36C24519R0011_0001.docx

36C24518Q0061

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV. 11/2016)

is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO: (Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:

D. OTHER

Contractor

16C. DATE SIGNED

14. DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME AND TITLE OF SIGNER

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

(X)

CHECK

ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 12-11-2018 Department of Veterans Affairs Network Contract Office (NCO 5) 849 International Drive Linthicum

MD

21090 Department of Veterans Affairs Network Contract Office 849 International Drive Linthicum

MD

21090 To all Offerors/Bidders

36C24519R0011 12-07-2018

X X X

X

The purpose of this modification is to include the attached solicitation and to correct the response date to 12/28/2018

CHARLES WILLIS

Contracting Officer 36C24519R0011

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

519-19-1-825-0013 36C24519R0011 12-07-2018 CHARLES WILLIS; charles.willis@va.gov 410-691-1328 12-28-2018 2:00pm 00512 Department of Veterans Affairs Network Contract Office (NCO 5) Charles Willis, Contract Specialist 849 International Drive, Suite 275 Linthicum MD 21090 X X 621910 $5.5 Million X N/A X 00512 Department of Veterans Affairs

VAMC (512)

10 North Green Street Baltimore MD 21201 Department of Veterans Affairs Network Contract Office (NCO 5) Charles Willis, Contract Specialist 849 International Drive, Suite 275 Linthicum MD 21090

OB-10

USA Headquarters 1040 Crown Point Parkway

OB-10.COM

Atlanta GA 30338 770-698-1420 See CONTINUATION Page Contractor shall provide all vehicles, personnel, supervision supplies and necessary equipment to provide patient transportation services in accordance with the attached Performance Work Statement for the Veterans Affairs Maryland Health Care System.

Period of Performance: Base plus 4 year option Note: This solicitation is being issued as tiered evaluation for VOSB concerns and or set aside for other small business C oncerns with HUBZONE and 8a participants having priority.

All questions are to be submitted by email to charles.willis@va.gov. by 12/14/2018. Response to questions Will be answered in www.fbo.gov.

$0.00 See CONTINUATION Page 512-3690160-825-829800-2119 010041085 X X X

CHARLES WILLIS

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:

1. Government Contract Administration will be handled by:

1. Contractor Remittance Address:

0. Effective January 1, 1999 all payments by the Government to the contractor will be made in accordance with Federal Acquisition Regulation (FAR) Clause 52. 232-34, Payment by Electronic Funds Transfer--Other than Central Contractor Registration (31 U.S.C. 3332).

0. Payments shall be made MONTHLY in arrears upon receipt of properly prepared invoices. Invoices shall be submitted through the OB-10 website http://ob10.com/us/en/veterans-affairs-us/ by the tenth of the month – Address: USA Headquarters, 1040 Crown Point Parkway, Atlanta, GA 30338. Phone No. 770-698-1420 ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

AMENDMENT NO. DATE

B.2 PERFORMANCE WORK STATEMENT

1. Scope: The contractor shall provide all vehicles, personnel, supervision, supplies and the necessary equipment to provide patient transportation services within a 15-Minute Response Time or 45-Minute Response Time (VA clinician will determine the response rate needed for these services on a case-by-case basis) 24 hours a day/7 days a week for Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care (CC) Ambulance Transportation Services. This includes the potential transportation of bariatric patients. Transport will be provided to the beneficiaries of the Department of Veteran Affairs to and from the Baltimore VA Medical Center, Perry Point VA Medical Center, Loch Raven VA Community Living and Rehabilitation Center, Community-Based Outpatient Clinics (CBOCs), affiliated hospitals, beneficiaries’ residence, other VA facilities, and from non-affiliated hospitals.

