36C25221R0003_1.docx

36C25221R0003

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

36C25221R0003 11-17-2020 Maureen Falaschi 12-09-2020

2:00PM

CST

36C252 Department of Veterans Affairs Great Lakes Acquisition Center (GLAC) 115 S 84th Street, Suite 101 Milwaukee WI 53214-1476 X X 621910 $16.5 Million N/A X Jesse Brown VA Medical Center (JBVA) located in Chicago, IL and other VA and non-VA Medical Centers.

See Performance Work Statement 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 See CONTINUATION Page Non-Emergency ambulance transportation services (Stretcher Transports, Basic Life Support, Advanced Life Support, Critical Care Transports, and Transports of Deceased).

See Performance Work Statement.

SOLICITATION NOTICE OF TIERED EVALUATIONS INCLUDING

LARGE BUSINESS CONCERNS.

See CONTINUATION Page X X Maureen Falaschi

SECTION B - CONTINUATION OF SF 1449 BLOCKS

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

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:

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

a. CONTRACTOR:

CONTRACTOR NAME _____________________________________

ADDRESS ________________________________________________

CITY-STATE-ZIP __________________________________________

POINT OF CONTACT/TITLE ________________________________

DUNS NUMBER NO. ______________________________________

CONTRACTOR’S PAST PERFORMANCE POINT OF CONTACT

(IF DIFFERENT THAN ABOVE):

NAME: __________________________________________

EMAIL ADDRESS:_________________________________

b. GOVERNMENT: MAUREEN FALASCHI, CONTRACTING OFFICER

CONTRACTING OFFICE CODE: 36C252

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 FOR AWARD MANAGEMENT (OCT 2018)

3. INVOICES:

a. Invoices shall be submitted weekly in arrears in accordance with: 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 weekly in arrears 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.

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 Veterans Affairs Financial Services Center (VAFSC) 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. As of July 1, 2020, the VA10091 form has been eliminated and the VAFSC is requiring our vendors to update and add their information in the Customer Engagement Portal (CEP) at https://www.cep.fsc.va.gov/. This is for new vendors being added to FMS only.

e. 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. ACQUISITION OF COMMERCIAL ITEMS:

This Request for Proposal (RFP) solicitation is issued under the authority of FAR Part 15.101-2 Lowest Price Technically Acceptable Source Selection Process. See 52.212-2 Evaluation – Commercial Items for a description of the factors in addition to price 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.

For detailed instructions on submittal requirements, please see FAR 52.212-1 Instructions to Offerors – Commercial Items.

6. RFP QUESTIONS:

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 FRIDAY, DECEMBER 4, 2020 AT 10:00AM LOCAL TIME. Contracting will issue a consolidated response via solicitation amendment to https://beta.sam.gov Contract Opportunities.

7. CONTRACTING OFFICER AUTHORITY:

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.

8. SITE VISIT:

It is strongly suggested and expected that the offeror inspect the campus to be serviced to fully understand the nature of the work and the conditions under which the work is to be performed. In no case shall failure to inspect the campus constitute grounds for a claim after contract award.

Offerors must contract the Contracting Officer, Maureen Falaschi, at 414-844-4853 or Maureen.Falaschi@va.gov to schedule a site visit. Site visits must occur no later than December 3, 2020.

PLEASE NOTE: WHILE ON CAMPUS, ALL PERSONS WILL BE REQUIRED TO WEAR MASKS INSIDE ANY VAMC BUILDING AND WHILE TRAVELING IN VEHICLES FOR PURPOSES OF THE SITE VISIT.

9. PARKING, SMOKING AND VA REGULATIONS:

a. 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 VA will not invalidate or make reimbursement for parking violations of the Contractor under any conditions.

b. All VA facilities are drug free.

c. All contractor personnel are required to adhere to all VA rules and regulations.

d. Smoking is prohibited on the entire campus, both inside and outside the VA Facility

e. 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.

f. VHA DIRECTIVE 1192: This Veterans Health Administration (VHA) directive establishes policy and provides guidance for the prevention of seasonal influenza in VHA facilities through the vaccination or masking of health care personnel (HCP). AUTHORITY: Title 38 United States Code (U.S.C.) 7301(b), 7318(b). Contractor is responsible for providing face masks and influenza vaccines for all employees working at a VA facility. If Directive 1192 is applicable the Contractor, in conjunction with the Contracting Officer Representative (COR), is responsible in ensuring that all aspects of this directive are implemented.

