36C24219R0167-001.pdf

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. 2/2012)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS 90

632-20-1-7148-0002

36C24219R0167 09-09-2019

MILLS, BRAD | William.Mills4@va.gov 914.737.4400 x2074 09-24-2019

5:00 PM EDT

36C242 Department of Veterans Affairs Network Contracting Office 2 James J. Peters VA Medical Center 130 West Kingsbridge Road Bronx NY 10468-3904

X 100

X

485991

$16.5 Million

N/A

X

Department of Veterans Affairs Northport VA Medical Center

79 Middleville Rd Northport NY 11768

36C242

Department of Veterans Affairs James J. Peters VA Medical Center Network Contracting Office 2 130 West Kingsbridge Road Bronx NY 10468-3904

Tungsten Network http://www.tungsten-network.com/us/en /veterans-affairs

See CONTINUATION Page

This requirement is for Ambulette Services in which the Contractor shall provide all vehicles, personnel, management supplies, transportation, equipment and reports necssary to provide 24-hour-7days-a-week Ambulette Services to eligible beneficiearies of the Northport VA Medical Center in Northport, NY and its five Community-Based Outpatient Clinics (CBOCs) located in Riverhead, Patchogue, Bay Shore, East Meadow, and Valley Stream, respectively.

Anticipated Performance Periods are as follows:

Base Year: 11/01/2019 - 09/30/2020 Option Year 1: 10/01/2020 - 09/30/2021 Option Year 2: 10/01/2021 - 09/30/2022 Option Year 3: 10/01/2022 - 09/30/2023 Option Year 4: 10/01/2023 - 09/30/2024 See Schedule and Performance Work Statement for additional information.

See CONTINUATION Page 632-3600160-7148-829800-2119 010041088

X X

X 1

BRAD MILLS

Contracting Officer

36C24219R0167

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PERFORMANCE WORK STATEMENT

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

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

C.3 52.216-18 ORDERING (OCT 1995)

C.4 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.5 52.216-21 REQUIREMENTS (OCT 1995)

C.6 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.7 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ...31

C.8 52.228-10 VEHICULAR AND GENERAL PUBLIC LIABILITY INSURANCE (APR

1984)

C.9 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR

1984)

C.10 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.11 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.12 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (DEC 2009)

C.13 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.14 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.15 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS

(NOV 2018)

C.16 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.17 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN

2008)

C.18 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (MAY 2019)

C.19 IT CONTRACT SECURITY

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 WAGE DETERMINATION

BUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF

VETERANS AFFAIRS VETERANS HEALTH ADMINISTRATION, , AND

See attached document: CONTRACTOR RULES OF BEHAVIOR See attached document: PAST PERFORMANCE QUESTIONNAIRE

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (OCT 2018)

E.2 SPECIFIC INSTRUCTIONS TO OFFERORS

E.3 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)

E.5 52.216-1 TYPE OF CONTRACT (APR 1984)

E.6 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.7 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (JUL 2016)(DEVIATION)

E.8 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.9 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.10 ADDENDUM 52.212-2 EVALUATION – COMMERCIAL ITEMS

(b) EVALUATION FACTORS

E.11 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL ITEMS (OCT 2018)

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 36C242 Brad Mills | William.Mills4@va.gov

Department of Veterans Affairs Network Contracting Office 2 James J. Peters VA Medical Center 130 West Kingsbridge Road Bronx NY 10468-3904

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 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.

Tungsten Network http://www.tungsten-network.com/us/en /veterans-affairs

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

AMENDMENT NO DATE

B.2 PERFORMANCE WORK STATEMENT

Title of Project: Ambulette Services

Background/Need: The VA Medical Center, Northport, NY, has a requirement for 24-hour Ambulette service to transport eligible beneficiaries of the medical center for medical services. Services shall be provided 24 hours, 7 days per week, 365 days per year for eligible beneficiaries of the Northport VA Medical Center in Northport, NY and its 5 Community-Based Clinics (CBOCs) located in Riverhead, Patchogue, Bay Shore, East Meadow, and Valley Stream respectively. We have a patient population of radiation therapy, dialysis, mentally ill, spinal cord and homeless who will require frequent transport. The contractor will be servicing two beneficiary travel units at this facility: Administrative Medicine/ Primary Care Room and Spinal Cord Patient Care Center.

Facility Addresses:

Northport VA Medical Center 79 Middleville Road Northport, NY 11768

Riverhead Community Clinic 300 Center Drive Riverhead, NY 11901

Patchogue Community Clinic 4 Phyllis Drive Patchogue, NY 11772

Bay Shore Community Clinic 132 East Main Street Bay Shore, NY 11706

East Meadow Community Clinic 2201 Hempstead Turnpike, Bldg. Q East Meadow, NY 11554

Valley Stream Community Clinic 99 South Central Avenue Valley Stream, NY 11580

The Contractor shall provide all vehicles, personnel, management, supplies, transportation, equipment and reports necessary to cover all Ambulette services as identified in the Performance Work Statement.

