36C25018Q9773-001.docx

36C25018Q9773 BLS and ALS Ambulance Service

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

515-19-1-051-0001 36C25018Q9773 08-30-2018 Nikki Horther 260-426-5431 x 71593 09-11-2018 1:00 Eastern Department of Veterans Affairs Network Contracting Office 10 Ft. Wayne Campus 2500 E State Blvd Fort Wayne IN 46805 X 621910 $15 Million X N/A X Department of Veterans Affairs Battle Creek VA Medical Center 5500 Armstrong Road Battle Creek, MI 49037

Department of Veterans Affairs Network Contracting Office 10 Ft. Wayne Campus 2500 E State Blvd Fort Wayne IN 46805

Department of Veterans Affairs Financial Management System (FMS) PO Box 149971 Austin TX 78714-9971 512-242-7300 N/A X Contractor shall be licensed in accordance with Michigan Department of Health and Human Services and shall provide all vehicles, personnel, management, supplies, equipment, materials and reports necessary to furnish 24 hours per day, 7 days per week BLS and ALS Ambulance Services for Battle Creek Health Care System, Battle Creek, MI in accordance with the Performance Work Statement.

See Schedule of Supplies/Services 515-3690160-051-829800-2119 010041089 X X Nikki Horther Contracting Officer Table of Contents

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: Name: ___________________________________________

Address: _________________________________________

City, State, Zip: ___________________________________

Telephone Number: ________________________________

Fax Number: _____________________________________

E-mail address: ___________________________________

DUNS: __________________________________________

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.

5. SUBMISSION OF OFFER:

a. Offerors shall complete and return all information designated in:

1) Blocks 17(a) and 30(a-c) of SF 1449

2) Contract Administration Data

3) The Price/Cost Schedule, Section B

4) 52.212-1, Instructions to Offerors--Commercial Items, Quote Submission Information

5) 52.209-7, Information Regarding Responsibility Matters

6) 52.212-3, Representations and Certifications, or valid completion in SAM is acceptable

7) Small Business Subcontracting Plan if subcontracting opportunities exist

Information shall be received by the date and time specified in Block 8 of SF 1449 to be considered for award.

Quotes may be sent:

Electronically via e-mail to nikki.horther@va.gov or CD sent to Department of Veterans Affairs, VA Outpatient Annex, Attn: Nikki Horther (90C), 2500 E State Boulevard, Room 415, Fort Wayne, IN 46805.

46805.

b. By submission of an offer, the offeror acknowledges the requirement that the prospective awardee shall be registered in the System for Award Management (SAM) database prior to award. Offerors who are not registered in SAM should consider applying for registration immediately. Registration in SAM is a requirement to conduct business with the Federal Government. If the prospective awardee is not registered in SAM within the timeframe specified by the Contracting Officer, the successful offeror may be removed from further consideration for award. Offerors can register in SAM at https://www.sam.gov.

c. Simplified Acquisition Procedures of FAR Subpart 13.5 are being used to conduct the procurement.

d. Offeror must be certified in the SAM representations and certifications in FAR 52.212-3 that the firm meets the small business size standard for the NAICS Code assigned to the procurement.

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

AMENDMENT NO DATE

B.2 SCHEDULE OF SUPPLIES/SERVICES

Description: Contractor shall be licensed in accordance with Michigan Department of Health and Human Services (MDHHS) and shall provide all vehicles, personnel, management, supplies, transportation, equipment, materials, and reports necessary to furnish 24 hours per day, 7 days per week BLS and ALS ambulance service for BCHCS in accordance with all Federal, State and regional Medical Control Authority Regulations and in accordance with the Statement of Work. Period of performance is from October 1, 2018 through September 30, 2019 with four one-year option periods to be exercised at the discretion of the Government.

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 $5,000.00. The maximum total value of the contract, inclusive of the base year and all options exercised, shall not exceed $2,250,000.00.

Schedule of Services:

Base Year: Period of October 1, 2018 through September 30, 2019

Qty

Estimated Total for Base Year

Option Year 1: Period of October 1, 2019 through September 30, 2020

Qty

Estimated Total for Option Year 1

Option Year 2: Period of October 1, 2020 through September 30, 2021

Qty

Estimated Total for Option Year 2

Option Year 3: Period of October 1, 2021 through September 30, 2022

Qty

Estimated Total for Option Year 3

Option Year 4: Period of October 1, 2022 through September 30, 2023

Qty

Estimated Total for Option Year 4

Estimated Total Base Year

Estimated Total Option Year 1

Estimated Total Option Year 2

Estimated Total Option Year 3

Estimated Total Option Year 4

Estimated Grand Total

B.3 PERFORMANCE WORK STATEMENT

Part I: General Information

A. Introduction Department of Veterans Affairs Battle Creek Health Care System, Battle Creek, MI (BCHCS) has a requirement for a non-personal services contract to provide Basic Life Support (BLS) and Advanced Life Support (ALS) ambulance service for eligible beneficiaries of BCHCS.