10. RAMP-UP:

The contract will include a ramp-up period, gradually ordering more transports under contract over the first weeks after contract award. The contractor shall be responsible for all orders placed under contract no later than 1 month after contract award.

B.1 PRICE/COST SCHEDULE

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

The total maximum amount of services acquired under this contract shall not exceed $10,000,000.00. The Contractor shall notify the Contracting Officer when they have invoiced for 80% of the contract ceiling amount.

The guaranteed minimum is $375,000.00 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” and CLINs ending in 015.

CLINs that include “Within Indiana Only” must have both an origin and destination in the state of Indiana.

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 Estimated Quantities column are estimated quantities only and shall be considered nonbinding. The Contractor shall track the aggregate quantity of services performed under each line item for each ordering period and provide to the COR quarterly, or more frequently if requested.

Ordering officers may 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.

**NOTE** The estimated quantities in the Price Schedule below are under normal operating conditions. The estimated # of transports throughout the period of the COVID-19 Safe at Home was approximately 1/3 less than normal operating conditions.

The Attachment entitled “Actual JBVA Ambulance Transports” depicts the actual number of transports completed since July 2019. Approximately 90% of the BLS Transports are considered Stretcher Transports.

ITEM INFORMATION

QUANTITY

Stretcher Services Base Rate (up to 10 miles) Includes 30 min. wait time Ordering Period 1 POP Begin: 01/01/2021 POP End: 09/30/2021

Stretcher Services Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 1

Stretcher Services Loaded Mileage Rate (per mile rate beyond the Base Rates) Ordering Period 1

BLS Base Rate (up to 10 miles)

Ordering Period 1

BLS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 1

BLS Loaded Mileage Rate (per mile rate beyond the Base Rates)

ALS Base Rate (up to 10 miles)

Ordering Period 1

ALS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 1

ALS Loaded Mileage Rate (per mile rate beyond the Base Rates)

CCT Base Rate (up to 10 miles)

Ordering Period 1

CCT Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 1

CCT Loaded Mileage Rate (per mile rate beyond the Base Rates)

Transports of Deceased

Wait Time (15 min. intervals, beyond initial 30 min)

Flat Fee: When unloaded mileage exceeds loaded mileage (See PWS 4.9.3)

Stretcher Services Base Rate (up to 10 miles)

Ordering Period 2 POP Begin: 10/01/2021 POP End: 09/30/2022

Stretcher Services Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 2

Stretcher Services Loaded Mileage Rate (per mile rate beyond the Base Rates) Ordering Period 2

BLS Base Rate (up to 10 miles)

Ordering Period 2

BLS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 2

BLS Loaded Mileage Rate (per mile rate beyond the Base Rates)

ALS Base Rate (up to 10 miles)

Ordering Period 2

ALS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 2

ALS Loaded Mileage Rate (per mile rate beyond the Base Rates)

CCT Base Rate (up to 10 miles)

Ordering Period 2

CCT Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 2

CCT Loaded Mileage Rate (per mile rate beyond the Base Rates)

Transports of Deceased

Wait Time (15 min. intervals, beyond initial 30 min)

Flat Fee: When unloaded mileage exceeds loaded mileage (See PWS 4.9.3)

Stretcher Services Base Rate (up to 10 miles)

Ordering Period 3 POP Begin: 10/01/2022 POP End: 09/30/2023

Stretcher Services Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 3

Stretcher Services Loaded Mileage Rate (per mile rate beyond the Base Rates) Ordering Period 3

BLS Base Rate (up to 10 miles)

Ordering Period 3

BLS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 3

BLS Loaded Mileage Rate (per mile rate beyond the Base Rates)

ALS Base Rate (up to 10 miles)

Ordering Period 3

ALS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 3

ALS Loaded Mileage Rate (per mile rate beyond the Base Rates)

CCT Base Rate (up to 10 miles)

