36C24418Q9331-001.docx

36C24418Q9331

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

36C24418Q9331 07-02-2018 Cynthia Grygier - cynthia.grygier@va.gov 814 860 2974 08-01-2018 4:00 pm 00244 Department of Veterans Affairs Network Contracting Office 4

X X 621910 $15 Million X N/A X Altoona VA Medical Center 2907 Pleasant Valley Boulevard Altoona, PA 16602

00244

Austin Payment Center

PO Box 149971 Austin

TX

78714-9971

(877) 353-9791

(512) 460-5429 This is a Request for Quote for Ambulance Services for the Altoona VA Medical Center (VAMC) in accordance with the Performance Work Statement (PWS) and Schedule.

Anticipated Period of Performance:

September 1, 2018 to August 31, 2023.

This will be a 5 year fixed price Indefinite Delivery Indefinite Quantity (DIQ) Contract.

This procurement is being competed in accordance with FAR 13.5. Any reference to FAR 15 is unintended and the contractor should seek clarification from the CO.

All questions must be submitted via email to cynthia.grygier@va.gov and received by July 16, 2018.

NOTE: This is a Small Business Set-Aside Procurement.

X

CYNTHIA J. GRYGIER

Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR: TBD

b. GOVERNMENT: Contracting Officer Cynthia Grygier

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.

Austin Payment Center Department of Veterans Affairs

PO Box 149971 Austin TX 78714-9971 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-14 Limitations on Subcontracting. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

PRICE/COST SCHEDULE:

The Government shall order the below specified minimum contract value of services and may order up to the below specified maximum contract value of services through task orders under this basic IDIQ contract for all ordering periods. The maximum amount under this contract is not guaranteed.

IDIQ contract minimum: $250,000.00 IDIQ contract maximum: $5,700,000.00

Basic Life Support (BLS) – Altoona VAMC to University Drive,

Bariatric Transport

15 minute increment.

TOTAL CONTRACT PERIOD 1: ______________

Basic Life Support (BLS) – Altoona VAMC to University Drive,

Bariatric Transport

15 minute increment.

TOTAL CONTRACT PERIOD 2: ______________

Basic Life Support (BLS) – Altoona VAMC to University Drive,

Bariatric Transport

15 minute increment.

TOTAL CONTRACT PERIOD 3: ______________

Basic Life Support (BLS) – Altoona VAMC to University Drive,

Bariatric Transport

15 minute increment.

TOTAL CONTRACT PERIOD 4: ______________

Basic Life Support (BLS) – Altoona VAMC to University Drive,

Bariatric Transport

15 minute increment.

TOTAL CONTRACT PERIOD 5: ______________

GRAND TOTAL

36C24418Q9331

ALL PERIODS OF PERFORMANCE: ______________

Page 1 of Page 1 of PWS- Altoona VAMC Ambulance Transportation Service

1. CONTRACT DEFINITIONS:

(a) Administrative Officer of the Day (AOD) - VA official that works in the admissions area during evenings and nights, and monitor hospital activities during other than normal working hours. This person is located at the site of the Altoona VAMC and acts as hospital administrator during off-hours.

(b) Advanced Cardiac Life Support (ACLS) – Set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions.

(c) Advanced Life Support Transport (ALS) - Defined as services required for critical patient care in which Patients require an ambulance, staffed in accordance with Pennsylvania State laws and Pennsylvania Department of Health (DOH) rules and regulations governing the certification and licensure of private ground ambulances. This ambulance, at a minimum, will be staffed with an Emergency Medical Technician (EMT) and a Paramedic who can provide cardiac monitoring, Advanced Cardiac Life Support (ACLS), advanced airway management, and medication administration and monitoring. [The on-site ALS ambulances will, however, each be staffed with two (2) paramedics.]

(d) Authorized Ordering Personnel - Individuals employed at Altoona VAMC who are authorized to request services from the Contractor and receive copies of the Trip Sheets from the Contractor.

