36C24122Q0552.docx
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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.
UEI:
EFT:
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. SIGNAT
URE 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
Per VISN site Funded per Task Order 36C24122Q0552 09-19-2022 Mercedes Blanton, Mercedes.Blanton@va.gov
401-273-7100 X21584 10-19-2022
10AM
EDT
Department of Veterans Affairs Regional Procurement Office East (RPO-E) Contracting Officer (90c) 830 Chalkstone Avenue Providence RI 02908 Mercedes Blanton, (401) 273-7100 x21584 Mercedes.Blanton@va.gov X X Y 562112 $41.5 Million N/A X Department of Veterans Affairs Regional Procurement Office East (RPO-E) VISN 1 sites throughout the New England States
Department of Veterans Affairs Regional Procurement Office East (RPO-E) Contracting Officer (90c) 830 Chalkstone Avenue Providence RI 02908
All invoices from the Contractor shall be submitted electronically as per VAAR Clause 852.232-72 Electronic Submission of Payment Request.
Austin TX 78714-9971 1 (877) 353-9791
(512) 460-5429 See CONTINUATION Page Contractor shall provide all equipment, labor, materials, apparatus, tools, transportation, supervision, permits and disposal necessary to perform regulated medical waste and sharps disposal services for VISN 1, New England as identified in the Performance Work Statement (PWS) and attached service schedules in section D.
Period of Performance:
Base Year: 11/01/2022 - 10/31/2023 Option Year One (1): 11/01/2023 - 10/31/2024 Option Year Two (2): 11/01/2024 - 10/31/2025 Option Year Three (3): 11/01/2025 - 10/31/2026 Option Year Four (4): 11/01/2026 - 10/31/2027 The attachment D.1 Wage Determinations applies to the base period of performance.
All quotes shall be emailed to Mercedes Blanton at, Mercedes.Blanton@va.gov on or before the due date and time.
See CONTINUATION Page Per VISN 1 site via a funded document X X X Mercedes Blanton
VA-VHA-SAOE-2016-70627244
Table of Contents
| SECTION A | 1 |
| A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES | 1 |
| SECTION B - CONTINUATION OF SF 1449 BLOCKS | 4 |
| B.1 CONTRACT ADMINISTRATION DATA | 4 |
| B.2 PERFORMANCE WORK STATEMENT (PWS) | 5 |
| B.3 PRICE/COST SCHEDULE | 20 |
| ITEM INFORMATION | 20 |
| SECTION C - CONTRACT CLAUSES | 46 |
| C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021) | 46 |
| C.2 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998) | 52 |
| C.3 SUPPLEMENTAL INSURANCE REQUIREMENTS | 52 |
| C.4 52.216-18 ORDERING (AUG 2020) | 53 |
| C.5 52.216-19 ORDER LIMITATIONS (OCT 1995) | 53 |
| C.6 52.216-22 INDEFINITE QUANTITY (OCT 1995) | 54 |
| C.7 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) | 54 |
| C.8 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF COMMERCIAL ITEMS (APR 2020) | 56 |
| C.9 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND COMPLIANCE (JUL 2018) | 58 |
| C.10 VAAR 852.219-77 VA NOTICE OF LIMITATIONS ON SUBCONTRACTING—CERTIFICATE OF COMPLIANCE FOR SERVICES AND CONSTRUCTION (SEP 2021) (DEVIATION) | 58 |
| C.11 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020) | 60 |
| C.12 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2022) (JUL 2020) (DEVIATION) | 60 |
| SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS | 69 |
| D.2 WAGE DETERMINATION | 69 |
| D.2 TOGUS SERVICE SCHEDULE. | 72 |
| D.3 WRJ SERVICE SCHEDULE. | 72 |
| D.4 BEDFORD SERVICE SCHEDULE. | 72 |
| D.5 BOSTON SERVICE SCHEDULE. | 72 |
| D.6 CWM SERVICE SCHEDULE. | 72 |
| D.7 MANCHESTER SERVICE SCHEDULE. | 72 |
| D.8 PROVIDENCE SERVICE SCHEDULE. | 72 |
| D.9 CONNECTICUT SERVICE SCHEDULE. | 72 |
| D.10 BOSTON DETAIL LOCATIONS. | 72 |
| D.11 TOGUS Estimated Weights FY19-21. | 72 |
| D.12 WHITE RIVER JUNCTION Estimated Weights FY19-21. | 72 |
| D.13 BEDFORD Estimated Weights FY19-21. | 72 |
| D.14 BOSTON Estimated Weights FY19-21. | 72 |
| D.15 MANCHESTER Estimated Weights FY19-21. | 72 |
| D.16 CENTRAL WEST MASS Estimated Weights FY19-21. | 72 |
| D.17 PROVIDENCE Estimated Weights FY19-21. | 72 |
| D.18 CONNECTICUT Estimated Weights FY19-21. | 72 |
| D.19 CENTRAL STAGING. | 72 |
| SECTION E - SOLICITATION PROVISIONS | 73 |
| E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2021) | 73 |
| E.2 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998) | 77 |
| E.3 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021) | 78 |
| E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018) | 80 |
| E.5 52.216-1 TYPE OF CONTRACT (APR 1984) | 82 |
| E.6 52.233-2 SERVICE OF PROTEST (SEP 2006) | 82 |
| E.7 52.212-2 EVALUATION—SIMPLIFIED ACQUISITION PROCEDURES | 82 |
| E.8 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2022) (JUL 2020) (DEVIATION) | 84 |
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 Mercedes Blanton Department of Veterans Affairs Regional Procurement Office East (RPO-E) Contracting Officer (90c) 830 Chalkstone Avenue Providence RI 02908
2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:
| [X] |
| 52.232-33, Payment by Electronic Funds Transfer—System For Award Management, or |
| [] |
| 52.232-36, Payment by Third Party |
3. INVOICES: Invoices shall be submitted in arrears:
| a. Quarterly | [] |
| b. Semi-Annually | [] |
| c. Other | [X] Monthly |
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.
