36C25625Q1538.docx

36C25625Q1538

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

520-26-1-119-0007 36C25625Q1538 09-24-2025 Tina Harris 228-523-5066 10-08-2025 12pm

CDT

Department of Veterans Affairs Gulf Coast Veterans Health Care System Network Contracting Office 16 400 Veterans Avenue Biloxi MS 39531 X X 524292 $45.5 Million N/A X Department of Veterans Affairs Gulf Coast Veterans Health Care System Network Contracting Office 16 400 Veterans Avenue Biloxi MS 39531 Department of Veterans Affairs Gulf Coast Veterans Health Care System Network Contracting Office 16 400 Veterans Avenue Biloxi MS 39531

FSC e-Invoice Payment http://www.fsc.va.gov/fsc/einvoice.asp Invoice Setup Information 1-877-489-6135 invoice must be submitted electronically 1-877-489-6135 See CONTINUATION Page Contractor to provide Pharmacy Benefit Manangement first fill pharmacy services as per the statement of work within, All questions are due by 12pm CT 10/01/2025 via email to tina.harris3@va.gov. A modification will be issued to answer all questions.

All quotes are due by 12pm CT 10/08/2025 via email to tina.harris3@va.gov Pay close attention to section E.1 Instructions to Offerors This solicitation utilizes Lowest Price Technically Acceptable (LPTA) Evaluation See CONTINUATION Page X X X Tina Harris Contracting Officer Table of Contents

SECTION B - CONTINUATION OF SF 1449 BLOCKS

B.1 CONTRACT ADMINISTRATION DATA

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

a. CONTRACTOR:

b. GOVERNMENT: Contracting Officer 36C256 Tina Harris tina.harris3@va.gov Department of Veterans Affairs Gulf Coast Veterans Health Care System Network Contracting Office 16 400 Veterans Avenue Biloxi MS 39531

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

3. INVOICES: Invoices shall be submitted in arrears:

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.

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

36C25625Q1538

Page 1 of Page 1 of

B.2 STATEMENT OF WORK

BACKGROUND: The VA Gulf Coast Veterans Health Care System (VAGCVHCS) is responsible for establishing a “pharmacy benefit management services” contract for emergency services for its Community-Based Outpatient Clinics (CBOCs) and it is up to the government add or change locations.

There is the main hospital in Biloxi, MS 39531 and currently (4) VA operated CBOC—five (4) (located in Mobile, AL, Pensacola, FL 32507, Eglin, FL 32542 and Panama City, FL 32408).

CBOC Location

Biloxi, MS 400 Veterans Ave Biloxi, MS 39531

Mobile Outpatient Clinic 4444 Demetropolis Road Mobile, AL 36995

Pensacola Outpatient Clinic 790 Veterans Way Pensacola, FL 32507

Eglin Outpatient Clinic 100 Veterans Way Eglin AFB, FL 32542

Panama City Outpatient Clinic 2600 Veterans Way Panama City Beach, FL 32408

1. SERVICES, NON-PERSONAL; The Contractor shall provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services) for the VAGCVHCS CBOCs in accordance with the services outlined in this Statement of Work (SOW).

The Contractor shall be required to fill all prescription orders written by VA CBOC physicians/providers during the contract period through the use of local Pharmacies that fully meet all Federal, State, and Local Laws, Guidelines, etc., and whose Pharmacists are fully trained and licensed. The fact that the estimated total amount or the estimated number of prescriptions to be filled is not obtained shall not constitute a price adjustment under the contract delivery order.

All prescriptions to be filled must contain medication in the VA’s Formulary. In the event that a prescribed medication is not in the VA’s Formulary, approval must be obtained from the VAGCVHCS Chief of Pharmacy or their designated representative before it is filled. The VA’s Formulary can be accessed through the following website: http://www.pbm.va.gov/Default.aspx

It is the sole responsibility of the Contractor to coordinate and set up agreements with local Pharmacies to fill Veterans’ Prescriptions. The Contractor must set up agreements with at least four (4) Pharmacies within fifteen (15) miles of the each applicable CBOCs and may set up agreements with several other Pharmacies outside of the fifteen (15) mile range if they feel that it will benefit our Veterans. Note: This list is not a recommendation on the part of the Government as to which Pharmacies the Contractor may choose to utilize and is provided for informational purposes only. The Government does not certify the accuracy of all the Pharmacy Directory information below (distances from the CBOC’s, exact addresses, phone numbers) and it is the sole responsibility of the offerors to verify this information if they choose in any way to use it. Again, the Contractor is free to set up agreements with any Pharmacies it wants to within the applicable ranges listed above. A list of Pharmacies that the Contractor has set up agreements with must be provided to the Contracting Officer’s Technical Representative (COTR) so that the list can be provided to the CBOCs to provide to our Veterans. As the list is updated or changed, a copy of the revised list must be provided to the COTR within two (2) workdays of the change so that our CBOCs and Veterans can be advised of the change.

