36C25018Q0768-001.pdf

PAGE 1 OF 1. REQUISITION NO.

2. CONTRACT NO. 3. AWARD/EFFECTIVE DATE 4. ORDER NO. 5. SOLICITATION NUMBER

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 63

Individual Orders Fund

36C25018Q0768

6. SOLICITATION ISSUE DATE

6-25-2018

Christopher Gundy 734-222-7168 07-06-2018

3:00 PM EST

Department of Veterans Affairs Veterans Health Administration Network Contracting Office 10 2215 Fuller Road Ann Arbor MI 48105

X

621910

$15 Million

X

N/A

X

Department of Veterans Affair VA Ann Arbor Healthcare System

2215 Fuller Road Ann Arbor MI 48105

Y

Department of Veterans Affair Veterans Health Administration Network Contracting Office 10 2215 Fuller Road Ann Arbor MI 48105

Department of Veterans Affairs Financial Management System PO Box 149971 Austin TX 78714-9971

877-353-9791 512-460-5540

See CONTINUATION Page

The contractor shall provide all Basic Life Support and Advanced Cardiovascular Life Support ambulance services for eligible beneficiaries of the Ann Arbor VA Healthcare System.

Questions concerning this solicitation must be submitted by email to the contracting officer at christopher.gundy@va.gov Subject line must read "Technical question - Ann Arbor Ambulance Service". Question must be received by the Contracting Officer no later than 12:00 PM EST, June 28, 2018.

See page 43 for Proposal Submission Instructions.

See CONTINUATION Page

X X

36C25018Q0768

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

B.3 STATEMENT OF WORK (SOW)

I. GENERAL DESCRIPTION

II. DEFINITIONS

III. PLACES OF PERFORMANCE

IV. PERIOD OF PERFORMANCE

V. RESPONSIBILITY OF THE CONTRACTOR

VI. VEHICLES

VII. CONTRACTOR EMPLOYEES

VIII. INSURANCE REQUIRMENTS

SECTION C - CONTRACT CLAUSES

C.1 52.216-18 ORDERING (OCT 1995)

C.2 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.3 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.4 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.5 52.228-10 VEHICULAR AND GENERAL PUBLIC LIABILITY INSURANCE (APR

1984)

C.6 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.7 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.8 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2012)

C.9 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.10 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.11 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (JAN 2018)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 RECORDS MANAGEMENT LANGUAGE FOR CONTRACTS

D.2 IT CONTRACT SECURITY

SECTION E - SOLICITATION PROVISIONS

E.1 INSTRUCTIONS FOR PROPOSAL SUBMISSION

E.2 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (JUL 2013)

E.3 52.216-1 TYPE OF CONTRACT (APR 1984)

E.4 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.5 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(JAN 2008)

E.6 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (JAN 1998)

E.7 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.8 52.212-2 EVALUATION—COMMERCIAL ITEMS (OCT 2014)

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (NOV 2017)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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/Position:_______________________________

POC Phone:_________________________________________

Email:______________________________________________

DUNS NO.:__________________________________________

Tax ID NO.:__________________________________________

b. GOVERNMENT: Contracting Officer 36C250

Christopher Gundy

Department of Veterans Affairs

Veterans Health Administration

Network Contracting Office 10

2215 Fuller Road

Ann Arbor MI 48105

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, or [] 52.232-36, Payment by Third Party

3. INVOICES: Invoices shall be submitted in arrears:

a. Quarterly []

b. Semi-Annually []

c. Other [X] Monthly

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.

Department of Veterans Affairs

Financial Management System

PO Box 149971

Austin TX 78714-9971

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

AMENDMENT NO DATE

B.2 PRICE/COST SCHEDULE

ITEM INFORMATION

Ambulance Service with Basic Life Support (BLS) and Advanced Cardiovascular Life Support (ACLS/ALS)

Year 1 July 15, 2018 – July 14, 2019 Item Number

Description of Services

Estimated Quantity

Unit Cost Per Unit Extended Cost

0001 BLS Rate per trip within 25 mile radius of origin of transportation.

700 EA

(Trip)

0002 ACLS/ALS

Rate per trip within 25 mile radius of origin of transportation.

120 EA

(Trip)

0003 Mileage beyond 25 mile radius from start of transportation (trip)

50,000

EA

(Mile) _______________ _____________

0004 Cancellation Fee

4 EA ______________ _____________

0005 Wait time per quarter hour when required

100 EA ______________ _____________

Estimated Total Base Year: _________

Year Two: July 15, 2019 – July 14, 2020 Item Number

Description of Services

Estimated Quantity

Unit Cost Per Unit Extended Cost

0001 BLS Rate per trip within 25 mile radius of origin of transportation.

700 EA

(Trip)

0002 ACLS/ALS

Rate per trip within 25 mile radius of origin of transportation.

