36C25026R0012.docx

36C25026R0012

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

UEI:

EFT:

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. NOV 2021)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

OFFEROR TO COMPLETE BLOCKS 12, 17, 23, 24, & 30

583-26-1- 36C25026R0012 03-13-2026 Kristina L. Peart 734-845-3444 04-10-2026 13:00

EDT

Department of Veterans Affairs Network Contracting Office 10 24 Frank Lloyd Wright Drive Lobby M, Suite M2200 Ann Arbor, MI 48105 X X 621320 $9 Million N/A X Department of Veterans Affairs VISN 10 Optical Lab 5610 Dividend Road Suite B Indianapolis IN 46241 Department of Veterans Affairs Network Contracting Office 10 24 Frank Lloyd Wright Drive Lobby M, Suite M2200 Ann Arbor, MI 48105

See Invoices section

N/A N/A See CONTINUATION Page See Section B.4 Price Schedule The Contractor shall provide Optical Dispensary Services for IN/MI VA Medical Centers in VISN 10.

FAR Parts 12 and 15 are being using to conduct this procurement.

See Instructions to Offerors in Section E.

Questions shall not be submitted after 3/23/2026 - All questions will be answered via amendment to the solicitation posted to Contract Opportunities.

See CONTINUATION Page X X One(1) Kristina L. Peart Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(Continuation from Standard Form 1449, block 18A.)

1. Contract Administration: All contract administration matters will be handled by the following individuals:

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

3. INVOICES: Invoices shall be submitted in arrears via tungsten:

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. Tungsten Network: https://www.tungsten-network.com/customer-campaigns/veteransaffairs

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

AMENDMENT NO DATE

B.2 ELECTRONIC INVOICE SUBMISSION AND INVOICING

VENDOR ELECTRONIC INVOICE SUBMISSION REQUIREMENTS AND METHODS

E-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below:

1. VA’s Electronic Invoice Presentment and Payment System – the FSC uses a third-party contractor, Tungsten Network (referred to OB10), to transition vendors from paper to electronic invoice submission. Please go to website: https://www.tungsten-network.com/customer-campaigns/veteransaffairs to enroll in the program and begin submitting the electronic invoices, free of charge.

1. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI). The X12 EDI website is: http://www.x12.org

1. Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have questions about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:

2. Tungsten e-Invoice Setup Information: 1-877-489-6135

2. Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com

2. FSC e-Invoice Contact Information: 1-877-353-9791

2. FSC e-Invoice email: vafsccshd@va.gov

BILLING AND INVOICING

1. In accordance with this contract, all services shall be billed in arrears monthly.

2. Contractor shall only bill for services and for line-items delivered.

3. A proper invoice that is submitted for payment; shall be accepted and certified for payment if:

i. Monthly invoice is submitted in arrears, no later than the 20th business day of the following month that services were rendered.

ii. Invoice contains in addition to the information required for submission of a ‘proper’ invoice in accordance with FAR 52.212-4(g) the following information:

a. Name and Address of the Contractor

b. Invoice Date and Invoice Number

c. Contract Number

d. Contract Order Number

e. Purchase Order Number

f. Date Range of Services Provided

g. Description of Services Provided

h. Line/Sub-Line Item number(s) of services provided

i. Quantity of each Line/Sub-Line Item

j. Unit Rate for each Line/Sub-Line Item

k. Total Cost for each Line/Sub-Line Item

l. Total Invoice Cost

4. The Certifying Official will confirm the information in the submitted invoice to the contract and invoice to ensure it is correct and valid.

i. If the invoice submitted is not a proper invoice, the certifying official shall refuse the invoice with a detailed statement as to why the invoice was refused.

ii. Contractor shall make corrections and resubmit using a separate invoice number, notating the invoice number it is replacing.

