36C25220Q0269.docx

36C25220Q0269

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1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9.

ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE

WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15

CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

17b. CHECK IF REMITTANCE IS DIFFERENT AND PUT SUCH ADDRESS IN OFFER 18b. SUBMIT INVOICES TO ADDRESS SHOWN IN BLOCK 18a UNLESS BLOCK BELOW IS CHECKED

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

(Use Reverse and/or Attach Additional Sheets as Necessary)

25. ACCOUNTING AND APPROPRIATION DATA

26. TOTAL AWARD AMOUNT (For Govt. Use Only) 27a. SOLICITATION INCORPORATES BY REFERENCE FAR 52.212-1, 52.212-4. FAR 52.212-3 AND 52.212-5 ARE ATTACHED. ADDENDA

ARE

ARE NOT ATTACHED.

27b. CONTRACT/PURCHASE ORDER INCORPORATES BY REFERENCE FAR 52.212-4. FAR 52.212-5 IS ATTACHED. ADDENDA

ARE

ARE NOT ATTA

CHED

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. SIGNAT

URE OF OFFEROR/CONTRACTOR

31a. UNITED STATES OF AMERICA (SIGNATURE OF CONTRACTING OFFICER) 30b. NAME AND TITLE OF SIGNER (TYPE OR PRINT) 30c. DATE SIGNED 31b. NAME OF CONTRACTING OFFICER (TYPE OR PRINT) 31c. DATE SIGNED

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C25220Q0269 02-10-2020 Cannaday, Erika 414-844-4800 x43253 02-20-2020 4:00 p.m.

36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 X X 561720 $19.5 Million N/A X 36C252 Wausau Community-Based Outpatient Clinic 515 South 32nd Avenue Wausau WI 54401 36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476

Department of Veterans Affairs Financial Services Center PO Box 149971 Austin TX 78714-9971 877-353-9791 512-460-5540 Selected Contractor to provide janitorial services at Wausau Community-Based Outpatient Clinic, in accordance with the Statement of Work. See Continuation Page.

The latest DOL Wage Determination (#15-4907, revision 10, dated 12/23/2019) shall apply to any award made from this Solicitation.

x X x

SECTION B - CONTINUATION OF SF 1449 BLOCKS

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

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

a. CONTRACTOR: (Contractor’s Name)

(Address)

(City, State Zip)

(Point of Contact)

DUNS NUMBER NO. ______________________________________

b. GOVERNMENT: ERIKA A CANNADAY, CONTRACT SPECIALIST

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)

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

c. 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.

d. 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.

e. 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.

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

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

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 is a commercial item acquisition that will be conducted 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. See 52.212-2 Evaluation – Commercial Items for a description of the factors that the Government will use to evaluate offers. Prospective contractors must furnish the information listed herein with their proposals to ensure they receive full consideration.

CONTRACT ADMINISTRATION:

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.

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 erika.cannaday@va.gov no later than Monday, February 17th, 2020 at 4:00 PM local time. Contracting will issue a consolidated response via solicitation amendment to www.fbo.gov to all parties.

SITE VISIT:

A site visit has been scheduled and will be conducted with Mr. Todd Harelstad on Wednesday, February 12th, 2020 at 2:00 p.m. local time at Wausau Community-Based Outpatient Clinic at 515 S 32nd Avenue, Wausau, WI 54401.

B.2 COST/PRICE SCHEDULE

Base Year: 3/1/2020 – 2/28/2021

Base Year Total: $ Option Year One: 3/1/2021 – 2/28/2022

Option Year One Total: $ Option Year Two: 3/1/2022 – 2/28/2023

Option Year Two Total: $ Option Year Three: 3/1/2023 – 2/29/2024

Option Year Three Total: $

Option Year Four: 3/1/2024 – 2/28/2025

Option Year Four Total: $

36C25220Q0269 Base and all Option Years Total: $

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B.3 STATEMENT OF WORK

1. DESCRIPTION OF SERVICES. The contractor shall provide all labor, tools, materials, appropriate equipment and supervision, necessary to professionally clean and maintain the VA Wausau Clinic located at Wausau, WI. at an acceptable level of cleanliness that meets the requirements for a medical clinic. Cleaning and restocking supplies will be provided by the Wausau VA Community-Based Outpatient Clinic (example: cleaning chemicals, paper towel, toilet paper, etc.). The clinic is located at 515 South 32nd Avenue, Wausau, WI 54401 and consists of approximately 10,000 square feet on two levels with 10 exam rooms, 6 bathrooms, and 3 conference-style rooms. Cleaning shall occur between the hours of 5:00 p.m. and 8:00 a.m., Monday through Friday, excluding legal and/or public holidays. Contractor shall be responsible to provide Safety Data Sheets (SDS) to the COR in accordance with the conformance standards. All disinfectants used in the cleaning of the facility will be FDA/EPA approved. All cleaning agents used must be clearly labeled.

