36C25019R0093-A00006000.docx

5. PROJECT NUMBER (if applicable)

CODE

7. ADMINISTERED BY

2. AMENDMENT/MODIFICATION NUMBER

CODE

6. ISSUED BY

8. NAME AND ADDRESS OF CONTRACTOR

4. REQUISITION/PURCHASE REQ. NUMBER

3. EFFECTIVE DATE

9A. AMENDMENT OF SOLICITATION NUMBER

9B. DATED

PAGE OF PAGES

10A. MODIFICATION OF CONTRACT/ORDER NUMBER

10B. DATED

BPA NO.

1. CONTRACT ID CODE

FACILITY CODE

CODE

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 ITEM 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 reference 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

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

16A. NAME AND TITLE OF CONTRACTING OFFICER

15B. CONTRACTOR/OFFEROR

STANDARD FORM 30

PREVIOUS EDITION NOT USABLE

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)

(X)

CHECK

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) A00006 02-26-2020

NONE

Department of Veterans Affairs Network Contracting Office 10 8888 Keystone Crossing Suite 1100 Indianapolis

IN

46240 Department of Veterans Affairs Network Contracting Office 10 8888 Keystone Crossing Suite 1100 Indianapolis

IN

46240 To all Offerors/Bidders

36C25019R0093 12-06-2019

X X

X 1 (one) The purpose of this amendment is to answer contractor questions. Please see the attached (beginning on page 2) for all of the questions and thier respective answers. This amendment answers questions received from 2/14/20 through 2/21/20.

Questions received on 2/24/20 will be posted in a separate amendment. This amendment is not being extended because amendment A00005 has provided the extension to March 17, 2020 at 3pm ET.

Lisa Bailey Contracting Officer Questions Received from Vendors for the Week of 2.14.20 – 2.21.20

1. The answers to questions 35 and 74 appear to provide conflicting information. The answer to question 35b states that one copy of each proposal part should be submitted, while the answer to question 74 states “Please provide one binder for the price factor and 3 binders for the non-price factors portion.” We additionally note that the answer to 37 indicates that the three Factors that comprise the Non-Price Response are to be submitted in one binder. Accordingly (in consideration of the VAs intention related to answers to questions 35, 37 and 74) we request clarification of the following:

a. Should all factors included in the Non-Price Response be submitted in the same binder? Yes, all non-price factors should be included in the same binder.

b. How many copies of the Non-Price Response are to be submitted? Three (3) identical non price binders shall be submitted.

2. The answer to question 37 states, “Yes, please redact or remove any marks that would indicate your company’s name/logo.” However, page 138 of the Solicitation requires “The 1-page cover page shall include the name and address of the organization submitting the proposal and point(s) of contact to include e-mail address and phone number.” to be submitted with the Non-Price Response. Accordingly, we request clarification of the following:

a. Is it the Government’s intention for this one-page cover sheet to be the only part of the Non-Price response to include the offeror’s name? Please only include this cover page on the price response as that is for the CO’s knowledge. An amendment to remove the cover page from the non-price response is to follow.

b. Is it acceptable to identify the offeror’s name on the outside of the binder? No, these will be blind evaluations and we don’t want any identifying information on the non-price binders.

3. Based on the answers to question 65 and 73, we did wish to request confirmation of the following:

a. That locations in Kosciusko County that are northeast of Warsaw, but happen to fall outside the city limits of Warsaw, are acceptable. Any potential site in Kosciusko county must be within US Congressional District 2.

b. That locations in Elkhart County that are southeast of Goshen, but happen to fall outside the city limits of Goshen, are acceptable. Any potential site in Elkhart County will be South and East of the intersection of County Roads 15 and 28 (This point is near the northwest corner of Goshen city limits).

4. Question 63 in Amendment 3 states, “The RFP calls for four consult rooms and two women’s health rooms. Are these six rooms separate or can they be included in the PACT team exam room counts?” and the answer provided is “These are included in the PACT room counts.” However, page 4 of Amendment 4 requires four (4) consult rooms; eight (8) PACT exam rooms, and two (2) Women’s health exam rooms. Accordingly, please clarify the following:

a. Is it acceptable for the clinic to have four (4) consult rooms; six (6) PACT exam rooms, and two (2) Women’s health exam rooms (such that the Women’s health exam rooms are also PACT exam rooms)? As long as two exam rooms are equipped for Women’s Health (restroom and pap smear table) they can be included in the PACT rooms

5. The tables on pages 3-6 of Amendment 4 replacing section 4.9.1 of the original Solicitation contain significant new information. In review of the new requirements, we have the following questions:

a. The square footage required for vestibule (200 square feet) and waiting area (1,260 + 225 = 1,485 square feet) seems to be excessive compared to VA size requirements for other similarly sized CBOCs. Would the VA consider reducing these minimum requirements? No, considering this clinic will be built for 4 PACT teams, the VA feels this area is adequate.