B.3 CONTRACTOR PERFORMANCE ASSESSMENT REPORTING SYSTEM (CPARS)

As prescribed in FAR Part 42.15, the Department of Veterans Affairs (VA) evaluates contractor past performance on all contracts and contracts that exceed $250,000.00 and shares those evaluations with other Federal Government contract specialists and procurement officials. The FAR requires that the contractor be provided an opportunity to comment on past performance evaluations prior to each report closing. To fulfill this requirement VA uses an online database, CPARS, which is maintained by the Naval Sea Logistics Center in Portsmouth, New Hampshire. CPARS is the system used to collect and retrieve performance assessment reports used in source selection determinations. CPARS also includes access to Federal Awardee Performance and Integrity Information System (FAPIIS). FAPIIS is a web-enabled application accessed via CPARS for contractor responsibility determination information.

Each contractor whose contract award is estimated to exceed $250,000.00 requires a CPARs evaluation. A government Focal Point will register your contract within 30 days after award and, at that time, you will receive and email message with a User ID (to be used when reviewing evaluations). Additional information regarding the evaluation process can be found at www.cpars.gov or if you have any questions, you may contact the Customer Support Desk at DSN: 684-1690 or COMM: 207-438-1690.

For contracts with a period of one year or less, the contracting officer will perform a single evaluation when the contract is complete. For contracts exceeding one year, the contracting officer will evaluate the contractor’s performance annually. Interim reports will be filed each year until the last year of the contract, when the final report will be completed. The report shall be assigned in CPARS to the contractor’s designated representative for comment. The contractor representative will have 60 days to submit any comments and re-assign the report to the CO.

Failure for the contractor’s representative to respond to the evaluation within those 60 days will result in the governments evaluation being placed on file in the database with a statement that the contractor failed to respond. The Contractor’s representative will be locked out of the evaluation and may no longer send comments.

B.4 PRICE/COST SCHEDULE INFORMATION

Contractor shall provide all necessary labor, management, equipment, deliverables, and support to provide Optical Dispensary Services in accordance with the Performance Work Statement.

Estimated Quantities: The Government has provided their best estimate as to the number of items/units that will be required. The need for services may change due to needs of the medical center. There is no guarantee that the exact number items/units listed in the price schedule will be ordered.

Minimum Guarantee: The minimum guarantee for each contract is $1,000.00 in the initial fiscal year the contact is awarded. The Government does not guarantee that it will place any orders under this contract in excess of the guaranteed minimum award amount.

Maximum Contract Value: The maximum value for Indiana is $10,100,000.00. The maximum contract value for Michigan is $6,700,000.00.

· All payments for services rendered shall be paid in accordance with the Electronic Invoice Billing section of the Contract.

B.5 PRICE/COST SCHEDULE

ITEM INFORMATION

Dispensing Services VA Indiana Healthcare System Richard L. Roudebush VA Medical Center 1481 W. 10th Street Indianapolis, IN Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027 PRINCIPAL NAICS CODE: 621320 - Offices of Optometrists PRODUCT/SERVICE CODE: Q511 - Medical - Ophthalmology and Optometry

Dispensing Services VA Northern Indiana Healthcare System Ft. Wayne Campus 2121 Lake Avenue Ft. Wayne, IN 46805-5100 Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Marion Campus 1700 East 38th Street Marion, IN Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Jackie Walorski VA Clinic 1540 Trinity Place Mishawaka, IN 46545 Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Brownsburg CBOC 557 Pitt Rd.

Brownsburg, IN 46112 Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Wakeman VA Clinic 3871 10th Street Edinburgh, IN Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Shelbyville CBOC 2158 Intelliplex Dr. #200 Shelbyville, IN Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Bloomington VA Clinic 3098 N Lintel Drive Bloomington, IN Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Lafayette VA Clinic 930 Park East Blvd.

West Lafayette, IN Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Terre Haute VA Clinic 5080 East Bill Farr Drive Terre Haute, IN 47802 Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Hoosier VA Clinic 1496 West Hoosier Blvd.

