36C25018R0234-00002000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

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6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

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Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:

The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers

E. IMPORTANT:

is extended,

(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR ACKNOWLEDGMENT TO BE RECEIVED AT THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.

12. ACCOUNTING AND APPROPRIATION DATA

(REV.

11/2016) is required to sign this document and return ___________ copies to the issuing office.

is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO:

Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITE M 10A.

15C. DATE SIGNED

B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADMINISTRATIVE CHANGES

SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR

43.103(b).

RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes r eference to the solicitation and this amendment, and is received prior to the opening hour and date specified.

C. THIS SUPPLEMENTAL AGREEMENT IS

ENTERED INTO

PURSUANT TO AUTHORITY OF:

D. OTHER

BY

Contractor

16C. DATE SIGNED

14.

DESCRIPTION OF AMENDMENT/MODIFICATION

16B. UNITED STATES OF AMERICA

Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.

15A. NAME

AND TITLE OF SIGNER

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STANDARD FORM 30

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Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)

(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)

(If required)

(SEE ITEM 11)

(SEE ITEM 13)

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ONE

13. THIS ITEM APPLIES ONLY TO MODIFICATIONS OF CONTRACTS/ORDERS,

IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.

11. THIS ITEM ONLY APPLIES TO AMENDMENTS

OF SOLICITATIONS

AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT

(Signature of person authorized to sign) (Signature of Contracting Officer) 00002 04-24-2018

NONE

36C250 Department of Veterans Affairs Network Contracting Office (NCO) 10 6150 Oak Tree Blvd., Suite 300 Independence OH 44131 Department of Veterans Affairs Network Contracting Office (NCO) 10 6150 Oak Tree Blvd., Suite 300 Independence OH 44131 To all Offerors/Bidders

36C25018R0234 04-24-2018

X X X X The purpose of this amendment is to provide answers to questions received.

No other changes are incorporated to the solicitation as a result of this amendment.

ALEX DANIEL

CONTRACTING OFFICER

CONTINUATION PAGE

Delivery Time-Frames

· 2.3 Delivery of Medical Equipment

· A. “The Contractor shall deliver and set up in the patient’s residence all equipment and supplies ordered. This contract is a full-service contract. Services are required to be provided 24 hours a day, seven (7) days a week, including holidays, including all emergency service calls.”

· 3.3 Initial Set-Ups

· A. “Initial set-ups shall be completed within 8 hours of request.”

· 3.7 Emergency Services

· E. “The Contractor shall be prepared to provide services on an emergency basis. Contractor shall provide initial setups and emergency services seven (7) days a week, twenty-four (24) hours a day, this includes holidays. For example, if a patient discharges requiring initial setups after 7:00 pm shall be completed that same day (within four (4) hours).”

Questions:

1. Based on the information provided within sections 2.3, 3.3 and 3.7, the initial setup time-frame does not seem consistent for O2 setups. May you please clarify if an initial setup is required within 4 hours or 8 hours of receipt of the order?

A. Government Response:

Initial set-ups that are not considered an emergency will be required to be set-up within the 8 hours. If the initial set-up is indicated to be an EMERGENCY set-up, it is required to be set-up within 4 hours.

2. May the Government please clarify the setup timeframe requirement for Ventilator patients?

A. Government Response:

Ventilator equipment would fall under the same delivery time frames as stated in 2.3 and 3.3.

Locations

· 1.2 Locations

· “The Contractor shall provide Home Oxygen within a defined area of responsibility/jurisdiction to the patients’ residence, or other location as indicated on the order for Home Oxygen. Area of responsibility/jurisdiction for each VA facility includes the counties identified as applicable to the area of responsibility/jurisdiction.

· 5.9 Contractor’s Facility

· “The Contractor shall maintain service location(s) that is (are) physically located within the geographic area covered by the area of responsibility/jurisdiction that the Contractor shall provide home oxygen services (specifically for performance of emergency service requirements).”

Questions:

3. Is it the Government’s intent for the contractor to have facilities throughout the U.S. to provide services to patients who are outside of the geographical areas stipulated within the PWS?

A. Government Response:

Refer to section 1.2 “Area of responsibility/jurisdiction for each VA facility includes the counties identified as applicable to the area of responsibility/jurisdiction.”

