36C25219Q0914-0004009.docx

36C25219Q0914 0004

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 NUMBERE

D 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 amendmen t, 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) 03-11-2020 556-20-1-1298-0001 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 To all Offerors/Bidders

36C25219Q0914

X X X March 17, 2020 at 2:00pm local time See CONTINUATION Page The purpose of this amendment is to update the Pricing Schedule, revise portions of the PWS (additions in red text and deletions in blue text with strikethrough), update the instructions to offerors, and incorporate the updated Wage Determination.

All FAR & VAAR clauses and provisions have been updated

All original offerors will be allowed to submit an updated quote. Final quotes are due by 2:00pm local time on March 17, 2020.

Mauree n Falaschi

CONTINUATION PAGE

B.1 CONTRACT ADMINISTRATION DATA (continuation from Standard Form 1449)

1. CONTRACT ADMINISTRATION: All contract administration matters will be handled by the following individuals:

DUNS NUMBER NO. ______________________________________

CONTRACTOR’S PAST PERFORMANCE POINT OF CONTACT

(IF DIFFERENT THAN ABOVE):

NAME: __________________________________________

EMAIL ADDRESS:_________________________________

b. GOVERNMENT: MAUREEN FALASCHI

DEPARTMENT OF VETERANS AFFAIRS

GREAT LAKES ACQUISITION CENTER

115 S. 84TH ST., STE 100

MILWAUKEE WI 53214

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

a. FAR 52.232-33 PAYMENT BY ELECTRONIC FUNDS TRANSFER SYSTEM – SYSTEM FOR AWARD

3. INVOICES: Invoices shall be submitted in arrears in accordance with:

a. 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018)

4. GOVERNMENT INVOICE ADDRESS (See SF1449 Block 18):

a. All invoices from the contractor shall be submitted electronically in accordance with 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV 2018)

b. Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests.

c. VA’s Electronic Invoice Presentment and Payment System – The FSC uses a third-party contractor, Tungsten Network e-Invoice, to transition vendors from paper to electronic invoice submission. Please go to this website: http://www.tungsten-network.com/customer-campaigns/veterans-affairs-us/ to begin submitting electronic invoices, free of charge.

d. For assistance setting up e-Invoice, the below information is provided:

i. * Tungsten Network e-Invoice Setup Information: 1-877-489-6135

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

* FSC e-Invoice Contact Information: 1-877-353-9791

* FSC e-invoice email: vafsccshd@va.gov

5. INVOICES cont:

a. Payments shall be made in arrears upon receipt of a properly prepared invoice

b. In order to comply with the Improper Payment Elimination and Recovery Act of 2010 (IPERA), the VA has mandated electronic invoice submission to the Veterans Affairs Financial Services Center (VAFSC). VAFSC has partnered with Tungsten Network e-Invoicing network, for submissions of all electronic invoices to VA. Tungsten Network electronic invoicing is free to all VA vendors. In order to submit electronic invoices, all VA vendors must register with Tungsten Network by submitting an email to VA.Registration@Tungsten-Network.com or calling 1-877-752-0900 option 2 for Enrollment.

c. Contractor shall submit an electronic invoice by the tenth (10th) of the following month services were performed to the Veterans Affairs Financial Services Center (VAFSC) e-Invoice through the website at https://portal.Tungsten-Network.com/Login.aspx. For questions regarding the submission of VA electronic invoices, Tungsten Network customer service may be contacted at 1-877-489-6135.

d. All invoices shall reference the vendor name and address, customer name, contract number, appropriate obligation/funding order number, description of services provided, quantity, unit price, and total invoice amount (any additional info). Invoices shall also include any payment discount terms.

e. For questions regarding invoice receipt or payment, please call VAFSC directly at 1-877-353-9791 or email vafsccshd@va.gov

OFFERORS MUST COMPLETE AND RETURN ALL INFORMATION DESIGNATED HEREIN PRIOR TO THE TIME SPECIFIED IN BLOCK 8 OF SF 1449 IN ORDER TO BE CONSIDERED FOR AWARD.

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

OFFER REQUIREMENTS & INSTRUCTIONS:

See Section E.1. 52.212-1 INSTRUCTIONS TO OFFERORS – COMMERCIAL ITEMS (OCT 2018) and Section E.2 GENERAL INSTRUCTIONS TO OFFERORS.

