36C24220Q0003-002.docx

36C24220Q0003

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

561-20-3-482-0007 36C24220Q0003 12-06-2019 Harsch, Michelle Michelle.Harsch@va.gov 716-862-7373 01-10-2020 3:00pm Department of Veterans Affairs Network Contracting Office (NCO) 2 2875 Union Road Suite 3500 Cheektowaga NY 14227 X 485991 $15 Million N/A X Department of Veterans Affairs New Jersey Healthcare System East Orange and Lyons Campuses 385 Tremont Avenue East Orange NJ 07018 Department of Veterans Affairs Network Contracting Office (NCO) 2 2875 Union Road Suite 3500 Cheektowaga NY 14227

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

See CONTINUATION Page Ambulette transports for eligible Veteran patients in accordance with 38 U.S. Code 111 for the New Jersey Healthcare System at the East Orange and Lyons campuses, and all outlying outpatient clinics.

**Please refer to Section E, E.9

FAR 52.212-2

Evaluation- Commercial Items specifying requirements and instructions for submitting offers.

See CONTINUATION Page 561-3600160-482-829800-2119 010041086 X X X One Cheryl A. Brimmer Contracting Officer Table of Contents

B.2 STATEMENT OF WORK…………………………………………………………………..5

D.2 WAGE DETERMINATIONS………………………………………………………………48

D.3 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)……………………………72

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 Cheryl A. Brimmer

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

3. INVOICES: Invoices shall be submitted in arrears:

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

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:

B.2 STATEMENT OF WORK

AMBULETTE SERVICES STATEMENT OF WORK

VA New Jersey Health Care System (VANJHCS) requires 24 hour, 7 days per week, 365 days per year Ambulette Service for eligible Veteran patients under 38 U.S. Code 111 at the following locations:

(732) 532-4500

Paterson Outpatient Clinic 11 Getty Avenue Building 275 Paterson, NJ 07503

(973) 247-1666

This procurement is for the provision of Ambulette transportation services for eligible beneficiaries of the Department of Veterans Affairs New Jersey Healthcare System (VANJHCS). The contractor shall provide all vehicles, personnel, management, supplies, transportation, vehicle fuel, uniforms, nametags and/or badges, equipment and reports necessary to provide Ambulette services as specified in this Statement of Work.

DEFINITIONS:

“Travel Unit” – Beneficiary Travel Clerks or the Travel Supervisor at the applicable VA facility “AOD” – Administrative Officer of the Day; VA employee who acts as the administrator after 4:30pm Monday through Friday, on weekends and holidays.

SERVICE AREA: Services shall be required throughout the states of Connecticut, Delaware, New York, New Jersey, and Pennsylvania.

CONTRACTOR QUALIFICATIONS:

Established in the business of providing ambulette transports, who are financially responsible and have the necessary equipment and personnel to furnish these services in the volume required under this procurement. The contractor shall meet all requirements of Federal, State, City and Local laws and regulations regarding operation of this type of service.

WORK HOURS:

Services shall be provided as requested seven (7) days a week, twenty-four (24) hours a day, 365 days per year, including all National Federal Holidays.

RATES AND MILEAGE

Base Rate: For all Veteran patient transports within the threshold limits from a designated pick-up point to a designated delivery point, the contractor shall receive a flat base rate. The Base Rate shall constitute full compensation for each pick up that does not exceed the mileage threshold.

Mileage Rate: The contractor shall receive the mileage rate for each mile traveled beyond the specified threshold limit. In the event a fraction of a miles results, VA shall pay the rounded off amount to the next higher whole mile. In no event shall the contractor receive this mileage rate for miles traveled within the specified threshold limit.

Mileage Threshold: The mileage threshold is defined as within fifteen (15) driven road miles from the patient’s pickup point to the patient’s destination. Mileage shall be calculated utilizing the latest internet Google Maps version that provides the shortest route in terms of mileage, or a similar mapping service (i.e. Microsoft, or use of a Global Positioning System within the vehicle) that provides the shortest route in terms of mileage.

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 legitimate toll charges incurred shall be limited to only when the patient is traveling in the vehicle or no-pick up trips 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 shall 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 waiting due to causes beyond the control of the driver, the contractor shall 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 15-minute waiting grace period at origin and destination; the wait time charge only applies if the crew is delayed longer than 15 minutes at the time of pickup or delivery.

