36C24226R0087

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

UEI:

EFT:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

561-26-3-482-0008 36C24226R0087 05-18-2026 Harsch, Michelle Michelle.Harsch@va.gov 716-862-7373 06-15-2026

1:00PM

EDT

36C528 Department of Veterans Affairs Network Contracting Office (NCO) 2 3495 Bailey Avenue Building 3, 2nd floor Buffalo NY 14215 X X 621910 $22.5 Million N/A X Department of Veterans Affairs NJ Healthcare System East Orange and Lyons Campuses 385 Tremont Avenue East Orange NJ 07018 36C528 Department of Veterans Affairs Network Contracting Office (NCO) 2 3495 Bailey Avenue Building 3, 2nd floor Buffalo NY 14215

Tungsten Network https://www.tungsten-network.com/ customer-campaigns/veteransaffairs/

See CONTINUATION Page BLS and SCT Ambulance Transports for eligible Veteran patients in accordance with 38 U.S.C. Section 111A as specified in the Statement of Work included herewith.

See CONTINUATION Page 561-3660160-482-829800 010041086 X X X Joseph Cellino Contracting Officer Table of Contents

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

D.1 QUALITY ASSURANCE SURVEILLANCE PLAN (QASP)………………………...…48

D.2 WAGE DETERMINATIONS……………………………………………………………..52

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 Joseph Cellino Department of Veterans Affairs Network Contracting Office (NCO) 2 3495 Bailey Avenue, Building 3, 2nd floor Buffalo NY 14215

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:

https://www.tungsten-network.com/customer-campaigns/veteransaffairs/ ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 STATEMENT OF WORK - Basic Life Support (BLS) and Specialty Care Transport (SCT) Ambulance Transport Services

DESCRIPTION

Contractor shall provide all required labor, material, equipment and supervision of contractor personnel for Basic Life Support (BLS) and/or Specialty Care Transport (SCT) Ambulance Services. The contractor shall conform to all regulations of Federal, State and local governing in the performance of ambulance transport services including the Federal Department of Transportation Regulations at 49 CFR Part 391.11-391.13. The contractor shall furnish ambulance transport services 24 hours, 7 days per week, 365 days per year for eligible Veteran beneficiaries under 38 USC Section 111A of the Department of Veterans Affairs, New Jersey Healthcare System:

(732) 729-0646

BASIC LIFE SUPPORT AMBULANCE (BLS): service shall be defined as an ambulance transportation mode equipped and staffed to provide fundamental emergency medical care and non‑invasive interventions during transport. BLS services must comply with all standards and requirements established by the New Jersey Office of Emergency Medical Services (NJOEMS) in accordance with N.J.A.C. 8:40, “Mobility Assistance Vehicle and Basic Life Support Ambulance Service.” BLS may be used for inpatient unit transfers, ED‑to‑ED transfers, clinic appointments, CBOCs, nursing home discharges/admissions, and home transports when clinically appropriate and ordered by a provider. This level of transport is intended for patients whose medical needs can be met through basic emergency care and monitoring and do not require specialty Care Transport (SCT) capabilities.

SPECIALTY CARE TRANSPORT (SCT): shall be defined as an ED‑to‑ED mode of ambulance transportation intended for Veterans who require advanced medical monitoring and specialized clinical interventions during transfer. SCT services must be provided by a qualified critical care transport nurse in accordance with the standards, competencies, and requirements established by the New Jersey Office of Emergency Medical Services (NJOEMS), as outlined in N.J.A.C. 8:41. This level of transport is reserved for patients whose medical condition exceeds the clinical capabilities of Basic Life Support (BLS) and requires continuous, high‑acuity care throughout the inter‑facility emergency transfer. SCT is available for ED‑to‑ED and inpatient transfers and is ordered based on the patient’s acuity and clinical needs.

SERVICE AREA: The Contractor shall provide services throughout the State of New Jersey and, when clinically appropriate and authorized, interstate transfers to designated VA facilities (e.g., VA NY Harbor and Bronx VAMC). Toll charges for loaded trips (Veteran onboard) are reimbursable with documented receipts (EZPass, etc.). Ferry use is prohibited unless specifically authorized by the Contracting Officer.