EVALUATION/BASIS OF AWARD:

This Request for Quote (RFQ) solicitation is issued under the authority of FAR Part 13.5 Simplified Procedures for Certain Commercial Items in which simplified acquisition procedures in FAR Part 13 will be used. FAR Part 14 and 15 will not be used.

This procurement is set aside based on an order of priority as established in 38 U.S.C. 8127.

TIERED EVALUATIONS INCLUDING LARGE BUSINESS CONCERNS: All proposals under this solicitation will be subject to a tiered evaluation that include the following tiers: (1) SDVOSB concerns, (2) VOSB concerns, (3) small business concerns, with HUBZone small business concerns and 8(a) participants having priority; and (4) full and open competition (unrestricted), which includes large businesses (other than small business concerns). If award cannot be made in any of these tiers, the solicitation will be cancelled and the requirement may be resolicited.

For detailed instructions on tiered evaluations, please see FAR 52.212-2 Evaluation – Commercial Items.

SPECIAL NOTES:

In order to maintain integrity of this solicitation and subsequent award date, all offerors are advised that any question and answer requests must be submitted in a written form via e-mail to the Contracting Officer Maureen.Falaschi@va.gov no later than 1:00pm local time on November 7, 2019. Contracting will issue a consolidated response via solicitation amendment to www.fbo.gov to all parties.

The Contracting Officer is the only person authorized to approve changes or modify any of the requirements under this contract. The Contractor shall communicate with the Contracting Officer on all matters pertaining to contract administration. Only the Contracting Officer is authorized to make commitment or issue changes that will affect price, quantity or quality of performance of this contract. In the event the Contractor effects any such change at the direction of any person other than the Contracting Officer, the change shall be considered to have been made without authority and no adjustment will be made in the contract price to cover any increase in cost incurred thereof.

Price Schedule Contractor must provide firm-fixed unit pricing and total pricing for all line items listed in the following Price Schedule for all six (6) ordering periods.

The total maximum amount of services acquired under this contract shall not exceed $5,000,000.00 The guaranteed minimum is $50,000.00 and will be met in the initial fiscal year of the contract award.

All prices and rates shall be for loaded (patient onboard) services and mileage only. The Government shall not pay for unloaded (no patient) services or mileage with the exception of “no shows” as indicated in PWS.

Transportation services listed shall include any bridge, tunnel or road toll charges. Contractor shall not bill the VA for any such separate charges.

The quantities listed in the schedule are estimated quantities only and shall be considered nonbinding.

The VA will conduct an annual economic price adjustment to CLINs ending in 003 and 006 (mileage rates). See VAAR Clause 852.216-72 PROPORTIONAL ECONOMIC PRICE ADJUSTMENT OF CONTRACT PRICE(S) BASED ON A PRICE INDEX (MAR 2018) for more information.

Ordering officers will be authorized to place orders against this contract. The Contracting Officer will furnish the Contractor with the names of individuals authorized as ordering officers, by separate memorandum upon issuance of the contract. When ordering officers are added after award, the Contracting Officer will furnish the Contractor with the names of individuals authorized as ordering officers, by memorandum upon ordering officer appointment. Ordering officers are responsible for issuing and administering orders placed under this contract. Ordering officers have no authority to modify any term of this basic contract. Any deviation from the terms of the basic contract must be approved in writing by the Contracting Officer responsible for this contract. The Contractor shall accept orders against this contract only from the Contracting Officer and/or authorized ordering officers. Fulfilling orders from persons other than the Contracting Officer or ordering officer may result in loss or delay in payment for supplies/services provided under such orders.

A.1 PRICE/COST SCHEDULE

ITEM INFORMATION

QUANTITY

BLS Ambulance Services Intracampus Transports Includes 30 min. wait time Ordering Period 1 POP Begin: 05-01-2020 POP End: 09-30-2020

BLS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 1

BLS Loaded Mileage Rate (per mile rate beyond the 15-mile radius) Ordering Period 1

ALS Ambulance Services Intracampus Transports

Ordering Period 1

ALS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 1

ALS Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Critical Care Transport (up to 15 miles)

CCT Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Waiting time (15 min. intervals, beyond initial 30 min.)

Transport of Deceased

BLS Ambulance Services Intracampus Transports

Ordering Period 2 POP Begin: 10-01-2020 POP End: 09-30-2021

BLS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 2

BLS Loaded Mileage Rate (per mile rate beyond the 15-mile radius) Ordering Period 2

ALS Ambulance Services Intracampus Transports

Ordering Period 2

ALS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 2

ALS Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Critical Care Transport (up to 15 miles)

CCT Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Waiting time (15 min. intervals, beyond initial 30 min.)