vafsccshd@va.gov ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:
| AMENDMENT NO |
| DATE |
36C24122Q0552
Page 1 of Page 1 of
B.2 PERFORMANCE WORK STATEMENT (PWS)
REGULATED MEDICAL WASTE AND SHARPS DISPOSAL SERVICES
1. GENERAL:
Contractor shall be responsible for allocating all equipment and personnel, including back-up resources, to meet all requirements for the comprehensive management of the infectious waste for the responsible VISN 1, Medical Center(s) throughout New England and all affiliated facilities. The comprehensive waste services shall not only include the collection and disposal of the waste, but also the training and support required to ensure compliance with all Federal, State, and Local regulations. The Contractor shall provide regularly scheduled pickup and subsequent recycling/disposal of Regulated Medical Waste (RMW), Pathological Waste, Other Potentially Infectious Material (OPIM) and Trace Chemotherapy waste for their responsible VISN 1 Medical Center(s) throughout New England and all affiliated facilities. It shall be the responsibility of the Contractor to provide the tracking and reports in a timely manner, and action plans to address any shortfalls. The Government will evaluate each site separately therefore contractor shall quote for each site they chose to be responsible for.
2. BACKGROUND:
VISN 1: New England Healthcare System is an integrated healthcare system comprised of Medical Centers, and many community-based outpatient clinics located throughout New England.
VISN 1: New England Healthcare System provides ambulatory care, primary care, and secondary care in acute medicine and surgery, specialized tertiary care, transplant services, spinal cord injury, outpatient care, and a full range of extended care and mental health services.
The Government reserves the right to make eight multiple single awards based on the evaluation. Contractors can submit a quote for one site or multiple sites but only one contractor will be selected for each site. The Government will award a Firm Fixed Price Multiple Award Indefinite Delivery Indefinite Quantity (IDIQ) contract to provide regulated medical waste and sharps disposal services. The Government is breaking the areas into eight sites by facilities. 1. Togus, ME, 2. White River Junction, VT, 3. Bedford, MA, 4. Boston Healthcare System, 5. Manchester, NH, 6. Central Western Massachusetts (Northampton), 7. Providence, RI and 8. Connecticut Healthcare System. The Government intends to select one contractor for each area with an opportunity of one contractor to be selected for multiple areas. Performance will be at various locations servicing eights VA facilities throughout New England and their related sites as seen below and will be determined at the individual task order level. The Government intends to make multiple single awards and will place a task order for the for each location.
3. PERIOD OF PERFORMANCE:
| Base Year: | 01 November 2022 – 31 October 2023 |
| Option One (1): | 01 November 2023 – 31 October 2024 |
| Option Two (2): | 01 November 2024 – 31 October 2025 |
Option Three (3): 01 November 2025 – 31 October 2026 Option Four (4): 01 November 2026 – 31 October 2027
4. PLACES OF PERFORMANCE:
Medical Waste Locations:
| a. |
| VA Togus Medical Center and affiliated facilities |
| b. |
| VA White River Junction Medical Center and affiliated facilities |
| c. |
| VA Bedford Medical Center and affiliated facilities |
| d. |
| VA Boston Healthcare System and affiliated facilities |
| e. |
| VA Manchester Medical Center affiliated facilities |
| f. |
| VA Central Western Massachusetts affiliated facilities |
| g. |
| VA Providence Medical Center affiliated facilities |
| h. |
| VA Connecticut Healthcare System affiliated facilities |
*See attached document for full list of each participating facility; see section D, Attachments D.2-D.10.
5. FREQUENCY OF SERVICE(s) PROVIDED:
Current Services Only: see attached documents in section D, Attachments D.2-D.10 for Service Schedules for each participating facility.
*Note. The Government may need to add or change container locations or service needs as they become necessary in the future.
6. DAYS AND HOURS OF OPERATION:
This contract is a full-service contract to include all necessary service calls, five (5) days per week, eight (8) hours per day, between the hours of 7:00 a.m. to 4:30 p.m., Monday through Friday, National Holidays excluded.