REQUIRED SERVICES:

Government Responsibility

VA is responsible for determining the type of services required, ordering the required services and monitoring the performance of the contractor. It is the policy of the VA New Jersey Healthcare System (VANJHCS) to provide transportation to eligible Veterans in need of receiving healthcare in accordance with 38 USC Section 111A. VA may order SCT or BLS depending on acuity and level of care required during transport

Contractor Responsibility

The Contractor shall transact business as specified in this Statement of Work with the Contracting Officer (CO) and/or the Contracting Officer's Representative (COR). Under no circumstance shall the contractor deal directly with or solicit from beneficiaries of the VA.

The Contractor shall furnish linen and blankets for use in the ambulance. Clean and fresh linen and blankets must be used for each patient to specifications as follows:

Two (2) sheets, disposable or cloth Two (2) pillowcases, disposable or cloth for each pillow Two (2) cloth towels

Contractor shall maintain all vehicles in a clean and orderly condition, free from debris and any accumulations which may constitute an accident, injury, or fire hazard.

Scheduling/Coordination

A. All routine and urgent requests shall be submitted and managed through the VetRide Vendor Portal (or VA‑Approved Transportation Software). VANJHCS will provide access/training. Contractor must ensure monitoring VetRide 24/7, receive electronic trip requests, utilize Vendor Pass, and submit claims electronically (HCFA‑1500) through the portal. If VetRide is down, requests shall be made by designated individuals who are authorized representatives of the VA to request BLS and SCT ambulance services. These include the Veterans Transportation Service, Travel Clerks, Contracting Officers Representative (COR), Mobility Manager, or Administrative Officer on Duty (AOD). The request for service shall include the time and location for pick-up and drop-off of the patient.

1. If the Contractor fails to furnish ambulance services within one hour after receiving a request for service, the VANJHCS reserves the right to obtain the services from another source where the contractor shall be responsible for any excess costs over the contracted rates.

2. When conditions, neither foreseeable and/or controllable by the Contractor occur such as, but not limited to, severe storms, flooding, hazardous road and travel conditions, time and distance requirements shall be considered secondary to safety precautions. Delays or exceptions to the required quality of services shall be reported to the Veterans Transportation Service-Travel Department, Office of the Chief Mobility Manager, or the Administrative Officer of the Day (AOD-during off hours) for reporting to the Contracting Officer. The Contracting Officer shall decide if such delays in service will be excused in accordance with FAR 52.212-4(f) Contract Terms and Conditions.

b. The Contractor shall ensure that the pickups and drop-offs are scheduled so that the total distance traveled shall result in the most economical charge to the Government

4. Adherence to schedules is of the utmost importance. The Contractor shall pick up the patient as near to the scheduled pickup time as possible. If the Contractor arrives earlier than the scheduled pick up, the driver shall wait at the pickup location until 15 minutes past the scheduled pickup time before calling the dispatcher for instructions.

a. The Contractor shall be required to maintain 95% On-Time performance. Trips shall be considered "On-Time" if they arrive at the destination on or before the scheduled arrival time.

b. The dispatcher shall contact the authorized VA representative to allow resolution of the delay and approval of additional wait time.

B. Unless specifically authorized by the COR after consultation with the Contracting Officer, the driver is to take the shortest distance available. The Contractor shall be reimbursed accordingly if advised to take the most expeditious route regardless of mileage.

C. If a dispatched BLS crew determines the patient meets criteria for SCT, COR approval (in consultation with VA Provider, CO when SCT rates apply) is required prior to transport under upgraded service.

D. The Contractor shall immediately report to the COR all vehicle breakdowns or other problems that may cause service disruptions.

E. Trip tickets for all transports shall be submitted to the COR within 24 hours of the transport for records and to verify invoices.