DEFINITIONS:

One-Way Trip: The distance over which a patient is transported, from point of pick up to destination. Round trip transportation shall be invoiced as two one-way trips.

No-Load Trip: When Ambulette service is ordered under the terms of this contract, but the patient is not available for pick-up due to unforeseen circumstances. The Contractor shall collect for such no-load trips at the applicable schedule rates.

VA Travel Unit: Includes beneficiary travel clerks and the travel supervisor.

Administrative Officer of the Day (AOD) – VA employee who acts as the administrator during all hours that are not normal working hours, as well as weekends and holidays. Normal working hours are 8:00 a.m. to 4:30 p.m. Monday through Friday.

SERVICE AREA:

Services may be required throughout Nassau and Suffolk counties, the boroughs of Queens, Brooklyn, Bronx, Manhattan, Staten Island. Occasional travel to upstate New York, as well as Pennsylvania and Connecticut, may also be required.

CONTRACTOR QUALIFICATIONS:

a. Contractor shall be regularly established in the business called for and who are financially responsible and have the necessary equipment and personnel to furnish service in the volume required for all items under this contract.

Successful offeror shall meet all requirements of Federal, State and City codes regarding operations of this type of service.

b. Each offeror must submit, along with proposal:

1. Copy of insurance certificate(s)

2. Copy of business license(s)

3. List of all vehicles (including make, model and year) and vehicle identification number (VIN), as well as location of hub/main office. This list must contain information as to the metering devices or methods offeror proposes to use in determining mileage.

4. Inspection report for all vehicles.

5. Proof that Contractor vehicles are licensed and meet minimum requirements as mandated by the Department of Transportation of the State of New York, as described in the PWS.

6. List of all vendor personnel that will be performing contract tasks & requirements listing name, title and job description of each employee.

7. Written verification that all drivers are in compliance with applicable New York State requirements for the performance required under this contract, as required in the PWS.

WORK HOURS:

Services will be provided, as requested, 7 days a week, 24 hours a day, 365 days per year, including all national Federal Holidays.

RATES AND MILEAGE

Base Rate: For all one-way trips and no-loads to a designated delivery point located within Nassau County east of the Meadowbrook Parkway or Suffolk County Townships – Huntington, Babylon, Smithtown, Islip, and Brookhaven, the contractor shall receive the flat base rate awarded for that destination location. The Base Rate shall constitute full compensation for one-way trips and no-load trips to a destination within Nassau or Suffolk County.

Mileage Rate: For all one-way trips and no-load trips to a designated delivery point west of the Meadowbrook Parkway in Nassau County and Suffolk County Townships – Riverhead, Southampton, Easthampton, Southold, and Shelter Island, the contractor shall receive the mileage rate for each mile traveled. In the event fraction miles result, VA shall pay the rounded off amount to the next higher even mile. In no event shall the Contractor receive this rate for miles traveled within the specified threshold.

Mileage Determination: Utilize Bing Maps located at http://www.bing.com/maps/.

Toll Charges: It is agreed and understood that the prices quoted in the schedule do not include any ferry, bridge, tunnel or road toll charges. Any such legitimate toll charges incurred shall be limited to only when the patient is traveling in the vehicle, or to a no-load trip, and shall be listed separately on the contractor's invoice. The contractor is responsible for all initial EZ PASS or payment of all tolls, to be reimbursed after the fact by VA. Tolls will not be billed or paid for bridges or tunnels used when a non-toll road was feasibly available for the trip.

All invoices must be accompanied by supporting documentation of tolls actually paid (i.e. receipts, EZ Pass, etc.).

WAIT TIME:

For time lost in waiting due to causes beyond the control of the driver, the contractor will be reimbursed in 15-minute increments, at the rate of one-fourth the hourly rate quoted. The base rate for medical transportation services shall include a 30-minute waiting grace period at origin and destination; the wait time charge only applies if the crew is delayed longer than 30 minutes at the time of pickup or delivery.

1. For add-on trips, waiting charges shall commence 30 minutes from the time the Contractor actually arrives at the designated pick-up and/or delivery points. For add-on trips with specified time for pick-up, waiting charges shall commence 30 minutes after that pick-up time. For scheduled trips, waiting charges shall commence 30 minutes from the scheduled pick-up time or from the time the Contractor arrives as the designated pick-up point, whichever is later.

