36C24822Q1641.docx

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V225--FY23 Ambulance Transportation (new Base+4OYs)
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36C24822Q1641
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36C24822Q1641

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE

DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a.

PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

UEI:

EFT:

PHONE:

FAX:

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

SEE

ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

26.

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

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212

-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNAT

URE 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

36C24822Q1641 09-07-2022 Kurt Kramer 407-631-8708 09-19-2022 11:00

EDT

36C248 Department of Veterans Affairs Network Contracting Office 8 (NCO 8) Orlando VA Healthcare System 13800 Veterans Way Orlando FL 32827 X 621910 $16.5 Million N/A X Department of Veterans Affairs Orlando VA Healthcare System 13800 Veterans Way Orlando Fl 32827 36C248 Department of Veterans Affairs Network Contracting Office 8 (NCO 8) Orlando VA Healthcare System 13800 Veterans Way Orlando FL 32827

Department of Veterans Affairs Financial Services Center P.O. Box 149971 Austin TX 78714-9971

(877) 353-9791

(512) 460-5429 See CONTINUATION Page Non-emergency Ground Ambulance Transportation services for the Orlando

VA Healthcare System (OVAHCS).

See Section B.2 for the PRICE SCHEDULE or ATTACHMENT 4 for a fillable spreadsheet.

Video or audio recording of transportation services provided under this contract is strictly prohibited unless independently authorized by the Contracting Officer Department of Labor Wage Determinations (DOL_WD) apply See CONTINUATION Page X X Kurt Kramer

VA-VHA-RPOE-2019-A65EFC3E

Table of Contents

SECTION A1
A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES1
SECTION B - CONTINUATION OF SF 1449 BLOCKS4
B.1 CONTRACT ADMINISTRATION (continuation from Standard Form 1449, block 18A.)4
B.2 PRICE SCHEDULE6
B.3 PERFORMANCE WORK STATEMENT (PWS)12
SECTION C - CONTRACT CLAUSES40
C.1 52.216-18 ORDERING (OCT 1995)40
C.2 52.216-19 ORDER LIMITATIONS (OCT 1995)40
C.3 52.216-22 INDEFINITE QUANTITY (OCT 1995)41
C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)41
C.5 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)41
C.6 52.223-99 ENSURING ADEQUATE COVID-19 SAFETY PROTOCOLS FOR FEDERAL CONTRACTORS (OCT 2021) (DEVIATION)42
C.7 SUPPLEMENTAL INSURANCE REQUIREMENTS42
C.8 VAAR 852.212-70 PROVISIONS AND CLAUSES APPLICABLE TO VA ACQUISITION OF COMMERCIAL ITEMS (APR 2020)43
C.9 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND COMPLIANCE (JUL 2018)45
C.10 VAAR 852.219-76 SUBCONTRACTING PLANS MONITORING AND COMPLIANCE (JUL 2018)45
C.11 VAAR 852.219-71 VA MENTOR-PROTÉGÉ PROGRAM (DEC 2009)46
C.12 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)47
C.13 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2022) (JUL 2020) (DEVIATION)47
C.14 MANDATORY WRITTEN DISCLOSURES55
SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS56
D.1 ATTACHMENT 1: WD 2015-4533 Rev 19 (Volusia).56
D.2 ATTACHMENT 2: WD 2015-4553 Rev 21 (Orange).56
D.3 ATTACHMENT 3: WD 2015-4555 Rev 19 (Brevard).56
D.4 ATTACHMENT 4: Price Schedule Template.56
SECTION E - SOLICITATION PROVISIONS57
E.1 INSTRUCTIONS TO QUOTERS—COMMERCIAL ITEMS57
E.2 52.204-24 REPRESENTATION REGARDING CERTAIN TELECOMMUNICATIONS AND VIDEO SURVEILLANCE SERVICES OR EQUIPMENT (NOV 2021)61
E.3 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018)63
E.4 52.216-1 TYPE OF CONTRACT (APR 1984)64
E.5 52.233-2 SERVICE OF PROTEST (SEP 2006)64
E.6 VAAR 852.219-72 EVALUATION FACTOR FOR PARTICIPATION IN THE VA MENTOR-PROTÉGÉ PROGRAM (DEC 2009)64
E.7 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB 1998)65
E.8 52.212-2 EVALUATION—SIMPLIFIED ACQUISITION PROCEDURES65
E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (MAY 2022) (JUL 2020) (DEVIATION)67

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION (continuation from Standard Form 1449, block 18A.)

