RFQ Amendment 36C25722Q1173 0006.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 23

0006 11-25-2022 671-23-1-5539-0001

36C257

Department Of Veterans Affairs Network Contracting Office 17

5441 Babcock Road Ste. 302 San Antonio TX 78240

36C257

Department Of Veterans Affairs Network Contracting Office 17

5441 Babcock Road Ste. 302 San Antonio TX 78240

To all Offerors/Bidders

36C25722Q1173

10-05-2022

X

X X

** HOUR & DATE for Receipt of Offers is EXTENDED to: 3PM CST on 12/05/2022

X 1

The purpose of this amendment is to provide answers to questions and a revised Performance Work Statement. A time extension is granted as noted in section 11 of this amendment. See the continuation pages.

36C25722Q1173 0006

STX Regulated Medical Waste Removal Services

Questions and Answers

RFQ 36C25722Q1173

1. In the solicitation on page 10 it states that the contractor is responsible for providing 3-gallon sharp containers and the 5 qt sharps containers. In the published Q&A the answer to question 4 states “The VA would supply the sharps containers”. Is this a change to the solicitation? This clarification could make a big difference in the final price.

Answer: The PWS has been revised to state that the contractor will provide 5 qt sharps containers, 28 gallon reusable container, 18 gallon yellow container (chemo waste), 18 gallon blue on white container (pharmaceutical waste).

2. Please explain these items in the PWS. The PWS contradicts itself.

1.1.3. The Contractor is responsible for all sharp’s container inventory levels, ensuring that all required containers are available during each service period. Each sharp’s container must be accompanied with the appropriate lid.

1.1.3.1. The Contractor shall provide a full-service sharps management program to include the final processing of sharps containers. The Contractor shall be solely responsible to ensure area/rooms have satisfactory capacity for disposal of sharps between servicing and adequate supply of sharps containers during each service period.

1.1.3.2. Contractor shall provide equipment, and proper vehicles, as legally required, for the transportation of sharps waste to disposal site(s). Contractor vehicles shall be operated only by licensed operators and only on paved roadways, unless otherwise authorized by the VA Contracting Officer Representative’s (COR’s).

1.1.3.3. The Contractor shall provide appropriate containers and packaging labels for transportation of medical waste.

Answer: The PWS has been revised. These items remain in PWS.

2.1.1.1. Container description and service. The Government will provide all DOT approved Sharps containers, alongside will provide all wall mounted sharps container mounts for installation. This would also include ensuring all containers have horizontal/vertical direct drop openings, are rigid, heavy duty, puncture resistant, leak proof on sides, bottoms and able to be closed for transport. Each sharp’s container must be accompanied with the appropriate locking lid.

2.1.1.2. The Government shall supply sharps containers with a viewing window so that clinicians can see the level of sharps in the container while remaining aesthetically pleasing to patients and visitors. Each sharp’s container must be accompanied with the appropriate locking lid.

2.1.1.3. The Government shall provide medical waste containers/tubs to include the red liner biohazard bags.

Answer: These items have been corrected. See answer to question number 5 below.

Does this mean that the VA will be buying ALL the containers, (the 28-gallon, 5 quart, 17 GL, red bags cactus items and all other items) The contractor ONLY provided labor to move the waste, process the waste, weight the waste?

Answer: The contract will provide 28 gal and larger containers and 5-qt containers (whichever it is that we are using). The Government will supply 17-gal sharps container and 17-gallon yellow container. Contractor will provide red bags for any and all containers’ sizes most likely from small bags 24x24 large bags 40x47.

3. Due to the set cost of an FTE can we provide a tiered pricing structure? Our cost per pound varies depending on how much weight. We must cover the price of an employee even if the weights were to drop. Another option is to add a line item for the FTE and then a price per pound. Simple example is if we pick up 1 pound per year, we would need to cover the $40,000 FTE so the price would be higher versus if you have 40,000 lbs. we would only need $1.00 per pound.

Answer: In accordance with FAR 52.212-1(e) Multiple offers. “Offerors are encouraged to submit multiple offers presenting alternative terms and conditions, including alternative line items (provided that the alternative line items are consistent with FAR subpart 4.10), or alternative commercial products or commercial services for satisfying the requirements of this solicitation. Each offer submitted will be evaluated separately.” A separate line item for an FTE will not be included.

4. Are CAT scales acceptable? We could provide a certified scale ticket after we run only the

VA routes. We collect every location except Audie, Kerrville, and Victoria on Thursdays.

Answer: Yes, as long as the scale is certified.

5. In the amendment it talks about the duties of the Government versus the contractor. During the below sections, the VA states the Government will provide all sharps containers, tubs, and red bags. Has the Government been able to procure these in time for a Jan 1, 2023, start date? It later states in 1.1.3 that the contractor is in charge of container levels. How would we accomplish this if the Government is doing the procuring?

