24-10027-000_IFB.pdf

Department of State Hospitals Atascadero

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

Environmental Medicine

INVITATION FOR BID (IFB)

Notice to Prospective Bidders

IFB Number: 24-10027-000

“Medical Evaluations within the Specialty of Occupational and Environmental Medicine”

February 6, 2025

You are invited to review and respond to this Department of State Hospitals – Atascadero (DSH) solicitation. DSH is seeking bids for a contractor to perform Medical Evaluations within the Specialty of Occupational and Environmental Medicine.

In submitting a bid, bidders agree that they have read, understood, and will comply with the instructions found herein. Failure to comply with any of the requirements may result in rejection of a bidder’s bid.

By submitting a response, bidders agree to the terms and conditions stated in this solicitation and any resulting agreement.

All agreements entered into with the State of California will include by reference the State’s General Terms and Conditions and Contractor Certification Clauses that may be viewed and downloaded at:

https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List- Folder/Standard-Contract-Language.

On March 4, 2022, Governor Gavin Newsom issued Executive Order N-6-22 (the EO) regarding Economic Sanctions against Russia and Russian entities and individuals. “Economic Sanctions” refers to sanctions imposed by the U.S. government in response to Russia’s actions in Ukraine, as well as any sanctions imposed under state law. By submitting a bid or proposal, Contractor represents that it is not a target of Economic Sanctions. Should the State determine Contractor is a target of Economic Sanctions or is conducting prohibited transactions with sanctioned individuals or entities, that shall be grounds for rejection of the Contractor’s bid any time prior to contract execution, or, if determined after contract execution, shall be grounds for termination by the State.

This bid solicitation is published online at the Cal eProcure web site at:

https://caleprocure.ca.gov/pages/index.aspx To ensure receipt of any addenda that may be issued and answers to questions posed, you must register at https://caleprocure.ca.gov/pages/BidderRegistration-BS3/bidder-registration-1.aspx

Revision 8/2/2024 https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://caleprocure.ca.gov/pages/index.aspx https://caleprocure.ca.gov/pages/BidderRegistration-BS3/bidder-registration-1.aspx

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

TABLE OF CONTENTS

I. DESCRIPTION OF SERVICES

A. Description of Services/Background:

B. Agreement Term and Security Provisions:

C. Generative Artificial Intelligence (GenAI):

II. MINIMUM QUALIFICATIONS (MQ)

A. Proof of Legal Right To Do Business:

B. References:

C. Agreement to Sign:

D. Medical Office/Clinic Address:

E. Medical License:

F. Board Certified:

III. BID REQUIREMENTS AND INFORMATION

A. Key Action Dates:

B. Bidder’s Questions:

C. Submission of Bids:

IV. BID EVALUATION AND AWARD

A. Review of Bid Requirements:

B. Responsiveness and Responsibility Determination:

C. False Statements Disclaimer:

D. Intention to Award:

E. Tie Breaker:

F. Award and Protest:

G. Disposition of Bids:

H. Tax Delinquency Disclaimer:

V. PREFERENCE AND INCENTIVE PROGRAMS

A. Small Business Preference:

B. Disabled Veteran Business Enterprise Program and Incentive:

C. Calculation of Multiple Preferences:

D. Other Preference Programs:

E. Additional Small Business and Disabled Veteran Enterprise Information:

VI. REQUIRED ATTACHMENTS

A. Listing of Attachments:

ATTACHMENT 1 – BID SUBMISSION CHECKLIST

ATTACHMENT 2 – BIDDER’S CERTIFICATION

ATTACHMENT 3 – MINIMUM QUALIFICATIONS RESPONSE

ATTACHMENT 4 – BIDDER’S REFERENCES

ATTACHMENT 5 – BIDDER’S RATE SHEET

ATTACHMENT 6 – INSURANCE CERTIFICATIONS

ATTACHMENT 7 – DARFUR CONTRACTING ACT CERTIFICATION

ATTACHMENT 8 – BIDDER DECLARATION FORM (GSPD-05-105)

ATTACHMENT 9 – GENERATIVE ARTIFICIAL INTELLIGENCE (GENAI) REPORTING &

FACTSHEET (STD 1000)

ATTACHMENT 10 – CONTRACTOR CERTIFICATION CLAUSES (ccc 04/2017)

ATTACHMENT 11 – PAYEE DATA RECORD (STD. 204)

ATTACHMENT 12 – DVBE DECLARATION FORM (STD. 843)

ATTACHMENT 13 – CALIFORNIA CIVIL RIGHTS LAW CERTIFICATION

ATTACHMENT 14 – SAMPLE AGREEMENT (STD. 213 AND EXHIBITS)

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

I. DESCRIPTION OF SERVICES

A. Description of Services/Background:

1. Contractor shall provide all necessary materials, supplies, tools, equipment, transportation, licenses, certifications, permits, insurance, personnel, and any other items necessary to provide DSH with medical evaluations within the specialty of occupational and environmental medicine for pre-employment and employment purposes, on an as-needed basis.

2. Contractor shall provide medical clearance physicals, functional capacity physicals, and physical abilities testing of applicants, civil service employees, and contracted staff, as requested in accordance with Government Code (GC) 18931 to ensure employees are able to safely and efficiently perform the essential functions of various state job classifications. Contractor shall act as the Medical Review Officer for DSH in the performance of all duties, in accordance with Attachment 14, Sample Agreement.

