36C24519R0053-0002000.docx

DOCX document 56 KB Posted Aug 22, 2019

Attached to: Ambulance Service (VA-19-00046615)
Solicitation number: 36C24519R0053
Issued by: Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 5

About this file

Written by GovTribe AI · Dec 30, 2023

This document is a revised price schedule for an ambulance services contract opportunity between the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 5 and offerors. The contract requires the provision of advanced life support, basic life support, critical care transport, wheelchair van transport, and minivan transport services for the Clarksburg and Beckley VA Medical Centers in West Virginia. Pricing is provided for multiple service line items covering ambulance transports between the medical centers and surrounding locations from October 2019 through September 2024. Additional line items include mileage rates, oxygen, medical equipment, and waiting time. The opportunity is set aside 100% for small businesses and will be solicited on an unrestricted basis with an anticipated posting date of May 3, 2019 and contract award on or around June 10, 2019. The primary point of contact is identified.

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36C24519R0053 0002 36C24519R0053 0002.docx

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File	Type	Posted
36C24520D0009-000.docx	DOCX document	Oct 24, 2019
36C24519R0053-0001000.docx	DOCX document	Aug 20, 2019
36C24519R0053-017.docx	DOCX document	Aug 1, 2019
36C24519R0053-016.docx	DOCX document	Aug 1, 2019
36C24519R0053-000.docx	DOCX document	Apr 25, 2019
36C24519R0053-000.docx	DOCX document	Apr 25, 2019

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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 ADM

INISTRATIVE 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 d ate 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 3

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) n/a Department of Veterans Affairs

VAMC (613)

VISN 5 Contract Satellite Office 510 Butler Avenue, Building 306A Martinsburg WV 25405 Department of Veterans Affairs

VAMC (613)

VISN 5 Contract Satellite Office 510 Butler Avenue, Building 306A Martinsburg WV 25405 To all Offerors/Bidders

36C24519R0053

X x x

The purpose of this amendment is to incorporate a revised price schedule into the solicitation.

Price Schedule:

Item Number

SLIN

Description

Ordering Period

Start Ordering Period End

Quantity

Unit of

Measure Unit Price Total Cost

Advanced Life Support (ALS) for Clarksburg, and Beckley VAMC.

0001

Clarksburg Advanced Life Support (ALS) One Way

10/01/19

09/30/20

280

Beckley VAMC Advanced Life Support (25) miles from Beckley VAMC.

10/01/19

09/30/20

ALS: One way from Beckley VAMC to 1201 Broad Rock Blvd, Richmond, VA

10/01/19

09/30/20

ALS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/19

09/30/20

ALS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/19

09/30/20

ALS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/19

09/30/20

ALS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/19

09/30/20

ALS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/19

09/30/20

Basic Life Support (BLS) for Beckley and Clarksburg

0002

Clarksburg VAMC Base Rate for BLS One Way Only

10/01/19

09/30/20

2000

0002

Beckley VAMC BLS (25) miles from Beckley VAMC.

10/01/19

09/30/20

1385

BLS: One way from Beckley VACM to 1201 Broad Rock Blvd, Richmond, VA

10/01/19

09/30/20

BLS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/19

09/30/20

BLS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/19

09/30/20

BLS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/19

09/30/20

BLS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/19

09/30/20

BLS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/19

09/30/20

Critical Care Transport (CCT)

Critical Care Transport (CCT) Beckley One Way within PSA

10/01/19

09/30/20

Critical Care Transport (CCT) Clarksburg One Way within PSA

10/01/19

09/30/20

CCT Beckley Mileage Charge beyond PSA (Shall be for loaded miles and one way only).

10/01/19

09/30/20

100000

CCT Clarksburg Mileage Charge beyond PSA (Shall be for loaded miles and one way only).

0003

Oxygen Per Patient

10/01/19

09/30/20

1500

Cardiac Monitory, Pulse Oximetry, IV Solutions, Glucometer (per patient)

10/01/19

09/30/20

Wheelchair Van one way within 50 miles of Clarksubrg VAMC

10/01/19

09/30/20

Minivan One Way Only Clarksburg VAMC

10/01/19

09/30/20

200

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 0001AA. One way only.

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 0002AA.

One way only.

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 0004 and 0005. One way only.