2. The Contractor’s Pharmacies shall fill and dispense up to a 10-day supply of medication from original prescriptions written by VAGCVHCS physicians/providers assigned to VAGCVHCS within the primary service area. It is anticipated that the 10-day supply of medication will allow the patient to begin therapy, etc., until a continuing supply of medication can be provided by the VA Pharmacy. Refills will not be honored by the Contractor’s Pharmacies when presented by the VA beneficiary. The Contractor’s Pharmacies must be capable of providing pharmacy services and shall be properly licensed by Federal, State, and Local authorities to provide said services. The Contractor’s may be required to provide copies of all licenses and permits indicated in the SOW.

3. EMERGENCY OCCURENCES (Natural Disaster Non-Personal Services:

Contractor to provide Pharmacy Benefit Management Services (aka First-Fill)

4. Pharmacy services shall be available between the hours of 8:00am and 5:30pm Monday through Friday, as a minimum, excluding Federal holidays. The ten (10) Federal Holidays observed by the Federal Government for this requirement are:

When a Federal holiday falls on a Sunday, the following Monday shall be observed as a Federal holiday. When a Federal holiday falls on a Saturday, the proceeding Friday is observed as a Federal holiday by U.S. Government agencies. Also included, would be any other day, specifically declared by the President of the United States of America to be a Federal Holiday.

4. Prescriptions filled will be in written form provided by the VAGCVHCS CBOC Physicians/provider. Contractor’s dispensing Pharmacies must be able to accept the written prescription on either an overprinted VA Form 1158, Doctor’s Orders or on VA Form 10-2577F, Security Prescription Form. VA uses the VA Form 10-2577F for Schedule II drugs. Should the State in which the dispensing Pharmacy operate require other than the VA Form 10-2577F, Security Prescription Form, it will be the Contractor’s responsibility to provide the VAGCVHCS Chief of Pharmacy (located in Biloxi, MS), with the regulation/requirement, ordering addresses, and ordering information needed to provide the CBOC with the proper security form. The successful offeror may obtain a sample of each VA Form from the COTR.

Definitions & Acronyms

1. HIPAA Compliance: Contractor must adhere to the provisions of Public Law 104-191, Health Insurance Portability and Accountability Act (HIPAA) of 1996 and the National Standards to Protest the Privacy and Security of Protected Health Information (PHI).

1. FDA – Federal Drug Administration

1. VHA – Veterans Health Administration

1. AWP – Average Wholesale Price

1. OBRA – Omnibus Budget Reconciliation Act

1. HIPAA – Health Insurance Portability and Accountability Act

1. A&MM – Acquisition & Material Management

1. COB – Close of Business

1. NLT – Not Later Than

1. ID – Identification

1. COTR – Contracting Officer Technical Representative

1. U.S. – United States

Specific Tasks

Pharmaceutical services shall be performed in such a manner as to be least disruptive to medical center operations. The following services shall be for filling and dispensing of prescriptions and will consist of but not limited to:

1. Prescriptions shall be filled only when presented on a VA Prescription Blank (VA Form 10-2577F) or on an overprinted VA Form 1158, Doctor’s Orders with the Panama City or Eglin AFB CBOC identification.

1. Prescriptions will be filled and dispensed only for medication listed in the VA Gulf Coast Veterans Health Care System Formulary. The Contractor should periodically check the website for formulary changes that may have occurred.

1. All new prescriptions should be filled for the quantities written but not to exceed a 10-day supply based on directions for use. All prescriptions must have auxiliary labels attached and appropriate containers. Consideration must be given to patient’s ability to open “child-proof” containers. Generic name must be indicated on drug label for all medications.

1. All prescriptions will be filled utilizing low-cost generic equivalent medications such as mandated and readily available.

The Average Wholesale Price (AWP) will be based on the Medispan AWP prices, utilizing the most current edition. If private company generics are used, a catalog with prices must be submitted to the VA Gulf Coast Veterans Health Care System Contracting Officer who will forward them to the Pharmacy service for professional review. Upon written approval from the Contracting Officer, prescriptions may be filled with the private company generic medication.

1. Medication Order Review: The Contractor’s Pharmacists will check for actual and potential drug related problems to include but not limited to:

4. Therapeutic duplication

4. Drug-disease contraindications

4. Drug-drug interactions

4. Incorrect drug dosage

4. Drug-allergy interactions

4. Clinical misuse/abuse

1. Patient Focused Care: All patients will be offered counseling by a pharmacist consistent with Omnibus Budget Reconciliation Act (OBRA) 1990 requirement to insure appropriate use and optimal outcomes from drug therapy. Counseling includes the following information:

5. Name, description and use of the medication

5. Dose, dosage form and route

5. Special directions and precautions

5. Common side effects and action required if they occur

5. Techniques for self-monitoring drug therapy

5. Action to be taken if a dose is missed

5. Proper storage

5. Proper storage

A pharmacist will be available to answer any drug-related questions that a patient may have after the prescription is filled. This may be in the form of written and/or verbal information.