1.1 BASIC CLEANING SERVICES. The contractor shall accomplish all cleaning tasks to meet the requirements of this SOW and the Service Delivery Summary (SDS). The minimum cleaning frequencies are established in Appendix A. All work listed under 1.1.1 through 1.1.15 shall be performed in accordance with the above.

1.1.1. Maintain Floors. All floors, except carpeted areas, shall be swept, dust mopped, and damp mopped or wet mopped, to ensure they have a uniform, glossy appearance and are freedom from dirt, debris, dust, scuff marks, heel marks, other stains and discoloration, and any other foreign matter. Baseboards, corners, and wall/floor’ edges shall also be clean. All floor maintenance solutions shall be removed from baseboards, furniture, trash receptacles, etc. Chairs, trash receptacles, and other moveable items shall be moved to maintain floors underneath these items. All moved items shall be returned to their original and proper position.

1.1.2 Remove Trash. All trash containers shall be emptied and returned to their original location, if moved. Boxes, cans, and paper placed near a trash receptacle and marked “TRASH” shall be removed. All trash containers, waste baskets, and all trash receptacles shall be fitted with a disposable plastic liner when the receptacle is emptied. Trash receptacles shall be left clean, free of foreign matter, and free of odors. The trash shall be deposited in the nearest outside trash collection container as directed by the COR.

1.1.3 Clean Interior Glass/Mirrors. Clean all interior glass, including glass in doors, partitions, walls, display cases, directory boards, and any other interior glass. After glass cleaning, there shall be no traces of film, dirt, smudges, water, or other foreign matter.

1.1.4 Clean Drinking Fountains. Clean and disinfect all porcelain and polished metal surfaces, including the orifices and drain, as well as exterior surfaces of fountain. Drinking fountains shall be free of streaks, stains, spots, smudges, scale, and other obvious soil.

1.1.5 Clean Stairways. All floor surfaces on and around, stairways to include the stairs themselves, shall be cleaned in accordance with paragraph 1.1.1 or 1.1.7, as appropriate for floor covering. Grease and grime shall be removed from stair guards, handrails, and baseboards. Contractor shall remove all marks, dirt, smudges, scuffs, and other foreign matter from adjoining stairwell walls to provide or maintain a clean, uniform appearance.

1.1.6 Vacuum Carpets. Vacuum carpeted areas. After vacuuming, the carpeted area shall be free of all visible dirt, debris, litter and other foreign matter. Any spots shall be removed by carpet manufacturer’s approved methods as soon as noticed. All tears, burns, and raveling shall be brought to the attention of the government representative. Area and throw rugs are included to receive this service.

1.1.7 Clean Carpets. Spot clean or shampoo dirty carpets for dirt or stains over an area of 2 square feet or less. Spots must be removed immediately.

1.1.8 Vacuum and Clean Floor Mats. Vacuum and clean interior and exterior floor mats. After vacuuming or cleaning, mats shall be free of all visible lint, litter, soil and other foreign matter. Soil and moisture underneath mats shall be removed, and mats returned to their original location.

1.1.9 General Spot Cleaning. Perform spot cleaning on a continual basis. Spot cleaning includes, but is not limited to removing, or cleaning smudges, fingerprints, marks, streaks, spills, etc., from washable surfaces of all walls, partitions, vents, grillwork, doors, door guards, door handles, push bars, kick plates, light switches, temperature controls, and fixtures. After spot cleaning, the surface shall have a clean, uniform appearance, free of streaks, spots, and other evidence of soil.

1.1.10 General Dusting. All horizontal surfaces must be dusted or cleaned to eliminate dust collection, to include all surfaces where dust may collect (i.e. picture and door frames). All vertical surfaces shall also be kept free from the accumulation of dust. All furniture, computers, and medical and other equipment is also to be kept free from dust.

