36C25523Q0456.pdf

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. UEI: EFT:

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. NOV 2021)

PREVIOUS EDITION IS NOT USABLE Prescribed by GSA - FAR (48 CFR) 53.212

7. FOR SOLICITATION

INFORMATION CALL:

STANDARD FORM 1449

SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES

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

36C25523Q0456 05-17-2023

SHELLEY WELTON, SHELLEY.WELTON@VA.GOV 913-946-1163 05-24-2023

11:00 CDT

36C255 Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Leavenworth KS 66048

X

621910

$20 Million

N/A

See Performance of Work Under Section B.4, Section 1, Paragraph 1.1

36C255

Department of Veterans Affairs Network Contracting Office (NCO) 15 3450 S 4th Street Trafficway

Leavenworth KS 66048

36C255

Department of Veterans Affairs Financial Services Center http://www.fsc.va.gov/einvoice.asp

Austin TX

877-353-9791 512-460-5429

See CONTINUATION Page

AIR AMBULANCE (EMERGENT FIXED WING) SERVICES FOR THE EASTERN

KANSAS HEALTHCARE SYSTEM.

1. The contractor shall provide air ambulance (emergent fixed wing) transportation services to include ground ambulance to and from prospective airports in accordance with the Performance of Work.

2. The government anticipates awarding a contract for a base year and up to four (4) options years, exercisable at the discretion of the government.

3. This solicitation is Unrestricted Open Market.

4. Submit all questions and quotes via email to Bruce Kidder (bruce.kidder@va.gov) AND Shelley Welton (shelley.welton@va.gov). Questions are due by Friday, May 19, 2023, 11:00 am CST. Quotes are due by Wednesday May 24, 2023, 11:00 am CST.

NOTE: FAR Provisions 52.212-1 (including addendum) and 52.212-2 (including addendum) provide instructions for quote submittal.

See CONTINUATION Page

BRUCE KIDDER

Contract Officer

36C25523Q0456

Table of Contents

SECTION A

A.1 SF 1449 SOLICITATION/CONTRACT/ORDER FOR COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES

SECTION B - CONTINUATION OF SF 1449 BLOCKS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

B.2 LIMITATIONS ON SUBCONTRACTING—MONITORING AND COMPLIANCE (JUN

2011)

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

B.4 PERFORMANCE WORK STATEMENT

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS

AND COMMERCIAL SERVICES (DEC 2022)

C.2 52.216-18 ORDERING (AUG 2020)

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

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

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

C.6 52.217-9 OPTION TO EXTEND THE TERM OF THE CONTRACT (MAR 2000) ... 25

C.7 VAAR 852.201-70 CONTRACTING OFFICER'S REPRESENTATIVE (DEC 2022)

C.8 VAAR 852.232-72 ELECTRONIC SUBMISSION OF PAYMENT REQUESTS (NOV

2018)

C.9 52.252-2 CLAUSES INCORPORATED BY REFERENCE (FEB 1998)

C.10 VAAR 852.203-70 COMMERCIAL ADVERTISING (MAY 2018)

C.11 VAAR 852.215-70 SERVICE-DISABLED VETERAN-OWNED AND VETERAN-

OWNED SMALL BUSINESS EVALUATION FACTORS (OCT 2019)

C.12 VAAR 852.215-71 EVALUATION FACTOR COMMITMENTS (OCT 2019)

C.13 VAAR 852.228-71 INDEMNIFICATION AND INSURANCE (MAR 2018)

C.14 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT

STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAR 2023)

SECTION D - CONTRACT DOCUMENTS, EXHIBITS, OR ATTACHMENTS

D.1 WAGE DETERMINATIONS INCORPORATED BY REFERENCE

SECTION E - SOLICITATION PROVISIONS

E.1 52.212-1 INSTRUCTIONS TO OFFERORS—COMMERCIAL PRODUCTS AND

COMMERCIAL SERVICES (MAR 2023)

E.2 52.216-1 TYPE OF CONTRACT (APR 1984)

E.3 52.233-2 SERVICE OF PROTEST (SEP 2006)

E.4 VAAR 852.233-70 PROTEST CONTENT/ALTERNATIVE DISPUTE RESOLUTION

(OCT 2018)

E.5 VAAR 852.233-71 ALTERNATE PROTEST PROCEDURE (OCT 2018)

E.6 52.252-1 SOLICITATION PROVISIONS INCORPORATED BY REFERENCE (FEB

1998)

E.7 52.204-1 APPROVAL OF CONTRACT (DEC 1989)

E.8 52.212-2 EVALUATION—COMMERCIAL PRODUCTS AND COMMERCIAL

SERVICES (NOV 2021)

E.9 52.212-3 OFFEROR REPRESENTATIONS AND CERTIFICATIONS—

COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (DEC 2022)

SECTION B - CONTINUATION OF SF 1449 BLOCKS

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

(Continuation from Standard Form 1449, block 18A.)

