19GE5018R0066.pdf

SOLICITATION

DOCUMENT

Health Insurance for Locally Engaged Staff US Embassy Baku, Azerbaijan

Solicitation No. 19GE5018R0028

American Consulate General Regional Procurement Support Office Giessenerstrasse 30 60435 Frankfurt am Main, Germany

19GE5018R0066 Baku, Azerbaijan Locally Engaged Staff Health Insurance Page 3 of 67

TABLE OF CONTENTS

Section 1 – The Schedule

SF 1449 cover sheet Continuation To SF-1449, Prices, Block 23 Continuation To SF-1449, Schedule Of Supplies / Services, Block 20 Description /

Specifications / Work Statement

Attachment 1 – Prices Attachment 2 – Contract Information / Experience Listing Exhibit A – Employee Statistics Exhibit B – ORE Employees Rider & Employee Association Riders

NOTE: Further contractor-provided attachments will be included after award

Section 2 – Contract Clauses

Contract Clauses Addendum to Contract Clauses - FAR and DOSAR Clauses not Prescribed in Part 12

Section 3 – Solicitation Provisions

Solicitation Provisions Addendum to Solicitation Provisions - FAR and DOSAR Provisions not Prescribed in Part 12

Section 4 – Evaluation Factors

Evaluation Factors Addendum to Evaluation Factors - FAR and DOSAR Provisions not Prescribed in Part 12

Section 5 – Representations and Certifications

Offeror Representations and Certifications Addendum to Offeror Representations and Certifications - FAR and DOSAR Provisions not

Prescribed in Part 12

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SECTION 1 – THE SCHEDULE

CONTINUATION TO SF-1449

PRICES – BLOCK 23

I BACKGROUND / SCOPE OF SERVICES

A. The Government of the United States of America requires Health Insurance for its Locally

Engaged Staff and their dependents in Azerbaijan.

The Contractor shall provide the Health Insurance services to employees of the Government of the United States of America in Azerbaijan, as described in Section 1.IV.A and the Exhibits attached. The groups of employees who shall be provided this insurance are listed in Section

1.IV.C.1.6.

This insurance shall be provided in accordance with Section 1.IV.A and the Exhibits attached.

The insurance company will reimburse covered medical expenses incurred, subject to the stated limits. Payment will be made for reasonable and customary costs of covered benefits.

The medical treatment must be prescribed or provided by a physician or nurse licensed in Azerbaijan, the United States, or in the country in which the treatment or prescription is received. Coverage of expenses will be made in the local currency, Azerbaijani New Manat.

B. This is a fixed price with economic price adjustment requirements type contract under which annual firm, fixed-price task orders will be issued. The contract shall remain unfunded. The fixed prices / premium rates for the health insurance services as specified in Section 1.IV. A and B are listed in Section1.III.C

C MINIMUM (Reference Section I, Clause 52.216-22(b))

During the term of this contract, the Government shall order, as a minimum, services in an amount of at least $5,000.00 or equivalent in local currency.

The Government makes no guarantee as to the number of orders or actual amount of services that will be requested above the guaranteed minimum of $5,000.00 or equivalent in local currency.

The maximum dollar value during the entire life of this contract is $4,500,000.00.

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II ACRONYMS AND ABBREVIATIONS

Acronym Definition

CLIN Contract Line Item Number

Contractor Insurance Company

CO

Contracting Officer

COR

Contracting Officer Representative (Human Resources Supervisor of the US Embassy Baku)

Dependent Dependents are defined as the covered employee’s legal spouse (limit one) and each unmarried, economically dependent child who primarility resides with 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 the child turns age 18, or in the case of a child who is a full-time student, until the end of the contract year in which the child turns age 25. There is no age limit for an eligible child who is physically or mentally handicapped so as to be unable to live independently.

There is no limit on the number of children covered per employee. Parents, grandparents, siblings, and other relatives are not eligible dependents

Employer

The United States Government = USG

Employee Staff member of the US Embassy Baku FMO Financial Management Officer 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, 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.

LS

Lump Sum

PII

Personally Identifiable Information

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

QA

Quality Assurance

QC

Quality Control

QCP

Quality Control Plan

QTY Quantity

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SOW

Statement of Work

Surgical Procedure

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

TBD

To be determined

USG

U.S. Government

III PRICES

A.1 The contractor shall complete all work, including furnishing all labor, material, equipment and services, unless otherwise specified herein, required under this contract for the firm fixed unit prices indicated below and within the time specified herein. These individual prices shall include all labor, materials, profit, and, if applicable, value added tax (VAT).