1.Contract Administration: All contract administration matters will be handled by the following individuals:
a. CONTRACTOR:(Company Name)
(Address)
(City-State-Zip)
POINT OF CONTACT:
PHONE NUMBER:
E-MAIL ADDRESS:
SAM UEI #:
GOVERNMENT:Kurt Kramer, Contracting Officer (CO)
(E): Kurt.Kramer@va.gov

Network Contracting Office 8 (NCO 8) Orlando Contracting - Services Team 13800 Veterans Way Lakemont Bldg., Room 221 Orlando, FL 32827-7403

2.CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:
[X]
52.232-33 Payment by Electronic Funds Transfer - System For Award Management (JUL 2013)

3. INVOICES/PAYMENT: Invoices shall be submitted electronically, in arrears:

[X]
Bimonthly (twice per month – once for services rendered from the 1st day through the 15th day of the month and once for services rendered from the 16th day through the last day of the month.

a. In order to comply with the Improper Payment Elimination and Recovery Act of 2010 (IPERA), the VA has mandated electronic invoice submission to the Veterans Affairs Financial Services Center (VAFSC). VAFSC has partnered with Tungsten Corporation e-Invoicing network, for submissions of all electronic invoices to VA. Tungsten Network electronic invoicing is free to all VA vendors. In order to submit electronic invoices, all VA vendors must register with Tungsten Network by submitting an email to Tungsten Network VA.Registration@tungsten-network.com or calling 1-877-752-0900 option 2 for Enrollment.

b. VA’s Electronic Invoice (e-Invoice) system uses a third-party contractor (Tungsten Network) for submission of electronic invoices. Go to this website to begin submitting electronic invoices, free of charge: http://www.tungsten-network.com/customer-campaigns/veteransaffairs-us/

For assistance setting up e-Invoice, the below information is provided:

· Tungsten Network e-Invoice Registration: VA.Registration@tungsten-network.com

· Tungsten Network Customer Service: (877) 489-6135

· VAFSC – for Invoice receipt or payment questions, call: (877)353-9791 or

· VAFSC Email: vafsccshd@va.gov

FACSIMILE, E-MAIL, AND SCANNED DOCUMENTS ARE NOT ACCEPTABLE FORMS OF

SUBMISSION FOR PAYMENT REQUESTS

4. CONTRACT ADMINISTRATION: The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitment or issue changes that will affect price, quantity or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase in cost incurred thereof.

5.SPECIAL NOTES. To maintain the integrity of this solicitation and subsequent award, all quoters are advised that any question(s) must be submitted in written form via e-mail to the Contracting Officer at Kurt.Kramer@va.gov no later than Tuesday, September 13, 2022, at 11:00 am (EST). Submissions shall reference ‘36C24822Q1641 – Questions’ in the email subject line. A consolidated response via solicitation amendment to Contract Opportunities (www.SAM.gov) will be provided.
Any question(s) received after the exact time specified for receipt of questions is late and will not be considered unless the Contracting Officer determines that accepting the late question(s) would not unduly delay the acquisition.
6.ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:
AMENDMENT NO
DATE

B.2 PRICE SCHEDULE

All prices and rates shall be for loaded (patient onboard) services and mileage only. But for exceptions (dry-runs or cancellations) indicated in the Performance Work Statement (PWS), the Government shall not pay for unloaded (no patient) services or mileage.

Orders shall be placed in accordance with the PWS. The default method of payment shall be electronic funds transfer submitted into Tungsten, unless the Contracting Officer specifies otherwise. The Contractor is required to maintain an awareness of available order quantities as they are depleted during performance. Services rendered which exceed order quantities issued by the Contracting Officer shall be the risk of the Contractor and any cost thereof may be borne by the Contractor.

The quantities are estimated quantities only and shall be considered nonbinding.

The guaranteed minimum for the fiscal year in which the contract was awarded shall be $500.00.

The total maximum amount of services acquired under this contract shall not exceed $7,500,000.00.

ITEM NUMBER
DESCRIPTION OF SERVICES
QUANTITY
UNIT
UNIT PRICE
AMOUNT
2,200
EA
__________________
__________________

Basic Life Support (BLS) Ambulance Transportation (A0428) Contract Period: Base POP Begin: 10-01-2022 POP End: 09-30-2023 PRINCIPAL NAICS CODE: 621910 - Ambulance Services PRODUCT/SERVICE CODE: V225 - Transportation/Travel/Relocation - Travel/Lodging/Recruitment: Ambulance

400
EA
__________________
__________________

Advanced Life Support 1 (ALS1) Ambulance Transportation (A0426)

Contract Period: Base POP Begin: 10-01-2022 POP End: 09-30-2023

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

50
EA
__________________
__________________

Advanced Life Support 2 (ALS2) Ambulance Transportation Rate (A0433)

Contract Period: Base POP Begin: 10-01-2022 POP End: 09-30-2023

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

50,000
EA
__________________
__________________

Mileage Rate (A0425)

Contract Period: Base POP Begin: 10-01-2022 POP End: 09-30-2023

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

100
EA
__________________
__________________

Wait Time (1 EA = one 15-minute time block) *in excess of initial 15 minutes Contract Period: Base POP Begin: 10-01-2022 POP End: 09-30-2023

