorized to be grandfathered into the plan and considered dependents).

Disability, Total and Permanent A physical or mental impairment which precludes the individual from performing ordinary motor or bodily functions and which requires separation from employment. If the impairment is the result of a previous impairment, it shall be considered a continuation of the prior impairment.

Employee An individual employed by the U.S. Government, under a direct-hire appointment, personal services contract, or personal services agreement, as further defined in Section C.1.3 for health insurance and C.2.3 for life insurance. This may also include ORE Staff, EAE and Peace Corp PSCs, if this category of individual is listed as participating under a rider in C.1.3.3 for health insurance and C.2.3.3 or life insurance.

Employer The United States Government or in the case of ORE and Gaborone Embassy

Employee Association employees, the Chief of Mission/Deputy Chief of Mission and Employee Association, respectively.

GSO General Services Officer in charge of the General Services Office at post. This officer is usually the Contracting Officer for this contract.

Hospital An institution established and operated for the care and treatment of sick and injured persons. It provides 24-hour nursing care and has diagnostic, 18 | P a g e laboratory, treatment, and surgical facilities. Any institution which does not meet this definition is not considered a hospital.

Hospital Patient An individual who has been admitted to a hospital, is assigned a bed, and is given diagnostic tests or receives treatment for a disease or an injury.

Maximum Benefit The total amount that will be paid to any one covered individual for covered medical expenses or life insurance/disability benefit.

Customary and Reasonable Treatment A diagnostic test or medical treatment which is usually performed in the community where the individual is being treated.

Physician An individual who has graduated from an accredited medical school and is licensed to practice medicine in the jurisdiction in which the contract is to be performed. If the individual is a medical specialist, then he or she is Board

Certified in that specialty.

Surgical procedure Any invasive medical procedure by manual or instrument operation undertaken for diagnosis or treatment of a diseased patient.

SECTION D

PACKAGING AND MARKING

(RESERVED)

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SECTION E

INSPECTION AND ACCEPTANCE

E.1. 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates the following 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 address:

http://www.acquisition.gov/far/ or http://farsite.hill.af.mil/vffara.htm

These addresses are subject to change. If the Federal Acquisition Regulation (FAR) is not available at the locations indicated above, use the Department of State Acquisition website at http://www.statebuy.state.gov/ to see the links to the FAR. You may also use an internet “search engine” (for example, Google, Yahoo, Excite) to obtain the latest location of the most current

FAR.

The following Federal Acquisition Regulation clause(s) is/are incorporated by reference:

CLAUSE TITLE AND DATE

52.246-4 INSPECTION OF SERVICES - FIXED PRICE (AUG 1996)

E.2. QUALITY ASSURANCE AND SURVEILLANCE PLAN (QASP)

This plan is designed to provide an effective surveillance method to promote effective Contractor performance. The QASP provides a method for the Contracting Officer's Representative (COR) to monitor Contractor performance, advise the Contractor of unsatisfactory performance, and notify the Contracting Officer of continued unsatisfactory performance. The Contractor, not the

Government, is responsible for management and quality control to meet the terms of the contract.

The role of the Government is to conduct quality assurance to ensure that contract standards are achieved.

Performance Objective

PWS

Paragraph Performance Threshold

Services

Performs all the insurance services set forth in the Performance Work Statement (PWS)

C.1.0 thru

C.3.0

All required services are performed and no more than one

(1) customer complaint is received per month

E.2.1 Surveillance. The COR will receive and document all complaints from Government personnel regarding the services provided. If appropriate, the COR will send the complaints to the Contractor for corrective action.

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E.2.2 Standard. The performance standard is that the Government receives no more than one

(1) customer complaint per month. The COR shall notify the Contracting Officer of the complaints so that the Contracting Officer may take appropriate action to enforce the inspection clause (FAR 52.246-4, Inspection of Services – Fixed Price (AUG 1996) or the appropriate

Inspection of Services clause), if any of the services exceed the standard.

E.2.3 Procedures

(a) If any Government personnel observe unacceptable services, either incomplete work or required services not being performed, they should immediately contact the COR.

(b) The COR will complete appropriate documentation to record the complaint.

(c) If the COR determines the complaint is invalid, the COR will advise the complainant. The COR will retain the annotated copy of the written complaint for his/her files.

(d) If the COR determines the complaint is valid, the COR will inform the Contractor and give the Contractor additional time to correct the defect, if additional time is available. The

COR shall determine how much time is reasonable.

