20R0004 FOH Solicitation.pdf

SEE ADDENDUM

(No Collect Calls)

W91ZRU20R0004 09-Apr-2020

b. TELEPHONE NUMBER

907-428-6188

8. OFFER DUE DATE/LOCAL TIME

12:00 AM 23 Apr 2020

5. SOLICITATION NUMBER 6. SOLICITATION ISSUE DATE

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

STANDARD FORM 1449 (REV. 2/2012)

Prescribed by GSA – FAR (48 CFR) 53.212

(TYPE OR PRINT)

(SIGNATURE OF CONTRACTING OFFICER)

ADDENDA ARE

26. TOTAL AWARD AMOUNT (For Gov t. Use Only )

23.

CODE 10. THIS ACQUISITION IS

SUCH ADDRESS IN OFFER

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT

BELOW IS CHECKED

TELEPHONE NO.

W91ZRU9. ISSUED BY

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

7. FOR SOLICITATION

INFORMATION CALL:

a. NAME

VIRGINIA M. TREZISE-HARMAN

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NUMBER

(TYPE OR PRINT)

30b. NAME AND TITLE OF SIGNER 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a.UNITED STATES OF AMERICA

27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1. 52.212-4. FAR 52.212-3. 52.212-5 ARE ATTACHED.

25. ACCOUNTING AND APPROPRIATION DATA

1. REQUISITION NUMBER

20.

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED.

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

0011469747

ARE NOT ATTACHED

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

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

SET FORTH HEREIN, IS ACCEPTED AS TO ITEMS:

. YOUR OFFER ON SOLICITATION

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN

% FOR:SET ASIDE:UNRESTRICTED OR X

SMALL BUSINESSX

17a.CONTRACTOR/ CODE FACILITY

OFFEROR CODE

USPFO AK PURCHASING AND CONTRACTING

KO FOR AKNG

PO BOX B, CAMP DENALI

FT RICHARDSON AK 99505-2610

18a. PAYMENT WILL BE MADE BY CODE

RATED ORDER UNDER

DPAS (15 CFR 700)

13a. THIS CONTRACT IS A

13b. RATING

CODE15. DELIVER TO CODE W90FHD 16. ADMINISTERED BY

12. DISCOUNT TERMS11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

X SEE SCHEDULE

14. METHOD OF SOLICITATION

RFQ IFB RFPX

W90FHD SAFETY AND OCCUPATIONAL HEALTH

SARAH ROBINSON

P O BOX 5800

FORT RICHARDSON AK 99505-5800

TEL: 907-428-6488 FAX:

907-428-6191FAX:

TEL: 907-428-6100

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

8(A)

HUBZONE SMALL

BUSINESS

SIZE STANDARD:

$12,000,000

NAICS:

621111

X

OFFER DATED

29. AWARD OF CONTRACT: REF.

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

EMAIL:

TEL:

31c. DATE SIGNED

SEE SCHEDULE

SCHEDULE OF SUPPLIES/ SERVICESITEM NO. QUANTITY UNIT UNIT PRICE AMOUNT

24.22.21.19.

WOMEN-OWNED SMALL BUSINESS (WOSB)

ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

32g. E-MAIL OF AUTHORIZED GOVERNMENT REPRESENTATIVE

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

(CONTINUED)

PAGE 2 OF40

ACCEPTED, AND CONFORMS TO THE CONTRACT, EXCEPT AS NOTED: ______________________________________________________

32a. QUANTITY IN COLUMN 21 HAS BEEN

RECEIVED INSPECTED

32b. SIGNATURE OF AUTHORIZED GOVERNMENT

REPRESENTATIVE

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

REPRESENTATIVE

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

37. CHECK NUMBER

FINALPARTIALCOMPLETE

36. PAYMENT35. AMOUNT VERIFIED

CORRECT FOR

34. VOUCHER NUMBER

FINAL

33. SHIP NUMBER

PARTIAL

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

41a. I CERTIFY THIS ACCOUNT IS CORRECT AND PROPER FOR PAYMENT

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

42a. RECEIVED BY (Print)

42b. RECEIVED AT (Location)

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

STANDARD FORM 1449 (REV. 2/2012) BACK

Prescribed by GSA – FAR (48 CFR) 53.212

AUTHORIZED FOR LOCAL REPRODUCTION

PREVIOUS EDITION IS NOT USABLE

SEE SCHEDULE

20.

SCHEDULE OF SUPPLIES/ SERVICES

21.

QUANTITY UNIT

22. 23.

UNIT PRICE

24.

AMOUNT

19.

ITEM NO.

W91ZRU20R0004

Section SF 1449 - CONTINUATION SHEET

PWS 06 APRIL 2020

PERFORMANCE WORK STATEMENT (PWS)

FOR

Occupational Health Medical Surveillance Examination Services Revision date 06 April 2020

1.0 General:

1.1 Scope: The contractor shall provide all personnel, equipment, tools, materials, supervision, and quality control necessary, except as specified in Paragraph 3.0 as Government Furnished, to perform Occupational Health Medical Surveillance Examination Services, as defined in this PWS.