1.1.11 Clean Interior Windows. Clean glass surfaces/windows throughout the area. After surfaces have been cleaned, all traces of film, dirt, smudges, water and other foreign matter shall be removed from frames, casings, sills, and glass.

1.1.12 Clean Exterior Windows. Windows are the glass surfaces that are an integral part of the outer wall of the building. Clean exterior glass surfaces/windows throughout the area. Window screens shall be removed and cleaned, as needed. After window has been cleaned, exterior frames, casings, sills, and glass shall be free of all traces of film, dirt, smudges, water and other foreign matter.

1.1.13 Clean Air-Conditioning/Heating Vents. All heating and air conditioning ventilation grates/grilles/louvers/covers shall be kept free from dust and dirt and shall be cleaned on an as-needed basis.

1.1.14 Clean Fluorescent Light Fixture Diffusers. All plastic diffusing lenses for ceiling mounted fluorescent light fixtures will be kept in a clean condition (on both sides of diffuser) and free of dust, dirt, and dead insects.

1.1.15 Empty/Clean Exterior Ashtrays/Trash. All exterior ashtrays/trash receptacles shall be emptied and returned to their initial location. Boxes, cans, paper placed near a trash receptacle and marked “TRASH” shall be removed. All trash containers shall be fitted with disposable plastic liner. All plastic liners for trash receptacles of any sort shall be replaced with new ones when receptacle is emptied and replace sand in ashtrays as necessary (VA to provide sand substitutes). The trash shall be deposited in the nearest outside trash collection container as directed by the COR. Trash receptacles shall be left clean, free of foreign matter, and free of odors.

1.1.16 Clean Elevator. Clean the floor. Damp dust the door and features. Spot clean fingerprints and marks from the walls. Clean the elevator tracks. Polish all metal surface.

1.2 BASIC EXAMINATION ROOM/LABORATORY/REST ROOM CLEANING SERVICES.

1.2.1 Clean and Disinfect. Completely clean and disinfect all surfaces of sinks, toilet bowls, urinals, lavatories, dispensers, plumbing fixtures, saunas, partitions, dispensers, doors, walls, and other such surfaces, using a germicidal detergent. After cleaning, receptacles will be free of deposits, dirt, streaks, and odors. Disinfect all surfaces of partitions, stalls, stall doors, entry doors, (including handles, kick plates, ventilation grates, metal guards, etc.), and wall areas adjacent to wall mounted lavatories, urinals, and toilets, as well as all surfaces of specimen pass through.

1.2.2 De-scale Toilet Bowls and Urinals. De-scaling shall be performed monthly, as a minimum, and as often as needed to keep areas free of scale, soap films, and other deposits. After de-scaling, surfaces shall be free from streaks, stains, scale, scum, urine deposits, and rust stains.

1.2.3 Sweep and Mop Floor. After sweeping and mopping, the entire floor surface, including grout, shall be free from litter, dirt, dust and debris. Grout on wall and floor tiles shall be free of dirt, scum, mildew, residue, etc. Floors shall have a uniform appearance without streaks, swirl marks, detergent residue, or any evidence of soil, stain, film or standing water. Moveable items shall be tilted or moved to sweep and damp mop underneath. Floors shall be stripped, scrubbed, waxed, etc., twice yearly in the spring and fall to maintain sanitary conditions and a clean, uniform appearance. Contractor shall mop using only clean water and appropriate cleaning agents and shall dispose of soiled water after each cleaning.

1.2.4 Stock Examination Room/Restroom Supplies. Contractor shall ensure examination rooms/restrooms are stocked sufficiently so that supplies including soap for the soap dispensers, paper towels, and toilet paper do not run out. Supplies shall be stored in designated areas and shall be kept up off the surface of floors. No overstocking shall be allowed. If supplies run out prior to the next service date, contractor shall refill within 24 hours using VA-provided supplies.

1.2.5 Clean/Disinfect Examination Room/Lab Room Furniture. Patient examination tables, visitor chairs, and blood draw chairs in all examination rooms or lab rooms will be cleaned and disinfected with FDA/EPA approved germicidal detergent. Only preapproved FDA/EPA approved germicidal disinfectant detergent will be provided by the contractor.