3. Contractor shall provide two-view chest x-rays for civil service employees and contracted staff who have been referred by DSH Human Resources (HR) in accordance with California Code of Regulations (CCR), Title 17, §2500 and §2505, as well as other applicable federal and state laws. Tuberculosis screening shall follow the most current Centers for Disease Control and Prevention and the California Tuberculosis Controllers Association Guidelines.

4. Contractor shall provide medical testimony for DSH if Contractor is subpoenaed for a

State Personnel Board Case/Medical Disqualification Appeal, or related matter on an as-needed basis.

5. Please carefully review and consider the minimum qualifications, and the detailed

Scope of Work located in Attachment 14, Sample Agreement, Exhibit A, Scope of Work, in order to complete your bid.

B. Agreement Term and Security Provisions:

1. The term of any agreement resulting from this IFB is anticipated to be June 1, 2025 through May 31, 2028. Any agreement resulting from this IFB shall have no force or effect until it is signed by both parties and approved by the Department of General Services (DGS) if such approval is required. Performance shall start no later than on the expressed date set by the awarding agency and after all approvals have been obtained and the agreement is fully executed.

2. All performance, under the agreement, shall be completed on or before the termination date of the agreement.

3. Should Contractor fail to commence work at the agreed upon time, DSH reserves the right to terminate the agreement for cause upon five (5) calendar days written notice to Contractor.

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

4. Bidder shall agree to all security provisions where the performance of work takes place on any state hospital grounds.

C. Generative Artificial Intelligence (GenAI):

1. The State of California seeks to realize the potential benefits of GenAI, through the development and deployment of GenAI tools, while balancing the risks of these new technologies.

2. Bidder/Offeror/Contractor must notify the State in writing if their solution or service includes, or makes available, any GenAI including, GenAI from third parties or subcontractors.

3. The State has developed a GenAI Reporting and Factsheet (STD 1000) to be completed by the Bidder/Offeror/Contractor.

4. Failure to submit the GenAI Reporting and Factsheet (STD 1000) will result in disqualification of the Bidder/Offeror/Contractor.

5. Failure to report GenAI to the State may void any resulting contract. The State reserves its right to seek any and all relief to which it may be entitled to as a result of such non-disclosure.

6. Upon receipt of a Bidder/Offeror/Contractor GenAI Reporting and Factsheet (STD

1000), the state reserves the right to incorporate GenAI Special Provisions into the final contract or reject bids/offers that present an unacceptable level of risk to the State.

II. MINIMUM QUALIFICATIONS (MQ)

A. Proof of Legal Right To Do Business:

Bidders must submit proof of their legal right to do business in the State of California:

1. Bidders must submit a copy of their license to do business in the State of California, including any proof of “Doing Business As (DBA)” documentation, as applicable.

2. Bidders must certify that they are and will continue to meet all terms and conditions for operating a business in the city/county in which the business is headquartered.

3. Bidders which are corporations, regardless of where they are incorporated, shall certify they are currently in good standing with the California Secretary of State (SOS).

DSH shall verify that the proposed awardee(s) is in good standing by checking the (SOS) website: https://bizfileonline.sos.ca.gov/search/business.

4. For the purposes of this bid, and, as required by the Medical Practice Act (Business and Professions Code, section 2000 et seq.), only bidders which are a) medical corporations, b) entities solely owned by physicians or individual physicians licensed https://bizfileonline.sos.ca.gov/search/business

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and to practice medicine in the State of California, and which physicians are in good standing with the Medical Board of California (and/or the Osteopathic Medical Board of California, as applicable), c) entities as defined in Business and Professions Code section 2401, d) a hospital owned and operated by a public entity (state or local), or e) otherwise in compliance with the Medical Practices Act may submit a bid.

Bidders who are individual physicians must submit a copy of each physician’s license issued by the Medical Board (or the Osteopathic Medical Board) of California with their bid. Bidders who are Medical Corporations must submit copies of physician licenses issued by the Medical Board (or the Osteopathic Medical Board) of California for each physician on staff relevant to their status as a medical corporation with their bid.

Bidders who are entities solely owned by physicians must submit copies of physician licenses issued by the Medical Board (or the Osteopathic Medical Board) of California for all owners with their bid. Bidders who are entities as defined in Business and Professions Code section 2401 must indicate which type of entity and submit proof that they meet the requirements of the appropriate subsection. Bidders which are public entity hospitals shall submit proof that they are a public entity (state or local).

Bidders which otherwise comply with the Medical Practices Act must submit a declaration describing how they comply with the Act.

5. If a bidder is using any name other than his or her own, either alone, in conjunction with a partnership or group, or as the name of a professional corporation, a Fictitious Name Permit (FNP) must be on file with the California Department of Consumer Affairs under the name of the bidder, as specified in the Medical Practice Act (Business and Professions Code, section 2000 et seq.). Bidders must provide proof that they have an approved FNP on file with the Medical Board by submitting a copy of the FNP as part of their bid package.

B. References:

Bidder must submit applicable references:

1. Bidder must provide a letter of reference from a governmental entity for whom the bidder has provided medical evaluations within the specialty of occupation and environmental medicine within the past two (2) years (from the date of this solicitation). The letter of reference must contain sufficient information (i.e., specific times and locations where the bidder provided services) in order to verify the bidder’s experience. The letter must be composed by someone who had direct experience with the provision of services outlined in the letter. The letter of reference must address each of the following:

i. The bidder’s responsiveness to requests for service

ii. The bidder’s ability to provide the contracted services

iii. The customer’s overall assessment of the bidder’s performance

To prove the submitted letter has been completed by the appropriate party, the letter must also:

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

i. Provide the name, address, title, company, and phone number of the qualifying employer/company

ii. Be submitted on the employer/company’s official letterhead

iii. Contain an original signature by the completing party

DSH reserves the right to utilize the letter of reference in determining whether a bidder is responsible.

C. Agreement to Sign:

1. The bidder shall certify that, if awarded an agreement, they shall sign and return one

(1) original of the Standard Agreement signature pages (Std. 213), to be received by DSH no later than seven (7) calendar days from the date that DSH e-mails the agreement to the email address provided by bidder on the Minimum Qualifications Response Form (Attachment 3). This requirement shall be ten (10) calendar days if DSH elects to mail the agreement. DSH reserves the right, at its sole discretion, to require documentation to be submitted in addition to the Std. 213. If DSH exercises that right, Contractor must submit all required documentation within the timeframes noted here.

2. The bidder shall further certify that they understand the insurance requirements in

Attachment 15, Sample Agreement, Exhibit G, Insurance Requirements, and if awarded an agreement, shall provide DSH with all required insurance documents as may be applicable, in a timely manner.

3. DSH reserves the right, at its sole discretion, to cancel a proposed award to a bidder who does not submit the required documentation described herein. Should DSH cancel a proposed award for this reason, DSH reserves the right, at its sole discretion, to award the contract to the next lowest, responsive and responsible bidder.

D. Medical Office/Clinic Address:

1. Bidders medical office or clinic where services shall be performed must be within a 20-mile radius of DSH – Atascadero, 10333 El Camino Real, Atascadero, CA 93422. The physical address where services will be performed must be provided at the time of bid submission.

2. If Bidder must refer patients to outside clinic for any of the services listed within this agreement, the outside clinic locations must also be within a 20-mile radius of DSH – Atascadero, 10333 El Camino Real, Atascadero, CA 93422.

E. Medical License:

1. Bidders must provide with their bid package a current copy of the medical license(s) issued by the Medical Board of California or Osteopathic Medical Board of California, Department of Consumer Affairs, for any physician(s) who will provide services under this agreement.

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

F. Board Certified:

1. Bidders must provide with their bid package a current copy of Board Certification issued by the American Board of Medical Specialties, or American Osteopathic Association Board Certification, for any physician(s) who will provide services under this agreement.

III. BID REQUIREMENTS AND INFORMATION

A. Key Action Dates:

Event Date Time IFB available to prospective bidders 02/06/2025 3:00 PM Deadline for Submission of Questions 02/13/2025 3:00 PM Final Date for Bid Submission 02/27/2025 3:00 PM Public Bid Opening 03/04/2025 11:00 AM Notice of Intent to Award Posted 03/06/2025 N/A Anticipated Start Date 06/01/2025 N/A

Note: Unless otherwise indicated, all times noted in this solicitation are Pacific Time.

B. Bidder’s Questions:

1. Bidders shall notify DSH immediately via e-mail at ASHProcurement@dsh.ca.gov and CC: Stefanie.Faria@dsh.ca.gov if they need clarification about the services being sought or have questions about the IFB instructions or requirements. The level of detail that shall be provided in response is subject to the availability of DSH resources. DSH shall respond to all questions via an addendum to the solicitation with all questions and answers posted on Cal e-Procure (www.caleprocure.ca.gov).

Note: It is the responsibility of the bidder to check Cal eProcure for questions and/or changes within the IFB as all questions, answers, and addendums will be posted there. DSH will not be held responsible for inaccurate bids due to bidder’s oversight in reviewing any and all information via Cal eProcure. This official bid solicitation is only published online at the California E-Procure, FI$Cal web site at:

https://caleprocure.ca.gov/pages/index.aspx.

2. Verbal comments regarding this IFB are unofficial and are not binding on DSH unless later confirmed in writing as an official addendum.

3. Bidders that fail to report a known or suspected problem with the IFB or fail to seek clarification and/or correction of the IFB, submit a bid at their own risk.

C. Submission of Bids:

1. Physical Submission:

mailto:Stefanie.Faria@dsh.ca.gov http://www.caleprocure.ca.gov/ https://caleprocure.ca.gov/pages/index.aspx

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

i. All bids must be submitted under a sealed cover and received by DSH by the date and time shown in Section III, A – Key Action Dates. The sealed cover must be plainly marked with the IFB number and title, and must be marked “DO NOT OPEN,” as shown in the following example:

IFB # 24-10027-000

Medical Evaluations

ATTN: Contracts Department Department of State Hospitals – Atascadero

P.O. Box 7002 Atascadero, CA 93423-7002

DO NOT OPEN

ii. All bids submitted under a sealed cover must clearly and legibly show the bidder’s name and address.

iii. Bids not submitted under a sealed cover shall be rejected. A minimum of one (1) original of the bid must be submitted, and marked accordingly

iv. The bid package should be prepared in the least complicated method. Originals and copies should be bound with binder-clips or staples (no covers, no spiral bindings, etc.). All pages in the bid must be standard 8.5" x 11" paper, except charts, diagrams, etc., which may be foldouts. If foldouts are used, the folded size must fit within the 8.5" x 11" format. Double-sided printing is preferred except for required attachments numbers 1 through 13 of this IFB, which must be printed single-sided. It is the bidder’s responsibility to ensure that his or her bid is submitted in a manner that enables DSH to easily locate all response descriptions and exhibits for each requirement of this IFB. Note: Attachment 14 should not be returned with the bid.

v. Mail Delivery, Hand Delivery, or Overnight Delivery of bids should be addressed as in Item 1.i. above.

vi. Hand Delivery of bids are by appointment only. To schedule Hand Delivery of bid please contact ASHProcurement@dsh.ca.gov.

2. Signature Requirements:

i. All documents requiring a signature must bear an original signature of a person authorized to bind the bidding firm.

ii. An individual who is authorized to bind the bidder contractually shall sign the

Bidder Certification Sheet. The signature should indicate the title or position that the individual holds in the firm. An unsigned bid may be rejected.

3. General Contents:

mailto:ASHProcurement@dsh.ca.gov

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

i. All bids shall include all of the documents identified in Section VI, Required

Attachments, Attachment 1 – Bid Submission Checklist.

ii. All bids shall include any required documents as shown in Attachment 3 – Minimum Qualification Response.

iii. Bids should provide straightforward and concise descriptions of the bidder's ability to satisfy the requirements of this IFB. The bid must be complete and accurate. Omissions, inaccuracies or misstatements will be sufficient cause for rejection of a bid.

iv. Bids must be submitted for the performance of all the services described herein.

Any deviation from the work specifications will not be considered and shall cause a bid to be rejected.

v. A bid shall be rejected if it is conditional or incomplete, or if it contains any alterations of form or other irregularities of any kind. DSH may reject any or all bids and may waive an immaterial deviation in a bid. DSH’s waiver of an immaterial defect shall in no way modify the IFB document or excuse the bidder from full compliance with all requirements if awarded the agreement.

vi. Before submitting a response to this solicitation, bidders should review, correct all errors, and confirm compliance with the IFB requirements.

vii. Where applicable, bidders must carefully examine work sites and specifications.

Bidders shall investigate conditions, character, and quality of surface or subsurface materials or obstacles that might be encountered. No additions or increases to the agreement amount will be made due to a lack of careful examination of work sites and specifications.

4. General Considerations:

i. No oral understanding or agreement shall be binding on either party.

ii. Costs for developing bids in anticipation of award of the agreement are entirely the responsibilities of the bidder and shall not be charged to the State of California.

5. Withdrawing and Resubmitting:

i. A bidder may modify a bid, after its submission, by withdrawing their original bid package and resubmitting a new bid package prior to the bid submission deadline. Bidders modifications offered in any other manner, oral or written, will not be considered. If a bidder submits a second bid package without withdrawing the first as described herein, both packages shall be considered non-responsive.

ii. A bidder may withdraw their bid by submitting a written withdrawal request to

DSH – Contracts Office, signed by the bidder or an authorized agent. A bidder

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and may thereafter submit a new bid package prior to the bid submission deadline.

Bids may not be withdrawn without cause, subsequent to the bid submission deadline. DSH Contracts Office is located at:

Department of State Hospitals – Atascadero ATTN: Contracts Department

P.O. Box 7002

6. Modification and Rejections:

i. DSH may modify the IFB, prior to the solicitation due date and time, by the issuance of an addendum to all parties who received a solicitation package.

ii. DSH reserves the right to reject all bids. DSH is not required to award an agreement.

iii. DSH does not accept alternate contract language from a prospective contractor, unless offered through the Question and Answer period. A bid with alternate contract language will be considered a counter proposal and will be rejected.

DSH’s terms and conditions are not negotiable. Bidders are hereby advised that proposals of alternate contract language or attempts to negotiate DSH’s Terms and Conditions after the selection of a proposed awardee shall be considered a counter proposal for the purposes of this solicitation. In such a situation, DSH shall notify the proposed awardee that they must accept DSH’s language and terms as offered or be disqualified from being awarded a contract. Should a contractor fail to accept the language and terms offered, DSH shall disqualify that vendor and award the contract to the next lowest bidder after issuing a revised Notice of Intent to Award, if applicable.

IV. BID EVALUATION AND AWARD

A. Review of Bid Requirements:

1. At the time of the bid opening, each bid will be opened, read aloud, and checked for preference and incentive requests.

B. Responsiveness and Responsibility Determination:

1. After the bid opening, DSH will evaluate each bid to determine its responsiveness and each bidder’s responsibility to the published requirements of this IFB.

2. A responsive bidder is one who submits a bid that meets all of the submission requirements and minimum qualification requirements stated in the IFB. A responsible bidder is one that is trustworthy and possesses the necessary quality, fitness and capacity to satisfactorily perform the proposed work. Bidders who are determined to not be responsible or who submit non-responsive bids shall have their bids rejected.

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

3. Responsive bids shall be considered evidence of the proposer’s responsibility. DSH reserves the right to reevaluate a bidder’s responsibility prior to award and is in no way limited to submitted bid packages in making a determination as to a bidder’s responsibility. In determining whether a bidder is responsible, DSH may require bidders to submit further evidence of their qualifications at such times, and under such conditions, as it may require.

C. False Statements Disclaimer:

1. Bids that contain false or misleading statements, or which provide references which do not support an attribute or condition claimed by the bidder, may be rejected.

D. Intention to Award:

1. DSH intends, if an award is made, to award to the lowest responsive and responsible bidder in accordance with Section V, Preference and Incentive Programs.

E. Tie Breaker:

1. Should two or more bidders submit bids that, after the calculation of preferences as described in Section V, Preference and Incentive Programs, result in a tie, DSH shall resolve the tie as follows:

i. In accordance with Government Code section 14838, subdivision (g), in the event of a precise tie between a small business or microbusiness, and a disabled veteran-owned small business or microbusiness, the agreement shall be awarded to the disabled veteran-owned small business or microbusiness.

ii. In accordance with the California Code of Regulations, title 2, section 1896.6, if, after the application of the small business preference, the bid of the small business is equal to the lowest priced bid from a responsible non-small business, the agreement shall be awarded to the small business.

iii. In all other circumstances a coin toss witnessed by two DSH admin staff shall determine the proposed awardee.

F. Award and Protest:

1. Whenever an agreement is awarded under a procedure which provides for competitive bidding, but the agreement is not to be awarded to the low bidder, the low bidder shall be notified by telegram, electronic facsimile transmission, overnight courier, electronic mail, or personal delivery five (5) working days prior to the award of the agreement.

2. Upon written request by any bidder, notice of the proposed award shall be posted in a public place in the office of the awarding agency at least five (5) working days prior to awarding the agreement.

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

3. If any bidder, prior to the award of agreement, files a written protest with the DGS and

DSH, including the grounds that the (protesting) bidder is the lowest responsive and responsible bidder, the agreement shall not be awarded until either the protest has been withdrawn or the DGS has decided the matter.

4. Within five (5) calendar days after filing the initial protest, the protesting bidder shall file with the DGS and DSH a detailed written statement specifying the grounds for the protest.

5. Submissions shall be made to:

Department of General Services Office of Legal Services

Attention: Bid Protest Coordinator 707 Third Street, 7th Floor, Suite 7-330

West Sacramento, CA 95605 OLSProtests@dgs.ca.gov

AND

Department of State Hospitals – Atascadero

ATTN: Contracts Department P.O. Box 7002

ASHProcurement@dsh.ca.gov

G. Disposition of Bids:

1. Upon bid opening, all documents submitted in response to this IFB will become the property of the State of California and will be regarded as public records under the California Public Records Act (Government Code section 7920.000, et seq.) and subject to review by the public. Should a bidder desire to keep any or all components of their response to this IFB confidential, the bidder would need to obtain a protective order from a court of competent jurisdiction.

H. Tax Delinquency Disclaimer:

1. Pursuant to the Public Contract Code section 10295.4, persons or companies identified as the largest tax delinquents by the Franchise Tax Board (FTB) or the California Department of Tax and Fee Administration (CDTFA) are ineligible to enter into any agreement with the state. Any agreement entered into in violation of section

10295.4 is void and unenforceable.

Prior to executing any state agreement or renewal for goods or services, DSH shall verify that the proposed awardee(s) is not on a prohibited list by checking both the FTB and CDTFA websites. The established lists can be found at:

mailto:OLSProtests@dgs.ca.gov mailto:ASHProcurement@dsh.ca.gov

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

i. FTB: https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/corporate-income-tax-list.html

ii. CDTFA: https://www.cdtfa.ca.gov/taxes-and-fees/top500.htm

V. PREFERENCE AND INCENTIVE PROGRAMS

A. Small Business Preference:

1. In accordance with Government Code section 14838, et seq. and California Code of Regulations, title 2, section 1896.6, et seq., a five (5) percent preference will be granted to bidders properly certified as a California Small Business (SB), Microbusiness (MB), or Non-Small Business (NSB) with a Small Business subcontracting for a minimum of 25% of the bid amount. A five (5) percent preference will be granted to bidders certified as a Non-Profit Veteran Service Agency in accordance with the Military and Veterans Code sections 999.50 and 999.51.

Applications must be on file at the Office of Small Business and Disabled Veteran Business Enterprise Services (OSDS) by 5:00 p.m. on bid opening day. SB, MB, or NSB certification will be verified by DSH. The preference adjustment for awards based on low price cannot exceed $50,000.00.

2. For solicitations where bidders are asked to submit rates per service, the preference shall be calculated solely on the basis of those rates.

3. Small Business Preference Example (Single Award):

Bidder A Bidder B Bidder C Bidder Status NSB NSB w/ 25% SB

Preference Applicable? X X Original Bid Amount $100,000 $105,000 $102,500

Apparent Low Bid X Pref. Amount (5% of Low Bidder) $0 $5,000 $5,000

Revised Bid $100,000 $100,000 $97,500 Revised Lowest Bidder X

4. Explanation of Example:

The lowest bidder at the time of bid opening is Bidder A, which is a NSB not claiming a SB subcontracting preference. Since both Bidder B and Bidder C claim a SB Preference, five (5) percent of Bidder A’s bid is subtracted from those of Bidder B and C. In the example above, five (5) percent of $100,000 is $5,000. After applying these preferences, Bidder C’s revised bid ($97,500) is less than the other bids, making them the revised apparent low bidder.

https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/corporate-income-tax-list.html https://www.ftb.ca.gov/about-ftb/newsroom/top-500-past-due-balances/corporate-income-tax-list.html https://www.cdtfa.ca.gov/taxes-and-fees/top500.htm

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

Note: Since the preferences are used only for computation purposes to determine the successful bidder, if an agreement was awarded to Bidder C, it would be at the original $102,500 amount.

B. Disabled Veteran Business Enterprise Program and Incentive:

1. DSH hereby waives the mandatory Disabled Veteran Business Enterprise (DVBE) participation requirement for this IFB.

2. An incentive for bidders who include DVBE participation is available and encouraged for this IFB. For evaluation purposes only, DSH shall apply an incentive to bids that include California certified DVBE participation. The incentive amount will vary in conjunction with the percentage of DVBE participation in accordance with the following formula:

DVBE Incentive Participation DVBE Incentive

5% or Over 5% 4% to 4.99% Inclusive 4% 3% to 3.99% Inclusive 3% 2% to 2.99% Inclusive 2% 1% to 1.99% Inclusive 1%

3. For solicitations where bidders are asked to submit rates per service, the preference shall be calculated solely on the basis of those rates.

4. The net bid price of responsive bids with DVBE participation will be reduced (for evaluation purposes only) by the amount of DVBE incentive as applied to the lowest responsive net bid price. If the #1 ranked, responsive and responsible bid is a California certified small business, the only bidders eligible for the incentive will be other California certified small businesses. The incentive adjustment for awards based on low price cannot exceed 5% or $50,000.00, whichever is less, of the #1 ranked net bid price. When used in combination with a Small Business preference adjustment, the cumulative adjustment amount cannot exceed $100,000.00.

5. Information submitted by the bidder to claim the DVBE incentive will be verified by

DSH. Only the DVBEs who shall perform a commercially useful function relevant to the Scope of Work included in this IFB may be used to qualify the bidder for a DVBE incentive. All DVBE bidders and their proposed subcontractors must submit a copy of the DVBE Declarations Form (Std. 843). See Attachment 12.

5. Disabled Veteran Business Enterprise Incentive Example (Single Award):

Bidder A Bidder B Bidder C

Bidder Status NSB NSB w/ 3% DVBE Incentive Applicable? X X

Original Bid Amount $100,000 $105,000 $102,500 Apparent Low Bid X

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

Incentive Qualified 3% 5%

Incent. Amount (% of Low Bidder) $0 $3,000 $5,000 Revised Bid $100,000 $102,000 $97,500

6. Explanation of Example:

The lowest bidder at the time of bid opening is Bidder A, which is a NSB not claiming a DVBE subcontracting incentive. Bidder B claims (and qualifies for) a DVBE incentive of three (3) percent. Bidder C is a DVBE, which qualifies them for a five (5) percent incentive. To apply the incentive, three (3) percent of Bidder A’s bid is subtracted from Bidder B’s bid, resulting in a revised bid of $102,000. Five (5) percent of Bidder A’s bid is subtracted from Bidder C’s bid, resulting in a revised bid of $97,500. After applying the incentives, Bidder C’s revised bid ($97,500) is less than the other bids, making them the revised apparent low bidder.

Note: Since the preferences are used only for computation purposes to determine the successful bidder, if an agreement was awarded to Bidder C, it would be at the original $102,500 amount.

C. Calculation of Multiple Preferences:

1. In the event that bidders qualify for the SB preference and/or the DVBE incentive, the

SB preference shall be calculated first. In circumstances where DSH will award a single agreement as a result of this solicitation, in accordance with Government Code section 14838, subdivision (g), the DVBE incentive will not be calculated if, after the application of the SB preference, an SB bidder is the apparent low bidder unless another SB bidder is also a DVBE or has subcontracted with DVBE firms.

Note: In accordance with Government Code section 14838, subdivision (g), in the event of a precise tie between a small business or microbusiness, and a disabled veteran-owned small business or microbusiness, the agreement shall be awarded to the disabled veteran-owned small business or microbusiness.

2. Example of the Calculation of Multiple Preferences:

Bidder A Bidder B Bidder C Bidder D

Bidder Status NSB NSB w/ 25% DVBE SB SB Pref. Applicable? X X Original Bid Amount $100,000 $105,500 $103,000 $106,000

Apparent Low Bid X SB Pref. Amt. (5% of Low Bid) $0 $5,000 $0 $5,000

Revised Bid $100,000 $100,500 $103,000 $101,000 Revised Lowest Bidder X

DVBE Incentive Applicable? X Incentive Qualified 5%

Incent. Amt. (% of Low Bid) $0 $0 $5,000 $0

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

Revised Bid $100,000 $100,500 $98,000 $101,000

D. Other Preference Programs:

1. Additional preference programs exist and may be applicable. Specifically, the Target Area Contract Preference Act (TACPA). For information regarding these programs please see the following website: https://www.dgs.ca.gov/PD/Services/Page- Content/Procurement-Division-Services-List-Folder/Request-Target-Area-Contract- Preference?search=TACPA

E. Additional Small Business and Disabled Veteran Enterprise Information:

1. Adherence to the DVBE Requirements:

i. Failure of Contractor to seek substitution and adhere to the DVBE participation level identified in the bid may be cause for agreement termination, recovery of damages under rights and remedies due to the State, and penalties as outlined in Military & Veterans Code section 999.9; Public Contract Code section

10115.10. Contractor must immediately notify DSH’s SB/DVBE Advocate that the substitution of a DVBE subcontractor is requested.

ii. Failure of Contractor to adhere to the certification requirements of Military and Veterans Code section 999.5, subdivision (d) may be used as evidence of the bidder’s non-responsibility in future solicitations.

2. Commercially Useful Function (CUF) Disclaimer

Each certified SB/MB or DVBE must perform a commercially useful function. Bidders who are found to not be performing a CUF will have their bids deemed non-responsive. A SB/MB or DVBE is deemed to perform a CUF when the business does all the following:

i. Is responsible for the execution of a distinct element of the work of the agreement.

ii. Carries out its obligation by actually performing, managing, or supervising the work involved.

iii. Performs work that is normal for its business services and functions.

iv. Is responsible, with respect to products, inventories, materials, and supplies required for the agreement, for negotiating price, determining quality and quantity, ordering, installing, if applicable, and making payment.

v. Is not further subcontracting a portion of the work that is greater than that expected to be subcontracted by normal industry practices.

https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Request-Target-Area-Contract-Preference?search=TACPA https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Request-Target-Area-Contract-Preference?search=TACPA https://www.dgs.ca.gov/PD/Services/Page-Content/Procurement-Division-Services-List-Folder/Request-Target-Area-Contract-Preference?search=TACPA

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

Agreements resulting from this solicitation shall afterwards be monitored for compliance with CUF for the duration of the agreement.

VI. REQUIRED ATTACHMENTS

A. Listing of Attachments:

Refer to the following list for additional attachments that are a required part of this solicitation.

Attachment 1 Bid Submission Checklist Attachment 2 Bidder’s Certification Attachment 3 Minimum Qualifications Response Attachment 4 Bidder’s References Attachment 5 Bidder’s Rate Sheet(s) Attachment 6 Insurance Certifications Attachment 7 Darfur Contracting Act Certification (Only if applicable) Attachment 8 Bidder Declaration Form (GSPD-05-105) Attachment 9 Generative Artificial Intelligence (GenAI) (STD 1000) Attachment 10 Contractor Certification Clauses (CCC 04/2017) Attachment 11 Payee Data Record (Std. 204) Attachment 12 DVBE Declarations Form (Std. 843) Attachment 13 California Civil Rights Law Certification Attachment 14 Sample Standard Agreement (Std. 213 and Exhibits)

Note: Attachment 14 is included for reference only. Only the successful bidder will submit these documents, when requested by DSH.

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

ATTACHMENT 1 – BID SUBMISSION CHECKLIST

Complete this checklist to confirm the items in your bid. For your bid to be considered responsive, Attachments 1 through 13 in this checklist must be submitted by the Bid Submittal Deadline indicated in this IFB. Include this checklist with your bid package.

Contractor Name:

Attachment Name of Attachment ______ Attachment 1 Bid Submission Checklist

______ Attachment 2 Bidder’s Certification

______ Attachment 3 Minimum Qualifications Response

______ Attachment 4 Bidder’s References

______ Attachment 5 Bidder’s Rate Sheet(s)

______ Attachment 6 Insurance Certifications

______ Attachment 7 Darfur Contracting Act Certification https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/PD_1.pdf

______ Attachment 8 Bidder Declaration Form (GSPD 05-105) https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/gspd05-105.pdf

Attachment 9

Generative Artificial Intelligence (GenAI) (STD 1000) STD 1000 Generative Artificial Intelligence (GenAI) Reporting & Factsheet (ca.gov)

Attachment 10 Contractor Certification Clauses (CCC-4/2017) https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of- Legal-Services-Resources-List-Folder/Standard-Contract-Language

______ Attachment 11 Payee Data Record (Std. 204) https://www.documents.dgs.ca.gov/dgs/FMC/PDF/Std204.pdf

Attachment 12 DVBE Declarations Form (Std. 843) https://www.documents.dgs.ca.gov/dgs/fmc/gs/pd/pd_843.pdf

Attachment 13 California Civil Rights Law Certification OLS004.pdf (ca.gov) https://www.documents.dgs.ca.gov/dgs/FMC/GS/PD/PD_1.pdf https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std1000.pdf https://www.documents.dgs.ca.gov/dgs/fmc/pdf/std1000.pdf https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://www.dgs.ca.gov/OLS/Resources/Page-Content/Office-of-Legal-Services-Resources-List-Folder/Standard-Contract-Language https://www.documents.dgs.ca.gov/dgs/FMC/PDF/Std204.pdf https://www.documents.dgs.ca.gov/dgs/FMC/DGS/OLS004.pdf

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

ATTACHMENT 2 – BIDDER’S CERTIFICATION

The signature affixed hereon and dated certifies compliance with all the requirements of this bid document. The signature below authorizes the verification of this certification.

By signing below, the bidder represents and warrants that statements and representations contained in the documents and data submitted in connection with this bid are true and correct. In the event the bidder’s submittal in connection with this bid contains false statements or misrepresentations of fact, the bid may be rejected, or any succeeding contract terminated for cause and the bidder deemed to be a non-responsible bidder which may adversely affect future bids submitted by the bidder. In addition, any misrepresentation of fact or fraud in connection with an attempt to secure a state contract, could result in legal action being taken against the bidder.

An Unsigned Bidder’s Certification May Be Cause for Rejection

Company Name Telephone Number Fax Number

Address Email

Name Title

Original Signature Date

Small Business Preference Request Check one:

This bidder requests a Small Business preference

This bidder does NOT request a Small

Business preference

California Certified Small Business Number:

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

ATTACHMENT 3 – MINIMUM QUALIFICATIONS RESPONSE

Bidder’s Name: ___________________________________Email: __________________________

Minimum Qualification Bidder's Response Bidder must submit a copy of their license to do business in the State of California including any proof of “Doing Business As (DBA)” documentation, as applicable.

Business License(s) Included?

Yes No N/A

Bidders must certify that they are and will continue to meet all terms and conditions for operating a business in the city/county in which the business is headquartered.

Do you so certify?

Yes No

Bidders which are corporations, regardless of where they are incorporated, shall certify they are currently in good standing with the California Secretary of State (SOS). DSH shall verify that the proposed awardee(s) is in good standing by checking the (SOS) website:

Bidders must either be medical corporations, be individual physicians licensed to practice medicine in the State of California, be entities which are otherwise physician owned, be entities as defined in Business and Professions Code section 2401, be a hospital owned and operated by a public entity (state or local) or be otherwise in compliance with the Medical Practices Act.

Valid license, proof, or declaration included?

If a bidder is using any name other than his or her own, a Fictitious Name Permit (FNP) must be on file with the California Department of Consumer Affairs.

Fictitious Name Permit included?

Bidder must provide a letter of reference from a governmental entity for as described in II. Minimum Qualifications (MQ), Section B., References.

References

The bidder certifies that they understand the insurance requirements and, if awarded an agreement, shall sign and return an original of the Standard Agreement signature pages (Std. 213) and any required insurance documents as directed.

Bidders medical office or clinic where services shall be performed must be within a 20-mile radius of DSH – Atascadero. The physical address where services will be performed must be provided at the time of bid submission.

Address_______________________________________________________

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

If Bidder must refer patients to outside clinic for any of the services listed within this agreement, the outside clinic locations must also be within a 20-mile radius of DSH – Atascadero, 10333 El Camino Real, Atascadero, CA 93422.

Bidders must provide with their bid package a current copy of the medical license(s) issued by the Medical Board of California or Osteopathic Medical Board of California, Department of Consumer Affairs, for any physician(s) who will provide services under this agreement.

Medical License

Bidders must provide with their bid package a current copy of Board Certification issued by the American Board of Medical Specialties, or American Osteopathic Association Board Certification, for any physician(s) who will provide services under this agreement.

Board Certification

I, the undersigned, declare that the certifications required above are true and that I am authorized to make such certifications and bind the bidder contractually.

Signature of Declarant Print First and Last Name Date Signed

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

ATTACHMENT 4 – BIDDER’S REFERENCES

Bidder must provide a letter of reference from a governmental entity for whom the bidder has provided employee medical clearance and physicals within the past two (2) years (from the date of this solicitation). The letter of reference must contain sufficient information (i.e., specific times and locations where the bidder provided services) in order to verify the bidder’s experience. The letter must be composed by someone who had direct experience with the provision of services outlined in the letter. The letter of reference must address each of the following:

i. The bidder’s responsiveness to requests for service

ii. The bidder’s ability to provide the contracted services

iii. The customer’s overall assessment of the bidder’s performance

To prove the submitted letter has been completed by the appropriate party, the letter must also:

iv. Provide the name, address, title, company, and phone number of the qualifying employer/company

v. Be submitted on the employer/company’s official letterhead

vi. Contain an original signature by the completing party

DSH reserves the right to utilize the letter of reference in determining whether a bidder is responsible.

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

ATTACHMENT 5 – BIDDER’S RATE SHEET

Important Considerations:

1. The bidder shall set forth the bid rates in clear, legible figures in the space provided.

2. By submitting a bid, the bidder agrees that his or her final bid constitutes an irrevocable offer which shall be valid for 180 calendar days from the bid submission date.

3. DSH does not expressly or by implication agree that the actual amount of work will correspond therewith and reserves the right to omit portions of the work as may be deemed necessary or advisable by DSH. The estimates listed below are a good faith estimate and are not a guarantee of business and is subject to change. The amounts indicated below will be used solely for comparison of bids. DSH makes no guarantee, expressed or implied for actual number of services to be used. However, the rates quoted by the bidder shall be binding for the term of the agreement.

4. Bidder shall place their bid amounts for each service in the spaces below:

Note: Rates are required for all services listed. Failure to provide required rates shall be cause for rejection of a submitted bid.

PART A: For services performed between June 1, 2025 through June 30, 2025

DESCRIPTION OF SERVICE COST PER SERVICE

Pre-Employment Physical

Annual Respiratory Medical Clearance Physical

Annual Asbestos Medical Clearance Physical

Tuberculin Skin Test (TST)

Venipuncture

Complete Blood Count (CBC)

Urinalysis (UA)

Rapid Plasma Reagin (RPR)

Rubella Antibody

Mumps Antibody (lgG)

Measles (Rubeola) Antibody (lgG)

IFB Number: 24-10027-000 Medical Evaluations within the Specialty of Occupational and

Hepatitis B Surface Antibody (HBsAb) +

Hepatitis B Surface Antigen (HBsAg)

Hepatitis B Core Antibody (HBcAb)

Hepatitis C Virus Antibody (HCVAb)

Varicella-Zoster Virus Antibody (VZV)

Hemoglobin A1C

QuantiFERON – TB Gold

Occult Blood x3

Vision Test

Color Vision Test

Grip Strength Test (Dynamometer)

Audiogram

Respirator Fit Test-Qualitative only

Spirometry/Pulmonary Function Test

Cardiac Stress Test

Chest x-ray (2 views)

Appointment for Follow-up Chest X-ray Results

Review

Department of Motor Vehicles (DMV) Physical

Functional Capacity Evaluations

Medical Testimony (Hourly labor rate for time in court and phone…