4. May the Government please clarify if the servicing locations within the geographic area covered by the area of responsibility/jurisdiction must be in place at the time of bid proposal submission?

A. Government Response:

The awardee will have 90 days after award.

5. May the Government please clarify the process for patients who reside outside of the geographical areas stipulated within the PWS, but prefer to be seen at a specific VAMC facility, and the contracted vendor not having a location within the area (i.e. patient resides in the catchment area for Fort Wayne VA but prefers to be seen by the Cincinnati VA)?

A. Government Response:

The location of the patient’s place of residence, and not which VA facility will order the home oxygen services.

6. May the Government please clarify the process to follow if a patient resides outside the Contractor’s area of responsibility/jurisdiction and the contracted home oxygen provider where the patient resides does not have the ability to service the patient and/or declines to offer assistance as they are not the contracted home oxygen provider for the patient (i.e. patient resides in the catchment area for Fort Wayne VA but prefers to be seen by the Cincinnati VA)?

A. Government Response:

The location of the patient’s place of residence, and not which VA facility will order the home oxygen services Traveling Patients

· 3.9 Traveling Patients

· A. “The Contractor shall be responsible for coordinating all home oxygen for patients who travel both within and outside their respective contracted area of responsibility/jurisdiction, unless otherwise indicated.”

Questions:

7. May you please confirm if travel is only approved for travel completed within the Continental U.S?

A. Government Response:

Travel is only approved within the United States (US), patients are responsible for travel outside of the US.

8. May you please confirm if it is the Governments intent to also allow a patient to utilize a concentrator, LOX or portable cylinders for travel purposes?

A. Government Response:

Yes. Patient’s shall be provided with a Federal Aviation Administration (FAA) approved portable concentrator for travel purposes.

· Section 3.9D. “Patients traveling within contracted areas of responsibility/jurisdiction covered under other VISN 10 contracts for home oxygen, but not within the Contractor’s area of responsibility/jurisdiction, shall be provided all required oxygen services at whatever contract rate that applies to the area the patient is traveling. The Contractor currently providing home oxygen shall notify and arrange for home oxygen with the contractor whose area the patient is traveling.”

Questions:

9. May you please advise the facilities covered within other VISN 10 contracts and their respective Home Oxygen contractors (i.e Fort Wayne VA, etc.)?

A. Government Response:

It is the contractor’s responsibility to set up travel for patients when they go outside their perspective area. Refer to the PWS 3.9

9.1 It is not a common practice for Home Oxygen contractors to release/provide their contracted rates to other Home Oxygen vendors. May you please advise if the five (5) facilities included within this solicitation have experienced this practice previously, where contracted vendors provide their contracted pricing to outside vendors?

A. Government Response:

The old VISN 11 and VISN 10 have merged to make new VISN 10 Indiana, Michigan and Ohio. Previously, it wasn’t applicable for this to occur.

10. May the Government please clarify of the process to follow if a patient travels outside the Contractor’s area of responsibility/jurisdiction and the contracted home oxygen provider for the destination area does not have the ability to service the patient and/or declines to offer assistance as they are not the contracted home oxygen provider for the patient (i.e. Cincinnati VA patient travels to Reno, NV)?

A. Government Response:

It is the contractor’s responsibility to provide travel arrangements for patients traveling outside their perspective areas. Please refer to the PWS 3.9.

Equipment Specifications for Oxygen Concentrators

· B. “All electrically powered equipment used in performance of this contract shall be UL approved and shall state of the art.”

Questions:

11. May the Government please clarify its definition of “state of the art”?

A. Government Response:

At the time of contract award, the equipment must be recently developed in the field at the time of use and not more than three (3) years old.

Ventilator Service

· H. “Contractor responsibility for ventilator usage is as follows:”

· “2. Contractor shall provide in-facility (hospital, extended care facility) ventilator training to patient’s caregiver prior to patient discharge from facility to the home.”