Transport of Deceased

BLS Ambulance Services Intracampus Transports

Ordering Period 3 POP Begin: 10-01-2021 POP End: 09-30-2022

BLS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 3

BLS Loaded Mileage Rate (per mile rate beyond the 15-mile radius) Ordering Period 3

ALS Ambulance Services Intracampus Transports

Ordering Period 3

ALS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 3

ALS Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Critical Care Transport (up to 15 miles)

CCT Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Waiting time (15 min. intervals, beyond initial 30 min.)

Transport of Deceased

BLS Ambulance Services Intracampus Transports

Ordering Period 4 POP Begin: 10-01-2022 POP End: 09-30-2023

BLS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 4

BLS Loaded Mileage Rate (per mile rate beyond the 15-mile radius) Ordering Period 4

ALS Ambulance Services Intracampus Transports

Ordering Period 4

ALS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 4

ALS Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Critical Care Transport (up to 15 miles)

CCT Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Waiting time (15 min. intervals, beyond initial 30 min.)

Transport of Deceased

BLS Ambulance Services Intracampus Transports

Ordering Period 5 POP Begin: 10-01-2023 POP End: 09-30-2024

BLS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 5

BLS Loaded Mileage Rate (per mile rate beyond the 15-mile radius) Ordering Period 5

ALS Ambulance Services Intracampus Transports

Ordering Period 5

ALS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 5

ALS Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Critical Care Transport (up to 15 miles)

CCT Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Waiting time (15 min. intervals, beyond initial 30 min.)

Transport of Deceased

BLS Ambulance Services Intracampus Transports

Ordering Period 6 POP Begin: 10-01-2024 POP End: 04-30-2025

BLS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 6

BLS Loaded Mileage Rate (per mile rate beyond the 15-mile radius) Ordering Period 6

ALS Ambulance Services Intracampus Transports

Ordering Period 6

ALS Ambulance Services Base Rate (up to 15 miles)

Ordering Period 6

ALS Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Critical Care Transport (up to 15 miles)

CCT Loaded Mileage Rate (per mile rate beyond the 15-mile radius)

Waiting time (15 min. intervals, beyond initial 30 min.)

Transport of Deceased

PERFORMANCE WORK STATEMENT (PWS)

1. Purpose: The CAPT James A. Lovell Federal Health Care Center (FHCC) in North Chicago, IL, requires contracted non-emergency Ambulance Transportation Services. This includes both the West Campus and the East Campus located on Naval Station Great Lakes. Contractor shall provide all vehicles, personnel, and equipment required to provide Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transports (CCT) Ambulance, and Transport of Deceased Services 24 hours a day, 7 days a week (24/7), including weekends and holidays.

2. Background: FHCC is a Congressionally-created joint VA-DOD facility resulting from the product of the integration of the former North Chicago VA Medical Center (VAMC) and the former Naval Station Great Lakes Healthcare Center. FHCC is composed of a West Campus, where the main hospital, a Community Living Center, six (6) Greenhouse Homes, and many outpatient clinics are located; and an East Campus, located on the Naval Station Great Lakes, where there are several medical and dental clinics for treating active duty recruits. FHCC employs and treats Veterans, Active Duty Military, Retirees and dependents.

3. Acronyms ALS – Advanced Life Support AOD – Administrator on Duty BLS – Basic Life Support CCT – Critical Care Transport CO – Contracting Officer COR – Contracting Officer’s Representative CPR – Cardiopulmonary Resuscitation DOD – Department of Defense DOL – Department of Labor EMT – Emergency Medical Technical IAW – In Accordance With PWS – Performance Work Statement QASP – Quality Assurance Surveillance Plan QC – Quality Control Plan TB – Tuberculosis TJC – The Joint Commission

4. Scope/Requirements

4.1. Types of Ambulance Service

4.1.1. The contractor shall provide non-emergent Basic Life Support (BLS), Advanced Life Support (ALS), and Critical Care Transport (CCT) Tier 1, 2, and 3 ambulance services on an as-needed basis:

Refer to Illinois General Assembly Administrative Code 210 ILCS 50, the Emergency Medical Services (EMS) Act for specifics on the requirements for BLS, ALS, and CCT.