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

2,200
EA
__________________
__________________

Basic Life Support (BLS) Ambulance Transportation

Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024

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

400
EA
__________________
__________________

Advanced Life Support 1 (ALS1) Ambulance Transportation

Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024

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

50
EA
__________________
__________________

Advanced Life Support 2 (ALS2) Ambulance Transportation Rate

Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024

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

50,000
EA
__________________
__________________

Mileage Rate

Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024

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

100
EA
__________________
__________________

Wait Time

*in excess of initial 15 minutes Contract Period: Option 1 POP Begin: 10-01-2023 POP End: 09-30-2024

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

2,200
EA
__________________
__________________

Basic Life Support (BLS) Ambulance Transportation

Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025

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

400
EA
__________________
__________________

Advanced Life Support 1 (ALS1) Ambulance Transportation

Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025

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

50
EA
__________________
__________________

Advanced Life Support 2 (ALS2) Ambulance Transportation Rate

Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025

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

50,000
EA
__________________
__________________

Mileage Rate

Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025

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

100
EA
__________________
__________________

Wait Time

*in excess of initial 15 minutes Contract Period: Option 2 POP Begin: 10-01-2024 POP End: 09-30-2025

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

2,200
EA
__________________
__________________

Basic Life Support (BLS) Ambulance Transportation

Contract Period: Option 3 POP Begin: 10-01-2025 POP End: 09-30-2026

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

400
EA
__________________
__________________

Advanced Life Support 1 (ALS1) Ambulance Transportation

Contract Period: Option 3 POP Begin: 10-01-2025 POP End: 09-30-2026

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

50
EA
__________________
__________________

Advanced Life Support 2 (ALS2) Ambulance Transportation Rate

Contract Period: Option 3 POP Begin: 10-01-2025 POP End: 09-30-2026

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

50,000
EA
__________________
__________________

Mileage Rate

Contract Period: Option 3 POP Begin: 10-01-2025 POP End: 09-30-2026

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

100
EA
__________________
__________________

Wait Time

*in excess of initial 15 minutes Contract Period: Option 3 POP Begin: 10-01-2025 POP End: 09-30-2026

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

2,200
EA
__________________
__________________

Basic Life Support (BLS) Ambulance Transportation

Contract Period: Option 4 POP Begin: 10-01-2026 POP End: 09-30-2027

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

400
EA
__________________
__________________

Advanced Life Support 1 (ALS1) Ambulance Transportation

Contract Period: Option 4 POP Begin: 10-01-2026 POP End: 09-30-2027

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

50
EA
__________________
__________________

Advanced Life Support 2 (ALS2) Ambulance Transportation Rate

Contract Period: Option 4 POP Begin: 10-01-2026 POP End: 09-30-2027

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

50,000
EA
__________________
__________________

Mileage Rate

Contract Period: Option 4 POP Begin: 10-01-2026 POP End: 09-30-2027

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

100
EA
__________________
__________________

Wait Time

*in excess of initial 15 minutes Contract Period: Option 4 POP Begin: 10-01-2026 POP End: 09-30-2027

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

GRAND TOTAL
__________________

B.3 PERFORMANCE WORK STATEMENT (PWS)

1. DESCRIPTION/SPECIFICATIONS/WORK STATEMENT

In an effort to provide exemplary care and meet transportation requirements, the Orlando VA Healthcare System (OVAHCS) seeks a contractor to provide all ground non-emergency, Advance Life Support (ALS) and Basic Life Support (BLS) ambulance services as identified within this performance work statement (PWS) for beneficiaries of the Orlando VA Medical Center (OVAMC), and its associated healthcare facilities. The Contractor shall provide all transport vehicles, personnel, management, supplies, transportation, fuel, equipment, reports, and anything else necessary to successfully furnish service as identified in the Pricing Schedule and the PWS in accordance with all terms, conditions, and provisions stated herein.

The contractor’s responsibility shall cover non-emergency transportation services by ambulance in designated counties within the OVAMC catchment area: Orange, Seminole, Osceola, Brevard, Volusia, and Lake County. ALS/BLS transportation may be required to be provided to Veterans that live in the adjacent counties that border the six identified counties identified under the OVAMC catchment area.