· “5. Provide thorough education to patient and caregiver in proper ventilator usage, ventilator function and operation including control knobs, power sources, adding oxygen, troubleshooting the ventilator and alarms, the remote alarm, checking tidal volume, ventilator tubing change, talking devices, cleaning of tubing and humidifier, back pressure with Jackson trach tube (if applicable), bagging with AMBU bag, and supplies. When clinical respiratory services are provided to ventilator patients, education on trach changes, airway care and suctioning shall also be provided.”

Questions:

12. Is it the Government’s intent for the contractor to provide education only on the safe use and operation of the equipment being provided?

A. Government Response:

It is the Government’s intent for the contractor to provide thorough education to patient and caregiver in proper ventilator usage, ventilator function, and operation.

13. Is it the Government’s intent for the contractor to provide trach changes, airway care and/or perform suctioning in the patient’s home?

A. Government Response:

It is the Contractor Respiratory Therapist responsibilities shall include education on trach changes, airway care, and suctioning.

14. Is it the Government’s intent for the contractor to educate, train and perform suctioning/trach care on the patient in order to educate/train the patient’s caregiver while in the VA hospital, prior to patient discharge?

A. Government Response:

Contractor shall provide in-facility (hospital, extended care facility) ventilator training to patient’s caregiver prior to patient discharge from facility to the home.

14.1. If it is the Government’s intent for the contractor to educate, train and perform suctioning/trach care on the patient to educate/train the patient’s caregiver while in the hospital, will the Respiratory Therapist be required to chart the patient’s account while in the hospital?

A. Government Response:

Refer to the PWS section 5.7

14.2. Is it the Government’s intent for the Respiratory Therapist to perform CPR, if necessary, during a home visit?

A. Government Response:

This is not a clinical contract but a contract for service, please follow your company policy.

Air Compressors

· B. “All subsequent supplies and disposables for air compressors to include large bore tubing, large volume nebulizers and masks shall be provided by the Contractor and included in the monthly rental price of the unit.”

Question:

15. Is it the Government’s intent for a heated humidifier (i.e. Aquatherm, Thermagard, etc.), when deemed medically necessary, to be provided as part of the monthly rental of the air compressor?

A. Government Response:

NO

Portable Oxygen Concentrators

· “Contractor shall provide at no additional cost to the VAMC and Outpatient Clinics a portable oxygen concentrator, so patients can be titrated on actual unit before he/she goes home. Devices shall then be billed at monthly rental charge.”

Questions:

16. May the Government please provide a listing of all facilities requiring a POC to be provided at no additional cost?

A. Government Response:

Please refer to the PWS, section 1.2 and 1.3 for a listing of locations

17. Is it the Government’s intent for the Contractor to bring a POC, upon receipt of prescription, to the VA facility so the patient can be titrated on actual unit before he/she goes home or is it the Government’s intent for a POC to remain in storage at each VA/Outpatient Clinic within this PWS?

A. Government Response:

The POC is to remain at the facility, at all times. Please refer to the PWS section 1.2 and 1.3 for a listing of all of the facilities. The Contractor shall provide, upon receipt of prescription, a POC to the patient’s residence.

Concentrator with Portable Gaseous Oxygen System

· “A. Oxygen concentrator with home compressor used to fill portable oxygen cylinders. Home compressor feature may be integrated into the stationary concentrator or may be a separate component. Oxygen concentrator to deliver flow rates of either up to 5 LPM or up to 10 LPM (low flow or high flow concentrator). System shall include the following accessories: 1. Portable containers”

· “Contractor shall provide at no additional cost to the VAMC and Outpatient Clinics a home-fill system so patients can be titrated on actual unit before he/she goes home. Devices shall then be billed at monthly rental charge.”

Questions:

18. May the Government please provide a listing of all facilities requiring a home-fill system to be provided at no additional cost?

A. Government Response:

Please refer to the PWS, section 1.2 and 1.3 for a listing of locations

19. Is it the Government’s intent for the Contractor to bring a concentrator with portable gaseous system, upon receipt of prescription, to the VA facility so the patient can be titrated on actual unit before he/she goes home or is it the Government’s intent for a concentrator with portable gaseous oxygen system to remain in storage at each VA/Outpatient Clinic within this PWS?

A. Government Response:

The Contractor shall take a portable gaseous oxygen system to the patient’s residence upon receipt of prescription. There should always be one home-fill system provided at no additional cost in all of the VAMC facilities listed under this contract, please refer to the PWS section 1.2 and 1.3 for a listing of locations.