F. The Contractor must confirm all transports prior to dispatch for pick up.

ORDERS FOR SERVICE:

A schedule shall be provided (1) one day prior to patient transport. All routine and urgent requests shall be submitted and managed through the VetRide Vendor Portal (or VA‑Approved Transportation Software). Contractor shall ensure VetRide is monitored 24/7, receive electronic trip requests, utilize Vendor Pass, and submit claims electronically (HCFA‑1500) through the portal. If VetRide is down, Requests for services shall be made by the COR and/or Veterans Transportation Service, Travel Clerks, Contracting Officers Representative (COR), Mobility Manager, or Administrative Officer on Duty (AOD). The Contractor shall, at all times during the contract period, have on his/her premises a functioning fax machine to communicate requirements with the VA (i.e. requests for service, patient incidents, special correspondence, etc.).

Orders shall include pickup/drop‑off time and locations, authorization number, transport mode, and any special instructions.

Contractor must notify the Contracting Officer's Representative (COR) and/or designated VAMC personal at least eight (8) hours in advance of need when Contractor believes he/she may be unable to meet the number of scheduled trips required.

If the Contractor cannot provide service for any reason, immediately notify the authorized VA requestor via VetRide, and by phone to the VANJHCS Transportation Office (business hours; Lyons/East Orange numbers) or AOD (off‑hours).

For urgent transports called in the same day, if the Contractor fails to furnish service within thirty (30) minutes after receiving the transport request, VANJHCS may re‑procure services; the Contractor shall be liable for excess costs over contract rates.

The Contracting Officer shall be the sole judge in determining when to order service from another source. In the case of inclement weather, the decision whether a VA beneficiary will be transported shall be made mutually by the COR or designee and the Contractor.

PATIENT PICKUP AND DELIVERY

A. Ambulance drivers shall report to the floor where the Veteran patient is located. The VA East Orange and Lyons Medical Center campuses are staffed 24 hours a day, 7 days a week. The Contractor shall follow the following protocol:

1. Report to the personnel at the respective nursing Station and (1) announce his/her arrival to pick up and transfer patient, and (2) obtain report of pertinent information regarding patient's condition from primary nurse/physician.

2. When delivering a patient to the VA, check in at the assigned floor before proceeding to take the patient to the specified location in the facility and provide a report to the appropriate nursing personnel along with a copy of the run that will be retained by the facility for the patient's medical record.

3. VANJHCS reserves the right to substitute the beneficiary requiring services, prior to the vehicle being dispatched, at any time during the performance of this contract to prevent delays, cancellations, or dry runs. There shall be no additional charge to the VANJHCS when such changes occur.

B. Only one (1) patient shall be transported on a trip allowing only (1) family member escort or caregiver when authorized by VANJHCS. No more than one (1) psychiatric patient shall be transported at one time.

C. The Contractor shall be responsible for patient welfare and Government property during any and all transports. The Contractor shall exercise extreme caution and care in the handling of patients.

Any abuse of patients shall be grounds for default action or termination of the contract.

1. Any damaged or lost wheelchairs, walkers, crutches or personal belongings shall be replaced by the Contractor.

D. Patient Custody - The Contractor shall not release the patient from his/her custody, unless custody is released to the charge nurse on duty at the facility the patient is being transported to, or to a designated point of contact at the patient's residence. Patients brought in by ambulance for a scheduled clinic appointment shall be delivered directly to that specific clinic, released to the custody of clinic personnel, and picked up by the ambulance crew, as ordered, in the clinic after the appointment.

E. Incident Report -The Contractor shall immediately report all medical incidents and/or vehicle accidents including those where there is no apparent injury to the patient while transporting VA beneficiaries. Notify the Travel Clerks during normal business hours and the AOD after hours.

1. A written report from the driver documenting the facts of the incident/accident shall be provided to the Contracting Officers Representative (COR) within 24 hours of the occurrence. The written report shall include the names, addresses, and telephone numbers of any witnesses as well as any applicable police reports.

**Any accidents involving major damage, serious personal injury or loss of life shall be reported to the COR and CO immediately.**

CONTRACTOR PERSONNEL AND ORGANIZATION QUALIFICATIONS:

The contractor shall ensure that the following personnel requirements are met.

