36C24918R0399-001.docx

36C24918R0399 – TENNESSEE VALLEY HEALTHCARE SYSTEM – AMBULANCE SERVICES

OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL

BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SI

GN 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. SIGN

ATURE 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

626-19-1-732-0001 36C24918R0399 10-26-2018 Stephen Clabough 615-225-6479 11-27-2018

12:00 PM CT

90C Department of Veterans Affairs Network Contracting Office 9 1639 Medical Center Parkway Suite 400 Murfreesboro TN 37129 X 621910 $15 Million X N/A X

SEE CONTINUATION PAGE

90C Department of Veterans Affairs Network Contracting Office - 9 1639 Medical Center Parkway Suite 400 Murfreesboro TN 37129

90C FSC e-Invoice Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information 1-877-489-6135 Invoice must be submitted electronically

Setup 1-877-489-6135 See CONTINUATION Page The contractor shall furnish all labor, materials, insurance and equipment to provide safe and comfortable ambulance and transportation on an as-needed basis to beneficiaries of the Tennessee Valley Healthcare System (TVHS) located in Nashville, TN, Murfreesboro, TN, and the TVHS' Community Based Outpat ient Clinics (CBOC) referenced within the embedded Performance Work Statement (PWS).

See CONTINUATION Page 626-3690160-732-829800-2119 010058600 X X X Thomas N. Allman Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

U.S. Department of Veterans Affairs Mission Statement:

To fulfill President Lincoln's promise “To care for him who shall have borne the battle, and for his widow, and his orphan” by serving and honoring the men and women who are America’s Veterans.

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR: ______________________________________ (Contractor’s Name) ______________________________________ (Address)

E-MAIL ADDRESS ______________________________________

DUNS NUMBER NO. ______________________________________

b. GOVERNMENT:

Thomas N. Allman Contracting Officer Department of Veterans Affairs Network Contracting Office 9 1639 Medical Center Parkway, Suite 400 Murfreesboro TN 37129 615-225-3434 Thomas.Allman@va.gov

Stephen A. Clabough Contract Specialist Department of Veterans Affairs Network Contracting Office 9 1639 Medical Center Parkway, Suite 400 Murfreesboro TN 37129 61522-6479 Stephen.Clabough@va.gov

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with:

3. INVOICES: Invoices shall be submitted in arrears:

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

FSC e-Invoice Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information 1-877-489-6135 Invoice must be submitted electronically ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

B.2 PRICE/COST SCHEDULE

The contractor shall provide all equipment, vehicles, and personnel required to provide the services below and in accordance with the Performance Work Statement below.

The contract’s maximum amount is $18,000,000.00.

The contract’s minimum guaranteed amount is $2,500.00.

All prices and rates below shall be for loaded (patient onboard) miles only. With the exception noted in paragraph 13, Dry Runs, of the performance work statement (PWS) below, the government shall not pay for unloaded (no patient onboard) services or mileage.

Ordering Period: The contract will have five ordering periods as listed in the price schedule below. Task orders may only be placed by NCO 9 contracting officers."

When reviewing the CLINS immediately below, see section B.3 of the PWS for the definitions of Basic Life Support (BLS), Emergency Medical Technician (EMT) - Paramedic, and emergent and non-emergent services.

ITEM INFORMATION

ORDERING PERIOD 1: February 1, 2019 through September 30, 2019

BLS Non-Emergency - Base Rate

BLS Emergency - Base Rate

EMT - Paramedic - Non-Emergency - Base Rate

EMT - Paramedic - Emergent Unscheduled Transportation - Base Rate

EMT – Paramedic - Level 2 - Base Rate

Mileage Rate (for the services provided within CLINS 0001 through 0005)

Oxygen (if used)

Waiting Time Per 6 Minutes (See PWS Section 14)

Furnishing Cardiac Monitor When Required and Ordered

ORDERING PERIOD 2: October 1, 2019 through September 30, 2020

BLS Non-Emergency - Base Rate

BLS Emergency - Base Rate

EMT - Paramedic - Non-Emergency - Base Rate

EMT - Paramedic - Emergent Unscheduled Transportation - Base Rate

EMT – Paramedic - Level 2 Base Rate

Mileage Rate (for the services provided within CLINS 1001 through 1005)

Oxygen (if used)

Waiting Time Per 6 Minutes (See PWS Section 14)

Furnishing Cardiac Monitor When Required and Ordered

ORDERING PERIOD 3: October 1, 2020 through September 30, 2021

BLS Non-Emergency - Base Rate

BLS Emergency - Base Rate

EMT - Paramedic - Non-Emergency - Base Rate

EMT - Paramedic - Emergent Unscheduled Transportation - Base Rate

EMT – Paramedic - Level 2 Base Rate

Mileage Rate (for the services provided within CLINS 2001 through 2005)

