36C25018B0582-003.docx

36C25018B0582

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.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

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

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

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

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

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

30a. SIGNATURE OF OFFEROR/CONTRACTOR 31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

583-19-1-825-0002 36C25018B0582 2-2018 Kristina L. Gandy 734-845-3444 07-30-2018

1:00 PM

U.S. Department of Veterans Affairs Network Contracting Office 10 (NCO10) 8888 Keystone Crossing Suite 1100 Indianapolis, IN 46240 X X 621910 $15 Million X N/A X U.S. Department of Veterans Affairs Veterans Health Indiana (VHI) Richard L. Roudebush VAMC 1481 W. 10th Street Indianapolis IN 46202 U.S. Department of Veterans Affairs Network Contracting Office 10 (NCO10) 8888 Keystone Crossing Suite 1100 Indianapolis IN 46202

See FAR 52.232-33 - Payment by Electronic Funds Transfer- System for Award Management.

See Price Schedule in Section B of this document.

583-3690160-825-829800-2112 010041085 X X X One(1) Kristina L. Gandy Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(Continuation from Standard Form 1449, block 18A.)

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

b. GOVERNMENT: Kristina L. Gandy, Contracting Officer or Jared Tritle, Contract Specialist

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with FAR 52.232-33- Payment by Electronic Funds Transfer- System for Award Management.

3. INVOICES: Invoices shall be submitted in arrears monthly. Invoices shall be submitted via the following link: www.fsc.va.gov/fsc/vendors.htm. Please note that the Financial Services Center is no longer accepting physical invoices. They must be submitted electronically via the link listed above.

4. INSTRUCTIONS:

Sealed bids, containing all information described below, are due in Room 1106 at the place specified in block 9 of the SF1449, by specified time in block 8 of the SF1449. A public bid opening will be conducted at that time. Sealed envelopes containing bids shall be marked to show the bidder’s name and address, the solicitation number, and the date and time bids are due. Bids shall be submitted to the CO/CS identified in Section B.1.b.

Bidders must complete and return all information prior to the time specified in block 8 of SF 1449 in order to be considered for award. The required information is as follows:

SF1449 Blocks 17a and 30a through c;

The Pricing Schedule (Section B);

FAR provision 52.209-7 located in Section E;

All Licenses as required herein.

*To be considered for Award, bids must comply in all material respects within the invitation for bids. Any bid which fails to do so will be considered non-responsive and will not be considered for award.

ACKNOWLEDGMENT OF AMENDMENTS: The offeror acknowledges receipt of amendments to the Solicitation numbered and dated as follows:

System for Award Management: Federal Acquisition Regulation 52.212-1(k) requires contractor registration in the System for Award Management (SAM) database prior to the award of a contract. Offerors and Contractors may obtain information on registration and annual confirmation requirements via the internet at https://www.sam.gov/portal/public/SAM/.

Questions: Any bidder questions should be submitted no later than 10 calendar days after the issue date of the solicitation in block 6 of the SF1449.

The Contracting Officer is the only person authorized to approve changes in any of the requirements of this contract. In the event the Contractor affects any changes at the direction of any person other than the Contracting Officer, the changes will be considered to have been made without authority and no adjustment will be made in the contract price or schedule to cover any increase in costs incurred as a result thereof. The Contracting Officer shall be the only individual authorized to accept nonconforming work, waive any requirement of the contract, and/or modify any term or condition of the contract. The Contracting Officer is the only individual who can legally obligate Government funds. No costs chargeable to the proposed contract can be incurred before receipt of a fully executed contract or specific authorization from the Contracting Officer.

B.2 REGISTRATION WITH CONTRACTOR PERFORMANCE ASSESSMENT SYSTEM (CPARS)

As prescribed in Federal Acquisition Regulation (FAR) Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts that exceed $150,000, and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Sea Logistics Center in Portsmouth, Virginia. CPARS has connectivity with the Past Performance Information Retrieval System (PPIRS) database, which is available to all Federal agencies. PPIRS is the system used to collect and retrieve performance assessment reports used in source selection determinations and completed CPARS report cards transferred to PPIRS. CPARS also includes access to the federal awardee performance and integrity information system (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for contractor responsibility determination information.