All Contractor personnel, both prime and subcontractor, performing contract services for BLS and SCT Ambulance Transports shall meet all qualifications and licensing required by federal, state, county and local Government entities including the State of New Jersey Department of Health (DOH) EMS. In transporting patients the care provided by an EMT or Paramedic shall not exceed the scope of practice as defined by the State of New Jersey DOH EMS.

All staff on contractor ambulances shall possess and maintain a valid CPR/BLS/AED card.

All operators of ambulances, whether BLS or SCT shall possess and maintain a valid state driver’s license, as well as certification and training that qualifies them as emergency vehicle drivers.

BLS providers shall possess and maintain a valid EMT license issued by the State of New Jersey and/or the National Registry of Emergency Medical Technicians.

SCT providers shall be trained, certified, and/or licensed in their respective fields. Additionally, SCT providers shall be trained and meet contractor’s Medical Director requirements.

If licensing and certifications require periodic renewal, copies must be provided to the COR and CO upon request.

USE OF SUBCONTRACTORS:

All vendors utilized as subcontractors must meet all requirements of this contract.

The prime contractor shall disclose use of any subcontractors and ensure all certification and training requirements are in compliance with federal, state, and county regulations governing ambulance services.

The prime contractor shall be responsible for all subcontracted services provided under this contract and shall ensure that all such services comply fully with the terms, conditions, and requirements of this agreement.

CONTRACTOR EQUIPMENT VEHICLE AND INSPECTION:

The ambulance vehicle(s) (Emergency Medical Services Vehicle) under the terms of this contract shall be licensed and meet the minimal vehicle requirements as established by the New Jersey Office of Emergency Medical Services under New Jersey Administrative Code Title & Chapter 40: Subchapter 2. The contractor must be a licensed EMS Provider in the State of New Jersey.

CONTRACTOR COMMUNICATION SYSTEM:

Contractor's Communication System shall consist of:

Telephone System

Contractor shall have sufficient telephone capacity to ensure immediate communication access between the VA New Jersey Healthcare System (VANJHCS) and the Contractor's facility for the purposes of scheduling and canceling trip requests as well as handling other emergencies. If the Contractor's place of business is located beyond the local telephone call zone, the Contractor shall accept telephone orders for service on a collect call basis or provide a toll-free number.

The Contractor shall have telephone coverage to accept calls from VA New Jersey Healthcare System (VANJHCS) seven (7) days a week/24 hours a day Sunday through Saturday.

Vehicle Communication

Contractor shall ensure the availability of mobile radio and /or cellular telephone communication with all vehicles providing BLS and SCT transportation services at all times.

CONTRACTOR PERFORMANCE:

The Contractor shall be responsible for providing all vehicles and manpower, necessary to meet all SCT and BLS transport requirements of this contract.

In the event the Contractor is unable to perform services as required, the Contractor shall immediately notify the VA Transportation Office/ Contracting Officer Representative and provide a justification for non-performance.

The VA reserves the right to re-procure services that cannot be performed by the Contractor in accordance with the terms, conditions, and schedule of this contract. The Contractor shall indemnify the VA for excess re-procurement costs that result from the Contractor's inability to perform the required service. Payment of re-procurement costs shall not relieve the Contractor from any other provision in this contract covering inspection, acceptance and deductions from payment. The Contracting Officer shall be the sole judge in determining when services shall be re-procured. The failure of the Contractor to perform services within the required time frames and in accordance with terms and conditions may also provide cause for termination of the contract for cause [see FAR Clause 52.212-4(m)].

BACKUP SERVICES:

Contractor shall be responsible for notifying VA Transportation/Contracting Officer Representative when a vehicle is excessively late or is otherwise unavailable for services. The vehicle is excessively late if it is twenty (20) minutes late in meeting its assigned schedule. A back-up vehicle for an excessively late vehicle or an otherwise unavailable vehicle must be in place within thirty (30) minutes after a vehicle has been deemed unavailable for service for whatever reason.

DRIVER'S CONDUCT:

While on duty the following are not permissible by drivers that provide services under this contract or while on VA premises:

Do not participate in a dispute with a fellow employee, customer(s) or the public while on duty.