2. If the designated pick-up and/or delivery points are at other than the VA Medical Center and waiting beyond the required 30-minute grace period is anticipated, the Contractor shall notify the VA Travel Unit; if these individuals are not available, the Contractor shall notify the AOD. This call is only for verifying the Contractor’s time of arrival at pick-up and delivery points and is not necessary if the Contractor does not anticipate a delay for which waiting charges will be claimed. The Contractor’s failure to provide notification when waiting beyond the grace period shall result in non-payment for waiting time. No charges will be honored without prior approval. Immediate communication can often eliminate the possibility of delays. It is permissible for Contractor to confirm runs with beneficiaries by phone prior to dispatching units.

3. Wait time shall not apply to the reasonable amount of time required for escorting the patient to the vehicle, loading and securing patient in vehicle, or unloading and delivering the patient to the authorized care giver or specified destination area.

RATE FOR MULTIPLE PATIENT TRANSPORT: When more than one patient is being transported on a trip, reimbursement shall be made for each individual patient based upon their individual drop-off location. The Contractor must ensure that pick-ups and drop-offs are scheduled to ensure timeliness for all patients on the trip.

ORDERS:

1. Authorized Ordering Officials: Requests for services will be made by authorized VA staff only, in writing, telephone, or via telefax. The contractor will be provided a list of the names and telephone numbers of the persons authorized to place orders upon award of the contract. Patients are not permitted to order transportation at VA expense. The government will not be held liable for those services performed by the Contractor which are ordered by people who are unauthorized.

2. Scheduled Requests: Scheduled requests for services will be furnished to the Contractor no later than 4:30 p.m.

prior to the day the transportation is required. The following information shall be provided by the VA to the contractor:

• Patient name (first and last name)

• Last 4 of Social Security Number

• Pick up point (include address, telephone #, city, state, bldg. and/or room number if applicable)

• Destination

• Time of pick up

• Additional information as needed (whether there are papers, medications or other items to be transported with the patient and location of those items)

• Any specific physician instructions

3. Add-on Transports: Any transport ordered the same day is an “add-on”. An order will be generated for add-on that reflects the date and time the request was received by Contractor.

TRIP TICKETS:

Contractor shall provide drivers with a trip ticket for each transport. Trip tickets shall be signed and time/date stamped at both the point of pick up and at the destination. Signed trip tickets for all transports must be provided by the Contractor driver to the Travel Unit at the time of transport.

All trip tickets will be completed with the following information: company name, date and actual time of pickup, patient name, origin and destination, physician orders, approved waiting time, mileage, driver/attendant names, receiving attendant’s signature, applicable comments.

Tickets shall be maintained by the Contractor for record. Copies of signed trip tickets may also be requested/used for proof of transport for billing purposes. Failure to comply could result in non-payment. All trip tickets should contain the following information:

a. Patient's Name

b. Date and time of pickup and/or delivery

c. Vehicle Identification Number

d. Name of driver

e. Contractor name and contract number

f. Signature from sending unit and destination ensuring the patient arrived.

PATIENT TRANSPORT

a. Contractor shall provide “through the door” assisted service for all patients to and from their designated appointments. Patients shall be picked up on the ward, in their homes, in the clinics, or at other areas designated by the VA and taken to the authorized destination or appointment. All patients shall be attended by an authorized responsible party at all times. When the destination is other than a VA facility, patient will be taken directly to their destination and presented to their caregiver. When transporting to another Health Care facility (either VA or Private) the patient shall be presented to a staff member. Patient shall not be left at the entrance or in the hallway of the facility or outside their place of origin. Assistance in maneuvering stairs and other barriers shall be provided by the driver and/or authorized attendant when necessary. These services may need to be provided within or outside the home (i.e., from the door to the vehicle).

b. Contractor drivers shall ensure proper loading/unloading techniques are followed at all times, in accordance with Department of Transportation guidelines. Contractor shall comply with the most current guidelines at all times, including any revisions that occur during the life of this contract.

c. Contractor’s driver shall notify the COR, or designee, of any problems transporting patients, including but not limited to accidents, safety problems, and patients unbolting themselves. The COR or designee shall be notified within one hour of the occurrence of the incident(s) by telephone and, if requested by the COR and/or Contracting Officer (CO), a written report of the incident(s) will be delivered to the COR or his/her designee by close of business the next working day.

d. If the Contractor cannot furnish its own Ambulette during this contract performance period, the Contractor is authorized to utilize another Ambulette Service Company, as a subcontractor (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 VA Travel Unit and provide a justification for non-performance.

e. The Contractor shall notify the VA Travel Unit by telephone, at least one-hour in advance of scheduled pickup, in the event that the Contractor is unable to provide trips within the time frame necessary for the VA Patient to maintain their scheduled appointment or return trip from the medical facility. For trips outside Nassau and Suffolk Counties, the contractor must notify the VA in time for another company to travel to the destination and return in time for the patient to maintain their scheduled appointment.