Each contractor whose contract award is estimated to exceed $150,000 is required to register with CPARS database at the following web address: www.cpars.csd.disa.mil. Help in registering can be obtained by contacting Customer Support Desk @ DSN: 684-1690 or COMM: 207-438-1690. Registration should occur no later than thirty days after contract award, and must be kept current should there be any change to the contractor's registered representative.

For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the contractor's performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the contractor's designated representative for comment. The contractor representative will have sixty days to submit any comments and re-assign the report to the VA contracting officer.

Failure to have a current registration in the CPARS database, or to re-assign the report to the VA contracting officer within those sixty days, will result in the Government's evaluation being placed on file in the database with a statement that the contractor failed to respond.

B.3 LIMITATIONS ON SUBCONTRACTING-- MONITORING AND COMPLIANCE (JUN 2011)

This solicitation includes FAR 52.219-14, Limitations on Subcontracting. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

B.4 SCHEDULE OF SERVICES:

The contractor shall provide all vehicles, personnel, management, supplies, transportation, equipment, materials, and reports necessary to furnish services 24 hours per day, 7 days per week. All services provided shall be in accordance with the Performance Work Statement.

Transportation rates shall apply to any trip based upon the level of care requested by the Veterans Health Indiana (VHI). “Trip” is defined as “one way” from pick-up to drop-off. Payment for mileage traveled beyond a 30-mile limit shall be limited to “one way only” (i.e., loaded). Such mileage costs will be paid in addition to the applicable rate per trip. Trip mileage shall be rounded to the nearest mile down and shall be determined by the latest edition of Rand McNally Mileage Guide. https://www.randmcnally.com/home/ie

For example, an ALS trip point of origin is 48.7 miles from 1481 West 10th Street, Indianapolis, IN 46202-2803. The Contractor shall invoice a single ALS trip rate for the first 30 miles, and invoice per mile for the remaining 19 miles at the per mile rate. This charge includes the trip to pick up the patient and the trip transporting the patient.

The Contractor shall ensure that pick-ups and drop-offs are scheduled so that the total distance traveled will result in the most economical charge to the Government.

For time lost in waiting at either end or both ends of a trip due to causes beyond the Contractor’s control, the Contractor will be reimbursed at the rate stated in the Waiting Time line item in the Schedule from the time the contractor reports time to the ordering officer. If the pick-up is from other than at the VHI, the Contractor shall call the Chief, Travel Unit, or his/her designee on duty at the time, as soon as a delay is anticipated for which reimbursement is expected to be claimed. This call is only for the purpose of verifying the arrival time at the pick-up. Reimbursement for waiting time shall be documented in writing and submitted with the Contractor’s invoice for verification. Waiting time shall be reimbursed in 15-minute increments beginning with the first minute of waiting time within each 15-minute increment (e.g., contractor waits for 18 minutes; contractor to be reimbursed for two (2) Quarter Hours per the Waiting Time line item).

The prices in the schedule shall include all ferry, bridge, tunnel and road toll charges. Any toll charges incurred shall be part of the firm fixed price and shall not be part of the Contractor’s invoice.

Period of performance is from October 1, 2018 through September 30, 2019 with four one-year ordering periods.

All quantities are estimated. All prices are firm fixed prices (FFP). The guaranteed minimum only applies to the Federal Government Fiscal Year in which the contract is awarded. The guaranteed minimum for the fiscal year in which this contract is awarded is $50,000.00. The maximum total value of orders that can be placed under this contract, inclusive of all ordering periods, shall not exceed $13,000,493.00. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum.