120 EA

(Trip)

0003 Mileage beyond 25 mile radius from start of transportation (trip)

50,000

EA

(Mile) _______________ _____________

0004 Cancellation Fee

4 EA ______________ _____________

0005 Wait time per quarter hour when required

Estimated Total Year 2:____________________

Year Three: July 15, 2020 – July 14, 2021 Item Number

Description of Services

Estimated Quantity

Unit Cost Per Unit Extended Cost

0001 BLS Rate per trip within 25 mile radius of origin of transportation.

700 EA

(Trip)

0002 ACLS/ALS

Rate per trip within 25 mile radius of origin of transportation.

120 EA

(Trip)

0003 Mileage beyond 25 mile radius from start of transportation (trip)

50,000

EA

(Mile) _______________ _____________

0004 Cancellation Fee

4 EA ______________ _____________

0005 Wait time per quarter hour when required

Estimated Total Year 3:____________________

Year Four: July 15, 2021 – July 14, 2022 Item Number

Description of Services

Estimated Quantity

Unit Cost Per Unit Extended Cost

0001 BLS Rate per trip within 25 mile radius of origin of transportation.

700 EA

(Trip)

0002 ACLS/ALS

Rate per trip within 25 mile radius of origin of transportation.

120 EA

(Trip)

0003 Mileage beyond 25 mile radius from start of transportation (trip)

50,000

EA

(Mile) _______________ _____________

0004 Cancellation Fee

4 EA ______________ _____________

0005 Wait time per quarter hour when required

Estimated Total Year 4:____________________

Year Five: July 15, 2022 – July 14, 2023 Item Number

Description of Services

Estimated Quantity

Unit Cost Per Unit Extended Cost

0001 BLS Rate per trip within 25 mile radius of origin of transportation.

700 EA

(Trip)

0002 ACLS/ALS

Rate per trip within 25 mile radius of origin of transportation.

120 EA

(Trip)

0003 Mileage beyond 25 mile radius from start of transportation (trip)

50,000

EA

(Mile) _______________ _____________

0004 Cancellation Fee

4 EA ______________ _____________

0005 Wait time per quarter hour when required

100 EA ______________ _____________

Estimated Total Year 5:____________________

Estimated Total Value Five (5) Years:___________________________________

The guaranteed minimum amount for this contract is $100,000.00 over the life of the contract. The maximum aggregate value of orders that can be placed under this contract is $10,000,000.00. The government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum amount.

B.3 STATEMENT OF WORK (SOW)

I. GENERAL DESCRIPTION

a. The Contractor shall provide Basic Life Support (BLS) ambulance service and Advanced Cardiovascular Life Support (ACLS/ALS) ambulance service from date of award for one (1) five-year (5) Indefinite-Delivery Indefinite Quantity Contract. This service is for eligible beneficiaries of the Ann Arbor VA Health Care System (AAVAHCS), and its community based outpatient clinics (CBOC’s) on a twenty-four hour per day, seven days per week, 365 days per year.

b. The Contractor shall perform required services in accordance with the standards of the Commission on Accreditation of Ambulance Services (CAAS) http://www.caas.org/ and established principles and ethics of the medical profession.

c. The contractor shall transact all business, there under, with the Contracting Officer (CO) and/or the Contracting Officer’s Representative (COR) or his/her designee, and in no case shall deal directly with or solicit from beneficiaries of VA.

d. Indefinite-Delivery Indefinite Quantity Contracts are unfunded. Subsequent Task Orders shall be issued to provide funding for each ordering period.

e. Estimated Quantities shall be provided for each annual period. The minimum guaranteed quantities shall be reflected in the Contract Clauses (Section C).

f. The services of this contract shall be used primarily for but not limited to; trips between the Ann Arbor VA Medical Center including its Community Based Outpatient Clinics, other VA medical centers, clinics both inside and outside of the state of Michigan, The University of Michigan Medical Center, to and from nursing homes and patient homes both within and outside the state of Michigan on a twenty-four hour per day, seven days per week, 365 days per year basis. The VA does not guarantee any of these estimated quantities or any percentage of these estimated quantities; however, it is believed they are a realistic expectation of our requirements for the period of this contract.

g. Contractor shall provide or subcontract at contract rates all requests for transport received from the Ann Arbor VA medical center and its Community Based Outpatient Clinics including but not limited to transportation requirements both locally and from outlying areas. In addition, the contractor shall make available as needed a bariatric cot, which shall be provided to the VA, when requested by the VA.

h. Contractor shall notify the COR as soon as possible of those instances in which the Contractor knows that he will be unable to provide the required service at any specific time. This notice shall enable the VA to secure the service elsewhere to meet the requirements. In the event the Contractor is not able to service runs for the AAVAHCS, inclusive of the main facility and all CBOC’s, the Contractor shall be required to sub-contract to other providers to ensure SMT transportation services are provided.

i. Should the Contractor sub-contract, the subcontract plan shall be provided to the Contracting Officer IAW Contract Terms.