Contractor shall contact the list of authorized ordering officials in the event the Travel Unit is not available to receive the Contractor’s call.

f. The Contractor shall notify the Travel Unit and the patient by phone of any delays in transport.

g. The Contractor is to follow the designated pick up time or comments as specified for each patient on the

TRAVEL LOG SHEET. Prior to making any changes to the Travel Log Sheet requirements, the contractor must confirm with the Travel Unit; if the Travel Unit is not available, contractor shall contact an authorized ordering official or AOD.

h. All drivers are required to check in and out of the VA facility Travel Unit when dropping off and picking up patients. Driver shall notify the Travel Office in person when picking up or discharging a patient during regular duty hours of 8am – 4:30pm, Monday through Friday. After 4:30pm, weekends and holidays, the AOD shall be notified.

i. Patients shall arrive at their destinations no later than their appointed time.

j. A two-man team will be required occasionally to lift certain patients more than one flight of stairs to get to patient's residence and patient must be presented to caregiver. Contractor will be notified of this requirement at the time order is placed.

k. For patients being transported from a VA facility, drivers shall confirm the patient’s discharge address prior to transport. Drivers shall confirm the discharge address with the Travel Unit during regular duty hours of 8am – 4:30pm, Monday through Friday. After 4:30pm, weekends and holidays, drivers shall confirm the patient’s discharge address with the AOD.

l. The driver or dispatcher shall notify the travel office if a patient is being discharged or transferred is not ready for transport at the designated time.

m. All inter-facility transfers must have a direct transport between the facilities.

n. Priority of Transports: Contractor shall give priority to transporting VA Patients that have scheduled trips, over add-on trips, unless otherwise directed by VA Travel Unit. Contractor shall ensure add-on trips will not conflict with scheduled transports arriving at their destination timely.

o. The Contractor’s driver shall observe the patient during transport. At the onset of any significant change in the patient’s condition (i.e., sudden onset of rapid or labored respiration, complaints or chest pains, etc.), the driver shall call 911 and proceed according to the operator’s instructions. After contacting 911, the driver shall communicate the scenario immediately to the Travel Office at 631- 261-4400 x2371, AOD at 631-261-4400 x2655, or by contacting the VA Medical Center Emergency Room staff, at (631)-261-4400 - contact operator by dialing 0 and ask for Emergency Room Staff.

All diversions from destination shall be reported to the COR or designee.

PICK-UP PROCEDURES:

a. Pick-Up at a VA Facility: The driver shall announce to the facility Travel Unit that the Ambulette is waiting;

driver shall provide the beneficiary’s name as well as any other pertinent information as to his identification. The facility Travel Unit representative will sign, and time/date stamp the trip ticket and return to the driver. From this verified time of arrival, fifteen (15) minutes will be allowed as normal for the facility to release the patient to the Contractor. Such release time cannot be claimed as waiting time unless, through no fault of the Contractor, the patient is not released at all. Boarding activities are also normal to the services required and time spent at the pick-up location reaching the patient and assisting him to and into the waiting Ambulette cannot be claimed as waiting time. If a patient is unable to use the ambulette seats, patient shall be transported in a standard size wheelchair appropriately secured to the vehicle.

b. Pick-Up at Other than VA Facility: When a patient is picked up at his residence, or other location that is not a VA facility, the patient will verify the time and sign the trip ticket; if the patient is unable to do so, a member of his household will sign the trip ticket. The patient and/or household member will be allowed up to fifteen (15) minutes after this verified time of arrival for preparatory tasks exclusive of boarding activities, which shall commence when the individual is ready to be placed in the travel device which will be used to bring him to the waiting vehicle. If a patient is unable to use the ambulette seats, patient shall be transported in a standard size wheelchair appropriately secured to the vehicle.

NUMBER OF PATIENTS / RIDERS:

a. It is understood and agreed that only one patient shall be transported on a trip unless specifically authorized by the COR or designee.

b. The Contractor shall not transport non-VA contract beneficiaries or private-pay patients with VA beneficiaries under this contract. While transporting VA patients under this contract, only authorized drivers or attendants, or patient’s family member or representative shall be allowed in the vehicle. The number of riders in any vehicle shall not exceed the number of approved safety restraints available in the vehicle.

NON-PICK-UP OF PATIENT / NO-LOAD TRIP:

When Ambulette service is ordered under the terms of this contract, but the patient is not available for pick-up due to unforeseen circumstances, the Contractor shall collect for the trip at the applicable schedule rates (including base rate and applicable mileage rate). The VA reserves the right to substitute patients in these instances to prevent the ‘No- Load” situation.

