36C24122Q0099_3.docx

36C24122Q0099

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

36C24122Q0099 04-13-2022 Emily Hatcher 781-687-2514 05-11-2022 14:00

EDT

Department of Veterans Affairs Veterans Health Administration NCO1 / Services Team 1 200 Springs Road Bedford MA 01730 Emily.hatcher@va.gov X X Y 621910 $16.5 Million N/A X Department of Veterans Affairs Providence VA Medical Center Mobility Manager 830 Chalkstone Avenue Providence RI 02908-4734 Department of Veterans Affairs Veterans Health Administration NCO1 / Services Team 1 200 Springs Road Bedford MA 01730

Department of Veterans Affairs Financial Services Center https://www.fsc.va.gov/einvoice.asp PO Box 149971 Austin TX 78714-9971 877-353-9791 x This solicitation will result in award of a fixed- price Indefinite Delivery, Indefinite Quantity contract for non-personal services Contract for ALS/BLS Ambulance Service for the VA Providence RI Healthcare System with a period of Performance of a Base Year and four (4) Option Years.

All quotations must be submitted electronically to:

Emily.Hatcher@va.gov before 2:00pm EST, 5/11/2022.

Questions must be submitted electronically to Emily.hatcher@va.gov NLT 2:00 pm 4/20/2022 and will be answered via amendment to this solicitation.

SEE SECTION B.2 PRICE / COST SCHEDULE FOR ITEM INFORMATION

AND PERIOD OF PERFORMANCE.

Minimum Guarantee: $239,175.00 Ceiling: $5,500,000.00 x X x Ann Marie Stewart

VA-VHA-2021-9A527CD0

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C241 Department of Veterans Affairs Veterans Health Administration NCO1 / Services Team 1 200 Springs Road Bedford MA 01730

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Department of Veterans Affairs Financial Services Center https://www.fsc.va.gov/einvoice.asp PO Box 149971 Austin TX 78714-9971

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

Page 1 of Page 1 of

B.2 PERFORMANCE WORK STATEMENT

GENERAL OVERVIEW

The Providence VA Medical Center requires a contractor to furnish Basic Life Support (BLS) and Advanced Life Support (ALS) Ambulance Services to its beneficiaries. The contractor must provide all equipment, personnel, supervision, and support to have these services in place on or before July 1, 2022. All services will be provided in accordance with the terms and conditions of this contract, applicable federal and state regulations, and industry accepted quality standards highlighted in this Statement of Work. The awarded contract will have a Period of Performance (PoP) of One (1) Base Year with the option for Four (4) additional One (1) – Year Periods.

Pricing is established on a per trip basis (one way – loaded miles only) with an additional per mile charge for every mile over 25 miles. The estimated number for each type of transport is laid out in the Price/Cost Schedule.

A. SCOPE OF CONTRACT

The Providence VA system includes the VA Providence Medical Center and three (3) community- based outpatient clinics (CBOC) as laid out below. Services include patient transport twenty- four (24) hours per day, seven (7) days per week, including all holidays.

The contractor shall provide twenty- four (24) hour ambulance service (ALS and BLS) to VA beneficiaries receiving care at one or more of the facilities listed below. Upon request by the VA, the contractor shall transport VA beneficiaries from the beneficiaries’ place of origin to the beneficiaries’ place of treatment and at times return patient to origin. The Contractor shall have the capacity to schedule, coordinate and execute the estimated volume of 154 BLS and 15 ALS trips per month plus additional mileage. Average mileage per trip is approximately 20 miles. The VA experiences seasonal shifts in transportation needs and the contractor shall adapt to these changes while maintaining all performance standards. All vehicles, personnel, and services rendered shall conform to all Federal, state, and local statutes, rules, and regulations.

VA Medical Facilities The following facilities require transportation of VA beneficiaries. Any and all facilities may order transportation.

Page 1 of Providence VA Medical Center 830 Chalkstone Ave Providence, RI 02908

Hyannis CBOC 145 Falmouth road Hyannis, MA 02540

New Bedford CBOC 175 Elm Street New Bedford, MA 02740 Middletown CBOC One Corporate Place Middletown, RI 02840

A listing of VA personnel authorized to communicate the arrangement of these transportation services will be forwarded to the Contractor after award of contract. Updated listings shall be provided to the contractor when required during the term of the contract.