Answer: See below changes to 2.1.1.1, 2.1.1.2 and 2.1.1.3

2.1.1.1 Container description and service. The Contractor will provide all DOT approved Sharps containers, this includes ensuring all containers have horizontal/vertical direct drop openings, are rigid, heavy duty, puncture resistant, leak proof on sides, bottoms and able to be closed for transport. Each sharp’s container must be accompanied with the appropriate locking lid. The Government will provide all wall mounts for sharps containers.

https://www.acquisition.gov/far/subpart-4.10#FAR_Subpart_4_10

2.1.1.2 The Contractor shall supply sharps containers with a viewing window so that clinicians can see the level of sharps in the container while remaining aesthetically pleasing to patients and visitors. Each sharp’s container must be accompanied with the appropriate locking lid.

2.1.1.3 The Contractor shall provide medical waste containers/tubs to include the red liner biohazard bags.

1.1.3. The Contractor is responsible for all sharp’s container inventory levels, ensuring that all required containers are available during each service period. Each sharp’s container must be accompanied with the appropriate lid.

1.1.3.1. The Contractor shall provide a full-service sharps management program to include the final processing of sharps containers. The Contractor shall be solely responsible to ensure area/rooms have satisfactory capacity for disposal of sharps between servicing and adequate supply of sharps containers during each service period.

Answer: The PWS has been revised. These items remain in PWS.

6. Is the purchase of sharps containers and cactus cartridges happening through the current contract? If so is that price included in the $1,015,977.14? If so, how much has been spent on the disposal of waste?

Answer: Cactus cartridges are not purchased through the contract.

The following are revisions to questions posed with Amendment 0004.

1. Are Vendors required to supply all red bags or only those for our containers? Generally, we supply one bag per container left on site.

a. If the VA is requesting the purchase of boxes of red bags a line item would be required, this should not be put into the per pound rate as there is no limit or cap on consumption.

Answer: At a minimum, the contractor will supply red bags for containers they provide and the VA will purchase they red bags for the other containers.

4. Does the VA own the sharps container wall brackets and dollies? This would also be much more cost effective if utilizing a GSA supply contract outside of this requirement.

What brand disposable sharps containers are being utilized?

a. These would also need to be a line item if you’d like to purchase them from us as it would be impossible for us to calculate usage with the provided in the per pound rate.

Answer: VA owns (purchases) sharp container wall bracket and dollies. Any brand that meets requirements and fits into the wall mount is acceptable.

5. Would the VA consider different RMW containers, as an example 38- and 96-gallon containers instead of 28-gallon?

Answer: We can go up to 96 gallon if it is the contracted RMW staff moving them.

19. Is the VA interested providing one time funding to provide their own supplies (28 Gallon)?

Answer: No, the VA is not interested.

(End of Questions and Answers)

Performance Work Statement – Amendment 0006

STX RMW Removal Services

1. Introduction: This basic contract Performance Work Statement (PWS) defines the scope of a full range of collection, disposal and recycling of regulated medical and sharp waste. The Contractor shall provide all personnel, equipment, tools, materials, vehicles, supervision, other items and services necessary to perform Regulated Medical Waste Removal, Sharps Container Treatment/Recycling, and Final Disposal for the South Texas Veterans Health Care System (STVHCS). This requirement is based on the needs of the government and can be modified during the performance period (Base Year + Option Years) to comply with the current conditions of the healthcare system and its associated facilities outlined within this PWS.

1.1. Performance Period: The contractor shall complete required work detailed in this PWS upon contract award, unless otherwise directed by the Contracting Officer (CO).

If the contractor proposes an earlier date, and the Government accepts the contractor’s proposal, the contractor’s proposed date shall prevail. The performance period of the contract shall be one base year+ 4 option years. (January 1, 2023 expected begin date)

Type of Contract: Firm-fixed priced and is priced per pound.

1.2. Schedule of Services: Below is a schedule of services for the Base Year of this contract (Table1).

Description Bio/Chemo/Sharps/Cactus/Pharma waste removal Audie Murphy Medical Center Bio/Chemo/Sharps/Cactus/Pharma waste removal Kerrville Medical Center Bio/Chemo/Sharps/Cactus/Pharma waste removal Balcones Heights Outpatient Clinic Bio/Chemo/Sharps/Cactus/Pharma waste removal Villa Serena Bio/Chemo/Sharps/Cactus/Pharma waste removal South Bexar Outpatient Clinic Bio/Chemo/Sharps/Cactus/Pharma waste removal Data Point Audiology, Dental and Eye Clinic Bio/Chemo/Sharps/Cactus/Pharma waste removal North Central Federal Outpatient Clinic Bio/Chemo/Sharps/Cactus/Pharma waste removal Shavano Park Outpatient Clinic Bio/Chemo/Sharps/Cactus/Pharma waste removal Victoria Outpatient Clinic Bio/Chemo/Sharps/Cactus/Pharma waste removal Poly-Trauma Rehab Program

Bio/Chemo/Sharps/Cactus/Pharma waste removal Fisher House Bio/Chemo/Sharps/Cactus/Pharma waste removal North Bexar Outpatient Clinic Bio/Chemo/Sharps/Cactus/Pharma waste removal Northwest Health Care Center

Table 1

1.3. South Texas Veterans Health Care System facilities. Different waste streams, volumes and operation characteristics may exist in facilities identified in table 3. Waste stream locations are found in Appendix A.

