36C25623Q1495 0001.pdf

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 ADMINISTRATIVE 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 date 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 30 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)

1 1

Department of Veterans Affairs Overton Brooks VA Medical Center (90C) 510 East Stoner Avenue Shreveport LA 71101

Department of Veterans Affairs Overton Brooks VA Medical Center (90C) 510 East Stoner Avenue Shreveport LA 71101

To all Offerors/Bidders

36C25623Q1495

X

X X

8/17/2023 3:30 PM CDT

X 1

The purpose of this amendment is to replace the previously used Statement of Work.

The original Statement of Work is replaced in its entirety by the one attached below.

Previously submitted quotes must be resubmitted, whether or not there are any pricing changes by the offeror.

New quotes may be submitted even if the offeror did not previously submit a quote.

Offerors must sign this amendment in block 15 and submit with quotes.

This RFQ is still set aside 100% for Service Disabled Veteran Owned Small Business (SDVOSB).

Deadline for submission of quotes is 8/17/2023 at 3:30 PM CDT No other terms or conditions are affected by this modification.

Bennett W Smith bennett.smith2@va.gov

Performance Work Statement

Mobile Food Pantry for Veterans Health

Central Arkansas Veterans Healthcare System

OVERVIEW: The overarching goal of the Mobile Food Pantry (MFP) program is to improve nutrition security among the Veteran population served by Central Arkansas Veterans Healthcare System (CAVHS.) This goal will be accomplished by providing free food sourcing combined with nutrition education to Veterans experiencing nutrition and food insecurity. Through the MFP, Veterans will be able to access fresh fruits and vegetables, lean proteins, and dairy foods and will gain understanding on incorporating these healthy foods into their diets.

1. Scope: The MFP will take place at three sites each month and will provide 70 Veterans per site with 44 lbs. of nutritious food options. The MFP will take place at the designated sites listed in Section 2.

The contractor shall provide all transportation, materials, labor, supervision, and any items and services necessary to perform full mobile food distribution services as specified in this Performance Work Statement. The contractor will also provide the tents, tables, security barriers, refrigerated food truck, driver, boxes, paper bags, cleaning supplies, hand sanitizing station, insurance, fuel for food truck, and additional equipment as needed. The contractor shall provide at least 10 lbs. of protein foods (meat, fish, eggs, beans, nuts or seeds), 16 lbs. of fruits and vegetables (i.e bananas, oranges, apples, berries, broccoli, greens, lettuce, spinach, corn, cabbage, cucumbers, bell peppers, carrots, squash, onions, sweet potatoes or assorted low-sodium shelf stable vegetables and fruits) 10 lbs. of grains (i.e wheat, rice, oats, cornmeal, barley or cereal grain) and 8 lbs. of dairy foods (milk, yogurt, cheese). CAVHS Nutrition and Food Services and Whole Health will provide signage for the event.

The contractor can display signage that is pre-approved by the Contracting Officer Representative (COR). A Security Accreditation Package is not required.

2. Locations and Schedule:

2.1. The contractor will set up at the following three sites on a monthly basis (see Appendix A for photos of locations):

2.1.1. Veteran’s Day Treatment Center (VDTC), 1000 S Main Street, Little Rock in warehouse

2.1.2. Pine Bluff Veterans Community Based Outpatient Clinic (CBOC), 2906 Market

St, Pine Bluff in parking lot

2.1.3. Eugene J. Towbin VA, 2200 Fort Roots Drive, North Little Rock in the North entrance parking lot (parking lot 11)

2.2. The MFP will run on the following schedule, unless otherwise specified by the COR. The time schedule allows for one (1) hour of set up, two (2) hours of distribution and one (1) hour for break down.

2.2.1. 1st Tuesday of the month at Pine Bluff CBOC from 11am-3pm

2.2.2. 2nd Tuesday of the month at VDTC from 10am-2pm

2.2.3. 3rd Tuesday of the month at Eugene Towbin VA from 10am-2pm

2.3. Holidays: Should the Mobile Food Pantry delivery date fall upon a Holiday, the service shall be rescheduled with the pre-approval of the COR.

2.4. Emergency/Contingency Services: Service schedules may be altered due to emergencies per approval of CO.

3. MFP Veteran Eligibility: Prior to distribution day, the Registered Dietitian (RD) for the assigned location will prepare the list of eligible Veterans who may participate in the MFP. Veteran eligibility will be determined by using a combination of the national food insecurity screening tool and/or identified during nutrition assessment. A consult will be placed under the health and wellness program in the Computerized Patient Record System (CPRS). For Veterans who show up to the MFP who are not on the consulted list; an RD will be available to refer them to an RD within CAVHS and additional resources, such as Food Pantries within Central AR or Pine Bluff, or SNAP applications.