Organizational Performance Reports

· C. “Twice yearly, the Contractor shall visit the patient to inspect equipment, checking for proper functioning and prompting patients to replace disposables, such as filters, tubing and nasal cannula as needed.”

· G. “Infection Control/Communicable Diseases – report must include data related to the Contractor’s ongoing Infection Control Program, shall include the following items: 1. Number of patients stating past respiratory infection the past-30 days or since last Contractor quarterly visit.”

Question:

20. May the Government please clarify if follow-up visits are required on a quarterly or semi-annual basis?

A. Government Response:

Follow-up visits are required to be completed on a semi-annual basis, please refer to 6.2 (C) of the PWS.

Loss or Damaged Equipment

· “The VA shall not pay for the Contractor’s lost or damaged equipment provided under this contract except for contractor equipment that is stored at the VAMC and may be lost or damaged by VA employees within the scope of their official duties. Accordingly, this is considered to be the cost of doing business, and is the requirement of the Contractor to pay for this type of equipment.”

Questions:

21. May the Government please clarify the process to be followed, when a patient/caregiver loses or damages the contractor’s equipment, may the contractor bill the VA for the loss/damage of the equipment?

A. Government Response:

The VA will not pay for the Contractor’s lost or damaged equipment provided under this contract.

22. In a case where the patient/caregiver refuses to return the contractor owned equipment, may the contractor bill the VA?

A. Government Response:

No, please refer to 4.27 in the PWS. Billing of services ends at the time of VA-issued notification to discontinue order or prescribed duration of therapy.

23. In a case where the patient has expired and the caregiver/family has disposed, donated or unable to locate contractor owned equipment, may the contractor bill the VA?

A. Government Response:

No

3.2 Home Visits

· The contractor shall visit patients’ residences for regularly scheduled maintenance visits, two (2) times per year, in performance of this contract by appointment only; between the hours of 7:00am and 7:00pm.

Question:

24. May the Government please clarify if home visits for portable gaseous refills should also be completed between 7:00am and 7:00pm?

A. Government Response:

With the exception of emergency situations, the Contractor shall complete home visits for portable gaseous refills between the hours of 7am and 7pm.

6.4 Summary Report of Services Rendered

· H. List of all patients with oxygen concentrators in use for at least 20 days, detailing hours of use since last visit. Provide actual use and daily average. Note exception when concentrator is exchanged.

Questions:

25. May the Government please clarify if the reporting is for 100% of the VA population?

A. Government Response:

When reporting concentrator usage, this is 100% of the VA population that have concentrators in use.

26. If so, will this be a phone call to all patients to determine whether they are using their concentrator and obtaining hours of use?

A. Government Response:

The Contractor shall make a visit to the patient’s home to provide actual hours of use and daily average. Note: exception when concentrator is exchanged.

27. Or is the report to reflect only patients seen within 20 days for their biannual visit?

A. Government Response:

The Contractor shall submit a summary report of services rendered with each monthly submission of an invoice.

4.10 In-Home Nocturnal Continuous Pulse Oximetry test

· Procedure shall include delivery, setup, and pickup of rented oximeter.

· Data from the oximeter shall be downloaded and a written report be furnished to VAMC Clinical Coordinator or designee within 48 hrs of pickup.

Questions:

28. May the Government please clarify if the delivery, setup and pickup must be completed in person by a Respiratory Therapist to the patient’s place of residency?

A. Government Response:

No

29. May the Government please clarify if the written report should consist of the contractor obtaining medical interpretation of the downloaded report?

A. Government Response:

The Government will provide medical interpretation for the nocturnal continuous pulse oximetry test results provided by the contractor.

30. If so, may the Government clarify if the 48 hrs is to be completed after the receipt of the medical interpretation?

A. Government Response:

The Government will be responsible for interpretation of the overnight oximetry results.

B-4 Schedule of Services/Supplies, pages 6-184, Estimates for Rental Concentrator with Portable Gaseous Oxygen System, home compressor used to fill portable oxygen cylinders- (2) self-filling -type oxygen cylinders.

