36C25019Q9590-0002001.pdf

36C25019Q9590-0002

PAGE 1 OF 108 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 Not Applicable

36C25019Q9590-0002 06-21-2019 (Issued) 07-11-2019 (Re-issued)

Brad Burhite 513-559-3704 07-15-2019

36C250

Department of Veterans Affairs Network Contracting Office (NCO) 10 260 E. University Avenue Cincinnati OH 45219

X 100

X

485991

$15 Million

X

N/A

X

See SCHEDULE OF SERVICE - PRICE SCHEDULE

36C250

Department of Veterans Affairs Network Contracting Office (NCO) 10 260 E. University Avenue Cincinnati OH 45219

NOTE: This solicitation is 100% small business set-aside

Department of Veterans Affairs

FMS-VA-2(101)

Financial Services Center PO Box 149971 Austin TX 78714-9971

See CONTINUATION Page

The contractor shall provide all required labor, material, supplies, equipment and supervision of contractor personnel necessary to perform WHEELCHAIR TRANSPORTATION SERVICE for CINCINNATI Veterans Administration Medical Center (VAMC) in accordance with the terms and conditions established in hiestablished in this solicitation.

This solicitation shall be conducted in accordance with FAR Subpart 13.5 and is anticipated to result in the award of an Indefinite-Delivery type contract as defined in FAR Subpart 16.5. The performance of services under this contract shall only be authorized though the award of funded task order(s) by the cognizant government contracting.

The anticipated performance periods are summarized as follows:

- Base Year from 1 September 2019 to 29 February 2020;

- Option Year One from 1 March 2020 to 28 February 2021;

- Option Year Two from 1 March 2021 to 28 February 2022;

- Option Year Three from 1 March 2021 to 28 February 2022;

- Option Year Four from 1 March 2023 to 29 February 2024;

See CONTINUATION Page For accounting and appropriation data see each individually awarded task order. FAR 52.232-18 (Availability of Funds) applies to this contract.

X X

X 1

Bradley K. Burhite

VA-VHA-SAOC-2019-CD0069AC

Bradley K. Burhite 1461180 Digitally signed by Bradley K. Burhite 1461180 Date: 2019.07.11 11:32:24 -04'00'

Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 SCHEDULE OF SERVICES – PRICE SCHEDULE (19 June 2019) B.3 PERFORMANCE WORK STATEMENT (PWS) dated 10 July 2019

B.4 IT CONTRACT SECURITY

SECTION C - CONTRACT CLAUSES

C.1 52.204-9 PERSONAL IDENTITY VERIFICATION OF CONTRACTOR PERSONNEL

(JAN 2011)

C.2 52.204-17 OWNERSHIP OR CONTROL OF OFFEROR (JUL 2016)

C.3 52.204-18 COMMERCIAL AND GOVERNMENT ENTITY CODE MAINTENANCE

(JUL 2016)

C.4 52.209-7 INFORMATION REGARDING RESPONSIBILITY MATTERS (OCT 2018) ... 44

C.5 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS (OCT

2018)

C.6 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL ITEMS (OCT 2018)

C.7 52.215-22 LIMITATIONS ON PASS-THROUGH CHARGES—IDENTIFICATION OF

SUBCONTRACT EFFORTS (OCT 2009)

C.8 52.215-23 LIMITATIONS ON PASS-THROUGH CHARGES (OCT 2009)

C.9 52.216-1 TYPE OF CONTRACT (APR 1984)

C.10 52.216-18 ORDERING (OCT 1995)

C.11 52.216-19 ORDER LIMITATIONS (OCT 1995)

C.12 52.216-22 INDEFINITE QUANTITY (OCT 1995)

C.13 52.217-5 EVALUATION OF OPTIONS (JUL 1990)

C.14 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

C.15 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000)

C.16 52.219-6 NOTICE OF TOTAL SMALL BUSINESS SET-ASIDE (NOV 2011)

C.17 52.219-14 LIMITATIONS ON SUBCONTRACTING (JAN 2017)

C.18 52.224-1 PRIVACY ACT NOTIFICATION (APR 1984)

C.19 52.224-2 PRIVACY ACT (APR 1984)

C.20 52.224-3 PRIVACY TRAINING (JAN 2017)

C.21 52.228-5 INSURANCE—WORK ON A GOVERNMENT INSTALLATION (JAN 1997)

C.22 52.232-19 AVAILABILITY OF FUNDS FOR THE NEXT FISCAL YEAR (APR 1984)

C.23 INTERRUPTION OF SERVICE

C.24 52.242-15 STOP-WORK ORDER (AUG 1989)

C.25 52.244-6 SUBCONTRACTS FOR COMMERCIAL ITEMS (OCT 2018)

C.26 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.27 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.28 VAAR 852.219-74 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUL 2018)

C.29 VAAR 852.219-75 SUBCONTRACTING COMMITMENTS MONITORING AND

COMPLIANCE (JUL 2018)

C.30 VAAR 852.228-71 INDEMNIFICATION AND INSURANCE (MAR 2018)

C.31 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.32 VAAR 852.236-76 CORRESPONDENCE (APR 1984)

C.33 VAAR 852.237-7 INDEMNIFICATION AND MEDICAL LIABILITY INSURANCE

(JAN 2008)