(e) The COR shall, as a minimum, orally notify the Contractor of any valid complaints.

(f) If the Contractor disagrees with the complaint and challenges the validity of the complaint, the Contractor will notify the COR. The COR will review the matter to determine the validity of the complaint.

(g) The COR will consider complaints as resolved unless notified otherwise by the complaint.

(h) Repeat customer complaints are not permitted for any services. If a repeat customer complaint is received for the same deficiency during the service period, the COR will contact the Contracting Officer for appropriate action under the Inspection clause.

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SECTION F

DELIVERIES OR PERFORMANCE

F.1. 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

http://www.statebuy.state.gov/ to see the links to the FAR. You may also use an internet “search

The following Federal Acquisition Regulation clauses are incorporated by reference:

52.242-15 STOP WORK ORDER (AUG 1989)

52.242-17 GOVERNMENT DELAY OF WORK (APR 1984)

F.2 PERIOD OF PERFORMANCE. The performance period of this contract is one year beginning 30 days following contract award with four (4) one-year options to renew.

F.3 OPTIONS

(a) The Government may extend this contract in accordance with the option clause at

Section I, clause I.2, FAR Clauses Incorporated by Full Text (FAR 52.217-9, Option to Extend the Term of the Contract), which also specifies the total potential duration of the contract.

(b) The Government may exercise the option set forth at Section I, "FAR 52.217-8, Option to Extend Services".

F.4 REPORTS AND OTHER DELIVERABLES

All reports and other deliverables required under this contract shall be delivered to the following address:

Human Resources Office

U.S. Embassy Gaborone

P.O Box 90, Gaborone, Botswana

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SECTION G

CONTRACT ADMINISTRATION DATA

G.1. 652.242-70 CONTRACTING OFFICER’S REPRESENTATIVE (COR) (AUG 1999)

(a) The Contracting Officer may designate in writing one Government employee, by name or position title, to take action for the Contracting Officer under this contract. This designee shall be identified as a Contracting Officer’s Representative (COR). Such designation shall specify the scope and limitations of the authority so delegated; provided, that the designee shall not change the terms or conditions of the contract, unless the COR is a warranted

Contracting Officer and this authority is delegated in the designation.

(b) The COR for this contract is the Human Resources Officer.

G.2 COR DUTIES

G.2.1 The COR is responsible for inspection and acceptance of services. These duties include review of Contractor invoices, including the supporting documentation required by the contract. The COR may provide technical advice, substantive guidance, inspections, invoice approval, and other purposes as deemed necessary under the contract.

G.2.2 In addition, the COR shall maintain updated list of employees and dependents insured, which will supersede the initial list provided under this contract and as reported to the insurer without prejudice to the ineligibility clause.

G.2.3. The COR has the additional responsibility of maintaining the eligible listing of employees and dependents for insurance coverage.

G.2.4 The COR may not change the terms and conditions of the contract. While the

COR is authorized to provide the Contractor with updated listings of eligible employees and dependents, only the Contracting Officer may modify existing task orders or issue new task orders, reflecting these changes, since only the Contracting Officer can obligate funding and commit the Government.

G.3. Payment shall be made in the currency stated in the Section B pricing tables.

G.4 SUBMISSION OF INVOICES AND PAYMENT

G.4.1. Invoices for U.S. Government employees shall be submitted in an original and three (3) copies to the following address (designated billing office only for the purpose of submitting invoices):

Financial Management Office

U.S. Embassy Gaborone

P.O. Box 90, Gaborone, Botswana

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Payments at Beginning of Covered Period

G.4.2. Frequency of Payments. All funds under this contract will be obligated by issuance of task orders, as described in H.3. Each task order will fund a specific period of time and number of employees, and the task orders will be issued at the frequency described in H.3.

Contractor may submit invoices monthly for payment to be made at the beginning of the month for which insurance coverage is provided in accordance with FAR 32.404.

G.4.3. U.S. Government Employees. The Government shall make payments directly to the Contractor for all Government employees, whether or not the employee is contributing to the premium amount.

G.4.4 ORE Staff. The Chief of Mission and/or Deputy Chief of Mission will make payment directly to the Contractor for the entire premium amount of the ORE staff, whether or not the ORE employee is contributing to the premium amount.