1. Contract Administration: All contract administration matters will be handled by the following individuals:

a. CONTRACTOR: NAME: ___________________________________

UEI #: ____________________________________

ADDRESS: ________________________________

City/State/Zip: _____________________________

POC: _____________________________________

CONTACT INFO: __________________________

b. GOVERNMENT: CONTRACTING OFFICER 36C255

DEPARTMENT OF VETERANS AFFAIRS

NETWORK CONTRACTING OFFICE (NCO) 15

3450 S 4th STREET

LEAVENWORTH, KS 66048

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

[X] 52.232-33, Payment by Electronic Funds Transfer—System for Award Management

3. INVOICES: Invoices shall be submitted:

[ ] Upon acceptance and or installation of item(s) [X] Other

a. Monthly (In arrears) [X]

b. Semi-Annually [ ]

c. Annually [ ]

4. GOVERNMENT INVOICE ADDRESS: All Invoices from the contractor shall be submitted electronically in accordance with VAAR Clause 852.232-72 Electronic Submission of Payment Requests.

Department of Veterans Affairs Financial Services Center http://www.fsc.va.gov/einvoice.asp Phone: 877-353-9791 Fax: 512-460-5429 Austin, TX 78714-9971

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

AMENDMENT NO DATE

B.2 LIMITATIONS ON SUBCONTRACTING—MONITORING AND

COMPLIANCE (JUN 2011)

This solicitation includes FAR Clause 52.219-14, Limitations on Subcontracting. Accordingly, any contract resulting from this solicitation will include this clause. The contractor is advised in performing contract administration functions, the CO may use the services of a support contractor(s) retained by VA to assist in assessing the contractor's compliance with the limitations on subcontracting or percentage of work performance requirements specified in the clause. To that end, the support contractor(s) may require access to contractor's offices where the contractor's business records or other proprietary data are retained and to review such business records regarding the contractor's compliance with this requirement. All support contractors conducting this review on behalf of VA will be required to sign an “Information Protection and Non-Disclosure and Disclosure of Conflicts of Interest Agreement” to ensure the contractor's business records or other proprietary data reviewed or obtained in the course of assisting the CO in assessing the contractor for compliance are protected to ensure information or data is not improperly disclosed or other impropriety occurs. Furthermore, if VA determines any services the support contractor(s) will perform in assessing compliance are advisory and assistance services as defined in FAR 2.101, Definitions, the support contractor(s) must also enter into an agreement with the contractor to protect proprietary information as required by FAR 9.505-4, obtaining access to proprietary information, paragraph (b). The contractor is required to cooperate fully and make available any records as may be required to enable the CO to assess the contractor's compliance with the limitations on subcontracting or percentage of work performance requirement.

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

ITEM

NUMBER

DESCRIPTION OF SERVICE

ESTIMATED

MINIMUM

NUMBER

OF TRIPS

MAXIMUM

NUMBER OF

TRIPS

UNIT

ONE-WAY

STATUTE

MILE (SM) PER

TRIP

PRICE PER

STATUTE

MILE

TOTAL PRICE

PER STATUTE

(SM x PRICE)

BASE RATE

PER TRIP

(BRPT)

AMOUNT PER TRIP

(SM x PRICE + BRPT)

ESTIMATED TOTAL

(BASED ON

MAXIMUM NUMBER

OF TRIPS)

BASE YEAR: POP: 05/25/2023 – 05/24/2024

Air Ambulance (emergent fixed wing) transportation services to include ground ambulance to and from respective airports IAW the performance work statement (PWS).

Rate for trips over the base mileage of 300 miles.

1 2 TRIP 500 $ $ $ $ $

BASE YEAR ESTIMATED TOTAL: $

OPTION YEAR 1: POP: 05/25/2024 – 05/24/2025

wing) transportation services to include ground ambulance to and

Rate for trips over the base mileage of 300 miles.