j. Immediate Notification: It is the responsibility of the Contractor to immediately notify the AAVAMC ordering office when unable to make a pick-up or delivery by the exact time specified for previously scheduled trips; or unable to dispatch an ambulance to a designated pick-up point within the required time frame for unscheduled requests for services. The immediate notification shall include the reason for the delay and whether the pick-up or delivery can be made at a later time and if so, specification of that time. However, it shall be the sole discretion of the AAVAMC ordering office to accept the later pick-up or delivery time, and based upon the reason for delay, present the delay for payment reduction or refuse the later pick-up or delivery time and order the services from another source (the applicable ordering office shall be the sole entity for determining when to request the services from another source), and present the reason for the delay to the CO as an occurrence that may be subject to default. Based upon the reason for the delay, the Contractor may be charged with excess costs incurred by the AAVAMC in ordering the service from another source or other appropriate contractual action may be taken by AAVAMC.

However, if the Contractor states that he/she will provide additional ambulance(s) upon a specific request of the VA and is unable to provide the additional ambulance(s) within one hour of the request, and if the Contractor fails to notify the VA ordering officer of this inability to so provide, the Contractor shall be required to pay any difference in costs. Failure to notify the VA of any instance of inability to provide a required ambulance may reflect upon the Contractor’s ability to perform under this contract and may constitute sufficient cause for termination of the existing contract.

k. For purposes of clarification, the Contractor shall be responsible for having sufficient BLS/ALS ambulances and qualified personnel to meet the estimated annual requirements of this Medical Center. The Contractor shall not be required to maintain a standby group of vehicles at any one time, but should use good business judgment in having sufficient BLS/ALS ambulances to best meet our estimated requirements. If the Contractor provides more than the minimum number of vehicles required by this contract at any time, upon a specific request of VA during the contract period, the Contractor shall charge and VA will pay for such additional services only in accordance with the prices or rate of the Schedule by the Contractor.

II. DEFINITIONS

Commonly used terms and acronyms and their equivalent appear throughout this contract and shall have the following meanings:

a. ADMINISTRATIVE OFFICER of the DAY (AOD): The secondary (off tour) source for requests, contacts and signatures for transport. This person is located at the main site of the Ann Arbor VA Medical Center (AAVAMC) and acts as hospital administrator during off-hours.

b. Advanced Cardiovascular Life Support (ACLS): ACLS shall be provided by ambulance vehicles containing, at a minimum, two on-board attendants and shall be staffed in accordance with current Michigan State laws and regulations governing the certification and licensure of private ambulances. Ambulance services shall also include cardiac monitoring, Advanced Cardiovascular Life Support (ACLS) drugs and procedures, advanced airway management and medication monitoring and administration.

c. 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. For every trip traveled outside the mileage threshold, Contractor shall be reimbursed at the base rate plus mileage. This rate shall be paid for all authorized one-way trips ordered under this contract action, with employees receiving, at a minimum, the Department of Labor Service Contract Act wage rates (included herein), during all phases of the trip made on behalf of the Government. Attached Service Contract Act wage rate determinations shall be updated each option year when/if new revisions are issued. That Base Rate shall constitute full compensation for one-way trips which do not exceed the “Mileage Threshold”.

d. ANN ARBOR VA HEALTH CARE SYSTEM (AAVAHCS): The main hospital and all CBOC’s as detailed in the “Places of Performance” in Section III.

e. BASE RATE: the rate paid for one-way transportation from a designated pick-up point to a designated delivery point. For every trip traveled outside the mileage threshold, Contractor shall be reimbursed at the base rate plus mileage. This rate shall be paid for all authorized one-way trips ordered under this contract action, with employees receiving, at a minimum, the Department of Labor Service Contract Act wage rates (included herein), during all phases of the trip made on behalf of the Government. Attached Service Contract Act wage rate determinations shall be updated each option year when/if new revisions are issued. That Base Rate shall constitute full compensation for one-way trips which do not exceed the “Mileage Threshold”.

f. Basic Life Support (BLS): BLS is defined as services required for non-critical patient care in which a patient requires an ambulance, staffed in accordance with current Michigan State laws and regulations governing the certification and licensure of private ambulances. This ambulance, at a minimum, shall be staffed with two Emergency Medical Technicians (EMT), and be capable of providing basic airway management.

g. BENEFICIARY: Veterans and other members determined to be eligible for benefits by the VA.

h. Business Hours/Days: Business hours/days are defined as the time of 8:30a.m. to 5:00p.m., 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, New Year’s Day, and any other day specifically designated by the President of the United States to be a national holiday.

