36C25519Q0382-0001000.docx
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- Wheelchair Services | STL
- Solicitation number
- 36C25519Q0382
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5. PROJECT NUMBER (if applicable)
CODE
7. ADMINISTERED BY
2. AMENDMENT/MODIFICATION NUMBER
CODE
6. ISSUED BY
8. NAME AND ADDRESS OF CONTRACTOR
4. REQUISITION/PURCHASE REQ. NUMBER
3. EFFECTIVE DATE
9A. AMENDMENT OF SOLICITATION NUMBER
9B. DATED
PAGE OF PAGES
10A. MODIFICATION
OF CONTRACT/ORDER NUMBER
10B. DATED
BPA NO.
1. CONTRACT ID CODE
FACILITY CODE
CODE
Offers must acknowledge receipt of this amendment prior to the hour and date specified in the solicitation or as amended, by one of the following methods:
The above numbered solicitation is amended as set forth in Item 14. The hour and date specified for receipt of Offers
E. IMPORTANT:
is extended,
(a) By completing Items 8 and 15, and returning __________ copies of the amendment; (b) By acknowledging receipt of this amendment on each copy of the offer submitted; or (c) By separate letter or electronic communication which includes a reference to the solicitation and amendment numbers. FAILURE OF YOUR
ACKNOWLEDGMENT TO BE RECEIVED AT
THE PLACE DESIGNATED FOR THE RECEIPT OF OFFERS PRIOR TO THE HOUR AND DATE SPECIFIED MAY is not extended.
12. ACCOUNTING AND APPROPRIATION DATA
(REV. 11/2016)
is required to sign this document and return ___________ copies to the issuing office is not, A. THIS CHANGE ORDER IS ISSUED PURSUANT TO:
Specify authority) THE CHANGES SET FORTH IN ITEM 14 ARE MADE IN THE CONTRACT ORDER NO. IN ITEM 10A.
15C. DATE SIGNED
B. THE ABOVE NUMBERED CONTRACT/ORDER IS MODIFIED TO REFLECT THE ADM
INISTRATIVE CHANGES
SET FORTH IN ITEM 14, PURSUANT TO THE AUTHORITY OF FAR 43.103(b).
RESULT IN REJECTION OF YOUR OFFER. If by virtue of this amendment you desire to change an offer already submitted, such change may be made by letter or electronic communication, provided each letter or electronic communication makes reference to the solicitation and this amendment, and is received prior to the opening hour and d ate specified.
C. THIS SUPPLEMENTAL AGREEMENT IS ENTERED INTO PURSUANT TO AUTHORITY OF:
D. OTHER
Contractor
16C. DATE SIGNED
14. DESCRIPTION OF AMENDMENT/MODIFICATION
16B. UNITED STATES OF AMERICA
Except as provided herein, all terms and conditions of the document referenced in Item 9A or 10A, as heretofore changed, remains unchanged and in full force and effect.
15A. NAME AND TITLE OF SIGNER
16A. NAME AND TITLE OF CONTRACTING OFFICER
15B. CONTRACTOR/OFFEROR
STANDARD FORM 3
PREVIOUS EDITION NOT USABLE
Prescribed by GSA - FAR (48 CFR) 53.243 (Type or print) (Type or print) (Organized by UCF section headings, including solicitation/contract subject matter where feasible.)
(Number, street, county, State and ZIP Code) (If other than Item 6) (Specify type of modification and authority) (such as changes in paying office, appropriation date, etc.)
(If required)
(SEE ITEM 11)
(SEE ITEM 13)
(X)
CHECK
ONE
13. THIS ITEM APPLIES ONLY TO
MODIFICATIONS OF CONTRACTS/ORDERS,
IT MODIFIES THE CONTRACT/ORDER NO. AS DESCRIBED IN ITEM 14.
11. THIS ITEM ONLY APPLIES TO AMENDMENTS OF SOLICITATIONS
AMENDMENT OF SOLICITATION/MODIFICATION OF CONTRACT
(Signature of person authorized to sign) (Signature of Contracting Officer)
NONE
36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048 36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway Leavenworth KS 66048 To all Offerors/Bidders
36C25519Q0382 06-26-2019
X X July 12, 2019 X
1(ONE)
The Request for Qoute (RFQ) 36C25519Q0382 is here by amended as follows:
1. The price schedule (B2) as been amended to reflect corrections in line item numbering and to add addtional information.