B. Background The patient population treated at the BCHCS consists of veterans with varying physical, psychiatric, and psychological needs. Their conditions are, in many cases, directly related to the individual’s service to this country. Contract personnel shall provide compassionate care with respect for the special needs of the veteran population served, and show professional courtesy toward the VA support staff as an integrated part of the medical center’s mission, vision and values as stated below.

Mission: The Mission of the VA Battle Creek Health Care System, including Community Based Outpatient Clinics, is to provide timely, compassionate and high-quality care to those we serve by encouraging teamwork, education, research, innovation, and continuous improvement.

Vision: The Vision of the VA Battle Creek Health Care System for the next decade is to be recognized as a leader in healthcare with a focus on meeting the unique healthcare needs of our surrounding community. This shall be accomplished by integrating healthcare delivery to veterans; providing a seamless continuum of care; supporting education; promoting community health and becoming an employer of choice.

Values:

· Patients are our top priority

· Trust, integrity, mutual respect, compassion, and dignity guide our interactions

· We are dedicated to excellence through continuous improvement

· Teamwork, innovation and effective communication are essential to meeting our mission

· Our actions demonstrate commitment to ethical practices, pride in our workplace and our sense of responsibility. We embrace diversity as a positive value in relationships with patients, their families, our coworkers and others.

· We promote a workplace where contributions of all people are important

· We actively support and participate in the efforts of federal and other community agencies to improve our capabilities in homeland defense, disaster reaction and relief, and emergency preparedness at time of crisis.

C. 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 BLS and ALS ambulance services. The contractor shall transact all business with the Contracting Officer and/or the Contracting Officer’s Representative (COR) and shall not deal directly with or solicit from beneficiaries of VA. Changes to the contract shall only be made by written modification formally executed by the Contractor and the Contracting Officer.

D. Applicable Documents

1) Federal Standard KKK-A-1822F - https://www.ok.gov/health2/documents/KKK-A-1822F%20%2007.01.2007.pdf and https://www.michigan.gov/documents/mdhhs/Triple_K_Standards_Clarification_529332_7.pdf

2) The Joint Commission, National Patient Safety Goals® - https://www.jointcommission.org/standards_information/npsgs.aspx

3) Commission on Accreditation of Ambulance Services - http://www.caas.org/

4) Michigan Department of Health & Human Services (MDHHS) – Emergency Medical Services - https://www.michigan.gov/mdhhs/0,5885,7-339-73970_5093_28508---,00.html

· Agency Licensure

· Education

· Medical Control Authority Resources (transporting between Michigan localities) https://www.michigan.gov/documents/mdhhs/2017_MCA_Handbook_FINAL_579399_7.pdf

· Personnel Licensure

· Protocols

· Scope of Practice

· Statute & Administrative Rules

Part II: Work Requirements

A. Technical Requirements

1) Contractor shall be licensed in accordance with MDHHS and shall provide all vehicles, personnel, management, supplies, transportation, equipment, materials, and reports necessary to furnish 24 hours per day, 7 days per week BLS and ALS ambulance service for BCHCS in accordance with all Federal, State and regional Medical Control Authority (MCS) Regulations. All care shall be provided by licensed qualified, competent, and appropriately privileged individuals. Medications shall only be dispensed, prepared, and administered to patients by appropriately licensed and competent individuals.

2) Services shall primarily be from/to the BCHCS for trips within the city of Battle Creek, MI. Occasionally contractor shall transport eligible veterans for travel from/to BCHCS and other authorized VA locations. Authorized locations include but are not limited to the following.

Battle Creek VA Medical Center 5500 Armstrong Road Battle Creek MI 49037 VA Ann Arbor Healthcare System 2115 Fuller Road Ann Arbor, MI 48105

John D Dingell VA Medical Center 4646 John R Street Detroit, MI 48201 Aleda E Lutz VA Medical Center 1500 Weiss Street Saginaw, MI 48603

VA Northern Indiana Health Care System 2121 Lake Avenue Fort Wayne, IN 46805 VA Illiana Health Care System 1900 E Main Street Danville, IL 61832

3) Mileage rates shall apply to any trip beyond a 30-mile limit. “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 unless the patient(s) is transported round trip. Such mileage costs will be paid in addition to the applicable rate per trip. Trip mileage shall be determined by the latest edition of the Rand McNally Standard Mileage Guide. 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.