Off Business hours/days are defined as the time of 5:01p.m. to 8:29a.m.Monday through Friday, 5:01pm Friday through 8:29a.m. Monday, and Federal holidays.

i. CBOC: Community based outpatient clinic. The AAVAMC has 3 primary CBOCs and 2 offsite clinics;

i. Jackson Michigan (JCBOC), 4328 Page Ave Michigan Center MI 49254

ii. Flint Michigan (FCBOC), 2360 S Lindon Rd Ste 300, Flint, MI 48532

iii. Toledo Ohio (TCBOC), 1200 S Detroit Ave, Toledo, OH 43614

iv. Green Rd Clinic: 2500 Green Rd, Ann Arbor, MI 48105

v. Packard Rd Clinic: 3800 Packard Rd, Ann Arbor, MI 48108

j. COMMON CARRIER: Transportation services provided to an eligible beneficiary for the purpose of meeting their medical appointments.

k. CONTRACTING OFFICER (CO): The person executing this contract on behalf of the Government (Only the Contracting Officer is authorized to make commitments to issue changes that shall affect the price, quantity, and quality or delivery terms of this contract).

l. CONTRACTING OFFICER'S REPRESENTATIVE (COR): The COR is an employee of the VA designated to perform specified contract administration activities, but is not given authority to enter into contractual agreements or modifications.

m. CONTRACTOR: A person/business and all authorized representatives thereof contracted to furnish supplies or services in accordance with the contract, at a specified price/rate.

n. Emergency Medical Care Vehicle: Vehicle outfitted out with all personnel, supplies and equipment necessary to furnish BLS or ACLS emergency care to the patient during transport.

o. Emergency ALS/ BLS: Set of clinical interventions for the urgent treatment of cardiac arrest, stroke and other life-threatening medical emergencies, as well as the knowledge and skills to deploy those interventions. These need a response from the contractor in a much lower amount of time than the regular ALS and BLS.

p. Gender: For the purpose of equal rights wherever the masculine gender is used in this solicitation, and the resulting contract, it shall be considered to include both masculine and feminine gender.

q. Joint Commission (formerly known as JCAHO): A national organization dedicated to improving the care, safety and treatment of patients in a health care facility and environment.

r. Lie-Down Transportation: Transportation of a veteran when it is not anticipated that the patient will require any emergency treatment, but rather safe and secure non-emergent, non-ambulatory transportation.

s. MILEAGE RATE: Mileage for ground ambulance services is the rate paid for each mile traveled beyond the specified Mileage Threshold for each applicable medical facility. This rate applies to one-way transportation only. In no event, shall the Contractor receive this rate for miles traveled within the specified Mileage Threshold.

t. MILEAGE THRESHOLD: The Mileage threshold for the AAVAMC is a 25-mile radius from the point of pickup for each trip as determined by Rand McNally Standard Mileage Guide and verified by MapQuest.com .

u. Quality Assurance: Those actions taken by the Government to assure services meet the requirements of this Contract.

v. RATES: Rates are defined as the rate paid for one-way transportation from a designated pick-up point to a designated delivery point. For every trip traveled outside the city limits, Contractor shall be reimbursed at a fixed rate plus an amount for any mileage traveled outside of the mileage threshold. This rate shall be paid for all authorized one-way trips ordered under this contract action with employees receiving, at a minimum, the Department of Labor Service Contract Act wage rates (included herein), during all phases of the trip made on behalf of the Government.

Attached Service Contract Act wage rate determinations shall be updated each option year when/if new revisions are issued.

w. Scheduled Trip(s): The term “Scheduled Trip” as used in this contract refers to those trips in which the Contractor has been given advance notice of required services and a specific pick-up time. Advance notice is defined as notice given by 4: 30p.m.the prior business day.

x. Service Hours/Days: Service shall be provided on a twenty-four hour per day, seven day per week basis.

y. 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, alteration, 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.

z. Specification: Each ground ambulance used in the performance of this Contract must meet the current specifications of Federal Specification KKK-A-1822F (http://apps.fss.gsa.gov/vehiclestandards/

aa. TRAVEL TRIP (TRIP): One way transportation from a designated pick-up point to a designated delivery point.

bb. Unscheduled Trip(s): The term “Unscheduled Trip” as used in this Contract refers to those trips required on an as needed basis and advance notice is not given.

cc. Universal Precautions: Universal Precautions is an approach to infection control. According to the concept of Universal Precautions, all human blood and certain human body fluids are treated as if known to be infectious for HIV, HBV, and other blood-borne pathogens.

dd. Unscheduled Trip(s): The term “Unscheduled Trip” as used in this contract refers to those trips required on an as-needed basis and advance notice is not given.

ee. Vehicle(s): The term “Vehicle(s)” as used in this contract refers to ambulance transportation provided under the requirements of this contract.

ff. Waiting Grace Period: The waiting grace period is defined as fifteen (15) minutes prior to the time waiting charges commence. The base rate for ambulance services shall include a fifteen (15) minute waiting grace period at origin and destination