1. Background: The Veterans Affairs (VA) Maryland Health Care System is a dynamic and progressive health care organization dedicated to providing quality, compassionate and accessible care and service to Maryland’s veterans. The Baltimore and Perry Point VA Medical Centers, in addition to the Loch Raven VA Community Living & Rehabilitation Center and five community based outpatient clinics, all work together to form this comprehensive health care delivery system. The affiliated hospitals include but are not limited to University of Maryland Medical Center, University of Maryland Upper Chesapeake, and University of Maryland Harford Memorial.

1. Specific Tasks/Deliverables: Services are split into three levels of service with two time response requirements. The response times represent minimally acceptable response time standards. Any trips pre-scheduled in excess of 45 minutes prior to the pickup time shall be billed at the 45 minute rate. Contractor shall arrive no later than the pre-scheduled time.

2. Task1: Contractor shall provide the following Basic Life Support (BLS) ambulance services on an as-needed basis:

1. Basic Life Support (BLS) - Services. Basic Life Support (BLS) means a basic level of pre-hospital and inter-hospital emergency care and non-emergency medical services that includes airway management, cardiopulmonary resuscitation (CPR), control of shock and bleeding and splinting of fractures, as outlined in the Basic Life Support national curriculum of the United States Dept. of Transportation and any modifications to that curriculum specified in rules adopted by the Department.

1. Basic Life Support (BLS) – Emergency. When medically necessary, the provision of BLS services, as specified in 3.a.1., in the context of an emergency response. An emergency response is one that, at the time the ambulance provider or supplier is called, the provider or supplier responds immediately. An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary to respond to the call or order.

1. Staffing: For BLS service, each ambulance shall be staffed by minimum of (2) personnel with a current Maryland Emergency Medical Technician-Basic (EMT-B) license. Personnel shall be able to demonstrate sufficient knowledge of the U.S. Department of Transportation National Standard Curriculum for EMT-B as adapted and approved by the Maryland Institute for Emergency Medical Services Systems (MIEMSS).

2. Task 2: Contractor shall provide the following Advanced Life Support (ALS) ambulance services on an as-needed basis:

1. Advanced Life Support (ALS) - Services. Advanced Life Support (ALS) means an advanced level of pre-hospital and inter-hospital emergency care and non-emergency medical services that includes basic life support care, cardiac monitoring, cardiac defibrillation, electrocardiography, intravenous therapy, administration of medications, drugs and solutions, use of adjunctive medical devices, trauma care, and other authorized techniques and procedures as outlined in the Advanced Life Support national curriculum of the United States Department of Transportation and any modifications to that curriculum specified in rules adopted by the Maryland Institute for Emergency Medical Services Systems (MIEMSS). ALS services also include intermediate life support (ILS) services as outlined in the Maryland Institute for Emergency Medical Services Systems Health guidelines.

1. Advanced Life Support (ALS) – Emergency. When medically necessary, the provision of ALS services, as specified in 3.b.1, in the context of an emergency response. An emergency response is on that, at the time the ambulance provider or supplier is called, it responds immediately. An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary to respond to the call or order.

1. Staffing: For ALS service, each ambulance shall be staffed by minimum of (2) personnel with a current Maryland Emergency Medical Technician-Intermediate (EMT-Intermediate) or Emergency Medical Technician-Paramedic (EMT-P) license. Personnel shall be able to demonstrate sufficient knowledge of the U.S. Department of Transportation National Standard Curriculum for EMT-P as adapted and approved by MIEMSS.

2. Task 3: Contractor shall provide the following Critical Care Transport (CCT) ambulance services on an as-needed basis:

1. Critical Care Transport (CCT) - Services. Critical care transport means the pre-hospital or inter-hospital transportation of a critically injured or ill patient by a vehicle service provider, including the provision of medically necessary supplies and services, at a level of service beyond the scope of ALS Services. CCT services utilize EMT-Paramedics with additional training, nurses, or other qualified health professionals.

Tier I – Tier I provides a level of care for patients who require care beyond the paramedic USDOT Curriculum scope of practice, up to but not including the requirements of Tier II and Tier III. Tier I transport includes the use of ventilator, the use of infusion pumps with administration of medical drips, and the maintenance of chest tubes.