Audie L. Murphy Medical Center, 7400 Merton Minter Blvd, San Antonio, Texas, 78229 Kerrville Medical Center, 3600 Memorial Blvd, Kerrville, Texas, 78028 Balcones Heights Outpatient Clinic, 4522 Fredericksburg Rd, San Antonio TX 78201 Villa Serena, 4455 Horizon Hill Blvd San Antonio, Texas, 78229 South Bexar Outpatient Clinic, 4610 E. Southcross Blvd, San Antonio, TX 78222 Audiology, Dental and Eye Clinic, 8410 Data Point, San Antonio, TX 78284 North Central Federal Outpatient Clinic, 17440 Henderson Pass, San Antonio, TX 79232 Shavano Park Outpatient Clinic, 4350 Lockhill Selma Rd, San Antonio TX 78249 Victoria Outpatient Clinic, 1908 North Laurel St, Ste 150, Victoria, Texas 77901 Poly-Trauma Rehab Program, 4949 Gus Eckert Rd, San Antonio, TX 78240 Fisher House, 7485 Wurzbach Parkway, San Antonio, TX 78229 North Bexar Outpatient Clinic, 16103 Nacogdoches Rd, San Antonio, Tx 78247 Northwest Health Care System, 9939 State Hwy 151, San Antonio, Texas 78251

Table 2

1.4. Historical Data. The following historical data (Table 3) is provided as estimates in pounds and does not reflect full expectations of annual weights.

Medical Waste Collection Locations RED Bag Sharps Incineration Pharmacy Total Yearly Weight Audie L. Murphy Medical Center 332,064 37,500 8,499 29,688 407,751 Kerrville Medical Center 10,245 11,368 - 547 22,160 South Bexar Outpatient Clinic 479 532 - - 1,011 Balcones Heights Outpatient Clinic 660 125 - - 785 Villa Serena 31 35 - - 66 Audiology, Dental and Eye Clinic 287 318 - - 605 North Central Federal Outpatient Clinic 1,247 1,385 - - 2,632 Shavano Park Outpatient Clinic 52 58 - - 110 Victoria Outpatient Clinic 814 903 - - 1,717 Poly-Trauma Rehab Program 5 5 - - 10 Fisher House 71 81 - - 152 North Bexar Outpatient Clinic 195 125 - - 320 Northwest Health Care System (NWHCC) 180,000 8,160 4,080 192,240 Totals 526,150 60,595 8,499 34,315 629,559

Table 3

2. Scope. The Contractor shall be responsible for ensuring their proposed service solution will effectively achieve performance requirements.

System and/or equipment procedures designed by the Contractor shall ensure separation and preparation of waste streams for removal through final disposal.

The Contractor shall provide a contingency plan for the disposal of medical waste.

Provide recommendations and solutions to ensure the facilities develop onsite treatment of medical waste disposal, sharps disposal, used needle disposal, bio-hazard disposal, regulated waste disposal, bio-hazard cleanup infectious waste disposal for catastrophic disaster (Pandemic influenza plan, fire, flood or terrorism).

2.1. Container Phase-in and Phase-Out. In the event a new service provider is awarded, the Contracting Officer’s Representative (COR), Contracting Officer (CO), incumbent contractor and new contractor will coordinate the phase-out and phase-in of sharps and medical waste containers. The phase-out and phase-in period shall be accomplished within 30-days of the start of the period of performance, unless otherwise authorized by the CO. Installation of any additional containers needed shall proceed in accordance with an accepted phase-out and phase-in schedule. The new contractor will submit the schedule for acceptance to the COR. The COR will ensure to provide to old contractor for any inputs, concerns, or unavailable dates. The CO will intervene as necessary to ensure a smooth transition. No area, room or location will be without a container by close of duty day.

2.1.1.1. Container description and service. The Contractor will provide all DOT approved Sharps containers, this includes ensuring all containers have horizontal/vertical direct drop openings, are rigid, heavy duty, puncture resistant, leak proof on sides, bottoms and able to be closed for transport. Each sharp’s container must be accompanied with the appropriate locking lid. The Government will provide all wall mounts for sharps containers.

2.1.1.2. The Contractor shall supply sharps containers with a viewing window so that clinicians can see the level of sharps in the container while remaining aesthetically pleasing to patients and visitors. Each sharp’s container must be accompanied with the appropriate locking lid.

2.1.1.3. The Contractor shall provide medical waste containers/tubs to include the red liner biohazard bags.

1.1.1. An initial collection schedule shall be executed once weekly during the first 30-day contract period at all locations identified herein. The Contractor shall submit a proposed revision for the collection schedule and the pricing for contractor supplied sharps containers and red waste bags after initial 30-day period. Contractor’s pick-up schedules shall be coordinated and provided to VA CORs.

1.1.2. In the event a container is identified as full or overflowing, the contractor must be available to respond within 4-hrs by the COR at no additional cost to the government.

1.1.3. The Contractor is responsible for all sharp’s container inventory levels, ensuring that all required containers are available during each service period. Each sharp’s container must be accompanied with the appropriate lid.