TITLE 77: PUBLIC HEALTH

CHAPTER I: DEPARTMENT OF PUBLIC HEALTH

SUBCHAPTER f: EMERGENCY SERVICES AND HIGHWAY SAFETY PART 515 EMERGENCY MEDICAL SERVICES, TRAUMA CENTER, COMPREHENSIVE STROKE CENTER, PRIMARY STROKE CENTER AND ACUTE STROKE READY HOSPITAL CODE

4.1.2. The contractor shall provide Transport of Deceased services on an as-needed basis from buildings on the FHCC premises to the FHCC Morgue.

Definitions can be found at: http://il.elaws.us/law/210ilcs50 and http://www.ilga.gov/commission/jcar/admincode/077/077005150A01000R.html

4.2. Transport of Miscellaneous Items with the Patient

The Contractor may also be required to transport patient luggage, medical records, medication, and comfort items from pickup points to destination at no additional cost to the Government. Luggage to be transported will be restricted to suitcase and valise types. When patients are transported to FHCC, destination is deemed to be the ER, Admissions, the clinic or service within the hospital, or directly to the ward as instructed by VA Urgent Care Staff.

4.3. Contractor Personnel

Contractor personnel shall be courteous and conduct themselves in a businesslike manner at all times while providing services under this contract.

4.3.1. Emergency Medical Technicians (EMTs) & Other Medical Personnel

4.3.1.1. EMTs and other medical personnel (as applicable) shall at all times meet the qualifications specified in this contract as well as all applicable federal, state (see Illinois Compiled Statute 210 ILCS 50/ Emergency Medical Services (EMS) Systems Act) and local government laws, regulations, and standards. EMTs and other medical personnel (as applicable) shall be certified, licensed, or otherwise officially recognized by the local, state, or regional government or public entity where the emergency service is operated or by which it is governed.

4.3.1.2. If the contractor wishes to add or replace personnel throughout the life of the contract, it shall provide evidence of required training, certifications, licensing, and any other applicable qualifications the above requirements to the Contracting Officer’s Representative (COR) for review. The contractor shall provide evidence of required training, certifications, licensing, and any other qualifications of any personnel performing services under this contract.

4.3.1.3. All ambulance drivers shall have a valid driver’s license in accordance with state requirements for their place of operation and the services they perform. If the contractor wishes to add or replace drivers throughout the life of the contract, it shall provide a valid driver’s license to the COR.

4.3.1.4. Critical Care EMTs shall be capable of administering oxygen and have successfully completed the Standards and Advanced First Aid Courses of the American Red Cross or US Bureau of Mines or equivalent. Proof in the form of a current certificate for the successful completion of such training must be provided to the COR for any personnel added or replaced throughout the life of the contract. upon request.

4.3.1.5. Investigative Requirements for Contract Personnel: Contract personnel will be subject to the same investigative requirements as those for regular VA appointees and employees. The level of investigation commensurate with the level of access to perform the performance work statement is: Special Agreement Checks (SAC). Fingerprinting for contract personnel will be conducted at FHCC. Thereafter the contracted employees will be subject annually to the same requirement, with a 90-day window to complete such requirement as provided by FHCC. The VA Security and Investigation Center (SIC) is responsible for adjudicating all background investigations for contract employees.

4.3.2. Tuberculosis Exposure Control Policy

4.3.2.1. The contractor shall provide the VA with a policy on tuberculosis (TB) exposure and control, to include TB decontamination.

4.3.2.2. The contractor shall have its personnel tested for TB annually and provide written confirmation to the COR that all personnel (current employees and any new hires) performing services under this contract are current in their TB test by May 1 annually. each of these test results to the VA.

4.4. Contractor Equipment, Vehicles, and Inspection

4.4.1. Ambulances shall meet all applicable federal, state and local regulations and specifications, including but not limited to: licensing, registration, and safety standards. The contractor shall meet or exceed the ambulance inspection standards under Illinois General Assembly Administrative Code Title 77, Section 515.830 Ambulance Licensing Requirements.

4.4.2. The VA reserves the right to inspect the contractor’s equipment and vehicles or require documentation of compliance with state laws, rules, regulations, and guidelines governing emergency medical transport vehicles (ambulances). VA inspections of contractor equipment do not constitute a warranty or guarantee that the contractor’s vehicles and equipment are properly maintained. The VA reserves the right to restrict the contractor’s use of equipment and vehicles in the performance of this contract which are not in compliance with contract requirements. The restriction of such equipment and vehicles shall not relieve the contractor from performance in accordance with the contract nor necessitate additional cost to the VA.