Tier II – Tier II provides a level of care for patients who require care beyond the USDOT Curriculum and expanded scope of practice ALS (paramedic) transport program, and who require formal advanced education for ALS paramedic staff. Tier II transport includes the use of a ventilator, infusion pumps with administration of medication drips, maintenance of chest tubes, and other equipment and treatment, such as, but not limited to: arterial lines; accessing central lines; medication-assisted intubation; patient assessment and titration of IV pump medications, including additional active interventions necessary in providing care to the patient receiving treatment with advanced equipment and medications.

Tier III – Tier III provides the highest level of ground transport care for patients who require nursing level treatment modalities and interventions.

Critical Care level of service could include the following:

· Equipment

· Balloon Pump (with RN only)

· Chest tubes

· IV Infusion

· Portable CPAP

· Telemetry

· Monitor the following IV infusions:

· Amiodarone

· Dobutamine

· Dopamine

· Heparin

· Insulin

· Lidocaine

· Nitroglycerine

· Potassium Chloride

· TPN and Lipids

1. Critical Care Transport (CCT) – Emergency. When medically necessary, the provision of CCT services, as specified in 3.c.1, in the context of an emergency response. An emergency response is one that, at the time the ambulance provider or supplier is called, it responds immediately. An immediate response is one in which the ambulance provider/supplier begins as quickly as possible to take the steps necessary to respond to the call or order.

1. Staffing: For Critical Care service, each ambulance shall be staffed by a minimum of (2) personnel who hold a current Maryland Emergency Medical Technician-Paramedic (EMT-P) license, one of which has the necessary specialized training to administer the aforementioned services or operate the equipment. Personnel shall be able to demonstrate sufficient knowledge of the U.S. Department of Transportation National Standard Curriculum for EMT-P as adapted and approved by MIEMSS.

**Should the hospital wish to send a nurse or specialized personnel with the ambulance AND the equipment required from the contractor does not exceed the scope of ALS level of service AND the Government schedules an ALS level of service, the Government shall be charged for an ALS level of service. If the Government specifies Critical Care level when scheduling the transport, the Contractor shall be paid the Critical Care rate whether or not the VA Maryland Health Care System provides the personnel and equipment when they arrive.

1. Additional Services.

Bariatric Ambulance /Wheelchair transport- Contractor must have at least one (1) bariatric ambulance in their fleet. The ambulance must be customized to allow for extra wide stretcher and additional personnel when needed. The Bariatric Service must be designed to provide a safe and dignified transportation solutions to those whose weight or condition require special needs transport. The Bariatric unit should be specifically designed for, and outfitted with specialized stretchers that are designed to accommodate obese patients in a safe, comfortable, and respectful fashion. EMTs and Paramedics should be specially trained to provide patient-sensitive, safe and comfortable transport in a specially fitted vehicle.

1. Hours of Operation: Normal hours of coverage are Monday through Friday from 7:30 am to 4:30 pm EST, excluding holidays. Services will be performed as required, 24 hours a day, 7 days a week.

1. Places of Performance:

Baltimore VA Medical Center 10 North Greene Street Baltimore, MD 21201

Perry Point VA Medical Center Perry Point, MD 21902

Loch Raven VA Community & Rehab Center 3900 Loch Raven Boulevard Baltimore, MD 21218

1. Period of Performance:

This contract’s ordering period shall be effective from the Date of Award through year of 2023.

1. Orders: Task Orders will be issued by a Warranted Contracting Officer authorizing the contractor to perform service. The VA representative authorized to schedule services shall specify the level of service, required response time, and origin/destination locations. Should the contractor believe the scheduled delivery does not accurately match the minimum service needed, they should contact the authorized VA representative and request permission to change the service level scheduled. If the VA representative agrees and the contractor must make a second trip, the contractor is entitled to charge the Government the cost of both trips/services. No additional cost will be paid unless specifically authorized prior to a second trip.