C.34 SUPPLEMENTAL INSURANCE REQUIREMENTS

C.35 VAAR 852.237-70 CONTRACTOR RESPONSIBILITIES (APR 1984)

C.36 VAAR 852.270-1 REPRESENTATIVES OF CONTRACTING OFFICERS (JAN 2008) 74

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

B.1 BUSINESS ASSOCIATE AGREEMENT BETWEEN THE DEPARTMENT OF

VETERANS AFFAIRS VETERANS HEALTH ADMINISTRATION, Cincinnati VAMC, AND B.2 Wage Determination (WD) 15-4720 for Hamilton County, Ohio (see attached) B.3 Historical Trip Report from 1 to 15 January 2019 (see attached) B.4 Historical Trip Report from 16 to 31 January 2019 (see attached)

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL ITEMS (OCT 2018)

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

E.3 52.212-2 (Addendum A) – Past Performance Questionnaire E.4 52.212-2 (Addendum B) – Statement of Department of Labor Wage Determination Compliance E.5 52.212-2 (Addendum C) – Statement of FAR 52.219-14 Limitations on Subcontracting Compliance

E.6 52.212-4 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—COMMERCIAL

ITEMS (OCT 2018)

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

1998)

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:

b. GOVERNMENT: Contracting Officer 36C250

Department of Veterans Affairs

Network Contracting Office (NCO) 10

260 E. University Avenue

Cincinnati OH 45219

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

[] 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] Biweekly

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

FMS-VA-2(101)

Financial Services Center

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

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.2 SCHEDULE OF SERVICES – PRICE SCHEDULE (19 June 2019)

SCHEDULE OF SERVICES – PRICE SCHEDULE

BASE YEAR from 1 September 2019 to 29 February 2020

Wheelchair/Ambulette Transportation Service for Cincinnati VAMC

NOTE #1: This price schedule is for wheelchair transport service for Cincinnati VAMC which shall be invoiced and performed IAW the PWS.

NOTE #2: The minimum quantity that is specified for each line item in the base period applies only to the base period.

NOTE #3: The contractor shall be authorized to invoice for the “Total Price (Minimum)” identified for the base period ONLY if the base period is physically complete; the total invoices submitted for base period do not exceed the “Total Price (Minimum)” identified for the base period; and the CO has reviewed the final invoice submitted by the contractor for the base period and approved payment.

Line Item

Description of Services QTY Max NTE

Unit of Issue

Unit Price

Total Price (Minimum)

*Equals 15% of Max

Total Price Max NTE

C0001 Wheelchair Transport BASE RATE (ONE-WAY):

The BASE RATE (ONE-WAY) is for authorized one-way patient transports with a point-to-point (one-way) travel distance of 20 miles or less from the designated VA Medical Center as specified in the PWS. The contractor is NOT authorized to invoice for MILEAGE RATE (ONE-WAY) in addition to the BASE RATE (ONE-WAY) for patient transports with a point-to-point (one-way) travel distance radius of 20 miles or less from the designated VA Medical Center. For patient transports with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center, the BASE RATE (ONE-WAY) plus MILEAGE RATE (ONE-WAY) may be authorized. The contractor shall utilize the latest edition of BING maps to calculate the travel distance for all point-to-point trips.

2,674

EACH

(Trip)

C0002 Wheelchair Transport MILEAGE RATE (ONE-WAY): The

MILEAGE RATE (ONE-WAY) shall only be authorized for patient transports which exceed the BASE RATE (ONE-WAY) travel distance radius of 20 miles from the designated VA Medical Center as specified in the PWS. The contractor shall ensure that all invoices submitted with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center include the MILEAGE RATE (ONE-WAY) plus BASE RATE (ONE-WAY) which shall be calculated based on the total travel distance (one-way) minus 20 miles. The MILEAGE RATE (ONE-WAY) is not authorized for any patient transport that does not have a VA approved passenger onboard. The contractor shall utilize the latest edition of BING maps to calculate the travel distance for all point-to-point trips.

14,790

(Mile)

C0003 Wheelchair Transport | WAIT TIME RATE (15-Minute

Increments): WAIT TIME RATE (15-Minute Increments) shall only be authorized for patient transports which exceed the “wait time grace period” upon approval by the COR or authorized government representative designed in writing by the COR and/or CO as specified in this PWS.

(15-Minute Increment)

TOTAL PRICE | BASE YEAR $_______ $________

SCHEDULE OF SERVICES – PRICE SCHEDULE

OPTION YEAR ONE (1) from 1 March 2020 to 28 February 2021

Wheelchair Transportation Service for Cincinnati VAMC

NOTE #1: This price schedule is for wheelchair transport service for Cincinnati VAMC which shall be invoiced and performed IAW the PWS.

Line Item

Description of Services QTY Max NTE

Unit of Issue

Unit Price

Total Price Max NTE

C1001 Wheelchair Transport BASE RATE (ONE-WAY):

The BASE RATE (ONE-WAY) is for authorized one-way patient transports with a point-to-point (one-way) travel distance of 20 miles or less from the designated VA Medical Center as specified in the PWS. The contractor is NOT authorized to invoice for MILEAGE RATE (ONE-WAY) in addition to the BASE RATE (ONE-WAY) for patient transports with a point-to-point (one-way) travel distance radius of 20 miles or less from the designated VA Medical Center.