Interested Party Comment:

The estimated requirements for rental concentrators with self-filling oxygen cylinders (“non-portable self-filling concentrators) is approximately 55% percent of all the requirements (or 51% of all requirements if portable concentrators are included) for all concentrators. The predecessor contract did not include self-filling oxygen cylinders. This is also a much higher percentage of self-filling cylinders than are used by the VA or in the commercial oxygen industry, where self-filling cylinders only used in limited circumstances, particularly those that are not for portable use (referred to herein as “non-portable”).

Questions:

31. Are the estimates for non-portable self-filling concentrators based on actual, historic data from the incumbent contract? If so, what “historic” data was used given that non-portable, self-filling concentrators were not priced or authorized under the prior contract?

A. Government Response:

The Homefill systems are considered a portable source, the concentrator is not portable, the tanks are portable. The estimates are based on the population from the current facilities that the incumbent contract provided.

32. If the estimates are not based on actual, historic data, why is the VA increasing its use of non-portable, self-filling concentrators?

A. Government Response:

HomeFill systems give the patients more options for portability and to be more active without the worry of an empty tank. They can fill their own tank.

33. If the estimates are not based on actual, historic data, how did the VA calculate the estimate?

A. Government Response:

The estimates are calculated per the last fiscal year population of the area that the contract will serve.

34. Are the estimates for non-portable, self-filling concentrators only for new patients, or are they also for existing patients. If they include existing patients, how long will the contractor have to transfer patients using other methods to self-filling oxygen concentrators?

A. Government Response:

The self-filling system will also be for current patients as well as new patients. The Contractor has 90 days to transfer patients.

35. Does the VA’s estimate include any analysis of patients currently using other types of non-portable concentrators to see whether they would be eligible to transition to a self-filling concentrator? For example, did it consider: a. liter flow (patients with a high liter flow are not good candidates for self-filling concentrators); b. physical, cognitive, or mental capability to fill the tanks; or c. patient’s ability to pay increased electrical bills to pay for the increased electricity needed for self-filling concentrators (The additional electricity for self-fill is approximately $75 to $125 per month). If so— A. Government Response:

The Contractor shall adhere to the prescription that has been provided by the VA Home Oxygen Team. Contractors shall not add or substitute components or alter the beneficiary’s prescription in any way without prior approval and written authority from the VA.

37.1 What aspects did the VA consider?

A. Government Response:

The VA did consider the increase in electricity; a national survey was completed that showed the increase was very nominal and not significant.

37.2 What percentage did the VA determine would need to be converted?

A. Government Response:

The percentage that needs to be converted would be an evolving number of patients based on the current population of patients, there are factors that are dependent on these changes.

36. Non-portable, self-filling concentrators are older technology and only appropriate for a limited set of patients. Although they are offered in the commercial industry when appropriate, the customary commercial practice would not offer them in the numbers and percentages estimated by the Solicitation.

A. Government Response:

The VA has done market research and has determined the use of self-filling concentrators with portable cylinders viable.

Yes, Market Research was conducted and requested capability statements from interested parties that are able to provide Home Oxygen services with Home-fill concentrators. Interested parties provided information stated that they can fill the requirement.

38.2 Pursuant to FAR 12.302, has the VA obtained a waiver so that it may require terms and conditions that are inconsistent with customary commercial practice?

A. Government Response:

A waiver was not required because the terms and conditions are consistent with customary commercial practice.

38.3 Does the VA have an expectation that more than one offeror will submit an offer based on the VA’s estimated needs for self-filling cylinders? If so, how has the VA determined this?

A. Government Response:

Yes, this was determined through market research and historical information.

SECTION 3.4, ASSESSMENT REQUIREMENTS, PAGE 190

A. The Contractor shall perform an assessment of the patient’s home and environment in accordance with JC accreditation standards for Homecare, and maintain documentation of assessments in the individual patient file or folder.

B. The Contractor shall notify the COR/alternate COR during the home visit if the Contractor’s staff determines that the presence of oxygen in the home presents such a danger that the oxygen must be removed, or in the case of an initial set-up, not placed in the home.

