S06 RFP 36C10B26R0035 Amendment_0002.pdf

Amendment to a Previous Combined Solicitation

5. PROJECT NUMBER (if applicable)

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2. AMENDMENT/MODIFICATION NUMBER

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6. ISSUED BY

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Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR

ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office. is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER 16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

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Prescribed by GSA - FAR (48 CFR) 53.243

(Type or print) (Type or print)

(Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

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(such as changes in paying office, appropriation date, etc.)

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13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer)

1 6

0002 08-19-2026

VA-25-00046145

Department of Veterans Affairs

Technology Acquisition Center

23 Christopher Way

Eatontown NJ 07724

Department of Veterans Affairs

Technology Acquisition Center

23 Christopher Way

Eatontown NJ 07724

36C10B26R0035

08-10-2026

36C10B26R0034 x

X X

August 25, 2026; 10:00:00 AM ET

See Contiuation Pages

Brett Schwerin

Contracting Officer

RFP 36C10B26R0035

Amendment 0002

A. The purpose of this amendment is to extend the solicitation response date and time, provide response to questions received from industry, and revise the solicitation Section E.15, Instruction to Offerors.

B. RFP 36C10B26R0035 response date and time is extended to August 25, 2026, 10:00:00 AM Eastern Time.

C. The following questions were submitted by industry regarding the above-referenced solicitation. Government's responses are provided below.

1. PACS / Offline Image Availability

The amendment states that diagnostic mammography imaging storage will be handled by the VA’s PACS solutions and that diagnostic mammography images will not be stored in the MTRS solution. During a loss of Internet, cloud, WAN, or connectivity to the national MTRS instance, do the VA mammography sites retain local access to the diagnostic mammography images stored in PACS? If availability varies by site or PACS architecture, please provide the continuity assumption offerors should use when designing and pricing the solution.

Response: If either the MTRS or PACS is unavailable, local sites shall follow their established backup contingency plans. Once the affected system is restored, local sites will populate the system to ensure the record is complete and current.

2. Non-Imaging Data Volume

Does the VA have a rough estimate of the annual non-imaging MTRS data volume, preferably in GB or TB, either per site or nationally? If an estimated storage volume is not available, please provide any Government planning assumption offerors should use for sizing non-imaging data storage.

Response: Non-Imaging data storage should be minimal. The contractor shall account for the following VA Mammography Program characteristics:

• A national benchmark of 450,000 exams for all 88 sites.

• An estimated base-year exam volume of 175,000 exams across the 30 base-year implementation sites.

Reference: RFP Section E.15, Volume II, Instructions to Offeror – Volume II (Past Performance)

3. Section E.15, Volume II states in its initial sentence that offerors shall submit "up to three (3) Federal instances," yet subsequently states that past performance will be evaluated across "complex healthcare environments." Because enterprise healthcare software of equivalent size, scope, and technical complexity is overwhelmingly deployed within commercial health networks, restricting submissions exclusively to Federal contracts conflicts with the requirement to evaluate complex healthcare environments. To resolve this internal contradiction and promote maximum competition under FAR 15.305(a)(2), will the Government confirm that relevant commercial healthcare enterprise deployments are acceptable for submission under Volume II?

Response: See Section E.15, Volume II, Past Performance for an update to include Commercial Contracts.

4. Large-scale commercial health networks (e.g., multi-hospital integrated delivery networks managing millions of patient records) operate under equivalent technical, security, and operational complexities as Federal healthcare systems.

Will the Government confirm that relevant commercial past performance references will be evaluated on an equal basis and weighed equally with Federal past performance references without penalty or markdown?

Response: See Section E.15, Volume II, Past Performance for an update to include Commercial Contracts.

Reference: Section E.14 / E.15, Evaluation / Instructions to Offeror – Past Performance Evaluation

5. Section E.14 states the Government will review past performance data in CPARS. Because commercial healthcare systems and Original Equipment Manufacturer (OEM) subcontracts do not receive CPARS evaluations, will the Government confirm that completed Past Performance Questionnaires (PPQs - Attachment 2) submitted for commercial contracts or subcontracts will be evaluated with equal weight and without penalty compared to CPARS ratings?

Response: The Government confirms that completed Past Performance Questionnaires (PPQs, Attachment 2) submitted for commercial contracts or subcontracts will be evaluated with equal weight and without penalty compared to CPARS ratings, provided the underlying commercial contract or subcontract is of similar size, scope, and complexity in accordance with the solicitation.

Additionally, See Section E.15, Volume II, Past Performance for an update to include Commercial Contracts.

Reference: Section E.15, Volume I & PWS 5.2.4, 5.2.7, 5.2.9, Instructions to Offeror – Volume I (Technical Factor Page Limit & Screenshots)

6. The Government clarified in Q&A #23 [of Amendment 0001] that required screenshots and appropriate documentation count toward the 25-page Volume I limit. Given the extensive screenshot evidence required across PWS Sections 5.2.4, 5.2.7, and 5.2.9, forcing high-resolution clinical screenshots into the 25-page limit severely restricts space for narrative technical solutions. Will the Government consider expanding the Volume I page limit to 40 pages, or allow an unpaged Technical Image Appendix for mandatory screenshots and workflow diagrams?

Response: Solicitation Section E.15, Instructions to Offeror, Item 2.c ("Content Requirements") is hereby amended as follows:

The page limitation for Volume I (Technical Factor) is amended from twenty-five

(25) pages to a maximum of forty (40) pages, comprised of two separately paginated components:

(i) The written Technical Approach, which shall not exceed twenty-five (25) pages, consistent with the existing page limitation set forth in the table at Section E.15, Item 2.c; and

(ii) A newly established Technical Image Appendix, which shall not exceed fifteen (15) pages.

The Technical Image Appendix shall be used solely for the inclusion of screenshots, workflow diagrams, and other supporting visual documentation.

Narrative content, analysis, or discussion of the Offeror's technical approach shall not be included in the Technical Image Appendix; any such content, if included, will not be evaluated.

All other terms, conditions, formatting requirements, and page limitations set forth in Section E.15 remain unchanged and in full force and effect, except as expressly amended herein.

Reference: Section E.15, Item 1, Instructions to Offeror – Proposal Submission / Email Limits

7. Section E.15 restricts total proposal email submission size to no more than 5MB per email / total due to email gateway limits. Compression to meet 5MB may render required screenshots and architecture diagrams unreadable. Will the Government consider increasing the email size threshold, provide multiple emails to ensure files are delivered, or providing a secure electronic submission portal (e.g., VA File Transfer / DoD SAFE) for proposal submission?

Response: No, however, multiple emails may be submitted. If more than one email must be submitted, please number emails as appropriate, for example, “1 of total emails to be received (e.g., 1 of 3, 2 of 3 etc.). Proposals submitted by any other method will not be considered. Please request a receipt response to ensure files have been delivered.

Reference: Section E.15, Volume IV & Section B.5, Instructions to Offeror – Volume IV (Price Factor) / Schedule of Supplies & Services

8. Section E.15 imposes a strict 5MB limit on proposal email submissions. In Q&A #23, the Government confirmed that required high-resolution clinical screenshots and architectural workflow diagrams must be included in Volume I. Compressing multi-page graphic files to fit under a 5MB total threshold severely degrades image resolution, rendering critical clinical workflows and UI screenshots unreadable for evaluation. Will the Government allow visual addendums (e.g., hi-res screenshots, architecture diagrams) to be submitted in a separate graphic volume with a higher file size limit (e.g., up to 25MB)?

Response: The visual documentation required under this response shall be submitted as the Technical Image Appendix to Volume I (Technical Approach), consistent with the Government's response to Question 6 above. See updated solicitation Section E.15, Item 2.c, ("Content Requirements").

9. Due to strict VA network email gateway caps, single emails near or at 5MB frequently bounce or get quarantined without sender notification. To ensure complete and uncorrupted delivery of proposal packages, will the Government allow offerors to either: (a) submit proposal volumes across multiple sequential emails (e.g., Email 1 of 3, 2 of 3), or (b) utilize a secure VA electronic submission portal (such as VA File Transfer Service or DoD SAFE)?

Response: No, however, multiple emails may be submitted. If more than one email must be submitted, please number emails as appropriate, for example, “1 of total emails to be received (e.g., 1 of 3, 2 of 3 etc.). Proposals submitted by any other method will not be considered.

10. To ensure an apples-to-apples price evaluation across all offerors for T&M/Labor-Hour CLINs, will the Government provide standardized Government Estimated Labor Hours and Labor Mix ("plug numbers") for offerors to multiply by their proposed fully burdened labor rates for evaluation purposes?

Response: This solicitation/resultant contract is 100% Firm Fixed Price. Pursuant to Section E.8 (RFO 52.216-1, Type of Contract), the Government contemplates award of a Firm-Fixed-Price (FFP) contract, and all CLINs set forth in Section B.5, Schedule of Supplies and Services, are structured as FFP or Not Separately Priced (NSP) line items.

Reference: PWS 5.2.3 & PWS 5.13, Performance Work Statement – EHR Integration (VistA vs. FEHR / Oracle Health)

11. In Q&A #7 [of Amendment 0001], the Government confirmed active connections to both VistA/CPRS and Federal EHR through a DAS SPOE middleware integration point. Under Technical and Past Performance evaluations, will the Government confirm that commercial experience integrating with commercial Oracle Health (or similar) platforms will be evaluated as equivalent relevant experience, even if the vendor did not directly use VA's specific DAS SPOE middleware on past projects?

Response: Yes.

Reference: Section E.14 & Section E.15, Volume II, Past Performance Evaluation – Ongoing Contracts & Major Technical Components

12. Enterprise healthcare IT modernization projects involve massive non-deployment lifts—such as complex multi-system data migration, enterprise EHR middleware integration, Organizational Change Management (OCM), and multi-site workflow configuration—which demonstrate core capabilities long before final nationwide deployment is complete. Will the Government confirm that recent or ongoing contracts (both Federal and Commercial) that demonstrate substantial completed performance in these critical technical components will be evaluated as relevant past performance, even if final nationwide deployment or contract completion has not yet occurred?

Response: Consistent with the Past Performance Evaluation Approach set forth in (and updated as part of Amendment 0002) Section E.14, recent or ongoing contracts, whether Federal or commercial will be evaluated as relevant past performance where the Offeror's Section E.15, Volume II narrative demonstrates that substantial and verifiable performance has been completed in one or more of the following critical technical components: (i) complex multi-system data migration; (ii) enterprise Electronic Health Record (EHR) middleware integration;

(iii) Organizational Change Management (OCM); or (iv) multi-site workflow configuration. Such contracts will be considered relevant past performance even where final nationwide deployment or overall contract completion has not yet occurred, provided the Offeror's narrative sufficiently documents the scope, status, and outcomes of the completed work to permit the Government to assess performance risk in accordance with Section E.14.

The burden remains on the Offeror to demonstrate the relevance of the cited effort, consistent with Section E.14.

Reference: PWS 5.2.9.1 & PWS 5.15.6 (CLIN 5007), Baseline AI Capability vs.

Optional Task 6

13. PWS Section 5.2.9.1 requires an AI Capability Statement in Volume I, whereas the operational implementation of the AI Calculation Tool is structured as Optional Task 6 (CLIN 5007). Could the Government clarify whether the availability of fully developed AI risk calculation tools is evaluated as part of the core Technical Factor baseline, or if it is evaluated strictly under Optional Task 6?

Response: PWS Section 5.2.9.1 requires an AI Capability Statement as part of baseline Clinical Functionality, due as part of the RFP response and again within 30 days after award (see CLIN 0004AJ and the Performance Metrics table, PWS 5.2.9.1). This capability statement describing the offeror's ability to design/develop/validate/deliver a 5-year risk AI tool is a baseline Technical Factor requirement evaluated as part of Volume I. The actual implementation and license of the operational AI Calculation Tool is a separate, government-optional deliverable under Optional Task 6 / CLIN 5007, exercised at the Government's discretion. In short: the capability statement is baseline and the built tool itself is optional.

Reference: PWS Section 3.0 & PWS 5.15, Scope of Work – Deployment Cadence

14. Enterprise healthcare deployments across 88 VAMC sites carry distinct local readiness and technical integration variables. When the Government provides a generic baseline schedule while permitting alternative timelines, evaluation bias frequently favors offerors using the baseline, regardless of technical risk. To ensure an unbiased, objective evaluation and reduce overall project risk, we recommend the Government amend PWS Section 3.0 and Section 5.15 to mandate that all offerors independently propose, detail, and justify their own fine-grained implementation schedule, site sequence, and rollout cadence within Volume I. Will the Government adopt this recommendation and require offeror-proposed timelines?

Response: No, the Government is not changing the PWS. Per PWS section 5.1.1, the Contractor shall deliver a Contractor Project Management Plan (CPMP) that defines the Contractor’s approach, timeline, and tools for a fully functioning Mammography Tracking and Reporting System (MTRS).

Reference: Notice Summary (SAM.gov & Section E), Solicitation Period & Turnaround Time:

15. In Amendment 0001 (Item B), the Government stated the proposal due date of August 20, 2026, remains unchanged. Given the extensive requirement updates provided in Amendment 0001 (e.g., dynamic database licensing requirements, specific interface requirements, and mandatory page-counted screenshot inclusions), will the Contracting Officer reconsider extending the proposal submission deadline by 7 to 10 calendar days to allow offerors sufficient time to adjust technical and pricing models?

Response: The response time is extended through 10:00 am ET on August 25, 2026.

PWS Section 5.3 & Section E.15 (Volume I), MTRS Cloud Deployment Capability Report / Technical Factor:

16. Per the CIO Memorandum, VA acquisition documents shall not state or imply that existing FedRAMP certification is required for an offeror to compete for or receive an award at VA. Will the Government confirm that solutions without a pre-existing FedRAMP authorization will be evaluated on equal footing with FedRAMP-authorized solutions, provided the offeror demonstrates readiness to achieve a VA Authorization to Operate (ATO) post-award via NIST SP 800-53 Rev 5 / 'ATO in 60 Days' framework and provides required artifacts (e.g., Security Assessment Report, Data Flow Diagrams, Asset Inventory, Vulnerability Scans) upon award?

Response: Confirmed in part. Consistent with the cited CIO Memorandum and VA policy prohibiting VA acquisition documents from requiring pre-existing FedRAMP certification as a condition of competing for or receiving award, this solicitation does not require FedRAMP authorization at time of proposal submission or award. The RFP's security requirements (PWS Sections 5.3 and 6.1.2, and Addendum B) instead describe the standard VA Assessment & Authorization (A&A) process, conducted under VA Handbook 6500 and NIST SP 800-37, for obtaining an Authority to Operate (ATO) as part of contract performance rather than as a pre-award eligibility requirement.

Regarding evaluation: The Government will not, by policy, evaluate a non- FedRAMP-authorized solution less favorably solely on that basis; however, Offerors are advised that the completeness, and technical soundness of their proposal will be evaluated as part of the Offeror's overall technical approach.

Reference: PWS Section 5.3 & PWS 6.1.2, System Security, ATO, and Enterprise Cloud Integration

17. In Q&A #16 [of Amendment 0001], the Government confirmed it will accept proposals for VAEC, vendor-hosted, or on-premise solutions. In light of the Deputy CIO Clarification Memo (V14895023) and Q&A #15 [of Amendment 0001] regarding NIST SP 800-53 Rev 5 compliance, will the Government confirm that for vendor-hosted cloud options, the post-award 'ATO in 60 Days' assessment process will be utilized to achieve a VA Authorization to Operate (ATO) prior to system go-live, rather than requiring a pre-existing VA ATO at contract award?

Response: Confirmed. A pre-existing VA Authorization to Operate (ATO) is not a condition of contract award. Consistent with PWS Sections 5.3 and 6.1.2 and Addendum B, VA ATO is obtained through the standard VA Assessment & Authorization (A&A) process, conducted under VA Handbook 6500 and NIST SP 800-37, as part of contract performance following award — for vendor-hosted, VAEC, and on-premise solutions alike, consistent with the Government's response to Q&A #16 of Amendment 0001.

The Government further confirms that, for evaluation purposes, an Offeror's demonstrated readiness and technical approach to achieve a VA ATO post-award will be evaluated on an equal basis with an Offeror that already possesses an existing ATO; an Offeror will not be evaluated less favorably under the Technical Factor solely because it has not yet obtained an ATO at the time of proposal submission.

Reference: Section E.15, Volume II & Attachment 2 (PPQ), Instructions to Offeror – PPQ Submission Authority for Subcontractor References

18. When an offeror or proposed subcontractor submits a past performance reference where they acted as a subcontractor (and thus lacked direct contractual privity with the end-item customer), will the Government confirm that a completed Past Performance Questionnaire (PPQ) signed by the Prime Contractor's Program Manager / Contracting Officer Representative is fully acceptable in lieu of an end-customer signature?

Response: Confirmed. Where an Offeror or proposed subcontractor submits a past performance reference for effort performed as a subcontractor, and therefore lacks direct contractual privity with the end-item customer, a completed Past Performance Questionnaire (PPQ, Attachment 2) signed by the Prime Contractor's Program Manager or Contracting Officer's Representative (COR) is fully acceptable in lieu of a signature from the end-item customer, provided the signer possesses direct knowledge of the subcontractor's performance sufficient to complete the PPQ.

This is consistent with Section E.15, Volume II, which does not require that the PPQ respondent be the end-item customer specifically, but rather a knowledgeable Government or prime-contractor point of contact capable of assessing the cited work.

Reference: Section E.14, Past Performance Evaluation, Evaluation Factors

– Neutral Rating for Lack of Relevant Federal/Prime History

19. In accordance with FAR 15.305(a)(2)(iv), will the Government confirm that an offeror or proposed subcontractor lacking a direct federal prime past performance record will receive a Neutral past performance rating, and will not be evaluated favorably or unfavorably, rather than being downgraded under the Past Performance factor?

Response: Confirmed. In accordance with RFO 15.202(c)(1), an offeror without a record of relevant past performance or for whom information on past performance is not available may not be evaluated favorably or unfavorably on past performance.

Section B.5 & Section E.15, Volume IV, Schedule of Supplies/Services & Price Evaluation Mechanics (FFP vs. T&M)

20. Section B.5 structures requirements across both Firm-Fixed-Price (FFP) CLINs (e.g., software licenses, site rollouts) and Time-and-Materials (T&M) or Labor- Hour CLINs for custom technical services. Could the Government clarify how total evaluated price (TEP) will be calculated across FFP and T&M CLINs?

Specifically, will the Government provide standardized Government Estimated Labor Hours/Mix for the T&M CLINs for evaluation purposes, or will offerors submit independent labor hour estimates?

Response: This solicitation/resultant contract is 100% Firm Fixed Price. Pursuant to Section E.8 (RFO 52.216-1, Type of Contract), the Government contemplates award of a Firm-Fixed-Price (FFP) contract, and all CLINs set forth in Section B.5, Schedule of Supplies and Services, are structured as FFP or Not Separately Priced (NSP) line items.

Reference: Section E.14 & Section E.15, Volume IV, Price Evaluation – Labor Rate Realism & Professional Compensation:

21. For T&M/Labor-Hour CLINs, will (in accordance with FAR 15.404-1) to ensure proposed labor rates are realistic for the technical expertise required, and to prevent risk of low-ball pricing that could impact long-term operational performance?

Response: This solicitation/resultant contract is 100% Firm Fixed Price. Pursuant to Section E.8 (RFO 52.216-1, Type of Contract), the Government contemplates award of a Firm-Fixed-Price (FFP) contract, and all CLINs set forth in Section B.5, Schedule of Supplies and Services, are structured as FFP or Not Separately Priced (NSP) line items. Accordingly, the Government will conduct price evaluation conducted in accordance with Section E.14.

Reference: Section E.14 & Section E.15, Volume I, Technical Evaluation Method – Screenshots vs. Live Demonstration vs. Demo Sandbox:

22. Section E.15 requires technical evidence including workflow diagrams and screenshots across PWS Sections 5.2.4, 5.2.7, and 5.2.9. Will the technical evaluation be based strictly on the static written narrative, screenshots, and diagrams submitted within Volume I, without post-submission live software demonstrations or oral presentations?

Response: Yes.