1. For non-scheduled trips, waiting charges shall commence 15 minutes from the time the contractor actually arrives at the designated pick-up and/or delivery points. For non-scheduled trips with specified time for pick-up, waiting charges shall commence 15 minutes after that pick-up time. For scheduled trips, waiting charges shall commence 15 minutes from the scheduled pick-up time or from the time the contractor actually arrives at 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 15-minute grace period is anticipated, the contractor shall notify the Travel Unit; if these individuals are not available, the Contractor shall notify the AOD. This call is for the purpose of 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 waiting time charges will be honored without prior approval.

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 Veteran patient is being transported on a trip, reimbursement shall be made for each individual patient based upon their individual drop-off or pick-up location. The contractor must ensure that pick-ups and drop-offs are scheduled to ensure timeliness for all patients on the trip. Transports for each Veteran on a “multiple patient transport” must adhere to the requirement a transport will be reimbursed based on the shortest distance from the patient pick up to the patient destination.

ORDERS:

Order Requests: Requests for services shall be made by authorized VA staff only, in writing, by telephone, or via fax. 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 liable for those services performed by the contractor which are ordered by people who are unauthorized.

Scheduled Trips: Scheduled requests for services shall 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)

· Comments (number of steps and/or stairs, 2 man)

· 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

Non-Scheduled Trips: Any trip ordered the same day as needed is a non-scheduled transport. An order shall be generated for non-scheduled transport(s) that reflect the date and time the request was received by contractor.

TRIP TICKETS AND TRAVEL CLERK NOTIFICATION:

The driver is required to notify the Travel Unit in person when picking up or discharging a patient during regular duty hours of 8:00 am – 4:30 pm, Monday through Friday. After 4:30 pm, weekends and holidays, the AOD shall be notified.

Signed trip tickets for all transports must be provided by the driver at the time of transport to the VA Travel Unit. All trip tickets shall 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 shall contain the following information:

· Patient's Name

· Date and time of pickup and/or delivery

· Vehicle Identification Number

· Name of driver

· Contractor name and contract number

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

· tolls

PICK-UP PROCEDURES:

When the Veteran patient is picked up at a VA facility, the driver or attendant shall announce to the Travel Unit in Medical Administration Service at the medical center that the Ambulette is waiting. Contractor shall provide the beneficiary’s name as well as any other pertinent information as to his/her identification. The individual informed will verify the time on the trip ticket providing a copy of the trip ticket to the facility representative. 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/her to and into the waiting Ambulette. The patient shall be transported in a standard size wheelchair appropriately secured to the vehicle for Veterans unable to use the Ambulette seat.

When Veteran is picked up at his/her residence, the Veteran will verify the time and sign the trip ticket, or if unable to do so, a member of the household will sign the trip ticket. The household member will be allowed up to fifteen (15) minutes after this verified time of arrival for preparatory tasks exclusive of boarding activities that shall commence when the individual is ready to be placed in the travel device used to bring him to the waiting vehicle. The patient shall be transported in a standard size wheelchair appropriately secured to the vehicle for Veterans unable to use the Ambulette seat.

PATIENT TRANSPORT

1. A patient’s “destination” is considered to be within the premises of the particular area the beneficiary is required to report to or within their home in accordance with the address destination given by the COR. When patients are transported to the VA Medical Center, the destination is deemed to be the Emergency Room, Admissions, the clinic or service within the hospital, or directly to the ward as instructed by the VA.

2. 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, the 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).

3. 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.

4. If the contractor fails to furnish Ambulette service in a timely manner (within one hour) after receiving a VA request for service, the VA must be notified within that hour in order to make alternate transport arrangements. If the contractor cannot provide an Ambulette, the VA will obtain the Ambulette service from another source and the contractor will be liable for any charges above the contracted amounts.

5. The contractor is to follow the designated pick up time or comments as specified for each patient on the Schedule Patient Transport Manifest. Prior approval from the Travel Unit is required before any changes are made.

6. All drivers are required to check in and out of the particular VA facility Travel Unit when dropping off and picking up Veteran patients. Drivers shall have a contractor receipt time/date stamped by the Travel Unit. A copy of the receipt shall be left with the Travel Unit.

7. Two (2)-man team shall be required upon request to lift certain patient's more than one flight of stairs to get to the patient's residence when patient is presented to caregiver. The contractor will be notified of this requirement when the order is placed.