Use of loud, indecent or profane language and/or making threatening or obscene gestures towards customers or other employees.

Engaging customer in a verbal confrontation in an attempt to settle a disagreement. Should a disagreement arise, the driver shall contact his dispatcher/supervisor via the radio system or cellular phone.

Soliciting or accepting tips from customers, companions or others at any time.

CUSTOMER SERVICE:

Complaints against Contractor personnel behavior or courtesy may result in requiring the removal of the offender from providing these contracted services. Offenders who make five (5) unrelated and substantiated complaints within a 12-month period shall be prohibited from providing any further services under this contract. The COR shall monitor the service provided. The Contractor shall cooperate with the COR in providing information and answering questions in a timely manner when requested. The Contractor shall refer complaints received directly from the customer(s) to the COR. All complaints received by the COR and forwarded to the Contracting Officer (CO) shall be investigated promptly. After investigation and disposition, the Contractor shall respond to the CO within five (5) working days after receipt of the documented findings.

QUALITY ASSURANCE SURVEILLANCE PLAN:

The purpose of the Quality Assurance Surveillance Plan (QASP) is to provide guidance how the quality of services provided under this contract will be monitored. Please reference Section D of the RFP solicitation.

RATES AND MILEAGE:

Base Rate: For all one-way trips within the 15-mile threshold from a designated pick-up point to a designated delivery point, the contractor shall receive the flat base rate awarded for that trip.

The Base Rate shall constitute full compensation for one-way trips that do not exceed the 15-mile threshold.

Mileage Rate: In addition to the base rate, the contractor shall receive the mileage rate for each mile traveled beyond the 15-mile threshold. This rate applies to loaded, one-way transportation. In the event fraction miles result, VA shall pay the rounded off amount to the next higher mile. In no event shall the Contractor receive this rate for miles traveled within the 15-mile threshold.

Mileage Threshold: 15-mile radius

Mileage Beyond Threshold: The rate per mile charge shall apply to those trips with a point of origin and/or destination outside a 15-mileage threshold.

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

Toll Charges: Any such legitimate toll charges incurred shall be limited to loaded trips when the Veteran patient is traveling in the vehicle, shall be listed separately on the invoice.

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

The VA shall not be responsible for any overage costs, charges, or fees incurred by the contractor or its subcontractors beyond the agreed‑upon rates.

Subcontractor’s invoices shall not be submitted directly to the VA but rather may be incorporated as part of the prime contractor’s regular monthly invoice.

Ferry use is prohibited for all trips unless approved by COR or Health Administration Service Chief or Assistant Chief.

WAIT TIME CALCULATION:

For time lost waiting at either end of a trip due to causes beyond the Contractor's control, the Contractor shall be reimbursed at the rate of one-fourth the hourly rate specified in the Price Schedule if delayed longer than 15 minutes at time of pickup or delivery. The hourly rate shall be charged in 15-minute increments. If the pickup location is other than the VANJHCS, the Contractor shall contact the VANJHCS Travel Office (during business hours Monday- Friday 8 am-4:30 pm) or Administrative Officer on duty (during all hours outside of the business hours listed) as soon as the Contractor anticipates that a delay for which Contractor expects to claim reimbursement. This call is only for verifying the Contractor’s arrival time at the pick-up point (verification is made by confirming the time of pickup with the VA Staff, or the patient when the pickup is made off the VA Campus) and it is not necessary if the Contractor anticipates no delay for which the Contractor will claim reimbursement. Reimbursement for any wait time requires approval of the CO.

CONTRACTOR QUALITY CONTROL PROGRAM (QCP):

The Contractor shall provide assurance that the transportation services meet health and safety standards for vehicle maintenance, operation, and inspection; driver qualifications and training; client problem resolution, complaint resolution and the delivery of courteous, safe and timely service. The Contractor shall establish and maintain a QCP to ensure the requirements of this contract are provided as specified.

1. The Contractor's QCP shall include the following at a minimum, 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, or the title of the individual(s) who will perform the inspections.

2. 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 acceptable performance.

3. In-site records of all vehicle maintenance and repairs performed for vehicles used in the performance of this contract.