23. Will the Government require or permit offerors to provide login credentials to an unsupervised cloud demo or sandbox environment for evaluators to independently test and verify clinical software workflows?

Response: No.

Reference: Section E.15, Volume I (Technical) Live Demo Protocol & Evaluation Script (If Applicable)

24. If the Government plans to conduct live software demonstrations or require sandbox environment access, will a standardized demonstration script, scoring rubric, and advance notice schedule be provided to all offerors participating in Phase 1 / Technical evaluations?

Response: No, live demonstrations will be used as part of the evaluation.

Reference: Section E.15, Volume I (Technical), Live Demo Protocol & Evaluation Script (If Applicable)

25. Should the Government elect to conduct live software demonstrations as part of technical evaluations, will the Government confirm the anticipated period of time (e.g., a minimum of 10 to 14 calendar days) between formal notification of advancement and the scheduled live technical demonstration date.

Response: No, live demonstrations will be used as part of the evaluation.

Reference: B.5, CLIN 0001 (p. 14); PWS Section 3.0 (p. 46)

26. CLIN 0001 caps the subscription at 450,000 annual exams, but PWS §3.0 estimates 175,000 exams across the 30 base-year sites. Should we price CLIN 0001 to 450,000 or to the base-year volume?

Response: CLIN 0001 should be priced to the 450,000-exam ceiling, as the enterprise software license is intended to be procured at full national scale/capacity from contract inception regardless of the phased 30-site base-year rollout, to avoid re-licensing as additional sites go live under later option periods/optional tasks.

Reference: PWS Section 4.1.2 (p. 47); B.5 (pp. 14–40)

27. PWS 4.1.2 says to price travel as firm-fixed-price line items, but B.5 has no travel CLIN. Should travel be built into the installation, project management, training and Optional Task CLINs? And does the 58-trip estimate cover the 30 base sites, the 58 Optional Task 1 sites, or both?

Response: Yes, travel shall be built into the CLINS. The 58 trips is estimated for the entire period of performance, all 88 sites total.

Reference: Volume II (p. 168); Past Performance Evaluation Approach (p.

164)

28. Volume II allows up to three Federal instances, but the evaluation approach treats deployments in “federal or complex healthcare environments” as relevant.

May we submit non-Federal healthcare contracts, and if so, do they count against the three?

Response: See Section E.15, Volume II, Past Performance for an update to include Commercial Contracts.

Reference: Volume II (p. 168). Section 1 – 9. & 10

29. Does the completion of work refer to the completion of the software build and go-live? Or is this related to the period of performance for the contract? Even though the initial contract ran its term, software usage was renewed for continued use.

Response: Completion of work refers to the expiration of the period of performance of the specific contract instance being cited. If that contract's software usage was subsequently renewed under a new or extended contract action, the offeror should report the original contract's PoP end date, and may cite the renewal separately (as its own past performance instance, if relevant and within the three-year window) rather than treating it as a continuation of the same instance.

Reference: Volume V

30. Section E.15 lists the contents of Volume V as the SF 1449 with amendment acknowledgments, the signed BAA, and any proposed terms or assumptions. Are Offerors also required to include completed copies of the Section E representations and certifications (E.4 through E.11) in OfrRep.pdf, or are these incorporated by reference from the Offeror's active SAM registration under FAR 52.204-19?

Response: Yes, offerors are to complete section E.4 through E.11.

Section E.15 requires Volume V to include Solicitation Section A, Standard Form 1449.

31. The solicitation as issued does not contain a Section A or an SF 1449 form.

Please confirm whether an SF 1449 will be issued by amendment, or whether Offerors should complete a blank SF 1449 obtained from GSA. Additionally, please confirm whether amendments should be acknowledged on the SF 1449, in the acknowledgment table at Section B.1, or both.

Response: No, the offerors are not required to complete a SF1449. Amendments should be acknowledged in accordance with SF 30 Section 11, which requires one copy of the amendment to be returned with the offeror’s response.

Reference: E.16 – page 172

32. E.16 requires the AI self-certification be provided with the proposal but is not listed among the Volume V contents in E.15. Please confirm the AI self-certification should be included in Volume V (OfrRep.pdf), or identify the volume in which it should be submitted.

Response: Offerors shall include the completed AI self-certification (Section E.16) in Volume V (OfrRep.pdf), as it is a certification/representation document consistent with the other content in that volume. RFP will be amended to include AI self-certification in Volume V. See Section E.15, Item 2.c, Table.

Reference: PWS 5.2.9.1

33. The deliverable description says the capability statement describes existing or future capabilities, while the acceptable quality level says it must show current offerings. Will an offeror describing planned capability be evaluated the same way as one describing capability available today?

Response: Products with available capability may be rated differently than planned capability.

D. Solicitation Section E.15, Item 2.c, "Content Requirements" table is amended as follows:

1. The page limitation for Volume I “Technical Factor” is amended from twenty-five

(25) pages to a maximum of forty (40) pages, comprised of two separately paginated components:

(i) The written Technical Approach, which shall not exceed twenty-five (25) pages, consistent with the existing page limitation set forth in the table at Section E.15, Item 2.c; and

(ii) A newly established Technical Image Appendix, which shall not exceed fifteen (15) pages.