8. Contractor shall receive a patient’s destination address before the patient is discharged from a VA facility. All drivers shall confirm the discharged patient’s destination address prior to transporting the patient. Between the hours of 8:00 am – 4:30 pm, drivers shall confirm the address with the Travel Unit. For any patient discharged after 4:30 pm, the driver shall confirm the address with the AOD.

9. The driver or dispatcher MUST notify the Travel Unit if a patient being discharged or transferred is not ready for transport at the designated time.

10. All inter-facility transfers MUST have a direct transport between the facilities; no intermediate stops are permitted during inter-facility transfers.

***NOTE: THE CONTRACTOR SHALL NOTIFY THE PATIENT AND THE TRAVEL UNIT BY TELEPHONE OF ANY DELAYS IN THE TRANSPORTING OF PATIENTS. THE VA WILL ESTABLISH PRIORITIES WHEN NECESSARY. ***

NUMBER OF PATIENTS:

No more than two Veteran patients shall be transported on a trip unless specifically authorized by the COR. The contractor must ensure that pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government. If contractor transports more than one patient without approval, payment for extra patient (distance) will not be allowed.

The contractor shall not transport non-VA beneficiaries or private-pay patients with VA beneficiaries under this agreement. 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:

When ambulette service is ordered under the terms of this contract, and the patient is not available for pick-up due to unforeseen circumstances, the contractor shall be allowed reimbursement for the trip at the rates applicable under the schedule portion of this contract (including base rate and applicable mileage rate). The VA reserves the right to substitute patients in these instances to prevent the ‘Non-Pickup” 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 driver shall contact the Travel Unit [during normal working hours] or AOD [after business hours] and inquire as to the status of the arrival before the ambulette is dispatched. If appropriate, waiting time may be authorized for time lost in accordance with the rates applicable under the schedule portion of this contract. If the contractor reported as scheduled and no patient is transported, he/she shall be reimbursed at the rates applicable under the schedule of prices.

TRIP INTERRUPTIONS:

No Veteran beneficiaries shall be transferred from the original Ambulette and entered into another vehicle or be removed from the original vehicle at a location other than the destination address supplied by the 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 shall be required to transport patient luggage, medical records, medication and any other items (including wheelchairs, manual and electric, Stryker frames, or other medical equipment) 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. When patients are transported to the VA Medical Center, the destination is deemed to be the Emergency Room, Admissions, the clinic or service within the hospital, or directly to the ward as instructed by the VA.

KEY PERSONNEL AND TEMPORARY EMERGENCY SUBSTITUTIONS:

The Contractor shall assign to this contract the following key personnel:

1. The Contractor shall provide a dispatcher. The dispatcher will be the primary point of contact for all transportation orders placed by the VANJHCS. This shall include a primary dispatcher assigned to each working tour, 24-hours, and 7 days/week. A list of these points of contacts shall be provided to the Contracting Officer Representative (COR).

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, as soon as known by the contractor 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.

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

AMBULETTE DRIVERS:

1. Identification: All contractor drivers 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 uniforms that identify the drivers and attendants while performing any service prescribed in this contract.

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

3. Contractor personnel shall not smoke in vehicles while transporting Veteran patients.

4. Contractor personnel shall not text message while driving.

5. Prices include the provision of a non-emergency attendant/driver for each vehicle. In accordance with applicable Federal, State, City and Local laws and regulations regarding operations of this type of service, all drivers must meet the following requirements:

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

(2) Must have a valid driver license, valid for operation of this type of vehicle.

(3) Must have passed a driver physical examination and have the physical ability to operate this type of vehicle (Ambulette/Bus). Physical examination is to be an annual requirement for continued work under this contract.

(4) Must have passed a drug/alcohol screening examination.

(5) Must have completed and passed Safety and First Aid training provided by the contractor, pursuant to applicable state laws.

6. Drivers shall furnish any assistance required by the Veteran beneficiary in moving from pick-up point into the vehicle and from the vehicle to the point of destination.

VEHICLES:

1. Vendor vehicles must be high tops and have hydraulic lift.

2. All vehicles must comply with Federal, State, City and local laws and regulations regarding the operation of ambulette services. These regulations include but are not limited to Federal Specification KKK-A-1822, National Fire Protection Association (NFPA) 1917, New Jersey Department of Health and Senior Services – Manual of Standards for Licensure of Mobility Assistance Vehicle and Ambulance.

VEHICLE PERFORMANCE: The Government reserves the right to inspect any vehicle that will be used to provide services under this contract and reject any vehicle or equipment within the vehicle without advance notification that is found to be in a faulty condition or equipped in a manner that does not comply with contractual provisions.