6. An order is defined as one instance of a request for one-way service (BLS, ALS, or CCT service). Except when specifically authorized by designated VA ordering employees, no more than one patient will be transported per order.

6. Orders will be made by telephone. Only the following VA staff members are authorized to place orders: the COR, Flow Center Staff, Transfer Coordinator and the Administrative Officer of the Day (AOD). Private agencies (e.g. nursing homes) are not considered authorized to place orders.

1. For each order, the contractor will be given the patient’s name, pick-up appointment time (e.g. response time), pick-up address, caregiver/escort information (if applicable), drop-off address, and other applicable details.

1. Some orders for non-emergency services may be scheduled up to 24 hours or more in advance.

6. The type of transportation service (ALS, BLS, Wheelchair, and CCT) required will be discussed and determined by VA clinical personnel and the contractor. The contractor shall transport the patient per its policies and standard industry practice. If the type of transportation service differs from what was agreed upon by the VA and contractor, the contractor shall submit documentation to the VA explaining its rationale.

6. Response Times.

3. The contractor shall be on time for patient pick-up.

3. For all non-emergency orders outside the 50 mile radius of the destination, pick-up times shall be agreed upon at the time the order is placed, and shall be reasonable based on dispatch lead time, travel distance, speed limits, and weather conditions.

3. For all emergency orders, the contractor shall dispatch an ambulance immediately for prompt arrival at the pick-up location.

3. Contractor shall immediately notify the Flow Center staff or the Administrative Officer of the Day (AOD) of any delays in the transport of patients.

3. In the event the VA determines at its discretion that emergent transportation is essential to prevent the loss of life or serious bodily harm and that the contractor may not be or is not capable of performing these services or lacks reasonable proximity, the VA may procure transportation services from another source.

6. The VA may authorize an escort (e.g. spouse, relative, guardian, etc.) to accompany the patient during medical transport if it is practicable and in the patient’s best interest. The contractor shall allow the escort to accompany the patient at no additional cost.

6. Contractor shall not exceed the maximum quantities authorized on the task order without express written permission from the contracting officer.

6. If the contractor fails to furnish ambulance service within the requested time (15 minutes or 45 minutes) after receiving a request, the VA reserves the right to obtain the service from another source and the contractor shall not be reimbursed for any work completed on that order. Failure to furnish services in required times will be reflected in the contractor’s performance evaluations.

6. Failure to meet the required response times, submit the required documentation per the timeline set forth, and/or include all the required information will, at a minimum, be reflected in the contractor’s performance evaluation and could potentially serve as a reason for termination. Performance evaluations will be a key indicator when determining if the Government will exercise options and during evaluation for future source selections.

6. Contractor shall not be held liable for nonperformance 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 its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, and unusually severe weather.

6. Contractor may be required to transport patient luggage, medication, personal durable medical equipment, and comfort items from pickup points to destination at no additional cost to the Government. Luggage to be transported will be restricted to suitcase and valise types.

1. Cancellations

7. For trips in which the contractor is notified of cancellation before the vehicle is dispatched, there shall be no charge to the Government.

7. A “no show” is defined as an order which is cancelled after the contractor has dispatched a vehicle, the vehicle is on route or has arrived at the pick-up location, and there is no longer a requirement for patient transportation. The contractor may request one-way reimbursement for no-shows. No-show reimbursement shall be based upon the base rate for the type of service requested (BLS, ALS, CCT) and any applicable one-way mileage (BLS, ALS, CCT) accrued enroute to the pick-up location at time of cancellation. Mileage for no-show cancellations shall be confirmed by the contractor and reported to the VA as soon as possible from time of cancellation.

1. Pick-Up / Drop-Off / Reporting Procedures

8. Ambulance personnel shall pick-up and deliver patients at specified locations (e.g. front door of residence, Emergency Room, Ward, Clinic, etc.). These locations will be specified by VA staff when an order is placed.