(e) Base Rate - Base Rate is defined as the rate paid for one-way transportation from a designated pick up point to a designated delivery point. This rate will be paid for all authorized one-way trips ordered under this Contract action, with employees receiving at minimum the Department of Labor Service Contract Act wage rates (included under Attachments), during all phases of the trip made on behalf of the Government. Attached Service Contract Act wage rate determinations will be updated each year, when/if new revisions are issued. That Base Rate shall constitute full compensation for one-way trips which do not exceed the “Mileage Threshold” as shown in the Schedule of Supplies or Services and Prices/Costs.

(f) Basic Life Support (BLS) - Defined as services required for non-critical patient care in which Patient requires an ambulance, staffed in accordance with current Pennsylvania State laws and Pennsylvania DOH rules and regulations governing the certification and licensure of private ground ambulances. This ambulance, at a minimum will be staffed with a vehicle operator and an Emergency Medical Technician (EMT) who can provide basic airway management and IV’s at KVO (Keep Venous Open) without the use of medications.

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

(h) Business Hours/Days - Business hours/days are defined as the time of 8:00AM to 4:30PM, Monday through Friday, except Federal holidays. Federal holidays, include New Year’s Day, Martin Luther King Day, President’s Day, Memorial Day, Independence Day, Labor Day, Columbus Day, Veterans’ Day, Thanksgiving Day, Christmas Day and other specifically designated days by the President of the United States to be a Federal holiday. Off business hours/days are defined as the time of 4:31PM to 7:59AM, Monday through Friday, all day Saturday and Sunday and Federal holidays.

(i) Contract – The Contract awarded as a result of this solicitation.

(j) Contracting Officer (CO) - VA official with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings, and is a member of the vehicle inspection team.

(k) Contracting Officer’s Representative (COR) - VA official responsible for providing Contract oversight and technical guidance to the CO. Responsibilities include certifying invoices, placing orders for service, providing technical guidance, and overseeing technical aspects of the Contract. Also acts as member of the vehicle inspection team. All contacting authority remains with the CO.

(l) Contractor - The term “Contractor” as used herein refers to both the prime Contractor and his employees, and any subcontractors and their employees. The Contractor shall be responsible for assuring that his subcontractors comply with the provisions of this Contract. The Government has a contracting relationship with the Prime Contractor only.

(m) Dry Run - A dry run is defined as a request for service by authorized Medical Center personnel, whereby the Contractor arrives at the designated pick-up point and no Patient is transported due to a change in the Medical Center’s needs. The Contractor shall be entitled to the applicable base rate only when dry runs are encountered due to no fault or negligence of the Contractor.

(n) Escort - Such as a relative of the Patient or an Altoona VAMC employee accompanying the Patient when the Altoona VAMC has determined such an escort is in the best interest of the Patient.

(o) Excess Cost - The difference between prices charged by another source used and the applicable Contract prices.

(p) Financial Services Center VA - (FSC) – Payment is made through electronic funds transfer - Department of Veterans Affairs, Financial Services Center, PO Box #149971, Austin, TX 78714-9971; FAX: 512-460-5540 (services).

(q) The Joint Commission (TJC) – A national organization dedicated to improving the care, safety and treatment of patients in a health care facility and environment.

(r) KKK Specification - Each ground ambulance used in the performance of this Contract must meet the current specifications of Federal Specification KKK-A-1822F (http://apps.fss.gsa.gov/vehiclestandards/).

(s) Mileage Rate - Mileage for ground ambulance services is the rate paid for each mile traveled beyond the specified Mileage Threshold for each applicable medical facility. This rate applies to one-way transportation only. In no event shall the Contractor receive this rate for miles traveled within the specified Mileage Threshold.

(t) Mileage Threshold - The Mileage Threshold for the Altoona VAMC is a 25 mile radius from the designated pick-up point for each trip.

(u) No-Patient Charge - Fee allowed to Contractor for scheduled pick-ups for which due to circumstances beyond the Contractor’s control (i.e. Patient refuses pick-up, Patient not home, Patient not medically/mentally suitable for transport, etc.) are not completed. This charge shall only be accessed on actual trips to the Patient pick-up point, and shall not be assessed on scheduled pick-ups that are cancelled by the VA and/or the Patient.