III. PLACES OF PERFORMANCE

a. Ann Arbor VA Health Care System;

i. Ann Arbor VA Medical Center (AAVAMC), 2215 Fuller Rd, Ann Arbor, MI

48105, Washtenaw County

ii. Jackson Michigan (JCBOC), 4328 Page Ave Michigan Center MI 49254, Jackson County

iii. Flint Michigan (FCBOC), 2360 S Lindon Rd Ste 300, Flint, MI 48532, Genesee

County

iv. Toledo Ohio (TCBOC), 1200 S Detroit Ave, Toledo, OH 43614 Lucas County

v. Green Rd Clinic: 2500 Green Rd, Ann Arbor, MI 48105 Washtenaw, County

vi. Packard Rd Clinic: 3800 Packard Rd, Ann Arbor, MI 48108, Washtenaw County

b. Battle Creek VA Medical Center, 5500 Armstrong Road, Battle Creek, MI 49037

c. Detroit VA Medical Center, 4646 John R. St, Detroit, MI 48201, Wayne County

d. Saginaw VA Medical Center, 1500 Weiss St, Saginaw, MI 48602, Saginaw County

e. Other Medical Centers, VAMC’s or otherwise, as deemed medically required by the AOD/COR within the State of Michigan and Northern/Central Ohio.

IV. PERIOD OF PERFORMANCE

a. Estimated Period of Performance

i. Base Year: July 15, 2018 – July 14, 2023

b. The Period of Performance may be adjusted on a sliding scale based on time of award.

Timeframes above reflect the earliest possible effective date.

V. RESPONSIBILITY OF THE CONTRACTOR

a. The Contractor shall be responsible for providing all vehicles and personnel, necessary to meet all ACLS/ ALS and BLS transport requirements of this Contract. The Contractor shall be authorized to utilize another ambulance service company, as a subcontractor (certified to be within all requirements of this Contract) to complete these transportation requests only if prior approval for the subcontractor has been received from the CO. The Government has a business relationship with the Prime Contractor only. Only the Prime Contractor may bill the Government for services. All bills for this subcontractor service will be paid directly to the Prime Contractor at the Contract rate, and the Prime Contractor shall make payment to the subcontractor at their agreed rate. In the event the Contractor is unable to perform services or have services performed as required, the Contractor shall immediately notify the COR and provide a justification for non-performance. The VA reserves the right to re-procure services which cannot be performed by the

Contractor, in accordance with the terms, conditions, and schedule of this Contract. The Contractor is responsible for excess re-procurement costs which may result from the Contractor’s inability to perform the required service. Payment of re-procurement costs shall not relieve the Contractor from any other provision in this Contract covering inspection, acceptance and deductions from payment. The VA will be the sole judge in determining when services will be re-procured. The failure of the Contractor to perform services within the required time frames and in accordance with terms and conditions may also provide cause for termination of the Contract for “cause,” (see FAR clause 52.212-4(m)).

b. VEHICLE RESPONSE TIME:

The Contractor shall be at AAVAMC or its Community Based Outpatient Clinics within 30 minutes after notification for an Emergency Advanced Cardiac Life Support/Advanced Life Support Transport (ACLS/ALS) and/or Emergency Basic Life Support Life Support (BLS) vehicle. Exceptions to the 30-minute expectation (i.e., weather emergencies, traffic emergencies, etc.) will be investigated and analyzed, including the identification of corrective actions if applicable. As determined appropriate, Contractor shall take corrective actions to ensure timely response. The Contractor shall respond to all calls immediately for emergency ground ambulance transport service for the AAVA Medical Center. The Ann Arbor VA Medical Center contractor shall provide and respond to all emergency calls in accordance with Federal, State, and Local regulations, governing dispatch of emergency medical (ambulance) vehicles and medical care of on-board Patients, to include the use of sirens and other measures to ensure timely arrival at the designated VA Medical facility.

The Contractor shall be at AAVAMC or its Community Based Outpatient Clinics within 60 minutes after notification for ground ambulance transport service for a Non-Emergency Advanced Cardiac Life Support/Advanced Life Support (ACLS/ ALS) vehicle and/or Non- Emergency Basic Life Support Vehicle (BLS). Exceptions to this time requirement will be assessed similar to paragraph 1 above.

Response Time Compliance Rate: The Contractor shall maintain, at a minimum, a 95% compliance rate on responses to pick-up or deliver during the Contract year. Failure of the Contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the Contract for “cause,” (see FAR clause 52.212-4(m)) or other appropriate contractual action.

If the time period for pick-up, stated herein, is physically impossible due to location of Patient, the Contractor shall contact the COR, Veterans Transport Service (VTS), AOD, or AAVAMC ordering office and inform him/her of the anticipated time required for pick-up and delivery of said Patient.

Should the VA determine that immediate transportation is essential to prevent loss of life or serious bodily harm, transportation services may be procured without referral to the ambulance Contractor. However, in these extremely rare cases, no charge shall be levied against the Contractor.

c. BASIC LIFE SUPPORT (BLS): ambulances shall be staffed, at a minimum, with two EMTs.