Peru, IN Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

John D. Dingell VA Medical Center 4646 John R Street Detroit, MI 48201-1916 Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

VA Ann Arbor Health Care System Lieutenant Colonel Charles S. Kettles VA Medical Center 2215 Fuller Road Ann Arbor, MI 48105-2303 Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

VA Ann Arbor Healthcare System Toledo VA Outpatient Clinic 3333 Glendale Avenue Toledo, OH 43614 Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

VA Battle Creek Healthcare System Battle Creek VA Medical Center 5500 Armstrong Road Battle Creek, MI 49037-7314 Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

VA Battle Creek Healthcare System Wyoming Community-Based Outpatient Clinic 5838 Metro Way Wyoming, MI 49519 Contract Period: Ordering Period One (1) POP Begin: 05-01-2026 POP End: 04-30-2027

Dispensing Services

Richard L. Roudebush VA Medical Center 1481 W. 10th Street Indianapolis, IN Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Ft. Wayne Campus 2121 Lake Avenue Ft. Wayne, IN 46805-5100 Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Marion Campus 1700 East 38th Street Marion, IN Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Jackie Walorski VA Clinic 1540 Trinity Place Mishawaka, IN 46545 Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Brownsburg CBOC 557 Pitt Rd.

Brownsburg, IN 46112 Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Wakeman VA Clinic 3871 10th Street Edinburgh, IN Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Shelbyville CBOC 2158 Intelliplex Dr. #200 Shelbyville, IN Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Bloomington VA Clinic 3098 N Lintel Drive Bloomington, IN Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Lafayette VA Clinic 930 Park East Blvd.

West Lafayette, IN Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Terre Haute VA Clinic 5080 East Bill Farr Drive Terre Haute, IN 47802 Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Hoosier VA Clinic 1496 West Hoosier Blvd.

Peru, IN Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

John D. Dingell VA Medical Center

Detroit, MI 48201-1916 Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

VA Ann Arbor Health Care System

2215 Fuller Road Ann Arbor, MI 48105-2303 Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

VA Ann Arbor Healthcare System

3333 Glendale Avenue Toledo, OH 43614 Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

VA Battle Creek Healthcare System

5500 Armstrong Road Battle Creek, MI 49037-7314 Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

VA Battle Creek Healthcare System

5838 Metro Way Wyoming, MI 49519 Contract Period: Ordering Period Two (2) POP Begin: 05-01-2027 POP End: 04-30-2028

Dispensing Services

Richard L. Roudebush VA Medical Center 1481 W. 10th Street Indianapolis, IN Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Ft. Wayne Campus 2121 Lake Avenue Ft. Wayne, IN 46805-5100 Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Marion Campus 1700 East 38th Street Marion, IN Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Jackie Walorski VA Clinic 1540 Trinity Place Mishawaka, IN 46545 Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Brownsburg CBOC 557 Pitt Rd.

Brownsburg, IN 46112 Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Wakeman VA Clinic 3871 10th Street Edinburgh, IN Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Shelbyville CBOC 2158 Intelliplex Dr. #200 Shelbyville, IN Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Bloomington VA Clinic 3098 N Lintel Drive Bloomington, IN Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Lafayette VA Clinic 930 Park East Blvd.

West Lafayette, IN Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Terre Haute VA Clinic 5080 East Bill Farr Drive Terre Haute, IN 47802 Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Hoosier VA Clinic 1496 West Hoosier Blvd.

Peru, IN Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

John D. Dingell VA Medical Center

Detroit, MI 48201-1916 Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

VA Ann Arbor Health Care System

2215 Fuller Road Ann Arbor, MI 48105-2303 Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

VA Ann Arbor Healthcare System

3333 Glendale Avenue Toledo, OH 43614 Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

VA Battle Creek Healthcare System

5500 Armstrong Road Battle Creek, MI 49037-7314 Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

VA Battle Creek Healthcare System

5838 Metro Way Wyoming, MI 49519 Contract Period: Ordering Period Three (3) POP Begin: 05-01-2028 POP End: 04-30-2029

Dispensing Services

Richard L. Roudebush VA Medical Center 1481 W. 10th Street Indianapolis, IN Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Ft. Wayne Campus 2121 Lake Avenue Ft. Wayne, IN 46805-5100 Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Marion Campus 1700 East 38th Street Marion, IN Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Jackie Walorski VA Clinic 1540 Trinity Place Mishawaka, IN 46545 Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Brownsburg CBOC 557 Pitt Rd.