1.3 PERIODIC CLEANING SERVICES

1.3.1 Strip, Scrub, Seal, and Wax Floors. Floors shall be stripped, scrubbed, and waxed twice yearly, in the Spring and Fall, to maintain sanitary conditions and a clean, uniform appearance. Floor waxing will be coordinated with the COR, to be performed on the weekend, allowing sufficient dry time of flooring. A non-skid wax is required. A uniform glossy appearance is free of scuffmarks, heel marks, wax build-up, and other stains and discoloration. Chairs, trash receptacles, and other items shall be moved to wax floors underneath and returned to their original locations.

1.3.2 Clean/Shampoo Carpets. All carpets shall be cleaned in accordance with standard commercial practices. Entire carpets will be shampooed twice a year, Spring and Fall. Carpet cleaning will be coordinated with the COR, to be performed on the weekend, allowing sufficient dry time of flooring. A heavy-duty spot remover may be required in heavily soiled areas. After shampooing, the carpeted area will be uniform in appearance and free of stains and discoloration. All cleaning solutions shall be removed from baseboards, furniture, trash receptacles, chairs and other similar items. Chairs, trash receptacles, and other items shall be moved to clean carpets underneath and returned to their original location.

2. SERVICE DELIVERY SUMMARY. The contractor service requirements are summarized into performance objectives that relate directly to mission-essential items. The performance threshold briefly describes the minimum acceptable levels of service required for each requirement. These thresholds are critical to mission success.

Para Performance Threshold

Basic Cleaning Services.

Floor s, baseboards, corners and wall edges are free of dirt, dust and debris. Trash is empty; Plastic liners ate replaced each time trash is emptied. Trash containers are free of odors and visible dirt. Trash is emptied into outdoor trash collection container. Ash containers are emptied and free of ashes, odors and stains. Glass and mirrors have no traces of film, dirt, smudges, or water. Drinking fountains are disinfected and free of streaks, stains, spots, smudges, scale and other deposits. Stairways are free of dirt, debris, marks, smudges, scuffs and other foreign matter. Carpets are free of dirt, debris, litter and other foreign matter. Dust is not visible.

per month.

Basic Restrooms/Locker Rooms Cleaning Services.

Restrooms and locker rooms are disinfected and free of dirt, deposits, streaks and odors. Showers are disinfected and free of soap films, scum and other deposits. Toilets and urinals are disinfected and free of scale, stains, scum and other deposits. Floors are free of litter, dirt, dust and debris. Supplies are adequate until next service.

per month

Periodic Cleaning Services. Floors have a glossy uniform appearance free of scuffmarks, heel marks, wax build-up, and other stains and discoloration. Windows are free of film, dirt, smudges, water, and other foreign matter. Carpets are free of stains and discoloration.

1.3.

Not to exceed 3 customer complaints for the reporting period.

3. GOVERNMENT FURNISHED PROPERTY AND SERVICES. The government shall supply hand soap, hand sanitizer, toilet paper and paper towels. — All other equipment, materials and cleaning supplies shall be furnished by the contractor.

4. GENERAL INFORMATION.

4.1 Quality Assurance. The government will periodically evaluate the contractor’s performance in accordance with the Performance Standards above.

4.2 Government Remedies. The contracting officer shall follow FAR 52.212.4, Contract Terms and Conditions- Commercial Items, for contractor’s failure to perform satisfactory services or failure to correct non-conforming services.

4.3 Hours of Operation. The work required by the contract shall be performed daily, Monday through Friday, excluding Federal Holidays. Work shall begin no earlier than 5:00 pm and shall be completed no later than 8:00 am. Contractor shall provide proposed work schedule to the COR within five (5) calendar days from receipt of Award.

National Holidays: The ten (10) days observed by Federal Government are:

When one of the above designated legal holidays falls on a Sunday, the following Monday will be observed as a legal holiday. When a legal holiday falls on a Saturday, the preceding Friday is observed as a holiday by U.S. Government agencies.

4.4 Confidentiality Contractor and all personnel employed by Contractor, and any other individuals enlisted by Contractor (sub-contractors, etc.) to meet the requirements of this SOW, shall not disclose any information regarding the patients treated at the VA Primary Care Clinic (VAPCC). All clinical records, including names of patients, Social Security numbers and all medical, administrative, or demographic information that pertains to the patients treated at the VA Primary Care Clinic (VAPCC) is strictly confidential. This information is protected under federal regulations. All information and records that pertain to the employees of the VA Primary Care Clinic (VAPCC) is also confidential and is protected under law. Contractor, and any individuals employed or enlisted by Contractor, may be required to sign Confidentiality Statement as a condition of being allowed to work at the VA Primary Care Clinic (VAPCC).