1.2 Background: The purpose of the Occupational Medical Surveillance Examination Program is to provide job-related medical surveillance examinations and Occupational Health services to the Alaska Army National Guard (AKARNG) federal technicians who are, or could potentially be, exposed to health hazards in the work environment. The examinations shall include personnel assigned to positions requiring specific standards of physical fitness. Personnel not included under these examinations are AKARNG state employees, civilian contractors, and full-t ime or part-time traditional Soldiers.

1.3 Period of Performance (PoP): The Period of Performance shall be 1 Base Year of 12 months and two 12-month option years.

1.4 General Information:

1.4.1 Quality Control (QC): The contractor shall develop and maintain an effective QC Plan (QCP) to ensure services are performed in accordance with this PWS. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor’s QCP is the means by which it assures itself that its work complies with the requirements of the contract. As a minimum, the contractor shall develop QC procedures that address the areas identified in Technical Exhibit 1, Performance Requirements Summary (PRS). A final QCP shall be submitted to the Contracting Officer Representative (COR) NLT 10 days after contract award.

After acceptance of the QCP, the contractor shall obtain the Contracting Officer’s (KO’s) acceptance in writing of any proposed changes to its QCP.

1.4.2 Quality Assurance (QA): The Government will evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). This plan is primarily focused on what the Government will do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and acceptable quality level(s) or defect rate(s).

1.4.3 Recognized Holidays: The following are recognized United States (US) holidays.

The contractor shall not perform services on these days:

1.4.3.1 New Year’s Day: January 1st

1.4.3.2 Martin Luther King, Jr.’s Birthday

1.4.3.3 President’s Day

1.4.3.4 Memorial Day

1.4.3.5 Independence Day: July 4th

1.4.3.6 Labor Day

1.4.3.7 Columbus Day

1.4.3.8 Veteran’s Day: November 11th

1.4.3.9 Thanksgiving Day

1.4.3.10 Christmas Day: December 25th

1.4.4 Place and Performance of Services: The contractor shall provide services during normal business hours of operation at the contractor’s place of business Monday to Friday, except on recognized US holidays. The contractor shall at all times maintain an adequate work force for the uninterrupted performance of all tasks defined within this PWS. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the work force are essential.

1.4.4.1 Telework: The Government may permit telework by contractor employees when determined to be in the best interest of the Government in meeting work requirements.

In furtherance of Continuity of Operations Planning (COOP), a telework program may be enacted to ensure that the Government's mission-critical operations stay operational during times of national emergency or incidents of national significance. Telework shall be at no additional cost to the Government.

1.4.5 Security Requirements. The contractor shall comply with all applicable installation/facility access and local security policies and procedures, which may be obtained from the COR. The contractor and all associated subcontractor employees shall provide all information required for background checks to meet installation access requirements to be accomplished by installation Provost Marshal Office, Director of Emergency Services or Security Office. The contractor shall ensure compliance with all personal identity verification requirements as directed by Department of Defense (DoD), Headquarters Department of Army (HQDA) and/or local policy. Should the Force Protection Condition (FPCON) change, the Government may require changes in contractor security matters or processes.

1.4.5.1 For contractors requiring Common Access Card (CAC): The CAC is the DoD Federal Personal Identity Verification (PIV) credential. CAC issuance requirements are as follows:

In accordance with Department of Defense Manual (DoDM) 1000.13-M-V1, DoD Identification (ID) Cards, January 23, 2014, initial issuance of a CAC requires, at a minimum, the completion of an Federal Bureau of Investigation (FBI) fingerprint check with favorable results and submission of a National Agency Check with Inquiries (NACI) (or investigation approved in Federal Investigative Standards) to the Under Secretary of Defense for Intelligence (USD(I)) approved investigative service provider. The issuance of a CAC will be based on four criteria: (a) eligibility for a CAC; (b) verification of DoD affiliation from an authoritative data source; (c) completion of background vetting requirements according to the Federal Information Processing Standards Publication 201-2, Personal Identity Verification (PIV) of Federal Employees and Contractors, August 2013, and DoD Manual 5200.02, Procedures for the DoD Personnel Security Program (PSP), April 3, 2017, and (d) verification of a claimed identity. Sponsorship and enrollment information about each applicant must be registered in the Defense Enrollment Eligibility Reporting System (DEERS) through either the Real-Time Automated Personnel ID System (RAPIDS) using the DD Form 1172-2, or the Trusted Associate Sponsorship System (TASS).

1.4.5.1.1 HSPD-12 Background Investigation Requirements: The contractor shall ensure that all contractor and subcontractor personnel whose duties require CAC card issuance obtain them, and shall process all CAC card applications. The contractor shall ensure that all employees requiring an initial background investigation complete a Personnel Security Investigation Portal (PSIP) form at a date TBD, and that this form is forwarded to the COR immediately. The COR will review the form for completeness and accuracy and forward it to the National Guard Bureau (NGB) Personnel Security manager who will initiate the investigation process via the PSIP. Contractor personnel will then receive two e-mail messages; the first will confirm that the investigative service provider has received the request, and the second will provide instructions for the completion of the appropriate form via the Electronic Questionnaires for Investigations Processing (e-QIP) system. Upon completion of the e-QIP questionnaire and submittal of all required documents, including fingerprint card to the security manager, the background investigation (BI) will be initiated. The contractor shall ensure immediate compliance with all instructions regarding background investigation processing, including those provided verbally, by e-mail or via a Government system. The contractor is cautioned that the entire process from submittal of the PSIP form to return of the FBI fingerprint check may routinely take from two to six weeks and shall factor this lead time into its hiring/placement process. The contractor shall make all reasonable efforts to ensure that contractor employees meet CAC eligibility standards upon assignment to the contract and shall be held responsible for delays, failure to meet performance requirements or decreases in efficiency in accordance with the applicable inspection clause.