8. When applicable, ambulance personnel shall report to the Nursing Station to (1) announce his/her arrival to pick-up and transfer the patient and (2) obtain report of pertinent information regarding the patient’s condition from the primary nurse/physician.

8. When delivering a patient, ambulance personnel shall give report to the appropriate VA healthcare staff and provide a copy of the run sheet which will be retained by the facility for inclusion to the patient’s medical record.

8. In cases where ambulance personnel must divert to a local emergency room while performing a VA authorized transport, the contractor’s dispatcher shall notify the Flow Center or Administrative Officer of the Day of the patient’s location and status as soon as this information becomes available.

1. Patient Welfare

9. The contractor shall be responsible for the patient’s welfare during transport. The contractor shall be held responsible for patient and/or VA property during transport. Any damaged or lost wheelchairs, walkers, crutches, or personal belongings shall be replaced at the contractor’s expense.

9. The VA requires the contractor to exercise extreme caution and care in the handling of patients.

1. Performance Monitoring Standards Requirement Summary Matrix

1. The contractor shall meet or exceed (be less than) the required response times per level of service ordered. The contractor shall complete the service within the required response times at least 95% of the time within a quarter year of service. The contractor shall send a log sheet to include all the information listed under the Contractor’s Quality Control Program prior to submitting an invoice. The COR shall examine log sheet and compare with internal records. The COR shall report to the Contracting Officer trips that are not within the required times. Succeeding or failing to meet performance standard will be reflected in Contractors Performance Assessment Reporting System (CPARS) rating.

1. The contractor shall ensure that all personnel meet the required qualifications, training, and certification requirements per Federal and State regulations. Contractor shall ensure that the COR is in possession of all updated records at a minimum of 95% of the time. The COR shall randomly request a driver’s name and compare with records. Succeeding or failing to meet the performance standard will be reflected in Contractors Performance Assessment Reporting System (CPARS) rating.

1. The contractor shall ensure that all equipment is maintained in accordance with paragraph 12.i of the Performance work statement at a minimum 95% of quarter.

1. The contractor shall have adequate insurance in accordance with all Federal and State regulations including VAAR clauses 852.228-71, 852.237-7 and 852.237-70. Contractor shall maintain adequate insurance coverage 100% of the time with no deviations. The COR shall maintain copies of insurance and inspect quarterly. Succeeding or failing to meet the performance standard will be reflected in Contractors Performance Assessment Reporting System (CPARS) rating.

1. Contractor shall have a plan in place for handling patient complaints including methods for monitoring, correcting, and reporting. Contractor shall report all complaints and any corrective action taken to COR within 48 hours of incident. COR will track complaints received internally as well as complaints received from contractor. Contractor shall maintain less than 5 complaints per 100 trips of service per quarter. Succeeding or failing to meet the performance standard will be reflected in Contractors Performance Assessment Reporting System (CPARS) rating.

1. Security Requirements.

1. Contractor will have access to patient information, but will not have access to VA systems.

1. All contractor employees are subject to the same level of investigation as VA employees who have access to VA Sensitive Information. The level of background investigation commensurate with the level of access to perform the statement of work is: Special Agreement Check (SAC).

1. Upon contract award, the contractor shall complete the Contract Security Services Request Form and submit it to the Contracting Officer via fax or mail within five business days. The Contract Security Request Form shall list all contractor personnel who will be performing under this contract (See Section D Attachment Contractor Security Services Request Form).