The following facilities shall be covered; however, their physical addresses may change during the life of the contract:

· Orlando VA Medical Center (VAMC) at Lake Nona 13800 Veterans Way, Orlando, FL 32827 (in Orange County)

· Lake Baldwin VA Clinic, 5201 Raymond St., Orlando, FL., 32803 (in Orange County)

· Kissimmee Community Based Outpatient Clinic (CBOC) 2285 N. Central Ave., Kissimmee, FL., 34741 (in Osceola County)

· William V. Chappell Jr. (CBOC) 551 National Health Care Dr., Daytona Beach, FL., 32114 (in Volusia County)

· Westside Pavilion VA Clinic 1821 Business Park Blvd., Daytona Beach, FL., 32114 (in Volusia County)

· Deltona VA CBOC 1200 Deltona Blvd., Deltona, FL., 32725 (in Volusia County)

· Viera VA Health Care Center (VAHCC) 2900 Veterans Way, Viera, FL., 32940 (in Brevard County)

· Palm Bay VA Outpatient Clinic (OPC), 5200 Babcock St., Suite 101, Palm Bay, FL 32905 (in Brevard County)

· Tavares CBOC, 1390 E. Burleigh Blvd., Tavares, FL 32778 (in Lake County)

· Clermont CBOC, 805 Oakley Seaver Dr., Clermont, FL., 34711 (in Lake County)

2. CONTRACT DEFINITIONS/ACRONYMS & TERMS

A. Administrative Officer of the Day (AOD) - VA official that works in the admissions area during evenings and nights and monitors hospital activities during other than normal working hours. This person acts as the hospital administrator during off-hours.

B. Ambulatory Patient – A non-emergency VA beneficiary who does not require the use of a handicap ambulance, wheelchair, or stretcher van, who can utilize normal forms of transportation such as taxi or hired car but have been determined as needing transportation assistance for medical reasons. A VA clinician determines if the patient requires based on a medical impairment or special need (to include but not limited to: blindness, mental health deficiency, amputees, etc.)

C. Attendant/Escort – A medical attendant may be required to assist with transportation, when deemed necessary by a VA physician. An escort is a non-medical attendant which can be a caregiver, family member, or VA employee to accompany the patient.

D. 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 during all phases of the trip made on behalf of the Government. The attached Service Contract Act wage determination will be updated for each option when/if new revisions are issued. The Base Rate will constitute full compensation for one-way trips as shown in the Schedule of Services and Pricing for the medical facility.

E. Beneficiary – Veterans and other members determined to be eligible for benefits by the VA.

F. Beneficiary Travel Department Personnel – An individual designated by the Contracting Officer for the medical facility, who is authorized to schedule transportation services for orders issued by the Contracting Officer.

G. Beneficiary Travel Department – Department within the VA that oversees the Beneficiary Travel Program and its entitlements. This includes transportation such as the ALS/BLS services.

H. Beneficiary Travel Department Supervisor - Individual who manages the employees working within the Beneficiary Travel Department.

I. 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, Presidents 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 national 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. When a holiday falls on a Sunday, the following Monday shall be observed as a legal holiday. When a holiday falls on a Saturday, the preceding Friday is observed by U. S. Government agencies.

J. Cognitive Impairment - A cognitive impairment affects a person’s ability to reason, understand, and learn.

K. Contracting Officer (CO) – VA official with the authority to enter into, administer, and/or terminate contracts and make related determinations and findings.

L. Contracting Officer's Representative (COR) – VA official responsible for providing contract oversight and technical guidance to the Contracting Officer. Responsibilities include certification of invoices, placing orders for service, providing technical guidance, overseeing technical aspects of the contract, and serves as a member of the vehicle inspection team. All administrative functions remain with the Contracting Officer.

M. Contractor – The term "Contractor” as used herein refers to both the prime contractor and his/her employees, and any sub-contractor and their employees unless otherwise stated. The Contractor shall be responsible for assuring that his/her subcontractors comply with the provisions of this contract.

N. Disability – The term “disability” means, with respect to an individual means:

1. A physical or a mental impairment that substantially limits one or more of the major life activities of such individual;

2. A record of such impairment

3. Being regarded as having such impairment. (P.L. 101-336, July 1990)

O. 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.

P. Durable Medical Equipment (DME) - Medical equipment that is ordered by a doctor for use in the home, such as walkers and wheelchairs.

Q. Escort/Caregiver - An escort/caregiver is defined as an individual, not employed by the Contractor, who provides direct care to the patient being transported via Special Mode.

R. Healthcare Common Procedure Coding System (HCPCS) - A collection of codes that represent medical procedures, products, and services. HCPCS codes primarily correspond to services not covered by Current Procedural Terminology (CPT) codes.

S. Hearing Impairment - Hearing impairments range from a mild hearing loss to total deafness. Those who are hard of hearing often use their residual hearing and lip read when communicating face-to-face. People who are deaf may use American Sign Language or lip-read and may speak for themselves or use a sign-language interpreter.

T. Mileage Rate – Mileage rate for ambulance is the rate paid for each mile traveled for medical facility. This rate applies to one-way transportation only. Reimbursement for mileage shall be at the mileage rate stated in the schedule and shall be based upon the miles from the pick-up point and the specified destination. Distances areas of coverage shall be calculated using current www.bing.com/maps.

U. Mobility Impairment - Mobility impairment refers to the inability of a person to use one or more of his/her extremities, or a lack of strength to walk, grasp, or lift objects. The use of a wheelchair, crutches, or a walker may be utilized to aid in mobility.