4.4.3. Vehicles shall be clean and maintained in good repair in accordance with manufacturer’s instructions.

4.4.4. The contractor shall not borrow or exchange supplies, equipment, and/or medications with the VA. Equipment attached to or in use by the patient at time of pick-up may remain with the patient during transport to ensure continuity of care. Medical Control Authorities are responsible for maintaining and supplying medication during patient transport. All VA equipment and unused medications must be returned to VA during patient drop-off or as promptly as feasible within 24 hours.

4.4.5. At no time will the Contractor leave vehicles on FHCC premises unless a pick-up or delivery is in process.

4.4.6. The contractor must be capable of transporting the drugs and/or equipment as required by the patient as listed in Attachment A Critical Care Transport Capabilities Confirmation. The contractor shall have the appropriate medications, up to and including CCT Tier III if necessary, based on the EMS region the ambulance provider is functioning in.

4.5. Transportation Request

4.5.1. Scheduling

4.5.1.1. A transportation request is defined as one incidence of a request for one-way service (BLS, ALS, CCT, Deceased). No more than one patient will be transported per order unless approved by an authorized VA ordering employee.

4.5.1.2. Transportation requests will be made by telephone. Only the following VA staff are authorized to place transportation requests or make changes to transportation requests:

Contracting Officer Contracting Officer’s Representative (COR) PoC for Beneficiary Travel Office All Administrative Officers of the Day (AOD) All Transfer Coordinators Chief Patient Administration Service Assistant Chief Patient Administration Service Decedent Affairs Department (Deceased Transports Only) Non-authorized VA employees and private agencies (e.g. nursing homes) are not considered authorized to place transportation requests. A list containing the names and phone numbers of VA staff who are authorized (Delegated Ordering Officers) to place transportation requests will be submitted to the contractor at time of award, and updated as needed periodically throughout the life of the contract.

4.5.1.2.1. For each transportation request, the contractor will be given the patient’s name, pick-up appointment time, pickup address, caregiver/escort information (if applicable), drop-off address, and other applicable details.

4.5.1.3. For ALL Transports – an Audit system will be put in place by the VA to include the COR or designee, Beneficiary Travel Department staff, and clinical staff to ensure appropriateness of the order and timeliness of the response.

4.5.1.4. The type of transportation service (BLS, ALS, CCT, Deceased) required will be discussed and determined by VA clinical personnel and the contractor. The contractor shall transport the patient per its policies and standard industry practice. If the type of transportation service differs from what was agreed upon by the VA and contractor, the contractor shall submit documentation to the VA explaining its rationale.

4.5.1.5. The VA may authorize an escort (e.g. spouse, relative, guardian, etc.) to accompany the patient during medical transport if it is practicable and in the patient’s best interest. The contractor shall allow the escort to accompany the patient at no additional cost.

4.5.1.6. The contractor shall have sufficient vehicles and personnel to provide services for up to three (3) simultaneous transportation requests within a calendar day, for any mix of BLS, ALS, CCT, or Deceased transports. If FHCC requires ambulance services exceeding three (3) simultaneous transportation requests in a calendar day, the vendor will be offered to provide the services if they have sufficient vehicles/personnel available; but may decline these additional orders if sufficient vehicles/personnel are unavailable.

4.5.1.7. Response Times*

4.5.1.7.1. Orders that are scheduled by 7pm local time the day before the required services are defined as scheduled in advance. With the exceptions found in 4.5.1.7.4 below, the contractor shall arrive on time for all orders scheduled in advance.

4.5.1.7.2. For all transportation requests, with pick up at FHCC, the contractor will be allotted up to a thirty (30) minute response time from time of order placement for transportation requests that are not previously scheduled in advance.

4.5.1.7.3. For all transportation requests, which have a pick-up address within a 15-mile radius of FHCC:

a. The contractor will be allotted up to a sixty (60) minute response time from time of order placement for transportation requests that are not previously scheduled in advance.

4.5.1.7.4. For transportation requests which have a pick-up address beyond a 15-mile radius of FHCC:

1. The contractor may be required, if requested by the VA, to dispatch ambulances on short notice for transportation request not scheduled in advance; for these transportation requests the contractor shall dispatch ambulances within fifteen (15) minutes of receiving the order;

1. Pick-up appointment times shall be agreed upon by the VA and contractor at time of order placement. Pick-up arrival time shall be reasonable based upon travel distance, speed limits, and weather conditions. The contractor’s patient pick-up time shall not deviate by more than fifteen (15) minutes.