G.4.5. EAE Staff. The Employee Association will make payment directly to the

Contractor for the entire premium amount of the EA employee, whether or not the EA employee is contributing to the premium amount.

G.5 REFUNDS TO THE GOVERNMENT

If at any time during performance of the contract the Government finds that the Contractor has been overpaid because the number of employees and/or dependents covered has decreased, the

Contracting Officer may either allow that overpayment to be credited to the Government’s account or require that the Contractor refund the overpayment. If the Contracting Officer requests a refund, the Contractor shall make that refund to the Government within ten calendar days of receipt of the request.

G.6 VALUE ADDED TAX

VALUE ADDED TAX (VAT). The Contractor shall include VAT as a separate charge on the

Invoice and as a separate line item in Section B.

SECTION H

SPECIAL CONTRACT REQUIREMENTS

H.1 SECURITY. On occasion, a Contractor employee may require entry into U.S.

Government-owned or -operated facilities. If so, the Contractor should be prepared to provide the necessary identification to permit escorted access within that facility.

H.2 STANDARDS OF CONDUCT. The Contractor shall maintain satisfactory standards of employee competency, conduct, cleanliness, appearance, and integrity and shall be responsible for taking such disciplinary action with respect to employees as may be necessary. Each

Contractor employee is to adhere to standards that reflect credit on themselves, their employer, and the United States Government.

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H.3 ORDERING PROCEDURES. The Government will issue a task order as soon as possible after contract award to identify all employees to be covered by the insurance described in this contract and the coverage selected by each employee, including dependents to be covered.

The COR will make subsequent additions or deletions to this list in writing and provide the revised list to the Contractor. All such revisions shall be consolidated, and a new or modified task order will be issued by the Contracting Officer. If any changes have been made to the coverage listing, the Government anticipates issuance of a new task order on a [ X] monthly, [ ] quarterly basis. This new task order will include all changes made since the previous task order was issued and will include any increase or decrease in necessary funding. The changes to the list of eligible individuals will supersede the initial list provided under prior task orders without prejudice to the ineligibility clause. Task orders will indicate the effective date of employment, for purposes of calculating the premium due.

H.3.1. The ORE staff, EA employees under separate riders are not included under the task orders issued by the Contracting Officer. Because their coverage is under a rider, their employer is responsible for directly interacting with the Contractor to order any coverage for their employees. When contacted by the employer, the Contractor shall advise the employer of the paperwork and payment that will be necessary to order coverage for the identified individuals.

Because more than one employer may have ORE staff, the Contractor may be contacted by more than one employer (typically the Chief of Mission and Deputy Chief of Mission).

H.4. CONTRACTOR RESPONSIBILITY IN CLAIMS AND REIMBURSEMENT TO

CLAIMANTS

General.

The Contractor shall be responsible for all planning, estimating, programming, project management, scheduling, dispatching, supervision, and inspection of work. The Contractor shall maintain his own reference library of technical reference works and local laws and regulations, including current tariffs and registries. The Contractor shall treat the information provided by the Embassy concerning employee' personal data, medical information, and salaries as highly sensitive and not divulge any employee information to unauthorized persons. The Contractor shall establish procedures for handling medical insurance claims as follows:

(a) Administrative Records

(1) The Contractor shall maintain medical insurance files for each covered employee and each covered dependent including receipts and proof of paid claims, requests for claim reimbursements, and accounting of paid benefits with balances of amounts remaining in the annual per person reimbursement ceiling.

(2) The Contractor shall provide the COR with the necessary claim forms for each type of benefit that can be claimed under the contract. These forms shall specify a list of documents required to be appended to each claim and otherwise provide instructions for claim filing.

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(3) The Contractor shall use the English spelling of the employees' names in all transactions, including reimbursement checks.

(4) The Contractor shall provide employee claim reimbursement checks to the

COR for disbursement to the employee not later than the Tuesday which is two weeks after the claim has been submitted.

(b) Medical Insurance Claims. Settlement of medical insurance shall be completed as follows:

(1) All medical claims shall be submitted directly to the Contractor by employees, through a drop box in the COR's office. The claims shall be picked up from the

COR each Tuesday.

(2) The Contractor shall date stamp and screen all claims submitted on the day of receipt. If there are any missing documents or information thereby disallowing said claim to be payable, the Contractor shall notify the employee within two days, with a copy to the COR (if notification is written).

(3) The Contractor shall settle the claims no later than two weeks from the date the claim is submitted to the Contractor.