The Contractor shall contact the Contracting Officer on all matters pertaining to administration. Only the Contracting Officer is authorized to make commitments to issue changes that shall affect the price, quantity, quality, or delivery terms of this contract.

B. AMBULANCE SERVICES

The contractor shall furnish ambulance service 24 hours per day, 7 days per week, including all holidays for all patients including trips originating at one of the VA facilities.

The average number of daily runs is approximately six (6). The contractor shall provide as many ambulances as necessary to furnish timely service or subcontract the job to another company that meets all the terms and conditions in this contract. Timely service is service that meets the response times indicated in Paragraph C- “Response Time.”

The Contractor’s subcontractor, if any, shall not bill the VA directly and the VA will not pay more than the rates in this contract for all trips performed by the Contractor or their subcontractor. It is the responsibility of the Contractor to pay their subcontractors directly.

The contractor’s business, vehicles and personnel shall be licensed in accordance with the Rhode Island Rules and Regulations Relating to Emergency Medical Services; R23-4.1-EMS and Massachusetts State Rules and Regulations for Emergency Medical Services System; 105 CMR 170.000. with regard to vehicle storage, equipment and supplies as well as required safety inspections and certifications. The VA reserves the right to confirm compliance by viewing the Contractor’s records and/or performing a physical inspection themselves.

Federal HIPPA, state, and local laws shall govern the release of patient information to the contractor. For trips within Massachusetts, upon request and as required by 105 CMR 170.240, the VA shall release relevant patient information, including medical condition at scene. For trips originating outside of Rhode Island and Massachusetts, laws of the state in which the trip originates or federal HIPPA law shall govern the release of patient information.

C. RESPONSE TIME

It is estimated that 85% of all requests for service will be placed by email and 15% by telephone from an authorized representative of the VA Providence Healthcare System. A list of authorized employees will be provided at the time of contract award. Requests may also be completed by in person (by giving a written or verbal request).

PRESCHEDULED TRIPS: It is expected that the contractor will arrive at the prescheduled pickup time for any prescheduled trips.

UNSCHEDULED PICKUPS (Non-Emergency): The contractor shall respond to VA request for ambulance service by arriving at the patient’s place of origin within thirty (30) minutes from the time the order/call is placed by the VA for both unscheduled BLS requests and unscheduled ALS requests. Response time will be calculated from the time of receipt of the request for services.

EMERGENCIES: If at any time the contractor determines that the patient being transported requires emergency medical service, the contractor shall immediately call 911 for emergency services and/or proceed to the nearest emergency room.

LATE PERFORMANCE: If prior to travel or during travel to the beneficiaries’ place of origin the contractor determines that they cannot comply with the response time, the contractor shall notify the appropriate VA travel office immediately.

Upon request, the contractor shall cooperate and furnish to the VA information detailed in the contractor’s dispatch logs, electronic records or equivalent real time recording system, ambulance sheets, or other materials requested.

If available, the Contractor shall sign a “Transport Log” upon arrival at the VA facilities. Contractors may be asked to sign out for items listed but not limited to hospital linens, pillows, and any and all hospital equipment or property moved with a patient for transport.

D. CONTRACTOR EMPLOYEES

Contractor employees shall not be considered Government employees for any purpose. The Providence VAMC reserves the right to restrict any contractor employee from performing services under this contract who does not meet the required qualifications for the services he/she is required to perform and who violates Federal regulations or is identified as a potential threat to the security, safety, health and/or operational mission of the VA and its patient population. The restriction of such contractor personnel shall not relieve the Contractor from performing all the required services, in accordance with all terms, conditions, and schedules contained herein.

Contractor personnel performing services to the Providence VAMC shall conduct themselves in a professional manner, maintain personal hygiene, wear clean, neat uniforms and be identified by having the company name, and employee name affixed to the uniform.

When transporting patients to or from medical facilities, the driver, acting for the Contractor shall ensure that the patient's luggage, medical records, medications, and prosthetic devices are properly accounted for and delivered with the patient as required.

Each patient shall be treated with the utmost of respect and concern, with a professional approach to his/her dignity as an individual and patient. All communication, both verbal and non-verbal, by Contractor's personnel with and in the presence of the patient, will be conducted in a professional manner. The Contractor's personnel shall practice the utmost discretion when discussing the patient's condition with hospital professionals in the presence of the patient, relatives, and/or caregivers.