b. There seems to be a total of five (5) storage rooms requested with a total of 500 square feet: one (1) Storage, Shared Medical Appointment Room (page 4); one (1) Storage, Medical Equipment (page 5); one (1) Storage, General (page 5) and two (2) Storage Area, Logistics PACT 1 (page 6). What is the anticipated function of the “Storage, Shared Medical Appointment Room”? This is a storage room for the Shared Medical Appointment Room; which may be utilized to store equipment, supplies, etc. The PACT Space Module Design Guide (see solicitation section 4.9, page 76 for the weblink) describes the functions of the Shared Medical Appointment Room.

c. Based on smaller storage room requirements for other similarly sized CBOCs, would the VA consider reducing the number of storage rooms required? No, as this is the new PACT model.

d. Is it acceptable to combine more than one storage room into a single contiguous space that meets the square footage requirements? As required in the solicitation, the space proposed shall meet the requirements of the PACT Space Module Design Guide (see solicitation section 4.9, page 76 for the weblink).

e. For “Consult Room, Mental Health”, the quantity is listed as 6 and the unit area is listed 125. Please confirm that the net area for these rooms should be 750 square feet.

Confirmed, the net area is 750 sq. ft.

f. For “Storage Area, Logistics PACT 1”, the quantity is listed as 2 and the unit area is listed 125. Please confirm that the net area for these rooms should be 250 square feet. Verified with Logistics that one (1) room is sufficient, net area 125sq ft. An amendment to update this is to follow.

g. Is the “Communications Room” on page 6 the same room as the Network/Data Room required by section 4.11.2 of the Solicitation? Yes, it is the same room.

h. Per the answer to question 30 in Amendment 3, the Contractor is to provide the phone system for the clinic. Can the contractor’s phone system be co-located with the VA’s equipment in the Communications Room? Or is there a requirement for a separate room for the Contractor’s phone system above and beyond the “Communications Room” listed on page 6 of Amendment 4? No, the contractor phone system cannot be co-located with VA equipment. The VA equipment shall have its own room. Specifications for this room are listed in section 4.6.2.

i. The only space requirement for medication seems to be the “Alcove, Medication” on page 4. Is there a separate requirement for a locked medication room? If so, what is the square footage required for this room? We are working on verifying this to see if this alcove is planned to be the locked Medication Room or if there is supposed to be a separate locked medication room. An updated answer will be posted via a separate amendment. To clarify for now: At minimum, there has to be a locked medication room and per the PACT Space Module Design Guide it requires a sink, fridge, counter, etc. (please see the Design Guide for all specifics). the alcove appears to be for pyxis or Omnicell; but Goshen isn’t going to have a automated medication system. With that, Amy is going to verify if we need a separate locked med room or if the alcove is sufficient.

6. We note that extensive adjustments to the Solicitation space requirements were provided by Amendments 3 and 4, issued February 13, and there are additional follow-on clarifications also now being submitted in order to assure correct understanding of these space requirements as provided in Amendments 3 and 4. In view of the fact that significant steps must be performed by the Contractor in follow-up to receipt of finalized space/room count information related to space vendor negotiation, architectural layout, and applicable approval processes related to proposed space designs, would the Government consider providing a timeframe of 30 days between issuance of Amendment 4 and/or any adjustment which may be issued thereto and receipt date for offers? An amendment has been issued to extend the due date of the solicitation to 3/17/20 at 3pm ET. This amendment also included the Question and Answer period, stating that all questions shall be submitted by 2/24/20.

7. Question 18 states that 1,799 CIC referrals have been issued for the Goshen CBOC.

a. Please clarify whether 1,799 referrals is for the Goshen CBOC only.

Yes, this is just for the Goshen CBOC

b. If not, please provide the number of referrals specific to the Goshen CBOC only.

c. Please provide the number of Goshen CBOC referrals for primary care since implementation of the Mission Act. There was only one (1).

8. Question 33 states that 2,584 veterans are currently on the billable roster. Question 41 states that for the most recent three months (Sep-Nov) enrollment has been 2,612, 2,633, and 2,584, respectively. These enrollment figures reflect at the most a difference of 634 enrollees less than the Base Year CLINs of 3,218, and, at the least, a difference of 585 from the Base Year CLINs. The VA’s online database shows the clinic’s billable enrollment has declined steadily over the past five years from 3,333 in 2015. Several answers in the Amendments state that the VA does not expect Goshen CBOC enrollment to grow due to an aging population of veterans.