Brownsburg, IN 46112 Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Wakeman VA Clinic 3871 10th Street Edinburgh, IN Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Shelbyville CBOC 2158 Intelliplex Dr. #200 Shelbyville, IN Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Bloomington VA Clinic 3098 N Lintel Drive Bloomington, IN Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Lafayette VA Clinic 930 Park East Blvd.

West Lafayette, IN Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Terre Haute VA Clinic 5080 East Bill Farr Drive Terre Haute, IN 47802 Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Hoosier VA Clinic 1496 West Hoosier Blvd.

Peru, IN Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

John D. Dingell VA Medical Center

Detroit, MI 48201-1916 Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

VA Ann Arbor Health Care System

2215 Fuller Road Ann Arbor, MI 48105-2303 Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

VA Ann Arbor Healthcare System

3333 Glendale Avenue Toledo, OH 43614 Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

VA Battle Creek Healthcare System

5500 Armstrong Road Battle Creek, MI 49037-7314 Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

VA Battle Creek Healthcare System

5838 Metro Way Wyoming, MI 49519 Contract Period: Ordering Period Four (4) POP Begin: 05-01-2029 POP End: 04-30-2030

Dispensing Services

Richard L. Roudebush VA Medical Center 1481 W. 10th Street Indianapolis, IN Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Ft. Wayne Campus 2121 Lake Avenue Ft. Wayne, IN 46805-5100 Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Marion Campus 1700 East 38th Street Marion, IN Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Jackie Walorski VA Clinic 1540 Trinity Place Mishawaka, IN 46545 Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Brownsburg CBOC 557 Pitt Rd.

Brownsburg, IN 46112 Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Wakeman VA Clinic 3871 10th Street Edinburgh, IN Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Shelbyville CBOC 2158 Intelliplex Dr. #200 Shelbyville, IN Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Bloomington VA Clinic 3098 N Lintel Drive Bloomington, IN Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Lafayette VA Clinic 930 Park East Blvd.

West Lafayette, IN Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Terre Haute VA Clinic 5080 East Bill Farr Drive Terre Haute, IN 47802 Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Dispensing Services

Hoosier VA Clinic 1496 West Hoosier Blvd.

Peru, IN Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

John D. Dingell VA Medical Center

Detroit, MI 48201-1916 Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

VA Ann Arbor Health Care System

2215 Fuller Road Ann Arbor, MI 48105-2303 Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

VA Ann Arbor Healthcare System

3333 Glendale Avenue Toledo, OH 43614 Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

VA Battle Creek Healthcare System

5500 Armstrong Road Battle Creek, MI 49037-7314 Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

VA Battle Creek Healthcare System

5838 Metro Way Wyoming, MI 49519 Contract Period: Ordering Period Five (5) POP Begin: 05-01-2030 POP End: 04-30-2031

Ordering Period One (1)

Ordering Period Two (2)

Ordering Period Three (3)

Ordering Period Four (4)

Ordering Period Five (5)

Total of All Ordering Periods:

36C25026R0012

Page 1 of Page 1 of

B.6 PERFORMANCE WORK STATEMENT (PWS)

Veterans Integrated Service Network (VISN) 10: Indiana, and Michigan, Optical Dispensing Services

PART 1

GENERAL INFORMATION

Executive Summary:

Services are presently being provided to the VISN10 VA Medical Centers (VAMCs). With these present contracts, Contractors supply and manage their staff assigned to the various VA facilities to provide Optical Dispensing services to the Veterans serviced by VISN10 in the states of Indiana and Michigan and their associated Community Based Outpatient Clinics. Contractor’s staff is located within office space provided by the various VAMCs serviced by this contract. The Contractor’s staff are fully vetted, and VA PIV badged, and utilize the Government provided computers to conduct the administrative portion of their duties and responsibilities related to the contract. Contractor’s staff (Opticians) assist Veterans in frame selection, measurement, fit, and submit/enter eye glass orders to the VISN10 Optical lab for the fabrication of the eyeglasses. Lastly, the Contractors deliver and ensure that the Veterans are satisfied with the eyeglasses provided.

