Attachment K - Phase I Submission Forms_11.pdf

ATTACHMENT K – PHASE I SUBMISSION FORMS

Proposal Files for Solicitation #36C10X23R0058

Instructions: Offeror must complete the following forms as instructed, for Phase I. Page or Character Limitations for each section are provided within each form.

A Phase I- VITAL Viability Submission is mandatory for all SBA certified SDVOSBs seeking to serve in the role of VITAL. Failure to submit a Phase I SDVOSB Viability Submission by the 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 in Phase II).

Phase I Instructions- In addition to the specific instructions within each form, the following file naming and submission instructions apply.

Mandatory Phase I: The complete Phase 1 Submittal shall contain the following completed forms:

1A. PHASE I: VITAL VIABILITY SUBMISSION- ELIGIBILITY COVER PAGE

1B. PHASE I: VITAL VIABILITY SUBMISSION- ELIGIBILITY SUPPLEMENTAL

Save Phase I forms 1A-1B into a single file titled: “ph1_VITAL_Eligibility_<company name>.pdf”

1C. PHASE I: VITAL VIABILITY SUBMISISON- CAPABILITY

Save Phase I form 1C into a single file titled: “ph1_VITAL_Capability_<company name>.pdf”

1D. PHASE I: VITAL VIABILITY SUBMISSION- DRAFT VIT ROBUSTNESS

Save completed spreadsheet as: “ph1_VIT_Robustness_<company name>.xls/xlsx”

Submit all 3 files as email attachments IAW Section E, PROPOSAL SUBMISSION INSTRUCTIONS of the RFP.

1A. PHASE I: VITAL VIABILITY SUBMISSION – ELIGIBILITY COVER PAGE

Prospective VITAL Information

Primary POC Name:

Primary POC Phone Number:

Primary POC E-mail:

Submitting as (select one of the toggles): SBA-certified SDVOSB (Complete A below) Joint Venture (Complete B below)

If SDVOSB--

A

Business Name:

SAM UEI:

Address:

(Check as applicable):

Currently Registered in SAM and small under NAICS 561320 (verifiable through Reps and Certs)

SBA Certified SDVOSB1 or Currently seeking certification (submit evidence to Contracting Officer as attachment to Phase I submission if seeking SBA certification)(select one of the toggles)

If Joint Venture (JV)--

B

JV Separate Legal Entity Name:

SAM UEI:

SDVOSB Protégé (managing venturer):

Approved Mentor:

Mentor-protégé JV:

Has SBA approved a mentor-protégé agreement between the partners to the JV? Yes No

Protégé currently registered in SAM and small under NAICS 561320 Protégé currently SBA certified SDVOSB

Small-Small JV:

Both partners currently registered in SAM (reps and certs) as small under NAICS 561320 Managing Venturer currently SBA certified SDVOSB

Eligibility ‐ To be eligible to serve in role of Veteran Integrated Team Agile Lead (VITAL), submitter must meet one of the following criteria at time of phase II proposal.

a) SBA certified SDVOSB, registered in SAM.gov, and small under NAICS 561320, or

b) A small‐small JV (with each concern registered in SAM.gov, and small under NAICS 561320, and the managing venturer an SBA certified SDVOSB) or

c) A JV comprised of a Mentor‐Protégé (with SBA approved Mentor, an SBA certified SDVOSB Protégé that is registered in SAM, and small under NAICS 561320)2.

Please select the criteria that applies to your status:

Meets a, b, or c above at time of Phase I Submission.

Will meet a/b/c at time of Phase II Proposal (complete form 1B below.)

1 VA does not recognize SDVOSB self-certification. SDVOSBs seeking set-aside opportunities with the VA must be certified.

2 Note that a mentor that has more than one protégé cannot submit competing offers in response to a solicitation for a specific procurement through separate joint ventures with different proteges.” 13 C.F.R. § 125.9(b)(3)(i).

A

B

1B. PHASE I: VITAL VIABILITY SUBMISSION – ELIGIBILITY SUPPLIMENTAL

The Government will assess eligibility (or prospective eligibility) based upon the information provided on the Cover Page as well as any supplementary information provided below.

Offeror may provide supplemental information below if offeror does not clearly meet defined eligibility criteria at time of Phase I VITAL Viability Submission but will meet the criteria at time of Phase II Proposal. Supplemental information should include detailed evidence and status of process steps completed towards becoming eligible for this set-aside. General statements, without detailing steps taken and updated status, are inadequate.

The Government may request clarifications, if needed, to allow for the provision of accurate advice. If the Government determines the prospective VITAL eligible, it will then assess prospective VITAL Capability next.

VITAL Eligibility Supplemental Information Complete the below for the SDVOSB or JV submitting as prospective VITAL if not eligible at time of Phase I Submittal, but will be eligible at time of Phase II Proposal.