1.4.5.1.2 Trusted Associate Sponsorship System (TASS): The contractor shall process CAC applications through the TASS, the procedures for which are described below.

Although there is no requirement for the contractor to designate a “Corporate Facility Security Officer" (FSO) to serve as its single point of contact for the BI, the TASS application process and other CAC and security-related matters, such designation facilitates these processes. If an FSO is not established, all contractor employees requiring a CAC will be required to process their own applications. The submission process for CAC applications is as follows:

1. The contractor's FSO or contractor employee shall submit requests for a CAC via email to the designated TASS Trusted Agent (TA). The TASS TA for this requirement will be: TBD.

2. The Government will establish a TASS application account for each CAC Request and will provide each contractor employee a USER ID and password, via email, to the FSO. The FSO or contractor employee shall access the TASS account and complete the CAC application (entering/editing contractor information as applicable) at:

https://www.dmdc.osd.mil/tass/. The FSO or contractor employee shall follow up to ensure that the TA is processing the request.

3. The Government will inform the contractor's applicant, via email, of one of the following:

a. Approval.* Upon approval, the information is transferred to the DEERS database and an email notification is sent to the contractor with instructions on obtaining their CAC. The contractor proceeds to a RAPIDS station (RAPIDS Site Locator:

http://www.dmdc.osd.mil/rsl/).

b. Rejection.* The Government, in separate correspondence, will provide reason(s) for rejection.

c. Return. Additional information or correction to the application required by the contractor employee.

*The contractor shall maintain records of all approved and rejected applications.

1.4.5.1.3 At the RAPIDS station, the RAPIDS Verification Officer will verify the contractor employee by SSN and two forms of identification. Identity source documents must come from the list of acceptable documents included in Form I-9, OMB No. 1615- 0047, "Employment Eligibility Verification." Consistent with applicable law, at least one document from the Form I-9 list shall be a valid (unexpired) State or Federal Government-issued picture ID. The Identity documents will be inspected for authenticity and scanned and stored in the DEERS upon issuance of an ID. The photo ID requirement cannot be waived, consistent with applicable statutory requirements. The Verification Officer will capture primary and alternate fingerprints, picture, and updates to DEERS, and will then issue a CAC. Issued CACs will be valid for no longer than three years, or until the individual's contract end date (inclusive of any options), whichever is earlier.

https://www.dmdc.osd.mil/tass/

1.4.5.1.4 The contractor shall return issued CACs to the DEERS office upon departure or dismissal of each contractor employee, and shall obtain a receipt for each card and provide it to the TA/COR.

1.4.5.1.5 The contractor shall manage requests for new or renewal CAC cards in sufficient time to ensure that all contractor employees have them when needed to perform work under this contract. The contractor shall provide at least 10 calendar days advance notice to the TA, unless there are extenuating circumstances approved by the COR or KO.

1.4.5.1.6 The contractor shall obtain an Army Knowledge Online (AKO) email address for each applicant, including subcontractors, who may be deployed or require logical access to a government computer network. This can be done by going to:

http://www.us.army.mil and registering as an "Army Guest," with the sponsor being the COR or a COR- designated individual if the COR is ineligible to Serve as an AKO Sponsor. Note: If employees of a contractor lose the privilege to access AKO, they lose the ability to renew their CAC. Therefore, it is critical that contractor employees maintain their AKO accounts.

1.4.5.2 For contractors that do not require a CAC, but require access to a DoD facility or installation: Contractor and all associated sub-contractors employees shall comply with adjudication standards and procedures using the National Crime Information Center Interstate Identification (NCIC-III) and Terrorist Screening Database (TSDB) (Army Directive 2014-05/AR 190-13), and applicable installation, facility and area commander installation/facility access, and local security policies and procedures (provided by a government representative). Reserved.

1.4.5.3 Communications Security/Information Technology (COMSEC/IT) Security. All communications with DoD organizations are subject to COMSEC review. All telephone communications networks are continually subject to intercept by unfriendly intelligence organizations. DoD has authorized the military departments to conduct COMSEC monitoring and recording of telephone calls originating from, or terminating at, DoD organizations. Therefore, the contractor is advised that any time contractor personnel place or receive a call they are subject to COMSEC procedures. The contractor shall ensure wide and frequent dissemination of the above information to all employees dealing with DoD information. The contractor shall abide by all Government regulations concerning the authorized use of the Government's computer network, including the restriction against using the network to recruit Government personnel or advertise job openings.

1.4.5.4 Use of Government Information Systems (IS) and access to Government networks is a revocable privilege, not a right. Users are the foundation of the DoD strategy and their actions affect the most vulnerable portion of the Army Enterprise Infostructure (AEI). Contractor employees shall have a favorable background investigation or hold a security clearance and access approvals commensurate with the level of information processed or available on the system. Contractor employees shall:

http://www.us.army.mil/

1.4.5.4.1 Comply with the command's Acceptable Use Policy (AUP) for Government owned IS and sign an AUP prior to or upon account activation.