1.1.3.1. The Contractor shall provide a full-service sharps management program to include the final processing of sharps containers. The Contractor shall be solely responsible to ensure area/rooms have satisfactory capacity for disposal of sharps between servicing and adequate supply of sharps containers during each service period.

1.1.3.2. Contractor shall provide equipment, and proper vehicles, as legally required, for the transportation of sharps waste to disposal site(s). Contractor vehicles shall be operated only by licensed operators and only on paved roadways, unless otherwise authorized by the VA Contracting Officer Representative’s (COR’s).

1.1.3.3. The Contractor shall provide appropriate containers and packaging labels for transportation of medical waste.

1.1.3.4. Transport carts to service all VA facilities shall be provided by the contractor, all carts shall be disinfected after each use.

2.3. Collection and disposal documentation. The Contractor shall furnish all required controlled documents to the VA COR and the respective facility promptly after final disposal. After contract award, the Contractor shall conduct an annual site visit of their respective disposal/recycling sites, to verify capability and compliance. The VA reserves the right to inspect Contractor’s facility site(s), equipment, and disposal facilities at any time. All permits, including disposal permits, licenses, and insurance of the disposal site(s) shall be included in the proposal submitted. Contractor shall submit annually, updated documents as they are renewed.

The Contractor shall coordinate marking, packaging, and providing proof of disposition for medical waste, antineoplastic drugs, and pathological waste, in strict accordance with all local, state, and federal laws.

The Contractor shall provide necessary documentation to ensure compliance with Joint Commission requirements related to items under this contract.

The contractor shall ensure storage, pick up, transportation and disposals are performed in accordance with all local, state, and federal laws, regulations and codes.

The Contractor shall provide VA COR’s with documented proof that transportation and disposal of such waste in accordance with applicable legal requirements. Proof of all legally required permits, licenses, insurance, manifests, or any other documentation so required by law, shall be provided and furnished to the VA CORs.

The Contractor shall notify the VA CORs of any change or alteration to Contractor’s permits and licenses for facilities, (including but not limited to disposal sites), or for any change in status which may affect Contractor’s performance and in performance of obligations under this contractual agreement.

The Contractor’s services, as required by this contract, shall be in accordance with all Department of Transportation (DOT), Environmental Protection Agency (EPA), Department of Health (DOH), Department of Environmental Conservation (DEC), Food and Drug Administration (FDA) and applicable Federal, State and Municipal governmental regulations and codes that are applicable, but different in scope, are to be all complied with and shall be strictly adhered to, shall include:

Transporter must provide container water-resistant labeling of regulated waste with the following information: Name of Transporter or immediate handler and State permit or identification number of the transporter.

No intermediate handlers or subcontracting of collection and/or transportation is allowed without obtaining prior approval from the VA CORs.

Contractor shall sign, date, and furnish a copy of the manifest, prior to any medical regulated waste leaving the pickup sites, alongside providing proof of the official weight of the waste being removed from the facilities. It is the contractor’s responsibility to use/provide a certified calibrated scale for each site waste is retrieved from. Then the manifest will be broken down reflecting quantity / volume of sharps and medical waste being disposed. Contractor shall ensure manifest certification matches the removed material, transport waste to an authorized facility, and sign the manifest to verify that medical waste has been delivered. Contractor shall also maintain a copy of the manifest for their records, return all remaining copies of the manifest to the generator, assuring final disposal.

Contractor shall supply documentation assuring all employees are trained according to applicable Federal, State and local regulations and supply training updates to VA CORs.

Contractor shall have enough backup equipment and manpower to perform contractual obligation under adverse or emergency conditions, backup equipment and manpower shall be listed on the equipment and manpower list submitted with proposal.

Contractor shall have and submit with proposal, a listing of disposal site(s), backup disposal site(s), along with copy of permits. Contractor shall submit backup disposal site(s) permits annually thereafter.

Contractor shall provide all locations with the following containers in approximate size, locations, and quantities:

RED: YELLOW: BLUE:

5-quart sharp containers 18-gallon single use container 18-gallon single use container

28-gallon reusable container

3-gallon sharp containers

The Contractor shall be in communication with the COR providing a transition plan for coverage of all locations that use bio-waste containers and the process to expand total containers due to increased workload or establishment of new clinical space.

Contractor’s sharps containers, collection, processing of containers and disposal of waste must comply with all applicable Federal, State and local regulations including but not limited to the following standards:

Occupational Safety and Health Administration (OSHA), including but not limited to Blood Borne Pathogens Standard 29 CFR 1910 and 1030, and the Needle Stick Safety and Prevention Act HR 5178 as it specifically relates to reusable sharps containers.

Department of Environmental Conservation (DEC), Food and Drug Administration (FDA) including, but not limited to Title 21 of the Code of Federal Regulation (CFR) and Quality Systems Regulation (QSR) regarding reprocessing, validation reporting and annual registering for all equipment used to release medical equipment into commerce.

2.3.1. Cactus sinks and Pharma lock service: Cactus sink and Pharma lock devices (Table 4) are new to the STVHCS. These devices are a “green” waste solution for pharmaceuticals. This innovative and compact system assists bringing medical facilities into compliance eliminating environmental impact. The contractor shall provide all personnel, equipment, tools, materials, vehicles, supervision, and other items necessary to perform disposal services of these new devices.