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

1. Address to address routing

2. Voice prompts for turns & guidance

3. Built in road maps – detailed road map displays

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

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

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

7. Maps user can upload for area needed

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

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

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

11. Calculates speed from starting point to ending point

12. 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 any 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 Travel Unit will indicate concurrence or non-concurrence excusing such delays for the reasons after communication with the Contracting Officer.

RESPONSE TIME:

The contractor shall be present to receive the patient at the specified time; 15 minutes prior FOR SCHEDULED CALLS, and 30 minutes prior FOR UNSCHEDULED CALLS.

For time lost waiting at either end or both ends of a trip due to causes beyond contractor control, the reimbursement shall be at a rate of one-fourth the hourly rate for each quarter hour or fraction thereof in excess of one quarter (1/4) hour from the time the driver reports to the designated person. The contractor shall call the Travel Unit as soon as it is anticipated that a delay may develop for which claim wait time reimbursement is expected. The notification call is to verify arrival time at pick-up/drop off point.

SPECIAL REQUIREMENTS:

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

1. The contractor is required to maintain records that document competence/performance level of contractor employees performing under this contract. In accordance with NJS Joint Commission and other applicable regulatory requirements, the contractor shall maintain a file for each driver to include the following, and to be provided to the Contracting Officer upon request:

a. Copy of valid driver license.

b. Initial and subsequent annual physical examination assessments.

c. Completed criminal background investigation with fingerprints.

d. Completed drug/alcohol screening examinations.

e. Annual review of driving record.

f. Annual record of driver violations/accidents.

g. Biennial behind-the-wheel driving test conducted by Contractor.

h. Annual Safety/First Aid training certificates.

i. Competency assessment checklist/Annual performance summary.

2. All Contractor personnel performing contract services shall meet the qualifications as specified in this Statement of Work, as well as any qualifications required by Federal, State, County, City and Local government entities from the place where they operate.

3. Upon request of the Contracting Officer, the contractor shall remove any contractor employee who does not comply with or meet competency requirements for the work being performed.

4. When changes in contractor personnel are approved by the Contracting Officer in accordance with the “Key Personnel” requirements noted above, the contractor must provide evidence of current competence assessment and current performance evaluation.

EVIDENCE OF INSURANCE COVERAGE:

The contractor shall furnish to the Contracting Officer a certificate of insurance containing an endorsement to the effect that cancellation of, or any material change in, the policy adversely affecting the interests of the Government shall not be effective unless a thirty (30) day written notice of cancellation or change is furnished to the Contracting Officer.

MONTHLY TRIP/EXPENDITURE REPORTS:

To support each monthly invoice, the contractor shall provide monthly trip/expenditure reports to the COR detailing all trips, scheduled and non-scheduled, for the period invoiced. This documentation shall include the following:

1. Patient Name

2. Date of trip

3. Pick-up location

4. Drop-off location

5. Total Mileage

6. Tolls

CANCELLATIONS:

On trips within the mileage threshold limit 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 mileage threshold 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 not to include any mileage charge.

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, patient absence, or patient refusal; the contractor shall receive the base rate for trips within the mileage threshold limits or base rate plus mileage for trips outside the mileage threshold limits.

PATIENT WELFARE AND ABUSE:

The contractor shall be responsible for patient welfare during transport. Drivers shall be responsible to ensure that Veteran patients are not left abandoned at their destination. Drivers are to ensure that Veteran 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 property during transport. Any damaged or lost wheel chairs (including power wheelchairs), walkers, crutches, or personal belongings shall be replaced at the contractor’s expense.

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.

The Government expects the contractor to exercise extreme caution and care in handling of Veteran patients.

Contractor must take into consideration they will be transporting ill/psychiatric Veteran patients.

Contractor is responsible for enforcing NO SMOKING requirements while patients are in transport.

INCIDENT/ACCIDENT REPORT:

When an incident or accident occurs while a Veteran patient is in the contractor’s care, the Travel Unit MUST be contacted immediately. In cases where immediate emergency medical treatment is deemed necessary, notifications are required upon arrival at the nearest facility. In all cases, Veteran patients must be cleared by this facility’s emergency room physician as clearance must be documented. Contact can be made to the Travel Unit during business hours and the admitting desk during off tours. Written reports are required by 10:00 a.m. the first working day following the incident/accident to the Chief or Assistant Chief, Business Office; Travel Unit; COR; the Performance Improvement office at the VA Medical Center, East Orange, New Jersey; and a copy to the Contracting Officer.