2. Solicitation Section E.15, Instructions to Offerors, Past Performance Factor is amended to include Commercial Contract instances.

3. Solicitation Section E.15 Item 5, Volume V “Solicitation, Offer And Award Documents And Certifications/Representations, Small Business Subcontracting Plan (Required For Large Businesses Only” is amended to incorporate Artificial Intelligence Efforts Certification.

E. Solicitation E.15 Instructions To Offeror is amended as follows:

E.15 INSTRUCTIONS TO OFFEROR

1. PROPOSAL SUBMISSION INSTRUCTIONS

The Offeror’s proposal shall be submitted electronically by the date and time indicated in the solicitation to Terricia Lloyd, Terricia.Lloyd@va.gov, and Brett Schwerin, Brett.Schwerin@va.gov, in the files set forth below by the date and time indicated in the solicitation. The Offeror’s proposal shall consist of five Volumes. The Volumes are Volume One –Technical Factor, Volume Two - Past Performance, Volume Three – Past Performance, Volume Four – Price and Volume Five - Solicitation, Offer and Award Documents and Certifications/Representations.

The use of hyperlinks or embedded attachments in proposals is prohibited.

Accordingly, any hyperlinks or embedded attachments included with a proposal will neither be accessed nor viewed by the Government and thus, not evaluated as part of the Offeror’s proposal submission. Total submitted file size shall not exceed 5MB.

NOTE: Due to file size limitations, not all emails may be received, please request a receipt response to ensure files have been delivered; multiple emails may be required due to size limitations (5MB per email). If more than one email must be submitted, please number emails as appropriate, for example, “1 of total emails to be received (e.g., 1 of 3, 2 of 3 etc.). Proposals submitted by any other method will not be considered.

mailto:Terricia.Lloyd@va.gov mailto:Brett.Schwerin@va.gov

WARNING: Please do not wait until the last minute to submit your proposals! Late proposals will not be accepted for evaluation. To avoid submission of late proposals, we recommend the transmission of your proposal file 24 hours prior to the required proposal due date and time. Please be advised that timeliness is determined by the date and time an Offeror’s proposal is received by the Government not when an Offeror attempted transmission. Offerors are encouraged to review and ensure that sufficient bandwidth is available on their end of the transmission.

Any concerns or questions regarding the submission of quotes shall be addressed by email to Terricia Lloyd, Terricia.Lloyd@va.gov, and Brett Schwerin, Brett.Schwerin@va.gov.

2. PROPOSAL FILES

Offeror’s responses shall be submitted in accordance with the following instructions:

a. Format. The submission shall be clearly indexed and logically assembled. Each volume shall be clearly identified and shall begin at the top of a page. All pages of each volume shall be appropriately numbered and identified by the complete company name, date and solicitation number in the header and/or footer.

Proposal page limitations are applicable to this procurement. The Table below indicates the maximum page count (when applicable) for each volume of the Offeror’s proposal.

All files will be submitted as either a Microsoft Word 2010 (.doc) or later version, Microsoft Excel (.XLS) file or an Acrobat (PDF) file or compatible as indicated in the table. Page size shall be no greater than 8 1/2" x 11" with printing on one side, only.

The top, bottom, left and right margins shall be a minimum of one inch (1”) each.

Font size shall be no smaller than 12-point. Arial or Times New Roman fonts are required. Characters shall be set at no less than normal spacing and 100% scale.

Tables and illustrations may use a reduced font size not less than 8-point and may be landscape. Line spacing shall be set at no less than single space. Each paragraph shall be separated by at least one blank line. Page numbers, company logos, headers and footers may be within the page margins ONLY and are not bound by the 12-point font requirement. Footnotes to text shall not be used. All proprietary information must be clearly and properly marked. If the Offeror submits annexes, documentation, attachments or the like, not specifically required by this solicitation, such will count against the Offeror’s page limitations unless otherwise indicated in the specific volume instructions below. Pages in violation of these instructions, either by exceeding the margin, font, printing, or spacing restrictions or by exceeding the total page limit for a particular volume, will not be evaluated. Pages not evaluated due to violation of the margin, font or spacing restrictions will not count against the page limitations. The page count will be determined by counting the pages in the order they come up in the print layout view.

mailto:Terricia.Lloyd@va.gov mailto:Brett.Schwerin@va.gov

b. File Packaging. All of the proposal files may be compressed (zipped) into one file entitled “proposal.zip” using WinZip version 6.2 or later version or the proposal files may be submitted individually.

c. Content Requirements. All information shall be confined to the appropriate file.

The Offeror shall confine submissions to essential matters, sufficient to define the proposal and provide an adequate basis for evaluation. Offerors are responsible for including sufficient details, in a concise manner, to permit a complete and accurate evaluation of each proposal. The titles and page limits requirements for each file are shown in the Table below:

Volume Number

Factor File Name Page Limitations

Volume I Technical Tech.pdf 25 Pages

Volume I Technical Image Appendix Tech_Image_Appendix.pdf 15 Pages

Volume II Past Performance Past Perf.pdf None

Volume III Veterans Involvement VetsI.pdf None

Volume IV Price Price Exhibit.docx None

Volume V

Solicitation, Offer & Award Documents, Certifications & Representations, Artificial Intelligence Efforts Certification

OfrRep.pdf None

A Cover Page, Table of Contents and/or a glossary of abbreviations or acronyms will not be included in the page count of the Technical Volume. However, be advised that any and all information contained within any Table of Contents and/or glossary of abbreviations or acronyms submitted with an Offeror’s proposal will not be evaluated by the Government.