Beckley ALS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/19

09/30/20

Beckley BLS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/19

09/30/20

Waiting Time ( for each 15 minute increment). EA 1=15 min

10/01/19

09/30/20

Advanced Life Support (ALS) for Clarksburg, and

Clarksburg Advanced Life Support (ALS) One Way Only

10/01/20

09/30/21

Beckley VAMC Advanced Life Support (25) miles from Beckley VAMC.

10/01/20

09/30/21

ALS: One way from Beckley VAMC to 1201 Broad Rock Blvd, Richmond, VA

10/01/20

09/30/21

ALS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/20

09/30/21

ALS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/20

09/30/21

ALS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/20

09/30/21

ALS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/20

09/30/21

ALS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/20

09/30/21

Basic Life Support (BLS) for Beckley and Clarksburg

VAMC

Clarksburg VAMC Base Rate for BLS One Way Only

10/01/20

09/30/21

Beckley VAMC BLS (25) miles from Beckley VAMC.

10/01/20

09/30/21

BLS: One way from Beckley VACM to 1201 Broad Rock Blvd, Richmond, VA

10/01/20

09/30/21

BLS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/20

09/30/21

BLS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/20

09/30/21

BLS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/20

09/30/21

BLS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/20

09/30/21

BLS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/20

09/30/21

Critical Care Transport (CCT)

Critical Care Transport (CCT) Beckley One Way within PSA

10/01/20

09/30/21

Critical Care Transport (CCT) Clarksburg One Way within PSA

10/01/20

09/30/21

10/01/20

09/30/21

1003

Oxygen Per Patient

10/01/20

09/30/21

1500

Cardiac Monitory, Pulse Oximetry, IV Solutions, Glucometer (per patient)

10/01/20

09/30/21

Wheelchair Van one way within 50 miles of Clarksubrg VAMC

10/01/20

09/30/21

Minivan One Way Only Clarksburg VAMC

10/01/20

09/30/21

200

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 1001AA.

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 1002AA.

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 1004 and 1005. One way only.

Beckley ALS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/20

09/30/21

Beckley BLS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/20

09/30/21

Waiting Time ( for each 15 minute increment). EA 1=15 min

10/01/20

09/30/21

Advanced Life Support (ALS) for Clarksburg, and

Clarksburg Advanced Life Support (ALS) One Way Only

10/01/21

09/30/22

Beckley VAMC Advanced Life Support (25) miles from Beckley VAMC.

10/01/21

09/30/22

ALS: One way from Beckley VAMC to 1201 Broad Rock Blvd, Richmond, VA

10/01/21

09/30/22

ALS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/21

09/30/22

ALS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/21

09/30/22

ALS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/21

09/30/22

ALS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/21

09/30/22

ALS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/21

09/30/22

Basic Life Support (BLS) for Beckley and Clarksburg

Clarksburg VAMC Base Rate for BLS One Way Only

10/01/21

09/30/22

Beckley VAMC BLS (25) miles from Beckley VAMC.

10/01/21

09/30/22

BLS: One way from Beckley VACM to 1201 Broad Rock Blvd, Richmond, VA

10/01/21

09/30/22

BLS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/21

09/30/22

BLS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/21

09/30/22

BLS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/21

09/30/22

BLS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/21

09/30/22

BLS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/21

09/30/22

Critical Care Transport (CCT)

Critical Care Transport (CCT) Beckley One Way within PSA

10/01/21

09/30/22

Critical Care Transport (CCT) Clarksburg One Way within PSA

10/01/21

09/30/22

10/01/21

09/30/22

2003

Oxygen Per Patient

10/01/21

09/30/22

1500

Cardiac Monitory, Pulse Oximetry, IV Solutions, Glucometer (per patient)

10/01/21

09/30/22

Wheelchair Van one way within 50 miles of Clarksubrg VAMC

10/01/21

09/30/22

Minivan One Way Only Clarksburg VAMC

10/01/21

09/30/22

200

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 2001AA. One way only.

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 2002AA.

44470

44834

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 2004 and 2005. One way only.

Beckley ALS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/21

09/30/22

Beckley BLS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/21

09/30/22

Waiting Time ( for each 15 minute increment). EA 1=15 min

10/01/21

09/30/22

Advanced Life Support (ALS) for Clarksburg, and

Clarksburg Advanced Life Support (ALS) One Way Only

10/01/22

09/30/23

Beckley VAMC Advanced Life Support (25) miles from Beckley VAMC.