1. Within five days of award, contractor personnel listed on the Contract Security Services Request Form shall also be fingerprinted. Fingerprinting can be obtained Monday – Friday between the hours of 8:00 a.m. – 2:45 p.m. at the following location:

Personnel Security Office (PIV/FP) 10 North Greene Street Baltimore, MD 21201

1. Once contractor personnel have submitted the required paperwork and have been fingerprinted, the VHA Service Center (VSC) will conduct a background screening. The VSC may request an applicant to complete and send an OPM Optional Form 306, Declaration of Federal Employment, if issues are identified. Upon completion of a background screening, the VSC will forward a Fingerprint Check – National Criminal History Check Completion Notice (NCHC) to the Contracting Officer, which will indicate a favorable or unfavorable screening decision for each contract employee. Only those contract employees with a favorable screening decision shall be permitted to perform services under this contract. This process shall be repeated for all new contractor or subcontractor employees.

Contractor personnel with background screenings and who provide services on VA grounds shall obtain flash badges from the VA Police Department at the VA Medical Center. Contractor personnel shall present one photo ID to obtain flash badges.

1. Government-Furnished Equipment (GFE) / Government-Furnished Information.

Ambulance Linen. Due to ongoing significant losses of hospital linen to patient transport each year, the contractor will be required to provide all their own linen when transporting patients. Patient Protected Health Information (PHI) may be furnished by the government to the contractor via phone, facsimile or paper needed for the provision of ambulance transportation services.

1. Reporting.

13. The contractor shall provide a monthly report to the Flow Center which identifies each request for service by patient name, time of receipt of call, whether BLS, ALS or CC requested, time of arrival, and time elapsed rom receipt of call to time of arrival. Other pertinent information as necessary may be included.

13. Accident/Incident Reporting. The contractor shall record and report all available facts relating to each incident of accidental Government property damage or personal injury or contractor personnel injury to the Contracting Officer Representative (COR) within one hour of the incident. The contractor is required to notify the COR / AOD of any and all accidents and/or safety incidents that occur involving VAMC patients being transported under this contract. This notification will be made within one hour by telephone, and a written report of the event will be delivered to the COR by the close of business the next working day.

13. Complaints. The contractor shall record and report all available facts relating to each instance of patient complaint. Contractor shall submit documentation (email is acceptable) to the COR within two business days of the incident.

13. Failure to Perform. If, for any reason, the scheduled time for ambulance pick up cannot be met, the contractor is required to explain in writing within 48 hours of the incident, and may be grounds to terminate for cause.

1. Other Pertinent Information or Special Considerations.

14. Certification of Insurance Coverage: Before award of the contract, the Contractor shall furnish to the Contracting Officer a Certificate of Insurance containing bodily injury liability insurance coverage written on the comprehensive form of policy of at least $500,000 per occurrence, $200,000 per person and $500,000 per occurrence for bodily injury and $20,000 per occurrence for property damage and an endorsement to the effect that cancellation or any material change in the policies which adversely affect the interest of the Government shall not be effective unless a thirty (30) day written notice of cancellation or change is furnished to the Contracting Officer. The term “shall endeavor” is not acceptable as issued by Insurance Carrier.

14. Contractor’s Quality Control Program (QCP): The contractor shall establish and maintain a complete QCP to ensure the requirements of this contract are provided as specified. The QCP shall also address processes and procedures to ensure services are performed in accordance with all state and local standards and codes. An original and one (1) copy of this QCP are due with the initial quote. The Contractor’s QCP shall include the following at a minimum:

1. Organizational structure denoting management and supervisory responsibilities for ensuring total acceptable performance.

1. The methods for identifying and preventing deficiencies in the quality of service performed, before the level of performance becomes unacceptable.

1. Incorporation of either active or established internal policy or procedures for updating service protocols that may affect performance of contract.

1. On-Site records identifying the character (background checks) and certifications of ongoing training of each employee performing services under this contract.

1. Method used by contractor to ensure accuracy of and timely submission of invoices.

1. The methods of identifying and preventing radio communication breakdowns. A detailed procedure for alternative communications in the event of electronic and mechanical breakdown of vehicle two-way radios.