For patient transports with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center, the BASE RATE (ONE-WAY) plus MILEAGE RATE (ONE-WAY) may be authorized. The contractor shall utilize the latest edition of BING maps to calculate the travel distance for all point-to-point trips.

5,525

C1002 Wheelchair Transport MILEAGE RATE (ONE-WAY):

The MILEAGE RATE (ONE-WAY) shall only be authorized for patient transports which exceed the BASE RATE (ONE- WAY) travel distance radius of 20 miles from the designated VA Medical Center as specified in the PWS. The contractor shall ensure that all invoices submitted with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center include the MILEAGE RATE (ONE-WAY) plus BASE RATE (ONE-WAY) which shall be calculated based on the total travel distance (one-way) minus 20 miles. The MILEAGE RATE (ONE-WAY) is not authorized for any patient transport that does not have a VA approved passenger onboard. The contractor shall utilize the latest edition of BING maps to calculate the travel distance for all point-to-point trips.

29,580

C1003 Wheelchair Transport | WAIT TIME RATE (15-Minute

Increments): The WAIT TIME RATE (15-Minute Increments) shall only be authorized for patient transports which exceed the “wait time grace period” upon approval by the COR or authorized government representative designed in writing by the COR and/or CO as specified in this PWS.

TOTAL PRICE | OPTION YEAR ONE (1)

SCHEDULE OF SERVICES – PRICE SCHEDULE

OPTION YEAR TWO (2) from 1 March 2021 to 28 February 2022

NOTE #1: This price schedule is for wheelchair transport service for Cincinnati VAMC which shall be invoiced and performed IAW the PWS.

Item

Description of Services QTY Max NTE

Unit of Issue

Unit Price

Total Price

C2001 Wheelchair Transport BASE RATE (ONE-WAY):

distance of 20 miles or less from the designated VA Medical Center as specified in the PWS. The contractor is NOT authorized to invoice for MILEAGE RATE (ONE-WAY) in addition to the BASE RATE (ONE-WAY) for patient transports with a point-to-point (one-way) travel distance radius of 20 miles or less from the designated VA Medical Center.

For patient transports with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center, the BASE RATE (ONE-WAY) plus MILEAGE RATE (ONE-WAY) may be authorized. The

C2002 Wheelchair Transport MILEAGE RATE (ONE-WAY):

WAY) travel distance radius of 20 miles from the designated VA Medical Center as specified in the PWS. The contractor shall ensure that all invoices submitted with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center include the MILEAGE RATE (ONE-WAY) plus BASE RATE (ONE-WAY) which shall be calculated based on the total travel distance (one-way) minus 20 miles. The MILEAGE RATE (ONE-WAY) is not authorized for any patient transport that does not have a VA approved passenger onboard. The contractor shall utilize the all point-to-point trips..

C2003 Wheelchair Transport | WAIT TIME RATE (15-Minute

Increments) shall only be authorized for patient transports which exceed the “wait time grace period” upon approval by

TOTAL PRICE | OPTION YEAR TWO (2)

SCHEDULE OF SERVICES – PRICE SCHEDULE

OPTION YEAR THREE (3) from 1 March 2022 to 28 February 2023

NOTE #1: This price schedule is for wheelchair transport service for Cincinnati VAMC which shall be invoiced and performed IAW the PWS.

Item

Description of Services QTY Max NTE

Unit of Issue

Unit Price

Total Price

C3001 Wheelchair Transport BASE RATE (ONE-WAY):

distance of 20 miles or less from the designated VA Medical Center as specified in the PWS. The contractor is NOT authorized to invoice for MILEAGE RATE (ONE-WAY) in addition to the BASE RATE (ONE-WAY) for patient transports with a point-to-point (one-way) travel distance radius of 20 miles or less from the designated VA Medical Center.

For patient transports with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center, the BASE RATE (ONE-WAY) plus MILEAGE RATE (ONE-WAY) may be authorized. The

C3002 Wheelchair Transport MILEAGE RATE (ONE-WAY):

WAY) travel distance radius of 20 miles from the designated VA Medical Center as specified in the PWS. The contractor shall ensure that all invoices submitted with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center include the MILEAGE RATE (ONE-WAY) plus BASE RATE (ONE-WAY) which shall be calculated based on the total travel distance (one-way) minus 20 miles. The MILEAGE RATE (ONE-WAY) is not authorized for any patient transport that does not have a VA approved passenger onboard. The contractor shall utilize the

C3003 Wheelchair Transport | WAIT TIME RATE (15-Minute

Increments) shall only be authorized for patient transports which exceed the “wait time grace period” upon approval by

TOTAL PRICE | OPTION YEAR THREE (3)

SCHEDULE OF SERVICES – PRICE SCHEDULE

OPTION YEAR FOUR (4) from 1 March 2023 to 29 February 2024

NOTE #1: This price schedule is for wheelchair transport service for Cincinnati VAMC which shall be invoiced and performed IAW the PWS.