(v) Patient - A Beneficiary, VA employee, or visitor to Altoona VAMC receiving services from the ambulance Contractor under this Contract.

(w) Quality Assurance - Those actions taken by the Government to assure services meet the requirements of this Contract.

(x) Quality Assurance Evaluator - Government personnel responsible for surveillance of Contractor performance.

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

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

(aa) Scheduled Trip(s) - The term ”Scheduled Trip” as used in this Contract refers to those trips in which the Contractor has been given advance notice (advance notice is defined as notice given by 4:30PM the prior business day) of required services and a specific pick-up time.

(ab) Trip Sheet – Document that specifies the date, Patient name and last four digits of Social Security number, time of pickup, destination, time of drop off, mileage if outside the Contract Mileage Threshold, and any notes regarding issues particular to the specific transport or condition, including recording oxygen, cardiac monitoring, and any other items provided.

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

(ad) Vehicle(s) - The term “Vehicle(s)” as used in this Contract refers to all modes of ground transportation provided under the requirements of this Contract, unless a specific mode of transportation is identified.

(ae) Waiting - Waiting as used in this Contract is defined as the time required and verified by authorized medical facility personnel for the Contractor to wait at designated pick-up and/or delivery points in performing Contract services.

(af) Waiting Grace Period - The waiting grace period is defined as fifteen (15) minutes prior to the time waiting charges commence. The base rate for ambulance services shall include a fifteen (15) minute waiting grace period at origin and destination.

1. Purpose: The intent of this Contract is to have an IDIQ contract for ground ambulance emergency services for the patients at the Altoona VAMC. Contractor shall provide all vehicles, personnel, management, supplies, transportation, equipment and reports necessary to cover ground ambulance services. Contractor care shall cover the full range of ambulance services provided in the local community. Paramedics responding to codes will bring equipment/supplies required by state regulations, and ACLS equipment and medication to include, but not limited to, cardiac monitoring, intubation equipment, automated external defibrillator (AED), video laryngoscope, pulse oximetry, glucometer, portable oxygen, protective clothing and written procedures.

The Contractor shall have available the appropriate number of vehicles to provide services in a timely manner as outline by the contract.

Performance shall be in accordance with the requirements contained in this SOW and standards of the Pennsylvania DOH, Bureau of Emergency Medical Services, and The Joint Commission.

1. Contract Period: Five-Year Indefinite Delivery Indefinite Quantity (IDIQ).

1. Altoona VAMC Locations: James E. Van Zandt VA Medical Center consists of one main campus and five Community Based Outpatient Clinics (CBOCs).

1. Ambulance Transportation Services

a. The Contractor shall be responsible for providing all vehicles and personnel, necessary to meet all ALS and BLS transport requirements of this Contract. The Contractor shall be authorized to utilize another ambulance service company, as a subcontractor (certified to be within all requirements of this Contract) to complete these transportation requests only if prior approval for the subcontractor has been received from the CO. The Government has a business relationship with the Prime Contractor only. Only the Prime Contractor may bill the Government for services. All bills for this subcontractor service will be paid directly to the Prime Contractor at the Contract rate, and the Prime Contractor shall make payment to the subcontractor at their agreed rate. In the event the Contractor is unable to perform services or have services performed as required, the Contractor shall immediately notify the COR and provide a justification for non-performance. The VA reserves the right to re-procure services which cannot be performed by the Contractor, in accordance with the terms, conditions, and schedule of this Contract. The Contractor is responsible for excess re-procurement costs which may 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 VA will be the sole judge in determining when services will 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)).

b. Should the VA determine that immediate transportation is essential to prevent loss of life or serious bodily harm, transportation services may be procured without referral to the ambulance Contractor. However, in these extremely rare cases, no charge shall be levied against the Contractor.

c. Vehicle Response Times:

1. The Contractor shall respond to all calls for ground ambulance transport service by being on-site at the designated point of pick-up within 20 minutes of notification for an Emergency Advanced Life Support (ALS) vehicle and within 45 minutes of notification for an Emergency Basic Life Support (BLS) vehicle. Exceptions, to the 20 or 45 minute expectation will be investigated and analyzed, including the identification of corrective actions if applicable. As determined appropriate, Contractor shall take corrective actions to ensure timely response. The Contractor shall respond to all calls immediately for emergency ground ambulance transport service for the Altoona VAMC. The Contractor shall provide and respond to all emergency calls in accordance with Federal, State, and Local regulations, governing dispatch of emergency medical (ambulance) vehicles and medical care of on-board Patients, to include the use of sirens and other measures to ensure timely arrival at the designated VA Medical facility.