6. The Contractor must set up agreements with at least four (4) Pharmacies within fifteen (15) miles of the applicable CBOCs and may set up agreements with several other Pharmacies outside of the fifteen (15) mile range if they feel that it will benefit our Veterans.

7. Prescriptions shall be filled within one-hour from presentation by patient.

8. Quality Assurance: The VAGCVHCS may review the following:

a. Compliance/Accuracy with Filling Prescriptions: random view of Contractor’s reports completed by the VA Gulf Coast Veterans Health Care System Pharmacy representative or COTR.

b. Quality of Patient Education: review of patient education materials and random patient interviews conducted by VA Gulf Coast Veterans Health Care System Pharmacy representative or COTR.

c. Review of Errors: Contractor will track and report all medication errors and medication related incidents to the provider and the Chief, Pharmacy Service, VA Gulf Coast Veterans Health Care System, or designee, as discovered to prevent the perpetuation of the error by the system.

9. The Contractor shall notify the VA Gulf Coast Veterans Health Care System Contracting Officer in writing whenever a malpractice claim involving a VA Gulf Coast Veterans Health Care System patient has been filed against the Contractor within three (3) working days.

10. The parties agree that the Contractor’s personnel will not be considered VA Gulf Coast Veterans Health Care System employees for any purpose and shall be considered employees of the Contractor.

11. Contractor employees are not covered by the Federal Tort Claims Act. When a Contractor employee has been identified as a defendant in a Tort Claim; the Contractor employee is responsible for notifying the Contractor’s legal counsel and/or insurance carrier. Any settlement or judgment arising from a Contractor’s employee’s action or non-action is the responsibility of the Contractor and/or insurance carrier. The Contractor shall notify the VA of the action or non-action.

12. Invoice shall be entered into the OB10 tungsten electronic system for payment.

NOTE: Facsimile, e-mail, and scanned documents are not acceptable forms of submission for payment requests. Electronic form means an automated system transmitting information electronically according to the accepted electronic data transmission methods below:

A. 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.

B. A system that conforms to the X12 electronic data interchange (EDI) formats established by the Accredited Standards Center (ASC) chartered by the American National Standards Institute (ANSI).The X12 EDI Web site http://www.x12.org Customer support: 1-877-752-0900 or 1-877489-6135

Invoices must include:

a. Name and address of Contractor

b. Invoice date

c. Period of performance (Month)

d. Purchase order Number i.e. (520-C?????)

e. Terms of prompt payment discount offered.

f. Name and address of official to whom payment is to be sent to

g. Name, title and phone number of person to be notified in the event there is a question on the invoice

The VA Gulf Coast Veterans Health Care System may randomly audit all billings. The Contractor must make prescription records available to the auditor in a timely manner at the location where dispensed. A month is defined as the first calendar day of the month until the last calendar day of the month.

13. The Contractor shall maintain a log of VA Gulf Coast Veterans Health Care System prescriptions filled and have the patient sign next to each prescription number for each prescription received. A copy of this log must be sent with the corresponding invoices.

14. The Contractor understands that all information concerning VA Gulf Coast Veterans’ Health Care System beneficiaries shall be kept confidential and shall not be disclosed to any person, except in accordance with applicable Federal laws and when authorized in writing. The Contractor shall ensure the confidentiality of all patient information and shall be held liable in the event of a breach of confidentiality. Breach of confidentiality is grounds for termination of contract. The Contractor is subject to all federal and state statutes, rule and regulations regarding patient privacy. Said statutes, rules and regulations which include but are not limited to are 5 USC Section 552(a), 38 USC Section 5319, and 38 USC Section 7332 are available from the Contracting Officer upon request.

15. All prescriptions must be filled in a manner that meets or exceeds current State of Florida and Federal requirements that govern the filling and dispensing of prescriptions.

16. The Contracting Officer’s Technical Representative (COTR) will be the Chief, Pharmacy Service or designee, from the VA Gulf Coast Veterans Health Care System.

17. Confidentiality of Information: The Contractor shall insure the confidentiality of all patient information and will be held liable in the event of breach of confidentiality. The Contractor shall comply with the provision of the Federal Privacy Act of 1974 (Public Law 93-579), HIPAA (Public Law 104-191), and the Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment and Rehabilitation Act of 1972 (Public Law 83-255), as well as other statues regarding confidentiality of patient information during and after the execution of this contract. Because of the confidential medical record information that may be accessible and/or visible to Contractor employees during performance of their daily duties, the Contractor shall obtain a signed “confidentiality certificate” form each employee prior to allowing them to start work under this contract. Any information about an individual that is maintained by the VA, including, but not limited to education, financial transactions, medical history, and criminal or employment history or any record that contains the person’s name, or the identifying number, symbol or other identifying particular assigned to the individual shall be kept CONFIDENTIAL. A copy of this certificate shall be provided to the COTR upon request.