1 2 TRIP 500 $ $ $ $ $

OPTION YEAR 1 ESTIMATED TOTAL: $

OPTION YEAR 2: POP: 05/25/2025 – 05/24/2026

wing) transportation services to include ground ambulance to and

Rate for trips over the base mileage of 300 miles.

1 2 TRIP 500 $ $ $ $ $

OPTION YEAR 2 ESTIMATED TOTAL: $

OPTION YEAR 3: POP: 05/25/2026 – 05/24/2027

wing) transportation services to include ground ambulance to and

Rate for trips over the base mileage of 300 miles.

1 2 TRIP 500 $ $ $ $ $

OPTION YEAR 3 ESTIMATED TOTAL: $

OPTION YEAR 4: POP: 05/25/2027 – 05/24/2028

wing) transportation services to include ground ambulance to and

Rate for trips over the base mileage of 300 miles.

1 2 TRIP 500 $ $ $ $ $

OPTION YEAR 4 ESTIMATED TOTAL: $

ESTIMATED GRAND TOTAL: $

B.4 PERFORMANCE WORK STATEMENT

Performance Work Statement Air Ambulance Services

Eastern Kansas Health Care System

Section 1: General Information

1.1 General: This Performance Work Statement (PWS) defines non-personal services to provide Air

Ambulance (emergent fixed wing) transportation services under a fixed price Indefinite Delivery Indefinite Quantity (IDIQ) contract for the Eastern Kansas Health Care System (EKHCS). The Government shall not exercise any supervision or control over the contract service providers performing the services herein. Such contract service providers shall be accountable solely to the Contractor who, in turn, is responsible to the Government. The contractor shall not accept any instructions issued by any person employed by the U.S. Government, other than: the Contracting Officer (CO), or the Contracting Officers Representative (COR), all acting within the limits of their authority.

Transportation originates at a medical facility in the local area and ends at a medical facility outside the local area. In the case of organ transplant patients, transportation may originate from an airport near the veteran’s home address. The price should include all legs of transportation including ground ambulance to and from the respective airports.

1.2 Period of Performance:

Base Year: May 25, 2023 to May 24, 2024 Option Year 1: May 25, 2024 to May 24, 2025 Option Year 2: May 25, 2025 to May 24, 2026 Option Year 3: May 25, 2026 to May 24, 2027 Option Year 4: May 25, 2027 to May 24, 2028

1.3 Type of Contract: The government will award a single award-indefinite-delivery indefinite quantity (IDIQ), Firm Fixed Price contract.

1.4 Invoicing: All invoices from the contractor shall be submitted electronically in accordance with VAAR

Clause 852.232-723 Electronic Submission of Payment Requests.

Invoices shall be submitted (monthly in arrears) no later than fifteen (15) calendar days following the end of the month in which services are rendered. Invoices are to include obligation number and all contract services furnished for the preceding month. Invoices shall specify the patient name, 4 digit patient identifier, date of service, time of pick-up, whether the trip was “pre-scheduled” or “unscheduled”, pick-up and delivery point, trip number and separate charges (i.e.

toll fee, medications, etc.) per trip for which payment is requested. Separate charges must be itemized. All invoices must include a Health Insurance Claim Form OMB-form-1500 (HCFA).

All invoices shall include a fixed base-rate line item and a mileage rate line item. Each line item shall include rate, quantity, description, and line total.

Invoices will be reviewed and reconciled with trip tickets and travel logs. Unauthorized charges will be suspended pending investigation. Unauthorized charges are those that are being disputed or have not been pre-approved by authorized VA personnel. A final determination will be made within 30 days after notifying the Contractor of charges being suspended.

All invoices rendered by the Contractor to EKHCS for contract services furnished in accordance with this contract shall be in full. Neither the beneficiary nor any other party shall be required to bear the burden of additional payments, surcharges, tip or other gratuity.

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

More information on the VA Financial Services Center is available at http://www.fsc.va.gov/einvoice.asp.