7. PERFORMANCE REQUIREMENTS:
a. Contractor shall provide pick up, transport and disposal of RMW, Pathological Waste, OPIM and Trace Chemotherapy waste from Medical Center(s) that correlate to its award. Each medical center has a different process and method of disposing and transport of their waste; see Attachments D.10-D.17 for each facilities process. The awarded contractor shall review the processes and methods with VA’s assigned Contracting Officer Representative or Program Manager prior to the beginning of performance. Regulated Medical Waste includes "Biohazardous Waste", "Infectious Waste”, or any waste material or article which harbors, or may reasonably be considered to harbor pathogens which might be expected to produce disease in healthy individuals. RMW subject to these requirements includes wastes that generally have been considered infectious or potentially infectious by the health care community as well as waste originating from health care or research facilities that are aesthetically objectionable and thus, problematic when disposed of improperly. The following is a listing of RMW that are, included in the scope of this contract:
a. Cultures and stocks.
b. Pathological waste.
c. Trace Chemotherapy
d. Human blood and blood products.
e. Sharps
f. Isolation waste.
g. Unused sharps.
h. Glass specimen slides.
*Note. The Government may need to add various types of waste as they become necessary in the future.
b. “Trace Chemotherapy” waste includes items that are potentially, or have been, contaminated by antineoplastic agents or chemotherapy drugs provided that such items, including vials and syringes shall be empty or contain only such trace amounts of these drugs as are allowable under applicable Federal, State, Local laws regulations and guidelines to be considered waste.
c. In accordance with the applicable laws and regulations the preferred method of disposal is by incineration, the VA may accept disposal for Regulated Medical Waste and Sharps disposal by sterilization or incineration. Pathological and Trace Chemotherapy waste shall be incinerated.
d. Note. A seamless changeover transition with the incumbent contractor and the awardee shall happen in a timely manner but no longer than 45 days from time of award.
8. REGULATED MEDICAL WASTE MANAGEMENT AND DISPOSAL (RMW):
The shipping papers are to be in compliance with the requirements for the US DOT.
The contractor must be able to provide containers designed and dedicated solely for the collection of regulated medical waste. The only use for these containers shall be for the transportation of regulated medical waste. Boxes shall not be acceptable for the packaging of the regulated medical waste and sharps, only carts shall be used to minimize handling by the staff at the facilities.
All regulated medical waste that requires incineration shall be brought to a central staging area; location will be identified by each facility in attachment D.19 located in section D.
All pathological waste and trace chemotherapeutic waste collected from the facilities must be incinerated. The VA will be responsible for the segregation of waste in accordance with Federal, State, and Local requirements. All pathological waste and trace chemotherapeutic waste are collected in leak and puncture proof containers and will be packaged in corrugated boxes to ensure it is properly treated.
The Contractor shall provide leak and puncture proof reusable containers with lids that can be secured for transportation of the regulated medical waste. Contractor shall provide labeling on all containers of regulated waste with the following information at a minimum:
a. Name of transporter or immediate handler.
b. “Regulated Medical Waste”
c. UN3291
d. Bar-coded labels identifying the generator
Regulated medical waste liners shall be provided by the Contractor for the containers provided on each delivery. The liners shall meet the following certifications:
1. Impact resistance as prescribed in ASTM D 1709.04
2. Tear resistance as prescribed in ASTM D 1922.03a
The containers must be designed so it can be easily and safely handled by the VA staff. It should also be designed so that it can be easily secured and transported within the facility by the VA staff. The size of the container must preapproved by the Contracting Officer Representative (COR) and the facility. The Contractor must ensure that containers being delivered to the sites are sanitized and disinfected.
Pickup and delivery by the Contractor is required for each site. Full containers shall be removed from the designated storage area at each site and replaced with empty containers. The replacement containers are required to be sanitized and disinfected. The replacement containers shall be placed within the designated empty container storage area at each site. Delivery and pickup must be made at a time agreed upon by the COR or Program Manager. Scheduled arrangements shall be made in the best interest of the VA to ensure ample dock space is available.
Note: Scheduled pickup and delivery schedules as identified in the service schedules in section D are subject to change upon agreement by the COR and the Contractor.
Transportation vehicles shall be equipped with fully enclosed leak-resistant cargo body maintained in a sanitary condition and secured when left unattended. Vehicles shall bear the transporter's name, state permit number if required, and the words "Regulated Medical Waste" on the sides of the body. Waste shall not be subject to mechanical stress. Regulated medical waste shall not be combined with other wastes, such as solid waste or recyclables. Regulated medical waste shall be secured prior to leaving the VA facility. The waste shall remain on the permitted vehicle at all times and shall be unloaded at the appropriate disposal or transfer facility. The facility shall be permitted to accept regulated medical waste.
Contractor shall immediately notify the appropriate agencies, and the generator, if a vehicle is involved in a spill or accident which renders the vehicle non-compliant with applicable rules and regulations.