Any costs not separately priced will be considered to be included in the individual prices as overhead or other indirect cost. No additional sums will be payable on account of any escalation in the cost of materials, equipment or labor, or because of the contractor's failure to properly estimate or accurately predict the cost or difficulty of achieving the results required by this contract. Nor will the contract price be adjusted on account of fluctuations in the currency exchange rates.

A.2 The currency shall be fixed and cannot be changed by modification to the contract.

A.3.1 Economic Price Adjustment, Premium Adjustment Based on Experience – For health insurance, prices may be adjusted upward or downward based on the experience rating of the Mission covered by this contract, and it specifically excludes all riders in B.4.2.c No adjustment will be allowed during the first twelve months.

After such time, the contractor or the USG may request an adjustment in premiums on an annual basis to be effective per contract year. Adjustments are not retroactive to previous contract terms. Before any such adjustment is made, the contractor agrees to provide the USG a balance sheet showing three main components for the previous time period:

(1) receipts (premiums received),

(2) number of insurance policies and

(3) claims paid.

This information shall be provided per type of premium, i.e. per line item.

The USG reserves the right to have an independent third party review the balance sheet and claims 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 effective for the following option year. Any failure to reach agreement under this clause shall be subject to the procedures in the Disputes clause.

A.3.2.1 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

Locally Engaged Staff Health Insurance Page 7 of 67 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(s). The contractor agrees to provide all documentation necessary to support any requested adjustment.

A.3.2.2 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.

A.4 Administrative Retention Amounts

A.4.1 If the Contractor requests a price adjustment under A.3 above, 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 Attachment 1. 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. A.4.2 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 monthly 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.

A.4.2 Monthy Retention Amounts per separate premium paid per single employee and per family plan.

Period of Performance Single Employees (Self Only) Family Plan

Base Period

First Option Year

Second Option Year

Third Option Year

Fourth Option Year

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B. VAT does not apply. Embassy Baku is holding a VAT Exemption Certificate from the host government.

C. Offeror, insert the currency of prices offered __________________

The fixed prices / premium rates for the health insurance services as specified in Section IV are as follows:

SPACE INTENTIONALLY LEFT BLANK

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ATTACHMENT 001 – PRICES WILL BE INSERTED HERE

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CONTINUATION TO SF-1449

SCHEDULE OF SUPPLIES / SERVICES, BLOCK 20

DESCRIPTION / SPECIFICATIONS / WORK STATEMENT

IV SPECIFICATIONS

A Health Insurance Services

The Government of the United States of America requires Health Insurance coverage for its employees in Azerbaijan, as further described in this Section.

The specific health benefit coverage under this contract is set forth in Sub Sections B.1 though B.3:

B.1 Employee Health Services Benefits Reimbursement of covered expenses is limited to the stated percentages of reasonable and customary costs. Proposals that contain more benefits (even if there is no increase in cost) or fewer benefits than stated in the solicitation may be deemed technically unacceptable.

The health benefits under this contract are as follows:

Deductible : none

B.1.1 Hospitalization:

100% coverage of room and board expenses for a ward room or semi-private room. 80% coverage of room and board expenses for a private room, not to exceed 100% of the cost of a semi-private room. 100% coverage of hospital medical expenses including laboratory tests and x-rays, nursing care, operating room costs, intensive care, prescription medicines, and physical therapy. 100% coverage of ambulance service.

B.1.2 Professional Services and Treatment Coverage:

80% coverage of doctors’ and surgeons’ fees incurred while hospitalized, at a hospital on an out-patient basis, at a clinic or doctor’s office, or at home. 80% coverage for medical services and expenses when not hospitalized such as laboratory tests and x-rays, prescription medicines, physical therapy, routine annual physical examinations, and inoculations.

B.1.3 Prescription drugs and medicines Coverage:

Prescription medication: Inpatient 100%; outpatient 80%. Medications prescribed by a licensed health care provider that are medically necessary. Examples include, but are not limited to: prescription antibiotics to treat an infection; medication used to treat an ongoing condition, such as high cholesterol, and prophylaxis; and contraceptive medication.

B.1.4 HIV/AIDS coverage:

100% coverage for medications to suppress opportunistic infections, such as tuberculosis and toxoplasmosis for employees who have HIV/AIDS.