NON-ARRIVAL OF PATIENT:

When Ambulette service under the terms of this contract involves the pick-up of a patient scheduled to arrive by air, train, or bus, the Ambulette driver will contact the Travel Clerk [during normal working hours] or AOD [if the Travel Clerk is not available] and inquire as to the status of the arrival. If appropriate, wait time charges may be authorized for time lost in waiting in accordance with applicable schedule rates. If the Contractor reported as scheduled and no patient is transported, he/she shall be reimbursed at the applicable schedule rates.

TRIP INTERRUPTIONS:

No beneficiaries en route in any kind of trip shall be transferred from the original Ambulette entered into another vehicle or be removed from the original vehicle at a location other than the destination address supplied by the VA Travel Unit unless extraordinary, urgent situations arise, such as vehicle failure. All such events must be reported to the Travel Unit that submitted the request for service.

ADDITIONAL SERVICES:

Contractor will be required to transport patient luggage, medical records, medication and any other items (including wheelchairs, manual and electric, stryker frames, litters, etc.) from pick-up point to destination at no additional cost to the Government. Luggage to be transported will be restricted to suitcase and valise types.

KEY PERSONNEL AND TEMPORARY EMERGENCY SUBSTITUTIONS: The Contractor shall assign to this contract the following key personnel:

Dispatcher:

(1) The Contractor shall provide a dispatcher assigned to each working tour, 365 days per year, 24 hours per day, and 7 days per week. The dispatcher shall be the primary point of contact for all transportation orders placed by the Northport VA Medical Center. A list of the dispatchers, including contact information and hours of duty, shall be provided to the Contracting Officer prior to the start of performance.

(2) During the first sixty (60) days of performance, the Contractor shall make NO substitutions of key personnel unless the substitution is necessitated by illness, death, absence for leave, or termination of employment. The Contractor shall notify the Contracting Officer, in writing, within 15 calendar days after the occurrence of any of these events and provide the information required by paragraph (a) below. After the initial 60-day period of the contract, the Contractor shall submit the information required by paragraph (a) to the Contracting Officer at least 15 days prior to making any permanent substitutions.

a. The Contractor shall provide a detailed explanation of the circumstances necessitating the proposed substitutions, and any additional information requested by the Contracting Officer.

Proposed substitutes shall have comparable qualifications to those of the persons being replaced.

The Contracting Officer will notify the Contractor within 15 calendar days after receipt of all required information of the decision on the proposed substitutes.

(3) For temporary substitutions where the key personnel will not be reporting to work for three (3) consecutive work days or more, the Contractor shall provide a qualified replacement for the key personnel and notify the Contracting Officer and COR in advance of the replacement. This substitute shall have comparable qualifications to the key person. Any period exceeding two weeks will require the procedure stated in paragraph (a) above.

CONTRACTOR PERSONNEL: AMBULETTE DRIVERS/ATTENDANTS:

1. Prices include the provision of a non-emergency attendant/driver for each vehicle.

2. An attendant, separate from the driver, shall occasionally be required for the transport of patients requiring psychiatric care. The attendant shall act as an overseer of happenings while in transit, allowing the driver to focus on the safe transport of patients. The Contractor shall be notified of this requirement when the transportation order is placed. Prices bid in the schedule shall include the service of a trained professional (as required for the type of services ordered) on such trips.

3. Identification: All Contractor’s drivers and attendants shall wear, in a readily observable area on the employee, a Contractor supplied photo identification badge (including employee’s name and business name) and company uniform, which identify the drivers and attendants while performing any aspect of service prescribed in this contract.

4. Contractor personnel performing services under this contract shall at all times conduct themselves in a professional manner, maintain personal hygiene, and wear clean, neat uniforms.

5. Contractor personnel shall not smoke in vehicles while transporting VA patients.

6. Contractor personnel shall not play music in vehicles during patient transport.

7. Contractor personnel shall not text message or use cell phones for personal use while driving. Only communication related to service performance is permitted during patient transport.

8. 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. Contractor personnel shall meet these qualifications at all times while performing contract services.

9. Contractor shall be responsible to ensure that Contractor employees providing work on this contract are fully trained, certified, and when appropriate, licensed and completely competent to perform the required work.

10. In accordance with applicable NYS Laws, all drivers must meet the following requirements:

a. Must be twenty-one (21) years or older.

b. Must have a valid NYS CDL driver’s license, valid for operation of this type of vehicle.

c. Must have passed a driver physical examination, administered to NYS standard, and confirming physical ability to operate this type of vehicle (Ambulette/Bus). Physical examination is to be an annual requirement for continued employment.

d. Must have passed a documented criminal background investigation; including fingerprints.

e. Must have a clean driving record as per NYS CDL Requirements for operating this type of vehicle.

f. Must have passed a drug/alcohol screening examination.

g. Must have completed and passed Safety and First Aid training provided by the organization, pursuant to applicable state laws.

h. Must have completed a defensive driving course, with annual defensive driving review forms completed per NYS guideline.