Questions:

37. Is the contractor responsible for assessing the particular oxygen solution that is appropriate for the patient?

A. Government Response:

The prescribing VA physician is responsible for assessing the patient and prescribing the correct form of treatment.

38. If VA personnel assess that the patient is eligible for self-filling oxygen, but the contractor disagrees based on the assessment of the patient’s physical, cognitive, or mental capability or home environment that self-filling oxygen is not appropriate, what is the protocol for resolving the conflict?

A. Government Response:

The Contractor shall adhere to the prescription that has been provided by the VA Home Oxygen Team. Contractors shall not add or substitute components or alter the beneficiary’s prescription in any way without prior approval and written authority from the VA.

B.4 SCHEDULE OF SERVICES/SUPPLIES

Questions:

39. Does the Cleveland area have negative pressure vents under the current contract?

A. Government Response:

Yes

40. Can the manufacturers supply the required number of self-fill units within ninety (90) days? Invacare, the standard leader, has difficultly supplying 500 per month.

A. Government Response:

The government uses home fill systems in other parts of VISN 10 without issue.

SECTION B.5 PERFORMANCE WORK STATEMENT, 1.1, VETERANS SERVED, PAGE 185

The Department of Veteran Affairs (VA) Medical Centers in Chillicothe OH, Cincinnati OH, and Cleveland OH, Dayton OH, and Columbus OH currently serves estimated 5,500 oxygen-using patients. The volumes or amounts shown in the solicitation are estimates only. The contract shall be for the actual requirements of the VA as ordered by the VA during the life of the contract.

Question:

41. Does the patient mix count align with the modality required?

A. Government Response:

This is an estimate of the population currently receiving home oxygen services under the incumbent contract

SECTION B.5 PERFORMANCE WORK STATEMENT, 3.2, HOME VISITS, PAGE 189

The Contractor shall visit patients’ residences for regularly schedule maintenance visits. . . . On each scheduled set-up / delivery the Contractor shall reassess the need to instruct the patient on the use and care of the equipment and supplies as necessary.

42. What are the requirements for home-fills work where a veteran needs 5L or more of oxygen?

A. Government Response:

The Veteran will be seen by a VA prescribing physician and the modality will be determined by the prescribing physician. The Contractor shall adhere to the prescription that has been provided by the VA Home Oxygen Team. Contractors shall not add or substitute components or alter the beneficiary’s prescription in any way without prior approval and written authority from the VA.

SECTION B.5 PERFORMANCE WORK STATEMENT, 3.5, PATIENT EDUCATION REQUIREMENTS, PAGE 190 The Contractor shall provide education to each patient at the time of set-up, and twice yearly thereafter, and assess the need for reinforcement during visits.

43. It is estimated that additional electricity for self-fill will increase a veteran’s utility bills by $75-125 per month. Is the VA taking these additional costs into account, and will the contractor be responsible for communicating these costs to the veteran?

A. Government Response:

The VA did consider the increase in electricity; a national survey was completed that showed the increase was very nominal and not significant.

C.12 VAAR 852.237-70 Contractor Responsibilities (Apr 1984) The contractor shall obtain all necessary licenses and/or permits required to perform this work.

44. When must the licenses be in place?

A. Government Response:

Any licenses (if required) shall be in place immediately after contract award and prior to any performance on contract.

45. Price Schedule estimated quantities:

Question: The PWS references the need to service 5,500 oxygen using patients. The estimated number of patients listed on the pricing schedule reflect around 4,700. Please clarify either the total patient count in the PWS or the estimated quantities in the pricing schedule to reflect accurate information.

A. Government Response:

The numbers provided are an estimated quantity.

46. Will the VA pay the additional shipping cost for returning equipment taken out of contract area by a relocating veteran?

A. Government Response:

NO, this is the cost of doing business.

47. Will VA consider awarding partial areas such as just Columbus or just Chillicothe within VISN 10? Or are you only going to make one award for the entire VISN?

A. Government Response:

There will be only one award for the entire service area of VISN 10 Ohio.

48. How will the introduction of the Home-fill systems be done? All at once (during the phase-in period) for all of the requested Home Fill systems or is it the VA’s intention that the transition to Home Fill systems be phased in slowly over a longer period of time?

A. Government Response:

Per the contract it states 90 days.