1. The contractor’s patient pick-up time shall not deviate by more than fifteen (15) minutes of the scheduled pick-up time for transportation requests scheduled in advance.

* The contractor shall not be held liable for nonperformance caused by an occurrence beyond the reasonable control of the contractor and without its fault or negligence such as, acts of God or the public enemy, acts of the Government in its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, and unusually severe weather. The contractor MUST notify the VA with as much advance notice as possible should any of these occur.

4.5.2. Cancellations

4.5.2.1. For trips in which the contractor is notified of cancellation before the vehicle is dispatched, there shall be no charge to the Government.

4.5.2.1.1. A “no show” is defined as a transportation request which is cancelled after the contractor has dispatched a vehicle, the vehicle is enroute (exclusion – see below 4.9.2) or has arrived at the pick-up location, and there is no longer a requirement for patient transportation. The contractor may request one-way reimbursement for no-shows. No-show reimbursement shall be based upon the base rate for the type of service requested (BLS, ALS, CCT) and the one-way mileage (BLS, ALS, CCT) accrued enroute to the pick-up location at time of cancellation. Mileage for no-show cancellations shall be confirmed by the contractor and reported to the VA as soon as possible from time of cancellation.

4.5.2.2. For transportation requests OUT of FHCC ONLY – The contractor will dispatch a vehicle upon receipt of the order (including transportation requests in which the final destination may change prior to pick up due to the critical condition of the patient). When the contractor is notified of a cancellation prior to arrival at FHCC campus, there shall be no charge to the Government.

4.6. Pick-Up/Drop-Off/Reporting Procedures

4.6.1. Ambulance personnel shall pick-up and deliver patients at specified locations (e.g. Emergency Room, Clinic, Green House Homes, other outlying areas on the campus, East Campus clinics, etc.). These locations will be designated and communicated when an order is placed by authorized FHCC personnel.

4.6.2. When applicable, ambulance personnel shall report to the Nursing Station to (1) announce his/her arrival to pick-up and transfer the patient and (2) obtain report of pertinent information regarding the patient’s condition from the primary nurse/physician.

4.6.3. When delivering a patient, ambulance personnel shall give report to the appropriate VA healthcare staff and provide a copy of the run sheet which will be retained by the facility for inclusion to the patient’s medical record.

4.6.4. In cases where ambulance personnel must divert to a local emergency department while performing a VA authorized transport, the contractor’s dispatcher shall notify the VA Beneficiary Travel Department or Administrative Officer of the Day of the patient’s location and status as soon as this information becomes available.

4.7. Patient Welfare

4.7.1. The contractor shall be responsible for the patient’s welfare during transport. The contractor shall be held responsible for patient and/or VA property during transport. Any damaged or lost wheelchairs, walkers, crutches, or personal belongings shall be replaced at the contractor’s expense.

4.7.2. The VA requires the contractor to exercise extreme caution and care in the handling of patients.

4.8. Incident Reporting

4.8.1. The contractor shall notify the COR and Requestor of any accidents and/or safety problems that occur while the patient is being transported. This notification shall occur within one (1) hour by telephone. A written report of the incident shall be delivered to the COR, or Program Manager Beneficiary Travel Department, by the close of business of the next business day.

4.8.2. The COR will monitor the service provided. The contractor shall cooperate with the COR in providing information and answering questions in a timely manner. The contractor shall promptly inform the COR of any complaints received directly from patients. If warranted, the VA may conduct incident investigations and require written response from the contractor within 48 hours of request.

4.9. Invoicing

4.9.1. Each transport shall include thirty (30) minutes of wait time; the contractor may invoice for wait times in excess of this initial thirty (30) minutes. Wait time shall begin only once the contractor has both reached the pick-up address location and the appointment time has elapsed. All wait times shall be itemized and invoiced in fifteen (15) minute intervals. For partial fifteen (15) minute intervals, zero (0) to seven (7) minutes shall be rounded down to zero (0) minutes and eight (8) to fifteen (15) minutes rounded up to fifteen (15) minutes.

4.9.2. When invoicing for mileage, the contractor shall round to the nearest mile. Mileage ending in .5 or higher shall be rounded up to the nearest mile. Mileage ending in .4 or lower shall be rounded down to the nearest mile. Payment for mileage to or from the point of care shall be limited to the VA’s calculation according to the VA’s Bing Maps API determination. Bing Maps API is optimized to determine mileage based on the shortest time of travel.