2. Please refer to page s below.
3. All other terms and conditions remain the same.
Frank Novello
CONTINUATION PAGE
B.2 SUPPLIES OR SERVICES AND PRICES/COSTS:
Contractor shall furnish assisted wheelchair van transportation for eligible beneficiaries of the VA Medical Center, St. Louis, Missouri (herein after referred to as VAMC). The VAMC St. Louis has two divisions located as follows: John Cochran Division (JC), 915 North Grand Blvd., St. Louis, MO 63106 and Jefferson Barracks Division (JB), #1 Jefferson Barracks Drive, St. Louis, MO 63125. Services shall be provided in accordance with all terms, conditions, provisions and the schedule of this solicitation. The primary intent of this contract is for prearranged non-emergency transportation.
BASE YEAR:
| ITEM NO. |
| SCHEDULE OF SUPPLIES/SERVICES |
| EST ANNUAL QUANTITY |
| UNIT |
| UNIT PRICE |
| EXTENDED AMOUNT |
| % OF UNIT PRICE FOR FUEL |
| 0001 |
| Base Rate for transportation of one (1) beneficiary, one way only within the city limits of St. Louis, MO. |
| 3000 |
| Trips |
n/a
| 0002 |
| Rate per mile beyond city limits of St. Louis, MO, one way only (This rate in addition to base rate in CLIN 0001.) |
24,000
Miles
| 0003 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and VAMC, Jefferson Barracks Division |
1,200
Trips n/a
| 0004 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and St. Louis University Medical Center |
nter
| 0005 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and St. Louis University Medical Center |
| 0006 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and Barnes-Jewish Hospital |
| 0007 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and Barnes-Jewish Hospital |
| 0008 |
| Trip rate for wheelchair transportation between VASTLHCS, John Cochran Division or Jefferson Barracks Division and VAMC Poplar Bluff, MO |
| 0009 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division or Jefferson Barracks Division and VAMC Marion, IL |
| 0010 |
| Excess waiting Time per quarter hour (15 minutes) Must be pre-approved |
Hour
| 0011 |
| Rate for additional wheelchair patient transported on any trip |
Job
| 0012 |
| Rate for attendance (in addition to driver) needed to transport patient with prior VA authorization |
| 0013 |
| No load charge/trip within St. Louis City |
Trip
Base Year Total: $
OPTION YEAR I:
| ITEM NO. |
| SCHEDULE OF SUPPLIES/SERVICES |
| EST ANNUAL QUANTITY |
| UNIT |
| UNIT PRICE |
| EXTENDED AMOUNT |
| % OF UNIT PRICE FOR FUEL |
| 1001 |
| Base Rate for transportation of one (1) beneficiary, one way only within the city limits of St. Louis, MO. |
| 3000 |
| Trips |
n/a
| 1002 |
| Rate per mile beyond city limits of St. Louis, MO, one way only (This rate in addition to base rate in CLIN1001.) |
| 1003 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and VAMC, Jefferson Barracks Division |
| 1004 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and St. Louis University Medical Center |
| 1005 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and St. Louis University Medical Center |
| 1006 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and Barnes-Jewish Hospital |
| 1007 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and Barnes-Jewish Hospital |
| 1008 |
| Trip rate for wheelchair transportation between VASTLHCS, John Cochran Division or Jefferson Barracks Division and VAMC Poplar Bluff, MO |
| 1009 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division or Jefferson Barracks Division and VAMC Marion, IL |
| 1010 |
| Excess waiting Time per quarter hour (15 minutes) Must be pre-approved |
| 1011 |
| Rate for additional wheelchair patient transported on any trip |
| 1012 |
| Rate for attendance (in addition to driver) needed to transport patient with prior VA authorization |
| 1013 |
| No load charge/trip within St. Louis City |
Option Year I Total: $
OPTION YEAR II:
| ITEM NO. |
| SCHEDULE OF SUPPLIES/SERVICES |
| EST ANNUAL QUANTITY |
| UNIT |
| UNIT PRICE |
| EXTENDED AMOUNT |
| % OF UNIT PRICE FOR FUEL |
| 2001 |
| Base Rate for transportation of one (1) beneficiary, one way only within the city limits of St. Louis, MO. |
| 3000 |
| Trips |
n/a
| 2002 |
| Rate per mile beyond city limits of St. Louis, MO, one way only (This rate in addition to base rate in CLIN 2001.) |