Item

Description of Services QTY Max NTE

Unit of Issue

Unit Price

Total Price

C4001 Wheelchair Transport BASE RATE (ONE-WAY):

distance of 20 miles or less from the designated VA Medical Center as specified in the PWS. The contractor is NOT authorized to invoice for MILEAGE RATE (ONE-WAY) in addition to the BASE RATE (ONE-WAY) for patient transports with a point-to-point (one-way) travel distance radius of 20 miles or less from the designated VA Medical Center. For patient transports with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center, the BASE RATE (ONE-WAY) plus MILEAGE RATE (ONE-WAY) may be authorized. The

C4002 Wheelchair Transport MILEAGE RATE (ONE-WAY):

WAY) travel distance radius of 20 miles from the designated VA Medical Center as specified in the PWS. The contractor shall ensure that all invoices submitted with a point-to-point (one-way) travel distance radius which exceeds 20 miles from the designated VA Medical Center include the MILEAGE RATE (ONE-WAY) plus BASE RATE (ONE-WAY) which shall be calculated based on the total travel distance (one-way) minus 20 miles. The MILEAGE RATE (ONE-WAY) is not authorized for any patient transport that does not have a VA approved passenger onboard. The contractor shall utilize the

C4003 Wheelchair Transport | WAIT TIME RATE (15-Minute

Increments) shall only be authorized for patient transports which exceed the “wait time grace period” upon approval by

TOTAL PRICE | OPTION YEAR FOUR (4)

SCHEDULE OF SERVICES – PRICE SCHEDULE

PRICE SUMMARY for Base Period and Four (4) Options Years

Wheelchair Transport Service for Cincinnati VAMC

Period/Option

Period of Performance Total Price (Minimum) *Base Period Only

**Equals 15% MAX NTE

Total Price (Maximum NTE)

Base Period 1 September 2019 to 29 February 2020 $____________ $_____________ Option Year 1 1 March 2020 to 28 February 2021 $_____________ Option Year 2 1 March 2021 to 28 February 2022 $_____________ Option Year 3 1 March 2022 to 28 February 2023 $_____________ Option Year 4 1 March 2023 to 29 February 2024 $_____________

TOTAL PRICE $_____________

B.3 PERFORMANCE WORK STATEMENT (PWS) dated 10 July 2019

PERFORMANCE WORK STATEMENT (PWS)

Wheelchair/Ambulette Transportation Service for Cincinnati

VAMC

(Non-Personal Services)

10 July 2019

1. GENERAL. This is a non-personnel services contract in which the contractor shall provide wheelchair transportation service for Cincinnati Veterans Administration Medical Center (VAMC) in Ohio. It is important to note that wheelchair transportation service is otherwise known as ambulette transportation service in the state of Ohio in accordance with the Ohio Administrative Code (OAC). The government shall not exercise any supervision or control over the contract service providers performing the services herein.

1.1 SCOPE SUMMARY. The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items necessary to provide wheelchair transportation service for Cincinnati VAMC as established in this Performance Work Statement (PWS). The contractor shall adhere to Ohio Administrative Code (OAC), State Board of Emergency Medical, Fire, and Transportation Services and all applicable Federal, State and Local laws, rules, regulations and procedures as required to perform services under this contract. The contractor shall furnish the vehicles necessary to provide full and complete coverage for pick-up and delivery of all Veteran patients requiring transport in accordance with the terms and conditions of this contract for the locations specified herein. The contractor shall be responsible for providing patient pick-up and delivery as necessary from community hospitals and VA facilities within and outside the service area which may include personal residence of the patient and other locations as requested by the authorized government representative(s) designated in writing by the COR and/or CO in accordance with the procedures specified within this PWS in support of the following primary operating location:

Cincinnati Veterans Affairs Medical Center (VAMC) 3200 Vine Street Cincinnati, OH 45220

1.2 PERIOD OF PEFORMANCE. The periods of performance for base period and all option periods for this contract are summarized as follows:

Base Year: 1 September 2019 to 29 February 2020 Option Year One (1): 1 March 2020 to 28 February 2021 Option Year Two (2): 1 March 2021 to 28 February 2022 Option Year Three (3): 1 March 2022 to 28 February 2023 Option Year Four (4): 1 March 2023 to 29 February 2024

1.3 GENERAL REQUIREMENTS

1.3.1 Quality Control: The contractor shall develop and maintain an effective quality control program to ensure services are performed in accordance with this PWS. The contractor shall identify and define the management concept for ensuring compliance with all contract requirements. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services. The contractor will have an on-going quality assurance and /or quality improvement program designed to objectively and systematically measure, assess, and improve performance to enhance patient care and all patient care services. The contractor’s quality control program is the means by which the contractor assures that all work complies with the requirement of the contract. The contractor shall provide a copy of the QCP with their offeror as specified by the Contracting Officer and upon request thereafter. After acceptance of the quality control plan, the contractor shall immediately notify the contracting officer of any proposed changes to their quality control program and submit a change request in writing to the contracting officer. The contractor shall furnish copies of these records if requested by the Contracting Officer, COR or individual(s) designated by the COR and/or CO in writing. The contractor’s quality control program shall include the following:

1.3.1.1 An inspection plan outlining all services defined in this contract. The inspection plan shall specify the areas to be inspected on both a scheduled and unscheduled basis, how often inspections shall be accomplished, and the title of the individual(s) who shall perform inspections.