The contractor shall furnish, sign, and date a properly prepared manifest prior to removing the regulated medical waste from the facility. The VA designated employee and the transporter shall certify that the manifest data matches the contents of the load to be transported. A ticket or copy of the manifest will be left with the facility to verify the waste has been removed. The contractor shall deliver the waste to an authorized disposal facility. The disposal facility shall sign the manifest to verify that the regulated medical waste has been delivered and accepted. The contractor shall maintain a copy of the manifest for a minimum of 3 years. Contractor shall return a copy of the manifest to the generator, assuring final disposal.
The VA reserves the right to thoroughly inspect the Contractor's disposal facility to assure acceptable standard of performance.
Contractor shall maintain a log of regulated medical waste shipments. The log shall identify the quantities of regulated medical waste shipped.
9. TRAINING REQUIREMENTS
Due to the health and safety risks (especially Bloodborne Pathogens) associated with this requirement, the Contractor’s methods, procedures, training and other controls that are proposed must allow the performance of the tasks with no adverse effects from the risk factors.
Annually, at no cost to the Government, the contractor will conduct training with all contractor employees that meets or exceeds the requirements of the Department of Transportation, and any other training required by other regulatory entities that may apply to handling shipping of Regulated Medical Waste and Sharps.
The training plan shall demonstrate a good working knowledge of the US DOT, US Occupational Health and Safety (OSHA), and other applicable regulations that govern the health and safety risks involved in the handling and shipping of regulated medical waste. The contractor must be able to provide, at a minimum, the following training:
- US DOT
- HAZMAT Familiarization
- Function Specific
- Shipping Papers
- Proper Packaging
- Safety
- Security Awareness/In-Depth Security
- OSHA Bloodborne Pathogens Standard
10. SPECIAL CONTRACT REQUIREMENTS
a. QUALIFICATIONS:
1. Contractor shall have demonstrated at least three years’ experience servicing at least three similar size hospitals (individual hospitals)/ (demonstrating VISN combined services is beneficial but not required) by submitting a list of references including telephone numbers, addresses, and contact names.
2. Contractor shall provide a plan to demonstrate that they are capable of providing ongoing requirements and services in the event of service disruptions for any reason. Contractor shall provide information for primary and back-up sites for the following: regulated medical waste disposal services, reusable sharps container exchange services.
3. Contractor shall provide a complete background of their company as well as any company utilized to sustain this contract. Information will include but is not limited to company’s full legal name, primary business address, all other office locations (city and state), and history, along with the number of years in business.
4. Contractor shall demonstrate their ability to convert the VA locations to their services within 45 days after award of the contract.
5. Contractor shall have in place and maintain a valid contingency plan to meet the requirements of the contract. Contractor shall incur all cost associated with fulfilling this contingency plan at no additional expense to the Government. Contractor shall be liable for all expenses incurred by the Government due to the contractor's inability to perform in accordance with these requirements.
6. Contractor is required to identify any subcontractors and suppliers. Contractor is responsible for supervision, contract compliance and obtaining any necessary documentation from their subcontractors or supplies performing under this contract. If the contractor intends to utilize subcontractors and suppliers other than those initially identified, operating licenses, permits, certificates and any other forms required by regulatory agencies for the new subcontractor(s) must be submitted to the Contracting Officer no later than thirty (30) days prior to change. Any and all cost increases to meet additional regulatory requirements caused by such change of disposal facilities or any other contractor action relative to transport, storage, and/or disposal of regulated medical waste shall be borne by the contractor.
b. CONTRACTOR PERSONNEL
1. The contractor shall provide a contract manager who is responsible for the performance/coordination of work defined in this contract. The name and phone numbers (during and after hours) of this person and alternate(s), who shall act for the contractor when the manager is absent, shall be designated in writing to the Contracting Officer and Contracting Officer Representative no later than fifteen (15) days prior to the contract start date. The contract manager and alternate(s) shall be able to understand, read, fluently speak, and legibly write the English language. This person may perform services under this contract in addition to contract management duties. The contract manager or alternate shall have full authority to act for the contractor in all contractual matters relating to daily operation of this contract. All personnel changes must be provided in writing to the Contracting Officer and Contracting Officer Representative no later than forty-eight (48) hours prior to the implementation of such changes.
2. Contractor shall provide their employees with appropriate protective clothing, equipment, and apparel as prescribed by the Occupational Safety & Health Administration (OSHA). The technician shall be dressed neatly in appropriate uniform and wear an identification badge at all times when servicing at the VA facility.
3. Contractor shall provide details of what training their employees undergo. Contractor shall be available for consultation and education to Medical Center's staff on the proper use of reusable sharps containers.
4. The contractor shall provide all training necessary to perform the work as defined in this contract. Training shall not hamper the quantity, quality, or timeliness of work requirements of the contract.
5. The contractor shall ensure that all employees understand the risks involved with regulated medical waste and are trained in specific procedures to handle spills on the VAMC premises, and in route to a treatment facility.