Vendor e-Invoice Set-Up Information:

Please contact Tungsten at the phone number or email address listed below to begin submitting your electronic invoices to the VA Financial Services Center for payment processing, free of charge. If you have questions about the e-invoicing program or Tungsten, please contact the FSC at the phone number or email address listed below:

Tungsten e-Invoice Setup Information: 1-877-489-6135 Tungsten e-Invoice email: VA.Registration@Tungsten-Network.com FSC e-Invoice Contact Information: 1-877-353-9791 FSC e-Invoice email: vafsccshd@va.gov

Section 2: Definitions

Contractor: A supplier or vendor awarded a contract to provide specific supplies or service to the government. The term used in this contract refers to the prime.

Work Day: The number or hours per day the Contractor provides services in accordance with the contract.

Work Week: Monday through Friday, unless specified otherwise.

Air Ambulance: Fixed wing aircraft with a compartment that is designed and constructed to afford relative safety and comfort and to avoid aggravation of the patient’s condition. The aircraft, compartment, and personnel must meet all applicable federal and state standards for medical air transport.

ALS: Advanced Life Support.

Ground Ambulance: Vehicles for emergency medical care which provide a driver compartment and a patient compartment that will accommodate emergency personnel and patient, equipment and supplies for emergency care at the scene as well as during transport, and two-way radio communication and equipment for light rescue procedures. The ambulance must be designed and constructed to afford relative safety and comfort and to avoid aggravation of the patient’s condition.

AOD: Administrative Officer of the Day. This government employee is the administrative officer in charge during other than normal business hours.

BLS: Basis Life Support.

CCT: Critical Care Transport.

CO/Contracting Officer: The person executing this contract on behalf of the Government and the only person authorized to make changes to the contract.

COR/Contracting Officer Representative: Person or persons authorized to act for the Contracting Officer within the limits of his/her authority.

CHIEF, Business Office: Person or persons authorized to act for the Contracting Officer within the limits of his/her authority in the absence of a COR.

Federal Holidays: New Year’s Day, Martin Luther King Jr. Birthday, Presidents Day, Memorial Day, Juneteenth Day, Independence Day, Labor Day, Columbus Day, Veteran’s Day, Thanksgiving Day, Christmas Day, also any day determined by the President to be a Federal Holiday.

Normal Business Hours: Normal business hours are defined as Monday thru Friday, 8:00a.m. to 4:30p.m. local time.

Trip: A trip is defined as the distance, “ONE WAY ONLY,” over which a beneficiary will be transported.

For all one-way trips ordered under this contract, the contractor shall receive the base rate.

POC: Point of contact.

Section 3: Demand and Government’s Minimum Quantity

The estimated demand for the Air Ambulance is:

a. Base Year: 6 trips

b. Option Year One (1): 6 trips

c. Option Year Two (2): 6 trips

d. Option Year Three (3): 6 trips

e. Option Year Four (4): 6 trips

The One-Way Average Statue Mileage per trip is 300 miles. Trips vary from 300 miles up to 500 miles or more.

Government’s Minimum Quantity: The VA attempts to be as accurate as possible when providing estimated quantities; however, actual dollar value quantities may vary from the dollar value quantities as listed in the price schedule. The guaranteed contract minimum is $10,000.00.

Section 4: Compliance

All work related to this contract must be performed by the Contractor in accordance with all applicable Federal Aviation Administration (FAA), U.S. Department of Transportation, or Occupational Safety and Health Administration (OSHA) regulations, as well as applicable State health and safety regulations, health care accreditation standards (Joint Commission or equivalent accreditation organization) and standard industry practices as defined by the Association of Air Medical Services for air ambulance transportation.

Section 5: Personnel

The Contractor shall provide the necessary licenses/certificates, competencies, privilege and credentialing in accordance with applicable State(s) and Federal regulations for each employee that will perform services under this contract.

Section 6: Rate

For all one-way trips ordered under this contract, the Contractor shall receive the base rate as stated in the price/cost schedule. The “BASE RATE” shall constitute full compensation for ONE-WAY trips (patient leg of the transport only). Once the base trip rate has been exceeded, the per statute mile price schedule will be effective for statute miles over the base rate.

Section 7: Order Placement

Task orders will be issued as required by the Network Contracting Office to fund each requirement.

Scheduling will be done on an as-needed basis. Unit quantities are currently unknown. Orders will be placed in writing.