18. HIPPA Compliance: Health Insurance Portability and Accountability Act of 1996:

The Contractor shall be required to be in compliance with HIPAA requirements and will be required to sign a Business Associate Agreement with the VA and return it to the Contracting Officer. A signed copy of the Business Associate Agreement will be returned to the Contractor for their files.

19. Privacy Training: The Contractor’s employees directly involved with this contract will be required to complete annual web-based Privacy Training. The time associated with completed the web-based Privacy Training is estimated to be 1 hour. The COTR will coordinate with the Contractor on how to access the Privacy Training website. Copies of the completed Privacy Training Certificates shall be provided to the COTR within five (5) business days of completion. Any new employees shall complete the web-based Privacy Training prior to starting any work on the contract. Copies of the completed web-based Privacy Training Certificates for all new employees shall also be provided to the COTR within five (5) business days of completion.

20. Period and Place of Performance: The Period of Performance shall be one year beginning 1 April 2016 through 30 September 2016. Performance shall start three (3) to five (5) days after award. Place of Performance shall be at the Panama City Outpatient Clinic located at 101 Vernon Ave, Panama City Florida 32407.

Applicable Publications and Forms:

VA Prescription Blank - (VA Form 10-2577F) VA Form 1158

B.3 PRICE/COST SCHEDULE

ITEM INFORMATION

Services, Non-Personal; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services) for the VA Gulf Coast Veterans Health Care System (VAGCVHCS) Community Based Outpatient Clinics (CBOCs) in accordance with the services outlined in the Performance Work Statement (PWS).

(Pricing to be based on estimated 6000 prescription per year)

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Base POP Begin: 10-13-2025 POP End: 09-30-2026 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds PRODUCT/SERVICE CODE: Q517 - Medical - Pharmacy Services

EMERGENCY OCCURENCES (Natural Disaster) - Non-personal Services; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services from eligible pharmacy locations with the Gulf Coast Veterans Health Care System Locations (Biloxi, MS; Mobile, FL; Pensacola, FL; Panama City, FL; and Eglin

(Pricing to be based on estimated 2000 prescription per year)

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Base POP Begin: 10-13-2025 POP End: 09-30-2026 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Services, Non-Personal; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services) for the VA Gulf Coast Veterans Health Care System (VAGCVHCS) Community Based Outpatient Clinics (CBOCs) in accordance with the services outlined in the Performance Work Statement (PWS).

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Option 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

EMERGENCY OCCURENCES (Natural Disaster) - Non-personal Services; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services from eligible pharmacy locations with the Gulf Coast Veterans Health Care System Locations (Biloxi, MS; Mobile, FL; Pensacola, FL; Panama City, FL; and Eglin

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Option 1 POP Begin: 10-01-2026 POP End: 09-30-2027 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Services, Non-Personal; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services) for the VA Gulf Coast Veterans Health Care System (VAGCVHCS) Community Based Outpatient Clinics (CBOCs) in accordance with the services outlined in the Performance Work Statement (PWS).

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Option 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

EMERGENCY OCCURENCES (Natural Disaster) - Non-personal Services; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services from eligible pharmacy locations with the Gulf Coast Veterans Health Care System Locations (Biloxi, MS; Mobile, FL; Pensacola, FL; Panama City, FL; and Eglin

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Option 2 POP Begin: 10-01-2027 POP End: 09-30-2028 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Services, Non-Personal; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services) for the VA Gulf Coast Veterans Health Care System (VAGCVHCS) Community Based Outpatient Clinics (CBOCs) in accordance with the services outlined in the Performance Work Statement (PWS).

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Option 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

EMERGENCY OCCURENCES (Natural Disaster) - Non-personal Services; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services from eligible pharmacy locations with the Gulf Coast Veterans Health Care System Locations (Biloxi, MS; Mobile, FL; Pensacola, FL; Panama City, FL; and Eglin

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Option 3 POP Begin: 10-01-2028 POP End: 09-30-2029 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Services, Non-Personal; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services) for the VA Gulf Coast Veterans Health Care System (VAGCVHCS) Community Based Outpatient Clinics (CBOCs) in accordance with the services outlined in the Performance Work Statement (PWS).