The contractor shall ensure storage, pick up, transportation and disposals are performed in accordance with all local, state, and federal laws, regulations and codes. The Contractor shall provide VA COR’s with documented proof that transportation and disposal of such waste in accordance with applicable legal requirements. Proof of all legally required permits, licenses, insurance, manifests, or any other documentation so required by law, shall be provided and furnished to the VA CORs.

2.3.1.1. Cactus sinks and Pharma Lock disposal cartridges. Cactus sinks and Pharma Lock cartridges utilize two replaceable cartridges: one for liquid and one for solid waste. The government will provide the disposal cartridges, batteries to the contractor on an as needed basis. The contractor shall contact the COR to receive necessary replacement cartridges.

2.3.1.2. Service Frequency. The contractor shall provide cactus sink and pharma lock cartridge removal, replacement with government furnished cartridges and final disposal upon request and not less than once every 3-months.

Table 4 – Cactus Sink and Pharma Lock Locations

UNIT/AREA ROOM NUMBER CACTUS SINK

QUANTITY

PHARMA LOCK

QUANTITY

ALM Ground Level A A007.1 1

ALM Spinal Cord D035.1 1 ALM Interventional Radiology H134 1

ALM Oral Surgery/OMS N116.6 1 ALM Community Living Center 2 2A130 1 1

ALM Pain Clinic 220.8 1 1 ALM Pain Clinic 220.9 1 1 ALM Polytrauma 255.1 1

ALM PTRP 122 1

ALM 2W – High Side A235 1 ALM 2W – Low Side A207 1

ALM Surgical Intensive Care Unit D205.1 1 ALM Outpatient Surgery F205 1 1

ALM Operating Rm / Anesthesia Pharmacy N235 1 1 ALM Post Anesthesia Care Unit N239 1 1

ALM Gastrointestinal Clinic E208 1 ALM Gastrointestinal Clinic E211 1 ALM Gastrointestinal Clinic E212 1 ALM Gastrointestinal Clinic E214 1 ALM Gastrointestinal Clinic E215 1

ALM 2M M204.2 1

ALM Gastrointestinal Clinic Z215 1

ALM 4A A403 1

ALM 4B B410 1

ALM 5A A508 1

ALM Progressive Care Unit B515.2 1 ALM Mobile Intensive Care Unit C508.18 1 ALM Cath Recovery (Old CCU) A625 1

ALM 6B B610 1

ALM Heart Station C633 1

ALM Cath Lab C624 1 ALM Research A707 1

ALM Bone Marrow Transplant Unit B701.14 1 ALM CCU Medication Rm Medication Rm 1

ALM Chemo Clinic Chemo Rm 1 ALM Emergency Dept Medical Fridge 1 ALM Emergency Dept Fast Track 1 ALM Emergency Dept Dirty Linen Rm 1

ALM OMS N116.5 1

Data Point Dental Clinic 346 1 1

Data Point Dental Clinic 321 1 Data Point Dental Clinic 322 1 Data Point Dental Clinic 324 1 Data Point Dental Clinic 326 1 Data Point Dental Clinic 327 1 Data Point Dental Clinic 329 1 Data Point Dental Clinic 331 1 Data Point Dental Clinic 333 1 Data Point Dental Clinic 343 1 Data Point Dental Clinic 344 1

NWHCC 1st Floor 1E108 1

NWHCC 1st Floor OR 1E100.2 1 NWHCC 1st Floor OR 1E100.4 1 NWHCC 1st Floor OR 1E120 1 NWHCC 1st Floor OR 1E124 1 NWHCC 1st Floor OR 1E125 1

NWHCC 2nd Floor 2E130 1 NWHCC 2nd Floor 2E165 1 NWHCC 2nd Floor 2E166 1 NWHCC 2nd Floor 2E167 1 NWHCC 2nd Floor 2E168 1 NWHCC 2nd Floor 2E101 1 NWHCC 2nd Floor 2E102 1

Kerrville 1 (Home of the Brave) 1B115 1

Kerrville 3 (Heroes’ Haven) 2B137A 1 Kerrville 2A (Eagles’ Landing) 620A 1 Kerrville 2B (Sky Blue Vista) 673 1 Kerrville Gastrointestinal Lab KMC 476 1

TOTAL 53 22

**Cactus sinks/Pharma-locks are provided per Pharmacy Request, will provide modification to locations/amounts pending information**

2. Federal, state and local regulations:

- The United States Environmental Protection Agency (EPA) rules and guidelines

- The National Environmental Policy Act (NEPA), 42 USC, §§4321

- 4370e (1969, as amended).

- The Resource Conservation and Recovery Act (RCRA), 42 USC, §§6901 - 6991i (1976, as amended).

- The Texas Solid Waste Disposal Act (TSWDA)-, THSC, Chapter 361.

- Clean Water Act, Federal Water Pollution Control Act (CWA), 33 USC, §§1251 - 1387 (1977, as amended).

- The Texas Administrative Procedure Act (APA)-, Texas Government Code, Chapter 2001.