All trip orders by the end user should contain the following information:

1. Date of order

2. Contract number and purchase order number

3. Contract line item number and description, quantity, and unit price

4. Delivery or performance schedule

5. Place of delivery or performance

6. Accounting and appropriate data.

Section 8: Scheduling

1. Authorized EKHCS personnel will place telephone requests for contract services only with the Contractor’s dispatch office. The request for services shall specify the originating point and final destination. Only such travel is authorized, and any costs incurred for unauthorized travel, stops, waiting time, etc. shall be the responsibility of the Contractor. Authorized EKHCS personnel are:

Beneficiary Travel Personnel Transfer Coordinators Administrative Officer of the Day (AOD)

2. For prescheduled pickups, the Contractor shall be required to furnish the ground ambulance within twenty (20) minutes of the prearranged time.

3. For unscheduled pickups, the Contractor agrees to have patient(s) transported to the departing airport, prepared, and airborne within 4 hours after the receipt of order or as agreed between the Contractor and the authorized EKHCS requestor. If the Contractor identifies they cannot furnish the services within the time required, they shall notify the government at the time of scheduling, or as soon as possible.

4. In the event of a contractor “NO-SHOW”, the Government reserves the right to obtain the necessary services from another source.

5. The Contractor shall respond to phone calls or messages from the Government within 30 minutes.

Section 9: Inspection, Quality, and Performance Standards

1. The Government has the right to inspect the Contractor premises, maintenance records of medical equipment and aircraft(s), flight logs, and dispatch records being used for the contracted services.

Furthermore, annually the Contractor must provide proof of insurance (see Clauses 852.228-71, 852.237-7, and 852.237-70 for further details on insurance requirements) and copies of any licenses for all staff providing services under this contract upon request of the POC.

2. The last month of each contract year, the Contracting Officer will review contract compliance reports submitted by the POC. The review will employ various monitoring methods but will specifically include complaints and timeliness.

3. Maintain full compliance with Quality Assurance Surveillance Plan (QASP)

Section 10: Reporting Responsibilities

1. The Contractor shall furnish an in-flight medical attendant report of the patient’s status to the receiving facility. The report should include:

Patient’s full name and social security number (whenever possible) – if not possible, explain the reasons.

Time picked up.

Originating and terminating points.

Who called (initiator) Presenting problem.

Immediate First Aid Measures (bandages, oxygen, restraints, etc.)

State of consciousness.

Blood pressure.

Pulse.

Respiration.

Any other noted symptoms or pertinent information, including vital signs not already described, level of consciousness, drugs administered, and details of therapeutic intervention.

Any unusual circumstances encountered during the flight, including but not limited to inordinate altitudes flown, turbulence, and times associated with these conditions.

Section 11: Licenses, Certifications and Insurance

1. Air Ambulance Pilot – Shall have a valid operator’s license in accordance with Federal, State and local government requirements for their place of operation and for the services they perform.

2. Medical Staff – Shall be certified, licensed, or otherwise officially recognized by the local, state, or regional government or public entity where the emergency ambulance service is operated or by which it is governed.

3. Ambulance Driver – Shall have a valid operator’s or chauffeur’s license in accordance with Federal, State, and local government requirements for their place of operation, for the services they perform.

4. Contractor – Shall maintain personal liability, automobile liability, and property damage insurance, as prescribed by the laws of the state in which they operate, and in accordance with VAAR 852.228- 71, VAAR 852.237-7, and VAAR 852.237-70.

Section 12: Health Insurance Portability and Accountability Act (HIPAA), Privacy Rule, and Security Rule

Whereas the Contractor will have access to Business Associate Protected Health Information (PHI) and Electronic Protected Health Information (EPHI) that is subject to protection under regulations issued by the Department of Health and Human Services, as mandated by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), 45 CFR Parts 160 and 164, Subparts A and E, the Standards for Privacy of Individually Identifiable Health Information (“Privacy Rule”), and 45 CFR Parts 160 and 164, Subparts A and C, the Security Standard (Security Rule”); and whereas, Department of Veterans Affairs Veterans Health Administration is a “Covered Entity” as that term is defined in the HIPAA implementing regulations, 45 CFR 160.103, the Contractor shall be required to complete the blanks, sign, date and provide a completed Business Associate Agreement with their quotation (as provided as an attachment to this solicitation).

Contractor staff shall sign and follow confidentiality statements as required.

The C&A requirements do not apply, and that a Security Accreditation Package is not required.

The Contractor shall comply with the Privacy Act, 38 USC 5701 and 38 USC 7332. Any information the Contractor may obtain on personnel and/or patient data as a result of performance of this contract will not at any time be disclosed to third parties or used for the Contractor’s own purpose except to the extent allowed by the Privacy Act.