4) Contractor shall coordinate with the appropriate state authorized MCA when transfers originate and/or terminate outside of Calhoun County.

5) Contractor shall be responsible for having sufficient ambulances and qualified personnel to meet the estimated annual requirements of BCHCS. 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 ambulances to best meet the estimated requirements. Contractor shall furnish all necessary linen. Any equipment, machinery or linens taken with patients shall be returned to BCHCS.

5) Vehicles

a. All ambulances shall be licensed and meet the minimum vehicle requirements, as mandated by MHDDS, and Federal Specifications KKK-A-1822F, Emergency Medical Care Vehicles, dated August 1, 2007 with all changes. Vehicles and equipment shall be clean, orderly, and in excellent operating condition. Records of inspection/maintenance/ preventative maintenance shall be made available for inspection upon request.

b. The basic emergency care vehicle shall be a Type I, Type II, or Type III ambulance (See KKK-A-1822F). If your 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.

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

d. VA reserves the right to inspect vehicles 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 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 week of vehicle addition.

6) Equipment

a. Each ambulance shall have patient compartment facilities, oxygen and suction system equipment, environmental climatic equipment, and additional systems equipment, accessories, and supplies as required by the MDHHS and Federal Specification KKK-A-1822F, dated August 1, 2007.

b. The Contractor shall provide Ambu-bag 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 which may or may not be prior intubated by tracheostomy or end tracheal tubes. Contractor may choose respirator or Ambu-bag, as appropriate. However, for long distance trips, contractor is required to "bag" the patient.

c. 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.

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

7) Response Times

· Contractor shall respond within 30 minutes to a request for BLS patient transport and arrive on-site within 90 minutes.

· Contractor shall respond within 30 minutes to a request for ALS patient transport and arrive on-site within 45 minutes.

8) Orders:

a. Request for services will be made by telephone by the Travel Clerk, COR, or the Administrative Officer of the Day (AOD).

b. Only one patient shall be transported on a trip unless specifically authorized by VA. When more than one patient is transported on a trip, reimbursement shall not exceed the cost of transporting a single patient. However, when travel beyond the city limits is involved, the longest distance over which the patient is transported may be claimed when more than one (1) patient is transported in a single ambulance at the same time.

c. The ordering officer as designated above may, in the best interest of the patient, allow a relative to accompany the patient at no additional cost. The Contractor shall ensure that pick-ups and drop-offs are scheduled so that the total distance traveled shall result in the most economical charge to the Government.

9) Trip Acceptance/Non-Acceptance

a. Acceptance of the trip shall obligate the contractor’s ambulance crew to arrive within the required response time and/or to assume payment of the difference in billing rate if they fail to meet this deadline and the VA subsequently goes off contract to secure transport on the open market. Contractor shall be responsible for costs incurred for services obtained from an alternate source for any orders not accepted by the contractor that are within the ordering requirements of FAR 52.216-19.

b. 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 has no available BLS ambulances from those on the fleet list to provide services on the contract, the Contractor shall be required to sub-contract to other providers to ensure services are provided.

c. If the Contractor fails to furnish services within the required time frame stated above in paragraph 7, VA reserves the right to obtain such services from another source and to charge the Contractor with any excess costs above the contract price associated with obtaining the services from the alternate source. VA retains the sole authority to determine when to order services from another source.

10) Personnel:

The Schedule of Supplies/Services shall include the services of all personnel on any assignment where a patient is transported in the performance of the contract. Should new employees be used in the performance of the contract, the Contractor shall provide VA the credentials for those employees.

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

Drivers shall be licensed by the State of Michigan 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 administer oxygen when necessary and shall have successfully completed the Standard First Aid Course and Basic Life Support Training of the American Red Cross or equivalent. Contractor shall provide a minimum of three BLS units at any given time; however additional units as required shall be provided at the contract price.

b) ALS Staff:

Vehicles shall be staffed with Paramedics or Advanced Emergency Medical Technician (AEMT) with controlling capabilities for Endotracheal Intubation, IV Therapy, Cardiac Monitoring, Defibrillation, and Drug Therapy. Vehicles shall be on-site within 45 minutes after Contractor receives a request for ALS ambulance. The contractor shall be required to provide a minimum of one ALS unit at any given time; however, additional units requested shall be furnished at the contract price.