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Option 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

EMERGENCY OCCURENCES (Natural Disaster) - Non-personal Services; Contractor to provide Pharmacy Benefit Management Services (aka First-Fill Pharmacy Services from eligible pharmacy locations with the Gulf Coast Veterans Health Care System Locations (Biloxi, MS; Mobile, FL; Pensacola, FL; Panama City, FL; and Eglin

Contractor Must annotate:

Dispensing Fee per prescription Discount from AWP ___% off generic drugs ___% Brand name if no generic exist Administration fee, if any Contract Period: Option 4 POP Begin: 10-01-2029 POP End: 09-30-2030 PRINCIPAL NAICS CODE: 524292 - Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

Base Period Total

Option Year One (1) Total

Option Year Two (2) Total

Option Year Three (3) Total

Option Year Four (4) Total

Contract GRAND TOTAL

For the purposes of the award of this Contract, the Government intends to evaluate the option to extend services under FAR 52.217-8 as follows:

The evaluation will consider the possibility that the option can be exercised at any time and can be exercised in increments of one to six months, but not for more than a total of six months during the life of the contract. The evaluation will assume that the prices for any option exercised under FAR 52.217-8 will be at the same rates as those in effect under the contract at the time the option is exercised. The evaluation will therefore assume that the addition of the price or prices of any possible extension or extensions under FAR 52.217-8 to the total price of all proposals relative to each other, and will not affect the ranking of proposals based on price, unless, after reviewing the proposals, the Government determines that there is a basis for finding otherwise. This evaluation will not obligate the Government to exercise any option under FAR 52.217-8.

SECTION C - CONTRACT CLAUSES

ADDENDUM to FAR 52.212-4 CONTRACT TERMS AND CONDITIONS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES Clauses that are incorporated by reference (by Citation Number, Title, and Date), have the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available.

The following clauses are incorporated into 52.212-4 as an addendum to this contract:

C.1 VAAR 852.242-71 ADMINISTRATIVE CONTRACTING OFFICER (OCT 2020)

The Contracting Officer reserves the right to designate an Administrative Contracting Officer (ACO) for the purpose of performing certain tasks/duties in the administration of the contract. Such designation will be in writing through an ACO Letter of Delegation and will identify the responsibilities and limitations of the ACO. A copy of the ACO Letter of Delegation will be furnished to the Contractor.

(End of Clause)

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

This contract incorporates one or more clauses by reference, with the same force and effect as if they were given in full text. Upon request, the Contracting Officer will make their full text available. Also, the full text of a clause may be accessed electronically at this/these address(es):

https://www.acquisition.gov/browse/index/far https://www.va.gov/oal/library/vaar/

(End of Clause)

(End of Addendum to 52.212-4)

C.3 52.212-5 CONTRACT TERMS AND CONDITIONS REQUIRED TO IMPLEMENT STATUTES OR EXECUTIVE ORDERS—COMMERCIAL PRODUCTS AND COMMERCIAL SERVICES (JAN 2025) (DEVIATION FEB 2025)

(a) The Contractor shall comply with the following Federal Acquisition Regulation (FAR) clauses, which are incorporated in this contract by reference, to implement provisions of law or Executive orders applicable to acquisitions of commercial products and commercial services:

(1) 52.203-19, Prohibition on Requiring Certain Internal Confidentiality Agreements or Statements (JAN 2017) (section 743 of Division E, Title VII, of the Consolidated and Further Continuing Appropriations Act, 2015 (Pub. L. 113-235) and its successor provisions in subsequent appropriations acts (and as extended in continuing resolutions)).

(2) 52.204–23, Prohibition on Contracting for Hardware, Software, and Services Developed or Provided by Kaspersky Lab Covered Entities (DEC 2023) (Section 1634 of Pub. L. 115–91).

(3) 52.204–25, Prohibition on Contracting for Certain Telecommunications and Video Surveillance Services or Equipment. (NOV 2021) (Section 889(a)(1)(A) of Pub. L. 115–232).

(4) 52.209-10, Prohibition on Contracting with Inverted Domestic Corporations (NOV 2015).

(5) 52.232–40, Providing Accelerated Payments to Small Business Subcontractors (MAR 2023) (31 U.S.C. 3903 and 10 U.S.C. 3801).

(6) 52.233-3, Protest After Award (AUG 1996) (31 U.S.C. 3553).

(7) 52.233-4, Applicable Law for Breach of Contract Claim (OCT 2004) (Public Laws 108-77 and 108-78 (19 U.S.C. 3805 note)).

(b) The Contractor shall comply with the FAR clauses in this paragraph (b) that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial products and commercial services:

[X] (1) 52.203–6, Restrictions on Subcontractor Sales to the Government (JUN 2020), with Alternate I (NOV 2021) (41 U.S.C. 4704 and 10 U.S.C. 4655).

[] (2) 52.203–13, Contractor Code of Business Ethics and Conduct (NOV 2021) (41 U.S.C. 3509).

[] (3) 52.203–15, Whistleblower Protections under the American Recovery and Reinvestment Act of 2009 (JUN 2010) (Section 1553 of Pub. L. 111-5). (Applies to contracts funded by the American Recovery and Reinvestment Act of 2009.)

[X] (4) 52.203–17, Contractor Employee Whistleblower Rights (NOV 2023) (41 U.S.C. 4712); this clause does not apply to contracts of DoD, NASA, the Coast Guard, or applicable elements of the intelligence community—see FAR 3.900(a).

