36C10X20R0002-004.pdf

ATTACHMENT D- PROPOSAL FORMS

Proposal Files for Solicitation 36C10X19R0036

Instructions: Offeror must complete the following information as instructed, for Phase I and Phase II. Page Limitations for each section are provided within each section.

Phase I- Viability Assessment is mandatory for any VIP-verified SDVOSBs seeking to serve in the role of VITAL. Failure to submit a Phase I SDVOSB Viability statement by date and time required, will render the prospective VITAL ineligible to submit a team response in Phase II (without a Phase I Assessment, proposal will be rejected).

Phase II- VIT Proposal is the viable VITAL’s opportunity to assemble and present details on its proposed Veteran Integrated Team’s collective capability to deliver on any and all areas within the three functional categories.

Solicitation 36C10X19R0036 (IHT) Offeror Name:

Phase I: VITAL Viability Assessment (Mandatory)

Instructions: Prospective VITAL must complete the form D1 on the following page and deliver as the cover page to its VITAL Viability Submission. When submitting the VITAL Viability Submission, prospective VITAL shall combine into one file (MS Word or Adobe pdf formats only) and submit as a single volume. Character limits are built into each form.

The complete Phase 1 Submittal will contain the following:

Section Pages

D1: VITAL VIABILITY SUBMISSION- ELIGIBILITY (COVER PAGE) 1

D2: VITAL VIABILITY SUBMISSION- CAPABILITY --

D2A: VITAL CAPABILITY RESPONSE- FC1 CAPABILITY 8

D2B: VITAL CAPABILITY RESPONSES- HEALTHCARE INTEGRATION 2

D2C: VITAL CAPABILITY RESPONSES- CONTRACT MANAGEMENT/ OVERSIGHT 2

D1: VITAL VIABILITY SUBMISSION- ELIGIBILITY (COVER PAGE)

Prospective VITAL Information

Primary POC Name:

Primary POC Phone Number:

Primary POC E-mail:

Submitting as (select one):

If SDVOSB, A

Business Name:

DUNS:

Address:

Check as applicable:

Currently Certified in SAM (reps and certs) as small under NAICS 541611 VIP-Verified in VetBiz as SDVOSB or currently seeking verification (submit proof of CVE submittal to Contracting Officer as attachment to Phase I Submission if seeking verification )

If Joint Venture (JV), B

Separate Legal Entity Name:

DUNS:

Managing Venturer:

(or Protégé)

JV Partner:

JV is VIP-verified JV not VIP-verified, has not started verification process JV is not yet VIP-verified, but has started the verification process (submit proof of CVE submittal to Contracting Officer as attachment to Phase I Submission)

My JV is the following:

Small-small JV

- Both partners currently Certified in SAM (reps and certs) as small under

NAICS 541611

- Managing Venturer currently Verified in Vetbiz

Mentor-Protégé No

- Protégé currently Certified in SAM as small under NAICS 541611

- Is M-P agreement approved by SBA? Yes

- Protégé currently Verified in Vetbiz

D2: VITAL VIABILITY SUBMISSION- CAPABILITY

The VITAL shall be fully capable to deliver within all areas within Functional Category 1, shall have substantial healthcare integration experience, and shall have expert ability to manage and oversee contract performance including related administrative processes.

D2A: VITAL CAPABILITY RESPONSE- FC1 CAPABILITY

Complete the below for the SDVOSB or JV submitting as prospective VITAL.

OFFEROR (VITAL) NAME: <Prime Offeror Name> Functional Category I Capability (Health System Transformation and Innovation) Critical to the success of transformational efforts is an integrated, innovative approach to healthcare programs and projects, encompassing all lines of effort. Given the size and scope of healthcare transformation, the Government must have a high level of confidence that all VITALs are highly capable in the areas below:

• Program and Project Management;

• Business Requirements Development;

• Strategic Planning;

• Program Evaluation;

• Change Management and Transition;

• Quality Management; and

• Strategic Communications and Executive Support.

Provide a description of previous contract efforts where you were required to support each of the areas listed above in a healthcare environment. Responses are limited to the space provided for each area.