11) Personnel Licensure and Education Requirements Contractor and contractor EMS personnel shall be licensed in accordance with the requirements of MDHHS. Personnel shall complete continuing education/refresher training.

12) 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. The Infection Control Plan will identify how risks will be identified, methods to be used to reduce risk, identification and reporting of community-acquired and nosocomial infections, and data collection and reporting requirements.

13) Universal Precautions:

Universal Precautions shall be observed during transport of, or waiting with, all VA patients.

14) Safety Requirements:

Contractor shall take such safety precautions as the CO/COR may determine to be reasonably necessary to protect the lives and health of patients, and occupancy of the building. The CO/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 hour to which attention has been directed. 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.

15) 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 thirty days written notice of cancellation or change is furnished the CO.

16) Quality Oversight:

a) The contractor shall continuously meet or exceed all The Joint Commission standards. All applicable BCHCS policies and procedures shall be followed by the contractor. Contract personnel shall provide compassionate care with respect for the special needs of the Veteran population served. Care delivered shall reflect the VA Medical Center’s mission, vision and values.

b) 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.

c) Contractor shall provide and document a general orientation for all Contractor employees who are providing work on this contract prior to performance. 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:

i. Fire and safety policy and procedure

ii. Infection control policy and procedure

iii. Emergency Preparedness/Disaster policy and procedure

iv. Performance requirements according to the contract Scope of Work

d) 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:

i. An inspection system covering work performance of the contract. This system shall specify items to be inspected on both a schedule and unscheduled basis.

ii. Method of identifying deficiencies in the quality of services performed before the level of performance becomes unacceptable.

iii. A file of all inspections conducted by the contractor and corrective action taken.

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

17) 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. 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.

18) Patient Safety:

a. Patient safety shall be a primary focus of the contractor. Contractor shall comply with all National Patient Safety Goals. 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 with 24 hours of event. 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.

b. BCHCS staff will 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.

19) Waiting Time:

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 of one-fourth (1/4) the hourly rate as specified in the schedule for each quarter hour (i.e., 15 minutes) or fraction thereof more than one-quarter hour from the time the contractor reports to the ordering officer. If the pick-up is other than at BCHCS the Contractor shall call the travel clerk or COR as soon as a delay is anticipated for which reimbursement is expected to be claimed. This call is only to verify the arrival time at the pick-up and is not necessary if the contractor anticipates no delay for which a claim for reimbursement shall be made. Reimbursement for waiting time shall be documented in writing and submitted with the Contractor’s invoice for verification. Waiting time includes an attendant remaining with the patient.

B. Deliverables

1) The Contractor shall document each VA authorized transport on a Trip Report with the following information:

· Date

· Patient Name

· Patient identification number

· Pick-up Origin

· Time of Pick-up

· Destination

· Time of Delivery

· Mileage

· Any notes regarding issues particular to the specific transport, including recording oxygen, cardiac monitoring, and other services provided (i.e. material items, supplies).

The Contractor shall include a copy of this report with all invoices and provide the trip documentation form upon request by the COR. These reports shall serve as documentation of the transport and shall be a source document for reconciliation of the Contractor’s requests for payment.

2) Competency Assessments and annual reviews are required for VA accreditation by The Joint Commission and shall be maintained on site for all Contractor personnel. 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 for approval prior to starting work under this contract.

3) Contractor shall submit detailed invoices monthly in arrears to Department of Veterans Affairs FSC, VIA Tungsten Network. Information regarding invoice requirements can be found at https://www.fsc.va.gov/einvoice.asp . Invoices shall be submitted no later than fifteen calendar days following the end of the month of services and shall include all services provided under the agreement for the preceding month. Invoices shall specify the contract number, patient name and identification number, date of service, and pick-up time.

Part III: Supporting Information

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

All data to which contractor employees may obtain access shall remain the property of BCHCS. Contractor employees have an obligation to protect data and information which the loss, misuse, or unauthorized modification of or unauthorized access to could adversely affect the conduct of VA or other Federal programs. Further, information about individuals is confidential and must be protected by law and regulations from unauthorized disclosure.

B. Place of Performance:

Services shall primarily be from/to the BCHCS for trips within the city of Battle Creek, MI. Occasionally contractor shall transport eligible veterans for travel from/to BCHCS and other authorized VA locations.

C. Period of Performance Period of Performance is October 1, 2018 through September 30, 2019 with four one-year option periods to be exercised at the discretion of the Government.

D. Qualifications of Key Personnel Contractor and contractor employees shall have all licenses and certifications required for their designated duties. The contractor shall be licensed by the State of Michigan. Any lapse in any overall contractor licensure (contractor, ambulance, employees) that is not corrected within 12 hours shall result in the contractor being Terminated for Cause.