4.9.3. With the exception of “no shows” defined in 4.5.2.1.1 above, the contractor shall invoice for loaded (patient onboard) services and mileage only. The contractor shall submit an electronic invoice by the tenth (10th) day of each month for services which occurred during the preceding month. Electronic invoices shall be submitted to the Department of Veterans Affairs Financial Service Center. These invoices shall not include patient information, but shall include the following:

· Contractor Name and Contract Number

· Current Purchase Order Number

· Dates of service

· Total amount invoiced, including a summary of the total number of charges that align with the line items of this contract (total number of BLS Intracampus Transports, total BLS Mileage incurred, etc.)

· An itemized list of charges or services rendered that align with the line items of this contract (BLS Intracampus Transports, BLS Base Rate, BLS Mileage incurred, etc.)

Additionally, a copy of the invoice along with secondary documentation shall be provided to the COR. This may be delivered via fax, email, or hand carried. The secondary documentation must include the following information:

· Contractor name and telephone number for billing questions

· Contract Number

· Current Purchase Order Number

· Dates of service

· Name of the patient

· Date and time of pick-up/drop-off

· Address for pick-up/drop-off

· Daily itemized listing of transports and charges that align with the line items of this contract. List should include patient’s name, the last four digits of the SSN, date of transport, and pick‐up/drop‐off points.

· Total amount invoiced, including a summary of the total number of charges that align with the line items of this contract (total number of BLS Intracampus Transports, total BLS Mileage incurred, etc.)

4.9.4. Any transports of deceased shall be invoiced separately under a separate Purchase Order number.

UNDER NO CIRCUMSTANCES ARE VA BENEFICIARIES, THIRD PARTY INSURANCES, MEDICARE OR MEDICAID TO BE BILLED FOR THE SERVICES PERFORMED UNDER THIS CONTRACT.

5. Period & Place of Performance

5.1. This contract’s ordering period shall be effective from May 1, 2020 through April 30, 2025 January 1, 2020 through December 31, 2024.

5.2. The Place of Performance is variable and may occur within the states of Illinois, Wisconsin, and Indiana; ambulance services may be required to or from locations including, but not limited to the following:

5.2.1. Intracampus Transports including any areas on the West Campus and/or East Campus (ie. Emergency Room, Clinic, Green House Homes, other out-lying areas on the campus, East Campus clinics, etc.)

5.2.2. Other VA Medical Centers, Hospitals, or CBOCs within Veterans Integrated Service Network (VISN) 12 including, but not limited to:

5.2.3. Non-VA medical facilities within a 20-mile radius of FHCC Lovell.

5.2.4. Veterans’ residence

6. Quality Control Plan

6.1. Quality Control

6.1.1. The contractor shall provide a Quality Control Plan (QCP) that contains, at a minimum, the items listed below. The Contracting Officer will notify the contractor of acceptance or required modification to the plan before the contract start date. The contractor must make appropriate modifications and obtain acceptance of the plan by the Contracting Officer before the contract start date.

6.1.1.1. A description of the company’s organizational structure including a description of the roles and responsibilities of denoting management and supervisors.

6.1.1.2. A description of the methods to be used by the contractor for identifying and preventing deficiencies or problems in the quality of service performed and specific steps the contractor will take for corrective action if needed.

6.1.1.3. A description of the company’s records and tracking system used to identify up-to-date background checks, applicable certifications, tests (e.g. TB tests), and training of each employee performing services under this contract.

6.1.1.4. A description of the method used to provide on-time ambulance services to meet the requirements of this contract (24/7 availability and up to 3 simultaneous transports for any mix of BLS, ALS, CCT, Deceased).

6.1.1.5. A description of the methods used to identify and prevent radio communication breakdowns and a detailed procedure for alternative communications in the event of electronic and mechanical breakdown of vehicle two-way radios.

6.1.1.6. A description of the method/system used to log all requests for service. The contractor shall confirm that the log shall indicates the date and time of service call, actual time of pick-up versus the scheduled time, name of patient requiring services, designated pick-up and delivery points, mileage, and actual waiting time at pick-up and delivery points if waiting charges are claimed. The contractor shall confirm the send log sheet will be sent to the COR monthly.

6.2. Quality Assurance

6.2.1. The Government will evaluate the contractor’s performance under this contract to ensure that the contractor’s quality control plan is adequate, and that quality is achieved through a Quality Assurance Surveillance Plan (QASP).