4. Sustenance and Material Handling:

4.1. The contractor shall set up and close down service area in a manner which promotes ease in shopping. The CAVHS RD will be responsible for checking Veterans in and verifying identification. The contractor team members will assist Veterans in selecting foods and place them in bags/boxes once shopping is complete for ease of transfer.

4.2. The contractor’s team shall have a working knowledge of healthy eating and will be responsible for conducting all innerworkings of the market the day of the distribution.

4.3. Contractor services and/or education materials will address the following factors:

4.3.1. Food insecurity and access to healthy foods- provide free, fresh, and healthy foods

4.3.2. Cooking literacy- knowledge and skills to make a healthy dish from available foods

4.3.3. Supplemental Nutrition Assistance Program (SNAP) Information- knowledge on where and how to apply for SNAP benefits

4.3.4. Food Safety education- address food safety as it relates to items available in the mobile food pantry

4.4. The contractor shall meet all federal mandated subsistence handling procedures in the current

U.S. Food and Drug Administration (FDA) Food Code 2017, Supplemental and VHA Directive 1439.

5. Nutrition Education provided by CAVHS during the MFP: Prior to selecting foods, Veterans will participate in a nutrition education demonstration led by a CAVHS RD. Demonstrations may consist of food preparation, storage, nutrition, and utilization of ingredients.

6. Documentation after MFP Events: The RD will document an education note in the CPRS detailing the education provided, resources provided, capture of Health and Wellness event and identify possible coordination of care opportunities for each participant.

7. Housekeeping Services: The contractor shall clean areas that immediately affect Veteran services that have been completed. Though a large volume of trash is not anticipated for these events, the contractor shall support the government by complying with VHA recycling program. This requires segregating recyclable cardboard and placement in appropriately labeled container provided by VHA (if the cardboard is stained then it cannot be recycled). Contractor may be responsible for collecting trash and recycling in multiple areas and taking items to designated area for disposal.

8. Contractor Past Performance: Prior mobile food distribution and/or food service experience is preferred. Contractor must be flexible, adaptable, and able to comprehend all functions of responsibilities in a timely fashion and be able to complete them with minimal direct supervision. At least one member of the contracting team should be ServSafe certified or equivalent (such as a Food Handlers Permit).

9. Quality Control Manager (QCM): The contractor will follow all local quality controls, policies and procedures. The contractor shall have an identified manager who will obtain the reports from VHA staff regarding quality concerns and will resolve concerns within established timeframe as dictated by the local facility. The QCM shall ensure that timely and effective corrective action is obtained for all deficiencies identified by the Government related to the contracted work. All deficiency responses shall include identification of the cause of the deficiency to preclude recurrence and an analysis of the quality program's effectiveness in the area of the deficiency.

10. Badging and Appearance: All personnel will be expected to present themselves in a professional and appropriate manner. Jeans or pants with a branded shirt that indicates proper identification will suffice.

11. Veteran Satisfaction Survey: Veterans will be asked to fill out an anonymous satisfaction survey (Appendix B) after participating in the MFP. Results from the survey will be analyzed on a monthly basis.

12. Quality Assurance Surveillance Plan

Performance Objectives

Location of Services

SOW

Reference

Performance Thresholds

Frequency

44 lbs. (at least 10 lbs. of protein foods, 16 lbs. of fruits and vegetables, 10 lbs.

of grains and 8 lbs. of dairy foods) of healthy foods shall be provided to 70 Veterans at each site monthly.

Pine Bluff Clinic

Veteran’s Day Treatment Center

Eugene Towbin VA

Section 1 100% throughout contract duration

Monthly

Contractor shall set up the site on time and break down/clean up by the specified end time.

Center

Section 4.1 / Appendix A

100% of the time Monthly

Satisfaction Survey for Veterans

Center

Section 10 / Appendix B

Average rating should be >3

Monthly

Appendix A

Pine Bluff CBOC

North Little Rock – Parking Lot 11

Veteran’s Day Treatment Center

Appendix B

Mobile Food Pantry Veteran Satisfaction Survey

The overall purpose/goal for this Community Event is to provide healthy foods to improve nutrition status of Veterans experiencing food insecurity.

Strongly

Agree

(Rating of 5)

Agree

(Rating of 4)

Neutral

(Rating of 3)

Disagree of 2)

Strongly Disagree of 1)

The foods I received today were fresh and of good quality.

The service I received today was of good quality.

The information I received today will benefit my health and well-being.

Other comments or feedback: