24Q2001_Attachment 1_PWS.pdf

PERFORMANCE WORK STATEMENT

Department of Defense Education Activity (DoDEA) Mid-Atlantic District Field Site PR

Drivers Annual Physical Examination comply with Department of Transportation (DOT)

Federal Compliance-DOT Standard 49 CR Chapter III, 391.43

Medical Surveillance

Department of Defense Education Activity

4800 Mark Center Drive

Alexandria, VA 22350

Controlled Unclassified Information (CUI) Source Selection Information - See FAR 2.101 and 3.104

Controlled Unclassified Information (CUI) Source Selection Information - See FAR 2.101 and 3.104

PERFORMANCE WORK STATEMENT

FOR

Puerto Rico Student Transportation Office

Annual Drivers Physical Examination

INTRODUCTION

The Department of Defense Education Activity (DoDEA) is a Federally operated school system, responsible for planning, directing, coordinating, and managing prekindergarten through 12th grade educational programs on behalf of the Department of Defense (DoD). DoDEA is globally positioned, operating 163 accredited schools in 8 districts located in 11 foreign countries, 7 states, Guam, and Puerto Rico. DoDEA employs approximately 8,700 employees who serve more than 78,000 children of active-duty military and DoD civilian families. DoDEA is committed to ensuring that all school-aged children of military families are provided a world-class education that prepares them for postsecondary education and/or career success and to be leading contributors in their communities as well as in our 21st century globalized society.

DoDEA operates as a field activity of the Office of the Secretary of Defense (Personnel and Readiness). It is headed by a director who oversees all agency functions for DoDEA headquarters in Alexandria, Virginia. DoDEA’s schools are divided into 3 geographic areas: Europe, the Pacific, and the Americas.

1. SCOPE OF WORK

The federal Department of Transportation (DOT) requires an annual physical examination for any drivers with Commercial Category 8/9 driver licenses. DoDEA Schools Mid-Atlantic District, Field Site Puerto Rico, provides bus transportation services for three (3) schools in the San Juan metropolitan area and one (1) school located on the island west coast (Aguadilla). 45 bus drivers are required to complete a physical examination annually to be in compliance with the DOT Standard 49 CFR 391.41 “Physical Qualification for Drivers of Commercial Vehicles”.

The National Registry of Certified Medical Examiners is a listing of medical personnel who have been approved to conduct medical exams on DOT-regulated commercial motor vehicle drivers. The term medical examiner includes, but is not limited to, Doctor of Medicine (MD), doctors of osteopathy (DO), physician assistants (PA), advanced practice nurses (APN), and doctors of chiropractic (DC).

2. REQUIREMENT (OBJECTIVE)

A DOT physical examination must be conducted by a licensed medical examiner listed on the Federal Motor Carrier Safety Administration (FMCSA) National Registry. The Contractor shall provide a medical examination to ALL (estimate of 70) drivers during the specific time frame provided by the COR. The Contractor shall perform medical examination and laboratory testing only to personnel whose name appears on the provided listing.

2.1 Contractor shall submit credentials of medical personnel performing the examinations and tests to the

COR prior to performing the services.

2.2 Annual driver physical examination for any drivers with Commercial Category 8/9 driver licenses must include:

2.2.1 Physical Examination, to include:

2.2.1.1 Vital Signs (weight, blood pressure, pulse, stature)

2.2.1.2 Vision Test

2.2.1.3 Audiometric Test

2.2.1.4 Alcohol Breath Test

2.2.2 Medical Record-File

2.2.2.1 The Federal Motor Carrier Safety Administration requires that interstate commercial motor vehicle drivers maintain a current Medical Examiner’s Certificate (MEC), Form MCSA-5876 to drive. As part of the physical, drivers are required to fill out the medical history portion of the Medical Examination Report (MER) Form, MCSA-5875. The Contractor will maintain a copy of the medical records file and provide it to the COR or KO, when requested.

2.3 Laboratory Tests shall be conducted on all drivers and must include the necessary supplies and equipment to complete the following tests:

2.3.1 Urinalysis (U/A)

2.3.2 Board Controlled Substances-Panel 5 (SAMHSA Certified) – NIDA-5: The five-panel drug screen will test through a urine sample and able to detect the following substances:

2.3.2.1 Marijuana (THC)

2.3.2.2 Cocaine

2.3.2.3 Amphetamines/methamphetamines (Ecstasy, crystal meth)

2.3.2.4 Opiates (heroin)

2.3.2.5 Phencyclidine (PCP).

The results of this examination should be completed within three business days (3). Contractor shall evaluate all abnormal test findings and make necessary referral immediately

2.4 Invoice -Wide Area Work Flow (WAWF): Contractor will submit invoices in WAWF NLT the 10th of each month following services provided. (Example. January invoice is due NLT February 10th.) COR may request invoice review prior to submission in WAWF at any time.

3. CONSTRAINTS. This section includes any limitations or restrictions that the contractor can/will encounter in performance duties of the PWS.

3.1 Security

3.1.1 Installation Access under Different Force Protection Conditions for Contractor Personnel.

Installation access requirements may change without notice based on various threat-based scenarios as dictated by the installation commander. The COR, in concert with the DoDEA Force Protection Officer, will advise the contractor of any noted access changes.

3.1.1.1 Base Access (Contractors): The local supporting military installation will issue all required installation passes to Contractor employees at no cost to the Contractor. To be eligible to perform work under this contract, the Contractor shall meet all applicable installation access requirements

Controlled Unclassified Information (CUI) Source Selection Information - See FAR 2.101 and 3.104 specific to each installation. The STO, in conjunction with the COR, will provide the Contractor copies of the installation access forms as referenced above. Installation passes shall always be in the employee’s possession while on a military installation. The Contractor shall return installation passes to the appropriate office within one (1) business day upon termination of an employee or completion of this contract.

3.1.2 Security/Force Protection Conditions.

3.1.2.1 In the event security threats increase, the Government may require:

3.1.2.1.1 Inspection of Contractor vehicles and/or parking areas by U.S. military and/or Host Nation security personnel.

3.1.3 Zero Tolerance Weapons Policy. Weapons are items carried, presented, or used in the presence of another person in a manner likely to make a reasonable person fear for their safety. Contractor personnel shall not carry and/or possess weapons of any type while performing duties on or off any installation.

3.1.4 Contractor Vehicles on Government Installations.

3.1.4.1 Parking of Contractor privately owned vehicles on Government Installations is subject to approval of the Installation Commander.

3.1.4.2 The US Government assumes no liability for damage or loss of parked property under this contract.

4. CONTRACT DELIVERABLES

DELIVERABLES SCHEDULE

Description Frequency Deliver To Method Contract Reference

Driver Physical Examination Annually or as required.

COR *Electronically 2.2.1

Medical Record File Submit proof of files 15 days after physical examination and update as changes occur or annually.

COR *Electronically 2.2.2

Laboratory Tests Annually or as required.

COR *Electronically 2.3

Invoices / WAWF NLT the 10th of each month following service provided. COR *Electronically 2.4

* Electronically = Email, Microsoft TEAMs, WAWF, etc.

Controlled Unclassified Information (CUI) Source Selection Information - See FAR 2.101 and 3.104