Oxygen (if used)

Waiting Time Per 6 Minutes (See PWS Section 14)

Furnishing Cardiac Monitor When Required and Ordered

ORDERING PERIOD 4: October 1, 2021 through September 30, 2022

BLS Non-Emergency - Base Rate

BLS Emergency - Base Rate

EMT - Paramedic - Non-Emergency - Base Rate

EMT - Paramedic - Emergent Unscheduled Transportation - Base Rate

EMT – Paramedic - Level 2 Base Rate

Mileage Rate (for the services provided within CLINS 3001 through 3005)

Oxygen (if used)

Waiting Time Per 6 Minutes (See PWS Section 14)

Furnishing Cardiac Monitor When Required and Ordered

ORDERING PERIOD 5: October 1, 2022 through September 30, 2023

BLS Non-Emergency - Base Rate

BLS Emergency - Base Rate

EMT - Paramedic - Non-Emergency - Base Rate

EMT - Paramedic - Emergent Unscheduled Transportation - Base Rate

EMT – Paramedic - Level 2 Base Rate

Mileage Rate (for the services provided within CLINS 4001 through 4005)

Oxygen (if used)

Waiting Time Per 6 Minutes (See PWS Section 14)

Furnishing Cardiac Monitor When Required and Ordered

B.3 PERFORMANCE WORK STATEMENT

1. Purpose

a. The Department of Veterans Affairs’ (VA) Tennessee Valley Healthcare System (TVHS), which encompasses Community-Based Outpatient Clinics (CBOCs) in Tennessee and Kentucky and affiliated healthcare clinics require, contracted ambulance transportation services. Contractor shall furnish all labor, materials, insurance, licenses and equipment to provide safe and comfortable ambulance litter/stretcher transportation on an as-needed basis. The contractor shall be ready to provide services on February 1, 2019 as a fully capable entity with all equipment required up and ready, with trained and certified personnel prepared to respond as directed by TVHS as to what is expected. Ambulance services shall be provided seven (7) days a week, as detailed further below, including holidays, to and from locations (i.e. clinics, ward locations, inpatient floors, ICU, patient homes, hospitals, pre-approved fee basis appointments) designated by the TVHS, Nashville or Murfreesboro Beneficiary Travel Office, in accordance with all terms, conditions, provisions and schedules set forth in this solicitation. Contractor shall assist the patient as needed to access the vehicle for transportation. This may include, but is not limited to bed to stretcher or stretcher to bed transfer when necessary.

2. Background

a. The TVHS is an integrated healthcare system comprised of Medical Centers, the Alvin C. York Campus in Murfreesboro, TN, and the Nashville Campus in Nashville, TN, and many community based outpatient clinics (CBOCs) located in Tennessee and Kentucky. For purposes of this requirements, any future reference to “TVHS” shall be interpreted as included all facilities referenced within this PWS. Specifically, all facilities referenced within section 3(e) below. Historically, the TVHS has relied upon contracted ambulance services to transport some patients to and from its facilities and other locations. This procurement will establish a new four-year eight-month indefinite-quantity contract for ambulance services.

3. Scope/Requirements

3. The contractor shall provide the following Basic Life Support (BLS) ambulance services on an as-needed basis:

0. BLS – Non-Emergency - Defined as transportation by ground ambulance vehicle and the provision of medical care that is rendered to a sick, disabled, or injured individual, based on signs, symptoms, or complaints, prior to the individual’s hospitalization or while transporting the individual between healthcare facilities and that is limited to use of the knowledge, skills, and techniques received from trainings required for licensure as an emergency medical technician. BLS includes a basic level of pre-hospital and inter-hospital care and medical services that includes, but is not limited to, airway management, cardiopulmonary resuscitation (CPR), control of shock and bleeding, and splinting of fractures, as outlined in/by the Basic Life Support national curriculum of the United States Department of Transportation, National Highway Traffic Safety Administration (NHTSA), and the Centers for Medicare and Medical Services (CMS).

0. BLS – Emergency - When medically necessary, the provision of BLS services, as specified in 3(a)(i), on an emergency basis is defined in section 3(c) below.

0. Staffing for BLS services: Each ambulance shall be staffed by licensed EMTs or its State of Kentucky equivalent, as appropriate, and in accordance with the state, local or regional government or public entity where the ambulance service is operated or by which it is governed.