(4) Settlement shall be by issuance of checks in the name of the employee for each claim submitted. Each check shall be accompanied by a form providing details of the amount reimbursed with an explanation of deductions, if any.

(5) The Contractor shall accept the employee's or dependent's choice to go for surgery to hospitals designated by the Contractor in order that the Contractor will pay the expenses directly to the hospitals.

H.5. REPORT REQUIREMENTS. The Contractor shall provide the following reports monthly. All reports must be received by the COR no later than the 10th day of each month.

These reports shall report on the previous month's activities.

(a) Employee Claims Report. The report will list all claims paid by the Contractor to a claimant, including the name of the claimant, date claim is received by the Contractor, and the amount claimed. This report shall also include all outstanding claims and a brief description of why claim has not been paid.

H.6. MISCELLANEOUS CONTRACTOR REQUIREMENTS

H.6.1. General. The Contractor shall take all such steps as are necessary, and obtain and pay for all permits, taxes and fees as are required by the Botswana government to establish and/or operate a commercial venture locally. A contract with the U.S. Government conveys no special privileges or immunities to the Contractor. The Contractor is an independent commercial concern and not a part of the U.S. mission. The Contractor's employees are not U.S.

Government employees. Registration of this contract with the Botswana government, if

26 | P a g e required by law, will be the sole responsibility of the Contractor, and any fees, taxes, or other duties shall be payable by the Contractor without recourse to the Government of the amounts thereof.

H.6.2. Licenses and Local Laws. The Contractor shall possess all permits, licenses, and any other appointments required for the prosecution of work under this contract, all at no additional cost to the Government. The Contractor shall perform this contract in accordance with local laws.

H.7 ERRONEOUS PAYMENTS. If the Government becomes eligible for a refund of payment because of erroneous overpayment or other cause, the Contractor shall refund the amounts or use them to offset future payments owed by the Government, whichever the

Government prefers. The Contractor shall refund any refunds not complete or discovered after the completion date of this contract.

H.8 REQUIRING ACTIVITY. The requiring activity under this contract is the U.S.

Embassy/Consulate.

SECTION I

CONTRACT CLAUSES

I.1. 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

http://www.statebuy.state.gov/ to see the links to the FAR. You may also use a network “search

The following Federal Acquisition Regulation clauses are incorporated by reference:

52.202-1 DEFINITIONS (NOV 2013)

52.203-3 GRATUITIES (APR 1984)

52.203-5 COVENANT AGAINST CONTINGENT FEES (MAY 2014)

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52.203-6 RESTRICTIONS ON SUBCONTRACTOR SALES TO THE GOVERNMENT

(SEPT 2006)

52.203-7 ANTI-KICKBACK PROCEDURES (MAY 2014)

52.203-8 CANCELLATION, RESCISSION, AND RECOVERY OF FUNDS FOR

ILLEGAL OR IMPROPER ACTIVITY (MAY 2014)

52.203-10 PRICE OR FEE ADJUSTMENT FOR ILLEGAL OR IMPROPER ACTIVITY

(MAY 2014)

52.203-12 LIMITATION ON PAYMENTS TO INFLUENCE CERTAIN FEDERAL

TRANSACTIONS (OCT 2010)

52.203-17 CONTRACTOR EMPLOYEE WHISTLEBLOWER RIGHTS AND

REQUIREMENT TO INFORM EMPLOYEES OF WHISTLEBLOWER

RIGHTS (APR 2014)

52.203-19 Prohibition on Requiring Certain Internal Confidentiality Agreements or

Statements (JAN 2017)

52.204-4 PRINTED OR COPIED DOUBLE-SIDED ON POSTCONSUMER FIBER

CONTENT PAPER (MAY 2011)

52.204-10 REPORTING EXECUTIVE COMPENSATION AND FIRST-TIER

SUBCONTRACT AWARDS (OCT 2015)

52.204-13 SYSTEM FOR AWARD MANAGEMENT MAINTENANCE (OCT 2016)

52.204-18 COMMERCIAL LAND GOVERNMENT ENTITY CODE MAINTENANCE

(JUL 2016)

52.204-19 INCORPORATION BY REFERENCE OF REPRESENTATIONS AND

CERTIFICATIONS (DEC 2014)

52.209-6 PROTECTING THE GOVERNMENT’S INTEREST WHEN

SUBCONTRACTING WITH CONTRACTORS DEBARRED, SUSPENDED,

OR PROPOSED FOR DEBARMENT (OCT 2015)