See RFO 52.212-1, Instructions to Offerors – Commercial Items.

1. VOLUME I – TECHNICAL FACTOR.

a. The Offeror shall clearly demonstrate an understanding of the requirements by explaining how its proposed approach supports an enterprise-wide MTRS and meets the Clinical Functionality criteria below.

1. Deliver a COTS solution that provides vendor-driven radiologist workflows incorporating API functionality with PACS and voice dictation systems.

(PWS Section 5.2.6)

2. Support multiple automated and manual trigger mechanisms for generating and transmitting Patient Lay Summary Letters. (PWS Section 5.2.8)

3. Implement an AI calculation tool for a 5-year risk score in alignment with the most recent NCCN guidelines for breast cancer screening and diagnosis. (PWS Section 5.2.9.1)

4. Develop user groups with distinct privileges and permissions. The

Contractor shall describe the available default user groups in their Mammography Tracking System solution and the permissions/privileges assigned to each group. (PWS Section 5.8)

b. The Offeror’s approach shall demonstrate its ability to install the MTS client software using a fully automated silent installer package, including the ability to apply software updates while retaining all user preferences, configurations, and customizations. The Offeror shall also describe the capabilities to implement the MTS solution within the VA Enterprise Cloud (VAEC) environment. (PWS Section 5.3)

c. The Offeror’s approach shall include screenshots or appropriate documentation to demonstrate the following capabilities:

1. A fully validated, bi‑directional HL7 integration with both VistA and FEHR, supported by evidence of successful completion of VA’s HL7 qualification processes to ensure interoperability and adherence to VA standards.

(PWS section 5.9)

2. Provide HL7 integration to VistA and OH Millenium and meet the qualification process for the VA VistA and OH Millenium HL7 interface.

(PWS section 5.9)

3. Provide DICOM Conformance Statements for all included products in the proposed Mammography Tracking System (MTS) solution. (PWS section 5.10)

4. Demonstrate successful HL7 interface integration with the proposed

Mammography Tracking System solution. (PWS section 5.9).

2. VOLUME II – PAST PERFORMANCE FACTOR

Offerors shall submit up to three (3) instances including all Federal and commercial contracts (prime contracts, task/delivery orders, and/or major subcontracts) in performance at any point during the three (3) years immediately prior to the proposal submission date, which are relevant to the efforts required by this solicitation. Areas of relevance include integration, clinical workflow solution, data migration, interoperability, training, implementation, sustainment, and program management and execution of large‑scale, multi‑facility Mammography Tracking and Reporting system deployments within federal or complex healthcare environments. Data concerning the prime contractor shall be provided first, followed by each proposed major subcontractor, in alphabetical order. This volume shall be organized into the following sections:

a. Section 1 – Contract Descriptions. This section shall include the following information:

1. Contractor/Subcontractor place of performance, CAGE Code and DUNS Number. If the work was performed as a subcontractor, also provide the name of the prime contractor and Point of Contact (POC) within the prime contractor organization (name, and current address, e-mail address, and telephone numbers).

2. Contracting activity, and current address, Procuring Contracting Officer's name, e-mail address, and telephone numbers.

3. Technical representative/Contracting Officer’s Representative (COR), and current e-mail address, and telephone numbers.

4. Contract administration activity and the Administrative Contracting Officer's name, and current e-mail address, and telephone numbers.

5. Contract Number, GSA contracts, and Blanket Purchase Agreements, include Delivery Order Numbers.

6. Contract Type (specific type such as Fixed Price (FP), Cost Reimbursement

(CR), Time & Materials (T&M), etc.).

7. Awarded price.

8. Final or projected final price.

9. Original delivery schedule, including dates of start and completion of work.

10. Final or projected final, delivery schedule, including dates of start and completion of work.

b. Section 2 - Performance. Offerors shall provide a specific narrative explanation of each contract listed in Section 1 describing the objectives achieved and detailing how the effort is relevant to the requirements of this solicitation. For any contract(s)/task order(s) that did not/do not meet original schedule or technical performance requirements, provide a brief explanation of the reason(s) for the shortcoming(s) and any corrective action(s) taken to avoid recurrence. The Offerors shall list each time the delivery schedule was revised and provide an explanation of why the revision was necessary. The Offerors shall indicate if any of the contracts listed were terminated and the type and reasons for the termination.

c. Section 3 – Subcontracts. Offerors shall provide an outline of how the effort required by the solicitation will be assigned for performance within the Offeror’s corporate entity and among the proposed subcontractors. The information provided for the prime Offeror and each proposed major subcontractor must include the entire company name, company address, CAGE Code, DUNS Number and type of work to be performed by citing the applicable Government PWS paragraph number.

d. Section 4 – New Corporate Entities. New corporate entities may submit data on prior contracts involving its officers and employees. However, in addition to the other requirements in this section, the Offeror shall discuss in detail the role performed by such persons in the prior contracts cited. Information should be included in the files described in the sections above.

e. Customer/Client Performance Risk Assessment Questionnaire:

A Past Performance Questionnaire prepared by the Offeror’s Government customer/client for each of the Offeror’s contract citations is required. The Offeror shall send the questionnaire electronically to the POCs for each Government contract/subcontract cited. It is the Offeror’s responsibility to prepare and issue instructions with the questionnaire requesting that each customer/client complete their response and send it electronically directly to the Contract Specialist and Contracting Officer identified below by the time of proposal due date.