Ordering Period One (1): October 1, 2018 through September 30, 2019

(all trips are loaded/one-way)

Ordering Period One (1) Estimated Total $_________

Ordering Period Two (2): October 1, 2019 through September 30, 2020

(all trips are loaded/one-way)

Trip

Ordering Period Two (2) Estimated Total $_________

Ordering Period Three (3): October 1, 2020 through September 30, 2021

(all trips are loaded/one-way)

Ordering Period Three (3) Estimated Total $_________

Ordering Period Four (4): October 1, 2021 through September 30, 2022

(all trips are loaded/one-way)

Ordering Period Four (4) Estimated Total $_________

Ordering Period Five (5): October 1, 2022 through September 30, 2023

(all trips are loaded/one-way)

Ordering Period Five (5) Estimated Total $__________

Ordering Period One (1) Estimated Total $__________ Ordering Period Two (2) Estimated Total $__________ Ordering Period Three (3) Estimated Total $__________ Ordering Period Four (4) Estimated Total $__________ Ordering Period Five (5) Estimated Total $__________ Aggregate Estimated Total $__________

B.5 PERFORMANCE WORK STATEMENT

Part I: General Information

A. Introduction

Veteran Health Indiana (VHI) has a requirement for Basic Life Support, Advanced Cardiovascular Life Support, and Specialty Care Ambulance Services for eligible beneficiaries of the VHI Transportation Service, located in the Richard L Roudebush VA Medical Center at 1481 West 10th Street, Indianapolis, IN 46202-2803.

B. Scope

The Contractor shall provide all vehicles, personnel, management, supplies, transportation, equipment, materials, and reports necessary to furnish 24 hours per day, 7 days per week Basic Life Support, Advanced Cardiovascular Life Support, and Specialty Care Ambulance Services primarily within Veterans Integrated Service Network 10 (VISN 10), which has a defined geographical area of Indiana, Ohio, and Michigan, but may include locations outside of VISN 10. VHI shall pay the cost of modes of transportation herein when VHI determines it is medically required. Transportation shall include trips to and from nursing homes, patient homes, treatment centers, other medical facilities, and any other destination deemed necessary by VHI.

C. Service Definitions:

For the purpose of this contract, the following definitions shall be used to define services identified in this Performance Work Statement:

· Basic Life Support (BLS) Ambulance Services- Basic life support is a level of medical care which is used for patients of life-threatening illnesses or injuries until they can be given full medical care at a hospital. It can be provided by trained medical personnel, including non-emergency attendant(s)/driver(s) as defined in Part II(A).

· Advanced Cardiovascular Life Support (ALS) Ambulance Services- Advanced Life Support care is a level of medical care which is used for patients of life-threatening illnesses or injuries requiring medical monitoring and care by, at a minimum, a Certified Nursing Assistant or licensed Emergency Medical Technician, as defined in Part II(A), and may include monitoring vital signs, advanced drug therapy, cardiac monitoring, oxygen and intravenous (IV) therapy.

· Specialty Care Ambulance Services (SCAS)- Specialty Care is a level of medical care which is used for patients of life-threatening illnesses or injuries requiring medical monitoring and care for patients who have needs that exceed those skills/standards/regulations of EMTs (e.g., use of ventilators). Care is provided by, at a minimum, paramedics as defined in Part II(A).

D. Applicable Documents

· Indiana Administrative Code – Title 836 Indiana Emergency Medical Services commission http://www.in.gov/legislative/iac/iac_title?iact=836

· Indiana Department of Homeland Security http://www.in.gov/dhs/3525.htm

· Indiana Emergency Medical Services Commission Levels of EMS Personnel Certification, http://www.in.gov/dhs/files/Indiana_EMS_Commission_Levels_of_EMS_Personnel_Certification6-17-13.pdf

· Federal Specifications KKK-A-1822F, dated August 1, 2007.

http://www.sysign.com/Ref_Files/KKK-A-1822F.pdf

· KKK-A-1822F Change Notice 7, https://www.nasemso.org/documents/KKK-A-1822F-Cumulative-Change-Notice7-02Feb2015.pdf

Part II: Work Requirements

A. Personnel Requirements

Contractor shall be responsible for having sufficient qualified personnel to meet the annual requirements of the VHI. The Contractor shall not be required to maintain a minimum number of qualified personnel at any one (1) time, but shall use good business judgment in having sufficient qualified personnel to best meet the requirements.