For employee and spouse: 100% coverage for brief courses of anti-retroviral drugs during childbirth to prevent the transmission of HIV to the employee’s child. This expanded coverage generally excludes medications for the long-term suppression of AIDS through the combination of anti-retroviral drugs at those posts with inadequate local healthcare infrastructures.

B.1.5 Obstetrical Care Coverage:

100% coverage when hospitalized, and 80% coverage when not hospitalized, of obstetrical medical care including prenatal and postnatal care.

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B.1.6 Family Planning Coverage:

80% coverage of prescribed contraceptive devices and drugs, voluntary sterilization, and diagnosis and treatment of infertility. Not covered is reversal of voluntary sterilization, infertility treatment after voluntary sterilization, genetic counseling, fertility drugs, and assisted reproductive technology.

B.1.7 Hearing Aids Coverage:

80% coverage of the cost of a hearing aid apparatus and related examination. Limited to one apparatus per ear per patient in a three-year period

B.1.8 Optical Care Coverage:

50% coverage for eye examination and treatment and prescription eyeglass or contact lenses.

Limited to two lenses per patient every two years.

No coverage for eyeglass franonprescription lenses, or tinting.

B.1.9 Dental Care Coverage:

50% of expenses for dental services including dentists’ fees, x-rays, examination and treatment, cleaning, fillings, extractions, false teeth, crowns, and bridges. Orthodontia treatment is covered only if treatment begins before age 15, unless required as the result of an accident. A maximum of four years of orthodontia treatment will be covered per patient.

B.1.10 Psychiatric Treatment Coverage:

50% coverage

B.1.10 Medical Expenses Incurred Out of Azerbaijan:

B.1.10.1 Medical Expenses Incurred Out of Country: Medical expenses incurred out of country will be covered for employees and dependents when (a) a life threatening condition occurs when the individual is out of the country and treatment is medically necessary before the individual returns home or (b) the individual’s attending physician certifies in advance that such treatment is medically necessary and unavailable locally. Reimbursement will be made at the same percentage rate and subject to the same annual maximum limit as for expenses incurred in country.

B.1.10.2 Transportation for Out of Country Treatment: Transportation for out of country treatment is a covered expense for employees and dependents. The patient’s attending physician must certify in advance that the treatment is medically necessary and unavailable locally. 80% of the patient’s transportation expenses by the least expensive, appropriate means of transportation to the nearest city with adequate medical facilities will be reimbursed. 80% of the transportation expenses of an attendant will be reimbursed if the patient’s attending physician certifies that an attendant for the patient is necessary, e.g., a parent in the case of a patient who is a minor or a family member to make medical decisions in the case of a patient who is unconscious. All reimbursements for transportation expenses are subject to the annual maximum limit.

B.2 Annual Maximum Limit:

With the exception of expenses incurred under paragraph B.1.4 above, the Insurance Company will reimburse covered expenses up to a limit of 77,810 USD per covered individual (patient) per contract year. The insurance company will reimburse covered expenses described under paragraph B.1.4 of the plan up to a separate limit of 77,810 USD per employee per contract year.

The maximum limit for employees regularly scheduled to work on a part-time basis work for fewer than 30 hours per week will be prorated based on hours in the workweek. For example, the maximum limit for an employee regularly scheduled to work 20 hours per week is 77,810 USD x 20/40, 38,905 USD.

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B.3 Health Benefits Conditions and Limitations:

No coverage will be made for elective cosmetic surgery; spa cures; rejuvenation cures; massage;

exercise therapy; long term rehabilitative therapy; eyeglass frames; 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 coverage will be made for expenses that will be reimbursed or paid directly under a host country medical program, the U.S. workers’ compensation program, or any host government workers’ compensation program.

No coverage will be made 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.

No coverage will be made for expenses incurred after an employee leaves the service of the U.S.

Mission.

B.4 DELIVERABLES

B.4.1 The Contractor shall provide a document (brochure/pamphlet/other written document) in English, Azerbaijani and Russian 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.

The Contractor shall provide the document to the COR not later than thirty (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.

The Contractor assumes full responsibility for ensuring that the document described in B.4.1 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 with all contract terms.

B.4.2 The Contractor shall provide the following summary 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. No PII information will be included in the report.

(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.

(b) Demographic Information Report to include employee age distribution, dependent distribution, member movement, and distribution of benefits.