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).

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 COTR 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.

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.

Based on the determinations of independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages in the amount of $ TBD per affected individual to cover the cost of providing credit protection services to affected individuals consisting of the following:

(1) Notification;

(2) One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports;

(3) Data breach analysis;

(4) Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution;

(5) One year of identity theft insurance with $20,000.00 coverage at $0 deductible; and

(6) Necessary legal expenses the subjects may incur to repair falsified or damaged credit records, histories, or financial affairs.

Section 13: Patient Privacy and Confidentiality

All “patient papers” transported with the patient are confidential in accordance with HIPAA. Contractor’s personnel may review these records for assessment and treatment purposes only. Appropriate administrative and medical information will be provided to the Contractor for patient transport. If the medical record is transported with the patient, it may be used as a source of information if the situation warrants (i.e. emergent care while en-route). In all other instances, all documents will remain intact and sealed.

Section 14: Security Requirements

A. Service contractor is expected to perform functions that will require access to VA sensitive information. In the course of providing services, it will be necessary for the service contractor to view and receive protected health information (PHI), and personnel identifiable information (PII).

B. Contracts, in which VA sensitive information are accessed by a VA contractor/subcontractor require the following requirements per 38 U.S.C. § 5723 and 5725:

1) A prohibition on unauthorized disclosure: “Information made available to the contractor or subcontractor by VA for the performance or administration of this contract or information developed by the contractor 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” See VA Handbook 6500.6, Appendix C, paragraph 3.a.

2) A requirement for data breach notification: Upon discovery 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, the contractor/subcontractor shall immediately and simultaneously notify the COTR, the designated ISO, and Privacy Officer for the contract. 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. See VA Handbook 6500.6, Appendix C, paragraph 3.a.

3) A requirement to pay liquidated damages in the event of a data breach: “In the event of a data breach or privacy incident involving any SPI the contractor processes or maintains under this contract, the contractor shall be liable to VA for liquidated damages for a specified amount per affected individual to cover the cost of providing credit protection services to those individuals.” See VA Handbook 6500.6, Appendix C, para. 7.2, 7.5.

4) A requirement for annual security/privacy awareness training: “Before being granted access to VA information, all contractor employees and subcontractor employees requiring such access shall complete on an annual basis either (i) the VA security/ privacy awareness training (contains VA’s security/privacy requirements) within 1 week of the initiation of the contract, or (ii) security awareness training provided or arranged by the contractor that conforms to VA’s security/privacy requirements as delineated in the hard copy of the VA security awareness training provided to the contractor. If the contractor provides their own training that conforms to VA’s requirements, they will provide the COTR or CC a yearly report (due annually on the date of the contract initiation) stating that all applicable employees involved in VA’s contract have received their annual security/privacy training that meets VA’s requirements and the total number of employees trained. See VA Handbook 6500.6, Appendix C, paragraph 9.

5) A requirement to sign VA’s Rules of Behavior: “Before being granted access to VA information, all contractor employees and subcontractor employees requiring such access shall sign on an annual basis an acknowledgement that they have read, understand, and agree to abide by VA’s Contractor Rules of Behavior which is attached to this contract.” See VA Handbook 6500.6, Appendix D. Note: If the vendor anticipates that the services under the contract will be performed by 10 or more individuals, the Contractor Rules of Behavior may be signed by the vendor’s designated representative. The contract must reflect by signing the Rules of Behavior on behalf of the vendor that the designated representative agrees to ensure that all such individuals review and understand the Contractor Rules of Behavior when accessing VA’s information.

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. VA information should not be co-mingled, if possible, with any other data on the contractors/subcontractor’s information systems or media storage systems in order to ensure VA requirements related to data protection and media sanitization can be met. If co-mingling must be allowed to meet the requirements of the business need, the contractor must ensure that VA’s information is returned to the VA or destroyed in accordance with VA’s sanitization requirements.

VA reserves the right to conduct onsite inspections of contractor and subcontractor IT resources to ensure data security controls, separation of data and job duties, and destruction/media sanitization procedures are in compliance with VA directive requirements.

