36C24421R0034_1.docx

36C24421R0034

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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

36C24421R0034 09-12-2022 Bethany Diaz, Contract Specialist 610-380-4307 10-24-2022 12:00 pm

EDT

00244 Department of Veterans Affairs Network Contracting Office 4 1111 East End Blvd Wilkes-Barre

PA

18711 X 621498 $22 Million N/A X Department of Veterans Affairs Butler VA Healthcare Center 353 North Duffy Road Butler

PA

16001 00244 Department of Veterans Affairs Network Contracting Office 4 353 North Duffy Road Butler

PA

16001

Austin Payment Center Department of Veterans Affairs PO Box 149971 Austin

TX

78714-9971

(877) 353-9791

(512) 460-5429 See CONTINUATION Page Community Based Outpatient Clinic Services Armstrong and Clarion Counties and Cranberry Township, PA See Schedule of Services pages 6-7 This procurement is set aside based on an order of priority as established in 38 U.S.C. 8127.

TIERED EVALUATIONS INCLUDING LARGE BUSINESS CONCERNS:

This solicitation is being issued as a tiered evaluation with the following tiers: (1) SDVOSB concerns, (2) VOSB concerns, (3) all other small business concerns, and

(4) large business concerns. If award cannot be made, the solicitation will be cancelled, and the requirement resolicited.

See CONTINUATION Page X X Kevin Balser Contracting Officer

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

See attached document: RFP 36C24421R0034 CBOC Services Armstrong-Cranberry-Clarion PA.

See attached document: D.1 Quality Assurance Surveillance Plan (QASP).

See attached document: D.2 VA Privacy and Info Sec Awareness and ROB.

See attached document: D.3 CONFLICT OF INTEREST.

See attached document: D.4 FORM I9.

See attached document: D.5 SCA WD 2015-4235 R19 03152022 Armstrong and Butler County.

See attached document: D.6 SCA WD 2015-4247 R17 03152022 Clarion County.

See attached document: D.7 DBA WD PA20220074 M3 02252022 Armstrong County.

See attached document: D.8 DBA WD PA20220079 M3 02252022 Butler County.

See attached document: D.9 DBA WD PA20220046 M4 04012022 Clarion County.

See attached document: D.10 PC-31 Womens Health.

See attached document: D.11 MM-29 Medication Reconciliation.

See attached document: D.12 Environment of Care Guide Book Drupal_1.

See attached document: D.13 MM-35 Anticoagulation Therapy Management Program.

See attached document: D.14 Laboratory Order Entry in CPRS.

See attached document: D.15 Lab Instructions.

See attached document: D.16 Ancillary Testing Training and Competency Assessment.

See attached document: D.17 MCM PC-43 Reporting of Critical and Abnormal Test Results.

See attached document: D.18 MCM PC-110 High Risk for Suicide Patient Record Flags.

See attached document: D.19 MCM PC-14 Center for Behavioral Healthcare.

See attached document: D.20 Connected Care Telehealth Manual.

See attached document: D.21 IM-034 Records Management Policy.

See attached document: D.22 MCM RI-03 Patient and Nursing Home Residents Rights and Responsibilities.

See attached document: D.23 PC-15 MANAGEMENT OF SUICIDAL VETERANS (Prevention).

See attached document: D.24 SOP-BH-01 One-to-One Observation for Suicide Risk.

See attached document: D.25 IM-32 DOCUMENTATION OF VETERAN CARE.

See attached document: D.26 Clinical Laboratory and Anatomic Pathology Manual.

See attached document: D.27 Butler Telehealth Emergency Response SOP.

See attached document: D.28 Past Performance Questionnaire.

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