Ordering Period 3

CCT Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 3

CCT Loaded Mileage Rate (per mile rate beyond the Base Rates)

Transports of Deceased

Wait Time (15 min. intervals, beyond initial 30 min)

Flat Fee: When unloaded mileage exceeds loaded mileage (See PWS 4.9.3)

Stretcher Services Base Rate (up to 10 miles)

Ordering Period 4 POP Begin: 10/01/2023 POP End: 09/30/2024

Stretcher Services Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 4

Stretcher Services Loaded Mileage Rate (per mile rate beyond the Base Rates) Ordering Period 4

BLS Base Rate (up to 10 miles)

Ordering Period 4

BLS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 4

BLS Loaded Mileage Rate (per mile rate beyond the Base Rates)

ALS Base Rate (up to 10 miles)

Ordering Period 4

ALS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 4

ALS Loaded Mileage Rate (per mile rate beyond the Base Rates)

CCT Base Rate (up to 10 miles)

Ordering Period 4

CCT Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 4

CCT Loaded Mileage Rate (per mile rate beyond the Base Rates)

Transports of Deceased

Wait Time (15 min. intervals, beyond initial 30 min)

Flat Fee: When unloaded mileage exceeds loaded mileage (See PWS 4.9.3)

Stretcher Services Base Rate (up to 10 miles)

Ordering Period 5 POP Begin: 10/01/2024 POP End: 9/30/2025

Stretcher Services Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 5

Stretcher Services Loaded Mileage Rate (per mile rate beyond the Base Rates) Ordering Period 5

BLS Base Rate (up to 10 miles)

Ordering Period 5

BLS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 5

BLS Loaded Mileage Rate (per mile rate beyond the Base Rates)

ALS Base Rate (up to 10 miles)

Ordering Period 5

ALS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 5

ALS Loaded Mileage Rate (per mile rate beyond the Base Rates)

CCT Base Rate (up to 10 miles)

Ordering Period 5

CCT Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 5

CCT Loaded Mileage Rate (per mile rate beyond the Base Rates)

Transports of Deceased

Wait Time (15 min. intervals, beyond initial 30 min)

Flat Fee: When unloaded mileage exceeds loaded mileage (See PWS 4.9.3)

Stretcher Services Base Rate (up to 10 miles)

Ordering Period 6 POP Begin: 10/01/2025 POP End: 12/31/2025

Stretcher Services Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 6

Stretcher Services Loaded Mileage Rate (per mile rate beyond the Base Rates) Ordering Period 6

BLS Base Rate (up to 10 miles)

Ordering Period 6

BLS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 6

BLS Loaded Mileage Rate (per mile rate beyond the Base Rates)

ALS Base Rate (up to 10 miles)

Ordering Period 6

ALS Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 6

ALS Loaded Mileage Rate (per mile rate beyond the Base Rates)

CCT Base Rate (up to 10 miles)

Ordering Period 6

CCT Base Rate (Within Indiana Only - up to 30 miles)

Ordering Period 6

CCT Loaded Mileage Rate (per mile rate beyond the Base Rates)

Transports of Deceased

Wait Time (15 min. intervals, beyond initial 30 min)

Flat Fee: When unloaded mileage exceeds loaded mileage (See PWS 4.9.3)

PERFORMANCE WORK STATEMENT (PWS)

1. Purpose: The Jesse Brown VA Medical Center (hereafter JBVA), its associated Community-Based Outpatient Clinics (CBOCs), and affiliated healthcare clinics require contracted non-emergency ambulance transportation services. The contractor shall provide all vehicles, personnel, management, supplies, equipment, and necessary reporting for the provision of Stretcher Transports, Basic Life Support (BLS), Advanced Life Support (ALS), Critical Care Transport (CCT) services, and Transport of Deceased. The contactor shall make these ambulance services available to the VA as needed, 24 hours a day, seven days a week (24/7), including weekends and holidays.

2. Background: The JBVA main campus is located downtown Chicago at 820 S. Damen Ave., serving over 62,000 veterans, primarily from the Chicago metro service area and it’s four (4) Community-Based Outpatient Clinics. The hospital has 200 inpatient beds and sees approximately 8,100 -inpatient admissions and 560,000 outpatient visits a year.