V. Multiple Riders - Multiple riders is defined as, more than one patient transported simultaneously in one vehicle at any given point during a trip.

W. No Show - is defined when the beneficiary receiving services is not present at the time of transport or declines to go with the contracted service.

X. No-Patient Transport – The Contractor shall not assess charges on scheduled pick-ups that are cancelled in advance by the VA and/or the patient cancels due to being unable to arrive for scheduled appointment in time.

Y. Non-Ambulatory Patient – A VA beneficiary who cannot utilize normal forms of transportation such as taxi, hired car, or wheelchair/stretcher van and has been determined as needing non-emergency transportation assistance for medical reasons. A VA clinician determines the level of care (ALS or BLS) based on a medical impairment or special need.

Z. Quality Assurance Surveillance Plan (QASP) – an organized written document used for quality assurance surveillance. The document contains specific methods for performing surveillance of the Contractors continuous performance.

AA. Quality Control and Quality Control Plan (QCP) – Those actions taken by the Contractor to control the production of goods or services so they shall meet the requirements of the contract.

AB. Ratification - The act of approving an unauthorized commitment made by a representative of the government who lacked the authority to contractually commit the VHA.

AC. Routine Services – Trips scheduled in advance by the VA, typically one day prior to travel. Beneficiary, caregiver, or significant others cannot contact the Contractor directly to schedule routine trips.

AD. Scheduled Trip(s) – The term "Scheduled Trip" refers to those trips in which the Contractor has been given advanced notice of required services and a specific pick-up time.

AE. Speech Impairment - Speech impairments range from problems with articulation or voice strength to complete voiceless. People with speech impairments may have difficulty in projection, articulation and fluency. Some people with speech impairments may use assistive devices or an interpreter to communicate.

AF. The Joint Commission (TJC) (Formerly Joint Commission on Accreditation of Healthcare Organizations) – A national organization dedicated to improving the care, safety and treatment of patients in a health care facility and environment.

AG. Unauthorized Commitment (UAC) - An assurance that results in a contract action, either an original contract or a modification, that is not binding because the government representative who made it lacked the authority to undertake the action on behalf of the government. This usually occurs when a contractor relies upon the apparent authority of a Government official who does not, in fact, have authority to obligate the Government contractually. Such actions must be ratified at very high levels. If the approval authority, in his discretion, does not ratify the unauthorized commitment, the person who caused it may be held personally and financially liable. Even if the action is ratified, the person who caused it may be subjected to administrative or other penalties. (See Ratification)

AH. Visual Impairment - A visual impairment affects a person’s ability to see, and includes: (1) inability to see images clearly and distinctly; (2) loss of visual field; (3) inability to detect small changes in brightness; (4) color blindness; and (5) sensitivity to light. A cane or sight dog may be used to assist with mobility, and/or Braille may be used to read.

AI. Ambulance Service - Basic Life Support, non-emergency transport (BLS) means transportation by ground ambulance vehicle and medically necessary supplies and services, plus the provision of BLS ambulance services. The ambulance must be staffed by an individual who is qualified in accordance with State of Florida and local laws as an emergency medical technician-basic (EMT-Basic).

Advanced Life Support, Level 1, non-emergency transport (ALS1) means transportation by ground ambulance, medically necessary supplies and services and an ALS assessment by ALS personnel or the provision of at least one ALS intervention. Advanced life support assessment is an assessment performed by an ALS crew as part of an emergency response that was necessary because the patient's reported condition at the time of dispatch was such that only an ALS crew was qualified to perform the assessment. An ALS assessment does not necessarily result in a determination that the patient requires an ALS level of service. Advanced life support intervention means a procedure that is, in accordance with the State of Florida and local laws, beyond the scope of authority of an emergency medical technician-basic (EMT-Basic). Advanced life support personnel mean an individual trained to the level of paramedic. The EMT-Paramedic is defined as possessing the qualifications of the EMT Basic and, in accordance with State of Florida and local laws, as having enhanced skills that includes being able to administer additional interventions and medications.

Advanced Life Support, Level 2 (ALS2) - The Advanced Life Support, Level 2 category is: Whereby the patient, during transport, is given three or more different administrations of medications by intravenous push/bolus or by continuous infusion excluding crystalloid, hypotonic, isotonic, and hypertonic solutions (Dextrose, Normal Saline, Ringer's Lactate), or Ground transportation, medically necessary supplies and services, and the provision of at least one of the following ALS procedures: Manual defibrillation/cardioversion Endotracheal intubation (The monitoring and maintenance of an endotracheal tube that was previously inserted prior to the transport also qualifies as an ALS2 procedure.);

· Central venous line

· Cardiac pacing

· Chest decompression

· Surgical airway or Intraosseous line

AJ. Subcontract – Means any agreement (other than one involving an employer-employee relationship) entered into by a Government prime contractor or subcontractor calling for supplies and/or services required for performance of the contract, contract modifications, or subcontract.