52.209-9 UPDATES OF PUBICALLY AVAILABLE INFORMATION REGARDING

RESPONSIBILITY MATTERS (JULY 2013)

52.215-2 AUDIT AND RECORDS - NEGOTIATION (OCT 2010)

52.215-8 ORDER OF PRECEDENCE--UNIFORM CONTRACT FORMAT (OCT 1997)

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52.215-11 PRICE REDUCTION FOR DEFECTIVE CERTIFIED COST OR PRICING

DATA – MODIFICATIONS (AUG 2011)

52.215-13 SUBCONTRACTOR CERTIFIED COST OR PRICING DATA -

MODIFICATIONS (OCT 2010)

52.215-21 REQUIREMENTS FOR COST OR PRICING DATA OR INFORMATION

OTHER THAN COST OR PRICING DATA--MODIFICATIONS (OCT 2010)

52.222-19 CHILD LABOR – COOPERATION WITH AUTHORITIES AND REMEDIES

(FEB 2016)

52.222-50 COMBATTING TRAFFICKING IN PERSONS (MAR 2015)

52.223-18 ENCOURAGING CONTRACTOR POLICIES TO BAN TEXT MESSAGING

WHILE DRIVING (AUG 2011)

52.224-1 PRIVACY ACT NOTIFICATION (APR 1984)

52.224-2 PRIVACY ACT (APR 1984)

52.224-3 PRIVACY TRAINING (JAN 2017)

52.225-5 TRADE AGREEMENTS (FEB 2016)

52.225-13 RESTRICTIONS ON CERTAIN FOREIGN PURCHASES (JUN 2008)

52.225-14 INCONSISTENCY BETWEEN ENGLISH VERSION AND TRANSLATION

OF CONTRACT (FEB 2000)

52.228-3 WORKERS’ COMPENSATION INSURANCE (Defense Base Act) (JUL 2014)

52.228-5 INSURANCE-WORK ON A GOVERNMENT INSTALLATION (JAN 1997)

52.229-6 TAXES - FOREIGN FIXED PRICE CONTRACTS (FEB 2013)

52.232-1 PAYMENTS (APR 1984)

52.232-8 DISCOUNTS FOR PROMPT PAYMENT (FEB 2002)

52.232-11 EXTRAS (APR 1984)

52.232-17 INTEREST (OCT 2010)

52.232-18 AVAILABILITY OF FUNDS (APR 1984)

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52.232-24 PROHIBITION OF ASSIGNMENT OF CLAIMS (MAY 2014)

52.232-25 PROMPT PAYMENT (JAN 2017)

52.232-33 PAYMENT BY ELECTRONIC FUNDS TRANSFER - SYSTEM FOR AWARD

MANAGEMENT (JULY 2013)

52.232-34 PAYMENT BY EFT – OTHER THAN SAM (JULY 2013)

52.232-40 PROVIDING ACCELERATED PAYMENTS TO SMALL BUSINESS

SUBCONTRACTORS (DEC 2013)

52.233-1 DISPUTES (MAY 2014) Alternate I (DEC 1991)

52.233-3 PROTEST AFTER AWARD (AUG 1996)

52.233-4 APPLICABLE LAW FOR BREACH OF CONTRACT CLAIM (OCT 2004)

52.237-2 PROTECTION OF GOVERNMENT BUILDINGS, EQUIPMENT, AND

VEGETATION (APR 1984)

52.242-13 BANKRUPTCY (JULY 1995)

52.243-1 CHANGES (AUG 1987) – Alternate I (APR 1984)

52.244-6 SUBCONTRACTOR AND COMMERCIAL ITEMS (JAN 2017)

52.246-25 LIMITATION OF LIABILITY - SERVICES (FEB 1997)

52.248-1 VALUE ENGINEERING (OCT 2010)

52.249-2 TERMINATION FOR CONVENIENCE OF THE GOVERNMENT (FIXED

PRICE) (APRIL 2012)

52.249-8 DEFAULT - FIXED PRICE SUPPLY AND SERVICE (APR 1984)

I.2. FEDERAL ACQUISITION REGULATION (FAR) CLAUSES INCORPORATED

IN FULL TEXT

52.216-18 ORDERING (OCT 1995)

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the

Schedule. Such orders may be issued from the first day of the ongoing performance…