2. The Contractor shall respond to all calls for ground ambulance transport service by being on-site at the designated point of pick-up within 20 minutes of notification for a psychiatric transport to the emergency department.

3. The Contractor shall respond to all calls for ground ambulance transport service by being on- site at the designated point of pick-up within 45 minutes of notification for a Non-Emergency Advanced Life Support (ALS) vehicle and/or Non-Emergency Basic Life Support Vehicle (BLS).

4. If the time period for pick-up, stated herein, is physically impossible due to location of Patient, the Contractor shall contact the individual who placed the call and inform them of the anticipated time required for pick-up and delivery of said Patient.

d. Response Time Compliance Rate: The Contractor shall maintain, at a minimum, a 95% compliance rate on responses to pick-up or deliver during the Contract year. Failure of the Contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the Contract for “cause,” (see FAR clause 52.212-4(m)) or other appropriate contractual action.

e. Immediate Notification: It is the responsibility of the Contractor to immediately notify the Altoona VAMC authorized ordering personnel when unable to make a pick-up or delivery by the exact time specified for previously scheduled trips; or unable to dispatch an ambulance to a designated pick-up point within the required time frame for unscheduled requests for services. The immediate notification shall include the reason for the delay and whether the pick-up or delivery can be made at a later time and if so, specification of that time. However, it shall be the sole discretion of the Altoona VAMC ordering personnel to accept the later pick-up or delivery time, and based upon the reason for delay, present the delay for payment reduction or refuse the later pick-up or delivery time and order the services from another source (the applicable ordering office shall be the sole entity for determining when to request the services from another source), and present the reason for the delay to the CO as an occurrence that may be subject to default. Based upon the reason for the delay, the Contractor may be charged with excess costs incurred by the Altoona VAMC in ordering the service from another source or other appropriate contractual action may be taken by Altoona VAMC.

f. Waiting Time:

1. For scheduled trips, waiting charges shall commence fifteen (15) minutes from the time the Contractor actually arrives at the designated pick-up and/or delivery points.

2. If the designated pick-up and/or delivery points are at other than the VA Medical facilities and waiting beyond the required fifteen (15) minute grace period is anticipated, the Contractor shall notify the COR. This call is only for the purpose of verifying the Contractor’s time of arrival at pick-up and/or 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 notify the COR, when waiting beyond the grace period, shall result in non-payment for waiting time.

3. There are occurrences when a Beneficiary will be scheduled for appointments requiring transportation from different VAMC facilities, nursing home or Beneficiary place of residence. At no time shall a Beneficiary be required to wait arrival of a pre-scheduled trip beyond fifteen (15) minutes. Failure of the vehicle to arrive at the Beneficiary’s residence or VA facility /nursing home within the allotted time frame (15 minutes), may result in automatic cancellation of the trip, and services may be secured from other sources with default action to be considered against the Contractor.

g. Substitution of Patient: The VA reserves the right to substitute the Patient requiring services at any time during the performance of this Contract, to prevent delays, cancellations, or dry runs. There shall be no additional charge to the VA when such changes occur.

h. Morgue Transports: It may become necessary for the Contractor to be called upon to transport the remains of a deceased Patient between the various VA facilities or to the County morgue for purposes of post-mortem. The Contractor shall agree to accept such assignments when called upon under the provisions of the Contract and to supply personnel normally assigned non-emergency vehicles in performing this service.

i. Number of Patients: The Contractor shall transport one Patient per trip under ambulance services.

j. Direct Patient Transfer: All Patient transfers between VA facilities shall be direct transfers.