AK. Subcontracting Plan (Commercial) – A subcontracting plan (including goals) that covers the offeror’s fiscal year and that applies to the entire production of commercial items sold by either the entire company or a portion thereof (e.g. division, plant, or production line). A commercial plan is the preferred type of subcontracting plan for contractors furnishing commercial items.

AL. Subcontracting Plan (Individual) - A subcontracting plan that covers the entire contract period (including option periods), applies to a specific contract, and has goals that are based on the offeror’s planned subcontracting in support of the specific contract, except those indirect costs incurred for common or joint purposes may be allocated on a prorated basis to the contract.

AM. Electronic Subcontracting Reporting System (eSRS) - The Government-wide, electronic, web-based system for small business subcontracting program reporting.

3. PERFORMANCE & QUALIFICATIONS

A. The Contractor shall provide ambulance transportation services, 24 hour per day / 7 days per week / 365 days per year (24/7/365). The Contractor must maintain an adequate fleet of vehicles and qualified personnel to meet contracted response times and the government’s need for services to include spikes or lulls in daily transportation schedules.

B. The Contractor shall comply with all applicable Federal, State and local laws, executive orders, rules and regulations applicable to its performance under this contract. In addition, services shall be performed in accordance with the established principles and ethics of the medical profession established by the American Medical Association (AMA) and American College of Emergency Physicians (ACEP). The Contractor shall adhere to the Department of Veteran Affairs regulations and the policies of the Orlando VAMC. The regulation that governs the Beneficiary Travel Program is Title 38 Code of Federal Regulations (CFR) Section 70 and VHA Handbook 1601B.05, Beneficiary Travel.

C. The Contractor, upon request, shall provide quality data and information related to services for verification purposes or participation in OVAMC Performance Improvement Programs. The Contractor shall also provide documentation of the competency of staff that shall be providing the contracted services. The Contractor shall ensure Contractor employees providing work on this contract are fully qualified and licensed with the State of Florida to perform the required work; they shall also maintain records that document the employee’s certifications and competency assessment checklist. Upon request, the contractor shall make available for inspection at contractor’s headquarters a current copy of their competency assessment checklist and annual performance evaluation for each contractor employee working on this contract.

D. The Contractor shall comply with the provisions of the Privacy Act of 1974, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, and VA Handbook 0710 Personnel Security and Suitability Program. The Contractor shall not maintain and/or share sensitive or patient identifiable information in any form or for any purpose, other than what is needed to perform its obligation under this contract. By entering into this contract, the Contractor certifies they comply with HIPAA as it pertains to general patient information, HIV, drug and alcohol abuse, and sickle cell anemia.

E. The Contractor shall provide a minimum of a toll-free telephone and/or a locally dialed telephone number for accepting VA calls. It is estimated that 90% of all transportation services will be scheduled initially by telephone. Requests for service may also be submitted via email or fax from an authorized representative of the VA.

The contractor shall, at all times during the contract period, have on his/her premises a functioning telephone and designated email address to communicate requirements with the VA (i.e., requests for service, patient incidents, special correspondence, etc.).

Secure/Encrypted Email - The Contractor shall have the ability to transmit encrypted email with personally identifiable information and receive similar encrypted email from the VA.

4. TRANSPORTATION SERVICES

A. A transportation request is defined as a one incidence for ambulance transportation services by the VA to the Contractor and shall be one-way only.

1. Ordering. Transportation requests will be made via Task Order (TO), or other arrangements deemed tenable by both the VA and Contractor.

a. Only the Contracting Officer is authorized to place orders. Only authorized representatives of the VA may schedule or make changes to transportation requests. Non-authorized VA employees and private agencies (e.g., nursing homes) are not authorized to place orders, schedule, or transportation requests.

2. Scheduling. Scheduling is defined as providing the Contractor the following information for a transportation request:

a. - VA authorization number

- Mode of transportation required;

- Required date and time of arrival;

- Name of beneficiary;

- Pick-up and delivery point;

- Type of equipment required;

- Last four of the patient's Social Security Number

- Any special instructions

b. Only designated VA personnel are authorized to schedule transportation requests. Services rendered in response to a request from other than authorized personnel shall be the risk of the Contractor and any cost thereof may be borne by the Contractor.

c. Scheduling may be performed via telephone, email, in person, or other arrangements deemed tenable by both the VA and Contractor.

d. The Contracting Officer will provide the Contractor a written list of personnel authorized to schedule transportation services prior to the commencement of services. The list of authorized personnel shall be updated and provided to the Contractor, as needed. The list shall be reviewed by the COR for accuracy no less than annually.