11. The Contractor is required to maintain records that document competence/performance level of Contractor employees working on this contract. In accordance with NYS DOT and NYS Department of Motor Vehicle Regulations, the Contractor shall maintain a file for each driver to include all documents subject to Department of Transportation regulations. These files shall be provided to the Contracting Officer for review upon request.

12. Notwithstanding other contract requirements, upon request of the Contracting Officer, the Contractor will remove from the work site any Contractor employee who does not comply with or meet competency requirements for the work being performed.

VEHICLES:

a. Vendor must have a minimum of ten (10) vehicles, all 10 vehicles must be high tops and have hydraulic lift.

b. All vehicles utilized in performance of this contract must comply with New York State Department of Transportation Rules & Regulations covering vehicles for hire to transport, Article 17, Parts 720, 721, 722, and 723, and the US Department of Transportation, Federal Motor Vehicle Safety Standards and Regulations (FMVSS). Vehicles must display DOT inspection sticker. In addition to the above, all vehicles must be equipped with a standard size wheelchair, kept/stored onboard at all times with all vehicles assigned under this contract.

Furthermore, all vehicles must possess the following salient characteristics:

1. Air conditioning and heating.

2. Be equipped with permanently mounted cylinder holders for patients requiring oxygen. Patients will have portable oxygen cylinders.

3. Be equipped with, a five-pound dry chemical or ABC type fire extinguisher or an IOBC (minimum D.L.) extinguisher mounted in an accessible place.

4. Be equipped with an American Red Cross type 24 first aid kits or equivalent.

5. Be maintained in a clean and sanitary condition.

c. The Contractor shall provide proof of vehicle inspection/maintenance records with the Contractor’s proposal, reflecting compliance with NYS Department of Transportation regulations, for each vehicle to be utilized under this agreement.

d. Standard wheelchair securement devices shall not be attached to van doors.

e. All standard wheelchair restraints (for occupied or unoccupied wheelchairs) shall hold the standard wheelchair stable in all manners of driving. Installation of wheelchair restraints should be installed according to the restrain manufacturer’s installation instructions. The standard wheelchair should not be able to move more than 6 inches in any direction while driving under normal conditions.

f. Patient must be secured in the standard wheelchair at all times when he/she is being transported to and from vehicle as well as being driven in an Ambulette.

g. Additional chest straps, body positioners or other equipment may be added where necessary to assist in a client’s balance and stabilization.

h. All wheelchair securement systems must be installed according to the manufacturer’s specifications and instructions.

i. Three/four-wheel scooter type wheelchairs or transport chairs will be transported only if properly secured within the vehicle. No patient will be allowed to be transported in a three/four-wheel scooter type wheelchair or transfer chair. They must be placed in a wheelchair with restraints as outlined previously.

j. Safety belt systems will be provided whether the client is a driver or passenger.

VEHICLE PERFORMANCE: The Government reserves the right to inspect any vehicle which will be used to provide services under this contract and reject any vehicle or equipment within the vehicle, without advance notification, found to be in a faulty condition or equipped in a manner which does not comply with contractual provisions. Such suspensions will be effective at the time of arrival of such equipment, or at the time the Contracting Officer notifies the contractor that deficiencies have been reported.

GLOBAL POSITIONING SYSTEM (GPS): All vehicles shall be equipped with a GPS system which has the following capabilities:

a. Address to address routing

b. Voice prompts for turns & guidance

c. Built in road maps – detailed road map displays

d. Route capabilities show best route to take from point A to point B

e. Waypoints capable shows locations & ability to pint to a desired destination

f. Turn Here – unit gives signal for a next turn

g. Maps user can upload maps for area needed

h. Traveling user can input series of addresses the unit displays lowest time/distance route between several destinations’ points

i. Large & bright screen that is easily visible to the driver

j. Engine idle – tells you that the vehicle has stopped and is on/running

k. Calculates speed from starting point to ending point

l. Calculates travel mileage

EXTRAORDINARY CONDITIONS:

When conditions unforeseeable and/or uncontrollable by the Contractor occur, such as: storms, flooding, or other hazardous road and travel situations, time and distance qualifications shall be considered secondary to safety precautions. Any delays or exceptions to the required quality of services, due to such substantial difficulties, shall be reported to the Travel Unit/per vehicle, if only a few ambulettes are involved, or per event if all drivers in particular area were affected. The COR or designee will indicate concurrence or non-concurrence re-excusing such delays for the reasons communicated to the Contracting Officer.