(c) Benefits utilization information to include hospital benefit statistics, chronic illness statistics, claims expenditure distribution, and health promotion utilization.

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B.4.3 Insurance Card (Optional – this requirement shall be discussed with the COR after contract award) An ID card shall be provided for each insured person (preferablly with photo).

If the ID card is lost or stolen the contractor shall provide a replacement at no cost.

C Eligible Participants

C.1.1 Eligible Employees Eligible employees are Locally Employed Staff who are (1) working on a full time or part time basis under non-temporary direct hire appointments, personal services agreements, or personal services contracts and (2) paid under the terms of the Local Compensation Plan. Participation is voluntary.

C.1.2 Location of Employment The individuals authorized by C.1.1 must be employed within the geographic boundaries of Azerbaijan by:

Department of State Agency for International Development Department of Defense (including Office of Defense Cooperation and Defense Threat Reduction Office) Export Border Security

Department of Justice Department of Energy Peace Corps

C.1.3 Participants Covered Under a Rider Official Residence Expense (ORE), Employee Association (EA) employees and employees separated due to retirement may be covered under a rider to the contract. The employing officer/Employee Association, and not the USG, is responsible for the employer's share of the premium costs for an ORE/EA employee. For retirees, premium costs are entirely borne by the retiree.

C.1.4 Individuals Not Eligible for Coverage

C.1.4.1 Not eligible are those working under temporary appointments; those working under a PSC or PSA that is time limited to less than one year; those with an intermittent, seasonal, or WAE (when actually employed) schedule; non-personal services contract personnel and their employees, supplied by an independent contractor licensed to do business in Azerbaijan 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 743.

C.1.4.2 New retirees are ineligible.

C.1.5. Dependent Coverage Eligible employees may elect to enroll their eligible dependents. Expenses incurred by an enrolled employee's eligible dependents are covered under this plan. For the purposes of this plan, an employee's dependents are defined as the covered employee's legal spouse (limit one) and each unmarried, economically dependent child who primarily resides 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 the child turns age 18, or in the case of a child who is a full-time student, until the end of the contract year in which the child turns age 25. There is no age limit for an eligible child who is physically or mentally handicapped so as to be unable to live independently. There

Locally Engaged Staff Health Insurance Page 14 of 67 is no limit on the number of children covered per employee. Parents, grandparents, siblings, and other relatives are not eligible dependents

C.1.6. Eligibility

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.

C.1.6.2 Premium Costs

C.1.6.2.1 For active employees who are regularly scheduled to work 30 or more hours per week, the USG will pay 100% of the premium cost for both employee and eligible dependent coverage.

C.1.6.2.2 For active 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 coverage based on the number of hours the employee is regularly scheduled to work, and the employee will pay the remaining premium cost.

C.1.6.2.3 For active employees who are regularly scheduled to work less than 30 hours per week, there is no USG contribution for dependent coverage.

C.1.6.2.4 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.1.6.3 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.

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V CONTRACT ADMINISTATIVE REQUIREMENTS AND PROCEDURES

V.1 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 USG, is responsible for management and quality control to meet the terms of the contract. The role of the USG is to conduct quality assurance to ensure that contract standards are achieved.

Performance Objective Performance Threshold

Timely payment of benefits (within 21 calendar days)

No more than one (1) customer complaint is received per month.

No incorrectly denied claims

No more than one (1) customer complaint is received per month.

V.1.1 Surveillance – The COR will receive and document all complaints from USG personnel regarding the services provided. If found valid, the COR will send the complaints to the contractor for corrective action.

V.1.2 Standard – The performance standard is that the USG 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.

V.1.3 Complaint Procedures

a. If USG personnel observe unacceptable services such as but not limited to lack of coordination during medical evacuation, extended referral periods, delays in receipt of payment, etc., they will 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.

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e. The COR shall, as a minimum, provide e-mail notification informing the contractor of any valid complaints.

f. If the contractor disagrees with the complaint and challenges the validity of the complaint, the contractor shall notify the COR by e-mail. 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 complainant.

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.

V.1.4 Employee Claims Report

The contractor shall provide a monthly Employee Claims Report. The report shall be received by the COR no later than the 10th calendar day of each month. The report shall 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.

V.2 REPORTS AND OTHER DELIVERABLES

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

US Embassy Baku ATTN: Human Resources Officer

111 Azadlig Ave

AZ 1007

Baku, Azerbaijan

NOTE: Any and all costs for the preparation, handling, mailing and submission of progress reports or any other required reports and documentation shall be included in the total price of each delivery order.