Ambulance shall be on-site within one (1) hour after Contractor receives a request for BLS ambulance. The contractor shall be required to provide a minimum of three BLS ambulances at any given time; however, additional ambulances requested shall be furnished, if available, and at the contract price.

d. ADVANCED CARDIOVASCULAR LIFE SUPPORT (ACLS): ambulance shall be staffed with two attendants. One shall be a Paramedic and the other shall be a Paramedic or Certified Emergency Medical Technicians (EMT) with controlling capabilities for Endotracheal Intubation, IV Therapy, Cardiac Monitoring, Defibrillation, and Drug Therapy. Ambulance shall be on-site within thirty (30) minutes after Contractor receives a request for ACLS ambulance. The contractor shall be required to provide a minimum of one ACLS ambulance at any given time;

however, additional ambulances requested shall be furnished, if available, and at the contract price.

e. Mileage Threshold for Ground Ambulance Services: The Mileage Threshold for the AAVAMC is a 25 mile radius from the designated pick-up point for each trip (i.e., Contractor is required to pick-up Patient at the VA, the Mileage Threshold would be a 25 mile radius from the VA). Charges for travel within this Mileage Threshold shall be inclusive with the base rate. One way mileage for travel beyond the 25 mile Mileage Threshold shall be claimed under the applicable mileage rate.

f. Contractor Reimbursement: Reimbursement for mileage outside the Contract Mileage Threshold of coverage, shall be at the mileage rate stated in the price schedule, and shall be based upon the miles from the pick-up point to the specified destination. Any mileage from the place of business and/or location of vehicle and the pick-up point, or from the delivery destination back to the place of business and/or location of next trip are not considered as a separate item of this reimbursement, but would be expected to be incorporated into the mileage rate that is the Contractor’s responsibility as part of the administrative costs (or costs of doing business). Trip mileage under the contract shall be determined by using the internet web site of Bing Maps;

Google Maps will be used when Bing Maps is not available. Allowable charges for mileage outside the Contract Mileage Threshold areas of coverage shall not exceed +5% of the current Rand McNally Standard Mileage Guide. Should the VA make a determination that a previously scheduled trip may be cancelled, and a vehicle has already been dispatched to the designated pick-up point, VA may notify the Contractor to cancel the order. For orders that are cancelled while the Contractor is already in route to the designated pick-up, the Contractor shall be entitled to receive cancellation rate for the trip, as provided in Schedule of Supplies or Services and Prices/Costs. This charge shall not include any mileage charge. If the Contractor fails to meet the time requirements in this Contract, AAVAMC will not be charged for these instances.

Other Charges: It is understood that the prices listed in the accepted Schedule of Supplies or Services and Prices/Costs shall be inclusive of all ferry, bridge, tunnel or road toll charges.

Contractor shall not bill the VA for any such separate charges. If the Contractor’s place of business is located beyond the local telephone call zone of the VA, the Contractor agrees to accept telephone orders for service on a collect basis. It is estimated that approximately one hundred (100) orders will be placed by telephone per month.

g. WAITING TIME: For time lost in waiting at either or both ends of a trip, due to causes beyond their control, the Contractor shall be reimbursed at the rate set forth in the Pricing Schedule, for each quarter hour in excess of the first quarter hour from the time the Contractor reports to the designated person. If the pick-up is other than at the VA, the contractor shall call the VTS or AAVAMC ordering office, or Supervisor of Patient Administration Service (contact numbers to be provided at time of award). This call is only for the purpose of verifying arrival time at the pick-up point and is not necessary if the contractor anticipates no delay for which a claim for reimbursement shall be made. Waiting time includes an attendant remaining with the patient at all times.

h. RATES: Rates shall refer to transportation of only one patient per ambulance. Payment for mileage traveled beyond the mileage threshold shall be limited to "one way only" (Mileage shall be reimbursed for one way only, regardless if patient(s) is transported round trip). Such mileage costs shall be paid in addition to the applicable rate per trip. Mileage shall not be paid for trips entirely within the mileage threshold. Trip mileage shall be determined by the latest edition of the Rand McNally Standard Mileage Guide. For purposes of verifying mileage claimed on invoices, www.mapquest.com shall be utilized. Total invoice shall not exceed Medicare/Medicaid maximum amounts.

i. ORDERS: Requests for services shall be made by telephone and subsequently confirmed by Veterans Transportation Program. If the contractor fails to furnish the required services within the time frames established in paragraphs above, the VA reserves the right to obtain the service from another source and to charge the contractor with any excess cost which may result. The VA shall be the sole judge in determining when to order service from another source. Services shall be primarily to the VA, 2215 Fuller Rd, Ann Arbor, Michigan 48105.

j. Response Time Compliance Rate: The Contractor shall maintain, at a minimum, a 95% compliance rate on responses to pick-up or deliver during the Contract year. Failure of the Contractor to perform in accordance with this compliance rating may constitute sufficient cause for termination of the Contract for “cause,” (see FAR clause 52.212-4(m)) or other appropriate contractual action

VI. VEHICLES

a. The ambulances under the terms of this contract shall be licensed and meet the minimum ambulance requirements, as mandated by the State of Michigan, and Federal Specifications KKK- A-1822F, dated July 1, 2007 (copy attached).