1. A log to account for all requests for service. The log shall indicate the date and time of service call, actual time of pick-up versus the scheduled time, name of patient requiring services, designated pick-up and delivery points, mileage and actual waiting time at pick-up and delivery points if waiting charges are claimed. Contractor shall send log sheet to COR monthly.

1. On-site records of complaints or problems, with procedures taken to allow for corrections and/or elimination before effects caused interruption of performance of contract. Contractor shall report any complaints to the COR within 48 hours along with any planned or completed corrective action.

1. The VA will assess the successful offeror’s QCP, modify it as necessary with concurrence of offeror and incorporate it into the Government’s Quality Assurance Surveillance Plan (QASP). The QASP will be incorporated into the contract and shall provide a systematic method for use by the VA to evaluate contractor performance for this contract.

14. Invoicing Procedures: The contractor shall forward invoices for payment to the VA directly and Austin via Tungsten at the end of each month. Contractor will submit invoices that include information listed below to the Beneficiary Travel Office for verification purposes on a monthly basis at the Baltimore VA. Monthly billings shall be submitted to the VA no later than 10 days past the last day of each month.

1. Name of contractor

1. Complete address of where payment is to be sent

1. Contractor’s telephone number for billing questions

1. Contract number and appropriate fiscal year purchase order/obligation number

1. Date of invoice

1. Total amount billed

1. Daily itemized listing of transports and charges (including patient’s name, the last four digits of the SSN, date of transport, and pick-up/drop-off points) 1.

1.

1. Allowable Expenses (Toll Charges). It is agreed and understood that the prices proposed in the schedule do NOT include any ferry, bridge, tunnel, or road toll charges. Any such legitimate toll charges incurred shall be limited to ONE WAY ONLY and shall be listed separately on contractor invoices. If the contractor’s place of business is located beyond the local telephone call zone of the hospital, the contractor agrees to accept telephoned schedule for services on a collect basis. There will be no additional charge for time spent at the site awaiting the arrival of additional contractor employees or equipment.

1. Contractor Personnel Qualifications. Emergency Medical Technicians (EMTs) and other medical personnel (as applicable) shall at all times meet the qualifications specified in this contract as well as all applicable federal and local government laws, regulations and standards. The contractor personnel shall be trained, certified and licensed or otherwise officially recognized by the local, state or regional government or public entity where the emergency service is operated or by which it is governed. The contractor shall submit to the Contracting Officer written certification that each contract employee has been trained and certified in the subject areas prior to assignment under this contract.

1. Tuberculosis Exposure Control Policy

0. Contractor shall provide the VA with a policy on tuberculosis (TB) exposure and control, to include TB decontamination.

0. Contractor shall have its personnel tested for TB annually, and provide each of these test results to the VA.

1. Within seven (7) days after receipt of award notification, the contractor shall provide evidence of required training, certifications, licensing, and any other qualifications of any personnel performing services under this contract. The initial documentation shall be provided to the Contracting Officer.

1. During the period of performance, if the Contractor proposes to add-on or replace personnel to perform contract services, the Contractor shall submit the required evidence of training, certifications, licensing, and any other qualifications to the designated Contracting Officer’s Representative (COR). At no time shall the Contractor utilize add-on or replacement personnel to perform contract services who do not meet the personnel qualifications of this contract.

1. The Contractor is solely responsible for compliance with OHSA standards for the protection of their employees.

1. Emergency Medical Technician (EMT) and Paramedic Qualifications: EMTs and Paramedics providing services under this contract shall have the following additional qualifications:

1. Have completed training in accordance with the standards published by the Department of Health and Human Services with a minimum curriculum of 150 hours or equivalent including an in-hospital training period. Such training programs must also be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154, Federal Register 39:24304 (1974).

1. Shall submit evidence of equivalent training program successfully completed to the Contracting Officer.

1. Shall be certified, licensed or otherwise officially recognized by the local, state, or regional government or public government entity in which service is rendered. In no instance shall this be less frequent than every two (2) years. Such refresher training shall be relevant to that developed by the Department of Transportation, National Highway Safety Administration.