3. The contractor shall provide the following EMT-Paramedic ambulance services on an as-needed basis:

1. EMT Paramedic– Non-Emergency. EMT-Paramedic service is defined as prehospital or interfacility transportation by ground ambulance vehicle and the provision of advanced life support and at least one EMT-Paramedic intervention such as the placement of advance airway adjuncts, intravenous infusions, manual defibrillation, electrocardiogram interpretation, administration of approved drugs, cardiac monitoring, and other advanced skills identified within the state, local or regional government, or public entity (i.e. CMS and NHTSA) where the ambulance services is operated or by which it is governed.

1. EMT Paramedic – Emergent Unscheduled Transportation - When medically necessary, the provision of EMT-Paramedic services, as specified in 3(b)(i), on an emergency basis is defined in section 3(c) below.

1. EMT Paramedic services, Level 2 - EMT-Paramedic services, Level 2, is the transportation by ground ambulance vehicle and the provision of medically necessary supplies and services including (1) at least three separate administrations of one or more medications by intravenous push/bolus or by continuous infusion (excluding crystalloid fluids) or (2) ground ambulance transport, medically necessary supplies and services, and the provision of at least one of the EMT-Paramedic services listed below:

2. manual defibrillation/cardioversion,

2. endotracheal intubation,

2. central venous line,

2. cardiac pacing,

2. chest decompression,

2. surgical airway, or

2. intraosseous line.

iii. Staffing for EMT-Paramedic services: Each ambulance shall be staffed by licensed EMT-Paramedics, or it’s State of Kentucky equivalent, as appropriate, in accordance with the state, local or regional government or public entity where the ambulance service is operated or by which it is governed.

b. Emergency unscheduled transportation, for the purpose of this contract, is defined as a medical emergency that requires ambulance transportation immediately, therefore being unable to be scheduled with the Contractor the day prior to transportation. Emergent unscheduled transportation shall be available at the pick-up location within 30 minutes from the time transport is requested. When calling in the run, the Travel Clerk or Administrator on Duty (AOD) will specifically state that the request is an emergent unscheduled transportation request. Under no circumstances shall the Contractor fail to meet the emergent unscheduled transportation timeliness requirement.

c. Non-Emergency unscheduled transportation, for the purpose of this contract, is defined as a non-emergent transportation request that was arranged without providing the Contractor with prior day notice. Non-emergent, unscheduled transportation, shall be at the pick-up location within 1 hour from the time the transport is called in, providing place of pick-up is within local mileage limits of the TVHS facilities. For pick up locations outside the local mileage limits from the TVHS facilities, transportation must dispatch to the pick-up location within 30 minutes. If patient is to be picked up at or delivered to a CBOC, transportation must arrive during business hours of 8:00 a.m. to 4:30 p.m.

d. Ambulance services shall be provided to all healthcare facilities under the jurisdiction of TVHS, the Nashville VA Medical Center (1310 24th Avenue South, Nashville, TN 37212), the Alvin C. York VA Medical Center (3400 Lebanon Pike, Murfreesboro, TN 37129), and the following CBOCs:

i. (Tullahoma/AEDC CBOC) 225 First St., Tullahoma, TN

ii. (Stewart County CBOC) 1031 Spring St., Dover, TN

iii. (Roane County CBOC) 2305 North Gateway Ave, Harriman, TN

iv. (Meharry OPC) 1818 Albion, Nashville, TN

v. (Charlotte OPC), 1919 Charlotte Ave., Nashville, TN

vi. (Cookeville CBOC) 851 S. Willow Ave., Cookeville, TN

vii. (Chattanooga CBOC) 6098 Debra Rd., Chattanooga, TN

viii. (Pointe Centre OPC) 1208 Pointe Centre Dr., Ste 100, Chattanooga, TN

ix. (Bowling Green CBOC) 600 US31 W/Bypass, Bowling Green, KY

x. (Maury County CBOC) 833 Nash Hwy, Columbia, TN

xi. (Clarksville CBOC) 782 Weatherly dr., Clarksville, TN

xii. (Clarksville-Dental OPC) 2292 Dalton Dr., Clarksville, TN

xiii. (Hopkinsville CBOC) 1002 So. Virginia Dr., Hopkinsville, TN

xiv. (McMinnville CBOC) 1014 S. Chancery St., McMinnville, TN

xv. (Dover CBOC) “Stewarts Co.”, 1225 Spring Street, Dover, TN 37058

xvi. (Athens CBOC) 1320 Decatur Pike, Athens, TN 37303

xvii. (International Plaza OPC) 2 International Plaza, Nashville, TN

xviii. (Veteran Recovery Center “VRC”) 260 Glenis Dr., Murfreesboro, TN

e. Contractor shall be able to meet the timeliness response requirements to and from the above referenced facilities, with most of the ambulance runs at the CBOCs being scheduled non-emergent transports from the residence or unscheduled emergent transports to TVHS or a local community hospital when medically indicated. This solicitation will culminate into an Indefinite Delivery/Indefinite Quantity (IDIQ), Firm Fixed-Price Contract.