The Contractor must have an adequate number of ambulances to meet the requirements of this contract, along with evidence of satisfactory ambulance inspection prior to use under this contract. Ambulances and equipment must be clean, orderly, and in excellent operating condition at all times. Records of maintenance/preventative maintenance must be made available for inspection upon request.

Subject specification applies to Emergency Medical Care Vehicles Only. Subject specifications are mandatory as minimal requirements for such vehicles, but chassis or compartment modifications are permissible when they clearly exceed the minimal specifications.

The basic emergency care vehicle contracted for shall be of the Type I, Type II, or Type III ambulance (See KKK-A-1822F).

If the contractor’s facility operates two Type I, Type II, or Type III model vehicles, and one is used for emergency services and the other for lie-down transportation, the equipment meeting the specifications for the emergency medical care vehicle can be transferred, when necessary, (i.e., when down for maintenance), to the lie-down transport vehicle, which then may operate as an ambulance, provided it otherwise meets the specifications of emergency.

All ambulances shall have restraints for securing wheelchairs. All ambulances shall be smoke free and have “No Smoking” signage posted.

b. AMBULANCE MEDICAL EQUIPMENT/SUPPLIES: Each emergency medical care ambulance shall have patient compartment facilities, oxygen, suction systems and equipment, and additional systems equipment, accessories and supplies (See KKK-A-1822F), as well as environmental climatic equipment, and communications equipment.

The Contractor shall provide Ambu-bag and/or respirator for respirator dependent patients who may or may not be prior intubated by tracheostomy or end tracheal tubes and/or respirator for respirator dependent patients who may or may not be prior intubated by tracheostomy or end tracheal tubes. Contractor shall choose respirator or Ambu-bag, as appropriate. However, for trips outside the Ann Arbor city limits, contractor is required to "bag" the patient.

The contractor shall provide blood transfusion monitoring if prior established and shall maintain in-place IV line with appropriate pressure of either a Swan Ganz catheter, Arterial line, or both.

c. The acuity of the patient with any of the above may require a VA provided RN or Physician to accompany the patient in transport from the Medical Center.

d. AUTHORIZED ATTENDANCE BY RELATIVE: An authorized official of the VA may, in the best interest of the beneficiary, allow a relative to accompany a patient at no cost to the VA.

e. GOVERNMENT OWNED EQUIPMENT/SUPPLIES: Any and all equipment and linens taken with patients from VA Medical Center must be returned to the Medical Center. The Contractor must provide its own linens and contractor linens shall not be exchanged with VA linens.

f. UNIVERSAL PRECAUTIONS: Universal Precautions shall be observed at all times during transport of, or waiting with, all VA patients.

g. INSPECTIONS: The contractor’s facility and all vehicles intended for use under this contract shall be inspected and approved by a VA Inspection Team prior to start of work under this contract and annually thereafter. The contractor shall make every effort to coordinate availability of vehicles on the date mutually agreed upon for the inspection of the facility and vehicles. The contractor shall be notified in writing of deficiencies found during inspections. Failure to correct deficiencies within the time frame allowed by the Contracting Officer, or to comply with all Federal, State, and local Safety requirements as specified herein, may result in action to terminate the contract for cause.

h. PERSONNEL POLICY: The Contractor shall be responsible for protecting the personnel furnishing services under this contract. To carry out this responsibility, the contractor shall provide Worker's Compensation, Professional Liability Insurance, Health Examinations, Income Tax Withholdings, and Social Security Payments. The parties agree that such personnel shall not be considered VA employees for any purpose and shall be considered employees of the Contractor.

i. Patient Rights: The Contractor shall respect 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. The medical record contains information about current Advance Directives, which shall be reviewed and honored by the Contractor. All required documentation shall be fully completed within VA-required timeframes. The Contractor patient care services provided shall be included in VA data collection activities related to patient compliments, complaints and satisfaction. All patient complaints which are unable to be resolved by the Contractor shall be referred to the Patient Representative. The Contractor shall abide by the VA Code of Ethics, which addresses marketing, admission, transfer, referral, discharge processes, and billing issues.

j. Care of Patients: Contract work shall consist of transportation of patients with varying medical needs. Medication control, security and safety shall be maintained at all times. Medications shall only be dispensed, prepared, and administered to patients by appropriately licensed and competent individuals. Verbal, written or electronic communication between any VA/VISN staff and contracted staff shall not be restricted by the Contractor. VA policies and procedures shall prescribe which information (i.e. Advance Directive, allergies, treatment plan, etc.) is to be shared among care settings at time of admission, discharge, referral or transfer. No samples shall be accepted from vendors or given to patients. All care provided shall be based on assessed patient needs. Findings from assessment and reassessment shall be clearly documented in the medical record, which is used by all members of the interdisciplinary care team in care planning and treatment. All required documentation shall be fully completed within VA-required timeframes.