1.3.1.2 The methods for identifying and preventing deficiencies in the quality of services being performed before the level of performance becomes unacceptable.

1.3.1.3 The on-site records of all inspections conducted by the contractor and corrective action taken.

1.3.1.4 The on-site records of all vehicle maintenance and repairs performed on vehicles used in the performance of this contract.

1.3.1.5 The on-site records of all vehicle maintenance and repairs performed on vehicles used in the performance of this contract. The methods of identifying and preventing vehicle breakdowns to include a detailed procedure for alternative transportation of patients in the event of mechanical breakdown of any vehicle(s).

1.3.1.6 The on-site records identifying the character, security and background checks, current driving records, physical capabilities, certifications and ongoing training of each employee performing services under this contract. This will include training in the safe and proper transport of beneficiaries and the necessary healthcare training, i.e., Health Insurance Portability and Accountability Act (HIPPA), Privacy Training for each employee performing services under this contract.

1.3.1.7 The methods of identifying and preventing radio communication breakdowns. A detailed procedure for alternative communications in the event of electronic and mechanical breakdown of vehicle two-way radios.

1.3.1.8 A log to account for all requests for service. The log shall indicate the date and time of service call, name of beneficiary requiring services, any required Medicare/Medicaid forms with Doctor’s signatures, type of transportation requested, designated pick-up and delivery points, actual time of arrival at pick-up and delivery points and actual waiting time at pick-up and delivery points, if waiting charges are claimed.

1.3.1.9 The on-site records of any complaints or problems, with procedures taken to allow for corrections and/or elimination before effects caused interruption of performance of contract.

1.3.2 Quality Assurance. The government shall evaluate the contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan. This plan is primarily focused on what the Government must do to ensure that the contractor has performed in accordance with the performance standards. It defines how the performance standards will be applied, the frequency of surveillance, and the minimum acceptable defect rate(s):

1.3.3 Federally Recognized Holidays. The contractor is not anticipated but may be required to provide service on Federally recognized holidays in accordance with the terms and conditions established in this PWS to include but not limited to the following:

New Year’s Day Labor Day Martin Luther King Jr.’s Birthday Columbus Day President’s Day Veteran’s Day Memorial Day Thanksgiving Day Independence Day Christmas Day

1.3.4 Hours of Operation. The contractor shall be available to provide service 24-hours per days, 7 days a week, 365 days per year. The majority of services under this contract are anticipated to be performed Monday through Friday from 0700-EST to 1900-EST, except on Federally recognized holidays. Limited services may be required at any time, to include weekends and Federal holidays, which shall be performed at the rates established in the SCHEDULE OF SERVICES – PRICE SCHEDULE. The contractor shall provide services in accordance with the terms and conditions of this contract. The contractor must at all times maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS. When hiring personnel, the contractor shall keep in mind that the stability and continuity of the workforce are essential.

1.3.5 Place of Performance. The contractor shall furnish the vehicles necessary to provide full and complete coverage for pick-up and delivery of all Veteran patients requiring transport in accordance with the terms and conditions of this contract for the locations specified herein. The contractor shall be responsible for providing patient pick-up and delivery as necessary from community hospitals and VA facilities within and outside the service area which may include personal residence of the patient and other locations and transportation across state lines as requested by the authorized government representative(s) designated in writing by the COR and/or CO in accordance with the procedures specified within this PWS.

1.3.6 Type of Contract and Task Orders. The government intends to award a single-award indefinite-delivery indefinite quantity (IDIQ) type contract for the effort specified herein. The base and option periods (if any) specified in the SCHEDULE OF SERVICES - PRICE SCHEDULE shall be exercised at the discretion of the government through the issuance of a task order for the entire period of performance. The authority that will be utilized to award this effort is FAR Part 13.5 (Simplified Procedures for Certain Commercial Items).

1.3.7 Security Requirements and Background Checks. All contractor employees shall comply with the security and background check requirements required by Federal, State, Local and the Department of Veterans Affairs to perform services in support of this VA medical facility in the state of Ohio.

1.4.12.1 PHYSICAL Security: The contractor shall be responsible for safeguarding all government equipment, information and property provided for contractor use. At the close of each work period, government facilities, equipment, and materials shall be secured.

1.4.12.2 Key Control: Not Applicable.

1.4.12.3 Lock Combinations: Not Applicable.

1.3.8 Special Qualifications. See requirements below.

1.3.9 Post Award Conference/Periodic Progress Meetings. The contractor agrees to attend any post award conference convened by the contracting activity or contract administration office in accordance with Federal Acquisition Regulation Subpart 42.5. The contracting officer, Contracting Officers Representative (COR), and other Government personnel, as appropriate, may meet periodically with the contractor to review the contractor's performance. At these meetings the contracting officer will apprise the contractor of how the government views the contractor's performance and the contractor will apprise the Government of problems, if any, being experienced.

Appropriate action shall be taken to resolve outstanding issues. These meetings shall be at no additional cost to the government.