6. Contractor employees who pick up regulated medical waste from the VAMC are identified as being susceptible and/or occupationally at risk to certain biological hazards. The contractor shall provide these employees with the required immunizations.
11. PROTECTION OF GOVERNMENT PROPERTY:
During work execution, the Contractor shall take special care to protect Government property including interior and exterior buildings, furniture, walls, baseboards, and other surfaces. Damage resulting from Contractor operations shall be repaired by the Contractor, including painting, refinishing, or replacement (if necessary), at no additional cost to the Government. Contractor shall be responsible to meet all OSHA/Safety requirements in the performance of the work. This shall include but not be limited to taking all the necessary precautions to protect the patients, visitors and/or staff at each location. Contractor shall be held responsible for any injuries and/or damage, which may be caused as a result of the Contractors failure to adhere to these requirements.
12. PRE-AWARD SURVEY:
Prior to award of this contract, the VA may conduct a pre-award survey to assess the Contractor on the following conditions:
| a. | Overall safety and sanitation of processing facility being used |
| b. | Evidence of applicable licenses |
| d. | Manifest tracking techniques and storage |
| e. | Ability to provide continuous, uninterrupted service |
Failure of any of the above pre-award aspects may be taken into consideration during the Technical Evaluation process in determining the offeror’s ability to successfully perform the services.
13. PERMITS AND RESPONSIBILITIES:
The Contractor shall, without additional expense to the Government, be responsible for obtaining any necessary licenses and permits, and for complying with any applicable Federal, State, local laws, codes, and regulations in connection with the prosecution of the work. This includes acquiring any installation listed in this contract. The contractor shall be similarly responsible for all damages to persons or property. The contractor shall take proper safety and health precautions to protect the work, the workers, the public and the property of others. The contractor shall also be responsible for all materials delivered and work per-formed until completion and acceptance of the entire work.
14. QUALITY ASSURANCE PLAN:
The contractor shall develop and maintain a quality program to ensure refuse and recycling services are performed in accordance with commonly accepted commercial practices. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. As a minimum, the Contractor shall develop quality control procedures addressing the areas identified in the next paragraph.
The Government will periodically evaluate the contractor performance by appointing a representative(s) to monitor performance to ensure service are received. The Government may inspect each task as completed or increase the number of quality control inspections if deemed appropriate. Likewise, the Government may decrease the number of quality control inspections if performance dictates.
15. COMMUNICATION:
The Contractor must be capable of sending and receiving e-mails and faxes, communicate with the Project Manager, communicate with service vehicles regularly to determine locations and relay service-related messages, and send/receive electronic data files. Communication shall be critical in ensuring no interruption of services. Communication shall include how waste will be collected, manifested, and treated. The communication shall be very important to ensure compliance.
16. PROJECT MANAGEMENT:
Contractor shall provide a highly qualified project manager with strong support from management as this shall be essential to successfully performing these requirements day to day over an extended period of time. The project manager shall be able to identify the organizational structure proposed to direct these operations. The management team members shall be able to be identified along with a description of qualifications and relative experience. Contractors should not view this as simply a trash disposal service. This requirement is broad and diverse and requires an integrated, involved management approach to deliver these services successfully.
17. HEALTH & SAFETY:
The Health and Safety shall demonstrate a good working knowledge of the US DOT, US Occupational Health and Safety (OSHA), Department of Health for specific state and other applicable regulations that govern the health and safety risks involved in the handling and shipping of regulated medical waste. All tasks with potential health and safety risks shall be identified along with the proposed control measures to ensure minimal exposure to minimize risk. The Contractor agrees that his personnel and equipment are subject to safety inspections by Government personnel while on Federal property. The Contractor shall ensure that all personnel involved in the handling, repackaging, and transportation of the items listed herein shall be trained in the areas of spills, and general first aid procedures.
The contractor is responsible for all spills or leaks that occur during the performance of this contract. The contractor agrees to clean up all spills or leaks to the satisfaction of all federal, state, local agencies, or other authority having jurisdiction. No cost for spill or leak cleanup will be charged to the Department of Veterans Affairs. The contractor shall provide a written emergency plan that outlines a formalized response to any accidents, spills or leaks that occur while the contractor is performing work for the facility.
18. REPORTS:
The contractor shall provide the VA POC, Contracting Officers Representative (COR) and GEMS Program Manager with manifests for all RMW, Pathological Waste, OPIM and Trace Chemotherapy waste removed from each site. The manifests (Shipping Papers) shall be compliant with federal and state regulations. This includes, but is not limited to the following information:
1. Generator Information:
Name:
Address/location:
Telephone number:
Description of waste:
Quantity of medical waste:
2. Transporter Information:
Truck Number.
Transporter name:
Address:
Telephone number:
Driver name:
Vehicle License Number:
State Vehicle certification:
There must be certification on the manifest by signature and date that the waste was picked up at the generator site and additional certification that the waste was delivered without incident to the approved destination.