1.0 General:

This is a nonpersonal services contract to provide optical dispensing services for the VAMCs, and Clinics. The Government shall not exercise any supervision or control over the personnel performing the services described herein. Such personnel shall be accountable solely to the Contractor.

Description of Services/Introduction:

The Contractor shall provide all labor, equipment, materials, supplies, transportation, and supervision, necessary for eyeglass dispensary services, to include functions such as fitting, ordering, adjusting, dispensing, repairing (minor), and education of Veterans, in the service area, as defined in this PWS, except for those items specified as Government-furnished property and services. The Government will provide spaces for performance as listed in 4.0.3 Facilities.

1.1 Background:

The Veterans Integrated Service Network (VISN) 10 Prosthetics Program fabricates eyeglasses for the VAMCs and their supporting clinics. While the eyeglasses are manufactured at the VISN 10 Optical Lab, VISN 10 requires on-site dispensing services. The Contractor shall provide all labor, equipment, materials, supplies, and supervision necessary for eyeglass dispensary services, to include functions such as fitting, ordering, adjusting, dispensing, repairing (minor), and education of Veterans.

1.2 General Information:

1.2.1 Quality Control:

The Contractor shall develop and maintain an effective Performance Monitoring Plan to ensure services are performed in accordance with this PWS. The Contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective services.

1.2.2 Quality Assurance:

The Government shall evaluate the Contractor’s performance under this contract in accordance with the Quality Assurance Surveillance Plan (QASP). 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 quality level.

1.2.3 Recognized Holidays:

Independence Day **and any other day declared by the President of the United States as a Federal Holiday**

1.2.4 Hours of Operation:

The Contractor shall conduct business during the hours a VA Optometrist is present/providing services at each site the Contractor is supporting. Minimal days of operation required are outlined in section 4.0.3 of this PWS. This includes the hours when the site is in operation and/or open for appointments, Monday through Friday. If the Contracting Officer’s Representative (COR) determines the volume of optical orders warrants additional coverage beyond Monday through Friday, additional hours will need to be added via modification of the contract. The schedule of days and hours of operation shall be mutually agreed upon between Contractor and COR. For locations that are open part time, the Contractor shall establish consistent on-site hours of operation. The Contractor shall not conduct business on the recognized holidays listed in section 1.2.3, or when the Government facility is closed due to local or national emergencies, administrative closures, or similar Government-directed facility closures or moves. The Contractor shall maintain an adequate workforce for the uninterrupted performance of all tasks defined within this PWS when the Government facility is not closed for the reasons identified in this section. An adequate workforce includes operating hours as well as staffing levels to support workload demand. When hiring personnel, the Contractor shall keep in mind that the stability and continuity of the workforce are essential to successful performance.

1.2.5 Place of Performance:

The work to be performed under this contract shall be performed at *:

Southern Tier Sites VA Indiana Healthcare System Richard L Roudebush VAMC (Indianapolis, IN) 1481 West 10th St. Indianapolis, IN 46202

VA Indiana Healthcare System Bloomington Clinic 3098 N Lintel Dr. Bloomington, IN 47404

VA Indiana Healthcare System Brownsburg Clinic 557 Pitt Rd. Brownsburg, IN 46112

VA Indiana Healthcare System Terre Haute Clinic 5080 East Bill Farr Dr. Terre Haute, IN 47803

VA Indiana Healthcare System Shelbyville Clinic 30W Rampart RD, Shelbyville, IN 46176

VA Indiana Healthcare System Wakeman Clinic 3871 10th St. Edinburgh, IN 46124

VA Indiana Healthcare System West Lafayette Clinic 930 Park East Blvd. West Lafayette, IN 47905

Northern Tier Sites

VA Ann Arbor Health Care System Lieutenant Colonel Charles S. Kettles VA Medical Center 2215 Fuller Road, Ann Arbor, MI 48105