[X] (5) 52.204–10, Reporting Executive Compensation and First-Tier Subcontract Awards (JUN 2020) (Pub. L. 109–282) (31 U.S.C. 6101 note).

[] (6) [Reserved] [X] (7) 52.204–14, Service Contract Reporting Requirements (OCT 2016) (Pub. L. 111–117, section 743 of Div. C).

[] (8) 52.204–15, Service Contract Reporting Requirements for Indefinite-Delivery Contracts (OCT 2016) (Pub. L. 111–117, section 743 of Div. C).

[X] (9) 52.204–27, Prohibition on a ByteDance Covered Application (JUN 2023) (Section 102 of Division R of Pub. L. 117–328).

[] (10) 52.204–28, Federal Acquisition Supply Chain Security Act Orders—Federal Supply Schedules, Governmentwide Acquisition Contracts, and Multi-Agency Contracts. (DEC 2023) (Pub. L. 115–390, title II).

[X] (11)(i) 52.204–30, Federal Acquisition Supply Chain Security Act Orders— Prohibition. (DEC 2023) (Pub. L. 115–390, title II).

[] (ii) Alternate I (DEC 2023) of 52.204–30.

[X] (12) 52.209–6, Protecting the Government’s Interest When Subcontracting with Contractors Debarred, Suspended, Proposed for Debarment, or Voluntarily Excluded. (JAN 2025) (31 U.S.C. 6101 note).

[X] (13) 52.209-9, Updates of Publicly Available Information Regarding Responsibility Matters (OCT 2018) (41 U.S.C. 2313).

[] (14) [Reserved] [] (15) 52.219–3, Notice of HUBZone Set-Aside or Sole-Source Award (OCT 2022) (15 U.S.C. 657a).

[] (16) 52.219–4, Notice of Price Evaluation Preference for HUBZone Small Business Concerns (OCT 2022) (if the offeror elects to waive the preference, it shall so indicate in its offer) (15 U.S.C. 657a).

[] (17) [Reserved] [] (18)(i) 52.219-6, Notice of Total Small Business Set-Aside (NOV 2020) (15 U.S.C. 644).

[] (ii) Alternate I (MAR 2020) of 52.219-6.

[] (19)(i) 52.219-7, Notice of Partial Small Business Set-Aside (NOV 2020) (15 U.S.C. 644).

[] (ii) Alternate I (MAR 2020) of 52.219-7.

[X] (20) 52.219-8, Utilization of Small Business Concerns (JAN 2025) (15 U.S.C. 637(d)(2) and (3)).

[] (21)(i) 52.219–9, Small Business Subcontracting Plan (JAN 2025) (15 U.S.C. 637(d)(4)).

[] (ii) Alternate I (NOV 2016) of 52.219-9.

[] (iii) Alternate II (NOV 2016) of 52.219-9.

[] (iv) Alternate III (JAN 2025) of 52.219–9.

[] (v) Alternate IV (JAN 2025) of 52.219–9.

[] (22)(i) 52.219-13, Notice of Set-Aside of Orders (MAR 2020) (15 U.S.C. 644(r)).

[] (ii) Alternate I (MAR 2020) of 52.219-13.

[] (23) 52.219–14, Limitations on Subcontracting (OCT 2022) (15 U.S.C. 657s).

[] (24) 52.219-16, Liquidated Damages—Subcontracting Plan (SEP 2021) (15 U.S.C. 637(d)(4)(F)(i)).

[X] (25) 52.219–27, Notice of Set-Aside for, or Sole-Source Award to, Service-Disabled Veteran-Owned Small Business (SDVOSB) Concerns Eligible Under the SDVOSB Program (FEB 2024) (15 U.S.C. 657f).

[X] (26) (i) 52.219-28, Postaward Small Business Program Rerepresentation (JAN 2025) (15 U.S.C. 632(a)(2)).

[] (ii) Alternate I (MAR 2020) of 52.219–28.

[] (27) 52.219–29, Notice of Set-Aside for, or Sole-Source Award to, Economically Disadvantaged Women-Owned Small Business Concerns (OCT 2022) (15 U.S.C. 637(m)).

[] (28) 52.219–30, Notice of Set-Aside for, or Sole-Source Award to, Women-Owned Small Business Concerns Eligible Under the Women-Owned Small Business Program (OCT 2022) (15 U.S.C. 637(m)).

[] (29) 52.219-32, Orders Issued Directly Under Small Business Reserves (MAR 2020) (15 U.S.C. 644(r)).

[] (30) 52.219–33, Nonmanufacturer Rule (SEP 2021) (15 U.S.C. 637(a)(17)).

[X] (31) 52.222-3, Convict Labor (JUN 2003) (E.O. 11755).

[] (32) 52.222–19, Child Labor—Cooperation with Authorities and Remedies (JAN 2025) (E.O. 13126).