10/01/22

09/30/23

ALS: One way from Beckley VAMC to 1201 Broad Rock Blvd, Richmond, VA

10/01/22

09/30/23

ALS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/22

09/30/23

ALS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/22

09/30/23

ALS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/22

09/30/23

ALS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/22

09/30/23

ALS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/22

09/30/23

Basic Life Support (BLS) for Beckley and Clarksburg

Clarksburg VAMC Base Rate for BLS One Way Only

10/01/22

09/30/23

Beckley VAMC BLS (25) miles from Beckley VAMC.

10/01/22

09/30/23

BLS: One way from Beckley VACM to 1201 Broad Rock Blvd, Richmond, VA

10/01/22

09/30/23

BLS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/22

09/30/23

BLS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/22

09/30/23

BLS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/22

09/30/23

BLS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/22

09/30/23

BLS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/22

09/30/23

Critical Care Transport (CCT)

Critical Care Transport (CCT) Beckley One Way within PSA

10/01/22

09/30/23

Critical Care Transport (CCT) Clarksburg One Way within PSA

10/01/22

09/30/23

10/01/22

09/30/23

3003

Oxygen Per Patient

10/01/22

09/30/23

1500

Cardiac Monitory, Pulse Oximetry, IV Solutions, Glucometer (per patient)

10/01/22

09/30/23

Wheelchair Van one way within 50 miles of Clarksubrg VAMC

10/01/22

09/30/23

Minivan One Way Only Clarksburg VAMC

10/01/22

09/30/23

200

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 3001AA.

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 3002AA. One way only.

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 3004 and 3005. One way only.

Beckley ALS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/22

09/30/23

Beckley BLS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/22

09/30/23

Waiting Time ( for each 15 minute increment). EA 1=15 min

10/01/22

09/30/23

Advanced Life Support (ALS) for Clarksburg, and

Clarksburg Advanced Life Support (ALS) One Way Only

10/01/23

09/30/24

Beckley VAMC Advanced Life Support (25) miles from Beckley VAMC.

10/01/23

09/30/24

ALS: One way from Beckley VAMC to 1201 Broad Rock Blvd, Richmond, VA

10/01/23

09/30/24

ALS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/23

09/30/24

ALS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/23

09/30/24

ALS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/23

09/30/24

ALS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/23

09/30/24

ALS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/23

09/30/24

Basic Life Support (BLS) for Beckley and Clarksburg

Clarksburg VAMC Base Rate for BLS One Way Only

Beckley VAMC BLS (25) miles from Beckley VAMC.

10/01/23

09/30/24

BLS: One way from Beckley VACM to 1201 Broad Rock Blvd, Richmond, VA

10/01/23

09/30/24

BLS: One way from Beckley VACM to 1970 Roanoke Blvd., Salem, VA

10/01/23

09/30/24

BLS: One way from Beckley VACM to 1100 Tunnell Road, Asheville, NC

10/01/23

09/30/24

BLS: One way from Beckley VACM to 508 Fulton St.

Durham, NC

10/01/23

09/30/24

BLS: One way from Beckley VACM to 1540 Spring Valley Dr. Huntington, WV

10/01/23

09/30/24

'4002

BLS: One way from Beckley VACM to 1 Medical Center Drive, Clarksburg, WV

10/01/23

09/30/24

Critical Care Transport (CCT)

Critical Care Transport (CCT) Beckley One Way within PSA

10/01/23

09/30/24

Critical Care Transport (CCT) Clarksburg One Way within PSA

10/01/23

09/30/24

10/01/23

09/30/24

4003

Oxygen Per Patient

10/01/23

09/30/24

1500

Cardiac Monitory, Pulse Oximetry, IV Solutions, Glucometer (per patient)

10/01/23

Wheelchair Van one way within 50 miles of Clarksubrg VAMC

10/01/23

09/30/24

Minivan One Way Only Clarksburg VAMC

10/01/23

09/30/24

200

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 3001AA.

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 3002AA.

10/01/23

09/30/24

100

Clarksburg mileage Rate for each mile travled outside the 50 mile threshold for items 4004 and 4005. One way only.

Beckley ALS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/23

09/30/24

Beckley BLS Mileage charge for each mile traveled outside the 25 mile threshold.

10/01/23

09/30/24

Waiting Time ( for each 15 minute increment). EA 1=15 min

10/01/23

09/30/24

File details come from the government source that posted it. Updated Dec 30, 2023.