4. The methods for identifying and preventing vehicle breakdowns and detailed procedure for alternative transportation of patients in the event of mechanical breakdown of vehicle.

5. On-site records identifying the character (background checks) and certifications of ongoing training of each employee performing service under this contract. Driver licensure, driving record, experience and appropriate driver training are required to be maintained by the Contractor.

6. The methods of identifying and preventing radio communication breakdowns.

7. A log to account for all requests for service. The log shall indicate the date and time of service call, name of patient requiring service, designated pick-up and delivery points, actual time of arrival at pick-up and delivery points, actual waiting time at pick-up and delivery points, if waiting charges are claimed, and the name and title of VA employee making the transport request.

Completion of drive logs and inspection of manifests are required.

8. Procedure for Accident/Incident reporting.

9. Analysis of complaints, including the tracking and investigating of complaints and disposition of the cases.

10. Random audit of existing rides performed (minimum 10% of trips).

11. Client safety

12. Monitoring of on-time performance

** The Government reserves the right to request copies of any parts of the Contractor QCP**

OTHER REQUIREMENTS:

1. At no time will the Contractor leave vehicles on VA premises unless a pick-up or delivery is in progress or it is authorized beforehand by VANJHCS Executive Management.

2. Contractor employees shall conduct themselves in a businesslike manner at all times.

3. When transporting Veteran patients to or from medical facilities, the driver acting for the Contractor shall ensure that the patient's belongings (i.e. medical records, luggage) are properly accounted for and delivered with the patient as required.

4. Vehicles transporting VA beneficiaries must be dedicated exclusively to VA transports. The Contractor may not carry non-VA contract beneficiaries or private-pay patients with VA beneficiaries under this contract.

5. In the case of a medical emergency, (patient experiences chest pain, seizure, etc.) drivers are to immediately call 911 for assistance and then notify their dispatcher of the situation. Drivers shall have the capability to notify 911 through either their dispatch or VANJHCS Travel Office.

6. If or when patient's medical records are transported, the Contractor shall ensure that HIPPA and The Privacy Act of 1974 guidelines are strictly followed:

-The Privacy Act of 1974, as amended at 5 U.S.C. 552a protects records that can be retrieved by personal identifiers such as a name, social security number, or other identifying number or symbol.

-The Privacy Act prohibits disclosure of these records without the written consent of the individual(s) to whom the records pertain unless one of the twelve disclosure exceptions enumerated in the Act applies.

VetRide or VA-approved Transportation Software Utilization:

The contractor agrees to utilize the VetRide Vendor Portal or VA-Approved Transportation Software with every patient transported under this contract.

Department of Veteran Affairs will provide the software and access to the VetRide Vendor Portal or VA-Approved Transportation Software for the vendor/contractor in this contract. The Contractor will utilize the VetRide Vendor Portal or VA-Approved Transportation Software fully as instructed:

1. Receive and respond to electronic trip requests

2. Receive, use, and ensure the use of the Vendor pass by the driver.

3. Submit claims via the electronic HCFA 1500 in the VetRide Vendor Portal or VA-Approved Transportation Software system.

4. All invoices must be submitted within 30 calendar days of date of service in accordance with 38 CFR 70 to be considered timely submission.

a. The contractor’s invoice must be on the HCFA 1500 to include:

b. Contract Number

c. Date of Service (to include Box 24 A-J)

d. Authorization number(s)

e. Pick-up and drop-off location of the patient

f. Base Rate

g. Name (Last, First and Middle Initial (if any)) and Full Social Security number (Box 1a) of patient transported

h. Date of Birth and Sex

i. Diagnosis Codes or Nature of Illness or Injury

j. Documentation of circumstances when billing for waiting time

k. Any miscellaneous charges for which the contractor is expecting reimbursement i.e., Tool charges, waiting time, etc.

l. VA authorizing official’s name

m. Healthcare Procedure Coding System/National Level II (HCPCS)