1.3.10 Contracting Officer’s Representative (COR). The (COR) if designated will be identified by separate letter issued by the cognizant government Contracting Officer. The COR monitors all technical aspects of the contract and assists in contract administration The COR is authorized to perform the following functions: assure that the contractor performs the technical requirements of the contract: perform inspections necessary in connection with contract performance: maintain written and oral communications with the Contractor concerning technical aspects of the contract: issue written interpretations of technical requirements, including Government drawings, designs, specifications: monitor Contractor's performance and notifies both the Contracting Officer and contractor of any deficiencies; coordinate availability of government furnished property, and provide site entry of contractor personnel. A letter of designation issued to the COR, a copy of which is sent to the contractor, states the responsibilities and limitations of the COR, especially with regard to changes in cost or price, estimates or changes in delivery dates. The COR is not authorized to change any of the terms and conditions of the resulting order.

1.3.11 Key Personnel. The following personnel are considered key personnel by the government: Project Manager/Alternate Project Manager and Officer in Charge. The contractor shall provide a contract manager who shall be responsible for the performance of the work. The name of this person and an alternate who shall act for the contractor when the manager is absent shall be designated in writing to the contracting officer. The contract manager or alternate shall have full authority to act for the contractor on all contract matters relating to daily operation of this contract. The contract manager or alternate shall be available 7 days a week, 24 hours per day, 365 days per year.

1.3.11.1 Personnel Roster. Within one (1) day of contract award, the contractor shall provide a list of all personnel that will perform services under this contract to the Contracting Officer (CO) that the CO shall forwarded to the requiring activity for review/action as appropriate. Thereafter, any changes to the personnel roster of the contractor shall be submitted to the CO within 24 hours of any change in staff. All personnel roster submissions shall include the following information:

Full Name Position and Title Assigned Responsibilities Qualifications and Professional Certifications Other information as requested by the COR and/or Contracting Officer

1.3.12 Identification of Contractor Employees: All contract personnel attending meetings, answering Government telephones, and working in other situations where their contractor status is not obvious to third parties are required to identify themselves as such to avoid creating an impression in the minds of members of the public that they are Government officials. They must also ensure that all documents or reports produced by contractors are suitably marked as contractor products or that contractor participation is appropriately disclosed.

1.3.13 Contractor Travel: Not Applicable

1.3.14 Other Direct Costs: Not Applicable

1.3.15 Data Rights: Not Applicable

1.3.16 Organizational Conflict of Interest: Not Applicable

1.3.17 Phase-In /Phase-Out Period: Not Applicable

2. DEFINITIONS AND ACRONYMS

2.1. DEFINITIONS

BASE RATE. The base rate is defined as the rate paid for one-way transportation from a designated pick up point to a designated delivery point. This rate will be paid for all authorized one-way trips requested under this contract with employees receiving at a minimum the Department of Labor Service Contract Act (SCA) wage rates for the ROSS COUNTY, as specified by the contracting officer for this requirement, during all phases of the trip made on behalf of the Government. Service Contract Act (SCA) wage rate determinations will be updated each option year, when/if new revisions are issued. The base rate shall constitute full compensation for one-way trips which do not exceed the “Mileage Threshold” as shown below.

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

COMMUNITY LIVING CENTER (CLC). The Community Living Centers (CLCs) are inpatient units for

VAMC nursing homes.

CONTRACT TASK ORDERS. Award of a funded contract task order for the appropriate period of performance is required prior to the commencement of any/all work in accordance with FAR part 16.506 as specified herein.

CONTRACTOR. A vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime contractor and its employees. The contractor is fully responsible for performance of their sub-contractor(s) and shall ensure that their subcontractor(s) are fully compliant with the terms and conditions of this contract at all-times.

CONTRACTING OFFICER. A person with authority to enter into, administer, and or terminate contracts, and make related determinations and findings on behalf of the government. Note: The only individual who can legally bind the government.

CONTRACTING OFFICER'S REPRESENTATIVE (COR). An employee of the U.S. Government appointed by the Contracting Officer to administer the contract. Such appointment shall be in writing and shall state the scope of authority and limitations. This individual has authority to provide technical direction to the Contractor as long as that direction is within the scope of the contract, does not constitute a change, and has no funding implications. This individual does NOT have authority to change the terms and conditions of the contract.

CONTRACTING OFFICER'S TECHNICAL REPRESENTATIVE (COTR). A government official or officials that work under the authority of the government Contracting Officer responsible for placing patient transport requests for authorized work within the scope and in accordance with the terms and conditions of this contract as specified in the COTR designation letter.

DEFECTIVE SERVICE. A service output that does not meet the standard of performance associated with the Performance Work Statement.

DELIVERABLE. Anything that can be physically delivered, but may include non-manufactured things such as meeting minutes or reports.

DRY RUN. A dry run is defined as a request for service by authorized Medical Center personnel, whereby the contractor arrives at the designated pick-up point and no patient is transported due to a change in the Medical Center’s needs. The contractor will be entitled to the applicable base rate only when dry runs are encountered due to no fault or negligence of the contractor.