RESPONSE TIME: The Contractor shall be present to receive the patient at the specified time. The Contractor will call the Beneficiary Travel Office, alerting the travel representative, as soon as he anticipates that a delay may develop which exceeds 30 minutes. This call is for verifying his arrival time at pick-up/drop off point and is not necessary if the Contractor anticipates no delay for which he will claim reimbursement.

Article 19-A – NY Vehicle and Traffic Law, is incorporated by reference in this acquisition.

New York State Department of Transportation; Bus & Passenger Vehicle Regulations; Title 17: Official Compilation of Codes, Rules and Regulations of the State of New York; Parts 720, 721, 722, and 723, is incorporated by reference in this acquisition.

EVIDENCE OF INSURANCE COVERAGE:

With the Contractor’s proposal, prior to award, the Contractor shall furnish to the Contracting Officer a certificate of insurance which shall contain an endorsement to the effect that cancellation of, or any material change in, the policies which adversely affect the interests of the Government in such insurance shall not be effective unless a thirty (30) day written notice of cancellation or change is furnished to the Contracting Officer.

INVOICES: Invoices shall be submitted monthly in arrears. All invoices from the Contractor shall be submitted electronically. Contractor shall follow e-Invoice Submission Protocol as described:

http://www.fsc.va.gov/einvoice.asp Disagreement with suspensions to payment of invoice will be brought to the attention of the COR within 60 days of receipt of payment. Supporting document for payment of suspended payments shall be presented within 60 days of receipt of explanation of the suspension.

DETAILED MONTHLY REPORTS

To support each monthly invoice, the Contractor shall send the COR a detailed record of all trips (whether scheduled or add-on) during the period invoiced. This record shall include the following:

1) Patient’s name

2) Date of birth

3) Date and time of trip

4) Point of origin and destination

5) Mileage, wait time, and any other authorized additional charges associated with that trip.

CANCELLATIONS:

On trips within the Nassau/Suffolk County limits, there will be no charge to the Government for cancellations made at least thirty (30) minutes prior to scheduled pick-up time. Outside of the above county limits, there will be no charge to the Government for cancellations made prior to the vehicle being dispatched. For orders that are cancelled while the Contractor is already in route to the designated pick-up, the Contractor shall be entitled to receive 50% of the base rate for the trip, or mileage, if outside of Nassau/Suffolk Counties, as provided in the Pricing Schedule. Should the Contractor arrive at a destination before VA cancels the order, or if the Contractor is unable to perform a scheduled pick-up for reasons beyond the Contractor’s control, e.g., incorrect address, or patient absence, or patient refusal, then the Contractor shall receive the base rate for trips within Nassau or Suffolk County or mileage for trips outside of Nassau/Suffolk County.

PATIENT WELFARE AND ABUSE:

a. The contractor shall be responsible for patient welfare during transport. Drivers shall be responsible to ensure that patients are not left abandoned at their destination. Drivers are to ensure that patients are left in the care of a responsible person prior to departure from drop off point. The contractor shall also be held responsible for patient and/or Government’s property during transport. Any damaged or lost wheel chairs (including power wheelchairs), walkers, crutches, or personal belongings will be replaced by the Contractor.

b. Contractor employees shall ensure proper loading/unloading techniques are followed at all times. Patients in wheelchairs shall be loaded onto ramps, ensuring all safety systems are working properly, e.g. roll back stops.

c. Contractor must take into consideration that he will be transporting ill/psychiatric patients. Special consideration should be taken in transporting psychiatric patients requiring restraints.

d. The VA reserves the right to bar any driver or attendant from transporting VA beneficiaries should he/she violate any terms of this contract.

e. Contractor is responsible for enforcing NO SMOKING requirements in vehicles while performing service under this contract.

http://www.fsc.va.gov/einvoice.asp

INCIDENT/ACCIDENT REPORT:

In all cases where an incident or accident occurs while a VA patient is in the contractor’s care, the Contractor shall notify the Travel Unit or AOD, within one hour of the occurrence of the incident(s) by telephone; in cases where immediate emergency medical treatment is deemed necessary, notifications will be required upon arrival at the nearest facility. A written report of the incident(s) will be delivered to the Travel Unit or COR, by close of business the next working day.

In all cases, patients must be cleared by this facility’s emergency room physician. Clearance must be documented.

Contact can be made with the travel office during business hours and with the admitting desk during off tours.

VA Furnished Parking Spaces:

VA will provide designated parking spaces for the company awarded this contract just outside the Northport Emergency Room entrance, Bldg. 200.

PATIENT RIGHTS AND INCIDENT REPORTS:

1. The contractor shall be courteous to VA beneficiaries and shall not smoke while transporting patients. Patients may bring a reasonable amount of equipment, such as a folding wheelchair, consumable medical supplies and personal suitcase.