k. Escorts: Altoona VAMC reserves the right to have an escort, such as a relative, care provider or staff member accompany the Patient when VAMC determines that such an escort is in the best interest of the Patient. VAMC will also be the sole judge in determining when an escort is required. There shall be no charge to VAMC when escorts are authorized to travel with Patient. The Contractor shall only be required to transport the escort with the Patient and shall not be required to return the escort back to point of origin.

l. Ordering: In accordance with FAR 16.505, The CO shall issue Task Orders against the IDIQ contract with a period of performance not to exceed one year. Authorized Government personnel shall place service calls against these Task Orders as stated below. Each Task Order will be funded with an estimated value for that period of performance. The contractor, along with the COR, must monitor the contract value as service calls are placed and invoices are paid. The contractor is not authorized to continue services if the contract value falls below a zero balance, therefore the CO must be notified when remaining contract value is low so that more funds can be added.

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

n. Request for Services: All requests will be placed against pertinent schedule items, on a unit price basis, and will be verified against invoices and Contractor’s request for services log submitted. When ordering services (whether it is by telephone, facsimile, mail, e-mail and/or person), the Altoona VAMC will provide the Contractor with the following type of information:

0. Mode of transportation required,

0. Required date and time of arrival,

0. Name of Patient,

0. Pick-up and delivery point, and

0. Any other special instructions.

o. If the Contractor’s place of business is located beyond the local telephone call zone of the VA (area code 412 and 724), the Contractor shall install and provide to the VA, a toll free number for accepting the VA calls. It is estimated that 90% of all requests for service will be placed by telephone. Requests for service may also be in writing or oral from an authorized representative of the VA, and may be completed by telephone, facsimile, mail, e-mail, or in person (by giving a written or verbal request).

p. Dispatcher: The contractor must provide a dispatcher 24 hours a day/ 7 days a week. The Contractor shall identify the contact information for transportation requests, including the following:

1. Company

2. Company Address

3. Normal Hours Contact Person

4. Normal Hours Telephone No.

5. After Hours Contact Person:

6. After Hours Services Telephone No.

q. The Veteran’s Administration will pay transportation costs only for eligible Veteran’s Administration patients, as determined by Veteran’s Administration regulations. Contractors shall contact the appropriate COR if there are any questions concerning the eligibility of the Veteran’s Administration patients.

r. The Contractor shall be required to transport non-ambulatory Patients on gurneys, litters, and geriatric chairs who are not in need of emergency transportation or medical attention.

s. Mileage Threshold for Ground Ambulance Services: The Mileage Threshold for the Altoona VAMC is a 25 mile radius from the designated pick-up point for each trip (i.e., Contractor is required to pick-up Patient at the VA, the Mileage Threshold would be a 25 mile radius from the VA). Charges for travel within this Mileage Threshold shall be inclusive with the base rate. One way mileage for travel beyond the 25 mile Mileage Threshold shall be claimed under the applicable mileage rate.

t. Contractor Reimbursement:

1. Reimbursement for mileage outside the Contract Mileage Threshold of coverage, shall be at the mileage rate stated in the price schedule, and shall be based upon the miles from the pick-up point to the specified destination. Any mileage from the place of business and/or location of vehicle and the pick-up point, or from the delivery destination back to the place of business and/or location of next trip are not considered as a separate item of this reimbursement, but would be expected to be incorporated into the mileage rate that is the Contractor’s responsibility as part of the administrative costs (or costs of doing business). Trip mileage under the contract shall be determined by using the internet web site of Google Maps, MapQuest, Yahoo, or other internet mileage authority. Allowable charges for mileage outside the Contract Mileage Threshold areas of coverage shall not exceed +5% of the current Standard Mileage Rate.

2. Should the VA make a determination that a previously scheduled trip may be cancelled, and a vehicle has already been dispatched to the designated pick-up point, VA may notify the Contractor to cancel the order. 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, as provided in Schedule of Supplies or Services and Prices/Costs. This charge shall not include any mileage charge.

3. Should the Contractor arrive at the destination before VA cancels the order, of 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 100% of base rate for a one way trip as provide in the Schedule of Supplies or Services and Prices/Costs, and applicable mileage if outside Contract Mileage Threshold areas of coverage.