OFFEROR (PROSPECTIVE VITAL) NAME:

VITAL Eligibility (3,000 Characters)

–1C. PHASE I: VITAL VIABILITY SUBMISSION- CAPABILITY

If determined eligible (or subject to becoming eligible by official phase II proposal due date) per above, the Government will assess the viability of the prospective VITAL through a review of its OC Capability, healthcare integration experience, and its draft contract management and administration plan.

a. OC Capability: An integrated, innovative approach to staffing and program support services, encompassing all VHA sites of care, is critical to the success of temporary staffing support under ICSP. Given the size and scope of healthcare staffing, the Government must have a high level of confidence that all VITALs are highly capable in the areas below:

• Nationwide recruitment and placement of temporary staffing,

• Efficient onboarding of personnel,

• Quality management,

• Planning and analytical services,

• Strategic and operational support,

• Implementation support, and

• Monitoring and evaluation support.

Demonstration of this OC Capability may be provided based on the integrated capabilities of the VIT, inclusive of its collective team members.

Based upon the VITAL Viability Submission‐Capability, the Government will determine the extent to which the prospective VITAL can execute within OC’s 1-3 and provide necessary program support services.

b. Healthcare Integration Experience: The requirements under this contract include diverse occupational areas and concurrent integration of staff into numerous highly complex (size and scope) national healthcare facilities. Therefore, having served as a prime contractor on contract(s) supporting large integrated healthcare systems is important to successfully fulfilling VHA requirements.

Based upon the VIT Viability Submission‐Capability, the Government will determine the extent to which the prospective VITAL is prepared to manage a team of vendors addressing multiple government staffing requirements simultaneously in a highly complex integrated healthcare setting.

To successfully serve in the role of Prime Contractor (VITAL), leading a VIT, an eligible SDVOSB must have capabilities necessary to execute staffing requirements in OC's 1-3 and must have deep healthcare integration experience and must have a sound contract management administration plan.

c. Contract Management and Administration: The Government recognizes the complexities associated with administering a vehicle of this size, scope, and complexity and therefore requires a VITAL (Prime) with a robust plan to meeting the various administrative requirements.

In the form that follows, prospective VITAL shall describe its capability in each of the areas identified within paragraph a. above, shall explain in detail the extent of experience in healthcare integration as per paragraph b. above, and shall provide a draft plan for meeting administrative requirements as per paragraph c.

Form begins on next page.

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

OFFEROR (VITAL) NAME:

VITAL OC Capability (5,000 Characters)

VITAL Healthcare Integration Experience (3,000 Characters)

VITAL Contract Management and Administration Plan (2,000 Characters)

***END OF FORM 1C***

1D. PHASE I: VITAL VIABILITY SUBMISSION – VIT ROBUSTNESS

Each prospective VITAL must assemble an integrated team that provides both breadth and depth of staffing capability to meet the needs of all VHA sites of care.

As part of Phase II, all Offerors will be required to identify all partners on the VIT and must include an affirmation that all listed partners have a current and valid teaming agreement, letter of commitment, or existing contract with the VITAL on file. The VIT’s geographical coverage area must include, as a minimum, all 50 states; with additional coverage of all U.S. territories preferred.

For Phase I:

The prospective VITAL shall complete Attachment M- VIT Coverage (Robustness) and submit as “ph1_VIT_Robustness_<company name>.xls/xlsx”. This submission will represent the draft VIT assembled to date by the prospective VITAL and is meant to give the government early assurance that the prospective VITAL understands the teaming concept and has a high likelihood of assembling a team meeting all Phase II requirements if it chooses to submit an offer.

Specific instructions for completing the Robustness Attachment (spreadsheet) are:

1. On “VIT Geographic Coverage” worksheet, in first four columns of the table:

a. Enter Offeror and Partner Names, SAM UEIs, and select the Socio-Economic status for each

(using dropdown), and “yes” or “no” based on whether prime offeror has a letter of commitment from proposed partner (these will be required in Phase II).

b. For the Offeror and each Partner, place an “x” below the states where staffing support is provided.

All offeror information will automatically be copied over to “VIT LCAT Coverage” worksheet.

2. On “VIT LCAT Coverage” worksheet:

a. For the Offeror and each Partner, place an “x” below all LCATs (Staffing) provided by Offeror and included Partners.

Based on evaluation of the VITAL Viability Submission, the Government will provide an advisement letter, indicating the Government’s assessment based on the below criteria. In accordance with FAR 15.202(b), the Government will advise each respondent in writing (advisement letter) either that it is a viable competitor for the resultant Phase II of the acquisition or, based on the information submitted, that it is unlikely to be a viable VITAL. The agency will advise respondents considered not to be viable VITALs of the general basis for that opinion. The agency will inform all respondents that, notwithstanding the advice provided by the Government in response to their submissions, they may participate in Phase II (either as a VITAL or by joining a VIT as a team member).

***END OF PHASE I FORMS***