3. Acronyms ALS – Advanced Life Support AOD – Administrative Officers of the Day BLS – Basic Life Support CCT – Critical Care Transport CCTP – Critical Care Transport Paramedic CCEMTP – Critical Care Emergency Medical Transport CO – Contracting Officer COR – Contracting Officer’s Representative CPR – Cardiopulmonary Resuscitation DOL – Department of Labor EMT – Emergency Medical Technician IAW – In Accordance With OO – Ordering Officer PWS – Performance Work Statement QASP – Quality Assurance Surveillance Plan QC – Quality Control Plan TB – Tuberculosis TJC – The Joint Commission VTS – Veteran Transportation Service

4. Scope/Requirements

4.1. Types of Ambulance Service

4.1.1. The contractor shall provide non-emergent Stretcher Transports, 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 in accordance with all federal, state, and local regulations.

4.1.2. The contractor shall provide Transport of Deceased services on an as-needed basis in accordance with state law.

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 the JBVA, destination is deemed to be the ER, Admissions, the clinic or service within the hospital, or directly to the ward as instructed by VA 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), Critical Care Transport Paramedics (CCTPs) & Other Personnel

4.3.1.1. EMTs, CCTPs and other medical personnel (as applicable) shall at all times meet the qualifications specified in this contract as well as all applicable federal, state, and local government laws, regulations, and standards. EMTs, CCTPs 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 qualifications to the Contracting Officer’s Representative (COR) for review.

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. CCTPs shall have met all state requirements for the tier in which they are performing services in (I, II, III). Proof in the form of a current certificate for the successful completion of such must be provided to the COR 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 JBVA. Thereafter the contracted employees will be subject annually to the same requirement, with a 90-day window to complete such requirement as provided by JBVA. The VA Security and Investigation Center (SIC) is responsible for adjudicating all background investigations for contract employees.

4.3.1.6. EMTs, CCTPs, and other contractor personnel as applicable must pass the Contractor’s background check and must not have been convicted of (or have any pending charges for) a felony for the past five years. Personnel (and Contractor) must report any new or additional charges or convictions if they arise during the course of performance under this contract so VA can review them and determine whether the employee in question needs to be discharged of his or her duties until the matter is adjudicated.

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 in accordance with state guidelines 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 at the start of each Ordering Period.

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.

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. The contractor shall furnish all linen required for patient transport at no additional cost. Linen shall not be exchanged with linen belonging to JBVA or its CBOCs.

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 (Stretcher Transports, BLS, ALS, CCT, Deceased). No more than one patient will be transported per order unless approved by an authorized VA staff.

4.5.1.2. Transportation requests will be made through VETRIDE. Contractors must have the capability to receive orders, update ride status, and input trip costs and other required data through this portal. Contractors must have dedicated staff available to monitor this portal 24/7. JBVA Travel Program Staff will be available to assist with account setup and training for the Contractor’s Staff. In the event VETRIDE is down, other methods of communication (ie. telephone, facsimile) will be used to place Transportation requests.

4.5.1.2.1. JBVA Travel Program Staff will work with the Contractor the following business day to reconcile any transportation requests that were placed outside of VETRIDE.

4.5.1.2.2. The Contractor must update VETRIDE with any data and/or notes in real time that deviate from the original order such as invoicing for additional mileage due to a road closure, wait time, reason for no load, etc. JBVA Travel Program Staff may place a “hold” on payment of this order until it has been reconciled.

4.5.1.3. Only the following VA staff are authorized to place, cancel, or make changes to transportation requests:

· Beneficiary Travel Office Staff

· Contracting Officer’s Representative (COR)

· All Administrative Officers of the Day (AOD) Ordering Officers may be authorized to place orders against this contract. The Contracting Officer will furnish the Contractor with the names of individuals above, who are authorized as Ordering Officers, by separate memorandum upon issuance of the contract. The Contracting Officer will update this list throughout the life of the contract as Ordering Officers change. 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.

Non-authorized VA employees and private agencies (e.g. nursing homes) are not considered authorized to place transportation requests.

4.5.1.3.1. 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. Orders may be confirmed via VETRIDE.

