36C10E21Q0009 0001.docx

5. PROJECT NUMBER (if applicable)

CODE

7.

ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF

PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

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 NUMBERE

D 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 amendmen t, 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

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

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.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

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)

VA

12-07-2020 00101 Department of Veterans Affairs Veterans Benefits Administration Acquisition Division 1800 G. Street N.W.

Washington DC 20006 00101 Department of Veterans Affairs Veterans Benefits Administration Acquisition Division 1800 G. Street N.W.

Washington DC 20006 To all Offerors/Bidders

36C10E21Q0009 12-07-2020

X

A. THIS

AMENDMENT IS ISSUED IN ORDER TO ADD QUESTIONS AND ANSWERS RECEIVED IN RESPONSE TO THE ABOVE-MENTIONED

SOLICITATION.

B. THE DATE AND TIME SE

T FOR THE RECEIPT OF PROPOSALS HAS NOT CHANGED.

C. THE OFFEROR IS REQUIRED TO ACKNOWLEDGE THIS AMENDMENT IN THEIR OFFER OR BY SEPARATE LETTER THAT ACKNOWLEDGES RECEIPT.

D. ANY REMAINING QUESTION MUST BE SUBMITTED NO LATER THAN 3:00CST ON DECEMBER 7, 2020 FOR FINAL POSTING TO CAREER

OPPORTUNITIES.

Rebecca S. Quilhot Contracting Officer

VA-VBA-2020-144ED0C2

PAGE NO.

CONTRACT NO.

ORDER NO.

MODIFICATION NO.

14.

DESCRIPTION OF AMENDMENT/MODIFICATION (CONTINUED)

STANDARD FORM 30 (CONTINUATION)

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

CONTINUATION PAGE

D. ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME AND UNCHANGED.

F. QUESTION AND ANSWERS, ATTACHMENT K, PAST PERFORMANCE QUESTIONNAIRE

FOLLOWS.

AMENDMENT #1 Q&A

Indianapolis Regional Office VR&E Indianapolis DISCRETE SERVICES 36C10E21Q0009 Question #1 If the veteran referrals request tele-counseling for their IL assessment due to COVID-19 and health reasons, is this arrangement agreeable by the VA?

The Coronavirus Relief Act and extension has authorized this service to be delivered in a remote modality through December 21, 2021.

Question #2 Can Life Skills Coaching referrals also be conducted via tele-counseling due to COVID-19?

The Coronavirus Relief Act and extension has authorized this service to be delivered in a remote modality through December 21, 2021.

Question #3 Contractor personnel may need to travel to remote locations for IL referrals, what is the distance from which the veteran must reside from the VA Offices or facilities to be pre-approval of travel costs by the VA, and can you provide the locations of the VA Offices?

50 miles, office locations are below

· 107 E 93rd Ave, Crown point, IN 46307

· 1540 Trinity Pl, Mishawaka, IN 46545

· 2500 e State Blvd, Fort Wayne, IN 46805

· 1700 E 38th St, Marion, IN 46953

· 220 N Main St #101, Kokomo, IN 46901

· 575 N Pennsylvania St, Indianapolis, IN 46204

· 4555 Central Ave #1300, Columbus, IN 47203

· 1467 Scott Valley Dr., Scottsburg, IN 47170

· 1100 N Burkhardt Rd, Evansville, IN 47711

· 1000 N 4th St, Vincennes, IN 47591

Question #4 What was the estimated number of IL referrals in 2019, and estimated IL referral numbers for 2020?

In 2019, the estimated number of Comprehensive IL assessments is 10 In 2020, the estimated number of Comprehensive IL assessments is 15

ATTACHMENT K – PAST PERFORMANCE QUESTIONNAIRE

PAST PERFORMANCE QUESTIONNAIRE

Department of Veterans Affairs (VA): 36C10E21Q0009 – Veteran Readiness & Employment Services Life Skills Coaching / Independent Living Assessment

TO: Rebecca S. Quilhot, Contracting Officer AGENCY: VBA Eastern Contracting Team

PHONE: 563-424-5874

E-MAIL: rebecca.quilhot@va.gov

INFORMATION REQUEST: CONTRACTOR PAST PERFORMANCE

The Department of Veterans Affairs is currently in the process of awarding a competitive service contract for Life Skills Coaching / Independent Living Assessment for the VR&E INDIANAPOLIS VA Regional Office [CONTRACTOR NAME] has provided this Questionnaire to you for a reference regarding [CONTRACTOR NAME]’s record of past performance under Contract No. [CONTRACT #].

Send completed questionnaires to rebecca.quilhot@va.gov NOTE TO VENDORS: If the Questionnaire is provided for Subcontractors reference, the Vendor’s name below must include both the Prime and Subcontractor Names.

PAST PERFORMANCE QUESTIONNAIRE

Vendor’s Name:

Request for Quote: 36C10E21Q0009 Name of Person Completing the Evaluation:

Telephone: E-mail:

Title:

Company/Organization:

Please rate the vendor in each of the following areas.

Note: There is room for comments where you deem remarks would be helpful to our evaluation.

· Not Applicable: N/A

· 1: Performance clearly below the contract performance standard or requirement

· 2: Performance occasionally does not meet minimum contract performance standard or requirement

· 3: Performance that meets the minimum contract performance standard or requirement

· 4: Performance that meets and occasionally exceeds the contract performance standard or requirement

· 5: Performance that almost always exceeds the contract performance standard or requirement

Overall satisfaction with the Vendor’s performance.

Delivery performance includes delivery consistency, on time performance, and flexibility in responding to emerging issues and implementing required solutions.

Rate the effectiveness and applicability of the plans and strategies delivered and the actual implementation of those.

This includes the vendor’s ability to solve problems, the speed in which they handle problems, and their effective delivery of resolutions.

Rate the quality of the contractor’s staff in executing the project work scope.

6. Have you issued a cure notice, show cause notice, suspension of progress payments or other letters directing the correction of a performance problem in the past 3 years? |_| Yes |_| No If Yes, please explain.

7. Have you terminated this contractor for default within the past 3 years, or are there any pending termination actions? |_| Yes |_| No If Yes, please explain.

8. Based on the vendor’s overall performance, would you award them another contract? |_| Yes |_| No If No, please explain.

9. Have you discussed any adverse past performance problems with the Vendor and given them an opportunity to comment? |_| Yes |_| No Please explain.

10. Do you file past performance information in a database that the Contracting Officer may search? |_| Yes |_| No Please explain.

11. If the contract had options, were those options exercised? |_| Yes |_| No Please explain.

12. What was the contract period of performance (i.e., when were services provided)?

13. What was the dollar value of the contract performed by the vendor?

14. Provide a brief description of the services provided by the vendor for this contract.

Please attach any past performance database reports or other material you deem appropriate to provide a full understanding of the Vendor’s past performance by the evaluator. Please provide information on any adverse performance by the contractor and the corrective actions taken.

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