All personnel under this contract providing transportation/medical services shall be defined as one (1) of the following and shall meet the standards included thereunder:

NOTE: Contractor employees shall not be considered Government employees for any purpose under this contract.

a) Non-Emergency Attendant/Driver(s):

Drivers shall be licensed by the State of Indiana or state of service origination to drive the ambulance. Both the driver and attendant shall be physically capable of performing the assigned duties. The attendant shall accompany the patient to the exact location of pick up or delivery specified when the service call is placed. Attendants and drivers shall be capable of administering oxygen and have successfully completed the Standard and Advanced First Aid Courses of the American Red Cross or U.S. Bureau of Mines, or equivalent.

b) Certified Nursing Assistant:

When required and authorized, a Certified Nursing Assistant (CNA) shall accompany the patient to the destination and provide necessary assistance. A paramedic or EMT may be substituted for the CNA, but shall be required to perform duties as stated below. The amount of assistance required for these activities ranges from the need for total care (i.e. change urine or colostomy bag or Attends, special diet, oxygen) to a requirement for minimal guidance (i.e. assistance from stretcher to wheelchair, help with food tray, help in finding clinical destination). This assistance may include:

· Help in meeting appointment schedules

· Assistance for meals, and management of meal tickets

· Aid in restroom activities

· Help getting to other areas such as x-ray, lab, or any other areas as needed.

· Constant supervision and care of confused and disabled patients CNA equivalent education and training may be submitted in lieu of state certification. The Manager, Patient Support Services, in collaboration with the Contracting Officer Representative (COR) shall approve equivalent education and training, as an acceptable substitute, on a case-by-case basis.

c) Emergency Medical Technician (EMT):

EMTs shall be certified in accordance with the Indiana Emergency Medical Services Commission (IEMSC) or state of service origination. EMTs shall periodically enroll in continuing education, or advanced training programs as required by the State of Indiana or state of service origination but in no instance, shall the continuing education be completed less frequently than every two (2) years. The training shall be in compliance with the IEMSC.

In accordance with the IEMSC, EMTs may transport any of the following under control of the provider organization’s medical director:

· PCA pump with any medication or fluid infusing through a peripheral IV

· Medication infusing through a peripheral IV or continuous subcutaneous catheter via a closed, locked system

· A central catheter that is clamped off (subclavian, Hickman, PICC, and Passport)

· A patient with a feeding tube that is clamped off

· A patient with a Holter monitor

· A patient with a peripheral IV infusing vitamins

· IV fluids infusing through a peripheral IV via gravity or an infusing system that allows the technician to change the rate of infusion are limited to D5W, Lactated Ringers, Sodium Chloride (0.9% or less), Potassium Chloride (20mEq or less for EMTs, 40mEq or less for Advanced EMTs)

d) Paramedic:

Paramedics shall be certified in accordance with the Indiana Emergency Medical Services Commission or state of service origination and may transport any of the following:

· Medication infusing through a peripheral or central IV or fluid infusing through a central IV via gravity or an infusing system that allows the operator or assistant to change the rate of infusion

· A patient with a chest tube

· A patient with a continuous feeding tube

· A vent dependent patient

The Paramedic shall be enrolled periodically in continuing education, or advanced training programs as required by and in compliance with IEMSC but in no instance, shall this be less frequently than every two (2) years.

Routine duties include:

· Determine blood glucose levels

· Oxygen & pulse oximetry

· Cardiac Monitoring

· Administer standard intravenous (IV) solutions of NS & LR

· Insert nasogastric tubes for administration of Activated Charcoal

· Insert Esophageal Tracheal Combi Tube

· Perform Needle Cricothyrotomy

· Oral Endotracheal intubation

· Nasal Endotracheal intubation

· Endotracheal suction

· Administer drugs through the following routes:

· Sublingual

· Subcutaneous

· Intramuscular

· Intravenous

· Endotracheal

· Perform needle thoracotomy to relieve tension pneumothorax

· Application of splints

· Order trauma alert (and request aero medical helicopters for serious trauma patients with significant mechanisms of injury or a grade of less than 12 on the Glasco Coma scale

· BLS in accordance with current Cardio-Pulmonary Resuscitation standards

· ALS in accordance with ACLS protocols, to include defibrillation, cardioversion, and external pacing if the RPM has current documentation of successful ALS course completion

· Treatment of acute respiratory failure

· PCA pump with any medication or fluid infusing through a peripheral IV

B. Vehicles

Contractor shall be responsible for having sufficient ambulances to meet the requirements of the VHI. The Contractor shall not be required to maintain a standby group of vehicles at any time, but shall use good business judgment in having sufficient ambulances to best meet the requirements.