Program and Project Management

(continue on next page)

Program and Project Management continued <Prospective VITAL Name>

Business Requirements Development <Prospective VITAL Name>

Strategic Planning <Prospective VITAL Name>

Program Evaluation <Prospective VITAL Name>

Change Management and Transition <Prospective VITAL Name>

Quality Management <Prospective VITAL Name>

Strategic Communications and Executive Support <Prospective VITAL Name>

D2B: VITAL CAPABILITY RESPONSES- HEALTHCARE INTEGRATION

Prospective VITAL: <SDVOSB or JV Name> Describe the largest team (companies, non-profits, academic institutions) you have managed in support of a contracted project?

Was this a Stand-alone contract or IDIQ/ BPA? Stand-alone contract IDIQ Contract/BPA

Describe the complexity, duration, number of vendors/subcontractors involved.

Complexity

Duration (POP)

Number of Subcontractors/ Number of Personnel supporting

Number and description of concurrent projects or workstreams supported:

Describe the extent to which this contract effort required you to manage resources across numerous task order requirements simultaneously.

Did limitations on subcontracting apply? Describe how you balanced subcontracting limitations with performance goals.

D2C: VITAL CAPABILITY RESPONSES- CONTRACT MANAGEMENT/OVERSIGHT

Prospective VITAL: <SDVOSB or JV Name> Recruitment: Describe how you have provided specialized resources (SMEs, Specialists, etc.) when required for task order requirements under short suspense?

Problem Resolution: Describe a situation when good contract management principles were applied to resolve a problem during contract administration and performance (personnel issues, performance quality, changing requirements, cost overruns, delays)? What was the problem and how did you work with the Government customer to resolve.

Contract Administration: Describe specifically how you have handled administrative functions, including invoicing, training, managing subcontractors, badging and background investigations, and managing travel in an environment with multiple concurrent task orders and heavy resources?

**********END OF PHASE 1 SUBMITTAL**********

Phase II: VETERAN INTEGRATED TEAM (VIT) PROPOSAL

Instructions: Prospective VITAL must submit its Phase II proposal using the forms on the following pages. Provide all requested information.

Offeror shall submit a summary of its VIT using the VIT SUBMISSION- TEAM SUMMARY (COVER PAGE), providing all requested information. Offeror may utilize COVER PAGE CONTINUATION pages as necessary to provide additional subcontractor names, however the format and headers shall not be altered. If the Prime is a Joint Venture, complete first table on COVER PAGE below.

There is no page limit for this Template. Any information other than requested information will not be evaluated. In completing the table below, offeror shall identify “Applicable Functional Category Areas” using the below identification.

Functional Category I: Health System Transformation and Innovation

Functional Category II:

Healthcare Implementation and Operations Support

Functional Category III:

Healthcare Business Enabling Services

1A Program and Project Management

2A Studies and Analysis 3A Medical Supply Chain and Healthcare Logistics Analysis

1B Business Requirements Development

2B Data Governance 3B Supply Chain Management

1C Strategic Planning 2C Performance Measurement 3C Supply Chain Planning

1D Program Evaluation 2D Training Development 3D Inventory Management and Operation

1E Business Process Reengineering, Improvement and Management

2E Training Delivery 3E Supply Chain Optimization

1F Change Management and Transition

2F Policy Research and Development

3F Financial Management Modernization

1G Quality Management 2G Policy Management 3G Internal Financial Controls

1H Strategic Communications and Executive Support

2H Advertising Services 3H Management and Operations

2 Media Buying 3 Research and Development Administration Support

2J Public Relations Services/Outreach

3J Human Resources Support

2K Conference, Events, and Planning Services

3K Acquisitions Support

2L Healthcare Related Promotional Materials

3L Information, Privacy and Records Management

2M Video/Film Production 3M Revenue Operations

2N Graphics Design 3N Value Based Healthcare Planning

D3A: PHASE II VIT PROPOSAL- TEAM SUMMARY (COVER PAGE)

If submitting as a Joint Venture, please complete the following table.

Name DUNS Number VIP Verified? (Yes or No) Small under 541611?

(Joint Venture)

Managing Venturer/ Protégé

Joint Venture Partner

All Prime Offerors must provide the following information for all team members beginning with VITAL, then all VITEPs, followed by all VITSOs.

Use the COVER PAGE-CONTINUATION if needed based upon team size.