I. NFPA - National Fire Protection Association.

4.6 Reporting Requirements. At the discretion of the COR or Contracting Officer, the Contractor may be required to submit an ongoing report of services rendered under the terms of the contract. The contractor may be required to submit a report, which shall include but not be limited to 1) dates and times when services were performed, 2) a list of the areas where services were performed, and 3) type(s) of services and brief description of the work.

VA Contact Person(s): Andrew J. Martin

Location (Building/Room Number. BLDG 406, Room 1617A

Telephone Number & Extension(s): 608-372-1743

Contractor - Provide telephone number(s) to call for your Service Department:

Provide name(s) of authorized contact person(s):

4.7 Conformance Standards. All work shall be performed, and equipment shall function in conformance with all VA safety standards, manufacturer’s/industry standards, the latest published edition of NFPA-99, FDA, OSHA, JCAHO, and other applicable national standards.

Once the quality control program is approved, careful application of the process and standards presented in the remainder of this document will ensure a robust quality assurance program.

5. SECURITY:

Background checks shall be required as further defined herein for all Contractors’ and any Subcontractors’ employee(s) providing services hereunder to the Government The contractor is responsible for the cost of this check. This shall allow the Contractor to access areas within the Medical Center such as offices, clinics, patient rooms, and other restricted areas. No employee shall be permitted to perform work or access non-public areas unescorted without a background check and written clearance by VA Police.

A. Contractor shall have or enter into an approved Business Associate Agreement (BAA) with VA prior to commencement of services.

B. Due to the increased emphasis on privacy and information security, the following special contract requirements are established and hereby made part of the contract entered into with the Department of Veterans Affairs.

C. Privacy Training: Contractor and their sub-contractors assigned work under the contract are required to receive annual training on patient privacy as established by HIPAA statues. Training must meet VHA’s and the Department of Health and Human Services Standards for Privacy of Individually-identifiable health information. Contractor shall provide documented proof to the contracting officer that all employees assigned work and/or having access to Protected Health Information have received annual training.

D. Proof of training is to be forwarded to the Contracting Officer. Training can be obtained through http://www.insidetms.va.gov/. An account must be set up in order to access the training site by visiting the http://www.insidetms.va.gov/ page and contacting the local TMS Administrator, contacting the VA TMS Help Desk by phone at 1-866-496-0463.

1. For contractors and sub-contractors who do not have access to VHA computer systems, this requirement is met by receiving VHA National Privacy Training, other VHA approved privacy training or contractor furnished training that meets the requirements of the HHS standards.

2. Rules of Behavior for Automated Information Systems: Contractor personnel having access to VA Information Systems are required to read and sign a Rules of Behavior statement which outline rules of behavior related to VA Automated Information Systems. The COR will provide, through the facility ISO, the Rules of Behavior to the Contractor for the respective facility.

3. VA Cyber Security Awareness Training: Each contractor assigned work under the contract is required to receive and document completion of VA training on Cyber Security. Training can be obtained through http://www.insidetms.va.gov/. . An account must be set up in order to access the training site by visiting the http://www.insidetins.va.gov/ page and contacting the local TMS Administrator, contacting the VATMS Help Desk by phone at 1-866-496-0463. Contractor shall provide documented proof to the contracting officer that all contractor employees servicing a VA contract have received annual training.

5.1 Damage. Extreme caution shall be exercised to prevent damage to the building and its contents. Any damage must be reported to the COR immediately for appropriate action. Any damage caused by the contractor will be repaired and or replaced to the satisfaction of the VA at the contractor’s expense. Damage to the building, its contents or loss of Government property, in excess of $100,000 will require a Report of Survey or Investigative Report by the VA OPC. Appropriate Government personnel will conduct the investigation. The responsible party will be required to replace and/or submit payment for damage or loss.

5.2 Unauthorized Use of Government Equipment

The Contractor shall not allow his/her employees, including Subcontractors’ employees, to open desk drawers, cabinets, or to use office equipment, including the use of non-pay telephones for any purpose other than a local emergency call.