3. EQUIPMENT MAINTENANCE: The contractor shall maintain all contract provided containers and cabinets ensuring they are free of unpleasant odors, dirt, debris, and pests. All containers and cabinets must remain in good, workable condition.

4. QUALITY CONTROL: The contractor shall develop and maintain a quality control program to ensure contracted services are performed in accordance with commonly accepted commercial practices. The contractor shall develop and implement procedures to identify, prevent, and ensure non-recurrence of defective service.

5. QUALITY ASSURANCE: The government will periodically evaluate the contractor’s performance by appointing a COR to monitor and ensure performance of services are received. The COR will evaluate the contractor’s performance through intermittent on-site inspections of the contractor’s quality control program and validation of customer complaints. The government may inspect each task as completed or increase the number of quality control inspections if deemed appropriate because of repeated failures discovered during quality control inspections or because of repeated customer complaints.

The Contractor will provide a Quality Assurance plan for review and ensure control measures are meet and evaluated for completeness. The Quality Assurance plan shall systematically monitor and evaluate various aspects of the service ensuring standards of quality are being met.

5.1. SERVICE SUMMARY (SS). The contract service requirements are summarized in performance objectives that relate directly to mission essential items. The performance threshold briefly describes the minimally acceptable levels of service required for each requirement. The Services Summary (Table 5) and the Contractor’s internal quality control plan (QCP) provide information on contract requirements, the expected level of Contractor performance, and the expected method of government validation and confirmation of services provided. These thresholds are critical to mission success. Procedures as set forth in the FAR 52.212-4 (a), Contract Terms and Conditions - Commercial Items, Inspection/Acceptance, will be used to remedy all deficiencies. During the first initial 30 days of the contract, two additional errors on each Performance Objective shall be allowed in an effort to identify normal phase-in problems.

Services Summary

Objective

SOW Paragraph References Assessment

Method Performance

Threshold

SS-1

Submit collection schedule within 30-days after contract start date

2.1

Review of work and accepted by the government.

100% Compliant

SS-2

Perform collection of medical and sharp waste.

2, 2.3 – 2.3.1.2

Random surveillance and customer complaints.

No more than one valid discrepancy per month.

SS-3

Perform on-call collection within 4-hours of notification

2.2.2 customer complaints.

No more than one valid discrepancy per month.

SS-4

Submit reports and deliverables

2.3 customer complaints.

No more than one valid discrepancy per month.

Table 5

6. PERSONNEL REQUIREMENTS: The Contractor shall designate and provide name(s) and phone numbers of contact person(s), and a backup, as representatives of the Contractor. The Contractor shall provide qualified employees who will conduct and/or supervise the removal and pickup of all regulated sharps waste from all VA locations.

STX671-01 LOW RISK-CONTRACTOR PERSONNEL SECURITY REQUIREMENTS (May 2010)

All contractor employees who require access to the Department of Veterans Affairs’ computer systems or routine access to VA Facilities shall be the subject of a background investigation and must receive a favorable adjudication from the VA Office of Security and Law Enforcement prior to contract performance. This requirement is applicable to all subcontractor personnel requiring the same access.

6.1. Position Risk and Sensitivity Designations – Shall be determined by Contracting Officer’s Technical Representative (COTR) in accordance with VHA Directive 0710 Appendix A. The position sensitivity for this contract has been designated as LOW

RISK

6.2. Position Risk and Sensitivity Designations are directly tied to background investigative requirements.

6.2.1. A position designated as Low Risk requires a National Agency Check with Inquires (NACI).

6.2.2. A position designated as Moderate Risk requires a Minimum Background Investigation (MBI).

6.2.3. A position designated as High Risk requires a Background Investigation (BI).

7. CONTRACTOR RESPONSIBILITIES:

The contractor shall prescreen all personnel requiring access to the computer systems or routine access to VA facilities to ensure they maintain a U.S. citizenship and are able to read, write, speak and understand the English language.

After award and prior to contract performance, contractor shall submit to the Contracting Officer’s Representative all required information to initiate background check by completing the latest version of Local Background Check Request Form for each employee providing services under this contract. This form shall be provided by the

COR.

Contractor shall notify the COR prior to changing/adding new contract personnel by submitting a new Local Background Check Request Form.

The Contractor, when notified of an unfavorable determination by the Government shall withdraw the employee from consideration of working under this contract.

7.1. The contractor shall submit the following required forms to the VA Office of Security and Law Enforcement as outlined within automatic email notification identifying the web site link following the detailed instructions regarding completion of the application process. This includes:

7.1.1. Standard Form 85, Questionnaire for Non-Sensitive Positions

7.1.2. If needed, Continuation Sheet for Questionnaires Standard Form 86A

7.1.3. FD 258, U.S. Department of Justice Fingerprint Applicant Chart; OR schedule to have electronic fingerprints as coordinated by COTR

7.1.4. VA Form 0710, Authority for Release of Information Form

7.1.5. Optional Form 306 (2 Copies), Declaration for Federal Employment (one copy submitted to office conducting electronic fingerprinting)

7.1.6. The Contractor shall ensure that all personnel requiring computer access will complete the VA’s Cyber Security Training and Privacy training prior to obtaining computer access and annually thereafter.