The VA does however anticipate an increase of users based on the veteran population in the area. As stated previously.

a. If not, please explain why the Government believes the new contractor will be able to grow enrollment by 634 in the first year and then will experience a decline in enrollment? The 3,218 enrollees are based on a national projection based on veterans in the area. The VA believes the veterans in the area are using other VA facilities and/or private providers that may be closer to their homes. It is anticipating the new clinic will bring those veterans.

b. Will the Government adjust the CLINs to reflect the current billable enrollment? No, the CLINs will reflect the projected number of users provided by the national database.

c. If the Government will not change the CLINs to reflect current enrollment, is the expectation that the contractor will add an additional PACT team (a fifth team) in the first year in order to be able to vest this influx of new enrollees? The space requirement is for 4 PACT teams.

9. The requirement of 2 FTE lab tech/phlebotomists seems disproportionate to the CBOC enrollment. Will the Government accept 1 FTE lab tech/phlebotomist for the Goshen CBOC? The VA would accept 1.5 FTE to allow the .5 FTE to provide back-up for lunches, leave etc.

10. Question 62 cites Section 4.9.16.1.2 and states that the required setback distance of the site to the bollards for physical security is 25 feet. “Setback distance from the face of the Building's exterior to the protected/defended perimeter (i.e., any potential point of explosion). This means the distance from the Building to the curb or other boundary protected by bollards, planters or other street furniture. Such potential points of explosion may be, but are not limited to, such areas that could be accessible by any motorized vehicle (i.e., street, alley, sidewalk, driveway, parking lot).”

a. Due to lack of availability of physical locations, will the Government consider allowing bollards to be placed 10- to 12-feet from the building provided any windows are covered with blast resistant film? If not, please extend the due date by at least 30 days to allow contractors to find other locations. As stated under Amendment A00003, the requirement is for 25 feet and blast resistant film cannot be used as an equivalent for this set back.

11. Amendment 4 makes substantial changes to the space and room requirements. The new requirements pose a set of unanticipated challenges to our selected site that will likely require us to find a new location. Or if we are able to continue with the selected site, substantial adjustments to the space and the usage agreement with the landlord will be necessary. In either case, the VA’s revised room requirements leave us no choice but to substantially revise our floor plan.

a. Will the Government extend the proposal due date by a minimum of 25 calendar days to allow for these changes? Please see the answer to #6 above.

12. The requirement of three toilets in the reception area is a substantial change from traditional Reception/Waiting Room requirements.

a. Will two toilets or one unisex toilet in the reception area be acceptable to the Government? No, the VA requires one male, one female, and one unisex toilet.

13. Amendment 4 requires a Shared Medical Appointment Room of 400 square feet and a behavioral health room of 300 square feet. Will one 400 room suffice? We do not see the behavioral health room listed in the updated PACT Table from Amendment A0004. There is Group Therapy Room of 300 sq. ft. for Mental Health and these two rooms should not be shared.

14. Please indicate type of phone that the contractor will be responsible for providing.

The contractor should provide a telephone system that can support multiple lines and forwarding capabilities, such as a NEC, or equivalent, telephone system.

15. Question 35 says only one copy of each part of the proposal is needed. Question 75 says provide one binder for the price factor and three (3) binders for the non-price factors.

a. Please clarify the number of copies required for each part. Please see the answer to #1 above.

b. Is a CD required? The RFP does not address this. No.

16. In Question/Answer 21, starting on page 3 of Amendment 3, there is a table with the heading “Vaccines”. We cannot tell if this table was provided by the vendor who submitted question 21 or if this table is being provided by the Government in answer to question 21, and accordingly, we submit the following questions:

a. Is the list of vaccines in the first column being provided by the Government? Currently, yes. This solicitation requires the vendor to be responsible for all vaccines.

b. Does this list indicate the full list of vaccines that are the responsibility of the contractor? Yes

c. Are the quantities and prices in the middle column provided by the Government? Yes, these are the prices that the Government’s paying.

d. Do the quantities in the middle column indicate the total quantities estimated by the Government to be needed for the Goshen CBOC? Yes

e. What time period are these quantities estimated for, e.g. one month of performance, one year of performance, etc.? The middle column indicates the frequency and last column is the total per year (with the exception of the Pneumovax 23 which states the monthly cost @ $565.25/box x 3 boxes/month with a total of $1,695.75/month. The yearly cost is $1695.75 x 12 = $20,349).

f. Do the prices in the middle column indicate the prices that the Government estimates these vaccines will cost the Contractor? Where does this price information come from and is it a source that the Contractor would be able to purchase from? (We note for comparison purposes that, under a volume discount we receive from our supplier, we are able to obtain the following prices, for example: Tdap - $42.36 each; Hepatitis A - $71.63 each; Hepatitis B - $61.96 each; Influenza - $18.15 each.) No, this is what the Government is currently paying. The contractor will need to obtain their own supplier and pricing.