The Contractor shall be responsible to provide all necessary equipment, tools, parts, and materials to perform the work. The Government shall not be obligated to provide any equipment, tools, parts, and materials to assist the Contractor in performing the work.

5.3 Identification, Parking, Smoking, and VA Regulations

A. The contractor's personnel shall be fluent in English language and follow applicable policies of the Department of Veterans Affairs and the Tomah VA OPC. Contractor’s employees must be courteous and respectful of the staff and/or any patients, visitors, etc. at the facility. No non-emergency or personnel phone calls, cell phones, or personnel business will be allowed during the performance of this contract. Disrespect, profanity or foul language towards the staff or anyone on premises will not be tolerated and will result in request for immediate dismissal. Contractor agrees to VA’s right to request removal of an employee if any of the above should occur or is in the best interest of the patients and staff. The VA is a drug free workplace.

B. The Contractor's employees and/or subcontractors approved by the COR shall wear visible identification at all times while on the premises of the VAMC facilities within the VISN. Identification shall include but not be limited to a company identification card, which shall include the company name, employee name, title, and a photograph of the employee. All employees of the Contractor or Subcontractor providing services to the Government shall wear a company uniform identified with the company name and/or logo. Uniforms shall be neat and clean at all times while working the VA premises and will be approved by the COR. The VA dress code and standards shall be adhered to at all times. Personal hygiene and grooming shall be maintained at all times.

C. Smoking is prohibited on all VA campuses, to include outdoors.

D. Possession of weapons is prohibited. Enclosed containers, including tool kits, shall be subject to search. Violations of VA regulations may result in citation answerable in the United States (Federal) District Court, not a local district, state, or municipal court.

E. It is the responsibility of the Contractor to park in the appropriate designated parking areas. Information on parking is available from the VA Police Section. The VAMC will not invalidate or make reimbursement for parking violations of the Contractor under any conditions.

F. Any interior or exterior doors that shall be unlocked to gain access shall be kept locked during the performance of work unless it results in the creation of a safety hazard. In those instances, the Contractor is responsible to take necessary actions to maintain the same level of security prior to gaining access/performing work. Should any other devices need to be unlocked like an entry gate, those devices shall be locked immediately upon entry or exit. At no time shall the Contractor allow any person into a locked area or loan keys/access cards to another person. Contractor may be held in default for failure to comply with this requirement and subject the Contractor and employees to contract and other legal remedies.

G. Due to the nature of working at a Government facility, the Contractor's staff shall be required to sign in and out each day at a designated location determined by the COR.

H. The Contractor agrees that none of its officers or employees shall use or reveal any research, statistical, medical, or security information which may be obtained during the performance of the work or as a result their presence on Government premises without the written consent of the Government.

5.4 BACKGROUND INVESTIATION

5.4.1 Contractor Personnel Security Requirements

Special Agreement Check - SAC All Contractor Employees who require access to the Department of Veterans Affairs computer systems or who have access to sensitive information shall be required to have, at a minimum, a Special Agreement Check (SAC) which includes electronic Fingerprinting. A Contractor Employee shall not perform any contract work (except for any other required orientation and training that does not require access to a VA computer system) until fingerprinting is completed by the local Human Resource Management Service. Fingerprinting should take place on the first day that a Contractor Employee enters on duty. The Contracting Officer’s Technical Representative shall facilitate the SAC process for the Contractor and Contractor Employee.

If the SAC identifies “potentially actionable issues” in connection with a Contractor Employee and it is determined that the Contractor Employee needs to be removed, the Contracting Officer shall notify the Contractor and the Contractor shall immediately remove that Employee from contract work. The removal of the Employee shall not excuse any failure to meet contract requirements.

SACs and fingerprinting of Contractor Employees will be required even when an Employee will not be working on site at a VA Facility. The Contracting Officer can identify other options for accomplishing these SACs.

All contractor employees who require access to the Department of Veterans Affairs' Contractors computer systems or have access to sensitive information shall be the subject of a background investigation. The contractor is encouraged to have its employee immediately download the background investigation packet from http://www.va.gov/vabackground_investigations upon notification of contract award. A contractor’s employee shall not commence working at VA under contract until the Contracting Officer receives notification from the VA Office of Security and Law Enforcement that the contract employee’s application was received complete. A favorable adjudication from the VA Office of Security and Law Enforcement must be received in order for a contractor employee to continue contract performance. This requirement is applicable to all subcontractor personnel.