7.1.7. Failure to comply with the contractor personnel security requirements may result in termination of the contract.

8. GOVERNMENT RESPONSIBILITIES:

The VA Office of Security and Law Enforcement will provide the necessary forms to the contractor or to the contractor’s employees after receiving a background investigation request. The COR shall submit Local Background Check Request Form to Contracting to initiate request in the Contractor Request Database (CRD).

Upon receipt, the VA Office of Security and Law Enforcement will review the completed forms for accuracy and forward the forms to OPM to conduct the background investigation. The forms will be returned to the Contractor if incomplete or inaccurate.

The VA Office of Security and Law Enforcement will notify the Contracting Office and contractor after adjudicating the results of the background investigations received from

OPM.

The Contracting Office will file and secure evidence that investigations have been completed or are in the process of being requested appropriately.

The COR shall ensure that all personnel requiring computer access have completed the VA’s Cyber Security Training and VA’s General Privacy Training and signed Rules of Behavior, prior to obtaining computer access and annually thereafter; hard copies provided to contract officer by contract number.

STX671-02 PERSONAL SECURITY VERIFICATION (PIV) CARD AND/OR SECURITY BADGE

REQUIREMENTS FOR CONTRACTOR EMPLOYEES (FEB 2010)

9. DEFINITIONS. As used in this clause –

9.1. Access means routine, unescorted physical entry into, and to the extent authorized, mobility within a government facility. Also, it means the ability to obtain, view, read, modify, delete, and/or otherwise make use of information technology.

9.2. Contractor employee means an employee of the prime contractor or of any subcontractor, affiliate, partner, joint venture, or team members with which the contractor is associated. It also includes consultants engaged by any of those entities.

9.3. Facility and Government facility mean buildings, including areas within buildings, owned, leased, shared, occupied, or otherwise controlled by the federal government.

9.4. Information technology means any equipment or interconnected system or subsystem of equipment, including telecommunications equipment that is used in the automatic acquisition, storage, manipulation, management, movement, control, display, switching, interchange, transmission, or reception of data or information. This includes both major systems/applications and general support systems as defined by OMB Circular A-130, owned by VA or owned and operated on VA’s behalf by another party.

10. Access to VA Facilities or Systems. The performance of this contract requires contractor employees to have routine, unescorted access to VA facilities. All such employees who do not already possess a current Security Badge or PIV Card acceptable to VA shall be required to provide personal information, undergo an FBI National Criminal History Fingerprint Check, and obtain a Security Badge or PIV Card prior to being permitted access to any such facility in performance of this contract. No contractor employee will be permitted routine, unescorted access to a VA facility without a proper Security Badge or PIV Card.

10.1. Citizenship-related requirements. If required by the contract, each affected contractor employee shall be:

- A United States (U.S.) citizen; or

- A national of the United States (see 8 U.S.C. 1408); or

- An alien lawfully admitted into the United States for permanent residence as evidenced by an Alien Registration Receipt Card Form I–151.

10.2. EMPLOYEE BACKGROUND INFORMATION

For each contractor employee that has access to VA facilities or systems, the contractor shall coordinate with assigned Contracting Officer’s Representative (COR) to schedule electronic finger printing and initiate a Special Agreement Check (SAC). The COR will provide instructions to the contractor regarding the local procedures for fingerprinting and obtaining Security Badges or PIV Cards.

After completion of the fingerprint check, the Contracting Officer will notify the contractor in writing if any contractor employee is determined to be unsuitable to be given access to a government facility or VA system. If so notified, the contractor shall not allow such employees to perform work on this contract.

10.3. Security Badge or PIV Cards

VA will issue a Security Badge or PIV Card to each contractor employee who is to be given routine, unescorted access to VA facilities or access to VA systems and does not already possess a Security Badge or PIV Card. Contractor employees that require logical access and email address in VA systems, access to sensitive records, sensitive physical access or common physical access of greater than 6-months, or considered as a fulltime equivalent will require PIV Card, requiring background investigation (NACI) and SAC.

VA will issue Non-PIV Security Badges to contractor employees that require logical access with no email address in VA systems, access to sensitive records, sensitive physical access or common physical access of less than 6-months, or not considered as a fulltime equivalent will require non-PIV Card, requiring SAC. This card is issued with expiration date of 6 months or less.

Security Badge or PIV Cards shall identify individuals as contractor employees.

Contractor employees shall always display their Security Badge or PIV Cards on their persons while working in a VA facility and shall present their cards for inspection upon request by VA officials or VA security personnel.

The contractor shall be responsible for all Security Badge or PIV Cards issued to the contractor’s employees and shall immediately notify the COR if any Security Badge or PIV Card(s) cannot be accounted for. The contractor shall notify the COR immediately whenever any contractor employee no longer has a need for his/her VA-issued Security Badge or PIV Card (e.g., employee terminates employment with the contractor, employee’s duties no longer require access to VA facilities). In such cases, the COR will instruct the contractor on how to return the Security Badge or PIV Card. Upon expiration of this contract, the COR will instruct the contractor on how to return all VA-issued Security Badge or PIV Cards not previously returned. The contractor shall not return Security Badge or PIV Cards to any person other than the COR.