All ambulances shall be licensed and meet the minimum vehicle requirements as mandated by the Indiana Department of Homeland Security http://www.in.gov/dhs/3525.htm and Federal specification KKK-A-1822F. Each vehicle shall be less than five (5) years old and shall include the required equipment in strict compliance with the federal, state and local laws, ordinances, codes, rules or regulations and shall have a minimum of:

· Air conditioning, heating and ventilation for patient comfort.

· Form of communications device in case of an emergency, i.e., CB radio, cellular phone

· Equipped with an American Red Cross Type 24 Unit first aid kit or equivalent.

· Patient compartment facilities, oxygen and suction system equipment, environmental climatic equipment, and additional systems equipment, accessories, and supplies as required by the Indiana Emergency Medical Services Commission, and Federal Specification KKK-A-1822F, dated July 2015.

· ALS transport units shall have portable ventilator equipment.

· All vehicles shall be kept in a sanitary condition both inside and outside.

· All Vehicles shall be registered in the state in which the service originates.

VHI reserves the right to inspect ambulances utilized for the performance of the contract requirements at any time. Mechanical defects noted at the time of inspection shall be corrected prior to being placed into service. Maintenance of vehicles and their equipment shall be on a periodic basis and meet or exceed manufacturer's recommendations. All vehicles shall be maintained and maintenance records shall be kept and made available for inspection by the Contracting Officer (CO)/COR upon request. As new ambulances are added to the fleet, Contractor shall notify the CO/COR and submit license and vehicle information within one (1) week of the vehicle entering service.

Contractor shall make available a bariatric cot when requested to accommodate patients weighing more than 350 pounds.

C. Request for Services/Order Placement

Request for services will be made either in writing, telephone, e-mail or fax by the Transportation Section (the COR or designee) during weekdays and by the Medical Administrative Assistant nights and weekends. The COR, Transportation Section designee and Medical Administrative Assistant shall be considered ordering officers.

For the purposes of this contract, there are two (2) types of service requests: Scheduled and Unscheduled.

· Scheduled transports shall be provided in advance to the contractor no earlier than 72 hours and no later than 24 hours in advance. An example of a scheduled transport is daily scheduled clinical appointments. Contractor shall provide notice to the patient of an estimated time of arrival for pick-up. For pick-ups prior to 12PM local time, notice shall be provided no later than 4PM local time the day prior to the transport. For pickups between 12PM local time and 5PM local time, notice shall be provided no later than 8AM local time the day of the transport.

· Unscheduled transports are those requested by VHI within 24 hours of required patient arrival. Contractor shall provide notice to the patient as soon as reasonably possible of estimated time of arrival for pick-up. Examples of unscheduled transports are hospital discharges or transfer of patients to better equipped facilities.

D. Response Times

For Scheduled services, Contractor shall have the patient at the facility not later than 15 minutes prior to the arrival time scheduled by VHI. Contractor shall notify the COR within eight (8) hours of those instances in which the Contractor knows they will be unable to provide the required services at any specific time.

For Unscheduled services, Contractor shall have the patient loaded and ready for transport within one (1) hour of the request being received, regardless of geographic location of the point of origination. The Contractor shall make the determination whether the Contractor is able to meet the required time frame of one (1) hour. If not, the Contractor is responsible for ensuring alternative transportation arrangements are made so that the one (1) hour time frame for pickup is met. In the instance the Contractor is not the transporter of the patient, the Contractor shall notify VHI within 30 minutes of the request.

For both Scheduled and Unscheduled services, if the Contractor fails to furnish services within the required time frames stated above, VHI reserves the right to obtain such services from another source and deduct the excess costs above the contract price associated with obtaining the services from the alternate source from the Contractor’s invoice for the month in which such services are provided. VHI will not be responsible for any additional costs incurred by the Contractor associated with transportation services obtained from another transporter to meet contract requirements. VHI retains the sole authority to determine when to order services from another source.