4. If the Contractor fails to meet the time requirements in this Contract, Altoona VAMC will not be charged for these instances.

5. Other Charges: It is understood that the prices listed in the accepted Schedule of Supplies or Services and Prices/Costs shall be inclusive of any and all ferry, bridge, tunnel or road toll charges. Contractor shall not bill the VA for any such separate charges.

u. Auxiliary Service: The Contractor may be required at times to transport Patient luggage, medical records, medication and other items including, but not limited to, wheelchairs, Stryker frames, litters, and nutritional supplements from the pick-up point to destination. The Contractor shall not open, manipulate or otherwise seek information from these records or personal effects. The records and personal effects shall be delivered intact to the prearranged destination. Luggage to be transported shall be restricted to suitcase and valise type. These services shall be provided at no additional cost; however, should there not be room to transport these items and a second vehicle is needed, payment will be half (1/2) the charge from the first transport, only if the second vehicle is pre-approved by Altoona VAMC. No payment will be made for the second vehicle without pre-approval.

1. General Contract Requirements

a. Contractor Employees:

1. Altoona VAMC reserves the right to restrict any Contractor employees from performing services under this Contract who do not meet the required qualifications for the services they are to perform, who violate Federal and/or any applicable regulations, or are identified as a potential threat to the security, safety, health and/or operational mission of the VA and its veteran population. The restriction of such Contractor personnel shall not relieve the Contractor from performing all the required services, in accordance with all terms, conditions, and schedules contained herein.

2. The Contractor shall furnish qualified personnel as required by the Contract specifications to accomplish all services under this Contract.

3. The Contractor shall comply with any and all legal provisions contained in the Immigration and Nationality Act of 1952, As Amended; its related laws and regulations that are enforced by Homeland Security, Immigration and Customs Enforcement and the U.S. Department of Labor as these may relate to non-immigrant foreign nationals working under contract or subcontract for the Contractor while providing services under this Contract.

4. Contractor personnel performing services to the VA shall at all times conduct themselves in a professional manner, maintain personal hygiene, wear clean, neat uniforms and be identified by having the company name, and employee name affixed to the uniform. The Contractor shall be responsible for furnishing all vehicles, personnel, equipment and supplies, vehicle fuel, uniforms, nametags and/or badges for performance of services under this Contract. Employee identifications shall be worn in clear view above the waist. Contractor personnel shall not smoke in vehicles while transporting VA Patients.

5. Contractor employees shall not represent themselves as VA employees while performing under this Contract.

b. Contractor Personnel Qualifications:

1. 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.

2. During the Contract period of performance, if the Contractor proposes to add-on or replace personnel to perform Contract services, the Contractor shall submit required evidence of training, certifications, licensing, background and security clearances, and any other qualifications to the designated COR. At no time shall the Contractor utilize add-on or replacement personnel to perform Contract services who do not meet the qualifications under the terms and conditions of this Contract.

3. Emergency Medical Technician (EMT) and Paramedic Qualifications: EMTs and paramedics providing services under this Contract shall have the following qualifications, in addition to those required by Federal, State, and Local Government:

a) EMTs shall have completed training in accordance with the standards published by the Pennsylvania DOH with a minimum curriculum of 152 hours of clinical and didactic training or equivalent. Paramedics shall have completed training in accordance with the standards published by the Pennsylvania DOH with a minimum of 1,250 hours of combined clinical and didactic training or equivalent. Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by the Pennsylvania DOH under PL 93-154.

b) Shall submit evidence of re-certifications and equivalent training program successfully completed to the CO.

c) Shall be certified, or otherwise officially recognized by the local, state or regional government or public entity where the emergency ambulance service is operated or by which it is governed.

d) Shall attend all refresher continuing education, or advance training programs as required by the local or state government entity in which service is rendered. In no instance shall this be less frequent than annually. Such refresher training shall be equivalent to that developed by the Pennsylvania Department of Health Bureau of Emergency Medical Services.