VA WILL FURNISH:

VA will provide designated parking spaces just outside the Emergency Room entrance.

Authorized Medical Center Personnel: Prior to performance, the COR shall provide the contractor a list of names, position titles and phone number of authorized Government personnel who may request services and receive calls from contractor.

1. The contractor shall ensure requests for services are received from authorized medical center personnel. Services rendered in response to a request from other than authorized personnel shall be at the contractor’s expense.

PATIENT RIGHTS:

1. The contractor shall be courteous to Veteran beneficiaries and shall not smoke while transporting patients.

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

3. The contractor shall notify the COR in writing within 24 hours of any complaints made by the Veteran patients with regards to the ambulette service.

CONTRACTOR’S QUALITY CONTROL PROGRAM (QCP):

The contractor shall establish and maintain a QCP to ensure contract requirements are met. The contractor’s QCP shall include the following, at a minimum:

1. 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, how often inspections will be accomplished and documented, and the title of the individual(s) performing the inspections.

2. On-site records of all inspections conducted by the contractor noting corrective action taken. The Contracting Officer reserves the right to request copies of any inspection.

3. The methods for identifying and preventing deficiencies in the quality of service performed and organizational functions noting intermediate supervisory responsibilities and overall management responsibilities for ensuring acceptable performance.

4. Maintaining 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 procedures for alternative transportation of Veteran patients in the event of mechanical breakdown of vehicle.

5. On-site records identifying the character, physical capabilities, certifications and ongoing training of each employee performing services under this contract.

6. Methods of identifying and preventing radio communication breakdowns providing a procedure for alternative communications in the event of electronic and mechanical breakdown.

7. System for maintaining on-site records of any complaints or problems and procedures taken to allow for corrections and/or elimination before effects caused interruption of contract performance.

8. Participation in quarterly scheduled and/or unscheduled conference calls with the Contracting Officer and COR to provide a report of on-going operational issues.

9. A system that verifies the licenses and driving records of individuals operating the vehicles. The Contracting Officer reserves the right to review these records upon request.

BUSINESS ASSOCIATE AGREEMENT:

A Business Associate Agreement (BAA) is required as defined in Health Insurance Portability and Accountability Act (HIPAA), Public Law 104-191. (See Section D of the RFQ solicitation for completion)

**Any/all subcontractors must meet the same criteria specified in this Statement of Work”

B.3 PRICE SCHEDULE

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate) Base Year 4/1/2020 – 3/31/2021

Trip / Load Fee

Base Year

Mile

Base Year

Hour

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate) Option Year 1 4/1/2021 – 3/31/2022

Trip / Load Fee

Option Year 1

Mile

Option Year 1

Hour

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate) Option Year 2 4/1/2022 – 3/31/2023 Trip / Load Fee

Option Year 2

Mile

Option Year 2

Hour

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate)

Option Year 3 4/1/2023 – 3/31/2024 Trip / Load Fee

Option Year 3

Mile

Option Year 3

Hour

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate)

Option Year 4 4/1/2024 – 3/31/2025 Trip / Load Fee

Option Year 4

Mile

Option Year 4

Hour

B.4 PRICE WORKSHEET*

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate) Base Year

12,000

Trip / Load Fee

Base Year

384,000

Mile

Base Year 4/1/2020 – 3/31/2021

Hour

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate) Option Year 1 4/1/2021 – 3/31/2022

Option Year 1 4/1/2021 – 3/31/2022

Option Year 1

Hour

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate) Option Year 2

12,000

Trip / Load Fee

Option Year 2 4/1/2022 – 3/31/2023 384,000

Mile

Option Year 2 4/1/2022 – 3/31/2023

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate)

Option Year 3

12,000

Trip / Load Fee

Option Year 3

384,000

Mile

Option Year 3 4/1/2023 – 3/31/2024

Ambulette Service – One Way Trip within Mileage Threshold (Base Rate)

Option Year 4 4/1/2024 – 3/31/2025 12,000

Trip / Load Fee

Option Year 4

384,000

Mile

Option Year 4

Hour

TOTAL: Base plus Four (4) Options

*This worksheet is for price evaluation purposes only.

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT 2018)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt Payment Act (31 U.S.C. 3903) and prompt payment regulations at 5 CFR part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B…