3. Destination Information:
Site name:
Address:
Telephone number:
Quantity of Medical Waste in Pounds
The contractor shall provide the government with an original copy of each manifest that includes the generator and Transporter information for each container of RMW, Pathological Waste, OPIM and Trace Chemotherapy Waste at the time the waste is removed. The contractor shall provide the government (Generator) with a matching completed manifest (carbon copy) that includes volume, weights and destination information within 30 days of receipt at the Treatment, Storage Disposal Facility (TSDF). The Contractor shall provide an electronic monthly report to the VAMC GEMS Program Manager documenting the RMW and Trace Chemotherapy wastes disposed of and the amount in lbs.
Document numbers on original manifests provided to the government when the waste is removed and document numbers on final manifests must match. The quantity of containers shall be placed on the original manifest and the total pounds shall be placed on the matching final manifest. Copies of all Invoices will be sent to the COR and GEMS Program Manager for Waste generation reporting.
19. CAPABILITIES AND RELEVANT CORPORATE EXPERIENCE:
The contractor shall describe the abilities of the contractor and any subcontractors to perform this work plus relevant experience. References to current or previous clients to whom similar services were or are being provided shall be included. Experience most relevant to this solicitation would be managing and providing a comprehensive waste and services program, including the required training and compliance services, similar to this requirement. Experience providing a comprehensive waste management program for an industrial generator, or a residential area is less relevant; the services should be specific to a hospital due to the unique needs and training requirements that face these facilities.
Capabilities shall be described in terms of equipment, management experience, qualified personnel, knowledge of the business and an organizational structure that is flexible and responsive enough to direct and support the services required herein. Strong capabilities would consist of demonstrating the available corporate financial resources, equipment, experienced management team and demonstrated experience of successfully managing a contract with complexities of service.
20. ADMINISTRATION:
a. Facility Orientation: An initial orientation of the facilities will be conducted by the Program Office Representative at each facility at the start of the contract. The contractor shall be responsible for conducting orientation for new employees thereafter.
b. Accident Reporting: In the event an accident occurs on the Department of Veterans Affairs property or involving Government personnel or property, the contractor shall contact the VA Police immediately. A report shall be provided to the Contracting Officer and COR in writing that shall include the following: (1) the time and date of occurrence; (2) the place of occurrence; (3) a list of personnel directly involved; and (4) a narrative or description of the accident to include chronological order of the accident and circumstances; (5) corrective action to prevent future occurrences.
c. Locations: The government reserves the right to modify the contract as needed to add or delete locations that are connected to a Medical Center (e.g. a CBOC).
d. Federal Holidays:
New Year’s Martin Luther King Jr. Day President’s Day Memorial Day Fourth of July Juneteenth Day Labor Day Columbus Day Veteran’s Day Thanksgiving Christmas
If a holiday falls on Sunday, the following Monday will be observed as the National Holiday. When a holiday falls on a Saturday, the preceding Friday is observed as a National Holiday by U.S. Government agencies. Also included would be any day specifically declared by the President of the United States.
e. Invoice: Payment will be made upon receipt of a properly prepared, itemized invoice, validated by the COR, and submitted through the Tungstun System.
(1) A properly prepared invoice will contain:
1. Invoice Number and Date
1. Contractor’s Name and Address
1. Accurate Purchase Order Number
1. Itemization of pounds recycled and disposed
1. Price per pound
1. Dates service performed
1. Location of service performed
1. Total amount due
(2) A separate invoice will be prepared for each facility.
21. LOCATION-SPECIFIC:
· Togus: We purchase our own yellow containers. There are (12) 18 gal containers on the wards that are collected to central location.
· White River Junction: Contractor must remove, transport and properly dispose of Regulated Medical Waste (RMW) and to provide all labor to include 9 gallon & 2 gallon chemo buckets, 45 gallon (3) mil red bio bags and all other materials and equipment necessary to properly dispose of sharps at White River Junction VA Medical Center, White River Junction, VT 05009 (estimated 64 containers), and seven CBOC’s this will include six, two gallon containers for each CBOC listed below, with a pick-up of every 4 weeks at the CBOC’s.
· Bedford: None
· Boston: The Contractor shall coordinate with VABHS and succeeding contractor to ensure no lapse in containment of containers. The Contractor will be responsible for all maintenance of the external storage unit and replacement if necessary. The Contractor will provide locks and keys to VABHS personnel as requested and at no additional cost to VABHS. For each year of this contract, VABHS may request up to twenty-five (25) additional containers per main campus and up to five (5) additional containers per CBOC at no additional cost to VABHS. The charge for additional containers beyond fifteen/five will be billed under a separate line item on current obligation.
· Manchester: Locations; The Manchester VA Medical Center has multiple locations throughout the state of New Hampshire. Locations are both government owned and leased. Due to varying lease expiration dates with the potential for locations to move; the lease locations may be subject to change but will remain in the same general area.