A. Position Sensitivity - The position sensitivity has been designated as SAC.

B. Background Investigation - The level of background investigation commensurate with the required level of access is Special Agreement Check (Electronic) (SAC)

C. Contractor Responsibilities - The contractor shall bear the expense ($50.00 per employee, which is subject to change) of obtaining background investigations. If the Office of Personnel Management (OPM) conducts the investigation, the contractor shall reimburse VA within 30 days. If timely payment is not made within 30 days from date of bill for collection, then VA shall deduct the cost incurred from the contractors 1st month’s invoice(s) for services rendered.

a. It is imperative for the contractor to provide, at the request of VA, a listing of contractor personnel performing services under the contract in order for the background investigation process to commence. This list will include name (first, middle, last) social security number; date of birth; city, state, and country of birth.

b. The contractor shall pre-screen all personnel requiring access to the computer systems to ensure they maintain a U.S. citizenship (or are fully authorized to work in the United States per current federal law) and are able to read, write, speak, and understand the English language.

c. The contractor or their employees shall submit a complete background investigation packet to the VA Security Investigations Center within 30 days or receipt. Additional guidance and information in completing the required forms, and examples of the forms, can be found at http ://www I.va.gov/VABackground_Investigations/page.cfm? pg—2.

The following required forms must be submitted to the VA Office of Security and Law Enforcement before contract performance begins:

VSC Security Request Package, SAC April 2012

d. Fingerprinting is required with the background investigation. Fingerprinting can be done at the local VA Facility. The Electronic Fingerprint Verification Form must be submitted with the above required forms.

e. The contractor, when notified of an unfavorable determination by the Government, shall withdraw the employee from consideration from working under the contract, and at the request of the VA, submit another employee for consideration.

f. The contractor may utilize a private investigating agency if such agency possesses an OPM and Defense Security Service certification. A Cage Code number must be provided to the VA Office of Security and Law Enforcement. VA Office of Security and Law Enforcement will verify the information and advise the contracting officer whether contractor’s access to the computer systems can be authorized.

g. All contractor employees and subcontractors are required to complete VA’s Privacy training annually. All Contractor employees and subcontractors requiring access to VA computer network are required to complete Cyber Security training courses annually either on-line or hard copy. Documented proof must be provided to the Contracting Officer.

h. The contractor will notify the COR immediately when their employee(s) no longer require access to VA computer systems.

i. Failure to comply with the Contractor personnel security requirements may result in termination of the contract for default.

D. Government Responsibilities

a. The VA Security Investigations Center will provide the necessary forms to the contractor or to the Contractor’s employees after receiving the required information.

b. Upon receipt, the VA Security Investigations Center will review the completed forms for accuracy and forward the forms to OPM to conduct the background investigation.

c. The VA facility will pay for investigations conducted by the Office of Personnel Management (OPM) in advance. In these instances, the Contractor will reimburse the VA facility within 30 days.

d. The VA Security Investigations Center will notify the Contracting Officer and Contractor after adjudicating the results of the background investigations received from OPM.

e. The Contracting Officer will ensure that the Contractor provides evidence that investigations have been completed or are in the process of being requested.

5.5 Access to VA Information and VA Information Systems

A. A contractor/subcontractor shall request logical (technical) or physical access to VA information and VA information systems for their employees, subcontractors, and affiliates only to the extent necessary to perform the services specified in the contract, agreement, or task order.

B. All contractors, subcontractors, and third-party servicers and associates working with VA information are subject to the same investigative requirements as those of VA appointees or employees who have access to the same types of information. The level and process of background security investigations for contractors must be in accordance with VA Directive and Handbook 0710, Personnel Suitability and Security Program. The Office for Operations, Security, and Preparedness is responsible for these policies and procedures.

C. The contractor or subcontractor must notify the Contracting Officer immediately when an employee working on a VA system or with access to VA information is reassigned or leaves the contractor or subcontractor’s employ. The Contracting Officer must also be notified immediately by the contractor or subcontractor prior to an unfriendly termination.