f. Contractor must possess sufficient ambulances to remain compliant with all timeliness response requirements as determined within sections h and i below. The outlying CBOCs in different states require VA patients to be retrieved from their residence and transported to the local CBOC and possibly for further transfer to one of the TVHS Medical Centers or CBOCs referenced above for further treatment, as necessary. Contractor shall comply with all state rules and regulations and have proper licensing to conduct such transportation.

g. Scheduled transportation, for the purpose of this contract, is defined as transportation arranged with the Contractor on the day prior to the date transportation is needed. Scheduled transportation requests will be either called in or faxed to the Contractor.

h. The local mileage limits (LML), for the purpose of this contract, is defined as mileage within a 40-mile radius in any direction, of the Nashville VA Medical Center, located at 1310 24th Avenue South, Nashville, TN and a 40-mile radius in any direction of the Alvin C. York VA Medical Center, located at 3400 Lebanon Pike, Murfreesboro, TN; or when transportation involves any of the CBOCs in Tennessee or Kentucky, as the pick-up or destination point, the LML is defined as mileage within a 40-mile radius in any direction of that VA CBOC. Any trip within the appropriate mile radius will be paid the applicable per trip rate. Any trip exceeding the mile radius will be paid the applicable per trip rate plus the mileage rate for any miles to the destination that exceeds the LML. The contractor will not be paid for the mileage traveled within the mile LML. Mileage will be based on the latest edition of readily available online commercial mileage calculator Bing (www.bing.com) for online driving directions. No payment will be made for the contractor’s mileage to the pick-up location or return to dispatch station (without VA patient being transported).

i. Contractor shall provide a dispatcher/supervisor who has no driving duties at all duty times. All materials and equipment required by the dispatcher to conduct the business of the contract will be provided by the Contractor. The dispatcher must be able to contact and communicate at all times with all staff engaged in patient transport.

j. Requests for service will be made in writing or by telephone by the Contracting Officer's Representative (COR) or AOD. Contractor will be provided with patient's pick-up and delivery points, appointment time and location, and vehicle requirements.

k. To the extent possible, transportation requests will be scheduled; however, Contractor must be able to accept requests for same day service if the minimum number of required vehicles for the awarded area are not yet being utilized and shall schedule them in a manner that meets the arrival time needs. On scheduled transports, the Contractor shall arrive at the pick-up point on time and shall deliver the patient on-time for appointments.

l. Contractor’s performance shall be in conformance with the contract and all applicable Federal, State and Local laws to include Department of Transportation 49 CFR Parts 27, 37, 38, 571, Transportation for Individuals with Disabilities, Americans with Disabilities Act (ADA) of 1990, Title III and VA standards. All regulations of the State Public Service Commission (PSC) (of which Contractor's facility is located) governing the control, operation of, and licensing of the transportation provider are incorporated herein by reference. All records submitted to and/or compiled by the PSC regarding inspections, safety, records and manifests, etc. may be reviewed prior to awarding a contract and on request throughout the contract term.

m. Contractor shall provide ambulance service under this contract as set forth. This requirement is defined as in use or in route exclusively for Nashville or Murfreesboro VA Medical Center and CBOC patients under the jurisdiction of the TVHS.

4. AMBULANCE SPECIFICATIONS:

a. Vendor must ensure that there are sufficient ambulances to respond within the specified time frames outlined in 3(c) and 3(d).

b. If the Contractor is unable to provide transportation within the specified timeframes, TVHS will contact a third party to obtain these services. The Contractor will be responsible to cover the cost of the third-party bill.

c. Each ambulance shall have patient compartment facilities, oxygen and suction systems and environmental climatic supplies as required by Federal Specification for Ambulances, KKK-A-1822E dated June 01, 2002. All ambulances shall meet the standards of KKK-A-1822E dated June 01, 2002.

d. Contractor shall ensure that all stretchers receive a quarterly safety inspection (See S02_Stretcher Checklist) of all working parts including belts and straps. Contractor shall maintain records of safety inspections and shall provide a current inspection certificate, when requested by the COR for vehicles used in transporting TVHS patients.

e. Ambulance proposed to be furnished under this contract shall meet the specification enumerated in KKK-A-1822E dated June 01, 2002 including but not limited to the following for adults:

i. IV supplies, including pumps – when required

ii. Monitors, defibrillators, mounting brackets

iii. First aid kit with Band-Aids, gauze, elastic bandages, sterile gauze pads, triangular bandages, cleansing wipes, tape scissors, eye pads, ammonia inhalants, sterile gloves, etc.