| 2003 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and VAMC, Jefferson Barracks Division |
| 2004 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and St. Louis University Medical Center |
| 2005 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and St. Louis University Medical Center |
| 2006 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and Barnes-Jewish Hospital |
| 2007 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and Barnes-Jewish Hospital |
| 2008 |
| Trip rate for wheelchair transportation between VASTLHCS, John Cochran Division or Jefferson Barracks Division and VAMC Poplar Bluff, MO |
| 2009 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division or Jefferson Barracks Division and VAMC Marion, IL |
| 2010 |
| Excess waiting Time per quarter hour (15 minutes) Must be pre-approved |
| 2011 |
| Rate for additional wheelchair patient transported on any trip |
| 2012 |
| Rate for attendance (in addition to driver) needed to transport patient with prior VA authorization |
| 2013 |
| No load charge/trip within St. Louis City |
Option Year II Total: $
OPTION YEAR III:
| ITEM NO. |
| SCHEDULE OF SUPPLIES/SERVICES |
| EST ANNUAL QUANTITY |
| UNIT |
| UNIT PRICE |
| EXTENDED AMOUNT |
| % OF UNIT PRICE FOR FUEL |
| 3001 |
| Base Rate for transportation of one (1) beneficiary, one way only within the city limits of St. Louis, MO. |
| 3000 |
| Trips |
n/a
| 3002 |
| Rate per mile beyond city limits of St. Louis, MO, one way only (This rate in addition to base rate in CLIN 3001.) |
| 3003 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and VAMC, Jefferson Barracks Division |
| 3004 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and St. Louis University Medical Center |
| 3005 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and St. Louis University Medical Center |
| 3006 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and Barnes-Jewish Hospital |
| 3007 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and Barnes-Jewish Hospital |
| 3008 |
| Trip rate for wheelchair transportation between VASTLHCS, John Cochran Division or Jefferson Barracks Division and VAMC Poplar Bluff, MO |
| 3009 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division or Jefferson Barracks Division and VAMC Marion, IL |
| 3010 |
| Excess waiting Time per quarter hour (15 minutes) Must be pre-approved |
| 3011 |
| Rate for additional wheelchair patient transported on any trip |
| 3012 |
| Rate for attendance (in addition to driver) needed to transport patient with prior VA authorization |
| 3013 |
| No load charge/trip within St. Louis City |
Option Year III Total: $
OPTION YEAR IV:
| ITEM NO. |
| SCHEDULE OF SUPPLIES/SERVICES |
| EST ANNUAL QUANTITY |
| UNIT |
| UNIT PRICE |
| EXTENDED AMOUNT |
| % OF UNIT PRICE FOR FUEL |
| 4001 |
| Base Rate for transportation of one (1) beneficiary, one way only within the city limits of St. Louis, MO. |
| 3000 |
| Trips |
n/a
| 4002 |
| Rate per mile beyond city limits of St. Louis, MO, one way only (This rate in addition to base rate in CLIN 4001.) |
| 4003 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and VAMC, Jefferson Barracks Division |
| 4004 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and St. Louis University Medical Center |
| 4005 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and St. Louis University Medical Center |
| 4006 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division and Barnes-Jewish Hospital |
| 4007 |
| Trip rate for wheelchair transportation between VAMC, Jefferson Barracks Division and Barnes-Jewish Hospital |
| 4008 |
| Trip rate for wheelchair transportation between VASTLHCS, John Cochran Division or Jefferson Barracks Division and VAMC Poplar Bluff, MO |
| 4009 |
| Trip rate for wheelchair transportation between VAMC, John Cochran Division or Jefferson Barracks Division and VAMC Marion, IL |
| 4010 |
| Excess waiting Time per quarter hour (15 minutes) Must be pre-approved |
| 4011 |
| Rate for additional wheelchair patient transported on any trip |
| 4012 |
| Rate for attendance (in addition to driver) needed to transport patient with prior VA authorization |
| 4013 |
| No load charge/trip within St. Louis City |
Option Year IV Total: $
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