2. The Contractor shall notify the COR, in writing within 24 hours of any complaints made by the patients with regards to the Ambulette service. The contractor may provide recommendations for improved services along with the patient complaints for the VA’s review. No recommendations shall be construed as being effective until and unless it is provided as written modification to the contract from the Contracting Officer.

CONTRACTOR’S QUALITY CONTROL PROGRAM (QCP): The contractor shall establish and maintain a QCP to ensure all contract requirements are met. The Contractor’s QCP shall include the following or have incorporated into during performance of the contract, at a minimum:

a. An inspection plan covering all services required by this contract. The inspection plan must specify the areas to be inspected on either a scheduled or unscheduled basis and how often inspections will be accomplished and documented, and the title of the individual(s) who will perform the inspections.

b. On-site records of all inspections conducted by the Contractor noting necessary corrective action taken.

The Contracting Officer reserves the right to request copies of any and/or each inspection.

c. The methods for identifying and preventing deficiencies in the quality of service performed, before the level of performance becomes unacceptable and organizational functions noting intermediate supervisory responsibilities and overall management responsibilities for ensuring total acceptable performance.

d. The contractor shall maintain on-site records of all vehicle maintenance and repairs performed on vehicles used in the performance of this contract. The contractor shall institute methods to identify and prevent vehicle breakdowns, with detailed procedure for alternative transportation of patients in the event of mechanical breakdown of vehicle.

e. The contractor shall maintain on-site records identifying the character, physical capabilities, certifications and ongoing training of each employee performing services under this contract.

f. The contractor shall have methods of identifying and preventing radio communication breakdowns and provide a detailed procedure for alternative communications in the event of electronic and mechanical breakdown.

g. The contractor shall maintain on-site records of any complaints or problems with procedures taken to allow for corrections and/or elimination before effects caused interruption of contract performance.

h. The contractor shall participate in quarterly scheduled and/or unscheduled conference calls with the Contracting Officer and COR to provide a report of on-going operational issues.

i. The contractor shall have a system that verifies the licenses and driving records of individuals operating the vehicles. The contractor shall make this information available for review by the Contracting Officer upon request.

QUALITY ASSURANCE SURVEILLANCE PLAN: The purpose of this Quality Assurance Surveillance Plan (QASP) is to provide guidance on how the quality of services provided under this contract will be monitored. Quality assurance will be conducted by the COR.

The Contractor will be notified any time a performance standard is missed or of any complaints related to services provided or personnel performance issues. The Contractor will be given an opportunity to correct any deficiency noted.

The timeframe for correcting deficiencies will be determined on a case by case basis by the Contracting Officer or COR depending of the circumstances.

Task ID Indicator Standard Acceptable

Quality Level

Method of Surveillance

Incentive/Penalty

Hours of Operation 1

Work Hours

The Contractor shall provide ambulette service 24 hour/7 days a week, regardless of distance

100% Daily Observation

Negative past performance rating for failure to comply.

Initial Pick-up Delivery /wait time

Patient must be picked up and/or Delivered by the Contractor’s employees in accordance with the PWS timelines.

Contractor will be responsible for pick-up and delivery points, actual time of arrival at pick-up and delivery points and actual waiting time at pick-up and delivery points.

95% Daily Observation/ Review of Transportation Log

Environment of Care

Vehicles and medical equipment

Contractor shall be responsible to ensure that all vehicles operated, and medical equipment utilized under the terms of this agreement meet all established requirements defined by this contract .

100%

Periodic Review of Contractor On-Site Vehicle and Equipment Maintenance/Inspection Records validating compliance with all State requirements.

Contractor will be required to provide annual compliance logs for all vehicles/equipment utilized to provide service to the VA.

Contractor vehicles will also subject to physical inspection by the VA at any time during the contract.

Contractor will be fully responsible to ensure that all vehicles in operation under this agreement meet all requirements.

Task ID Indicator Standard Acceptable

Quality Level

Method of Surveillance

Incentive/Penalty

Contractor Personnel

Contractor shall test drivers for prohibited drug use and alcohol misuse; administer a criminal background check, to the extent required by NY State Law.

Contractor shall be responsible to maintain on-site records of all employee competency requirements.

100%

Periodic Inspection of Contractor On-Site Competency Records for employees

If it is determined that a Contractor operator failed to meet all specified requirements, VA may provide negative past performance information and choose not to exercise any remaining option periods.

Additionally, VA may issue a cure notice and potentially terminate the contract for default.

Patient Safety

Patient safety incidents must be investigated, confirmed and resolved.

notify the COR of any problems transporting patients.

The COR or designee shall be notified within one hour of the occurrence of the incident(s) by telephone and, if requested by the COR and/or Contracting Officer (CO), a written report of the incident(s) will be delivered to the COR or his/her designee by close of business the next working day.

100% Direct Observation/ Review of Trip…