· Central Western Massachusetts: In the future VA CWM may wish to expand services at the satellite clinics. Total Chemo / Path – Generation is non-routine and episodic in nature. VA CWM may have the potential to generate this waste in the future.
In the future VA CWM may choose to expand services to Community Based Out-patient Clinics (CBOC’s) locations at:
· Springfield VA CBOC, 25 Bond Street, Springfield, MA 01104-3401
· Pittsfield VA CBOC, 73 Eagle Street, Pittsfield, MA 01201-4714
· Greenfield VA CBOC, 143 Munson Street, Greenfield, MA 01301-9694
· Fitchburg VA CBOC, 881 Main Street, Philip J. Philbin Federal Building, Fitchburg, MA 01420-3008
· Worcester VA CBOC, 605 Lincoln Street, Worcester, MA 01605-1901
· VA Lake Avenue Clinic, 55 North Lake Avenue, 7th Floor, Worcester, MA 01605-2300
· VA Plantation Street Clinic, 377 Plantation Street, Biotech Building 4, Worcester, MA 01605-2300
· Providence: None
Connecticut: The contractor’s employees shall remove all containers from the central collection point at both facilities to their vehicle. The central collection point will be located at the building 1 loading dock for West Haven and Building 3 loading dock for Newington. Pick up will be within 24 hours of notification by VA if deemed needed by hospital staff, in addition to Mondays and Thursdays for West Haven and Newington VA Healthcare System sites, and once per month as scheduled between the Contract Officer Representative (COR) and contractor at the Errera Community Care Center and above listed CBOC’s. New London CBOC requires a bi-weekly service. All containers, regardless of the weight, shall be handled, moved and placed in contractor’s vehicle by the contractor’s employees, in such manner that the structural integrity of the container is maintained, waste is properly contained, and environmental contamination is prevented. Yellow containers purchased by VA used in 6-8 areas. Connecticut ships about 6-8 yellow containers a week. Yellow Chemotherapy containers are disposable, 9gal and 17gal.
B.3 PRICE/COST SCHEDULE
ITEM INFORMATION
| ITEM NUMBER |
| DESCRIPTION OF SUPPLIES/SERVICES |
| QUANTITY |
| UNIT |
| UNIT PRICE |
| AMOUNT |
| 12.00 |
| MO |
| __________________ |
| __________________ |
Togus VA Medical Center
Regulated Medical Waste and Sharps Disposal Services for VISN 1
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Base POP Begin: 11-01-2022 POP End: 10-31-2023
0001AA
| 29,433.50 |
| LB |
| __________________ |
| __________________ |
Togus - Red Bag/Sharps Disposal (comingled/captured together) Contract Period: Base
0001AB
| 5,021.00 |
| LB |
| __________________ |
| __________________ |
Togus - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
White River Junction VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Base
0002AA
| 15,647.90 |
| LB |
| __________________ |
| __________________ |
White River Junction - Red Bag Disposal
0002AB
| 1,678.00 |
| LB |
| __________________ |
| __________________ |
White River Junction - Sharps Disposal
0002AC
| 4,649.10 |
| LB |
| __________________ |
| __________________ |
White River Junction - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Bedford VA Healthcare System
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Base
0003AA
| 20,831.00 |
| LB |
| __________________ |
| __________________ |
Bedford VA Healthcare System - Red Bag/Sharps Disposal (comingled/captured together)
0003AB
| 903.00 |
| LB |
| __________________ |
| __________________ |
Bedford Healthcare System - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Boston VA Healthcare System
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Base
0004AA
| 74,789.90 |
| LB |
| __________________ |
| __________________ |
Boston VA Healthcare System - Red Bag Disposal
0004AB
| 70,716.80 |
| LB |
| __________________ |
| __________________ |
Boston VA Healthcare System - Sharps Disposal
0004AC
| 11,117.50 |
| LB |
| __________________ |
| __________________ |
Boston VA Healthcare System -Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Manchester VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Base
0005AA
| 14,825.00 |
| LB |
| __________________ |
| __________________ |
Manchester VA Medical Center - Red Bag/Sharps Disposal (comingled/captured together)
0005AB
| 2,712.00 |
| LB |
| __________________ |
| __________________ |
Manchester VA Medical Center - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Central Western Massachusetts VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Base
0006AA
| 12,492.40 |
| LB |
| __________________ |
| __________________ |
Central Western Massachusetts VA Medical Center - Red Bag/Sharps Disposal (comingled/captured together)
0006AB
| 0.00 |
| LB |
| __________________ |
| __________________ |
Central Western Massachusetts VA Medical Center - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Providence VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Base
0007AA
| 63,989.40 |
| LB |
| __________________ |
| __________________ |
Providence VA Medical Center - Red Bag Disposal
0007AB
| 19,173.61 |
| LB |
| __________________ |
| __________________ |
Providence VA Medical Center - Sharps Disposal
0007AC
| 11,409.10 |
| LB |
| __________________ |
| __________________ |
Providence VA Medical Center - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Connecticut VA Healthcare System
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Base
0008AA
| 124,381.83 |
| LB |
| __________________ |
| __________________ |