3. Response time will be calculated from the Contractor’s receipt of the notification to schedule transportation service.

a. Contractors shall deliver services within the established response timeframes:

i. ALS: Thirty (30) minutes or sooner.

ii. BLS: Forty-five (45) minutes or sooner.

b. All Contractor(s) shall acknowledge and confirm, to the OVAMC, Contractor’s ability to provide services within the established response time.

i. In the event the contractor is unable to provide the service, immediately upon contact, the contractor’s dispatch shall notify the OVAMC’s authorized personnel of their inability to provide the service.

c. The contractor shall maintain at a minimum, a compliance rate to response times at or above the Acceptable Quality Level (AQL) identified in the Performance Requirement Summary (PRS). Failure of the contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the contract, see FAR 52.212-4(l) Termination for the Government’s convenience and 52.212-4(m) Termination for cause.

B. Patients may be transported to or from any designated location, to include county to county transports and within county transports. All transports shall be between VA facilities or between the VA facility and a facility that provides care under VA auspices (i.e., Contract Nursing Home, Community Outpatient Clinics, local hospital) and/or between the home of the beneficiary receiving travel services and the VA facility. The VA staff shall specify the points of origin and the destination of every trip.

C. When transporting patient(s) leaving the hospital, the Contractor shall be required, if necessary, to transport a maximum of three (3) items (boxes or luggage / not to exceed an aggregate weight of 40 lbs.) of the patient’s personal effects at no additional cost to the VA. Patients may bring a reasonable amount of equipment, such as folding wheelchair, consumable medical supplies and a personal suitcase. When transporting patients to or from medical facilities, the driver, acting for the Contractor, will ensure that the patient's luggage, medical records, medications and prosthetic devices are properly accounted for and delivered with the patient, as required.

D. When transporting patients to a VA, nursing home, or Assisted Living Facility (ALF), upon arrival, the driver shall give the VA Nursing Home Packet that accompanies the patient to the responsible nursing home staff member. If there are any discrepancies between the address listed on the Nursing Home Packet and the address listed in the trip request, the driver shall clarify the correct destination address with the Beneficiary Travel Department or the Administrator of the Day (AOD).

E. For return trips from scheduled outpatient visits, the Contractor shall ensure Veterans and other beneficiaries do not wait more than 45 minutes for pick up, no matter where patient lives.

5. INVOICE PROCEDURES

A. The Contractor shall submit an invoice summary to account for all services performed. The summary shall indicate the date and time of service call, name of beneficiary requiring services, type of transportation requested, designated pick-up and delivery points and actual time of arrival at the pick-up and delivery points. Copies of invoice summary shall be provided along with the invoices sent for payment.

In a secure email, the contractor shall submit copies (in .PDF format) of CMS 1500 form for each transport.

The Contractor shall submit an invoice summary that includes the contract number, invoice date, invoice number, dates of service, total amount due and billable rates per the contract’s Price Schedule.

All scheduled transportation requests may be verified against invoices and trip tickets for accuracy.

B. Invoices for payment will include a copy of the trip ticket and the VA authorization number to ensure payments. Invoices shall be submitted to the COR via email monthly for review prior to submission to Financial Service Center (FSC) in Austin, Texas. Each invoice will include:

· Authorization number

· The contract number

· Purchase order number

· Patient's name

· Patient's last four Social Security Number

· Date of Service

· Origination/Destination of Trip

· Mileage charged, if applicable

· Total number of miles traveled

· Total cost, in accordance with Schedule of Services and Pricing

C. The OVAMC reserves the right to reject payment for additional supplies and/or equipment used in the performance of this contract unless specifically ordered, required for patient care, or a common item not customarily furnished.

6. PATIENTS RIGHTS

A. The Contractor shall be courteous and considerate to all patients, escorts, family member passenger(s) or significant other passenger(s). SMOKING SHALL NOT BE PERMITTED in the Contractors’ vehicle.

B. The Contractor shall immediately notify the Beneficiary Travel Department, COR, or the AOD any incidents involving injury to VA patients or property during transport. The Contractor shall promptly complete and submit an Incident Report with all the information necessary to conduct a full review.

The VA will investigate, and the COR will provide the results to the Contractor. The Contractor will be afforded an opportunity to provide a written response to the VA within ten (10) calendar days. The response shall include any corrective action and/or adopted measures to be implemented by the Contractor to prevent reoccurrence.

C. The Contractor shall notify the COR within 24 hours, in writing, any complaints made by the patients or staff with regards to transportation services. Any substantiated mistreatment of patients in the performance of this contract may be cause for immediate termination of the contract.

Substantiated reports of mistreatment may be referred to appropriate law enforcement authorities, as applicable. The VA reserves the right to request driver removal from transporting VA patients if mistreatment is substantiated.

D. Drivers will return patients in the order that they are called in. Drivers will not skip departing patients to cover a longer distance versus a shorter distance. Only with the approval of the Supervisor of Transition Unit will this be authorized.