E. CONTRACTOR PERSONNEL QUALIFICATIONS

All Contractor personnel performing contract services shall meet the qualifications as specified in this contract, as well as any qualifications required by Federal, State, County and local government entities from the place in which they operate. Records of each employee as to name, level, and certification to perform the duties of an ambulance driver or attendant shall be maintained and made available for inspection upon request. The VA requires that all contractor personnel receive a physical verification of safe driving record and drivers check every 2 years, and safety training one time per year. Evidence of successful training shall be provided to the Contracting Office upon request.

EMT-P and EMT-B providing services under this contract shall have the following qualifications, in addition to those required by Federal, State, and Local Government:

· Have completed training in accordance with the standards published by the Department of Health and Human Services (HHS). Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154. Or shall submit evidence of equivalent training program successfully completed to the Contracting Officer.

· Shall attend (at the expense of the contractor) all refresher continuing education, or advance training programs as required by the local or state government entity in which service is rendered. In no instance shall this be less frequent than every two (2) years. Such refresher training shall be equivalent to that developed by the Department of Transportation, National Highway Safety Administration.

· The contractor shall provide its employees with certified training for ventilator operation as there may be a need to transport a patient who is on a ventilation system.

· Ambulance Driver: Drivers shall have a valid operator's or chauffeur's license in accordance with Federal, State, and local government requirements for their place of operation for the services they perform. Drivers shall have EMT-B certification as a minimum.

· All attendants/van drivers on duty must be qualified to administer oxygen and shall have successfully completed the Standard and Advance First Aid Courses of the American Red Cross, U.S. Bureau of Mines, or equivalent. Proof in the form of a current or unexpired certificate that such first aid training has been successfully completed must be available upon request.

F. CONTRACTOR EQUIPMENT, VEHICLES AND INSPECTION

Ambulances shall meet all current applicable Federal, State, and local specifications and regulations including, but not limited to, licensing, registration, and safety standards by the respective states of service. Providence VAMC reserves the right to inspect contractor's equipment and vehicles or require documentation of compliance with contract specifications, State laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulances). Inspections of contractor facilities shall in no way constitute a warranty by Providence VAMC that the contractor's vehicles and equipment are properly maintained. Providence VAMC reserves the right to restrict the Contractor's use of equipment and vehicles which are in need of repair, unclean, unsafe, damaged on the interior or exterior body, and are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the Contractor from performing in accordance with the strict intent and meaning of the contract without additional cost to the government.

Vehicles shall contain:

· An emergency safety kit,

· Portable oxygen unit(s),

· Fire suppression equipment

· Appropriate road emergency warning equipment.

· Written emergency procedures.

· Protective clothing required for the protection of contractor employees where patient care is expected, such as - i) gowns, ii) gloves, iii) masks, etc.

BLS vehicle shall, in conjunction with the above, also provide on-board EMT-B, perform basic airway management, and provide IV at KVO without additives.

ALS vehicle shall, in conjunction with the above, also provide an on-board EMT-P, perform cardiac monitoring, provide Advanced Cardiac Life Support (ACLS) drugs and procedures, and perform advanced airway management and medication monitoring and administration. Advanced airway management means the ability to intubate a patient and provide appropriate respiratory care, including emergency cricothyroidotomy.

Radios shall be adequately powered to provide communication within the regional area as a minimum.

The Contractor shall provide oxygen when it is requested by authorized Providence VAMC facility personnel or required by the patient's medical condition.

With the exception of intravenous administration pumps, the Contractor shall not be permitted to borrow medical equipment from the Providence VAMC facilities. The Contractor shall provide all medications required while in transport, linens and blankets, and other equipment and supplies required for use while in transport for direct patient care. An exception will be made for medications which are outside the realm of what is carried in the vehicle and are case-specific to the patient needs.

Contractor shall at no time and under any circumstances exchange supplies, equipment and/or medications with Providence VAMC (with the exception of intravenous administration pumps, as determined by the transporting facility). The prices quoted in the Price/Cost Schedule (Section B.1. of the contract) shall be inclusive of consumables used in transport. All vehicles used for critical patient care (i.e. ALS, BLS), shall include, but not be limited to, monitors, defibrillator with external pacemaker, intubation equipment, intravenous equipment, medications, patient compartment facilities, oxygen and suction system equipment including portable oxygen suction and accessories. Upon approval by the transporting facility, the Contractor will be allowed to transport the intravenous administration pumps that are delivering a fluid or medication to a patient during transfer. The Contractor shall return the pumps to the lending facility within 72 hours of patient delivery.