iv. Two-way radio or portable phone

v. Face masks/nasal cannula

vi. Splints

vii. Blood tubes

viii. Oxygen. Expected to be needed on 25% of jobs.

f. The ambulances (emergency medical care vehicles) under the terms of this contract shall be licensed and meet the minimum vehicle requirements for basic life support as mandated by the Tennessee Department of Public Health and Department of Transportation pertaining to ambulance service.

g. Federal specifications are mandatory as minimal requirements for such vehicles, but chassis or compartment modifications are permissible when they clearly exceed the minimal specifications.

h. Each ambulance used to provide services under this contract shall be a Type I, Type II or Type III ambulance.

i. The contractor shall only provide stretchers that have at least three functioning safety belts. TVHS reserves the right to refuse services from the contractor if the stretcher does not meet this minimum specification. TVHS will not incur any cost associated with the contractor providing inadequate or faulty equipment. All vehicles used in this contract shall:

i. Have functioning mechanisms, which ensure that all access doors are capable of being opened from the inside, and remain closed and secure during travel.

ii. Have a functioning speedometer indicating speed in miles per hour and a functioning odometer correctly indicating distance in tenths of a mile.

iii. Be equipped with operational air conditioning/heating systems. If the air conditioning system becomes inoperable or is unable to maintain temperatures between 68-79 degrees. Fahrenheit in the patient compartment, the vehicle must be immediately pulled from service at the termination of the current trip and shall not be used again for service under this contract until the air conditioning/heating system has been repaired.

iv. Have exterior free of grime, oil or other substances and free from cracks, breaks, dents and damaged paint that noticeably detracts from the overall appearance of the vehicle.

v. Be equipped with hubcaps or wheel covers and have all vehicle body molding in place, or if removed, holes must be filled and painted.

vi. Have passenger compartment that shall be clean of dirt and free from torn upholstery or floor coverings, damaged or broken seats, protruding sharp edges and vermin or insects.

vii. Have unobstructed vision on all sides.

viii. Be equipped with an operable two-way mobile radio and/or cellular telephone communication system, which affords contact with the vehicle during all hours of operation. Beepers are not an acceptable substitute.

ix. Meet all safety and mechanical standards established by State and Federal statutes and regulations.

x. Have windows and doors that can be opened and closed in accordance with manufacturer standards.

xi. No leaks of any kind.

xii. Be equipped with a functioning horn.

xiii. Have operable seat belts on all seats.

xiv. Have fully charged, certified, and non-expired fire extinguisher(s).

xv. The Contractor shall provide the COR with a list of all vehicles to provide services under this contract, including vehicle identification numbers, and insurance certificates prior to initiating service. An updated list shall be provided upon request by the COR or before a new ambulance is brought into the service of this contract.

xvi. All vehicles shall be made available for inspection at any time when ordered by the COR, at the VA's discretion. Any vehicle found not in conformity with the above standards or any vehicle receiving two or more complaints within a five-day period concerning cleanliness or other deficiencies shall be removed from service immediately until subsequent inspections verify correction of deficiencies. The VA reserves the right to order the immediate removal from service any vehicle not in compliance with any vehicle standards referenced herein.

5. MISCELLANEOUS AMBULANCE SPECIFICATIONS

a. The Department of Veterans Affairs (VA) will not be responsible for providing items that normally would be used or required for comfort, safety, or necessity of the patients being transported. These items include but are not limited to wrist restraints, disposable gloves, large pampers, linens, blankets, bedpans, urinals, emesis basins, pillows, and all other items normally stocked in ambulances.

6. ATTENDANTS:

a. A record of each employee as to character, mental, and physical capabilities of performing the duties of an ambulance driver or attendant must be maintained and made available for inspection upon the COR’s request. An additional record of each employee showing that the employee performing transportation service for or coming in contact with patients of TVHS is screened and found to be free of any infectious or communicable diseases on an annual basis and updated during the month of April of each contracted year. Qualifications of the attendants shall be submitted to the Contracting Officer prior to award. The COR reserves the right to obtain copies of all qualification records for TVHS local files. New driver records shall be made available to the Contracting Officer and/or COR along with proposal. Any offeror failing to submit proof of these records with its proposal shall be deemed technically unacceptable and that offeror shall not be considered for the award. An actual document or other proof is required. Any mere reference by an offeror in its proposal stating that it has such certification is not proof and the proposal shall still be rendered technically unacceptable and shall not be considered for award.

b. Contractor may allow, upon authorization from an authorized official of TVHS, a VA clinician, relative, or other appropriate person to accompany the veteran at no extra charge.

c. Only employees of the Contractor, who meet the qualifications of number 7 below, Emergency Medical Technician (EMT), and number 8 below, Paramedics, shall be allowed to accompany the attendant/driver on trips provided for the TVHS.

d. For airport trips, attendant shall remain with the patient until patient safely boards aircraft. It is estimated that 1 trip per quarter will be to an airport.

e. Psychiatric patient transports require one medical attendant, not the driver, to be fully dedicated to patient care during the transport.