The Offeror shall specifically request that the Government customer/client prepare questionnaire response NOT be provided back to the Offeror, either as an original or as a copy. The Government POC(s) completed questionnaire shall be sent via e-mail to the Contract Specialist, Terricia Lloyd, Terricia.Lloyd@va.gov, and Contracting Officer Brett Schwerin, Brett.Schwerin@va.gov. The Offeror shall request that the Government POC(s) maintain the original completed/signed questionnaire as a record of their response.

3. VOLUME III – VETERANS INVOLVEMENT FACTOR.

a. For SDVOSBS/VOSBs: In order to receive credit under this Factor, an Offeror shall submit a statement of compliance that it qualifies as a SDVOSB or VOSB in accordance with VAAR 852.215-70, Service-Disabled Veteran-Owned and Veteran-Owned Small Business Evaluation Factors (DEVIATION). Offerors are cautioned that they must be registered and verified in Veteran Small Business Certification (VetCert) database (https://veterns.certify.sba.gov) and must meet federal small business size standards for the NAICS code assigned to this solicitation at time of both proposal submission and at time of award.

b. For Non-SDVOSBs/VOSBs: To receive some consideration under this Factor, an Offeror must state in its proposal the names of SDVOSB(s) and/or VOSB(s) with whom it intends to subcontract and provide a brief description and the approximate dollar values of the proposed subcontracts. Additionally, proposed SDVOSB/VOSB subcontractors must be registered and verified in the VetCert database (https://veterans.certify.sba.gov) in order to receive some consideration under the Veteran’s Involvement Factor and must meet https://veterans.certify.sba.gov)/ federal s all business size standards for the NAICS code assigned to this solicitation at time of both proposal submission and time of award.

4. VOLUME IV – PRICE FACTOR

The Offeror shall complete the Price Schedule found in solicitation, Section B5.

Proposed unit prices shall be no more than two decimal places. These prices are binding as ceiling prices for each of the applicable ordering periods, regardless of the quantity being ordered. Calculation of the Total Evaluated FFP will be done by adding all items contained in the Price Schedule to arrive at the total FFP for the base, all option periods and optional tasks. All Offerors should propose using an estimated award date of September 30, 2026.

The Government will verify the Offeror’s calculation of the total proposed price.

Further, the Government may make adjustments to the evaluated price if mathematical errors are identified.

The Offeror shall complete B.5 Schedule of Supplies and Services and submit it as a Microsoft Word document titled 'Price Exhibit.' The Price Exhibit will be used for evaluation purposes and will be incorporated into the final award; therefore, the Offeror shall ensure that all unit prices, line items, and totals in the Price Exhibit are consistent with and accurately reflect the requirements of B.5 Schedule of Supplies and Services. .

Price Rounding Issue – The Government requires Offerors to propose unit prices and total prices that are two (2) decimal places and requires the unit prices and total prices to be displayed as two (2) decimal places. Ensure that the two (2) decimal unit price multiplied by the item quantity equals the two (2) decimal total item price, i.e., there should be no rounding. If an Excel spreadsheet is submitted by the Offerors, the Offerors shall ensure that the actual values in the spreadsheet cells are no more than two (2) decimal places even if values in the spreadsheet cells are formatted to display two (2) decimal places.

5. VOLUME V - SOLICITATION, OFFER AND AWARD DOCUMENTS AND

CERTIFICATIONS/REPRESENTATIONS, SMALL BUSINESS

SUBCONTRACTING PLAN (REQUIRED FOR LARGE BUSINESSES ONLY)

Certifications and Representations - An authorized official of the firm shall sign the SF 1449 and all certifications requiring original signature. An Acrobat PDF file shall be created to capture the signatures for submission. This Volume shall contain the following:

a. Solicitation Section A – Standard Form SF1449 and Acknowledgement of Amendments, if any.

b. Signed Business Associate Agreement.

c. Any proposed terms and conditions and/or assumptions upon which the proposal is predicated. Offerors are hereby advised that any Offeror-imposed terms and conditions and/or assumptions which deviate from the Government’s material terms and conditions established by the Solicitation, may render the Offeror’s proposal Unacceptable, and thus ineligible for award.

d. Artificial Intelligence Efforts Certification

3. COMPETITIVE RANGE LIMITATION NOTICE

Offerors are advised that the Government may establish a competitive range in accordance with RFO 15.204 and VAAR Subpart 815. Following initial evaluation of proposals, if the Contracting Officer determines that the number of most highly rated proposals exceeds the level at which meaningful and manageable comparisons can be conducted, the competitive range may be limited to the greatest number of proposals that will support efficient and effective discussions.