VA Ann Arbor Healthcare System Toledo VA Outpatient Clinic 3333 Glendale Avenue, Toledo, OH 43614

VA Battle Creek Healthcare System Battle Creek VA Medical Center 5500 Armstrong Road, Battle Creek, MI 49037

Battle Creek Healthcare System Wyoming VA Healthcare System 5838 Metro Way, SW, Wyoming, MI 49519

*These locations may change throughout the life of the contract as the needs of the Government change. This contract covers any site moves or Government-furnished space changes and/or additions deemed fair and reasonable by the Contracting Officer (CO). Any changes to the contract shall be mutually agreed upon by the Government and Contractor via a bilateral modification to the contract.

1.2.6 Type of Contract:

The Government intends to award one (1) or more Indefinite Delivery Indefinite Quantity Contract(s).

a. The Contractor will receive written orders from the prescribing VA physician;

b. Each Contractor will receive written orders from their respective awarded locations at VA facilities;

1.2.7 Security Requirement and Background Checks:

I. ACCESS TO PATIENT INFORMATION: In performance of official duties, Contractor’s providers(s) have regular access to printed and electronic files containing sensitive data, which must be protected under the provisions of the Privacy Act of 1974 (5 U.S.C. 552a), and other applicable laws, Federal Regulations, Veterans Affairs statutes and policies. Contractor’s employee(s) are responsible for (1) protecting that data from unauthorized release or from loss, alteration, or unauthorized deletions and (2) following all applicable regulations and instructions regarding access to computerized files, release of access codes, etc. , as set out in a computer access agreement which contract employee(s) signs.

II. CONFIDENTIALITY OF PATIENT RECORDS:

i. The Contractor is a VA Contractor and shall assist in the provision of healthcare to patients seeking such care from or through VA. As such, the Contractor is considered as being part of the Department health care activity. Contractor is considered to be a VA Contractor for purposes of the Privacy Act, Title 5 U.S.C. 552a. Further, for the purpose of VA records access and patient confidentiality, Contractor is considered to be a VA Contractor for the following provisions: Title 38 U.S.C. 5701, 5705, and 7362. Therefore, Contractor may have access as would other appropriate components of VA., to patient medical records including patient treatment records pertaining to drug and alcohol abuse, HIV, and sickle cell anemia, to the extent necessary to perform its contractual responsibilities. However, like other components of the Department and not withstanding any other provisions of the contract, the Contractor is restricted from making disclosures of VA records, or information contained in such records, to which it may have access, except to the extent the explicit disclosure authority from VA has been received. The Contractor is subject to the same penalties and liabilities for unauthorized disclosure of such records as VA.

ii. The records referred to above shall be and remain the property of the VA and shall not be removed or transferred from VA except in accordance with U.S.C. 551a (Privacy Act), 38 U.S.C. 5705 (Confidentiality of Certain Medical Records) and federal laws, rules and regulations. Subject to applicable federal confidentiality or privacy laws, the Contractor, or their designated representatives of federal regulatory agencies having jurisdiction over Contractor, may have access to VA’s records, at VA’s place of business on request during normal business hours, to inspect and review and make copies of such records.

III. HIPPA COMPLIANCE: Contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPPA) of 1996 and the National Standards to Protect the Privacy and Security of Protected Health information (PHI). As required by HIPPA, the Department of Health and Human Services (HHS) has promulgated rules governing the security and use and disclosure of protected health information by covered entities, including the Department of Veterans Affairs (VA).

Once TMS training is completed and training certificates for the required information security and privacy training courses are provided to the COR, and the VISN 10 Unified Access Request form has been submitted by the COR, the Contractor may be granted access to the Veterans Health Information Systems and/or previous prescription data needed for prescriptions, troubleshooting fitting, etc. The appropriate access is determined by the COR.

Background Check will be conducted in accordance with the PDAT generated by the COR and follow the Information Security background policy in Section C.1.2. a-e.