G. BILLING

The Contractor shall provide all vehicles and manpower necessary to meet the ALS and BLS transport requirements of this contract. The Contractor will be authorized to utilize other ambulance service companies, as subcontractors (certified to be within all requirements of this contract) to complete these transportation requests. All bills for this subcontractor service will be paid directly to the Contractor at the contract rate, and the Contractor shall reimburse the subcontractor at their agreed to rate. In the event the Contractor is unable to perform services or have services performed as required, the Contractor shall immediately notify the Providence VAMC Travel Section and provide a justification for non-performance. Providence VAMC reserves the right to re-procure services which cannot be performed by the Contractor or its subcontractor in accordance with the terms, conditions, and schedule of this contract. Providence VAMC shall be the sole judge in determining when services will be re-procured.

Should Providence VAMC determine that immediate transportation is essential to prevent loss of life or serious bodily harm, transportation services may be procured via local 911 services without referral or charges to the contractor.

I. SUBSTITUTION OF BENEFICIARY

The Providence VAMC reserves the right to substitute the beneficiary requiring services at any time during the performance of this contract to prevent delays, cancellations, or dry runs. There shall be no additional charge to Providence VAMC when such changes occur.

J. STANDARDS OF CARE

The Contractor shall adhere to the highest quality standards of both patient and medical care. Contractor shall adhere to the city, county, and state protocols established for emergency medical care and transportation. However, Providence VAMC may order specific levels of ambulance service to their campuses or to pick-up patients at other hospitals, nursing homes or patient homes when transporting to Providence VAMC.

K. ELECTRONIC TRANSMISSIONS

The Contractor shall, at all times during the contract period, have on his/her premises a functioning email to communicate requirements with Providence VAMC (i.e., patient incidents, requests for service, special correspondence, etc.).

L. WAITING TIME

In order to be reimbursed for any fifteen-minute Waiting Time periods, the Contractor must submit proof of arrival time (date, location and time from Trip report/GPS.)

Unscheduled trips: Waiting charges shall commence 15 minutes from the time the Contractor arrives at the designated pick-up and/or delivery points.

Prescheduled trips: Waiting charges shall commence 15 minutes from the prescheduled pick-up time or from the time the Contractor actually arrives at the designated pick-up point, whichever is later.

Trips shall be performed by Contractor so that patients are not held at any point to meet another vehicle for the purposes of carpooling unless authorized by the Providence VAMC Travel Clerk.

M. AUTHORIZED PROVIDENCE VAMC HEALTHCARE PERSONNEL

Authorized personnel will be full time staff employed by Providence VAMC. Authorized personnel shall be communicating directly from Government telephones/fax machines/computers from within the facility.

Prior to performance, the Contracting Officer will provide the Contractor with a list of names or position titles and phone numbers of authorized Government personnel who may request services and receive calls from Contractor regarding contract performance. This list will be updated and submitted to the Contractor as changes occur. The Contractor shall ensure that requests for services are received from authorized medical center personnel. Services rendered in response to requests from other than authorized personnel shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor.

N. REQUESTS FOR SERVICES

All requests shall be placed against pertinent schedule items, on a unit price basis, and will be verified against invoices and contractor’s request for service log submitted per Section 20. When ordering services (whether it be by telephone, facsimile, mail, e-mail and/or in person), the Providence VAMC representative will provide the Contractor with the following type of information:

1. Mode of transportation required;

2. Required date and time of arrival;

3. Name and date of birth of beneficiary;

4. Last 4 of social security number

5. Pick-up and delivery point;

6. Type and number of additional medical care specialists required;

7. Type of equipment required; and

Dispatcher Requests for Transportation services shall be made to the contractor personnel identified as seen below:

· Company

· Address

· City/State/Zip

· Contact Person

· Normal Hours Telephone No

· After Hours Contact Person

· After Hours Telephone No.

O. INVOICES

Billing documents shall include a report that (e.g., spreadsheet) shall contain the contract number, date, departure and arrival times, patient’s name, origin and destination addresses, total mileage per trip leg.

Payments for services will be monthly, in arrears, on certified invoices.

The prices listed in the accepted Schedule shall be inclusive of any and all ferry, bridge, tunnel or road toll charges. Contractor shall not invoice Providence VAMC for any such separate charges.