VIT NAME

(optional but encouraged) OPTIONAL--Use as little or much creativity here as desired)

Prime Contractor (VITAL): <SDVOSB or JV Name> VIT Member Name/ Address

DUNS #

Sub NAICS

VITAL

VITEP

VITSO

Status (e.g. SDVOSB, JV, VOSB, SB, LB, NFP)

Applicable Functional Category Area

<VITAL Name (SDVOSB or JV) VITAL Address <VITAL DUNS>

VITAL SDVOSB/JOINT VENTURE

1A, 1B, 1C…etc.

<VITEP /VITSO Name and Address> <VITEP /VITSO DUNS>

VITEP

VITSO

1G, 2A, 3A…

Yes No

Yes No

Yes No

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

<NAICS>

541611

(see NAICS Crosswalk)

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

D3B: VIT SUBMISSION- TEAM SUMMARY (COVER PAGE- CONTINUATION)

Use this CONTINUATION PAGE as needed based upon team size.

VIT Member Name/ Address

DUNS #

Sub NAICS

VITEP

VITSO

Status (e.g. SDVOSB, VOSB, SB, LB, NFP)

Applicable Functional Category Area

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

VITEP

VITSO

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

<VITEP /VITSO DUNS>

<Subcontract NAICS>

CAPABILITY NARRATIVE TEMPLATE

Instructions: Offerors shall submit from the next pages one capability form (TECH and PP) for each Functional Capability Area to be supported by each VIT Member.

For example: If a VITEP is proposed for Functional Category areas 1A, 2D, and 3C, three forms shall be completed for this Team Member. VIT Proposals shall submit forms covering all team members and all their respective capabilities.

D4: CAPABILITY NARRATIVE

Complete one form per member capability for each member of the VIT identified in table above.

Member Number (from Team Summary Table above)

Technical Capability and Past Performance Form: Phase 2, Part 1 Functional Capability Area: _________

OFFEROR (VITAL) NAME: <Prime Offeror Name>

VIT MEMBER

ADDRESSED BELOW:

<Name of VIT Member>

Relationship to VIT:

VIP Verification:

1. Technical Capability Summary of technical capability for Functional Capability Area

CAPABILITY NARRATIVE (PP)

Member Number (from Team Summary Table above)

Technical Capability and Past Performance Form: Phase 2, Part 1 Functional Capability Area: _________

2. Past Performance COMPANY who performed this work:

POSITION ON TEAM:

WORK WAS PERFORMED AS THE: PRIME SUBCONTRACTOR

Total Awarded Price/Cost:

Final or Projected Final Total Price/Cost:

Delivery date/Period of performance (including base and options if applicable):

Contracting Officer’s Name, Email, and Telephone Number:

Program Manager’s Name, Email and Telephone Number

North American Industry Classification System (NAICS) Code:

Was a CPARS/PPIRS Completed? : YES NO UNKNOWN

Description of the Requirement

D5: KEY PERSONNEL BIOGRAPHY

All offerors must complete and submit one form for the IDIQ Contract Manager and one for each additional key person proposed by the VIT to support the Base IDIQ Contract.

PROPOSED KEY PERSON’S NAME: <Insert Name Here>

KEY PERSONNEL ROLE: IDIQ CONTRACT MANAGER1 OTHER (SPECIFY BELOW)

ROLE (IF NOT IDIQ CONTRACT MANAGER): <Insert Role Here> LETTER OF COMMITMENT?: YES (Please Provide) NO

Education (List up to two relevant degrees and the area of focus) Note: The IDIQ Contract Manager must have a minimum education of a bachelor’s degree in a business or program related field University:

Level/ Type of Degree:

Major/ Field:

Experience (List relevant experience to the role of the key person being proposed) Note: The IDIQ Contract Manager must have a minimum of 10 years of experience managing programs, projects, or contracts of comparable size, scope and complexity to this procurement. The IDIQ Contract Manager shall have experience with government contract oversight.

<Describe experience relevant to requirements above. Please ensure experience dates clearly tie to required years of experience. Annotate government contract oversight experience by beginning example with “GOV”. If proposing additional key personnel, you may also highlight within this narrative any relevant certifications, etc.>

1 A Letter of Commitment shall also be submitted for the IDIQ Contract Manager to ensure individual proposed will be individual supporting the effort.

CONTRACT MANAGEMENT AND ADMINISTRATION

PRIME OFFEROR NAME: <Prime Offeror Name>

In the space provided below, provide your plan to manage contractor onboarding and training, travel administration, budgeting and invoicing, and general contract executions and administration. Please also address how your proposed VIT above will meet the subcontracting limitations required under this SDVOSB set-aside.