The Contractor shall maintain control over any Government-issued items, including the following:

· Keys

· Government Computers

· Sample Eyeglass Frames

All items and Government areas shall be secured when not in use.

1.2.8 Special Qualifications:

Contractor shall be qualified to educate and assist the Veterans in the proper choice, use, and care of their eyewear. In addition to frame selection, the Contractor shall be responsible for all measurements and fitting of eyewear. Appropriate state licensure/certifications shall be required in the State of Ohio. Contractor shall provide appropriate professional business license(s) within the state or states required per each facility serviced. Contractor shall also comply with any other federal, state, and local law applicable to the industry.

1.2.9 Post Award Conference/Periodic Progress Meetings:

The Contractor agrees to attend any post award conference convened by the contracting activity, in accordance with Federal Acquisition Regulation Subpart 42.5. The CO, COR, and other Government personnel shall meet yearly with the Contractor to review the Contractor's performance. COR may meet with Contractor more frequently if necessary. At these meetings, the CO will apprise the Contractor of how the Government views the Contractor's performance and the Contractor shall apprise the Government of problems, if any, being experienced. Appropriate action shall be taken to resolve outstanding issues. These meetings shall be attended at no additional cost to the Government.

1.2.10 Contracting Officer Representative (COR):

The COR will be identified by separate letter. The COR monitors all technical aspects of the contract and assists in contract administration. The CO will issue an appointment letter to the COR and a copy will be provided to the Contractor. This appointment letter will state the responsibilities and limitations of the COR. The COR is not authorized to change any of the terms and conditions of the contract.

1.2.11 Key Personnel:

The following personnel are considered key personnel by the Government:

A Prosthetics and Sensory Aids Service (PSAS) Representative will be located at each of the VAMC facilities. Contact information for the PSAS Representative will be provided to the Contractor upon contract award. A PSAS Representative has the exclusive responsibility for determining eligibility and necessity for VA Prosthetic goods and services, e.g., eyeglasses. The PSAS Representative also coordinates and resolves problems related to such goods and services. Any matter that cannot be resolved by a PSAS Representative will be referred to the COR. Any matter that cannot be resolved by the COR will be referred to the CO.

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 COR. 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 during regular working hours, Monday through Friday except on the recognized holidays listed in section 1.2.3 or when the Government facility is closed due to local or national emergencies, administrative closures, or similar Government-directed facility closures or moves. The Contractor shall identify key personnel for performance under the contract with 10 days of award.

1.2.12 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. All contract personnel shall wear identification on the outside of their attire while under performance under this contract. The identification tag shall indicate that he or she is a Contractor and include his or her first and last name. These may be either Government (Contractor Personal Identity Verification (PIV)) or Contractor-issued identification tags.

1.2.13 Contractor Required Dress Code:

All employees involved in the performance under this contract shall dress in accordance with the policies of the VAMC and Clinics at which they perform under the contract.

PART 2

DEFINITIONS & ACRONYMS

2.0 Definitions and Acronyms

2.0.1 Definitions:

· ACCEPTABLE QUALITY LEVEL (AQL). The AQL expresses the allowable variation from the standard that shall result in an acceptable level of quality (98% unless otherwise stated) – that is the maximum allowable error rate or variation from the standard.

· ACQUISITION UTILIZATION SPECIALIST (AUS). The Acquisition Utilization Specialist is responsible for all aspects of the acquisition process prior to submission to contracting. AUS is also responsible for COR duties and contract administration.

· CONTRACTOR. A supplier or Contractor awarded a contract to provide specific supplies or service to the Government. The term used in this contract refers to the prime.

· 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. The CO is 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.

· DISPENSED: Prosthetic devices shall be considered dispensed when the veteran has been contacted for pick-up or the device has been mailed. If the Contractor is unable to make contact with the veteran on the first attempt, the Contractor shall make a documented second attempt within five (5) business days. If after two (2) failed attempts to reach the veteran via telephone, the Contractor shall send a letter to the veteran informing him or her the eyeglasses are ready for pickup.

· 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.

· NOT TO EXCEED (NTE).