P. REIMBURSEMENT FOR CANCELLED TRIPS

Should Providence VAMC make a determination that a previously scheduled trip must be cancelled, and a vehicle has already been dispatched to the designated pick-up point, Providence VAMC will notify the Contractor to cancel the order.

· Order cancelled when Contractor is already enroute to the designated pick-up: The Contractor will be paid the one-way rate for the trip and applicable mileage, as provided in the Price/Cost Schedule.

· Order cancelled after Contractor arrives at the destination: The Contractor will be paid the one-way rate for the trip and applicable mileage, as provided in the Price/Cost Schedule.

Q. PATIENT RIGHTS

Contractor personnel shall not smoke in facilities or on the ambulance ramp to the Emergency Care Unit. There shall be no smoking within the vehicles by Contractor, beneficiary, or any other passenger.

Patients may bring a reasonable amount of equipment, such as folding wheelchair, consumable medical supplies and personal suitcase.

Each patient shall be provided with safe and comfortable transportation to and/or from the Providence VAMC Healthcare System. The Contractor shall assume the total responsibility for the patient's safety and comfort during the entire transfer process, from the time the Contractor's staff reaches the patient, through the loading and unloading of the patient into the vehicle, and until the time the patient is properly delivered to the professional staff of the medical Center or other final destination.

R. INCIDENT/ ACCIDENT REPORTS

IMMEDIATELY upon any incident/accident involving a Providence VAMC patient being transported or escorted, verbal notification shall be made to the Providence VAMC COR and/or CO with all the facts as they relate to the incident/accident. A written report with a list of the Contractor staff names (drivers/escorts), patient's name, and pertinent information and witnesses shall be filed within forty-eight (48) HOURS OF THE INCIDENT/ACCIDENT with the COR or CO. The report shall be filed no matter how minor the incident/accident appears to be.

The Contractor shall notify the COR in writing within 24 hours of any complaints made by the beneficiaries with regard to the ambulance service. The Contractor may provide recommendations for improved services along with the patient complaints for Providence VAMC review. No recommendation shall be construed as being effective until and unless it is provided as a written modification to the contract from the CO.

S. INFECTION CONTROL PROCEDURES

U.1 TUBERCULOSIS TESTING

- Contractor must provide evidence of negative PPD test within fourteen (14) calendar days prior to an employee with direct patient contact beginning service and annually thereafter.

- Contractor must provide medical evidence that employee is disease free for those employees having a positive PPD.

- In no circumstance will an employee or driver be allowed to begin duty without prior submission of the required testing certification.

U.2. HEPATITIS B VACCINATION

- The employer shall make available the Hepatitis B vaccine and vaccination series within ten (10) days of employment to all contract employees who have direct patient contact and follow-up to all contract employees who have an exposure incident.

- Contractor shall bear all costs associated with vaccinations.

- VA Form 10-5549c, Information about Hepatitis B Vaccine (Recombinant), Consent Form, or VA Form 10-5549d. Hepatitis B Vaccine Declination (Mandatory) (Attachment B) shall be submitted to the Contracting Officer within thirty (30) days of waiver, or completion of the first in the series of the Hepatitis B Vaccine, and at completion of the vaccination series. These forms shall be provided to the contractor upon award of the contract.

T. REQUIRED REPORTS AND DOCUMENTS

1. PATIENT DATA “RUN SHEET”: Contractor shall provide a "Run Sheet" as part of the beneficiary’s permanent record. This Run Sheet shall include a record of the beneficiary’s vital signs, medications used, oxygen use, beneficiary’s attitudes and any changes in the beneficiary's condition. The list stated herein shall not be construed to be as all inclusive; the Contractor shall provide all pertinent information.

2. CONTRACTOR AUTHORIZED REPRESENTATIVES: The contractor shall provide a list with the names, addresses, telephone numbers, and emails of authorized Contractor representative(s) who have the binding authority to act on behalf of the Contractor on administrative and/or performance matters pertaining to this contract.

U. CONTRACTOR’S QUALITY CONTROL PLAN (QCP)

The Contractor shall develop and maintain an effective Quality Control Plan (QCP) to ensure services are provided in accordance with Performance Work Statement. The Contractor shall develop and implement procedures to identify, prevent and ensure non-recurrence of defective services. The Contractor’s QCP is the means by which he assures himself that his work complies with the requirements of the contract. The QCP shall be submitted as part of the Contractor’s Quotation. Any changes made to the QCP after contract award shall be submitted to the Contracting Officer for acceptance in writing prior to implementation.

