Statement_of_Work_for_Patient_Transport-_EOS.doc

Statement of Work For

Medical Transportation

1. Description of Services: The contractor shall provide all supervision, licensed personnel, equipment, and transportation necessary to provide transportation services Monday through Friday from 0630 through 2200 for U.S. Coast Guard Cadets, Active Duty personnel, and Officer Candidate School students for the purpose of receiving medical care outside of the U.S. Coast Guard Academy. Patients will be picked up at the U.S. Coast Guard Health, Safety, and Work-Life Regional Practice New London (HSWL RP New London) Clinic and transported to various locations including the local area (Groton/New London/Waterford), the Naval Ambulatory Care Center (NACC) at the Naval Submarine Base in Groton, Yale-New Haven Hospital area, Westerly, RI area, and Newport, RI Naval Dental Facility or other locations in the surrounding area.

2. Hours of Operation: The contractor shall provide transportation services Monday through Friday from 0630 through 2200.

3. Personnel: All personnel shall be licensed and able to gain access to the U.S. Coast Guard Academy.

4. Contractor Furnished Items and Services

4.1 Vehicles Required: The contractor shall furnish sufficient vehicles to pick up a minimum of three (3) separate ambulatory patients at the same time during hours of operations. The drivers shall transport patients from the Medical clinic to various medical appointments based on the estimated quantities and locations provided. The vehicles shall be clean and free of smoke. The vehicles to be utilized may include passenger vans, sedans, and sport utility vehicles.

4.2 Pick-ups: Each pick up shall be one way. Pick-ups for return rides from appointments shall not have a wait time in excess of 30 minutes. Pick-ups may be for multiple patients at one time, but shall only be members of the US Coast Guard.

4.3 Proof of Insurance: The contractor shall provide the Academy with proof of insurance for damage to property of injury to persons prior to commencement of contract. Such insurance shall be in the amount of $5,000,000 and shall be secured from an insurance company authorized by law to transact business in the State of Connecticut.

4.4 Record Keeping: The contractor will also provide monthly trip reports documenting all patients transported, destinations, and numbers of miles traveled. These trip reports are to be provided to the Clinic Administrator at HSWL RP New London and the Contracting Officer for the Coast Guard Academy monthly. For next business day’s ride schedule, the contractor shall provide a functioning e-mail and fax number so that the schedule may be received.

4.5 Billing: The Academy is to be billed a fixed rate per pick up and a fixed rate per mile, and billing is to be done monthly in arrears.

5. Specific Task: The contractor shall provide for the pick-up and transportation of medically stable patients from the U.S. Coast Guard Academy Clinic for the purpose of receiving medical care outside of the of the U.S. Coast Guard Academy. Rides shall be available within one (1) hour of contractor notification. The majority of rides will be schedule 24 hours in advance. The contractor, while in performance of duties under this contract, shall comply with and observe the laws of the State of Connecticut and all other applicable laws including all Department of Transportation Rules and Regulations dealing with this type of service.

6. Estimated Quantities: The estimated number of pick-ups required per month is 150 and the estimated mileage to be provided is 2000 miles per month. Transportation one way from origin to destination equals one pick-up. Return transportation from destination back to origin constitutes an additional pick-up. The quantities provided are estimated quantities only. The contractor will be paid only for actual services provided.

7. Period of Performance: The period of performance for this contract is a 12 month period beginning October 1, 2016 through September 30, 2017 with an option to extend for an additional three years of service. Contract will be a Firm-Fixed Price Service Contract.

8. Personnel Authorized to Place Calls to the Contractor:

HSWL RP New London Clinic Health Benefits Advisor

Clinic Administrator (860)701-6738

Clinic Supervisor (860)444-8431

Senior Medical Petty Officer of the Watch under the instruction of the Administrator

9. Point of Contact: For questions or concerns with Statement of Work, calls should be directed to the Clinic Administrator at (860)701-6738.