Description QTY Submission Date Deliver to and how:

Reference para IV B.4.1 Brochures

Additional copies

For review 30 days after contract award

After review by the

COR

Within 10 calendar days of the COR’s request hard copy para IV.B.4.1 Employee claims report 1 ea No later than the

10th calendar day of each month

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Basic supply

Additional copies

30 days after contract award

Within 10 calendar days of the COR’s request

COR

mail, hard copy para IV.B.4.1 Employee claim reimbursement via EFT each Within 21 calendar days of the submission of the claim

COR

mail, hard copy para V.7 Draft version of Management

Plan 1 ea As part of the offer CO para V.7 Final version of Management

Plan 1 ea 15 calendar days after receipt of contract award

COR

V.3 Contractor Responsibility in Claims and Reimbursement to Claims

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 employees' 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 eligible employee 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 employee per year 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.

(3) The contractor shall use the English spelling of the employees' names in all transactions

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(4) The contractor shall provide claim reimbursement via EFTto the employyes for not later than 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 reimbursement via EFT. For each reimbursement the contractor shall send 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.

V.4 Miscellaneous Contractor Requirements

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 Angolan government, if 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.

V.5 Erroneous Payment

If the USG 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 USG, whichever the USG prefers. The contractor shall refund any refunds not complete or discovered after the completion date of this contract.

V.6 Physical and Information Security Requirements

The contractor shall be responsible for safeguarding all government information provided for contractor use. All material / documentation produced for the USG will be the sole property of the USG. The contractor shall not release any documents to anyone unless authorized by the USG. The following considerations shall be followed by the contractor and/or shall be incorporated into the design documents / shop drawings.

V.6.1 All documents received or generated under the contract are the property of the USG.

V.6.2 All documents shall be controlled and disseminated on a need-to-know basis. Reproduction and distribution is prohibited without express approval of the USG. All design documents generated shall be annotated as follows:

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V.6.3 All documents shall be marked and handled in strict accordance with all applicable requirements and regulations. Proposed and actual contract documents shall only be disseminated on a strict need-to-know basis, and shall not be further disseminated without prior authorization from the USG.

V.6.4 Those receiving any type of proposed and / or actual contract documents shall be responsible for these materials while in their possession, or that of any of their subcontractors. They shall return all documents, including all copies, promptly upon demand by the USG.

V.7 Contractor Management Plan

Offerors shall submit a draft version of their management plan as part of their proposal. The contractor shall submit the final version no later than 15 calendar days after receipt of a contract award.

V.7.1 The contractor’s management plan shall:

describe the organization of the work force, specify the names and responsibilities of the principal manager and the supervisors under this project, indicate the manner in which the contractor assures quality documents and service, state the frequency of inspections and the use of operational records include organizational and functional charts reflecting the line of management responsibility

V.7.2 Inspection System – The contractor’s management plan shall establish an inspection system covering all services stated in Section 1, The Schedule. The inspection system shall:

a. specify areas to be inspected on a scheduled basis;

b. include a method of identifying deficiencies in the quality of supplies (reports) and / or services before the level of performance becomes unacceptable;

c. include a filing system for all inspections conducted by the contractor and the corrective action taken.

This documentation shall be made available to the USG during the term of the contract.

The contractor shall obtain the COR’s approval prior to making any changes in its management plan. If directed by the COR, the contractor shall submit said changes in writing as a proposal for Government review and approval / disapproval.

V.8 Laws And Regulations

V.8.1 Compliance Required – If the contractor has or will establish a local office, he shall, without additional expense to the USG, be responsible for complying with all laws, codes, ordinances, and regulations applicable to the performance of the work, including those of the host country, and with the lawful orders of any governmental authority having jurisdiction.

V.8.2 Labor, Health and Safety Laws and Customs – If the contractor has or will establish a local office, he shall comply with all local labor laws, regulations, customs and practices pertaining to labor, safety, and similar matters, to the extent that such compliance is not inconsistent with the requirements of this contract.

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V.8.3 A contract with the USG 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 USG employees. Registration of this contract with the host country government, if 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 USG of the amounts thereof.

V.8.4 The only items that the USG will consider for price adjustments are those that are mandated e.g. changes in the VAT rate (if applicable) or minimum hourly wage rate.