1.4.5.4.2 Complete initial and/or annual Information Assurance (IA) training as defined in the IA Best Business Practices (BBP) training (https://informationassurance.us.army.mil).

1.4.5.4.3 Mark and safeguard files, output products, and storage media per classification level and disseminate them only to individuals authorized to receive them with a valid need to know.

1.4.5.4.4 Protect IS and IS peripherals located in their respective areas in accordance with physical security and data protection requirements.

1.4.5.4.5 Practice safe network and Internet operating principles and take no actions that threaten the integrity of the system or network.

1.4.5.5 Protection of Personally Identifiable Information (PII). The contractor shall protect all PII encountered in the performance of services in accordance with Defense Federal Acquisition Regulation Supplement (DFARS) 224.103 Personally Identifiable Information and Department of Defense Directive (DoDD) 5400.11, Department of Defense Privacy Program, and DoD 5400.11-R. If a PII breach results from the contractor’s violation of the aforementioned policies, the contractor shall bear all notification costs, call-center support costs, and credit monitoring service costs for all individuals whose PII has been compromised.

1.4.5.6 Information Assurance (IA)/Information Technology (IT) Training: All contractor employees and associated subcontractor employees shall complete the DoD IA Awareness Training before issuance of network access and annually thereafter. All contractor employees performing services involving IA/IT functions shall comply with DoD and Army workforce training requirements in DoDD 8140.01, DoD 8570.01-M and AR 25-2 within six months of the start of contract performance. In accordance with DoD 8570.01-M, DFARS 252.239.7001 and AR 25-2, contractor employees performing Information Assurance Technical (IAT) functions shall be appropriately certified upon contract award. The baseline certification as stipulated in DoD 8570.01-M shall be completed upon contract award.

1.4.5.7 Information Awareness: All contractor employees with access to a government information system shall be registered in the Army Training Certification Tracking System (ATCTS) (https://atc.us.army.mil/iastar/index.php) at commencement of services, and shall successfully complete the DoD Information Assurance awareness training prior to access to the IS and then annually thereafter.

(https://ia.signal.army.mil/DoDIAA/).

https://informationassurance.us.army.mil/ https://atc.us.army.mil/iastar/index.php https://ia.signal.army.mil/DoDIAA/

1.4.6 Physical Security. The contractor shall safeguard all Government property provided for contractor use. At the close of each work period, Government facilities, equipment and materials shall be secured.

1.4.7 Special Qualifications: Contractor employees directly conducting AKARNG Occupational Health examinations shall be licensed providers, which could include a registered nurse, nurse practitioner, physician, or physician assistant. The contractor shall provide a Board-eligible or Certified Occupational Medicine Physician, or other Licensed Independent Practitioner (Nurse Practitioner or Physician Assistant), to conduct job-related medical surveillance physical examinations and occupational health consultation services. A Board Certified Occupational Medicine Physician (Doctor of Medicine or Doctor of Osteopathic Medicine) shall conduct medical reviews and final determinations for the medical surveillance examinations and Occupational Health services. Audiograms shall be performed by contractor employees in accordance with 29 CFR 1910.95, and who are certified from the Council for Accreditation in Occupational Hearing Conservation (CAOHC). Contractor employees performing Pulmonary Function Tests (PFTs) shall be a licensed physician, Certified Pulmonary Function Technologist, or a Registered Respiratory Therapist with spirometry certification every five (5) years, Contractor employees reviewing PFTs shall be a Board Certified Occupational Medicine Physician in accordance with 29 CFR 1910.1001. The contractor shall ensure all clinical laboratory services are performed by a laboratory licensed through the U.S. Department of Health and Human Services (DHHS), Health Care Financing Administration pursuant to the terms of the Clinical Laboratories Improvement Act of 1967 (42 U.S.C. 263a) and the College of American Pathologies.

Contractor employees performing laboratory testing shall be certified under the American Society of Clinical Pathology. All contractor employees accessing patient records, data, or obtaining health information shall complete annual Health Insurance Portability and Accountability Act (HIPAA) training, and shall comply with the requirements stipulated in the Act of 1996. NOTE: The Government does not provide training to contractors.

Contractors must ensure that any personnel performing under a contract are fully trained, licensed, certified and qualified to provide services.

1.4.8 Post Award Conference/Periodic Progress Meetings: The contractor agrees to attend any post award conference convened by the KO in accordance with FAR Subpart 42.5. The KO, COR and other Government personnel, as appropriate, may meet periodically with the contractor to review the contactor’s performance. At these meetings, the KO will apprise the contractor of how the Government views the contractor’s performance and the contractor shall apprise the Government of problems, if any, being experienced. The contractor shall resolve outstanding issues raised by the Government. Contractor attendance at these meetings shall be at no additional cost to the Government.

1.4.9 Contract Manager (CM): The contactor shall designate a CM who shall ensure performance under this contract. The name of this person, and an alternate who shall act for the contractor when the CM is absent, shall be designated in writing to the KO.

The CM or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The CM shall work through the COR to resolve issues, receive technical instructions, and ensure adequate performance of services. The CM shall ensure that contractor employees do not perform any services outside the scope of the contract without an official modification issued by the KO. The CM shall ensure contractor employees understand that services performed outside the scope of the contract are performed wholly at the expense of the contractor.