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 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).

36C25018Q9773 BLS and ALS Ambulance Service

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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. 3903) and prompt payment regulations at 5 CFR part 1315.

(3) Electronic Funds Transfer (EFT). If the Government makes payment by EFT, see 52.212-5(b) for the appropriate EFT clause.

(4) Discount. In connection with any discount offered for early payment, time shall be computed from the date of the invoice. For the purpose of computing the discount earned, payment shall be considered to have been made on the date which appears on the payment check or the specified payment date if an electronic funds transfer payment is made.

(5) Overpayments. If the Contractor becomes aware of a duplicate contract financing or invoice payment or that the Government has otherwise overpaid on a contract financing or invoice payment, the Contractor shall—

(i) Remit the overpayment amount to the payment office cited in the contract along with a description of the overpayment including the—

(A) Circumstances of the overpayment (e.g., duplicate payment, erroneous payment, liquidation errors, date(s) of overpayment);

(B) Affected contract number and delivery order number, if applicable;

(C) Affected line item or subline item, if applicable; and

(D) Contractor point of contact.

(ii) Provide a copy of the remittance and supporting documentation to the Contracting Officer.

(6) Interest.

(i) All amounts that become payable by the Contractor to the Government under this contract shall bear simple interest from the date due until paid unless paid within 30 days of becoming due. The interest rate shall be the interest rate established by the Secretary of the Treasury as provided in 41 U.S.C. 7109, which is applicable to the period in which the amount becomes due, as provided in (i)(6)(v) of this clause, and then at the rate applicable for each six-month period as fixed by the Secretary until the amount is paid.

(ii) The Government may issue a demand for payment to the Contractor upon finding a debt is due under the contract.

(iii) Final decisions. The Contracting Officer will issue a final decision as required by 33.211 if—

(A) The Contracting Officer and the Contractor are unable to reach agreement on the existence or amount of a debt within 30 days;

(B) The Contractor fails to liquidate a debt previously demanded by the Contracting Officer within the timeline specified in the demand for payment unless the amounts were not repaid because the Contractor has requested an installment payment agreement; or

(C) The Contractor requests a deferment of collection on a debt previously demanded by the Contracting Officer (see 32.607-2).

(iv) If a demand for payment was previously issued for the debt, the demand for payment included in the final decision shall identify the same due date as the original demand for payment.

(v) Amounts shall be due at the earliest of the following dates:

(A) The date fixed under this contract.

(B) The date of the first written demand for payment, including any demand for payment resulting from a default termination.

(vi) The interest charge shall be computed for the actual number of calendar days involved beginning on the due date and ending on—

(A) The date on which the designated office receives payment from the Contractor;

(B) The date of issuance of a Government check to the Contractor from which an amount otherwise payable has been withheld as a credit against the contract debt; or

(C) The date on which an amount withheld and applied to the contract debt would otherwise have become payable to the Contractor.

(vii) The interest charge made under this clause may be reduced under the procedures prescribed in 32.608-2 of the Federal Acquisition Regulation in effect on the date of this contract.

(j) Risk of loss. Unless the contract specifically provides otherwise, risk of loss or damage to the supplies provided under this contract shall remain with the Contractor until, and shall pass to the Government upon:

(1) Delivery of the supplies to a carrier, if transportation is f.o.b. origin; or

(2) Delivery of the supplies to the Government at the destination specified in the contract, if transportation is f.o.b. destination.

(k) Taxes. The contract price includes all applicable Federal, State, and local taxes and duties.

(l) Termination for the Government's convenience. The Government reserves the right to terminate this contract, or any part hereof, for its sole convenience. In the event of such termination, the Contractor shall immediately stop all work hereunder and shall immediately cause any and all of its suppliers and subcontractors to cease work. Subject to the terms of this contract, the Contractor shall be paid a percentage of the contract price reflecting the percentage of the work performed prior to the notice of termination, plus reasonable charges the Contractor can demonstrate to the satisfaction of the Government using its standard record keeping system, have resulted from the termination. The Contractor shall not be required to comply with the cost accounting standards or contract cost principles for this purpose. This paragraph does not give the Government any right to audit the Contractor's records. The Contractor shall not be paid for any work performed or costs incurred which reasonably could have been avoided.

(m) Termination for cause. The Government may terminate this contract, or any part hereof, for cause in the event of any default by the Contractor, or if the Contractor fails to comply with any contract terms and conditions, or fails to provide the Government, upon request, with adequate assurances of future performance.