4.5.1.4. 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.

4.5.1.5. The type of transportation service (Stretcher Transports, 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.

4.5.1.6. 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.

4.5.1.7. The contractor shall have sufficient vehicles and personnel to provide services for up to four (4) simultaneous transportation requests. Transports required may be for any mix of Stretcher Transports, BLS, ALS, or Deceased transports. One of these four simultaneous transports may require CCT capability up to Tier III. If JBVA requires ambulance services exceeding four (4) simultaneous transportation requests, 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.

4.5.1.8. The number of transports under normal operating conditions will typically range from 28-38 transports each weekday and significantly less on weekends and holidays. The number of actual transports may vary throughout the life of the contract.

4.5.1.9. Response Times*

4.5.1.9.1. 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 4.5.1.9.3 below, the contractor shall arrive on time for all orders scheduled in advance.

4.5.1.9.2. For all transportation requests, with pick up at JBVA:

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.

b. For an urgent transport request for a critical patient (as deemed by the physician) with pick up at JBVA, the contractor will be allotted up to a thirty (30) minute response time.

4.5.1.9.3. For transportation requests which do not have a pick-up at JBVA:

a. 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;

b. Pick-up appointment times shall be agreed upon by the VA and contractor at time of order placement and be reasonable based upon travel distance, speed limits, and weather conditions. The contractor’s patient pick-up time shall not deviate by more than thirty (30) minutes.

c. The contractor’s patient pick-up time shall not deviate by more than thirty (30) 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, 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 (Stretcher Transports, BLS, ALS, CCT) and the one-way mileage (Stretcher Transports, 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 JBVA ONLY – The contractor will immediately 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 the JBVA 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. front door of Damen Entrance). These locations will be specified by VA staff when an order is placed and communicated to the transporting personnel.

4.6.2. When applicable, ambulance personnel shall report to the Veteran Transportation Service (VTS) Dispatcher or Administrative Officer of the Day (AOD) 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, Requestor, Program Manager, Beneficiary Travel Department, 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, Program Manager, or Beneficiary Travel Department, by the close of business of the next working 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. If unloaded mileage exceeds loaded mileage, the contractor may invoice for a flat fee only if the following also occur:

· Unloaded mileage exceeds 75 miles

· The contractor does not deviate from a route to intentionally make unloaded mileage exceed loaded mileage.

4.9.4. With the exception of “no shows” defined in 4.5.2.1.1 above and trips when unloaded mileage exceeds loaded mileage in accordance with 4.9.3, the contractor shall invoice for loaded (patient onboard) services and mileage only. The contractor shall submit an electronic invoice weekly for services of the preceding week. 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 (ie. total number of BLS Base Rate, total BLS Mileage incurred, etc.)

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

4.9.5. Invoices may be paid by the Government using Purchase Order Numbers or Delivery Order Numbers.

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 Date of Award through December 31, 2025.

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. Jesse Brown VA Medical Center to include specific Atrium Clinics, Emergency Department, pavilions, or out-buildings on the JBVA campus. The JBVA address is: 820 S. Damen Ave, Chicago, IL 60612.

5.2.2. JBVA Community-Based Outpatient Clinics (CBOCs):

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

VA Illiana Health Care System 1900 E. Main St.

Danville, IL 61832

5.2.4. Other Non-VA Medical facilities and Community Care facilities as authorized by the VA.

5.2.5. Veteran’s residence.

5.2.6. Local airports including Chicago O’Hare International Airport (ORD) and Chicago Midway International Airport (MDW).

6. Quality Control Plan

6.1. Quality Control

6.1.1. The contractor shall maintain a Quality Control Plan (QCP) that contains, at a minimum, the following:

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

6.1.1.3. A description of the specific steps the contractor will take for corrective action if needed if a deficiency or problem in the quality of service occurs.

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

6.1.1.5. 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 4 simultaneous transports in accordance with PWS 4.5.1.7).

6.1.1.6. 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.

6.1.1.7. A description of the method/system used to log all requests for service. The contractor shall confirm that the log 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 log will be sent to the COR monthly.

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

6.1.3. 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.

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

6.2. Minimum Performance Standards

6.2.1. 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.

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