V.9 Contract Administration Data

V.9.1 Authority of the Contracting Officer – All work shall be performed under the general direction of the Contracting Officer, who alone shall have the power to bind the Government and to exercise the rights, responsibilities, authorities and functions vested by the contract, except that the Contracting Officer and the Procurement Executive shall have the right to designate authorized representatives to act for the Contracting Officer, as specifically provided in the designation of that individual, such as the COR.

V.9.2 Government Personnel

Contracting Officer: Fabiola Bellevue

Contract Administrator: Wencke Jacobsen E-mail address: JacobsenW@state.gov

Contracting Officer's Representative (COR): TBA HRO, Baku, Azerbaijan

V.9.3 Invoices, Review and Payment

Invoices shall be issued monthly. Value Added Tax (VAT), if applicable, shall be a separate line item on each invoice.

The contractor shall e-mail the invoice as pdf document to the COR. The post procurement point of contact will review the invoice and, if it’s correct, forward it to the post FMC for payment. If there are mistakes, the post procurement point of contact shall inform the contractor and the COR which corrections are required.

The post procurement point of contact and COR will confirm to the post finance office that the invoice is correct.

Each invoice shall include the items listed in Section 2, FAR 52.212-4 g.1.

Payment shall be made in the currency the contractor specified in Section1.III.C Prices.

V.9.4 Advance Payment shall not be authorized under this contract.

V.9.5 Changes In Ownership – The contractor shall furnish the COR advance notification (90 calendar days prior to the effective date) of any disposition or the change in ownership or

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V.10 Funding / Task Orders / Procedures

V.10.1 The contract remains unfunded; funding will be provided by issuing an annual task orders with possible modification for staffing changes. Each task order will contain the following information:

Name of contractor Contract number Date of purchase Task order number Name of person placing the order Quantity, unit price, and total price of each service / insurance rate VAT or other taxes as a separate item, if applicable COR and post points of contact, including e-mail addresses applicable contract clauses, either in reference or in full text if necessary

V.10.2 Only an RPSO Contracting Officer may place a written order.

V.10.3 Ordering Procedures – The Government shall issue annual funded task orders to cover all eligible employees and their dependents with regular and ORE employees listed in separate line items. No task order shall include any names or PII (personally identifiable information).

The COR informs the contracting officer if any additions or deletions are required throughout the year and the Contracting Officer will issue funded modifications as required.

V.10.4 The ORE staff and BEA 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).

V.11 Choice of Law

This contract shall be construed and interpreted in accordance with the substantive laws of the United States of America. By the execution of this contract, the contractor expressly agrees to waive any rights to invoke the jurisdiction of local national courts where this contract is performed and agrees to accept the exclusive jurisdiction of the United States Civilian Board of Contract Appeals and the United States Court of Federal Claims for hearing and determination of any and all disputes that may arise under the Disputes clause of this

V.12 Start / Period of Performance

Contract performance is estimated to start October / November, 2018. The period of performance is one year, with four possible annual option years. Option years, if exercised, shall be for twelve (12) months each, commencing at the expiration of the previous period of performance.

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The Government may extend this contract in accordance with the option clause in Section 2, FAR 52.217-9, Option to Extend the Term of the Contract - Deviation, which also specifies the total duration of this contract.

The Government may exercise the option set forth at Section 2, "FAR 52.217-8, Option to Extend Services", within the currently ongoing period of performance.

Notwithstanding the expressed contract expiration date, this contract shall remain in full force and effect until the last items or services ordered hereunder have been delivered and accepted by the Government.

V.13 List Of Attachments

Exhibit A

Employee Statistic

Exhibit B

ORE Employees Rider & Employee Association Riders

Attachment 1

Pricing Spreadsheet

Attachment 2

Contract Information Sheet / Experience Listing

Attachment 3 Key Personnel

END OF SECTION 1

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SECTION 2 – CONTRACT CLAUSES

52.212-4 – CONTRACT TERMS AND CONDITIONS – COMMERCIAL ITEMS (JAN 2017)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights --

(1) Within a reasonable time after the defect was discovered or should have been discovered;

and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C.3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71,Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

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(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include --

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

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

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer— System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the r equirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

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(i) Payment.

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt Payment. The Government will make payment in accordance with the Prompt Payment Act (31 U.S.C. 3903) and prompt payment regulations at 5 CFR Part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212- 5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or EFT the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B) Affected contract number and delivery order number, if applicable;

(C) Affected line…