[] (33) [Reserved] [] (34) [Reserved] [X] (35)(i) 52.222–35, Equal Opportunity for Veterans (JUN 2020) (38 U.S.C. 4212).

[] (ii) Alternate I (JUL 2014) of 52.222-35.

[X] (36)(i) 52.222–36, Equal Opportunity for Workers with Disabilities (JUN 2020) (29 U.S.C. 793).

[] (ii) Alternate I (JUL 2014) of 52.222-36.

[X] (37) 52.222–37, Employment Reports on Veterans (JUN 2020) (38 U.S.C. 4212).

[X] (38) 52.222-40, Notification of Employee Rights Under the National Labor Relations Act (DEC 2010) (E.O. 13496).

[X] (39)(i) 52.222-50, Combating Trafficking in Persons (NOV 2021) (22 U.S.C. chapter 78 and E.O. 13627).

[] (ii) Alternate I (MAR 2015) of 52.222-50 (22 U.S.C. chapter 78 and E.O. 13627).

[X] (40) 52.222-54, Employment Eligibility Verification (JAN 2025). (E.O. 12989). (Not applicable to the acquisition of commercially available off-the-shelf items or certain other types of commercial products or commercial services as prescribed in FAR 22.1803.)

[] (41)(i) 52.223-9, Estimate of Percentage of Recovered Material Content for EPA-Designated Items (MAY 2008) (42 U.S.C.6962(c)(3)(A)(ii)). (Not applicable to the acquisition of commercially available off-the-shelf items.)

[] (ii) Alternate I (MAY 2008) of 52.223-9 (42 U.S.C. 6962(i)(2)(C)). (Not applicable to the acquisition of commercially available off-the-shelf items.)

[] (42) 52.223-11, Ozone-Depleting Substances and High Global Warming Potential Hydrofluorocarbons (MAY 2024) (42 U.S.C. 7671, et seq.).

[] (43) 52.223-12, Maintenance, Service, Repair, or Disposal of Refrigeration Equipment and Air Conditioners (MAY 2024) (42 U.S.C. 7671, et seq.).

[] (44) 52.223-20, Aerosols. (MAY 2024) (42 U.S.C. 7671, et seq.).

[] (45) 52.223-21, Foams (MAY 2024). (42 U.S.C. 7671, et seq.).

[X] (46) 52.223-23, Sustainable Products and Services (MAY 2024) (DEVIATION FEB 2025) (7 U.S.C. 8102, 42 U.S.C. 6962, 42 U.S.C. 8259b, and 42 U.S.C. 7671I).

[X] (47)(i) 52.224-3, Privacy Training (JAN 2017) (5 U.S.C. 552a).

[] (ii) Alternate I (JAN 2017) of 52.224-3.

[] (48)(i) 52.225-1, Buy American—Supplies (OCT 2022) (41 U.S.C. chapter 83).

[] (ii) Alternate I (OCT 2022) of 52.225-1.

[] (49)(i) 52.225-3, Buy American—Free Trade Agreements—Israeli Trade Act (NOV 2023) (19 U.S.C. 3301 note, 19 U.S.C. 2112 note, 19 U.S.C. 3805 note, 19 U.S.C. 4001 note, 19 U.S.C. chapter 29 (sections 4501-4732), Public Law 103-182, 108-77, 108-78, 108-286, 108-302, 109-53, 109-169, 109-283, 110-138, 112-41, 112-42, and 112-43.

[] (ii) Alternate I [Reserved].

[] (iii) Alternate II (JAN 2025) of 52.225-3.

[] (iv) Alternate III (FEB 2024) of 52.225-3.

[] (v) Alternate IV (OCT 2022) of 52.225-3.

[] (50) 52.225–5, Trade Agreements (NOV 2023) (19 U.S.C. 2501, et seq., 19 U.S.C. 3301 note [X] (51) 52.225-13, Restrictions on Certain Foreign Purchases (FEB 2021) (E.O.'s, proclamations, and statutes administered by the Office of Foreign Assets Control of the Department of the Treasury).

[] (52) 52.225–26, Contractors Performing Private Security Functions Outside the United States (OCT 2016) (Section 862, as amended, of the National Defense Authorization Act for Fiscal Year 2008; 10 U.S.C. Subtitle A, Part V, Subpart G Note).

[] (53) 52.226-4, Notice of Disaster or Emergency Area Set-Aside (NOV 2007) (42 U.S.C. 5150).

[] (54) 52.226-5, Restrictions on Subcontracting Outside Disaster or Emergency Area (NOV 2007) (42 U.S.C. 5150).

[X] (55) 52.226-8, Encouraging Contractor Policies to Ban Text Messaging While Driving (MAY 2024) (E.O. 13513) [X] (56) 52.229–12, Tax on Certain Foreign Procurements (FEB 2021).

[] (57) 52.232-29, Terms for Financing of Purchases of Commercial Products and Commercial Services (NOV 2021) (41 U.S.C. 4505, 10 U.S.C. 3805).