E. The Contracting Officer may request an investigation to address complaints or performance concerns. The Contractor shall cooperate fully and provide all relevant information, documentation, and circumstances surrounding any incident. The Contractor shall provide a written response to the Contracting Officer’s inquiries within the timeframe allotted. The Contractor may propose recommendations for improved services for the VA's review.

F. The Contractor shall not employ any persons for work on this contract if such employee is considered by the Government to be a potential threat to the health, safety, security, or operations of the VA its facilities or its staff. Contractor's employees shall understand, speak, read, and write the English language. No employee of the contractor can be a federal employee, nor can they have any conflict of interest either real or perceived.

G. The Contractor shall display a visible means of a medium (comment card with the Contractor’s address pre-printed) that allows the patient to provide feedback, positive and negative to the Contractor. Contractor shall provide a quarterly report of patient feedback to the COR.

H. For equal rights, wherever the masculine or feminine gender is used in this solicitation, and the resulting contract, it shall be considered to include both masculine and feminine gender.

7. PATIENT ESCORT/CAREGIVER

A. The VA reserves the right to have an escort, such as a relative, care provider, or VA staff accompany the beneficiary when the VA determines that such an escort is in the best interest of the beneficiary. The VA will also be the sole authority in determining when an escort is required. There will be no additional charge to the VA for escorts authorized to travel with beneficiaries. The Contractor shall only be required to transport the escort with the patient and will not be required to return the escort back to point of origin (unless the escort is a VA attendant).

B. OVAMC reserves the right to send an authorized official (registered nurse, Licensed Practical Nurse, Nursing Assistant, or Physician) to attend the patient in a transfer from our facility when, in the opinion of our medical staff, such as trained attendant is necessary to the patient's welfare. The Contractor is required to return VA attendant to the point of origin. Reimbursement shall be limited to mileage rates as stated in the Schedule of Services and Pricing. The furnishing of the VA attendant does not relieve the Contractor from furnishing a qualified attendant in accordance with this contract.

8. MILEAGE RATES. Payment for mileage traveled will be limited to the 'one-way' distance which the patient is transported. Such mileage costs will be paid in addition to the applicable transportation charge (e.g., BLS, ALS1, ALS2). Allowable charges for mileage are determined using the web-based map application found on Bing (www.bing.com/maps) and selecting the shortest driving time result.

9. WAIT TIMES/TOLLS/DRY RUNS/NO SHOWS/CANCELLATIONS

A. Waiting time. Each order shall include 15-minutes of wait time; the contractor may invoice for wait times in excess of this initial 15-minutes. Wait time shall begin only once the contractor has both reached the pick-up address location and the appointment time has elapsed. All wait times shall be itemized and invoiced in 15-minute intervals. For partial 15-minute intervals, zero to seven minutes shall be rounded down to zero minutes and eight to 15-minutes rounded up to 15-minutes.

B. If the pickup is other than that at the OVAMC, the contractor shall contact the Beneficiary Travel Office, during normal working hours, or the AOD, after-hours, as soon as the contractor anticipates that a delay may develop for which he/she expects to claim reimbursement. This call is only for verifying arrival time at the pickup point and is not necessary if the contractor anticipates no delay.

C. Transportation services listed in this Performance Work Statement includes ferry, bridge, or road toll charges.

D. The Contractor shall be entitled to the applicable transportation rate when dry runs or no shows are encountered due to no fault or negligence of the Contractor. Services must have been scheduled by authorized VA personnel.

E. Contractor shall not charge dry run or no shows for trips if driver arrives too late to allow patients to keep scheduled clinic appointment. Driver shall take the most direct route from pick up location to destination unless legitimately unavoidable.

F. Should the VA determine, a previously scheduled trip may be cancelled, and a vehicle has already been dispatched to the designated pick-up point, the VA may notify the Contractor to cancel such order. For cancelled orders while the Contractor is en route before being notified, the Contractor shall be entitled to receive reimbursement based upon the distance that would have been travelled one way using following criteria:

Distance Variables
Unit Price
0-10 miles
$25.00
11-50 miles
$50.00
> 51 miles
$75.00

Table 1

1. This charge shall not be allowed if authorized VA personnel cancelled the trip prior to the dispatching of the vehicle.

2. Should the Contractor arrive at the origin before the VA cancels the order, or if the Contractor is unable to perform a scheduled pick-up for reasons beyond the Contractor control, e.g., patient absence, patient refusal, the Contractor shall receive 100% of the transportation rate provided in the schedule. The Contractor shall not be entitled to mileage reimbursement.

3. Contractor must report all dry runs or no shows at time of occurrence and verify with VA staff before driver can depart location.

10. CONTRACTOR PERFORMANCE

A. At the time of scheduling, the Contractor shall acknowledge their ability to provide the service within the requested response time. If the Contractor cannot provide the services for any reason, they must notify the VA personnel scheduling the transportation request of their inability to provide the service. The Contractor shall not charge the VA when cancellations are made prior to the dispatching of the vehicle.

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