7. EMERGENCY MEDICAL TECHNICIAN (EMT):

a. Contractor Emergency Medical Technicians (EMTs) who perform emergency services on ambulances servicing the Nashville and Murfreesboro VAMCs and CBOCs shall have the following qualifications. Any offeror failing to submit proof of these certifications with its proposal shall be deemed technically unacceptable and that offeror shall not be considered for the award. An actual document or other proof is required. Any mere reference by an offeror in its proposal stating that it has such certification is not proof and the proposal shall still be rendered technically unacceptable and shall not be considered for award:

i. EMTs must have completed training in accordance with the standards published by the Tennessee Department of Public Health, Department of Health and Human Services. Such training programs must be acceptable under the regulating requirements for local EMS Systems supported by DHHS under PL 93-154.

ii. The “equivalent” training program successfully completed by the EMT must be submitted to the Contracting Officer for appropriate action/review with the proposal.

iii. The EMT must be certified, licensed or otherwise officially recognized by the Local, State, or Regional Government or public entity where the emergency ambulance service is operated, or by which it is governed. Certificate shall be submitted with proposal.

iv. The EMT must be enrolled periodically in “refresher” continuing education, or advanced training programs as required by the Local or State government entity in which the service is rendered to veterans, but in no instance shall this be less frequently than every two years. Such “refresher” training must be equivalent of that developed by the Department of Transportation, National Highway Safety Administration. Proof of such refresher training must be submitted to the COR when updated periodically as required by the governmental entity.

8. PARAMEDICS

a. Paramedics providing emergency services on ambulances servicing the Nashville or Murfreesboro VAMCs and CBOCs shall have the following qualifications. Any offeror failing to submit proof of these certifications with its proposal shall be deemed technically unacceptable and that offeror shall not be considered for the award. An actual document or other proof is required. Any mere reference by an offeror in its proposal stating that it has such certification is not proof and the proposal shall still be rendered technically unacceptable and shall not be considered for award:

i. Complete training in accordance with the standards published by the Tennessee Department of Public Health to be licensed in the state of Tennessee.

ii. The paramedic must be certified, licensed or otherwise officially recognized by the Local, State, or Regional Government or public entity where the emergency ambulance service is operated, or by which it is governed. Proof of such certification must be submitted with proposal.

iii. The paramedic must be enrolled periodically in “refresher” continuing education, or advanced training programs as required by the local or state government entity in which the service is rendered to veterans, but in no instance shall this be less frequently than every three years. Such “refresher” training must be equivalent to that developed by the Department of Transportation, National Highway Safety Administration. Proof of such refresher training must be submitted to the COR for appropriate action / review as required by governmental entity.

9. NUMBER OF PATIENTS

a. It is understood and agreed that only one (1) patient will be transported on a trip unless specifically authorized by the VA. If more than one (1) patient is authorized by the TVHS ordering official and is transported on a trip, reimbursement will be made at the rate not exceeding the cost of transporting a single patient. However, when travel beyond the local mileage limits is involved, the longest distance over which a patient is transported may be claimed when more than one patient is transported in a single ambulance concurrently. Contractor must ensure that the pick-ups and drop-offs are scheduled so that the total distance traveled shall result in the most economical charge to the government.

10. ORDERS

a. For purposes of the CLINS and invoicing/payments only, “orders” are referred to as “jobs.”

b. Personnel authorized to order service will make unscheduled requests for service via telephone. Scheduled runs will be faxed and/or phoned in the day before the scheduled pick-up date.

c. Orders, requests, or changes will only be made by an authorized party specified by the COR who is the Lead Claims Assistant, Business Office, TVHS.

d. Contractor will be provided with patient’s pick-up and delivery points, appointment time and location, and vehicle requirements. Under no circumstances shall orders or changes be accepted by any other party. In addition, Contractor shall make no deviation and shall provide direction to its staff during transport to specified locations.

e. A list of authorized ordering personnel will be made available upon award of the contract. Employees may be added or deleted from the list during the term of the contract at the discretion of the TVHS. The Contractor will be notified of such changes in writing as they occur.

f. Verification and acknowledgment of prior day orders scheduled shall be made by Contractor between the hours of 8:30 a.m. and 9:30 a.m., Monday through Friday, excluding holidays, on the day the service is to be performed. Verification is to be made with the Travel Clerk. Travel Office shall be notified of any delays or cancellations.