C. Prior to termination or completion of this contract, contractor/subcontractor must not destroy information received from VA, or gathered/created by the contractor in the course of performing this contract without prior written approval by the VA. Any data destruction done on behalf of VA by a contractor/subcontractor must be done in accordance with National Archives and Records Administration (NARA) requirements as outlined in VA Directive 6300. Records and Information Management and its Handbook 6300.1, Electronic Media Sanitization. Self-certification by the contractor that the data destruction requirements above have been met must be sent to the VA Contracting Officer within 30 days of termination of the contract.

D. 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.

E. The contractor/subcontractor shall not make copies of VA information except as authorized and necessary to perform the terms of the agreement or to preserve electronic information stored on contractor/subcontractor electronic storage media for restoration in case any electronic equipment or data used by the contractor/subcontractor needs to be restored to an operating state. If copies are made for restoration purposes, after the restoration is complete, the copies must be appropriately destroyed.

F. 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.

G. 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.

H. 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.

I. 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.

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 COTR 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.

D. 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 third party arising from, or related to, the incident.

Liquidate 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 any sensitive personal information involved in the data breach. The term “data breach” means the loss, theft, or other unauthorized access, or any access other than that incidental to the scope of employment, to data containing sensitive personal information, in electronic or printed form, that results in the potential compromise of the confidentiality or integrity of the data. Contractor shall fully cooperate with the entity performing the risk analysis. Failure to cooperate may be deemed a material breach and grounds for contract termination.

C. Each risk analysis shall address all relevant information concerning the data breach, including the following:

1) Nature of the event (loss, theft, unauthorized access)

2) Description of the event, including

(a) Date of occurrence;

(b) Data elements involved, including any PII, such as full name, social security number, date of birth, home address, account number, disability code;

3) Number of individuals affected or potentially affected;

4) Names of individuals or groups affected or potentially affected;

5) Ease of logical data access to the lost, stolen or improperly accessed data in light of the degree of protection for the data, e.g., unencrypted, plain text;

6) Amount of time the data has been out of VA control;

7) The likelihood that the sensitive personal information will or has been compromised

(made accessible to and usable by unauthorized persons);

8) Known misuses of data containing sensitive personal information, if any;

9) Assessment of the potential harm to the affected individuals;

10) Data breach analysis as outlined in 6500.2 Handbook, Management of Security and

Privacy Incidents, as appropriate; and

11) Whether credit protection services may assist record subjects in avoiding or mitigating the results of identity theft based on the sensitive personal information that may have been compromised.

D. Based on the determinations of the independent risk analysis, the contractor shall be responsible for paying to the VA liquidated damages in the amount of $ TBD per affected individual to cover the cost of providing credit protection services to affected individuals consisting of the following:

1) Notification;

2) One year of credit monitoring services consisting of automatic daily monitoring of at least 3 relevant credit bureau reports;

3) Data breach analysis;

4) Fraud resolution services, including writing dispute letters, initiating fraud alerts and credit freezes, to assist affected individuals to bring matters to resolution;

5) One year of identity theft insurance with $20,000.00 coverage at $0 deductible; and

6) Necessary legal expenses the subjects may incur to repair falsified or damaged credit records, histories, or financial affairs.

Security Controls Compliance Testing

On a periodic basis, VA, including the Office of Inspector General, reserves the right to evaluate any or all of the security controls and privacy practices implemented by the contractor under the clauses contained within the contract. With 10 working-days’ notice, at the request of the government, the contractor must fully cooperate and assist in a government-sponsored security controls assessment at each location wherein VA information is processed or stored, or information systems are developed, operated, maintained, or used on behalf of VA, including those initiated by the Office of Inspector General. The government may conduct a security control assessment on shorter notice (to include unannounced assessments) as determined by VA in the event of a security incident or at any other time.

Training

A. All contractor employees and subcontractor employees requiring access to VA information and VA information systems shall complete the following before being granted access to VA information and its systems:

1) Sign and acknowledge (either manually or electronically) understanding of and responsibilities for compliance with the Contractor Rules of Behavior, Appendix E relating to access to VA information systems;

2) Successfully complete the appropriate VA privacy training and annually complete required privacy training; and

3) Successfully complete any additional cyber security or privacy training, as required for VA personnel with equivalent information system access [to be defined by the VA program official and provided to the contracting officer for inclusion in the solicitation document – e.g., any role-based information security training required in accordance with NIST Special Publication 800-16, Information Technology Security Training Requirements.]