5.6 VA Information Custodial Language

A. Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor/subcontractor in performance or administration of the contract shall be used only for those purposes and shall not be used in any other way without the prior written agreement of the VA. This clause expressly limits the contractor/subcontractor's rights to use data as described in Rights in Data - General, FAR 52.227-14(d) (1).

B. The contractor/subcontractor must receive, gather, store, back up, maintain, use, disclose and dispose of VA information only in compliance with the terms of the contract and applicable Federal and VA information confidentiality and security laws, regulations and policies. If Federal or VA information confidentiality and security laws, regulations and policies become applicable to the VA information or information systems after execution of the contract, or if NIST issues or updates applicable FIPS or Special Publications (SP) after execution of this contract, the parties agree to negotiate in good faith to implement the information confidentiality and security laws, regulations and policies in this contract.

C. If VA determines that the contractor has violated any of the information confidentiality, privacy, and security provisions of the contract, it shall be sufficient grounds for VA to withhold payment to the contractor or third party or terminate the contract for default or terminate for cause under Federal Acquisition Regulation (FAR) part 12.

D. If a VHA contract is terminated for cause, the associated BAA must also be terminated and appropriate actions taken in accordance with VHA Handbook 1600.01, Business Associate Agreements. Absent an agreement to use or disclose protected health information, there is no business associate relationship.

E. Except for uses and disclosures of VA information authorized by this contract for performance of the contract, the contractor/subcontractor may use and disclose VA information only in two other situations: (i) in response to a qualifying order of a court of competent jurisdiction, or (ii) with VA’s prior written approval. The contractor/subcontractor must refer all requests for, demands for production of, or inquiries about, VA information and information systems to the VA contracting officer for response.

F. Notwithstanding the provision above, the contractor/subcontractor shall not release VA records protected by Title 38 U.S.C. 5705, confidentiality of medical quality assurance records and/or Title 38 U.S.C. 7332, confidentiality of certain health records pertaining to drug addiction, sickle cell anemia, alcoholism or alcohol abuse, or infection with human immunodeficiency virus. If the contractor/subcontractor’ is in receipt of a court order or other requests for the above-mentioned information, that contractor/subcontractor shall immediately refer such court orders or other requests to the VA contracting officer for response.

5.7 Security Incident Investigation

A. The term “security incident” means an event that has, or could have, resulted in unauthorized access to, loss or damage to VA assets, or sensitive information, or an action that breaches VA security procedures. The contractor/subcontractor shall immediately notify the COR and simultaneously, the designated ISO and Privacy Officer for the contract of any known or suspected security/privacy incidents, or any unauthorized disclosure of sensitive information, including that contained in system(s) to which the contractor/subcontractor has access.

B. To the extent known by the contractor/subcontractor, the contractor/subcontractor’s notice to VA shall identify the information involved, the circumstances surrounding the incident (including to whom, how, when, and where the VA information or assets were placed at risk or compromised), and any other information that the contractor/subcontractor considers relevant.

C. With respect to unsecured protected health information, the business associate is deemed to have discovered a data breach when the business associate knew or should have known of a breach of such information. Upon discovery, the business associate must notify the covered entity of the breach. Notifications need to be made in accordance with the executed business associate agreement.

In instances of theft or break-in or other criminal activity, the contractor/subcontractor must concurrently report the incident to the appropriate law enforcement entity (or entities) of jurisdiction, including the VA OIG and Security and Law Enforcement. The contractor, its employees, and its subcontractors and their employees shall cooperate with VA and any law enforcement authority responsible for the investigation and prosecution of any possible criminal law violation(s) associated with any incident. The contractor/subcontractor shall cooperate with VA in any civil litigation to recover VA information, obtain monetary or other compensation from a third party for damages arising from any incident, or obtain injunctive relief against any third party arising from, or related to, the incident.

5.8 Liquidated Damages for Data Breach

A. Consistent with the requirements of 38 U.S.C. §5725, a contract may require access to sensitive personal information. If so, the contractor is liable to VA for liquidated damages in the event of a data breach or privacy incident involving any SPI the contractor/subcontractor processes or maintains under this contract.

B. The contractor/subcontractor shall provide notice to VA of a “security incident” as set forth in the Security Incident Investigation section above. Upon such notification, VA must secure from a non-Department entity or the VA Office of Inspector General an independent risk analysis of the data breach to determine the level of risk associated with the data breach for the potential misuse of…