1.4.10 Identification of Contractor Employees: All contractor personnel attending meetings and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression that they are Government employees. The contractor shall ensure that all documents or reports produced by contractor personnel are suitably marked as contractor products or that contractor participation is appropriately disclosed. The contractor’s status as a “contractor” shall be predominantly displayed in all correspondence types (to include signature blocks on e-mail) and dealings with Government or non-Government entities.

1.4.11. Combating Trafficking in Persons: The United States Government has adopted a zero tolerance policy regarding trafficking in persons. Contractors and contractor employees shall not engage in severe forms of trafficking in persons during the period of performance of the contract; procure commercial sex acts during the period of performance of the contract; or use forced labor in the performance of the contract. The Contractor shall notify its employees of the United States Government’s zero tolerance policy, the actions that will be taken against employees for violations of this policy. The contractor shall take appropriate action, up to and including termination, against employees or subcontractors that violate the US Government policy as described at

FAR 22.17.

1.4.12 Contractor Travel

The contractor shall travel to Fairbanks and Juneau during the performance of this contract to conduct Occupational Health medical surveillance examinations.

The contractor will be authorized travel expenses consistent with the substantive provisions of the Joint Travel Regulation (JTR) and the limitation of funds specified in this contract. All travel requires COR recommendation for approval prior to travel arrangements being made. Note: COR may authorize travel if fully funded travel CLIN exists and funding is validated prior to travel arrangements being made.

1.4.13 Data Rights: The Government has unlimited rights to all documents/materials produced under this contract. All documents and materials, to include the source codes of any software, produced under this contract shall be Government owned and are the property of the Government with all rights and privileges of ownership/copyright belonging exclusively to the Government. These documents and materials may not be used or sold by the contractor without written permission from the KO. All materials supplied to the Government shall be the sole property of the Government and may not be used for any other purpose. This right does not abrogate any other Government rights.

1.4.14 Organizational Conflicts of Interest (OCI): The contractor and subcontractor personnel performing services under this contract may receive, have access to or participate in the development of proprietary or source selection information (e.g., cost or pricing information, budget information or analyses, specifications or work statements, etc.) or perform evaluation services which may create a current or subsequent OCIs, as defined in FAR Subpart 9.5. The contractor shall notify the KO immediately whenever it becomes aware that such access or participation may result in any actual or potential OCI and shall promptly submit a plan to the KO to avoid or mitigate any such OCI. The contractor’s mitigation plan will be determined to be acceptable solely at the discretion of the KO. In the event the KO unilaterally determines that any such OCI cannot be satisfactorily avoided or mitigated, the KO may impose other remedies as he or she deems necessary, including prohibiting the contractor from participation in subsequent contracted requirements which may be affected by the OCI.

2.0 Definitions and Acronyms:

2.1 Definitions:

2.1.1 Contractor: A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

2.1.2 Contracting Officer (KO): A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

2.1.3 Contracting Officer Representative (COR): An employee of the U.S. Government designated by the KO to monitor contractor performance. Such appointment will be in writing and will state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications.

This individual does NOT have authority to change the terms and conditions of the contract.

2.1.4 Defective Service: A service output that does not meet the standard of performance associated with the PWS.

2.1.5 Deliverable: Anything that can be physically delivered and includes non-manufactured things such as meeting minutes or reports.

2.1.6 Key Personnel: Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

2.1.7 Physical Security: Actions that prevent the loss or damage of Government property.

2.1.8 Quality Assurance: The government procedures to verify that services being performed by the Contractor are performed according to acceptable standards.

2.1.9 Quality Assurance Surveillance Plan (QASP): An organized written document specifying the surveillance methodology to be used for surveillance of contractor performance.

2.1.10 Quality Control: All necessary measures taken by the Contractor to ensure that the quality of an end product or service shall meet contract requirements.

2.1.11 Subcontractor: One that enters into a contract with a prime contractor. The Government does not have privity of contract with the subcontractor.

2.2 Acronyms:

AAOHN American Association of Occupational Health Nurses ABOEM American Board of Occupational and Environmental Medicine AEI Army Enterprise Infostructure AKARNG Alaska Army National Guard AKO Army Knowledge Online APHC Army Public Health Center AR Army Regulation AT/OPSEC Antiterrorism/Operational Security ATCTS Army Training Certification Tracking System AUP Acceptable Use Policy BI Background Investigation BP Blood Pressure BMI Body Mass Index CAC Common Access Card CAOHC Council for Accreditation in Occupational Hearing Conservation CFR Code of Federal Regulations CM Contract Manager CMRA Contractor Manpower Reporting Application COOP Continuity of Operations Planning COR Contracting Officer Representative DA Department of the Army DD254 Department of Defense Contract Security Classification Specification DEERS Defense Enrollment Eligibility Reporting System DFARS Defense Federal Acquisition Regulation Supplement DO Doctor of Osteopathic Medicine