11. REPORTING (PICK-UP, DELIVERY, DEPARTURE)

a. All drivers are required to report to the Travel Clerk or AOD on duty any time a pick-up, delivery, or departure is made at the medical center main campus. Drivers shall assist patients to/from vehicle as necessary.

12. RATES

a. For all one-way trips (within the local mileage limits) under the contract, the Contractor will receive the flat rate awarded for any trip within the local mileage limit. The Contractor shall also receive the mileage charge awarded for any one-way trip in excess of the flat rate outside the local mileage limit. In no event shall the Contractor receive reimbursement for the mileage charge for any mileage inside the local mileage limit of the TVHS or CBOCs.

b. Payment for mileage travel beyond the local mileage limit will be limited to the distance, over which the patient is transported, using the shortest route and street address to street address. No mileage will be charged for any period of time when the patient is not being transported unless charging one way for a “dry run” as discussed below.

c. The Government will deduct from the Contractor's compensation for late pick-ups according to the following chart:

Minutes Late Deduction 30 to 60 25% of trip value* More than 60 50% of trip value* *Trip value is the total of the basic trip plus any additional mileage (if applicable) for the scheduled trip.

d. The Government shall not pay for inbound services when the patient misses his/her appointment and/or must be rescheduled due to unexcused Contractor delay.

e. The Government reserves the right to cancel any patient pick-up due to late response time at any time after the specified or latest pick-up time ordered. Government may either reschedule the pick-up for another time or employ the services of another source, contracted or non-contracted, for same day service. Contractor will be responsible for all additional costs incurred by the Government if another source is utilized.

f. The Government reserves the right to cancel, change or substitute any patient pick-up.

13. DRY RUNS

a. For the purposes of this contract, dry runs are defined as trips made by the Contractor when the VA beneficiary is not available for pick-up.

b. The Contractor will be reimbursed one way at the full contract amount for dry runs. This charge will not be allowed if the trip is canceled by authorized VA personnel within one (1) hour before the scheduled pick-up time.

14. WAITING TIME

a. For time lost in waiting on either end or both ends of a trip due to causes beyond the Contractor’s control such as but not limited to severe storms, flooding, hazardous road and travel conditions, the Contractor will be reimbursed at the rate identified within CLIN 0008. Time waiting will be rounded to the next 6-minute time frame (i.e. Contractor waits 7 minutes. Contractor is paid for waiting 12 minutes).

b. The Contractor shall call the Travel Clerk or AOD on duty as soon as it is anticipated that a delay may develop for which they expect to claim reimbursement. This call is only for the purpose of verifying their arrival time at the pick-up point and is not necessary if the Contractor anticipates no time delay for which they will claim reimbursement. Only VA ordering officials may authorize waiting time. Unauthorized waiting time will not be reimbursed.

c. All waiting time charges must be supported by notification to the Travel Clerk or AOD that the vehicle is in a waiting status. At this point, information concerning reason for wait must be provided, and documentation must accompany the invoice.

15. RESPONSE TIME

a. If Contractor fails to furnish ambulance services within the specified delivery time for the order; the TVHS reserves the right to obtain the service from another source and to charge the Contractor with any excess cost which may result there-from. Contractor shall provide signed written documentation with an explanation when contract services are unavailable. TVHS will issue Bill of Collections for any excess costs incurred when service must be obtained from another source. Failure to pay as charged within timeframes specified in the Bill of Collections will result in cost deduction from the next month’s invoice.

b. TVHS is solely responsible for determining when to order service from another source. When all contract vehicles are in use and the VA requires additional vehicles, the Contractor will be contacted first to respond to. In the event the patient is not picked up or delivered as scheduled or agreed to, TVHS will be allowed a late credit equal to the rate charged by Contractor in Item 14(c) above.

16. SCHEDULED PICK-UPS

a. Adherence to schedules is of the utmost importance. Contractor shall pick-up the customer as near to the scheduled pick-up time as possible. If Contractor arrives earlier than the scheduled pickup, the driver must wait at the pick-up location until fifteen (15) minutes past the scheduled pick-up time before calling the dispatcher for instructions.

17. TOLL CHARGES:

a. Pricing referenced within the CLINs do not include any ferry, bridge, tunnel, or road charge. Any such legitimate toll charges incurred shall be limited to one way only and shall be listed separately on Contractor’s invoices.

b. The Contractor is responsible for all expenses incurred from the services provided under this contract to include ferry, bridge, tunnel and toll road charges subject to reimbursement when invoiced as per Paragraph A above. Contractor shall be responsible for all county, city, local or state fees imposed on the Contractor during performance of this contract.