V. CONTRACTOR'S RESPONSIBILITIES AND INSURANCE REQUIREMENTS

The Contractor shall obtain all necessary licenses and/or permits required to perform this work. The Contractor shall take all precautions necessary to protect persons and property from injury or damage during the performance of this contract. The Contractor shall be responsible for any injury to themselves, their employees, or others, as well as for any damage to personal or public property that occurs during the performance of this contract that is caused by his or his employees' actions and/or negligence. The Contractor shall maintain personal liability, automobile liability, and property damage insurance, as prescribed by the laws of the states, and in accordance with Federal and VA Acquisition Regulations herein. Evidence of coverage shall be submitted to the Contracting Officer before commencing work under this contract (copy of Certificate of Insurance), and it shall not be changed or cancelled without thirty (30) calendar days prior written notice to the Contracting Officer.

W. SERVICE CONTRACT LABOR STANDARDS

The solicitation and subsequent contact include FAR 52.222-41, Service Contract Labor Standards (SCLS). The Offeror and resultant contract awardee, by signing the offer and contract, is acknowledging they have reviewed the clause and will fully comply throughout the contract period. It is the responsibility of the Contractor to determine and pay the appropriate prevailing wage rate and fringe benefits for the location. The Government will not be held responsible for any mistakes in applying the SCLS.

VA reminds contractors of the Department of Labor Regulations which implement the SCLS and which read at 29 CFR § 4.115:

Employee coverage does not depend on form of employment contract. The Act, in section 8(b), makes it plain that the coverage of service employees depends on whether their work for the contractor or subcontractor on a covered contract is that of a service employee as defined in section 8(b) and not on any contractual relationship that may be alleged to exist between the contractor or subcontractor and such persons. In other words, any person, except those discussed in §4.156 below, who performs work called for by a contract or that portion of a contract subject to the Act is, per se, a service employee. Thus, for example, a person's status as an “owner-operator” or an “independent contractor” is immaterial in determining coverage under the Act and all such persons performing the work of service employees must be compensated in accordance with the Act's requirements.

X. DISPOSAL OF HAZARDOUS WASTE

The Contractor shall not dispose of any hazardous materials at any location on the Providence VAMC premises except as specified by the Contracting Officer.

Y. SALES OF COMPANIES OR NAME CHANGES

The Contractor gaining award of the contract shall notify the Contracting Officer, Department of Veterans Affairs, Contracting Officer (90C) in writing immediately upon entering an agreement (either oral or written) to sale or transfer all or part of its stock or other ownership interest to any other party. Contractor shall also contact the Contracting Officer immediately in writing in the event a company name change will happen, with information as to the reasons and/or determinations causing this action.

Z. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA), PRIVACY RULE, AND SECURITY RULE

1. Because the Contractor will have access to Protected Health Information (PHI) and Electronic Protected Health Information (EPHI) and is considered a covered entity, the Contractor is subject to regulations and guidelines issued by the Department of Health and Human Services, as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 CFR Parts 160 and 164, Subparts A and E, the Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”), and 45 CFR Parts 160 and 164, Subparts A and C, the Security Standard (“Security Rule”); and whereas, Department of Veterans Affairs Veterans Health Administration is a “Covered Entity” as that term is defined in the HIPAA implementing regulations, 45 CFR 160.103.

2. Patient Privacy and Confidentiality: All "patient papers" transported with the patient are confidential in accordance with HIPPA. Contractor's personnel may review these records for assessment and treatment purposes only. Appropriate administrative and medical information will be provided to the Contractor for patient transport. If the medical record is transported with the patient, it may be used as a source of information if the situation warrants (i.e. emergent care while in-route). In all other instances, all documents will remain intact and sealed.

AA. CONTRACT DEFINITIONS AND ACRONYMS

Advanced Life Support (ALS) - ALS shall be provided by ambulance vehicles containing at a minimum, an on-board EMT-P, cardiac monitoring, Advanced Cardiac Life Support (ACLS) drugs and procedures, advanced airway management and medication monitoring and administration. Ambulances for ALS services shall be staffed, certified, and licensed in accordance with current laws and regulations governing the certification and licensure of private ambulances by the respective states of service, and all ALS services shall be in accordance with current laws and regulations by the respective states of service.