5. Unauthorized charges will be reviewed by the Contracting Officer Representative (COR) as to the validity of the charges and as to whether the payment will be made. A final determination will be made within 30 days after notifying the Contractor of the charges that are being suspended. A transportation request is defined as one incidence of a request for one-way service (BLS and SCT). Transportation requests will be made through VetRide or VA-Approved Transportation Software Utilization. Contractors must have the capability to receive orders, update ride status, and input trip costs and other required data through this portal. Contractors must have dedicated staff available to monitor this portal 24/7. VANJHCS Travel Program Staff will be available to assist with account setup and training for the Contractor’s Staff. In the event VetRide or other VA-Approved Transportation Software Utilization is down, other methods of communication (i.e., telephone, facsimile) will be used to place Transportation requests.

a. VANJHCS Travel Program Staff/or authorized VA employees will work with the Contractor the following business day to reconcile any transportation requests that were placed outside of VetRide or VA-Approved Transportation Software Utilization.

b. The Contractor must update VetRide or VA-Approved Transportation Software Utilization with any data and/or notes in real time that deviate from the original order such as invoicing for additional mileage due to a road closure, wait time, reason for no load, etc. VANJHCS Travel Program Staff/or authorized VA employees may place a “hold” on payment of this order until it has been reconciled.

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

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

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

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

Basic Life Support, Non-Emergency Transport, One-Way within 15 Mile radius Contract Period: Base POP Begin: 08-01-2026 POP End: 07-31-2027 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Specialty Care Transport, One-way within 15 Mile radius

POP Begin: 08-01-2026 POP End: 07-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Mileage Outside the Base Rate 15-Mile Radius

POP Begin: 08-01-2026 POP End: 07-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Wait Time/15 minutes (paid after initial 15-minute wait; requires approval)

POP Begin: 08-01-2026 POP End: 07-31-2027

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Basic Life Support, Non-Emergency Transport, One-Way within 15 Mile radius Contract Period: Option 1 POP Begin: 08-01-2027 POP End: 07-31-2028

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Specialty Care Transport, One-way within 15 Mile radius

POP Begin: 08-01-2027 POP End: 07-31-2028

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Mileage Outside the Base Rate 15-Mile Radius

POP Begin: 08-01-2027 POP End: 07-31-2028

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Wait Time/15 minutes (paid after initial 15-minute wait; requires approval)

POP Begin: 08-01-2027 POP End: 07-31-2028

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Basic Life Support, Non-Emergency Transport, One-Way within 15 Mile radius Contract Period: Option 2 POP Begin: 08-01-2028 POP End: 07-31-2029

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Specialty Care Transport, One-way within 15 Mile radius

POP Begin: 08-01-2028 POP End: 07-31-2029

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Mileage Outside the Base Rate 15-Mile Radius

POP Begin: 08-01-2028 POP End: 07-31-2029

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Wait Time/15 minutes (paid after initial 15-minute wait; requires approval)

POP Begin: 08-01-2028 POP End: 07-31-2029

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Basic Life Support, Non-Emergency Transport, One-Way within 15 Mile radius Contract Period: Option 3 POP Begin: 08-01-2029 POP End: 07-31-2030

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Specialty Care Transport, One-way within 15 Mile radius

POP Begin: 08-01-2029 POP End: 07-31-2030

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Mileage Outside the Base Rate 15-Mile Radius

POP Begin: 08-01-2029 POP End: 07-31-2030

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Wait Time/15 minutes (paid after initial 15-minute wait; requires approval)

POP Begin: 08-01-2029 POP End: 07-31-2030

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Basic Life Support, Non-Emergency Transport, One-Way within 15 Mile radius Contract Period: Option 4 POP Begin: 08-01-2030 POP End: 07-31-2031

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Specialty Care Transport, One-way within 15 Mile radius

POP Begin: 08-01-2030 POP End: 07-31-2031

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Mileage Outside the Base Rate 15-Mile Radius

POP Begin: 08-01-2030 POP End: 07-31-2031

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

Wait Time/15 minutes (paid after initial 15-minute wait; requires approval)

POP Begin: 08-01-2030 POP End: 07-31-2031

PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

GRAND TOTAL

36C24226R0087

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (NOV 2023)

(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 Federal Acquisition Regulation (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)…