18. LINENS/MEDICAL EQUIPMENT

a. Contractor shall furnish all linen required for patient transport at no additional cost to the government. Linen shall not be exchanged with linen belonging to the Nashville or Murfreesboro VAMC or its CBOCs.

b. Medical equipment, such as IV pumps, shall routinely be furnished by the Contractor. However, if TVHS agrees that its equipment (such as IV pump) can be used by the Contractor to expedite the patient's transfer, the Contractor shall return the equipment to the department that issued the equipment as soon as possible but no later than three calendar days from date of issue at no expense to TVHS. The Contractor shall not leave TVHS's equipment at another facility.

19. PATIENT TRANSPORTATION

a. The Contractor will check in with the Travel Clerk or AOD upon arrival and departure at TVHS. Patients receiving treatment in the outpatient clinics will be dropped off and picked up in their respective clinic areas. Patients being transported to TVHS for inpatient treatment will be presented to Admissions where further instruction on where the patient is to be taken will be provided. Patients will not be left at the Travel Department, Admissions desk, or with the AOD.

b. Contractor shall not release the patient from his/her custody, unless custody is released to charge nurse on duty at the facility to which the patient is being transported, to a designated point of contact at the patient’s residence when ordered, or to the patient’s residence if patient lives alone, or if patient is to be moved. Contractor shall take every reasonable measure to assure the well-being of the patient at their destination and verify that the patient has all their personal belongings. In the event personal items are not delivered with the patient, contractor shall bring them to the patient immediately when found aboard the vehicle.

20. MEDICAL REPORTS

a. When a patient is delivered to a medical facility, the patient shall be delivered to personnel as explained above and a full medical report shall be made to the facility medical staff receiving the patient. Report shall be made about any changes in patient status during transport, whether Contractor’s oxygen, monitor or infusion pump was used, whether an IV was started, or any medical intervention was provided in route.

21. EMERGENCIES

a. The contractor shall notify the Travel Clerk (or AOD during non-administrative hours) as soon as reasonably possible in the event of any patient emergency and patient transport to a community hospital vice the trip destination. Note instructions in paragraph 28 below, Special Requirements.

22. TRAINING PROGRAM

a. The Contractor shall provide documentation of training on transporting and assisting disabled passengers for all personnel who will be assigned to perform any transportation for VA patients under this contract. Training should be in place covering Blood borne Pathogens, Age-Related Personal interactions and communication, and Body Mechanics. Copies of this documentation of training shall be submitted along with proposal. Any offeror failing to submit proof of these certifications with its proposal shall be deemed technically unacceptable and that offeror shall not be considered for the award. An actual document or other proof is required. Any mere reference by an offeror in its proposal stating that it has such certification is not proof and the proposal shall still be rendered technically unacceptable and shall not be considered for award

23. DRIVER LIST

a. Contractor shall provide the VA Contracting Officer a complete list of all drivers, utilized for this contract upon award of the contract. Updates must be submitted upon request by the VA Contracting Officer VA COR.

24. DRIVER QUALIFICATIONS

a. A record of each employee as to character, qualifications and physical capabilities of performing the duties of ambulance care driver or attendant must be maintained and made available for inspection upon request. The Contracting Officer reserves the right to request qualifications prior to award.

b. All drivers of employed by the contractor shall possess a safe driving record and a valid state driver’s license. The Contractor shall ensure that all drivers providing services under this contract shall have less than five (5) current points on their Tennessee driver’s license or six (6) points on their Kentucky driver’s license, none of which were assessed for “Reckless Driving” or “Driving under the Influence (DUI).” The applicability of licensing points is dependent upon what state ambulance services are being provided by each respective driver. Contractor shall provide copies of driver licenses to the VA Contracting Officer or COR who may independently verify the driving record of drivers at any time. TVHS reserves the right to order the removal from service under this contract, any driver who violates the provisions of this section.

25. DRIVER DUTIES

a. Contractor will ensure that its drivers shall:

i. Perform their duties with due regard for the safety, comfort and convenience of customers and their property.

ii. Comply with all applicable Federal and State laws, regulations and licensing requirements, including drug testing.

iii. Have and maintain a current Driver's License, valid in the State in which Contractor's facility is located, with less than five current points, none of which were assessed for "Reckless Driving” or “DUI."

iv. Contact the Contractor's dispatcher before leaving the designated location without picking up the customer(s) and when encountering problems such as customer(s) not being ready, incorrect addresses, or medical emergencies.

v. Drivers shall be…