Only one (1) patient shall be transported on a trip. The Contractor shall, at the request of VHI when in the best interest of the patient, allow a relative to accompany him/her.

E. Quality Oversight

The contractor shall continuously meet or exceed all The Joint Commission (TJC) standards. Contract personnel shall provide compassionate care with respect for the special needs of the Veteran population served. Care delivered shall reflect the VHI mission, vision and values. (http://www.jointcommission.org/standards_information/standards.aspx)

The Contractor shall maintain records that document competence/performance level of Contractor employees working on this contract in accordance with TJC and other regulatory body requirements and make available to CO upon request.

Prior to performance Contractor shall provide and document a general orientation for all Contractor employees who are providing work on this contract. Documentation of the orientation shall be maintained by the contractor and made available to the Government upon request. This orientation shall include the following topics:

The Government shall monitor Contractor performance using the Quality Assurance Surveillance Plan (QASP) located in Section D and reserves the right to conduct unannounced visits for the purpose of inspecting and/or verifying contract compliance.

The Contractor shall have a written quality control plan (QCP). It shall specify the areas to be inspected either on a scheduled or an unscheduled basis, how often inspections shall occur, and the title of the individual(s) who shall perform the inspection. At a minimum, the QCP shall include the following:

F. Safety Requirements:

Patient safety shall be a primary focus of the contractor. Every effort shall be made by the contractor to prevent medication errors, falls, and patient injury caused by acts of commission or omission in the delivery of care. All events related to patient injury, medication errors, and other breaches of patient safety shall be reported to the COR utilizing Contractor supplied Incident Report within 24 hours of event.

Contractor shall take such safety precautions as the CO and/or the COR may determine to be reasonably necessary to protect the lives and health of patients, and occupancy of the building. The CO or COR shall notify the contractor of any noncompliance with the foregoing provision and the action to be taken. The Contractor shall correct the situation within one (1) hour of notification by the CO or COR. If the Contractor fails to comply promptly the CO may issue an order stopping all or any part of the work and hold the contractor in default.

G. Evidence of Insurance Coverage:

Contractor shall have Certificate of Insurance which shall contain an endorsement to the effect that cancellation of, or any material change in the policies which adversely affect the interest of the Government in such insurance shall not be effective unless 30 days written notice of cancellation or change is furnished to the CO.

H. Training in Psychiatric Behavior:

All Contractor personnel shall be trained in the prevention and management of disturbed behavior as well as suicide prevention techniques. Documentation/certification must be submitted to the CO within 30 days of contract award and 30 days of new employment. If no prior training has been received, contractor personnel shall be required to complete VA-provided training.

I. Patient Rights:

Care provided shall respect and integrate the patient’s beliefs, values, and cultural influences. Protection of all patient rights is of highest priority. Patient privacy and confidentiality shall be maintained at all times.

J. Deliverables

a) The original copy of the trip ticket shall be turned into the transportation office at the time services are rendered. For runs that terminate at the VHI, 1481 West Tenth Street, the driver shall sign the trip ticket, in effect certifying the information thereon, and shall leave a copy with the Travel Clerk after completion of the transport.

b) For those transports that do not terminate at the VHI, 1481 West Tenth Street, or that end after 4:30 p.m., trip tickets shall be given to the Travel Clerk the next working day.

c) Contractor shall submit weekly invoices in arrears for all services performed during the week. These invoices shall be submitted no later than noon on the Monday following the previous week. A bulk invoice shall be submitted which includes data on each transport. All invoices shall be attached to VA Form 10-2511. The Contractor shall complete VA Form 10-2511 (Authorization for Travel by Ambulance), which shall be furnished by the COR as confirmation of all verbal orders. The COR will review invoices and notify the contractor of invoice discrepancies. The following information shall be provided by the Contractor:

· Name, address, POC and phone number of the contractor

· Invoice date and number

· Contract number and order number

· Time call received

· Time ambulance dispatched

· Name of beneficiary

· Address or location(s) where beneficiary was given service

· Address or location where beneficiary was taken

· In case of service to a point outside city limits, show one way mileage

Invoices shall also be sent to The Department of Veterans Affairs FMS, VIA Tungsten Network. Information regarding invoice requirements can be found at http://www.tungsten-network.com/customer-campaigns/veterans-affairs/. Contractor shall comply with the requirements of VA Information and Information System Security/Privacy Language located in Section B.