Basic Life Support (BLS) - BLS is defined as services required for non-critical patient care in which patient requires an ambulance, which has been staffed, certified, and licensed in accordance with current laws and regulations governing the certification and licensure of private ambulances by the respective states of service. All BLS services shall be in accordance with current laws and regulations by the respective states of service. The ambulance at a minimum shall be staffed with a vehicle operator and an Emergency Medical Technician (EMT) - Basic Ambulance, basic airway management, and IV's at Keep Vein Open (KVO) without additives.

Base Rate: Base Rate is defined as the rate paid for one‐way transportation and handling of a patient, from a designated pick‐up point to a designated delivery point. This rate will be paid for all authorized one‐way trips ordered under this contract action up to 25 miles.

Beneficiary - Veterans and other members determined to be eligible for benefits by the Veterans Administration (VA).

Business Hours/Days - Business hours/days are defined as the time of 8:00AM to 4:30PM, Monday through Friday, except Federal holidays. The Federal Government observes the following days as holidays.

*If the date of the holiday falls on a Saturday, the Government holiday is the preceding Friday. If the date of the holiday falls on a Sunday, the Government holiday is the following Monday.

In addition to the days designated as holidays, the Government observes the following days:

· Any other day designated by Federal Statute

· Any other day designated by Executive Order

· Any other day designated by the President’s Proclamation

Off-Business hours/days are defined as the time of 4:31PM to 7:59AM, Monday through Friday, all day Saturday, all day Sunday, and Federal holidays.

Contracting Officer (CO) – Veterans Administration official with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings. Any changes to a resultant contract may only be made through a written modification as prepared and executed by the CO.

Contracting Officer’s Representative (COR) - VA official responsible for providing contract oversight and technical guidance to the Contracting Officer. COR responsibilities will include, but not be limited to: surveillance of services required under this contract, determining the adequacy of Contractor performance according to the specifications of this contract, acting as the Government's representative, ensuring compliance with contract requirements insofar as the work is concerned, certification of invoices, placing orders for service, providing technical guidance, overseeing technical aspects of the contract, and serves as a member on the vehicle inspection team. The COR cannot authorize deviations from the specifications and requirements of this contract. In the event the Contractor deviates without approval from the CO, such deviation shall be at the risk of the Contractor and any cost related thereto shall be borne by the Contractor. The POC will be designated in writing by the CO after contract award.

Contractor - The term "Contractor" as used herein refers to both the prime Contractor, their employees, and any subcontractors and their employees. The Contractor shall be responsible for assuring that their subcontractors comply with the provisions of this contract.

Joint Commission - A national organization dedicated to improving the care, safety and treatment of patients in a health care facility and environment.

Prescheduled Trip(s) - The term "Prescheduled Trip" as used in this contract refers to those trips in which the Contractor has been given advance notice (advance notice is defined as a notice given by 4:00 p.m. the prior business day) of required services and a specific pick-up time and location.

Quality Assurance - Those actions taken by the Government to assure services meet the requirements of this contract.

Quality Assurance Surveillance Plan - An organized written document used for quality assurance surveillance. The document contains specific methods for performing surveillance of the Contractor's continuous performance.

Quality Control - Those actions taken by the Contractor to control the production of goods or services so they will meet the requirements of a contract.

Rate - Rate is defined as the rate paid for one-way transportation from a designated pickup point to a designated delivery point. This rate will be paid for all authorized one-way trips ordered under this contract action.

Unscheduled Trips(s) - The term "Unscheduled Trip" as used in this contract refers to those trips required on an as needed basis and advance notice is not given.

Waiting: Waiting, as used in this solicitation/contract, is defined as the time required and verified by authorized medical facility personnel for the contractor to wait at designated pick‐up and/or delivery points commencing after the required arrival check‐in with the individual(s) scheduling the travel.

Waiting Grace Period: The Waiting Grace Period is defined as fifteen (15) minutes prior to the time waiting charges commence. The base rate for ambulance services shall include a fifteen (15) minute waiting grace period at origin and destination. After the 15‐minute grace period charges are applied in 15‐minute increments.