Connecticut VA Healthcare System - Red Bag/Sharps Disposal (comingled/captured together)
0008AB
| 7,516.92 |
| LB |
| __________________ |
| __________________ |
Connecticut VA Healthcare System - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Togus VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 1 POP Begin: 11-01-2023 POP End: 10-31-2024
1001AA
| 29,433.50 |
| LB |
| __________________ |
| __________________ |
Togus VA Medical Center - Red Bag/Sharps Disposal (comingled/captured together) Contract Period: Option 1
1001AB
| 5,021.00 |
| LB |
| __________________ |
| __________________ |
Togus VA Medical Center - - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
White River Junction VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 1
1002AA
| 15,647.90 |
| LB |
| __________________ |
| __________________ |
White River Junction VA Medical Center - Red Bag Disposal
1002AB
| 1,678.00 |
| LB |
| __________________ |
| __________________ |
White River Junction VA Medical Center - Sharps
1002AC
| 4,649.10 |
| LB |
| __________________ |
| __________________ |
White River Junction VA Medical Center - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Bedford VA Healthcare System
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 1
1003AA
| 20,831.00 |
| LB |
| __________________ |
| __________________ |
Bedford VA Healthcare System - Red Bag/Sharps Disposal (comingled/captured together)
1003AB
| 903.00 |
| LB |
| __________________ |
| __________________ |
Bedford VA Healthcare System - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Boston VA Healthcare System
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 1
1004AA
| 74,789.90 |
| LB |
| __________________ |
| __________________ |
Boston VA Healthcare System - Red Bag Disposal
1004AB
| 70,716.80 |
| LB |
| __________________ |
| __________________ |
Boston VA Healthcare System - Sharps Disposal
1004AC
| 11,117.50 |
| LB |
| __________________ |
| __________________ |
Boston VA Healthcare System - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Manchester VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 1
1005AA
| 14,825.00 |
| LB |
| __________________ |
| __________________ |
Manchester VA Medical Center - Red Bag/Sharps Disposal (comingled/captured together)
1005AB
| 2,712.00 |
| LB |
| __________________ |
| __________________ |
Manchester VA Medical Center - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Central Western Massachusetts VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 1
1006AA
| 12,492.40 |
| LB |
| __________________ |
| __________________ |
Central Western Massachusetts VA Medical Center - Red Bag/Sharps Disposal (comingled/captured together)
1006AB
| 0.00 |
| LB |
| __________________ |
| __________________ |
Central Western Massachusetts VA Medical Center - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Providence VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 1
1007AA
| 63,989.40 |
| LB |
| __________________ |
| __________________ |
Providence VA Medical Center - Red Bag Disposal
1007AB
| 19,173.61 |
| LB |
| __________________ |
| __________________ |
Providence VA Medical Center - Sharps Disposal
1007AC
| 11,409.10 |
| LB |
| __________________ |
| __________________ |
Providence VA Medical Center - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Connecticut VA Healthcare System
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 1
1008AA
| 124,381.83 |
| LB |
| __________________ |
| __________________ |
Connecticut VA Healthcare System - Red Bag/Sharps Disposal (comingled/captured together)
1008AB
| 7,516.92 |
| LB |
| __________________ |
| __________________ |
Connecticut VA Healthcare System - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Togus VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 2 POP Begin: 11-01-2024 POP End: 10-31-2025
2001AA
| 29,433.50 |
| LB |
| __________________ |
| __________________ |
Togus VA Medical Center - Red Bag/Sharps Disposal (comingled/captured together) Contract Period: Option 2
2001AB
| 5,021.00 |
| LB |
| __________________ |
| __________________ |
Togus VA Medical Center - - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
White River Junction VA Medical Center
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 2
2002AA
| 15,647.90 |
| LB |
| __________________ |
| __________________ |
White River Junction VA Medical Center - Red Bag Disposal
2002AB
| 1,678.00 |
| LB |
| __________________ |
| __________________ |
White River Junction VA Medical Center - Sharps Disposal
2002AC
| 4,649.10 |
| LB |
| __________________ |
| __________________ |
White River Junction VA Medical Center - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Bedford VA Healthcare System
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 2
2003AA
| 20,831.00 |
| LB |
| __________________ |
| __________________ |
Bedford VA Healthcare System - Red Bag/Sharps Disposal (comingled/captured together)
2003AB
| 4,649.10 |
| LB |
| __________________ |
| __________________ |
Bedford VA Healthcare System - Pathological and Non-Hazardous Chemotherapy Waste Disposal
| 12.00 |
| MO |
| __________________ |
| __________________ |
Boston VA Healthcare System
*All quantities are estimated.
*This is not a priced line item; this is a total of alphabetic lines items for each site.
Contract Period: Option 2
2004AA
| 74,789.90 |
| LB |
| __________________ |
| __________________ |
Boston VA Healthcare System - Red Bag…
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