< Detail plan for contract management and administration here>

CONTRACT MANAGEMENT AND ADMINISTRATION-CONTINUATION

PRIME OFFEROR NAME: <Prime Offeror Name> < Continued details of plan for contract management and administration here>

Offeror Name:

TASK ORDER CAPABILITY (NO TEMPLATE)

Instructions: Offerors shall complete and submit as its Task Order Capability Volume, all information required (and in the format required) by E.3

INSTRUCTIONS AND EVALUATION APPROACH, C. PROPOSAL SUBMISSION

INSTRUCTIONS, adhering to the page limitations provided in B. GENERAL

INSTRUCTION.

PRICE TEMPLATES

Instructions: Offerors shall complete and submit as its Phase II Price Volume:

1. Attachment I- VHA IHT LCAT Price Spreadsheet (Provide fully burdened labor rates for all applicable Functional Category Capability Areas for Base and Option Period (all 10 years). Do not alter the spreasheet in any way other than to add labor rates for each category, where indicated. If the templates are altered in any other way, they may not be accepted. Hourly rates must be rounded to two decimal places. PDF files will not be accepted. Do not convert the files to .pdf format.

2. Attachment G- Representative Task Order Pricing Spreadsheet (Complete Sample Task Order LOE LM worksheet by inserting Labor Categories, IDIQ proposed labor rates, Sample Task Order discounted labor rates, and hours by labor category per task area. Additionally, for each LCAT, add VIT member where resource is pulled [note that these could be used for subcontract limitations assessment]--all necessary fields for offeror completion highlighted in yellow).

The second worksheet should auto populate the task order price schedule from the calculated CLIN pricing in worksheet 1.

See RFP Attachments for details.

Offeror Name:

SF 1449, AMENDMENTS, OTHER DOCUMENTS

Instructions: The following shall be submitted as the Phase II Volume:

a. Signed SF 1449 and amendment(s), if any. An authorized official of the VITAL submitting the response shall sign the SF 1449, amendment(s) and all certifications requiring signature;

b. Offeror’s statement(s) as required by paragraph b. of the VAAR Clause, E.2 VAAR 852.209-70 ORGANIZATIONAL CONFLICTS OF INTEREST and any applicable OCI Mitigation Plans;

c. Paragraph b of 52.212-3, Offeror Representations and Certifications must be completed below;

d. Paragraph (a)(4) from 52.212-4 Contract Terms and Conditions – Commercial Items (May 2015) Alternate 1 (May 2014) must be completed below, if applicable.

e. 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.

Excerpt from FAR 52.212-3 Offeror Representations and Certifications – Commercial Items (DEC 2014)

(b)(1) Annual Representations and Certifications. Any changes provided by the offeror in paragraph (b)(2) of this provision do not automatically change the representations and certifications posted on the SAM website.

(2) The offeror has completed the annual representations and certifications electronically via the SAM website access through http://www.acquisition.gov. After reviewing the SAM database information, the offeror verifies by submission of this offer that the representations and certifications currently posted electronically at FAR 52.212-3, Offeror Representations and Certifications—Commercial Items, have been entered or updated in the last 12 months, are current, accurate, complete, and applicable to this solicitation (including the business size standard applicable to the NAICS code referenced for this solicitation), as of the date of this offer and are incorporated in this offer by reference (see FAR 4.1201), except for paragraphs ____________________.

Excerpt from FAR 52.212-4 Contract Terms and Conditions – Commercial Items (May 2015) Alternate 1 (May 2014)

(a)(4) At any time during contract performance, but not later than 6 months (or such other time as may be specified in the contract) after acceptance of the services or materials last delivered under this contract, the Government may require the Contractor to replace or correct services or materials that at time of delivery failed to meet contract requirements. Except as otherwise specified in paragraph (a)(6) of this clause, the cost of replacement or correction shall be determined under paragraph (i) of this clause, but the "hourly rate" for labor hours incurred in the replacement or correction shall be reduced to exclude that portion of the rate attributable to profit. Unless otherwise specified below, the portion of the "hourly rate" attributable to profit shall be 10 percent. The Contractor shall not tender for acceptance materials and services required to be replaced or corrected without disclosing the former requirement for replacement or correction, and, when required, shall disclose the corrective action taken. [Portion of labor rate attributable to profit if other than 10% = _________] http://www.acquisition.gov/