[] (58) 52.232-30, Installment Payments for Commercial Products and Commercial Services (NOV 2021) (41 U.S.C. 4505, 10 U.S.C. 3805).

[X] (59) 52.232-33, Payment by Electronic Funds Transfer—System for Award Management (OCT 2018) (31 U.S.C. 3332).

[] (60) 52.232-34, Payment by Electronic Funds Transfer—Other than System for Award Management (JUL 2013) (31 U.S.C. 3332).

[] (61) 52.232-36, Payment by Third Party (MAY 2014) (31 U.S.C. 3332).

[] (62) 52.239-1, Privacy or Security Safeguards (AUG 1996) (5 U.S.C. 552a).

[X] (63) 52.240–1, Prohibition on Unmanned Aircraft Systems Manufactured or Assembled by American Security Drone Act—Covered Foreign Entities (NOV 2024) (Sections 1821–1826, Pub. L. 118–31, 41 U.S.C. 3901 note prec.).

[] (64) 52.242-5, Payments to Small Business Subcontractors (JAN 2017)(15 U.S.C. 637(d)(13)).

[] (65)(i) 52.247-64, Preference for Privately Owned U.S.-Flag Commercial Vessels (NOV 2021) (46 U.S.C. 55305 and 10 U.S.C. 2631).

[] (ii) Alternate I (APR 2003) of 52.247-64.

[] (iii) Alternate II (NOV 2021) of 52.247-64.

(c) The Contractor shall comply with the FAR clauses in this paragraph (c), applicable to commercial services, that the Contracting Officer has indicated as being incorporated in this contract by reference to implement provisions of law or Executive orders applicable to acquisitions of commercial products and commercial services:

[X] (1) 52.222-41, Service Contract Labor Standards (AUG 2018) (41 U.S.C. chapter 67).

[X] (2) 52.222-42, Statement of Equivalent Rates for Federal Hires (MAY 2014) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

[X] (3) 52.222-43, Fair Labor Standards Act and Service Contract Labor Standards—Price Adjustment (Multiple Year and Option Contracts) (AUG 2018) (29 U.S.C. 206 and 41 U.S.C. chapter 67).

[] (4) 52.222-44, Fair Labor Standards Act and Service Contract Labor Standards—Price Adjustment (MAY 2014) (29 U.S.C 206 and 41 U.S.C. chapter 67).

[] (5) 52.222-51, Exemption from Application of the Service Contract Labor Standards to Contracts for Maintenance, Calibration, or Repair of Certain Equipment—Requirements (MAY 2014) (41 U.S.C. chapter 67).

[] (6) 52.222-53, Exemption from Application of the Service Contract Labor Standards to Contracts for Certain Services—Requirements (MAY 2014) (41 U.S.C. chapter 67).

[X] (7) 52.222-55, Minimum Wages for Contractor Workers Under Executive Order 14026 (JAN 2022).

[X] (8) 52.222-62, Paid Sick Leave Under Executive Order 13706 (JAN 2022) (E.O. 13706).

[] (9) 52.226-6, Promoting Excess Food Donation to Nonprofit Organizations (JUN 2020) (42 U.S.C. 1792).

[] (10) 52.247-69, Reporting Requirement for U.S.-Flag Air Carriers Regarding Training to Prevent Human Trafficking (JAN 2025) (49 U.S.C. 40118(g)).

(d) Comptroller General Examination of Record. The Contractor shall comply with the provisions of this paragraph (d) if this contract was awarded using other than sealed bid, is in excess of the simplified acquisition threshold, as defined in FAR 2.101, on the date of award of this contract, and does not contain the clause at 52.215-2, Audit and Records—Negotiation.

(1) The Comptroller General of the United States, or an authorized representative of the Comptroller General, shall have access to and right to examine any of the Contractor's directly pertinent records involving transactions related to this contract.

(2) The Contractor shall make available at its offices at all reasonable times the records, materials, and other evidence for examination, audit, or reproduction, until 3 years after final payment under this contract or for any shorter period specified in FAR Subpart 4.7, Contractor Records Retention, of the other clauses of this contract. If this contract is completely or partially terminated, the records relating to the work terminated shall be made available for 3 years after any resulting final termination settlement. Records relating to appeals under the disputes clause or to litigation or the settlement of claims arising under or relating to this contract shall be made available until such appeals, litigation, or claims are finally resolved.

(3) As used in this clause, records include books, documents, accounting procedures and practices, and other data, regardless of type and regardless of form. This does not require the Contractor to create or maintain any record that the Contractor does not maintain in the ordinary course of business or pursuant to a provision of law.

(e)(1) Notwithstanding the requirements of the clauses in paragraphs (a), (b), (c), and (d) of this clause, the Contractor is not required to flow down any FAR clause, other than those in this paragraph (e)(1) in a subcontract for commercial products or commercial services.