DoD Department of Defense DODM Department of Defense Manual DOEHRS-HC Defense Occupational and Environmental Health Readiness System- Hearing Conservation EKG Electrocardiogram eQIP Electronic Questionnaires for Investigations Processing FAR Federal Acquisition Regulation FPCON Force Protection Conditions FSO Corporate Facility Security Officer GFP/M/E/S Government Furnished Property/Material/Equipment/Services HIPAA Health Insurance Portability and Accountability Act HQDA Headquarters, Department of the Army HSPD Homeland Security Presidential Directive IA Information Assurance IS Information System(s) JTR Joint Travel Regulation KO Contracting Officer MD Doctor of Medicine NACI National Agency Check with Inquiries NGB National Guard Bureau NIOSH National Institute for Occupational Safety and Health OCI Organizational Conflict of Interest OHN Occupational Health Nurse OSHA Occupational Safety and Health Administration PFT Pulmonary Function Test PII Personally Identifiable Information POC Point of Contact POP Period of Performance PRS Performance Requirements Summary PSIP Personnel Security Investigation Portal PWS Performance Work Statement QA Quality Assurance QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program RAPIDS Real-Time Automated Personnel ID System SSN Social Security Number STS Significant Threshold Shift TBD To Be Determined TASS Trusted Associate Sponsorship System TE Technical Exhibit USD(I) Under Secretary of Defense for Intelligence

3.0 Government Furnished Property, Material, Equipment and Services (GFP/M/E/S):

None.

4.0 Contractor Furnished Property, Materials, and Equipment (CFP/M/E):

4.1 General: Except for those items specifically stated to be Government-Furnished in Paragraph 3.0, the contractor shall furnish everything required to perform these services as indicated in Paragraph 1.1.

5.0 Requirements: The contractor shall:

5.1 The contractor shall provide Occupational Health Medical Surveillance Examinations:

Pre-placement, Baseline, Periodic (usually every 3 years), Annual, Retirement, Termination, Job Transfer, Return-to-Work, Functional Capacity Evaluation, Pre- and Post-deployment, and Post-exposure. Other occupational health services shall be provided upon request.

5.1.1 The contractor shall ensure all examination procedures are conducted in accordance with applicable American Board of Occupational and Environmental Medicine (ABOEM), American Association of Occupational Health Nurses (AAOHN), U.S. Department of Labor, Occupational Safety and Health Administration (OSHA), and the National Institute for Occupational Safety and Health (NIOSH) Standards.

5.1.2 The contractor shall provide a Board-eligible or Certified Occupational Medicine Physician, or other Licensed Independent Practitioner (e.g. Nurse Practitioner or Physician Assistant), to conduct job-related medical surveillance physical examinations and occupational health consultation services. A Board-certified Occupational Medicine Physician (MD or DO) shall review and sign-off on all AKARNG Occupational Health exams. In addition to examination requirements, the contracted physician, or Licensed Independent Practitioner, shall review with examinees the results of tests known at the time of an examination, and as appropriate, recommend follow-up services with private healthcare providers.

5.1.3. The contractor shall consult with the AKARNG Occupational Health Nurse (OHN) by telephone and/or email to coordinate or resolve issues that may arise before, during, and after the examination period. If the AKARNG representative is unreachable by telephone, the contractor is authorized to leave a message, as telephones listed for the AKARNG OHN representative are secure.

5.1.4. The contractor shall work directly with the AKARNG’s OHN to schedule examinations. If there is a question about examination requirements or specifications, the contractor shall first consult the AKARNG OHN for approval prior to conducting the procedure(s).

1. Female patients shall NOT be asked if they are pregnant, as the exam will be done regardless of pregnancy status.

a. Female examinees will NOT be instructed to provide the contractor with a valid copy of their last Pap/pelvic exam results.

2. No patients shall be drug tested or administered immunizations.

a. If contractor suspects drug or alcohol abuse in a patient, the contractor will notify the AKARNG OHN for further follow-up.

3. No patients shall be administered medical treatment.

a. Only requested Occupational Health screening and surveillance measures shall be provided by the contractor.

4. At the time of an examination, the contractor shall ask if a patient has any concerns about reproductive hazards in his or her workplace. Such workplace hazards may include blood-borne pathogens (i.e. Hepatitis and HIV); airborne infectious diseases (i.e.

rubeola, rubella and varicella-zoster); vibration; and other substances such as lead (inorganic), ethylene oxide, ionizing radiation, and mercury.

a. If a patient replies, “yes”, the contractor shall provide general information and counseling.

b. If the contractor is unable to answer specific workplace exposure concerns, the contractor shall instruct the patient to follow-up with his or her Primary Care Physician and the AKARNG OHN.

5. The contractor shall measure vital signs to include height, weight, temperature, Body Mass Index (BMI), abdominal girth, blood pressure (BP), pulse and respirations, for each AKARNG employee examined.

a. When determining “normal” BP readings, the contractor shall follow the American Heart Association’s guidance, which recognizes the following readings and interpretations: < 120/80 (normal), 120-129/less than 80 (elevated), 130-139/80-89 (HTN Stage 1), and > 140/90 (HTN Stage 2).

b. If BP is > 140/90, repeat two times and then record.

c. Hypertensive BP readings on just one visit will not be used as a basis for medical disqualification.

d. When measuring blood pressure, the National Institutes of Health (NIH) guidelines will be followed, which indicates that employees are to have their BP measured while seated, with back supported, and the upper arm supported at heart level.

e. Before measuring an employee’s BP, the contractor shall ensure that the patient has been resting for 5 minutes.

f. The contractor shall use a BP cuff that is of a sufficient size.

g. Determinations of “not medically qualified” for cardiovascular reasons shall be made in the following situations:

(1.) New onset chest pain which has not been adequately evaluated;

(2.) Unstable angina;

(3.) Evidence of congestive heart failure;

(4.) Ectopy (either atrial or ventricular) which has produced syncope or near-syncope;

(5.) Ventricular ectopy (symptomatic or not) which has not been evaluated by a cardiologist;

(6.) Recurrent atrial fibrillation or supraventricular tachycardia;

(7.) Stage 3 hypertension

6. The contractor shall perform a musculoskeletal assessment or Kraus-Weber Back Strength and Flexibility Rating that includes back strength and flexibility on all AKARNG employees.

a. Any pain, or recommended lifting limitations if less than 50 lbs., shall be noted.

7. Audiograms shall only be performed when requested by the AKARNG OHN. If an annual audiogram for an AKARNG employee was performed on his or her MILITARY side within the same Fiscal Year (FY), the AKARNG OHN will notify the contractor that an annual audiogram is not needed for the employee’s Occupational Health medical surveillance examination.

a. The contractor shall enter all AKARNG employee audiograms into Defense Occupational and Environmental Health Readiness System- Hearing Conservation (DOEHRS-HC), using a CAC card, per DA Pam 40-501 requirements, and within 30 days following testing;

b. The contractor shall test Only 500, 1000, 2000, 3000, 4000 and 6000

HRTZ;

c. The contractor shall ensure that any hearing aids are removed;

d. The contractor shall ensure patients are noise-free for at least 14 hours prior to testing;

e. The contractor shall ensure all audiograms, aside from the Pre-placement and Baseline, are compared against the employee’s Baseline audiogram in order to determine if there is a Significant Threshold Shift (STS). If there is an STS, the employee shall be retested immediately. If there is still an STS, the contractor shall notify the AKARNG OHN within five (5 ) business days following testing so that timely retesting can be scheduled.

f. The contractor shall test and calibrate audiometric equipment per OSHA / CAOHC / ANSI standards, and perform daily “functional operation” testing before each day’s use (listening test and an electronic biological check). Additionally, the contractor shall perform annual acoustic and exhaustive testing and calibration by a certified, specially-trained individual or appropriate laboratory.

g. The contractor shall perform audiograms in audiometry booths that have background noise no greater than the following, and shall be tested annually (usually during the exhaustive testing and calibration):

500 HRTZ 27 dB SPL 1000 HRTZ 29 dB SPL 2000 HRTZ 34 dB SPL 4000 HRTZ 42 dB SPL 6000 HRTZ 45 dB SPL

h. The contractor shall utilize the DD Form 2215 (Baseline) or DD Form 2216 to record audiogram results, and enter results into DOEHRS-HC.

8. The contractor shall perform Pulmonary Function Tests (PFTs) in accordance with TB MED 509. The contractor shall perform PFTs on AKARNG employees requiring respirator medical clearance, all Pre-placement Occupational Health exams, as well as employees determined to be in an OSHA-mandated asbestos, cadmium, coke oven emissions, formaldehyde, and/or cotton dust Medical Surveillance Program, and/or exposed to chemical substances identified in TB MED 509 (Appendix C) at levels above the action level.

a. The AKARNG’s OHN will request respirator medical clearance examinations, and related PFTs, based on job categories requiring respirator use, risk factors, and/or workplace exposures.

b. The contractor shall only perform PFTs on employees exposed to respiratory hazards (per TB MED 509) at or above OSHA and DoD actionable levels, will require the use of a respirator to mitigate workplace respirable exposures, report or exhibit lung disease risk factors, or report occupational or non-occupational exposure to respiratory hazards (per TB MED 509);

c. In the event that an AKARNG employee is not identified by the AKARNG OHN to undergo a PFT, but at the time of an examination, reports to the contractor as having previously been exposed to pulmonary hazards (based on the above criteria and TB MED 509), the contractor shall conduct a PFT, and communicate this to the AKARNG OHN within 48 hours after the completion of the exam;

d. PFTs shall include, at a minimum, Forced Expiratory Volume in one second (FEV1), Forced Vital Capacity (FVC), comparison with recognized normal readings for the individual's height and weight, sex, race, age, and a documented interpretation by a pulmonologist, and/or certified Occupational Health physician;

e. The contractor shall follow NIOSH, ATS-ERS and TB MED 509 standard requirements when performing PFTs:

(1) Continue testing when an employee is improving until improvement is <30ml;

(2) Test results are acceptable with a minimum of three acceptable maneuvers that are free from a leak, obstructed mouthpiece, hesitation, variable effort, false starts, baseline artifact, cough, glottis closure, early termination, and have a good curve of at least 6 seconds duration;

(3) Test results are reproducible (two largest FVCs are within 0.150 L of each other and two largest FEV1's are within 0.150 L of each other) when the test is repeated several times on the same employee;

(4) Testing shall be continued until criteria are met, eight (8) trials have been attempted, and/or the employee being tested cannot or should not continue;

(5) If three (3) acceptable and two (2) repeatable tests cannot be obtained, the contractor shall document the reason the standard could not be met;

(6) The contractor shall use employees’ measured, not reported, height (to the nearest half inch, without footwear);

(7) The contractor shall a lways indicate source of reference value on reports for adjusted predicted value;

(8) No smoking within 1 hour prior to testing;

(9) No reported cold, flu, or allergy symptoms within two weeks of testing;

(10) No inhaler use prior to testing that would still be in the employee’s system;

(11) The contractor shall not perform PFTs on any AKARNG employees who report a myocardial infarction within the past month, or if any of the following are present at the time of the examination:

(i) chest or abdominal pain;

(ii) oral or facial pain that is aggravated by the mouthpiece;

(iii) stress incontinence;

(iv) dementia/confusion

f. The contractor shall ensure PFT equipment, calibration, test administration and test interpretation meet applicable OSHA and ANSI standards. Supporting documentation shall be provided to the AKARNG OHN upon request.

g. Respirator medical clearance letters will be documented, and copies mailed to both the employee and the AKARNG OHN, within 30 days of an examination;

h. The contractor shall provide documentation of PFT results using the following forms, or equivalent internal forms:

(1) DA Form 7761 (for recording spirometry evaluation results);

(2) DA Form 7760 (to document an individual’s eligibility or non-eligibility for respirator use);

(3) DA Form 5551-R (to record serial spirometric results);

(4) DA Form 5550-R (for recording of calibration and equipment checks)

9. The contractor shall ensure dermatological examinations are performed by a licensed physician, and include an examination of the entire integumentary system, with emphasis on areas most likely to be affected by the employee’s occupational exposures (i.e.

radiation). Documentation shall include a body map of the presence of any dermatomes or lesions of the skin. If a dermatological referral is recommended, it shall only be to a certified dermatologist or Occupational Health Physician. Prior coordination with the AKARNG OHN is required before a referral can be made;

10. The contractor shall ensure vision screenings are in accordance with the Army Public Health Center’s (APHC) Technical Guide 006, DA PAM 40-506, and use multiphasic vision screening equipment (Titmus type) to measure the following primary visual skills:

a. Visual acuity for distance and near;

b. Lateral phorias for distance and near;

c. Vertical phorias for distance and near;

d. Depth perception;

e. Color perception;

f . Peripheral vision;

g. Amsler Grid, color vision, visual acuity and ocular history for laser workers (Baseline, Incidental and Termination exams)

11. The contractor shall ensure laboratory tests will be processed by certified clinical laboratories and performed by personnel certified under the American Society of Clinical Pathology. On all AKARNG employee examination reports, the contractor shall document that an employee was counseled by an examining provider about laboratory test results, and any follow-up requirements. A copy of lab results shall be provided to employees for their primary care physician. Possible requested laboratory tests shall include, but shall not be limited to:

a. Complete Blood Count (CBC), including differential and platelet counts (actual);

b. Urinalysis (UA) screening;

c. Chemistry Panel (serum), including, at a minimum: Glucose, BUN, Creatinine, electrolytes, liver function tests (to include AP and GGTP), and lipid panel (Triglycerides, LDL, HDL, and ratio);

d. Blood Lead Level;

e. Blood Zinc Proptoporphyrin (ZPP)

12. The contractor shall ensure that chest X-rays will be performed by a certified X-ray technician. The interpretation and classification will be performed by a B-reader, or a board eligible or certified radiologist meeting the requirements of 29 CFR 1910.1001 Appendix E:

a. Chest X-rays shall be a posterior-anterior and left lateral view;

b. Chest X-rays will only be ordered and approved by the contractor’s Board Certified Occupational Medicine physician, and upon request by AKARNG OHN.

13. The contractor shall not perform any electrocardiogram (EKG) tests unless requested by the AKARNG OHN;

14. Any other additional screening measures or examinations not described above shall require verification and approval by the AKARNG OHN prior to being performed;

otherwise, the AKARNG will not be charged for unauthorized expenses.

15. The contractor shall ensure examination instrumentation meets or exceeds appropriate performance standards, with accuracy being verified in accordance with current Occupational Medicine Certification standards.

5.1.5. Coordination of scheduling shall be a joint effort between the AKARNG’s OHN and the contractor. If possible, all AKARNG employees requiring Occupational Health Medical Surveillance examinations shall be scheduled for their Annual or Periodic examinations over the course of a three (3) month period, preferably at the beginning of the Federal Fiscal Year (October to December). If this is not possible, a portion of employees will be scheduled for their Annual or Periodic exams on a month-to-month basis, to be determined by the AKARNG OHN, over a 12-month period. Because each employee’s occupational exposures, both real and potential, are different, components of these exams will be determined on a case-by-case basis, and communicated by the AKARNG’s OHN to the contractor prior to appointment scheduling.

1. Either at the beginning of the Federal Fiscal Year or the beginning of each month, depending on the contractor’s ability, the AKARNG OHN, via secure means, will provide the contractor with a list of names of AKARNG employees to be examined, and the specific components to be performed in their examinations;

2. When possible, examinations will be scheduled by the AKARNG’s OHN using the Army National Guard’s online medical portal system, MEDCHART.

3. The contractor, utilizing a CAC card, shall retrieve scheduling information, and conduct post-examination data entry on each AKARNG employee, via MEDCHART.

a. In instances where scheduling via MEDCHART is not possible, the AKARNG OHN will email the contractor (via a password-protected Word document) a schedule request;

4. The contractor shall email the AKARNG OHN a schedule of examination appointments (with employee’s name, date, time and location of…