k. PATIENT SAFETY: Patient Safety shall be a primary focus of the Contractor. The Contractor shall comply with all National Patient Safety Goals found at http://www.jointcommission.org/PatientSafety/NationalPatientSafetyGoals . 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. The VA shall inform the Contractor of all applicable Sentinel Events or other patient Safety Alerts received by the VA. For every applicable alert, the Contractor shall take the necessary steps to redesign processes to prevent occurrences, and provide written feedback to the COR describing prevention actions taken. All events related to patient injury, medication error and other breeches of patient safety shall be documented utilizing the Contractor’s format, and reported to the COR. The Contractor shall maintain a safe environment at all times and follow all safety and emergency preparedness policies. Compliance with all safety management plans shall be continually demonstrated. The VA shall provide the Contractor with VA Sentinel Event definitions in the start-up phase. The Contractor shall verbally notify the VA COR immediately when a Sentinel Event has occurred, which is to be followed by written notification within three working days. The VA shall determine when a Root Cause Analysis (RCA) is required of the Contractor. The Contractor shall conduct all RCA’s according to VA policy, and within established timeframes. Completed RCA’s shall be provided to the VA COR.

l. Environment of Care: The VA shall approve the Contractors Emergency Preparedness Plan prior to the provision of patient care. The Contractor shall conduct annual field and disaster drills. The Contractor shall conduct monthly fire extinguisher inspections and ensure annual maintenance is performed. Routine and recurrent preventive maintenance inspections shall be the responsibility of the contracted ambulance service. All significant problems identified shall be reported verbally to the COR within twenty-four hours. A written corrective plan of action shall be submitted to the COR within five working days. Timeframes and priorities for completion of action plan items shall be mutually agreed upon by the Contractor, the COR, the Contracting Officer and the VA Safety Officer. An annual compliance report addressing preventive maintenance inspections, as well as Safety, Environmental, and Infection Control inspections shall be reported to the COR. Environmental safety shall be the responsibility of the Contractor, who shall provide vehicle upkeep and stocking of the emergency vehicle. Contracted staff shall complete all VA-required Safety education and training, as evidenced by attendance records provided to the COR on an annual basis. The Contracting Officer will provide the Contractor with written instructions describing how Contractor personnel complete the required VA Privacy and Security training online.

m. COMPETENCY ASSESMENTS: Competency Assessments and annual reviews are required for VA accreditation by The Joint Commission (formerly known as JCAHO) and shall be maintained on site for all Contractor personnel. The Contractor shall submit a copy of the competency assessment standards, a current competency assessment checklist and the most recent competency assessment review for each employee to the COR and Contracting Officer for approval prior to starting work under this contract. The Contractor shall be required to replace any employee who does not meet or exceed the contractors approved competency standards and/or fails to meet or exceed those competency standards under an approved improvement plan.

n. INFECTION CONTROL: Contracted patient care activities shall be integrated into the VA Infection Control program, and contract staff shall adhere to VA Infection control policies and procedures. Any patient who has, or is suspected to have, Tuberculosis (TB) or other infectious diseases requiring airborne precautions, shall be transported by themselves and shall be accompanied by ambulance attendants who are trained, medically screened, and shall have been fit tested with, at minimum, an N95 Respirator. These patients shall be identified due to the fact that they will be under isolation known as airborne precautions.

o. PERFORMANCE IMPROVEMENT: The Contractor shall fully participate in the VA Performance Improvement (PI) program. This shall entail monitoring of clinical processes, patient outcomes and satisfaction, data analysis and collaborative design and operationalization of improvement opportunities. Contractor PI activities may be directed by the VA, VISN or VHA, as well as accreditation or licensing bodies. The Contractor shall abstract, compile, format report, and reporting deadlines shall be defined by the VA. It is noted that PI activities are dynamic and subject to change, as driven by current priorities and resources. In all cases, the Contractor shall continually assess for, and act upon, clinical and administrative improvement opportunities. High priority shall be given by the Contractor to the prevention of risk for the patient. The Contractor shall implement process-related internal controls to prevent risk to the veteran. Monitoring for continuous compliance with The Joint Commission standards shall be directed by VA staff and communicated to the Contractor through the COR. Measures related to contract compliance shall be identified by the COR.

p. QUALITY REQUIREMENTS: The COR shall require the contractor to submit an annual report. The following shall be monitored: number of veterans arresting during transport, number of arresting patients with an Advance Directive, number of veteran arrests where the Advance Directive was honored, use of double identifiers, free-flow protection of IV pumps, routine testing and preventive maintenance of clinical alarms, medication errors, lack of VA ambulance transport…