36C25220Q0537_1.docx

36C25220Q0537

PAGE 1 OF

1. REQUISITION NO.

2. CONTRACT NO.

3. AWARD/EFFECTIVE DATE

4. ORDER NO.

5. SOLICITATION NUMBER

6. SOLICITATION ISSUE DATE

a. NAME

b. TELEPHONE NO. (No Collect Calls)

8. OFFER DUE DATE/LOCAL

TIME

9. ISSUED BY

CODE

10. THIS ACQUISITION IS

UNRESTRICTED OR

SET ASIDE:

% FOR:

SMALL BUSINESS

HUBZONE SMALL

BUSINESS

SERVICE-DISABLED

VETERAN-OWNED

SMALL BUSINESS

WOMEN-OWNED SMALL BUSINESS

(WOSB) ELIGIBLE UNDER THE WOMEN-OWNED

SMALL BUSINESS PROGRAM

EDWOSB

8(A)

NAICS:

SIZE STANDARD:

11. DELIVERY FOR FOB DESTINA-

TION UNLESS BLOCK IS

MARKED

SEE SCHEDULE

12. DISCOUNT TERMS

13a. THIS CONTRACT IS A

RATED ORDER UNDER

DPAS (15 CFR 700)

13b. RATING

14. METHOD OF SOLICITATION

RFQ

IFB

RFP

15. DELIVER TO

CODE

16. ADMINISTERED BY

CODE

17a. CONTRACTOR/OFFEROR

CODE

FACILITY CODE

18a. PAYMENT WILL BE MADE BY

CODE

TELEPHONE NO.

DUNS:

DUNS+4:

PHONE:

FAX:

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

SEE ADDENDUM

19.

20.

21.

22.

23.

24.

ITEM NO.

SCHEDULE OF SUPPLIES/SERVICES

QUANTITY

UNIT

UNIT PRICE

AMOUNT

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

25. ACCOUNTING AND APPROPRIATION DATA

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

ARE

ARE NOT ATTACHED.

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

ARE

ARE NOT ATTACHED

28. CONTRACTOR IS REQUIRED TO SIGN THIS DOCUMENT AND RETURN _______________

29. AWARD OF CONTRACT: REF. ___________________________________ OFFER

COPIES TO ISSUING OFFICE. CONTRACTOR AGREES TO FURNISH AND

DATED ________________________________. YOUR OFFER ON SOLICITATION

DELIVER ALL ITEMS SET FORTH OR OTHERWISE IDENTIFIED ABOVE AND ON ANY

(BLOCK 5), INCLUDING ANY ADDITIONS OR CHANGES WHICH ARE

ADDITIONAL SHEETS SUBJECT TO THE TERMS AND CONDITIONS SPECIFIED

SET FORTH HEREIN IS ACCEPTED AS TO ITEMS:

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

AUTHORIZED FOR LOCAL REPRODUCTION

(REV. 2/2012)

PREVIOUS EDITION IS NOT USABLE

Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

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

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL ITEMS

36C25220Q0537 06-08-2020 Becky Cincotta 414-844-4822 06-19-2020

1:30 PM

36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 X X 621512 $16.5 Million N/A X 36C556 Captain James A. Lovell Federal Health Care Center 3001 N. Green Bay Road North Chicago IL 60064-3048 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 Contractor to provide Teleradiology Services to the Captain James A. Lovell Federal Health Care Center in accordance wit the specifications, terms, and conditions contained herein.

This procurement is 100% set-aside for Service-Disabled Veteran-Owned Small Businesses (SDVOSB). All vendors must be listed and verified as an SDVOSB in the Veterans Information Pages (VIP) website in order to be eligible for award.

See pages through for Price Schedule.

X X

BECKY CINCOTTA

CONTRACTING OFFICER

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1. CONTRACT ADMINISTRATION DATA

1. CONTRACT ADMINISTRATION MATTERS WILL BE HANDLED BY:

a. Contractor Name/Address/City-State-Zip (Please Print Or Type):

b. Contractor Past Performance Point of Contact:

c. Government:

Contracting Officer (CO) Becky Cincotta E-mail: becky.cincotta@va.gov Phone (414) 844-4822 Fax: 414-844-4891

Department of Veterans Affairs Great Lakes Acquisition Center 115 South 84th Street, Suite 101 Milwaukee, WI 53214-1476

2. CONTRACTOR REMITTANCE ADDRESS: All payments by the Government to the contractor will be made in accordance with Federal Acquisition Regulation (FAR) Clause 52.232-33, Payment by Electronic Funds Transfer—System for Award Management (31 U.S.C. 3332).

3. INVOICES:

a. 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 e-Invoice 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 https://authentication.tungsten-network.com/login or calling 1-877-752-0900 option 2 for Enrollment. During implementation Tungsten will confirm your Tax Payer ID Number with the VAFSC. This process can take up to 5 business days to complete to ensure your invoice is automatically routed to the Certifying Official for approval and payment.

b. 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 customer service may be contacted at 1-877-489-6135.

c. In addition to information required for submission of a “proper” invoice in accordance with FAR 52.212-4(g), all invoices sent to Tungsten Network shall reference the contractor name and address, invoice date and number, customer (VA facility) name, contract number, appropriate obligation/funding order number, and total invoice cost. For physician services, invoices shall include the date service was performed, physician name, and image description (including accession number and CPT) code. Invoices shall also include any payment discount terms. Subsequent changes or corrections shall be submitted by separate invoice. Clarification regarding requirements or any additional requirements should be confirmed with the Certifying Official or Contracting Officer.

d. No patient information shall be included in the invoices sent to Tungsten. A separate invoice including patient information shall be sent directly to the Contracting Officer’s Representative (COR) by trackable mail or by using another method specified by the individual(s) authorized to place orders under this contract.

e. Payments shall be made monthly in arrears upon receipt of a properly prepared invoice. For questions regarding invoice receipt or payment, please call VAFSC directly at 1-877-353-9791.

[End of Contract Administration Data]

B. 2 SCHEDULE OF SERVICES AND PRICE

Contractor shall provide all space, supplies, equipment, and labor, including board certified radiologists, necessary to provide Teleradiology Services on an on-demand, as needed basis for the Captain James A. Lovell Federal Health Care Center, 3001 Green Bay Road, North Chicago, IL 60044 (hereinafter referred to as FHCC), in accordance with the pricing, specifications, terms and conditions listed herein.

The FHCC Imaging Service follows the standards & guidelines set forth by American College of Radiology (ACR). A contractor providing Teleradiology Services shall provide services consistent with TJC that meet or exceed the American College of Radiology practice parameters, technical standards, and guidelines found at the website below.

https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards/Practice-Parameters-by-Subspecialty

Place of Performance: All work performed under this contract will be done at the Contractor’s place(s) of performance. The contractor’s total Teleradiology operations shall be confined to within the borders of the United States of America, District of Columbia and/or Puerto Rico. The Contractor shall not access any FHCC data/information (for example, by remote computer access) from locations that are outside the above-stated borders. Furthermore, the Contractor shall not send, transfer, mail or otherwise transmit any FHCC data/information to locations outside the above-stated borders.

Period of Performance: The contract will be effective for a 5-year Ordering Period from July 1, 2020 – June 30, 2025, any option period(s) exercised at the discretion of the Government.

Contract Type: The resultant contract type will be a Fixed (Unit) Price Indefinite Delivery, Indefinite Quantity (IDIQ) contract. The quantities provided in the Price Schedule are estimates. Contractor shall be paid only for actual services performed.

Authority: This procurement is being conducted under the authority of 38 U.S.C. 8153 – Sharing of Health Care Resources and in accordance with a combination of Federal Acquisition Regulation (FAR) Part 12 – Acquisition of Commercial Items and VAAR 873 - Simplified Acquisition Procedures for Health-Care Resources.

Basis of Award: The Government may award on the basis of initial quotations received, without exchanges. Therefore, each initial offer should contain the offeror’s best terms from a cost/price standpoint. Award of a contract will be made to the offeror whose offer represents the best value to the Government, considering price and non-price factors.

Guaranteed Minimum and Maximum Ceiling Amount: The minimum guarantee by the Government for this contract is $20,000.00 and the maximum ceiling amount for this contract is $1,750,000.00.

Ordering: The FHCC Imaging Service personnel are the only individuals authorized to order services under this contract. An order for Teleradiology Services is issued upon delivery of the images to the contractor through the FHCC electronic imaging system or, if that is not possible, through either a secure fax request or through an oral order.

Pricing Instructions: Columns in the Price Schedule for each Contract Line Item Number (CLIN) must be filled out by the offeror. NO CLINS or CPT codes should be left blank. If for some reason a CPT code on the Price Schedule has expired or is for any other reason unusable, the offeror shall annotate the Price Per Code block with “N/A” or otherwise notate the replacement code. If a spreadsheet is used, it must be submitted in Microsoft Excel without protected/locked portions or other methods that prevent the facilitation of expeditious pricing validation. PDF and similar files are not acceptable.

For pricing and evaluation purposes, the current Centers for Medicare & Medicaid Services (CMS) rates found at https://www.cms.gov/apps/physician-fee-schedule/overview.aspx shall be used as the basis of the proposed unit costs for all ordering Years. The applicable CMS locality code is 0610215 non-facility fee for Suburban Chicago. The CMS modifier is 26 (professional component).

Offeror shall indicate the firm fixed percentage of the CMS rates (unit costs) that the proposed unit costs represent. This percentage rate shall remain the same throughout the life of the contract and may be validated by post-award audits. The firm fixed percentage will be used by the Government for future pricing of additional codes/procedures added through contract modification and for reimbursement under the contract. The FHCC will pay the awarded firm fixed percentage of the Medicare rate effective at the time of contract award and at each new ordering Year.

“STAT” pricing will include the preliminary report and the final report that is entered and verified in the FHCC computer system within 24 hours. “ROUTINE” pricing will be based on the final report that is entered and verified in the FHCC computer system within 24 hours.

PRICE SCHEDULE

Year 1: July 1, 2020 to June 30, 2021

Qty.

Annual Cost (for evaluation purposes)

STAT

ROUTINE

Estimated Total Year 1

Year 2: July 1, 2021 through June 30, 2022

Qty.

Annual Cost (for evaluation purposes)

STAT

ROUTINE

Estimated Total Year 2

Year 3: July 1, 2022 through June 30, 2023

Qty.

Annual Cost (for evaluation purposes)

STAT

ROUTINE

Estimated Total Year 3

Year 4: July 1, 2023 through June 30, 2024

Qty.

Annual Cost (for evaluation purposes)

STAT

ROUTINE

Estimated Total Year 4

Year 5: July 1, 2024 through June 30, 2025

Qty.

Annual Cost (for evaluation purposes)

STAT

ROUTINE

Estimated Total Year 5

Estimated Total for all Years: $_________________________

KEY PERSONNEL: The contract physicians listed below are identified as Key Personnel who are authorized to provide services under this contract upon successful completion of the credentialing and privileging requirements and initiation or existing favorable adjudication of an ANACI background investigation.

[End of Schedule of Services and Price]

B.3. PERFORMANCE WORK STATEMENT – TELERADIOLOGY

1. GENERAL:

1.1. Services Provided: Contractor shall provide all space, supplies, equipment, and labor, including board certified radiologists, necessary to provide Teleradiology Services for the FHCC. Services are required 24 hours/day, 365 days/year on an on-demand, as needed basis.

The FHCC Imaging Service follows the standards & guidelines set forth by American College of Radiology (ACR). A contractor providing Teleradiology Services shall provide services consistent with TJC and that meet or exceed the American College of Radiology practice parameters, technical standards, and guidelines found at the website below.

https://www.acr.org/Clinical-Resources/Practice-Parameters-and-Technical-Standards/Practice-Parameters-by-Subspecialty

1.2. Policy/Handbooks: Contractor shall be subject to the following policies, including any subsequent updates during the period of performance:

1.2.1.