1. Ambulance Driver: 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 the Standard and Advanced First Aid Course of the American Red Cross or U.S. Bureaus of Mines or equivalent and be capable of providing necessary medical assistance to the attending medical care specialist.

1. Ambulance Personnel Act as Attendant to Patient at Destination: Base rate includes number and type of personnel required by the State Maryland Emergency Medical Services (EMS) Systems Act for the operation of BLS ambulances. Ambulance personnel will deliver the patient to the admission point or clinic appointment.

1. The Contractor shall maintain a record of each employee as to the character, current driving records and physical capabilities of performing the duties of a wheelchair vehicle driver. The Contractor shall make these records available for inspection upon request by the Contracting Officer or the COR.

1. Drivers shall not transport the VA Medical Center beneficiaries if they appear to be under the influence of drugs or alcohol. Drivers shall not transport anyone who insists on smoking during the transport, this includes drivers and attendants as well. Drivers shall display professional manners at all times. Rude or obscene behavior or language shall not be accepted.

1. Drivers shall wear clean and unsoiled attire with a picture identification (ID) badge that clearly identifies the company they work for.

1. Contractor shall demonstrate to the VA Medical Center that their attendants are adequately trained in the safe and proper transport of beneficiaries.

1. Every two years each driver shall obtain a physician’s statement or the statement of a nurse practitioner certified by the American Nurses’ Association (or other professional nursing certifying organization having authority to certify registered nurses in advanced nursing practice) that the driver has no current medical condition that interferes with the driver’s ability to drive safely. It must be obtained before driving a special transportation service vehicle. Drivers for facilities that are licensed by the Department of Health or the Department of Human Services and required by either of those departments to provide a physician’s or nurse practitioner’s statement of health on a regular basis may substitute that form or statement for the form required in this part. A driver who has a driver’s license containing a valid school bus endorsement issued under Maryland Statutes, (or other state equal) or the rules of the commissioner of public safety, or a current United States Department of Transportation health card, may furnish a copy of that endorsement or card instead of furnishing the physician’s statement of health.

1. Each driver must be at least 18 years of age and have not less than one year of experience as a licensed driver. For the past three years have had a driving record clear of convictions for driving a motor vehicle without a valid current license for the class of vehicle driven; and driving and criminal record clear of convictions for driving under the influence of alcohol or a controlled substance, or of alcohol-related driving by commercial vehicle drivers and of driver's license revocations.

1. Each driver must also have a record clear of criminal convictions of crimes or anticipatory crimes against persons, and crimes or anticipatory crimes (to include warrants and pending court cases) reasonably related to providing special transportation services.

1. Drivers’ Conduct: Contractor employees shall conduct themselves in a businesslike manner at all times while on VA premises or transporting VA patients. Contractor personnel performing contract services shall continuously meet the qualifications 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. The following acts are not permissible by drivers that provide services under this contract or while on VA premises.

1. Use of intoxicating liquors, narcotics or controlled substances of any kind (excluding doctor’s prescriptions which do not impair driver’s driving ability) while on duty or reporting for duty while under the influence of liquors, narcotics or controlled substance of any kind (excluding doctors’ prescriptions which do not impair driver’s driving ability).

1. Gambling while on duty in any form.

1. Smoking and other uses of tobacco while on duty. Both Patients and Contractor are prohibited from smoking in vehicles at any time. The smell and residual smoke may cause other patients who shall be riding in the vehicle to become ill.

1. Carrying of pistols, firearms or concealed weapons.

1. Resorting to physical violence to settle a dispute with a fellow employee, customer(s) or the general public while on duty.

1. Spitting is prohibited.

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

1. Stopping for personal business, including excessive use of restroom facilities, while vehicle is occupied by a passenger. The driver shall not leave the vehicle with the key in the ignition at any time.

1. Engaging customer…