6.2.2. The Government shall prepare a QASP after contract award derived from the PWS and contractor’s submitted quality control plan. The QASP is a “living document” and the Government may review and revise it at any time. However, the Government shall coordinate changes to the QASP with the contractor.

6.2.3. The QASP will specify the work requiring surveillance and the Government’s method of surveillance.

6.3. Minimum Performance Standards

6.3.1. The contractor shall maintain performance standards in accordance with the standards outlined in the table below. Failure to meet the Acceptable Quality Levels (AQL) may result in termination of the contract.

6.3.2. The QASP will include the standards below as well as others derived from the successful offeror’s quality control plan.

SECTION C - CONTRACT CLAUSES

ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL ITEMS Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

The following clauses are incorporated into 52.212-4 as an addendum to this contract:

C.1 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

http://www.acquisition.gov/far/index.html (FAR) http://www.va.gov/oal/library/vaar/index.asp (VAAR)

(End of Clause)

C.2 52.216-18 ORDERING (OCT 1995)

(a) Any supplies and services to be furnished under this contract shall be ordered by issuance of delivery orders or task orders by the individuals or activities designated in the Schedule. Such orders may be issued from May 1, 2020 through April 30, 2025.

(b) All delivery orders or task orders are subject to the terms and conditions of this contract. In the event of conflict between a delivery order or task order and this contract, the contract shall control.

(c) If mailed, a delivery order or task order is considered "issued" when the Government deposits the order in the mail. Orders may be issued orally, by facsimile, or by electronic commerce methods only if authorized in the Schedule.

(End of Clause)

C.3 52.216-19 ORDER LIMITATIONS (OCT 1995)

(a) Minimum order. When the Government requires supplies or services covered by this contract in an amount of less than one order, the Government is not obligated to purchase, nor is the Contractor obligated to furnish, those supplies or services under the contract.

(b) Maximum order. The Contractor is not obligated to honor—

(1) Any order for a single ride item in excess of 150 miles;

(2) Any order for a combination of items in excess of 3 rides simultaneously;

(3) A series of orders from the same ordering office within 1 days that together call for quantities exceeding the limitation in paragraph (b)(1) or (2) of this section.

(c) If this is a requirements contract (i.e., includes the Requirements clause at subsection 52.216-21 of the Federal Acquisition Regulation (FAR)), the Government is not required to order a part of any one requirement from the Contractor if that requirement exceeds the maximum-order limitations in paragraph (b) of this section.

(d) Notwithstanding paragraphs (b) and (c) of this section, the Contractor shall honor any order exceeding the maximum order limitations in paragraph (b), unless that order (or orders) is returned to the ordering office within 1 days after issuance, with written notice stating the Contractor's intent not to ship the item (or items) called for and the reasons. Upon receiving this notice, the Government may acquire the supplies or services from another source.

(End of Clause)

C.4 52.216-22 INDEFINITE QUANTITY (OCT 1995)

(a) This is an indefinite-quantity contract for the supplies or services specified, and effective for the period stated, in the Schedule. The quantities of supplies and services specified in the Schedule are estimates only and are not purchased by this contract.

(b) Delivery or performance shall be made only as authorized by orders issued in accordance with the Ordering clause. The Contractor shall furnish to the Government, when and if ordered, the supplies or services specified in the Schedule up to and including the quantity designated in the Schedule as the "maximum." The Government shall order at least the quantity of supplies or services designated in the Schedule as the "minimum."

(c) Except for any limitations on quantities in the Order Limitations clause or in the Schedule, there is no limit on the number of orders that may be issued. The Government may issue orders requiring delivery to multiple destinations or performance at multiple locations.

(d) Any order issued during the effective period of this contract and not completed within that period shall be completed by the Contractor within the time specified in the order. The contract shall govern the Contractor's and Government's rights and obligations with respect to that order to the same extent as if the order were completed during the contract's effective period; provided, that the Contractor shall not be required to make any deliveries under this contract after April 30, 2025.

(End of Clause)

C.5 52.217-8 OPTION TO EXTEND SERVICES (NOV 1999)

The Government may require continued performance of any services within the limits and at the rates specified in the contract. These rates may be adjusted only as a result of revisions to prevailing labor rates provided by the Secretary of Labor. The option provision may be exercised more than once, but the total extension of performance hereunder shall not exceed 6 months.