COVID-19 INFORMATION AND REQUIREMENTS

VHA Supplemental Contract Requirements for Ensuring Adequate COVID-19 Safety Protocols for Federal Contractors

1. Contractor employees who work in or travel to VHA locations must comply with the following:

a. Documentation requirements:

1) If fully vaccinated, shall show proof of vaccination.

i. NOTE: Acceptable proof of vaccination includes a signed record of immunization from a health care provider or pharmacy, a copy of the COVID-19 Vaccination Record Card (CDC Form MLS- 319813_r, published on September 3, 2020), or a copy of medical records documenting the vaccination.

2) If unvaccinated and granted a medical or religious exception, shall show negative COVID-19 test results dated within three calendar days prior to desired entry date. Test must be approved by the Food and Drug Administration (FDA) for emergency use or full approval. This includes tests available by a doctor’s order or an FDA approved over-the-counter test.

3) Documentation cited in this section shall be digitally or physically maintained on each contractor employee while in a VA facility and is subject to inspection prior to entry to VA facilities and after entry for spot inspections by Contracting Officer Representatives (CORs) or other hospital personnel.

4) Documentation will not be collected by the VA; contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

2. Contractor employees are subject to daily screening for COVID-19 and may be denied entry to VA facilities if they fail to pass screening protocols. As part of the screening process contractors may be asked screening questions found on the COVID-19 Screening Tool. Check regularly for updates.

a. Contractor employees who work away from VA locations, but who will have direct contact with VA patients shall self-screen utilizing the COVID-19 Screening Tool, in advance, each day that they will have direct patient contact and in accordance with their person or persons who coordinate COVID-19 workplace safety efforts at covered contractor workplaces. Contractors shall, at all times, adhere to and ensure compliance with federal laws designed to protect contractor employee health information and personally identifiable information.

3. Contractor must immediately notify their COR or Contracting Officer if contract performance is jeopardized due to contractor employees being denied entry into VA Facilities.

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

The guaranteed minimum amount for this contract is $239,175.00. This minimum is applicable to the current fiscal year. The maximum aggregate value of orders including options is $5,500,000.00. The VA does not guarantee that it will place orders under this contract beyond the guaranteed minimum

ALS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

Contract Period: Base POP Begin: 07-01-2022 POP End: 06-30-2023

ALS - MILEAGE RATE PER MILE BEYOND 25 MILES OF PICKUP LOCATION (LOADED)

BLS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

BLS - MILEAGE RATE PER MILE BEYOND 25 MILES OF PICKUP LOCATION (LOADED)

WAITING PERIOD - 15 MINUTE INCREMENTS

ALS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

Contract Period: Option 1 POP Begin: 07-01-2023 POP End: 06-30-2024

ALS - MILEAGE RATE PER MILE 25 MILES OF PICKUP LOCATION (LOADED)

BLS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

BLS - MILEAGE RATE PER MILE BEYOND 25 MILES OF PICKUP LOCATION (LOADED)

WAITING PERIOD - 15 MINUTE INCREMENTS

ALS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

Contract Period: Option 2 POP Begin: 07-01-2024 POP End: 06-30-2025

ALS - MILEAGE RATE PER MILE 25 MILES OF PICKUP LOCATION (LOADED)

BLS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

BLS - MILEAGE RATE PER MILE BEYOND 25 MILES OF PICKUP LOCATION (LOADED)

WAITING PERIOD - 15 MINUTE INCREMENTS

ALS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

Contract Period: Option 3 POP Begin: 07-01-2025 POP End: 06-30-2026

ALS - MILEAGE RATE PER MILE 25 MILES OF PICKUP LOCATION (LOADED)

BLS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

BLS - MILEAGE RATE PER MILE BEYOND 25 MILES OF PICKUP LOCATION (LOADED)

WAITING PERIOD - 15 MINUTE INCREMENTS

ALS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

Contract Period: Option 4 POP Begin: 07-01-2026 POP End: 06-30-2027

ALS - MILEAGE RATE PER MILE 25 MILES OF PICKUP LOCATION (LOADED)

BLS - ANY TRIP WITHIN 25 MILES OF PICKUP LOCATION

BLS - MILEAGE RATE PER MILE BEYOND 25 MILES OF PICKUP LOCATION (LOADED)

WAITING PERIOD - 15 MINUTE INCREMENTS

Page 1 of

SECTION C - CONTRACT CLAUSES

ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

The following clauses are incorporated into 52.212-4 as an addendum to this contract:

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

http://www.acquisition.gov/far/index.html http://www.va.gov/oal/library/vaar/