4. Ambulance Drivers: Drivers shall have a valid operator’s or chauffeur’s license in accordance with Federal, State and local government requirements for their place of operation, for the services they perform, be capable of administering oxygen and have successfully completed an Emergency Vehicle Operator course approved by the Department of Health for the State of Pennsylvania and be capable of providing necessary medical assistance to the attending medical care specialist.

5. Should governmental requirements differ on this contract, then the strictest shall apply.

6. The ambulance Contractor’s Medical Director shall certify all EMTs and Paramedics and direct emergency medical response processes.

7. All staff of the ambulance Contractor is required to be assessed regarding competence and performance per Pennsylvania DOH, Emergency Medical Services.

c. Contractor Equipment, Vehicles and Inspection:

1. The VA reserves the right to inspect Contractor’s equipment and vehicles or require documentation of compliance with contract specifications, and State laws, rules, regulations and guidelines governing emergency medical transport vehicles (ambulances). VA inspections of Contractor facilities shall in no way constitute a warranty by the VA that the Contractor’s vehicles and equipment are properly maintained. The VA reserves the right to restrict the Contractor’s use of equipment and vehicles which are in need of repair, unclean, damaged on the interior or exterior body, and are not in compliance with Contract requirements. The restriction of such equipment and vehicles shall not relieve the Contractor from performing in accordance with the strict intent and meaning of the Contract without additional cost to the VA.

2. Ambulances shall meet all current applicable Federal, State and local specifications and regulations including, but not limited to, licensing, registration, and safety standards. Appropriate licensing by the State of Pennsylvania is required.

3. The vehicle(s) shall be clean and maintained in good repair in accordance with manufacturer’s instructions and specifications at all times during the performance of this Contract, and shall contain:

0. An emergency safety kit,

0. Portable oxygen unit (s),

0. Fire suppression equipment, and

0. Appropriate road emergency warning equipment.

4. BLS ambulance transports shall, in conjunction with the above, be equipped with stretchers to accommodate patients over 500 pounds, have an on-board EMT, and perform basic airway management. If bariatric ambulance services are required, there will be no additional charges to the Altoona VAMC above the rates established in the Schedule of Supplies or Services and Prices/Costs.

5. ALS ambulance transports shall, in conjunction with the above, be equipped with pulse oximetry and on-board Paramedic, perform cardiac monitoring, provide ACLS drugs and procedures, and perform advanced airway management and medication monitoring and administration. Advanced airway management means the ability to intubate a Patient and provide appropriate respiratory care, which does not include tracheotomies, cricoidotomies or cricotracheotomies.

6. The Contractor shall provide oxygen when it is requested by authorized medical facility personnel or required by the Patient’s medical condition. Oxygen required for ambulance services shall be at the rate and price shown in the Schedule of Supplies or Services and Prices/Costs.

7. The Contractor shall provide all medications required while in transport, sheets and blankets and other equipment and supplies required for use while in transport, for direct patient care. The Contractor shall at no time and under any circumstances exchange supplies, equipment and/or medications with VA. The prices quoted in the Schedule of Supplies or Services and Prices/Costs shall be inclusive of consumables used in transport. All vehicles used for critical patient care (e.g., ALS, BLS), shall include, but not be limited to, monitors, defibrillator with external pacemaker, intubation equipment, intravenous equipment, medications, patient compartment facilities, oxygen and suction equipment and accessories.

d. Patient Incidents and Complaints:

1. The Contractor shall immediately notify the COR of any incidents involving injury to VA Patients during transport. The Contractor shall promptly complete and submit to the COR an Incident Report with all information necessary for a full review.

2. The VA may request incident reports for any customer service related incident reported by patients, visitors, or staff requiring investigation. Fully documented reports are required within 24 hours of request and may result in additional requests for information.

3. The Contractor shall notify the CO and COR in writing within 24 hours of any complaints made by the Patients with regards to the ambulance service. The Contractor may provide recommendations for improved services along with the Patient complaints for the VA’s review. No recommendation shall be construed as being effective until and unless it is provided as a written modification to the Contract from the CO.

e. Infection Control Procedures:

1. The Contractor shall follow the Altoona VAMC Infection Prevention and…