EMERGENCY MEDICAL, FIRE, AND TRANSPORTATION SERVICES (EMFTS) CERTIFICATE: The certificate required by the state of Ohio to perform medical transportation services (air medical, ambulance, MoICU and ambulettes). In accordance with Chapter 119 of the Ohio Revised Code, the state of Ohio has adopted rules regulating medical transportation services and vehicles.

KEY PERSONNEL. Contractor personnel that are evaluated in a source selection process and that may be required to be used in the performance of a contract by the Key Personnel listed in the PWS. When key personnel are used as an evaluation factor in best value procurement, an offer can be rejected if it does not have a firm commitment from the persons that are listed in the proposal.

MILEAGE RATE. Mileage rate for service 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.

NOT TO EXCEED (NTE). The price and/or quantity that the contract or purchase order shall not exceed.

OHIO MEDICAL TRANSPORTATION BOARD (OMTB): The former state board prior to EMFTS responsible for the licensing of Ohio’s medical transportation services (air medical, ambulance, MoICU and ambulettes). In accordance with Chapter 119 of the Ohio Revised Code, the state of Ohio has adopted rules regulating medical transportation services and vehicles.

PATIENT BUSINESS SERVICES. An administrative department which processes patients’ medical records, appointments, etc.

PHYSICAL SECURITY. Actions that prevent the loss or damage of Government property.

QUALITY ASSURANCE. The government procedures to verify that services being performed by the contractor are performed according to acceptable standards.

QUALITY CONTROL. All necessary measures taken by the Contractor to assure that the quality of an end product or service shall meet contract requirements.

QUALITY ASSURANCE. Those actions taken by the Government to assure services meet the requirements of this contract.

QUALITY ASSURANCE EVALUATOR(S): Government personnel responsible for surveillance of contractor performance.

QUALITY ASSURANCE SURVEILLENCE PLAN (QASP). An organized written document specifying the surveillance methodology to be utilized by the government for surveillance of contractor performance.

QUALITY CONTROL PLAN (QCP): The QCP is the contractor's management plan for executing the contract which shall be provided to the government upon request and whenever updated by the contractor. The contractor QCP describes the way in which the contractor will produce the deliverables, and the step-by-step approach that will be taken to ensure the quality of service provided to the government.

SAME DAY TRIP(S). A trip or trips requested the same day as specified herein for patient transport on an as need basis with little notice. The price for a same day trip shall be that same as a price for a prescheduled trip as established in the SCHEDULE OF SERVICES – PRICE SCHEDULE.

SCHEDULED TRIPS(S). The term “Scheduled Trip” as used on this contract refers to those trips in which the contractor has been given advanced notice (advanced notice is defined as a notice given by 3:30p.m. the prior business day) of required services and a specific pick-up time.

SUBCONTRACTOR(S). A subcontractor is one who enters into a contract with a contractor (or prime contractor). The contractor (or prime contractor) may choose to subcontract a nominal amount of patient transports during periods of increased demand to comply with the terms and conditions of this contract. The prime contractor is fully responsible for performance of their sub-contractor(s) and shall ensure that their subcontractor(s) are fully compliant with the terms and conditions of this contract at all-times. In addition, the prime contractor shall ensure that their subcontractor(s) clearly identify themselves as the subcontractor for the prime contractor in all written correspondence (i.e. log books, patient transport sheets, etc.) and verbal exchanges with government representatives for all patient transportation runs.

THE JOINT COMMISSION (TJC). A national not-for-profit organization dedicated to administering accreditation programs that improve the care, safety and treatment of patients in a health care facility and environment.

UNIVERSAL PRECAUTIONS. The standard precautions which shall be taken by the contractor when it is anticipated that an individual may encounter blood or body fluid while performing normal duties which require the use of personal protective equipment (e.g., gloves).

UNSCHEDULED TRIP(S). The term “Unscheduled Trip” as used in this contract refers to those trips required on an as needed basis and advanced notice is not given.

VEHICLE(S). The term “vehicle(s)” as used in this contract refers to all modes of transportation provided under the requirements of this contract, unless a specific mode of transportation is identified.

VETERANS TRANSPORTATION DEPARTMENT (VTD). This department is under Patient Business Service (PBS) and coordinates Veteran transportation and eligibility issues. This section works under the authority of the Contracting Officer and is responsible for placing orders for service and certification of invoices under the terms and conditions of this contract.

VETERANS TRANSPORTATION MANAGER (VTM). The manager/supervisor of the VA section under PBS that is responsible for coordinating Veteran transportation and eligibility issues.

WAITING. Waiting as used in this contract is defined as the time required and verified by authorized medical facility personnel, for the contractor to wait at designated pick-up and/or delivery points in performing contract services.

WAITING GRACE PERIOD. The waiting grace period is defined as fifteen (15) minutes prior to the time waiting charges commence. The base rate for all transportation services shall include a fifteen (15) minute waiting grace period at origin and destination.