Part III: Supporting Information

A. Security

See VA Information and Information System Security/Privacy Language located in Section B. The Certification and Accreditation (C&A) requirements of VA Handbook 6500.3 do not apply and a Security Accreditation Package is not required.

B. Place of Performance:

· VHI, 1481 W 10th Street, Indianapolis, IN 46202.

· Other locations as ordered by Transportation Section (the COR or designee) during weekday hours and by the Medical Administrative Assistant nights and weekends.

C. Period of Performance

Period of Performance is October 1, 2018 through September 30, 2019 with four (4) one (1)-year ordering periods.

D. Qualifications of Key Personnel

Contractor and contractor employees shall have all licenses and certifications required for their designated duties and furnish same upon request. The contractor shall be licensed by the State of Indiana. Any lapse in any overall contractor licensure (contractor, ambulance, employees) that is not corrected within 12 hours may result in the contractor being Terminated for Cause.

Contractor shall inform the COR of any new employees assigned to the contract within two (2) business days of onboarding the employee and submit VA security package to the COR before starting work on the contract. All contractor employees are subject to the same level of investigation as VA employees who have access to VA Sensitive Information. The level of background investigation commensurate with the level of access needed to perform the performance work statement is: T1 Non-Sensitive, Low Risk. This requirement is applicable to all subcontractor personnel requiring the same access.

Contractor employees shall not be considered government employees for any purpose under this contract.

E. Contractor Responsibility

The contractor shall be responsible for patient and/or Government property during transport. Any damaged or lost wheelchairs, walkers, crutches or personal belongings shall be replaced by the contractor at no additional cost to the Government or beneficiary if the loss or damage is incurred during transport.

F. Sensitive Information

VA sensitive information is all Department data, on any storage media or in any form or format, which requires protection due to the risk of harm that could result from inadvertent or deliberate disclosure, alternation, or destruction of the information. The term includes information whose improper use or disclosure could adversely affect the ability of an agency to accomplish its mission, proprietary information, records about individuals requiring protection under various confidentiality provisions such as the Privacy Act and the HIPAA Privacy rule, and information that can be withheld under the Freedom of Information Act. Examples of VA sensitive information include the following: individually-identifiable medical, benefits and personnel information; financial, budgetary, research, quality assurance; confidential commercial, critical infrastructure, investigatory, and law enforcement information; information that is confidential and privileged in litigation such as information protected by the deliberative process privilege, attorney work-product privilege, and the attorney client privilege; and other information which, if released, could result in violation of law or harm or unfairness to any individual or group, or could adversely affect the national interest or the conduct of federal programs.

G. HIPAA Compliance, Privacy and Confidentiality

36C25018B0582 Contractor shall comply with the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA of 1996 and the National Standards to Protect the Privacy and Security of Protected Health Information (PHI). Contractor shall comply with applicable confidentiality statutes, including 38 U.S.C 5701, 38 U.S.C 5705, 38 U.S.C 7332, and 5 U.S.C. 552a (Privacy Act), as well as 45 C.F.R. Parts 160, 162, and 164 (Health Insurance Portability and Accountability Act).

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SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (JAN 2017)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered; and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at FAR 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is caused by an occurrence beyond the reasonable control of the Contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the Government waived the requirement to pay by EFT.

(2) Invoices will be handled in accordance with the Prompt Payment Act (31 U.S.C. 3903) and Office of Management and Budget (OMB) prompt payment regulations at 5 CFR part 1315.

(h) Patent indemnity. The Contractor shall indemnify the Government and its officers, employees and agents against liability, including costs, for actual or alleged direct or contributory infringement of, or inducement to infringe, any United States or foreign patent, trademark or copyright, arising out of the performance of this contract, provided the Contractor is reasonably notified of such claims and proceedings.

(i) Payment.—

(1) Items accepted. Payment shall be made for items accepted by the Government that have been delivered to the delivery destinations set forth in this contract.

(2) Prompt payment. The Government will make payment in accordance with the Prompt Payment Act (31 U.S.C.