10.3.1. Control of access. VA shall have and exercise full and complete control over granting, denying, withholding, and terminating access of contractor employees to VA facilities and systems. The Contracting Officer will notify the contractor immediately when VA has determined that an employee is unsuitable or unfit to be permitted access to a VA facility or system. The contractor shall immediately notify such an employee that he/she no longer has access to any VA facility or system, shall retrieve the employee’s Security Badge or PIV Card from the employee, and shall provide a suitable replacement employee in accordance with the requirements of this clause.

The VA will not give the contractor the reason for requiring the removal of the unsuitable contractor employee but can provide the applicant the phone number to call the FBI to receive a copy of the SAC report used for this determination. The Government shall not be responsible for any costs incurred by the contractor because of removing such employee from the subject contract.

10.3.2. Termination. Failure on the part of the Contractor to comply with the terms of this clause may result in termination of this contract for default.

10.3.2.1. All contract personnel shall be instructed that smoking is prohibited in building and only allowed in designated outside smoking areas as identified.

10.3.2.2. All conduct of contract personnel shall be respectable and sensitive to patients, visitors and VA Personnel.

11. PRIVACY: Upon the incidental discovery of any patient sensitive information found during the term of this contract, the contractor shall secure the material and notify the COR immediately. The Facility Privacy Officer and COR shall make the necessary arrangements to retrieve the material such as (Patient medical records, and documents with SSN and Names).

11.1. INFORMATION SYSTEMS OFFICER, INFORMATION PROTECTION: The contractor will not have access to VA Desktop computers nor will they have access to online resources belonging to the government while conducting services. If removal of equipment from the VA is required, any memory storage devices, such as hard drives, solid state drives and non-volatile memory units will remain in VA control and will not be removed from VA custody.

11.2. RECORDS MANAGEMENT

Citations to pertinent laws, codes and regulations such as 44 U.S.C Chapter 21 ,29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C. 552a); 36 CFR Part 1222 and Part 1228.

Contractor shall treat all deliverables under the contract as the property of the U.S.

Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government ‘IT’ equipment and/or Government records.

Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

Contractor shall not create or maintain any records containing any Government Agency records that are not specifically tied to or authorized by the contract.

The Government Agency owns the rights to all data/records produced as part of this contract.

The Government Agency owns the rights to all electronic information (electronic data, electronic information systems, electronic databases, etc.) and all supporting documentation created as part of this contract. Contractor must deliver enough technical documentation with all data deliverables to permit the agency to use the data.

Contractor agrees to comply with Federal and Agency records management policies, including those policies associated with the safeguarding of records covered by the Privacy Act of 1974. These policies include the preservation of all records created or received regardless of format [paper, electronic, etc.] or mode of transmission [e-mail, fax, etc.] or state of completion [draft, final, etc.].

No disposition of documents will be allowed without the prior written consent of the Contracting Officer. The Agency and its contractors are responsible for preventing the alienation or unauthorized destruction of records, including all forms of mutilation. Willful and unlawful destruction, damage or alienation of Federal records is subject to the fines and penalties imposed by 18 U.S.C. 2701. Records may not be removed from the legal custody of the Agency or destroyed without regard to the provisions of the agency records schedules.

Contractor is required to obtain the Contracting Officer's approval prior to engaging in any contractual relationship (sub-contractor) in support of this contract requiring the disclosure of information, documentary material and/or records generated under or relating to this contract. The Contractor (and any sub-contractor) is required to abide by Government and Agency guidance for protecting sensitive and proprietary information.

12. Compliance with Hospital Policies and Procedures: Contractor’s will adhere to all hospital policies and procedures related to non-smoking except in designated areas and the requirement for using I.D. badges. In addition, the contractor must also adhere to the Information Security, Records Management and Privacy local and national policies prescribed herein:

13. Information Systems Officer, Information Protection: The contractor will not have access to VA desktop computers, nor will they have access to online resources belonging to the government while conducting services in the application of complex adaptive systems theory to health care organizations. The certification and accreditation requirements do not apply to this procurement nor is a security accreditation package required.

14. Privacy Officer: The contractor will not have access to Patient Health Information (PHI) and will have the capability of accessing patient information during the services provided to the VA.

15. Records Manager: The following standard Items relate to records generated in executing this contract and should be included:

15.1. Citations to pertinent laws, codes and regulations such as 44 U.S.C Chapter 21, 29, 31 and 33; Freedom of Information Act (5 U.S.C. 552); Privacy Act (5 U.S.C. 552a);

36 CFR Part 1222 and Part 1228.

15.2. Contractor shall treat all deliverables under the contract as the property of the U.S. Government for which the Government Agency shall have unlimited rights to use, dispose of, or disclose such data contained therein as it determines to be in the public interest.

15.3. Contractor shall not create or maintain any records that are not specifically tied to or authorized by the contract using Government ‘IT’ equipment and/or Government records.

15.4. Contractor shall not retain, use, sell, or disseminate copies of any deliverable that contains information covered by the Privacy Act of 1974 or that which is generally protected by the Freedom of Information Act.

15.5. Contractor shall not create or maintain any records containing…