B. The contractor shall provide to the contracting officer and/or the COTR a copy of the training certificates and certification of signing the Contractor Rules of Behavior for each applicable employee within 1 week of the initiation of the contract and annually thereafter, as required.

C. Failure to complete the mandatory annual training and sign the Rules of Behavior annually, within the timeframe required, is grounds for suspension or termination of all physical or electronic access privileges and removal from work on the contract until such time as the training and documents are complete.

Additional Security Requirements

The contractor employees shall have access to VA sensitive information and will require routine access to VA Facilities. The contractor employees shall have intermittent access only and will be escorted by VA employees while at VA facilities.

SECTION C - CONTRACT CLAUSES

C.1 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL

PRODUCTS AND COMMERCIAL SERVICES (DEC 2022)

(a) Inspection/Acceptance. The Contractor shall only tender for acceptance those items that conform to the requirements of this contract. The Government reserves the right to inspect or test any supplies or services that have been tendered for acceptance. The Government may require repair or replacement of nonconforming supplies or reperformance of nonconforming services at no increase in contract price. If repair/replacement or reperformance will not correct the defects or is not possible, the Government may seek an equitable price reduction or adequate consideration for acceptance of nonconforming supplies or services. The Government must exercise its post-acceptance rights—

(1) Within a reasonable time after the defect was discovered or should have been discovered;

and

(2) Before any substantial change occurs in the condition of the item, unless the change is due to the defect in the item.

(b) Assignment. The Contractor or its assignee may assign its rights to receive payment due as a result of performance of this contract to a bank, trust company, or other financing institution, including any Federal lending agency in accordance with the Assignment of Claims Act (31 U.S.C. 3727). However, when a third party makes payment (e.g., use of the Governmentwide commercial purchase card), the Contractor may not assign its rights to receive payment under this contract.

(c) Changes. Changes in the terms and conditions of this contract may be made only by written agreement of the parties.

(d) Disputes. This contract is subject to 41 U.S.C. chapter 71, Contract Disputes. Failure of the parties to this contract to reach agreement on any request for equitable adjustment, claim, appeal or action arising under or relating to this contract shall be a dispute to be resolved in accordance with the clause at Federal Acquisition Regulation (FAR) 52.233-1, Disputes, which is incorporated herein by reference. The Contractor shall proceed diligently with performance of this contract, pending final resolution of any dispute arising under the contract.

(e) Definitions. The clause at FAR 52.202-1, Definitions, is incorporated herein by reference.

(f) Excusable delays. The Contractor shall be liable for default unless nonperformance is 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 either its sovereign or contractual capacity, fires, floods, epidemics, quarantine restrictions, strikes, unusually severe weather, and delays of common carriers. The Contractor shall notify the Contracting Officer in writing as soon as it is reasonably possible after the commencement of any excusable delay, setting forth the full particulars in connection therewith, shall remedy such occurrence with all reasonable dispatch, and shall promptly give written notice to the Contracting Officer of the cessation of such occurrence.

(g) Invoice.

(1) The Contractor shall submit an original invoice and three copies (or electronic invoice, if authorized) to the address designated in the contract to receive invoices. An invoice must include—

(i) Name and address of the Contractor;

(ii) Invoice date and number;

(iii) Contract number, line item number and, if applicable, the order number;

(iv) Description, quantity, unit of measure, unit price and extended price of the items delivered;

(v) Shipping number and date of shipment, including the bill of lading number and weight of shipment if shipped on Government bill of lading;

(vi) Terms of any discount for prompt payment offered;

(vii) Name and address of official to whom payment is to be sent;

(viii) Name, title, and phone number of person to notify in event of defective invoice; and

(ix) Taxpayer Identification Number (TIN). The Contractor shall include its TIN on the invoice only if required elsewhere in this contract.

(x) Electronic funds transfer (EFT) banking information.

(A) The Contractor shall include EFT banking information on the invoice only if required elsewhere in this contract.

(B) If EFT banking information is not required to be on the invoice, in order for the invoice to be a proper invoice, the Contractor shall have submitted correct EFT banking information in accordance with the applicable solicitation provision, contract clause (e.g., 52.232-33, Payment by Electronic Funds Transfer—System for Award Management, or 52.232-34, Payment by Electronic Funds Transfer—Other Than System for Award Management), or applicable agency procedures.

(C) EFT banking information is not required if the…