2.2. ACRONYMS:

ACOR Alternate Contracting Officer's Representative CBOC Community Based Outpatient Clinic CFR Code of Federal Regulations CLC Community Living Centers CO Contracting Officer CONUS Continental United States (excludes Alaska and Hawaii) COR Contracting Officer’s Representative COTR Contracting Officer's Technical Representative COTS Commercial-Off-the-Shelf EMFTS BOARD Emergency Medical, Fire, and Transportation Services Board (State of Ohio) FAR Federal Acquisition Regulation HIPAA Health Insurance Portability and Accountability Act of 1996 NHCU Nursing Home Care Unit NTE Not to Exceed OCI Organizational Conflict of Interest OCONUS Outside Continental United States (includes Alaska and Hawaii) ODC Other Direct Costs OMTB Ohio Medical Transportation Board OAC Ohio Administrative Code ORC Ohio Revised Code PBS Patient Business Services PCOR Primary Contracting Officers Representative PIPO Phase In/Phase Out POC Point of Contact PRS Performance Requirements Summary PWS Performance Work Statement QA Quality Assurance QAP Quality Assurance Plan QASP Quality Assurance Surveillance Plan QC Quality Control QCP Quality Control Program TE Technical Exhibit VAAR Veteran’s Administration Acquisition Regulation VAPS VA Police System VISTA Veteran’s Health Information Systems and Technology Architecture VSC VHA Service Center VAACC Veteran’s Administration Ambulatory Care Clinic VAMC Veteran’s Administration Medical Center

VHA Veteran’s Health Administration VHA PM Veteran’s Health Administration Procurement Manual

3. GOVERNMENT FURNISHED ITEMS AND SERVICES:

3.1.Services: Not applicable

3.2 Facilities: Not applicable.

3.3 Utilities: Not applicable.

3.4 Equipment: Not applicable.

3.5 Materials: Not applicable.

4. CONTRACTOR FURNISHED ITEMS AND RESPONSIBILITIES:

4.1 General: The contractor shall provide all personnel, equipment, supplies, facilities, transportation, tools, materials, supervision, and other items necessary to perform all services under this contract as defined in this PWS and in accordance with the terms and conditions of this contract.

4.2. Materials, Supplies and Equipment: The contractor shall furnish all material, supplies and equipment required to perform work under this contract. The contractor shall NOT be permitted to borrow medical equipment from the Medical facilities. The contractor shall provide all medications (including Naloxone) required while in transport, sheets and blankets and other equipment and supplies required for use while in transport, for direct patient care. The contractor shall at no time and under any circumstances exchange supplies, equipment and/or medications with VA.

The prices quoted in the SCHEDULE OF SERVICES – PRICE SCHEDULE shall be inclusive of consumables used in transport.

5. REQUIREMENTS:

5.1 RESPONSE TIMES. The contractor shall be on time for all scheduled and unscheduled patient transports. All Veteran patient beneficiaries shall be transported within 15 minutes of the scheduled transport time. The contractor shall transport and deliver beneficiary to the specific pick up/drop off transit point designated by the authorized government representative(s) to include but not limited to any VA Medical Center location (i.e. clinic or ward area), VAMC Nursing Homes, Community Living Centers (CLC), Community Based Outpatient Clinics (CBOCs), private residences or other requested non-VA locations. Under no circumstances shall the contractor drop beneficiaries off in the hall or entrance of any facility. Adherence to schedules is of utmost importance. If the Veteran patient is not at the location, unable to be transported, or refuses to be transported, the contractor shall be reimbursed for a one-way trip only after VA has authorized contractor to leave without the beneficiary:

5.1.1. All drivers will report to the assigned appointment locations specified by the authorized government representative(s) designated in writing by the COR and/or CO and sign the log for that trip.

5.1.2 Performance Requirements Standards. The performance requirements standards for this contract to include required response times are defined in the Performance Requirements Summary (PRS) section of this

PWS.

5.2 PATIENT TRANSPORT REQUESTS. A patient transportation request (or travel consult) is a government issued request for the contractor to transport a patient in accordance with the terms and conditions established in this contract. All patient transports under this contract shall be executed by issuance of a patient transport request issued in writing with Virtru Pro encrypted email by the authorized government representative(s) designated in writing by the COR and/or CO. Any patient transport request issued verbally by any authorized government representative should be immediately be followed by a written request utilizing Virtru Pro encrypted email. Specific requirements are summarized as follows:

5.2.1 Virtru Pro Encrypted Email | Patient Transport Correspondence. The contractor shall utilize Virtru Pro encrypted email capability for all for all patient transport related correspondence (i.e. travel requests, travel consults, etc.). Virtru Pro is an encrypted e-mail technology that provides VA a secure method of exchanging information with community providers. It enables recipients to do so in their existing email account without installing software, using portals, or creating accounts summarized as follows:

5.2.1.1 Virtru Pro provides VA a secure method of exchanging information with community providers using encrypted email. Virtru Pro reduces the time it takes to share Veterans’ protected health information (PHI) by allowing VA staff to send this information securely over email instead of via fax or by mail.

5.2.1.2 Virtru Pro allows only the intended recipient of the email to decrypt and respond to secure messages. It enables recipients to do so in their existing email account without installing software, using portals, or creating accounts.

5.2.1.3 Virtru Pro improves care coordination by ensuring VA and community providers can share patient documentation in a timely manner. This allows Veterans to receive the care and follow-ups they need more quickly and appropriately.

5.2.1.4 Virtru Pro improves Health Insurance Portability and Accountability Act (HIPAA) compliance by reducing paper medical records and providing integrity controls and encryption to meet…